December 6 Update

In This Week’s Update:

  • States to Cover Vaccine Counseling for Children
  • Measuring Medicaid Social Care Interventions 
  • Pediatric Vaccine Partner Webinar
  • Colorado’s New Guidance on Transgender Health
  • State Updates: CO, CT, DE, KY, MI, NC, NV, NY, PA, RI, TX, VA, & WA


States to Cover Vaccine Counseling for Children

Following the Biden administration’s announcement of new actions to address the COVID-19 pandemic in light of the Delta and Omicron variants, Centers for Medicare and Medicaid Services (CMS) announced that states must provide Medicaid coverage for COVID-19 “vaccine counseling” visits for enrollees under the age of 21. The federal government will pay the full cost of visits during which providers “talk to families about the importance of kids’ vaccination” without administering a vaccine for all enrollees under age 21 as part of the mandatory benefit for Early and Periodic Screening, Diagnostic and Treatment. CMS also announced that, moving forward, states will be required to cover standalone vaccine counseling visits for all federally recommended pediatric vaccines and indicated that additional guidance is forthcoming. On a related note, State Health and Value Strategies (SHVS) published an issue brief that highlights state strategies that have led to high childhood vaccination rates—and dramatic strides toward health equity—and identifies how those strategies could be applied in the context of the current COVID-19 crisis.


Measuring Medicaid Social Care Interventions

SHVS also published a new issue brief, Conceptualizing Performance Measurement for Social Care Interventions: An Issue Brief for State Medicaid Agencies, that explores opportunities for state Medicaid agencies to implement performance measures with contracted entities that could strengthen their growing interest in social care and highlights several barriers to those applications. 


CMS Pediatric Vaccine Partner Webinar

The Centers for Medicare & Medicaid Services Office of Minority Health and the Connecting Kids to Coverage National Campaign will be hosting a webinar on December 9 to discuss childhood vaccination and provide information and resources for partners and providers encouraging vaccinations in their community. The webinar will focus on COVID-19 vaccines and include flu shot information to celebrate National Influenza Vaccination Week. Intended for community partners and healthcare providers that specialize in pediatric care or those completing outreach and education encouraging flu and COVID-19 vaccinations, this webinar will highlight newly released recommendations on COVID-19 vaccines for children ages 5 to 11, federal COVID-19 resources, flu shot information, and more.


Vaccines: A Roadmap to Engage Women and Their Communities

The Society for Women’s Health Research (SWHR) published a roadmap, Crucial Vaccination Conversations: A Roadmap to Engage Women and Their Communities, that is designed to support the engagement of women and their families in meaningful conversations and initiatives to improve individual and public health through vaccinations. Inspired by insights from an Immunization Education Working Group of public health researchers and professionals, community leaders, patient advocates, and healthcare providers convened by SWHR, the roadmap is a guidance document that can be utilized when developing immunization education outreach programs. The roadmap is intended to be useful to any individual or group working in the vaccination campaign space. While it was created with special consideration for reaching women, the questions, templates, and guidance provided can be adapted for a diversity of target populations and objectives. 


Unpacking Colorado’s New Guidance on Transgender Health

In a new post for the Commonwealth Fund’s To the Point blog, Katie Keith reviews the history and current landscape of coverage for gender-affirming care, including improvements made to transgender health under the ACA, persistent disparities, and Colorado’s new essential health benefits changes set to take effect in 2023. The post highlights how Colorado’s initiative could bolster nondiscrimination protections for transgender people and describes additional policies that would increase healthcare access.


State Updates 

  • Colorado
    • The Colorado Division of Insurance submitted the Colorado Option 1332 waiver for federal approval. If approved, starting in 2023, the Colorado Option will be available to all Coloradans who buy their health insurance on the individual market and small employers with less than 100 employees. Colorado Option plans are forecasted to lower health insurance premiums for individuals, families, and small businesses by 15 percent by 2025. As a reminder, SHVS is tracking state activity of Section 1332 waivers. 
    • The Office of eHealth Innovation and eHealth Commission released the refreshed state health information technology strategy, the 2021 Colorado Health Information Technology (IT) Roadmap. Over the next year, the Polis-Primavera administration will focus on utilizing health IT to help address the gaps in the healthcare system, working toward expanding affordability, access, and equity in healthcare for all Coloradans.
  • Connecticut – Access Health CT Small Business is waiving the minimum number of employees that are typically required to enroll in a small group health insurance plan. Now through December 15, any small business with 50 or fewer employees in Connecticut can enroll in a group health insurance plan regardless of how many employees participate.
  • Delaware – The Delaware Division of Public Health (DPH) partnered with the state’s construction industry to drive down the number of drug overdose deaths in the state. This partnership has allowed DPH to provide construction supervisors with training about overdose and the stigma associated with addiction. 
  • Kentucky – Governor Andy Beshear announced the first healthcare facility to be approved for support through the newly established Kentucky Rural Hospital Loan Program (KRHLP). The KRHLP is making $20 million in low-interest loans available to assist rural hospitals throughout the state.
  • Michigan – The Michigan Department of Health and Human Services has expanded the Opioid Health Home initiative to more Michigan counties to provide intensive care management and care coordination services for Medicaid enrollees with an opioid use disorder.
  • Nevada – Nevada Health Link, the state-based marketplace, announced that nearly 17,452 Nevadans enrolled in qualified health insurance plans within the first 30 days of open enrollment.
  • New York – Governor Hochul launched the statewide “Boost Up, New York” campaign to urge New York adults to get their booster dose for better protection against COVID-19. The campaign will be featured at popular grocery stores, malls, and transit stations statewide including on bulletins, posters, and multimedia screens. All campaign activations will include a QR code or hyperlink so New Yorkers have easy-to-access scheduling information, as well as resources for those looking to learn more about the importance of getting a booster. The program will kick-off December 6 and run for four weeks. Governor Hochul also announced 18 new #VaxtoSchool pop-up vaccination sites—including eight sites open to children five years and older—to increase vaccination rates among school-aged New Yorkers.
  • North Carolina – Governor Roy Cooper announced that North Carolina Department of Health and Human Services (NCDHHS) Secretary Mandy K. Cohen will be stepping down from the agency after five years of service to the state. Governor Cooper has appointed Kody Kinsley, current NCDHHS Chief Deputy Secretary for Health and lead for COVID operations, to succeed her beginning January 1. 
  • Pennsylvania
    • Governor Tom Wolf announced $15.7 million in grant funding to support local strategies to stop gun and group violence across Pennsylvania. Grants were awarded to 40 projects through the Violence Intervention and Prevention Grant Program administered by the Pennsylvania Commission on Crime and Delinquency.
    • First Lady Frances Wolf hostedWomen In Reentry: Mental Health, the third in a series of virtual conversations between reentry advocates and mental health professionals. The panel discussed the impacts of incarceration on a woman’s mental health, the implications they can have on her reentry and highlighted active programs that are supporting the mental health needs of justice-impacted women. 
  • Rhode Island – A new study published by the Rhode Island Department of Health underscores the effects of adverse childhood experiences on health outcomes in adulthood among Rhode Islanders. According to the study, most Rhode Island adults (63 percent) have experienced at least one adverse childhood experience, and 16 percent experienced four or more types of adverse events during childhood.
  • Texas – The Texas Health and Human Services Commission announced the STAR+PLUS Pilot Program, which will carve into Medicaid managed care the coverage of long-term services and supports for individuals with intellectual and developmental disabilities, traumatic brain injuries, and acquired brain injuries. The two-year pilot will begin September 1, 2023.
  • Virginia – The Virginia Department of Medical Assistance Services announced that the state will offer Medicaid enrollees six new behavioral health services that strengthen crisis response, address a national emergency in children’s mental healthcare and provide new supports for individuals with developmental disabilities. The new services include two in-home therapy options for children in crisis.
  • Washington – Governor Jay Inslee announced that the Federal Emergency Management Agency (FEMA) is preparing to send a mobile vaccination unit to several western Washington communities to distribute life-saving COVID-19 vaccines to the public quickly and equitably. The FEMA mobile site is scheduled to open December 20 and will operate for about 30 days.