« Health Innovation Highlights: March 11, 2021 Issue

Full Edition

FROM THE CENTER & OUR PARTNERS

Community Catalyst Launches Community Benefit and Economic Stability Program

Last week, Community Catalyst launched our new Community Benefit and Economic Stability Project. With support from the Robert Wood Johnson Foundation, the program will support 12 community-based organizations spread across Georgia, Illinois and New Mexico. These groups will work with local hospitals in co-designing financial assistance and billing and collection policies and practices that are responsive to community need. Re-imagining hospital policies is especially critical for Black and brown communities, who too often bear the brunt of unfair billing practices due to discriminatory barriers to affordable coverage and economic stability.

The project will help consumers leverage existing requirements so that non-profit hospital financial assistance and billing and collection policies will be responsive to the experience and perspectives of people struggling to pay their medical bills. This project builds on Community Catalyst’s previous efforts, including

Sen. Van Hollen’s COVID-19 Medical Debt Collection Relief Act Reintroduced

With input and support from Community Catalyst, Sen. Chris Van Hollen of Maryland reintroduced legislation on Feb. 22 to prevent the seizure of patients’ bank accounts and wages during the COVID-19 pandemic. From our work, we at the Center understand the harmful impact medical debt has in the community, as well as the disproportionate impact to communities of color, which have only been further exacerbated by the pandemic. Emily Stewart, Community Catalyst’s executive director is quoted in Sen. Van Hollen’s press release on the bill saying, “Aggressive medical debt collection practices disproportionately target Black Americans, who are already facing the brunt of the crisis through higher death and infection rates and job losses. Congressional action is urgently needed to alleviate the pressure medical debt has and will continue to cause families if it’s left unaddressed. We applaud Senator Van Hollen for his leadership in proposing legislation that would put critical protections in place to shield people from medical debt during this crisis.”

Alabama Group Takes on Food Insecurity and Sparks Broad Community Effort

 
Bay Area Women Coalition Founder Leevones G. Fisher at one of the Trinity Gardens Community Gardens. Photo credit: Natural Awakenings, Gulf Coast Alabama/Mississippi Edition

Bay Area Women Coalition (BAWC), a local partner in the Center’s CVI 2.0 project in Alabama, was recently featured in an article for their work establishing a thriving network of community gardens in the Trinity Gardens neighborhood of Mobile. BAWC has had an historical impact in the Trinity Gardens community through their community housing development projects and fighting systemic health care barriers. Over the last several years, one of the founders of BAWC, Leevones G. Fisher, worked to create a new project designed to tackle food insecurity. The idea was born out of both difficult facts and her own experience. “Alabama has one of the worst poverty rates in the nation and we don’t have enough food. I saw so many people going hungry; I still see people going hungry. I didn’t want to just plant a few pots on my back porch. I wanted a garden on every street in this community so children wouldn’t have to be hungry,” she says.

As a coordinated response to chronic scarcity of healthy food, Trinity Gardens Community Gardens (TGCG) emerged. TGCG is a six-year project of BAWC that will bring people together of different ages to produce traditional crops otherwise unavailable in the neighborhood. Residents grow and sell greens, peas, okra, tomatoes, onions, peppers, corn, lettuce, melons, potatoes and other specialty crops. This endeavor is a major success so far, which was just highlighted in the most recent publication of Natural Awakening Gulf Coast Alabama/Mississippi. Take a few minutes to read this amazing article, and be prepared to feel inspired by the collective action of a community working together. For a video about the history of BAWC and more about Fisher's involvement, click this link.

Maine NEMT Bill Advances

Center partner Maine People's Alliance worked with state Sen. Chloe Maxmin to craft a bill, LD 17, which would establish a pilot program to fill a gap in the state’s non-emergency medical transportation (NEMT) system for Medicaid beneficiaries with disabilities, particularly those in rural areas. MaineCare, the state’s NEMT system, has struggled with efficiency for many years, and Maine People's Alliance has sought to untangle these bureaucratic barriers and eliminate the gap in transportation services for non-medical needs, such as trips to the store or pharmacy. Strengthening and expanding NEMT is one of the areas of focus for grantees of the Center’s Consumer Voices for Innovation 2.0 Grant Program.

On Feb. 10, LD 17 had its first public hearing with Mainers impacted by the bill testified in support of it. “Right now I have to ask my daughter to go to the store for me. Sometimes it’s a week or two before she can go. If she forgets things, I might have to wait another week,” said Dorothy Treadwell, a resident of Auburn, in testimony before the committee. “We need a transport system that promotes health and human dignity. LD 17 would ensure that seniors and disabled people like me are able to access what we need, when we need it.”

While this bill has a lot of bipartisan support, the Health and Human Services Committee tabled it, citing a desire to wait until a study of the state’s transportation system is  completed. The Department of Health and Human Services told the committee at a work session on the bill that it hopes to issue recommendations based on the study by late spring or early summer.

NOTEWORTHY NEWS

Vaccinating Older Adults in the US Against COVID-19: A Work in Progress

Despite the disproportionate impact of COVID-19 on older adults and expanded vaccine eligibility for individuals over 65, the majority of older adults have not yet received at least one dose of the COVID-19 vaccine. The Kaiser Family Foundation (KFF) analyzed CDC data to report key findings on older adult vaccination rates across the United States. Most states (41) and the District of Columbia have expanded eligibility for COVID-19 vaccines to include people 65 and older. Among older adults 65 and older, the vaccination rate is 41 percent (compared to 14 percent of the general population) but no state had crossed the 50 percent threshold as of Feb. 23, the date of the KFF-analyzed data. The older adult vaccination rate has increased considerably over the past month, yet more work remains to be done to increase rates and ensure equitable access to the vaccine.

ACAP Report: The Role of Medicaid Health Plans in Addressing Racial and Ethnic Health Disparities

A report released by the Association for Community Affiliated Plans (ACAP) analyzes the factors contributing to the disproportionate impact of COVID-19 on communities of color and focuses on the role of Medicaid health plans in addressing racial and ethnic health disparities. It highlights five key areas of work where ACAP member plans have acted: data collection and analysis, language and cultural competency, member engagement, provider engagement and community partnerships to address social determinants of health. The report also describes challenges plans may face in developing actionable programming, as well as examples of innovative approaches plans can take to overcome these challenges.

Short- and Long-Term Policy Solutions Urgently Needed to Improve LTSS

COVID-19 has dramatically amplified many deficits in the long-term services and supports (LTSS) system in the United States, including a lack of coordination with the U.S. public health system. An article published in the Milbank Quarterly presents both near-term and long-term policy solutions needed to restructure LTSS in the U.S. in order to address these systemic problems.. Near-term actions policymakers can take range from implementing uniform reporting of COVID-19 cases in LTSS settings to enhancing collaboration across U.S. health systems. The article concludes that long-term reform should focus on comprehensive workforce development, comprehensive LTSS financing reform, and the creation of an age‐friendly public health system.

Social Determinants and Health Outcomes Drive Availability of PCMH Model

The collaborative, multi-disciplinary practices utilized by patient-centered medical homes (PCMH) offers a promising approach to address longstanding inequities in the quality of primary care experienced among historically excluded populations. But according to a new research study, access to PCMH appears to favor populations who already reside in communities that are comparably healthier and less socioeconomically vulnerable. The results of this research have important policy implications for expanding access to PCMH for those with a high burden of health and social risk factors.

Making the Case for Paying Family Caregivers During the Pandemic – and Beyond

The AARP Public Policy Institute published a report explaining how paying family members to provide care for older adults and people with physical disabilities is a cost-effective option for home and community-based services. As highlighted in the report, paid family caregiving answers multiple needs: the person who needs care can age at home which is often the preference; family caregivers earn income to help offset the impact of lost job hours; it helps families who cannot otherwise afford to care for their family member; costs are kept much lower than paying for nursing homes; and costly institutionalization can be delayed or avoided. 

STATE HIGHLIGHTS

California

The California Department of Health Care Services (DHCS) proposed in early February to make select temporary telehealth flexibilities permanent and expand others. The flexibilities, which were put in place in response to the COVID-19 pandemic, include payment parity, expanded coverage for services delivered by federally qualified health centers and rural health centers, and some coverage for audio-only telehealth.

In other news, the DHCS released a revised “Expanding Access to Integrated Care for Dual Eligible Californians” policy memo earlier this month outlining the transition plan for dual eligibles and Cal MediConnect within the revised California Advancing and Innovating Medi-Cal Initiative (CalAIM) proposal. This policy is intended to help meet the statewide goals of improving care integration and person-centered care under both CalAIM and the California Master Plan for Aging (MPA). Under CalAIM, the DHCS will transition Cal MediConnect (CMC) and the Coordinated Care Initiative (CCI) to a statewide Managed Long-Term Services and Supports (MLTSS) and Dual Eligible Special Needs Plan (D-SNP) structure.

Massachusetts

The Massachusetts Center for Health Information Analysis released a report revealing the gaps in protections from medical bills found throughout the state. Even those with health insurance are not fully shielded from burdensome medical bills. Fifteen percent of families surveyed reported problems paying medical bills and of that sample, 52 percent were contacted by a collection agency.

Michigan

A case study published by the National Governor’s Association finds that the Michigan Coronavirus Racial Disparities Task Force reduced COVID-19-related cases and mortality among Black residents and may serve as a model for other states. A few of the best practices identified from the task force include: establishing clear objectives with specific metrics; ensuring cross-sectoral collaboration and diversity within the task force; and enabling leadership and state leaders who are committed to work and provide the right mix of expertise to minimize staff fatigue and stress. The case study found that the Task Force also contributed to reductions in health inequities by: distributing six million free masks; declaring racism a public health crisis; requiring implicit bias training for all state employees; and improving the quality of data reporting on racial disparities.

KEY DATES

Tuesday, March 16 (11-12 p.m. Eastern) - Webinar Series: Housing and LGBTQIA+ Older Adults (Part 1), presented by the the National LGBTQIA+ Health Education Center. Please register for the webinar.  

Thursday, March 18 (2-3:30 p.m. Eastern) - Webinar: Caring for Those Who Care: Meeting the Needs of American Indian and Alaska Native Caregivers, presented by the Diverse Elders Coalition. Please register for the webinar.  

Monday, March 22 (4-5 p.m. Eastern) - Webinar: A Dangerous Disruption? The Consequences of Delayed Care During COVID-19, presented by the Primary Care Collaborative. Please register for the webinar.  

Tuesday, March 23 (11-12 p.m. Eastern) - Webinar: Housing and LGBTQIA+ Older Adults (Part 2), presented by the National LGBTQIA+ Health Education Center. Please register for the webinar. 

Wednesday, March 24 (2-3 p.m. Eastern) - Webinar: Equitable Solutions for the Direct Care Workforce, presented by Altarum. Please register for the webinar.  

Wednesday, March 31 (1-2 p.m. Eastern) - Webinar: COVID-19 Vaccine for Homebound Older Adults - Challenges and Solutions, presented by Trust for America’s Health. Please register for the webinar.  

Thursday, April 15 - Application Deadline: Applications due for the Health & Aging Policy Fellows Program (2021-22). Please click here for an overview of the fellowship, including program tracks, eligibility and selection criteria, and application information.