Health Innovation Highlights: November, 2020

Full Edition

DIRECTOR’S CORNER

A New Day


Photo credit: bigstockphoto.com

Ann Hwang, MD
Director, Center for Consumer Engagement in Health Innovation

It has been an intense few weeks, amidst a harrowing year, on the heels of four very challenging years. In this momentous time, we look forward to new opportunities to advance the health of people with complex health and social needs. At the same time, we recognize that the country is more divided than ever and that it will take time, grace and healing to repair our society, and push forward with the change that is so needed. The words I have in my head these days come from Lincoln’s second inaugural address, after the bitter bloodshed of the Civil War: “With malice toward none, with charity for all, with firmness in the right as God gives us to see the right, let us strive on to finish the work we are in, to bind up the nation's wounds...” I look forward to this new day for our country.

At this juncture, I also wanted to share a personal update, which is that I will be stepping down from my role at Community Catalyst at the end of the year. It has been an honor to have spent the past five years here, working with this community of advocates to make our health system more person-centered. I am looking forward to more time for my clinical work and especially my family. I know that our work is in good hands with the stellar Center team, the rest of the talented Community Catalyst staff and with all of you. After the New Year, we expect to be recruiting for a new director for the Center, and I hope that you will help us find a wonderful person for the job!

As I am wrapping up my time at Community Catalyst, I feel above all a tremendous sense of gratitude. Gratitude for all who do this work. Gratitude to my colleagues whose support makes it possible for me to make this transition. And gratitude for the new day ahead and the hope that it brings. Thank you all for your partnership, wisdom, kindness and commitment.

In memoriam: Leah Zallman, MD, MPH

We are saddened to share the news of the passing of Dr. Leah Zallman on Nov. 5. We had the honor of working with and getting to know Leah over the past few years in her capacity as research director at the Institute for Community Health (ICH), which has been the evaluator on our Consumer Voices for Innovation program. In addition to her role at ICH, Leah was a primary care physician at East Cambridge Care Center at Cambridge Health Alliance, and assistant professor of medicine at Harvard Medical School. Leah was an exceptional partner to work with, and the Center has been greatly strengthened by the expertise and insights she shared with us around our work.

Both this memorial page and this Boston Globe article contain more information about Leah’s life, accomplishments and passion for caring for the most vulnerable among us. Our deepest condolences go out to her family and colleagues. 

FROM THE CENTER & OUR PARTNERS

Despite Pandemic, Community Engagement and Policy Victories Thrive

The Center's Consumer Voices for Innovation 2.0 (CVI 2.0) program supports state efforts to build an engaged consumer base, particularly from low-income communities, people of color and/or older adults, to improve food security, housing security and non-emergency medical transportation (NEMT). Despite COVID-19 erecting immediate barriers around conventional organizing, our advocacy partners have not only managed to pivot based on the new realities, they also managed to pull off impressive policy wins in the process. In late October, the Center released two reports on CVI 2.0 that demonstrate how advocates continue to organize, and their resulting policy wins.

Our first publication, prepared for the Center by the Institute for Community Health, captures the sudden course changes CVI 2.0 advocates had to make to respond to COVID-19, adapting both their organizing methods and their near-term goals, to better support urgent needs in their communities. 

Our second publication, “The Path to Victory: The Role of Grassroots Organizing in Policy Change,” describes the policy wins that advocates in the CVI 2.0 program have achieved over the past year. These include increasing the reach of Community Health Workers, preventing evictions, improving non-emergency medical transportation and more. The common denominator in each success is grassroots organizing. Each of these victories was made possible by the engagement of ordinary people in the policy-making process. In a recent Community Catalyst Health Policy Minute episode, Center State Advocacy Manager Ceci Thunes highlights these victories.

National Family Caregivers Month Focuses on #CaregivingInCrisis

Every November, National Family Caregivers Month (NFCM) recognizes and honors family caregivers across the country. Led by Caregiver Action Network (CAN), it is also an opportunity to raise awareness of caregiving issues, educate communities and increase support for caregivers. This year, CAN is making the focus the increasingly heightened stresses on caregivers amidst the coronavirus pandemic. On its NFCM webpage, CAN states, “Family caregivers manage health emergencies, juggle priorities, and suffer isolation - and all that was before COVID. The pandemic brings even more challenges as family caregivers handle Caregiving in Crisis.”

The Center has highlighted these increased challenges since the onset of the pandemic. Along with the Lewin Group, the Center produced a webinar in April and a panel discussion in July both on the topic, “Supporting Family Caregivers of Older Adults through Times of Stress and Isolation.” Recordings of the webinar and panel discussion, as well as the accompanying Powerpoint slides, are available on the event pages. In the spirit of National Family Caregivers Month, we hope that these resources can be helpful in coping with the many challenges that this pandemic is placing upon family caregivers.  

Make the Road New York Demonstrates to Press for Continued Eviction Moratorium



Photo credit: Daniel Efram

Since the beginning of the pandemic, our partners at Make the Road New York have been relentless in protecting housing by pushing the state to impose and keep in place an eviction moratorium. With the end of the moratorium looming and with no plan in place to help those still affected by the pandemic and unable to pay rent, advocates organized 500 people in Foley Square in New York City on Oct. 1and engaged in civil disobedience that shut down Broadway and resulted in 12 arrests. As of this writing, the eviction moratorium has been extended until Jan. 1, 2021. Make the Road New York continues to fight for housing justice for all. Follow them on Twitter to see more photos and videos from the event.

Senior Agenda Coalition of RI Op-Ed in Providence Journal

As is the case across the nation, Center partners in Rhode Island are concerned about looming state budget cuts due to the coronavirus and economic downturn. The Senior Agenda Coalition of Rhode Island (Coalition) published an op-ed in The Providence Journal detailing how cuts in prior recessions adversely affected the older adult community and warning against using across-the-board budget cuts that will result in more devastating economic impacts. For example, they point out that history has shown that a reduction or elimination of critical programs for older adults will result not only in worsening economic conditions, but escalating health problems and even death. The Coalition asks Rhode Islanders to reach out to the governor and assembly leadership and ask them to protect essential services such as senior centers, Meals on Wheels, respite care for caregivers and no-fare bus passes

GIA Report Looks at How Philanthropy Can Support Better Care for People with Complex Health and Social Needs

Grantmakers in Aging (GIA) published a report that summarizes key issues relevant to understanding complex care and offers resources and case studies for funders interested in entering the field or deepening their existing work. With the goal of engaging funders and increasing investment in the field of complex care, GIA profiles funding opportunities and presents a range of approaches that can help funders of all types and sizes take on the important role of championing this work.

Community Catalyst Focus Group Opportunity On Improving Substance Use Treatment and Services

Community Catalyst’s Substance Use Disorders program and Faces & Voices of Recovery are looking for people to participate in focus groups to help improve treatment and services. The group will meet once to discuss what results people want most from drug or alcohol addiction treatment and recovery services. The information shared will influence research and action to improve recovery outcomes nationwide. Participants will attend a two-hour video call during which they will be asked to answer questions drawing on their own experiences and those of their friends or family. Participants will receive a small payment for their time.   

We are looking for people who:  

  • Are 21 or older AND who have lived experience of substance use challenges, including addiction. This includes people with substance use disorders, people who are still using substances, people in recovery (using whatever definition of recovery is right for you), or their family members 
  • Have been directly affected by COVID-19, because they or their family members had COVID or because their substance use treatment and/or recovery services were significantly disrupted by COVID 

Online application available here: Focus Group Application 
URL: https://www.surveymonkey.com/r/SUDFocusGroupApp

Please contact the Project Team at Community Catalyst with any questions: 
email: TreatmentResults@communitycatalyst.org

 

NOTEWORTHY NEWS & RESOURCES

Rapid PACE Responses in the Covid-19 Era: Innovation and Adaptation to Keep Enrollees Safe in Their Communities

The COVID-19 pandemic’s devastating impact on older adults, particularly those in long-term services and supports (LTSS) settings such as nursing homes, has sparked more interest in home and community-based services. The Program for All-Inclusive Care for the Elderly (PACE) is a model of care that aims to help older adults manage medical crises at home and reduce admissions to hospitals and LTSS settings. A new report  describes how PACE providers have adapted to the pandemic, including pivoting to telehealth, repurposing transportation vans to deliver home-based care and inventing new programs to combat social isolation.

In a related blog post published on the Better Care Playbook website, the National PACE Association’s executive vice president for policy and strategy emphasizes the flexibility of PACE organizations in addressing participants’ needs comprehensively during the pandemic. The post lays out areas in which state and federal policymakers can take action to increase access to PACE.

Addressing Social Determinants of Health Through Dual-Eligible Special Needs Plans

The Association for Community Affiliated Plans has released a report exploring the ways in which dual-eligible special needs plans (D-SNP) are addressing the social determinant of health (SDoH) needs of their members. The report analyzes D-SNP members’ SDoH needs, how plans are using Special Supplemental Benefits for the Chronically Ill (SSBCI), and whether SSBCI provides enough flexibility and resources for plans to address SDoH needs. It then highlights policy options for Medicare to provide better tools to plans to address these needs.

NASHP Report Examines State Actions to Bolster Medicaid Supports for Family Caregivers

The National Academy for State Health Policy (NASHP) has released a report, "Medicaid Supports for Family Caregivers." Family caregivers help Medicaid enrollees safely stay in their own homes, prevent or delay hospital and nursing facility stays, and provide personal care services that Medicaid agencies would otherwise need to pay for. Giving them more support could help them provide higher-quality care over a longer period. The report examines the strategies states currently use and presents four interrelated actions the federal government could take to foster the spread of innovative strategies that some states have developed.

Growing Older in America: Aging and Family Caregiving during COVID-19

A new study from The Associated Press-NORC Center for Public Affairs Research reveals that despite the acute impact of the pandemic on family caregivers, there has not been any heightened awareness when it comes to preparations for growing older or providing care to an aging loved one. Caregiving responsibilities have increased and more young people are becoming caregivers due to COVID-19. Yet compared to 2018, more American adults say they have done little or no planning for their own care needs and believe it is unlikely that a loved one will need care.

STATE HIGHLIGHTS

Arizona

Given the pandemic and pressures on state budget, Arizona’s Medicaid office announced that it will no longer pursue a planned Whole Person Care Initiative to address social determinants of health in its December 2020 1115 waiver renewal request. Instead, the state will pursue series of smaller-scale, cost-effective initiatives within the confines of the existing Medicaid program. For example, it will leverage its Health Information Exchange to create a new referral system that providers can use to identify social risk factors and manage referrals to community-based agencies.

New Jersey

Last month, the governor of New Jersey signed into law two new bills that will impact long term care facilities. The first bill requires facilities to maintain a minimum staff-to-patient ratio during morning, evening and overnight shifts.  The next requires facilities to create policies to prevent social isolation of residents and enable better communication with loved ones. The two bills are a result of a report that was done over the summer on New Jersey’s long term care facilities and the impact of COVID-19. The report provided several recommendations to mitigate the devastating impact of COVID on long term care facility residents and their families.

Washington

The state of Washington entered into a memorandum of understanding with key stakeholders to improve primary care and develop a new payment model in the state. The model aims to:

  • Increase primary care expenditures while decreasing total health spending.
  • Align payment and incentives across payers as well as quality metrics across both payers and providers.
  • Promote and incentivize integrated, whole-person and team-based care. This includes primary care, physical and behavioral health care, and preventive services.
  • Improve provider capacity and access.
  • Work with interested public and private employers to spread and scale the model throughout the state.

KEY DATES

Monday, Nov. 16 (2-3 p.m. Eastern) - Webinar: State Approaches to Improving Health Through Housing, presented by the National Association for Health Policy. Please register for the webinar.  

Tuesday, Nov. 17 (4-5 p.m. Eastern) - Webinar: The Impact of the 2020 Elections on Healthcare: Preparing for the Future, presented by Manatt. Please register for the webinar.  

Wednesday, Nov.18 (1-2 p.m. Eastern) - Webinar: Flattening the Caregiver Crisis Curve, presented by National Alliance for Caregiving and Rosalynn Carter Institute. Please register for the webinar.

Thursday, Nov. 19 (12:30-2 p.m. Eastern) - Webinar: Expanded Medicare Advantage Supplemental Benefits: Offering Flexibility to Support High-Need Medicare Beneficiaries, presented by the Playbook for Better Care for People With Complex Needs. Please register for the webinar.

Thursday, Nov. 19 (1-2 p.m. Eastern) - Webinar: Medicaid MCO Overview and Financing, presented by the NORC Medicaid MCO Learning Hub. Please register for the webinar.  

Thursday, Dec. 3 (3-4 p.m. Eastern) - Webinar: Medicaid MCO Authorities and Partnership Strategies, presented by the NORC Medicaid MCO Learning Hub. Please register for the webinar.