Health Innovation Highlights: February 10, 2022

Full Edition

DIRECTOR’S CORNER

Introducing Myself!

Brandon G. Wilson, DrPH, MHA
Director, Center for Consumer Engagement in Health Innovation

Dear Partners,

Let me introduce myself! My name is Brandon and I’m elated to have joined the ranks of The Center for Consumer Engagement in Health Innovation at Community Catalyst as its next director. I couldn’t be more excited and energized to work alongside such passionate, dedicated, and knowledgeable colleagues and partners. It is because of the collective work of each of you that I’m afforded the incredible opportunity to amplify the work and voice of the Center — to bring people’s lived experience to the forefront of health innovation in order to deliver better care, better value and better health for every community, particularly vulnerable and historically underserved populations; and to help advance the mission of Community Catalyst — building the power of people to create a health system rooted in race equity and health justice and a society where health is a right for all.

I’m sure there are two immediate questions that you’d like me to answer and I’m happy to oblige.

  • Who Am I? Although I’m currently a proud resident of the Washington, D.C. Metropolitan area, I’m a native of a small town tucked between the swamps of the Atchafalaya Basin and Louisiana’s state capitol of Baton Rouge. In this small swamp town of legends and mysteries, diversity and inequities both abound. And, although I’ve witnessed an evil axis of racism, climate change, and environmental injustices, I’ve also watched a diverse people harness the energy of community empowerment to make real change. In this area, called “Cancer Alley,” for some communities, it’s seemingly never a question of if, but when, cancer will come knocking at your door. And my family and loved ones have had far too many knocks on our door. But, be not dismayed! I’ve also watched: grandmothers rise up and take on chemical companies; my family’s elders lead civil rights and voter registration drives for former sharecropper towns; loved ones empowered to demand equitable and quality Home and Community Based Services to remain in their home and community with dignity; and the Cajun Navy mobilize to rescue hundreds of neighbors from the rising waters of the Mighty Mississippi and its neighboring Gulf.

    Environmental justice and civil rights for my native community and loved ones was my catalyst into this health justice fight, which has taken me into areas of HIV prevention, treatment and biomedical research; health policy and minority health; and now to join ranks with each of you! One of my strengths is that I transparently bring my intersected identities to the table – I’m an HBCU educated Doctor of Public Health, Black Queer Cis-Gender Man, fueled and sustained by my faith!

  • Why Now? In the midst of Black History Month, I sit with the words of Rev. Dr. Martin Luther King, Jr., “The time is always right to do what is right.” Although we are living in times of anxiety and distress for so many, I wholeheartedly believe there is still reason to hope – we can mobilize – e pluribus unum! I’m confident about my personal why and why now. I’ve left a career in federal service at the Department of Health and Human Services to join ranks with each of you as a champion of a community-driven health system that is just and equitable for all, particularly for vulnerable and historically underserved and disinvested communities.

Since its inception, the Center has been steadfast in applying pressure to bend history’s arc towards health justice. With leadership from my predecessor and contributions by all of the Center’s remarkable team members, we’ve learned a lot over these past six years: community has an essential role to play in delivery and payment reform decision-making; we play a critical role in building the capacity and skills of advocates who are eagerly embracing next-generation topics; deliberate leadership alongside grassroots organizing is key; our work must be centered in racial and health justice; and, there is synergistic impact with our research and policy agenda through sustained community partnerships and empowerment. We are clear-eyed and certain about the state and future of the Center! Why? We are here for the long haul to effectively bring forward diverse community perspectives and best interests to policymakers, health provider networks and other stakeholders, to improve quality of care and health outcomes.

My immediate charge is to lead the development and implementation of a strategic vision for the Center’s next phase of work. What I can tell you now is that the process will be strategic and deliberate, we will center anti-racism and health justice, and we will magnify the voice and lived experiences of communities. We will talk soon!

“I come as one, but I stand as ten thousand” – Dr. Maya Angelou

Together in Service,

Brandon G. Wilson, DrPH, MHA

FROM THE CENTER & OUR PARTNERS 

Other Staff Change News from the Center

In addition to welcoming our new Center director this month, two other significant staffing changes have taken effect in this new year.  Renée Markus Hodin, who has served as the Center’s deputy director since its inception in January 2016 and served as interim leader over the past year, is moving into a cross-organizational role for Community Catalyst as senior strategic advisor. In this capacity, Renée will draw on her more than 20 years of experience at Community Catalyst managing a number of initiatives to lead the organization through the implementation of its strategic planning process in 2022.

Leena Sharma, who has been with Community Catalyst since 2011, is assuming the role of deputy director of the Center. Leena has also been a member of the Center team from the beginning, most recently serving as project manager/senior policy analyst, and brings her deep expertise in the area of Medicare-Medicaid integration for dually eligible individuals to this new role.

We are excited about all these staff developments, and look forward to our ongoing work together!

Center Presents Recommendations to the RAISE Family Caregiving Advisory Council

Working with Center partner LeadingAge LTSS Center @UMass Boston, Center Program and Policy Coordinator Siena Ruggeri, recently presented research findings to the RAISE Family Caregiving Advisory Council. The Council is charged with providing recommendations to the Secretary of Health and Human Services on effective models of both family caregiving and support to family caregivers. They are also tasked with improving coordination across federal government programs. The Advisory Council is codified under the “Recognize, Assist, Include, Support, and Engage Family Caregivers Act of 2017’’ or the ‘‘RAISE Family Caregivers Act,” which directs the Department of Health and Human Services (HHS) to develop and make publicly available a National Family Caregiving Strategy that identifies recommended actions for recognizing and supporting family caregivers in a manner that reflects their diverse needs.

The research presented included the results of Stakeholder Strategy Sessions, Key Informant Interviews and Stakeholder Listening Sessions, which were conducted from December 2020 to October 2021 and received input from representatives of over 162 organizations from the federal, state, local, private and public sector. The findings included a broad set of recommendations across five goals:

  1. Family caregivers’ physical, emotional and financial well-being will improve as a result of expanded awareness, outreach and education.
  2. Family caregivers are recognized, engaged and supported as key partners with providers of health care and long-term services and supports.
  3. Family caregivers have access to an array of flexible person- and family-centered programs, supports, goods and services that meet the diverse and dynamic needs of family caregivers and care recipients.
  4. Family caregivers’ lifetime financial and employment security is protected and enhanced.
  5. Family caregivers are engaged stakeholders in a national research and data gathering infrastructure that documents their experiences, translates evidence into best practices, develops person- and family-centered interventions, and measures progress toward the National Family Caregiver Strategy.

The recommendations include actions that can be taken at the federal level, as well as what state, local and private sector officials can do. A full report of all the activities and findings and the video presentation will be released here.

Delays in New Minimum Staffing Rules For Nursing Homes in Rhode Island

In May 2021, Gov. Dan McKee of Rhode Island signed into law The Nursing Staffing and Quality Care Act, which established minimum care hours and increased wages for caregivers. A local advocacy group that pushed for this legislation, Raise the Bar on Resident Care Coalition, is fighting to defend it again. Despite the Act just becoming law, Gov. McKee recently issued an executive order suspending the new requirements until at least Feb. 14 after a group representing 75 of the 80 nursing homes in the state asked the governor to do so. They cite concerns related to COVID-19, employee burn out and reimbursements for facilities, which make it "impossible for our homes to meet these new requirements," according to a representative of the nursing homes.

Advocates are pushing back on this executive order. Center partner Rhode Island Organizing Project (RIOP) is part of the "Raise the Bar" coalition and is taking part in a letter writing campaign and a sign on letter from the coalition to ask the governor to rescind his executive order and not delay implementation of the Nursing Home Staffing and Quality Care Act. According to the letter sent to the governor, "delaying the staffing law does nothing to solve this underlying problem that far predated the pandemic" and will make a crisis situation in nursing homes worse. Read more about this issue in The Boston Globe and Yahoo News.

Illinois Case Study Published in Medical Debt Resource Series

Recently, Community Catalyst’s Community Benefit and Economic Stability Project released a set of resources to equip advocates with important background information, lessons and strategies from successful campaigns to pass state-level policies that help mitigate the harm caused by medical debt. Included are a policy framework brief, an infographic which presents the key drivers of medical debt, and a case studies from Maryland, Colorado and New York.

Now, a new case study from Illinois is available on the resources page with more states to be added in the coming months. This recent blog post summarizes the project and all the resources available to date.

NOTEWORTHY NEWS & RESOURCES

Four Ways to Strengthen the Direct Care Workforce

As the demand for home and community-based services continues to rise, this CHCS blog post identifies four approaches states are taking to improve their direct care workforce. They are:

  1. Focus and organize state-level and advocacy efforts related to the direct care workforce
  2. Use federal funding and flexibilities
  3. Prioritize DCW-related goals in Medicaid managed care contracts
  4. Recognize the deep value and importance of the profession

The blog draws from recommendations detailed in a CHCS report on state direct care workforce strategies. The blog identifies specific and timely policy levers for state advocates to push to improve the lives of direct care workers and those they care for.

How the CMS 2023 Proposed Rule Hits (and Misses) the Integration Mark

A new brief from ATI Advisory takes an in-depth look at how the Calendar Year 2023 Medicare Advantage Proposed Rule from the Centers for Medicare and Medicaid Services (CMS) impacts non-medical supplemental benefits. The new changes proposed by CMS affect the integrated care plans people eligible for Medicare and Medicaid enroll in. In addition to context on the policy landscape leading up to this proposal, the blog gives feedback on the long- and short-term changes of the CMS proposed rule, with a section going into depth on changes surrounding Dual Eligible Special Needs Plans (D-SNPs).

Fact Sheet: Key Principles for Advocates When Talking About Home and Community-Based Services (HCBS)

A new Justice in Aging fact sheet provides valuable research insights on how advocates can effectively talk about home and community-based services (HCBS). As we continue to advocate for adequate HCBS funding in the Build Back Better Act, unified and effective messaging is essential. This fact sheet serves as a great resource for advocates pushing both Congress and their state legislatures to transform lives by expanding access to HCBS.

Insights on the Value Case for Complex Care: Lessons from the COVID-19 Pandemic

A blog post from the Better Care Playbook and the Camden Coalition’s National Center for Complex Health and Social Needs highlights how the COVID-19 pandemic impacted the business models and decision-making of health care leaders from more than 30 states. The lessons learned included the importance of building relationships with communities and the ability of value-based payments to provide the necessary flexibility and resources to respond to the pandemic.

Crafting Master Plans: States Supporting an Aging Population

As their older adult populations grow, a few states have taken up a strategy known as “master plans on aging” that comprehensively support the wellbeing of older adults. This blog post and podcast episode from the National Center for State Legislators details how Colorado and Texas are implementing their own master plans on aging and highlights the importance of community input.

STATE HIGHLIGHTS

Delaware

The Delaware Department of Health and Human Services’ (DHSS) latest RFP for the state's Medicaid managed care programs requires bidders to outline plans to incorporate community engagement, health equity and health-related social needs. DHSS released the RFP on Dec. 15, 2021 and proposals are due on March 15, 2022. Abbreviated questions asked in the RFP include:

  • Describe how the bidder will engage members, providers, and local/community organizations to understand needs and identify those needs.
  • Describe strategies and resources the bidder will employ to ensure members received culturally competent care.
  • Describe how the bidder will identify and reduce health disparities.
  • Describe how the bidder will identify and address health-related social needs.

Indiana

On Jan. 14, Indiana Family and Social Services Administration (FSSA) announced that the upcoming RFP release for the state’s Medicaid managed long-term services and supports (MLTSS) program will be delayed until May 2022. FSSA plans to use the additional time to continue engaging stakeholders and further clarify recommendations. With this new timeline contracts are expected to be awarded in the first quarter of 2023.  

New Mexico

On Dec. 31, 2021, New Mexico submitted an addendum to their 1115 waiver amendment, which would expand HCBS services using American Rescue Plan Act funding. The addendum is open for public comments through Feb. 13. Primary implications of the addendum include:

  • An additional 1,000 community benefit waiver slots for individuals not eligible for Medicaid but who require nursing facility level care.
  • An increase in limits on funding for individuals transitioning from institutional to community care.
  • An increase in funding limits for equipment and modifications to physical spaces, which increase independence.

Wisconsin

On Jan. 14, the Wisconsin Department of Health Services released an RFP, which includes support of the Include, Respect, I Self-Direct (IRIS) program. IRIS assists Wisconsin frail elders or adults with disabilities who are eligible for Medicaid by providing budgeting and planning for long-term care goals that support remaining in the community. 

KEY DATES

Wednesday, Feb. 16 (1-2 p.m. Eastern) - Webinar: Improving Digital Health Literacy among Hispanic/Latino Populations, presented by Health Resources & Services Administration. Please register for the webinar.  

Tuesday, Feb. 22 (2:30-4 p.m. Eastern) - Webinar: Person-Centered Decision Making in Healthcare and Care at End of Life, presented by National Center on Advancing Person-Centered Practices and Systems (NCAPPS). Please register for the webinar.  

Tuesday, Feb. 22 3-4:30 p.m. Eastern) - Webinar: Centering Racial Equity and Community Voice to Improve Research Development, Execution, and Analysis, presented by Urban Institute. Please register for the webinar. 

Wednesday, Feb. 23 (4-5 p.m. Eastern) - Webinar: Enhancing Tribal Environmental Health Program Capabilities and Engagement in COVID-19 Response, presented by the National Indian Health Board (NIHB).. Please register for the webinar.  

Monday, March 14 - Proposal Deadline: Request for Proposals due for The Root Cause Coalition's 2022 National Summit. Please click here for full information about the summit, proposal selection criteria, and link for online proposal submissions.

Friday, April 15 - Application Deadline: Applications due for the Health & Aging Policy Fellows Program (2022-23). Please click here for an overview of the fellowship, including program tracks, eligibility and selection criteria, and application information.