« Health Innovation Highlights: December 16, 2021 Issue

Full Edition

Celebrating Sue!

  

Please join us in congratulating Susan Sherry, Community Catalyst deputy director, on her retirement at the end of this year. Sue has devoted almost four decades of energetic and creative leadership to the movement for expanded access, quality and equity in health care. Sue has been instrumental in developing all of Community Catalyst’s major initiatives and campaigns, not least, her role in helping bring about the creation of the Center for Consumer Engagement in Health Innovation. We know that partners around the country are equally grateful for her decades of leadership and join us in wishing her all the best in her next adventures!

FROM THE CENTER & OUR PARTNERS

New Policy Resources Highlight State Efforts to Protect People from Medical Debt

Community Catalyst’s Community Benefit & Economic Stability Project released a new set of resources that highlights the important progress being made in a number of states to address the rampant national problem of medical debt. A policy framework document outlines the issue and surveys the leading efforts local and state advocates have taken in working for strong medical debt protections and robust hospital financial assistance policies. A detailed case study from Maryland, is the first in a series of case studies to be released over the next month. Accompanying the case study is an infographic, which presents the key drivers of medical debt. In 2020, approximately one in four people reported having unpaid medical bills, and medical debt in collection reached approximately $140 billion, threatening people’s health and economic stability. It causes people to postpone or forgo necessary care, ruins credit scores, and results in legal actions like wage garnishments and liens on homes or other property. 

 

ARPA Funds Boost NMT Improvement Efforts in Maine

As partners in the Center's Consumer Voices for Innovation project, Maine People's Resource Center organized low-income older adults, home care workers, immigrant small business owners and others to support policies that improve Maine’s transportation needs of older adults. They were successful in achieving those goals through the passage of LD 17, which created a pilot project to increase access to non-medical transportation services for those covered under MaineCare, the state's Medicaid program. Funding for this pilot project was made possible through the state's HCBS improvement plan, which provides federal funds established in the American Rescue Plan Act. The plan includes $1,132,560 for “consumer-centered transportation design,” which is twice as much as advocates originally requested. Gov. Janet Mills' full press release about the state's HCBS improvement plan can be found here.

Report Surveys Massachusetts Medicaid Health-Related Social Needs Program

Center Massachusetts partner Health Care for All recently co-authored a report, “LIFT OFF: Partnerships to Address Health-Related Social Needs” on an initiative of the MassHealth Accountable Care Organizations & Community-Based Organizations (CBOs) Collaboration. The report identifies key findings, challenges, best practices and policy recommendations based on the third year of structured interviews with ACOs and CBOs about their partnerships to address health-related social needs (HRSNs). In 2017, MassHealth – the Massachusetts Medicaid program – launched a multi-faceted Accountable Care Organization (ACO) program, which included requirements for HRSNs screening and targeted funding to address HRSNs for certain MassHealth members. HRSNs are also sometimes referred to as social determinants of health (SDOH), but HRSNs are specific to individuals, while SDOH are systemic in nature.

Rhode Island Advocate Spotlight: Public Transit is for Everyone

 
Paul Medici (photo credit: Brittany Taylor)

Paul Medici, a volunteer with Center partner Rhode Island Organizing Project (RIOP) was recently featured in Street Stories, an interview series with Providence residents about how they move around their city. In this video, Medici talks about why it’s critical to preserve a vital centrally located main transit point in Providence – Kennedy Plaza – in the face of efforts to eliminate it by the state. Medici digs into the impact of de-centralization and ways the system can be improved. You can watch the full interview here.

 
 

NOTEWORTHY NEWS & FEATURES

Addressing the Needs of Diverse Family Caregivers Before and During the Pandemic

A new report from the Diverse Elders coalition, “Family Caregiving in Diverse Communities: Addressing the Needs of Diverse Family Caregivers for Older Adults,” focuses on understanding the lived experiences of family caregivers who support older adults from the coalition’s constituent communities, including racially and ethnically diverse people; American Indians and Alaska Natives; and lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ+) people

Based on research from the Diverse Elders Coalition, its members and the National Alliance for Caregiving, this report highlights key findings from diverse caregivers for older adults prior to and throughout the pandemic. Key themes that have emerged include a lack of resources to adequately address caregivers’ mental health, social isolation and financial strain in a culturally competent manner.

The report also highlights protective factors, or the ways in which our communities exercise resilience in spite of the pandemic and other inequities. Finally, the report brings together recommendations for how to integrate these findings into the landscape of national caregiving policy that is being developed, including implementation of the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act.

Final Report and Recommendations of Presidential COVID-19 Health Equity Task Force

This fall, the Presidential COVID-19 Health Equity Task Force released its Final Report and Recommendations. The Task Force systematically advanced 316 recommendations, 55 of which are prioritized and highlighted in the body of the report. The Task Force also proposed five overarching priorities and four suggested outcomes. The five priorities are:

  1. Invest in community-led solutions to address health equity
  2. Enforce a data ecosystem that promotes equity-driven decision making
  3. Increase accountability for health equity outcomes
  4. Invest in a representative health care workforce and increase equitable access to quality health care for all
  5. Lead and coordinate implementation of the COVID-19 Health Equity Task Force’s recommendations from a permanent health equity infrastructure in the White House

This work was unanimously approved and finalized in the September 2021 Task Force meeting. President Biden had charged this Task Force with “recommending actions to mitigate health inequities caused or exacerbated by the COVID-19 pandemic and to prevent such inequities in the future.”

New CMS Guidance Allows States to Relax HCBS Financial Eligibility Standards

Under recent guidance from the Centers for Medicare and Medicaid Services (CMS), state Medicaid programs have increased ability to relax financial eligibility standards for home and community-based services (HCBS). There are two key points to note on the guidance:

  1. In order to make it easier to qualify financially for HCBS, a state Medicaid program may choose to disregard specified amounts of an applicant’s income and/or resources.
  1. Any disregard can be limited to apply only to HCBS (and not also to nursing facility services), or only to certain HCBS programs or benefits.

The guidance gives several examples of allowable disregards. For example, a state could implement a disregard for persons who need HCBS waiver services but are currently on a waiver wait list. This disregard could allow these persons to receive non-waiver Medicaid services while waiting for an HCBS slot to open up. 

 
 

Telehealth in Complex Care: Evidence and Implementation Tools

A new Playbook Collection of resources is designed to help stakeholders understand recent evidence behind telehealth-delivered interventions and learn about practical strategies to support effective implementation of these programs for people with complex needs.

Telehealth has shown promise in the past in decreasing barriers to care access, but was not widely used by provider organizations until the COVID-19 pandemic. The accelerated adoption of telehealth amid the pandemic demonstrates the potential value of telehealth beyond times of crisis. Many providers and patients enjoy the flexibilities offered by telehealth, but some individuals with complex health and social needs may still experience barriers to accessing it.

NASHP Resource: ARPA Opportunity for States to Invest in Transition Services and Housing

A new resource published by National Academy for State Health Policy (NASHP) charts and maps the American Rescue Plan Act (ARPA) spending plans that states have submitted to the Centers for Medicare and Medicaid Services (CMS) for review. ARPA allows states an opportunity to receive a 10 percent increase in the federal medical assistance program for Medicaid home and community-based services through March 31, 2022. Most states have received approval or partial approval pending clarifying questions from CMS. States are using these one-time funds to support transitions from institutional settings into the community through housing navigation, employment placement, assistance with transition costs and other social determinant supports, as well as by investing in affordable and accessible housing for HCBS populations to remain within the community.

STATE HIGHLIGHTS

Colorado

In November, the state of Colorado released an updated Health IT Roadmap. The Roadmap creates a shared vision for a more affordable, accessible and equitable health system for all Coloradans that leverages digital health solutions. Plans to achieve this shared vision focus on data sharing at all levels, investment in IT infrastructure and access to high-quality services for all Coloradans.

Massachusetts

In late November, Massachusetts’ Medicaid program, MassHealth, released two requests for information (RFIs) focusing on health equity. The RFIs focus on engaging members on issues related to health equity as well as identifying, prioritizing and addressing health care disparities through data collection and use. Responses to the RFIs are due Dec. 17.

New York

Gov. Kathy Hochul recently announced through New York’s Partnership to Support Aging in Place in Communities Severely Impacted by COVID-19 that six community health agencies will receive up to $9 million over five years. This funding supports community mental health providers in identifying and assisting New Yorkers who are age 55 or older with mental health, substance use, or aging-related concerns whose independence or survival is at risk.

Oregon

At the start of December, Oregon Health Authority shared a first draft of the state’s Medicaid 1115 waiver renewal application, which is now open for public comment. The draft includes a focus on equity through outlining plans to improve access and coverage, further incorporate social determinants of health into the health care system, invest in community-led solutions, shift towards equity-driven performance metrics and align with Oregon’s nine Tribal governments’ priorities.

Pennsylvania

The Wolf administration in Pennsylvania announced a plan to dedicate $1.3 billion of American Rescue Plan Act funding to improving the state's home and community-based services (HCBS) system. Some of the targeted domains for improvement are:

  • Increasing access to HCBS services
  • Staff recruiting and retention
  • Supporting families caring for their loves ones
  • Improving functional capabilities of people with disabilities

Wisconsin

Wisconsin’s Department of Health Services has called upon Wisconsin legislators to use American Rescue Plan Act funding to increase home and community-based (HCBS) reimbursement rates by 5 percent as of Jan. 1, 2022. This increased reimbursement would allow providers to begin to tackle the staff recruitment and retention issues that contribute to the workforce shortage in this sector.

KEY DATES