February 26 Update

In This Week’s Update:

  • Mapping Health Equity
  • State Strategies to Increase Medicaid Renewals
  • Promoting Equitable Healthcare Through Community-Led Initiatives
  • Medicaid to Address Health-Related Social Needs
  • New Maternal Health Grants for States
  • State updates: AZ, CA, CO, DE, IN, MA, MI, NC, ND, NJ, NM, PA, SC & WI


Mapping Health Equity
Last week, State Health and Value Strategies (SHVS) hosted a webinar to introduce two new interactive tools to help states advance health equity: the Health Equity Impact Tool, a multi-part online evaluation for state agencies to examine their equity work at a high level and the Health Equity Policy Tool, a framework for reviewing the impact on equity of current or proposed policies. The webinar slides are posted and a recording of the webinar is also available.


State Strategies to Increase Medicaid Renewals
Also last week, SHVS published a new post in our States of Unwinding series. Key findings include: a year into unwinding, some states are extending their timelines for renewals, and to outreach to enrollees yet to be redetermined, states are funding community-based organizations to engage specific populations, such as postpartum individuals and their children. Read the full post to learn what other strategies states are employing in support of unwinding. Updates follow.


Promoting Equitable Healthcare Through Community-Led Initiatives
Institution-led health equity initiatives often fail to produce effective, sustainable changes, in part because of superficial partnerships with the community that the interventions are intended to benefit. Community members have valuable knowledge and skills that are often underappreciated in these collaborations. A new blueprint published by the Urban Institute presents real world examples of how community-led efforts can bring about equitable health outcomes. The findings are drawn from interviews with representatives from five community-led organizations working to create system-level changes and address inequities in health and/or healthcare. The blueprint highlights commonalities in approach, structure, and needs among community organizations.

Medicaid to Address Health-Related Social Needs
A new report from the Center on Budget and Policy Priorities describes recent guidance issued by CMS and waiver approvals that broaden the ways in which states can use Medicaid funds to help pay for clinically appropriate, evidence-based services that address health-related social needs. This report describes those changes and outlines key considerations for healthcare advocates and other partners—especially housing advocates—to help their states respond to these important needs. As a reminder, SHVS updated a toolkit on addressing HRSNs through Medicaid managed care and published a companion expert perspective, which highlights what is new to the toolkit.


New Maternal Health Grants for States
In December 2022, Congress reauthorized for a five-year period the Health Resources and Services Administration (HRSA) Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program. Starting this year, states and territories have the option to apply for matching grants to provide evidence-based home visiting supports that connect families to health and social services. The federal government will contribute 75% of funding, with states contributing 25% of non-federal funds (or three federal dollars for every one state dollar), up to a statutorily defined funding ceiling and in compliance with certain parameters, including a maintenance of effort requirement. SHVS is continuing to monitor the forthcoming release of HRSA’s notice of funding opportunity for the MIECHV program grant, for which states will have 90 days to respond. (For more information, see HRSA’s August 2023 presentation.)


State updates: AZ, CA, CO, DE, IN, MA, MI, NC, ND, NJ, NM, PA, SC & WI

  • Arizona – Governor Katie Hobbs and the Arizona Health Care Cost Containment System (AHCCCS) announced two changes to Arizona’s Medicaid program that will positively impact children. AHCCCS received federal approval to increase the upper income limit of KidsCare, the state’s Children’s Health Insurance Program, and to make permanent AHCCCS’ ability to reimburse parents as paid caregivers of their Arizona Long Term Care System-enrolled minor children with disabilities.
  • California – As part of California’s efforts to combat the overdose epidemic, the Department of Health Care Services (DHCS) awarded more than $10 million to 25 DHCS-licensed nonprofit, residential substance-use disorder (SUD) treatment facilities. The funding supports SUD treatment facilities with costs associated with startup, recruitment, mentorship, and training programs to increase provider knowledge and comfort with prescribing medication-assisted treatment.
  • Colorado – The 2023 Colorado Health Access Survey, a survey of 10,000 Colorado households fielded from March to September 2023, reveals substantial changes in health, health access and social stressors stemming from the COVID-19 pandemic. Kevin Patterson, Chief Executive Officer of Connect for Health Colorado, the state’s health insurance Marketplace, published a blog post highlighting the findings from the survey, including a historic low uninsurance rate of 4.6% in 2023.
  • Delaware – The Delaware Department of Health and Social Services and the Delaware Health Care Commission have launched the Benchmark Trend Report Dashboard to support the state’s efforts to improve healthcare quality for all residents, while simultaneously working to monitor and reduce the economic burden of healthcare spending. The dashboard provides an interactive view of Delaware’s healthcare spending and quality data compared across multiple years. Information is broken down by state-, market- and insurer-level spending as well as type of insurance and total healthcare enrollment.
  • Indiana – Indiana Medicaid announced that the pause on cost sharing, implemented during the federal public health emergency, will end July 1, 2024. Indiana will restart cost sharing for Medicaid, including the Healthy Indiana Plan, the Children’s Health Insurance Program and the MEDWorks program for employed individuals with a disability. The change will impact approximately 1 million Medicaid members, the majority of which are on the Healthy Indiana Plan.
  • Massachusetts – MassHealth announced a partnership with Collective Insight to launch the new MassHealth Member Advisory Council (MAC) in the summer of 2024. Collective Insight will be supporting development of the MAC, including management of outreach planning and community input. MassHealth is encouraging members interested in learning more about the project and getting involved in MAC development to complete a Member Engagement Interest Form. As a reminder, SHVS hosted a webinar on CMS’ proposed rule, “Ensuring Access to Medicaid Services,” which would require states to replace the existing Medical Care Advisory Committee with two groups: A Medicaid Advisory Committee and a Beneficiary Advisory Group.
  • Michigan – To help protect Michigan families—particularly children—from the tragedies of gun violence and unintentional firearms injuries, a new secure storage law, Public Act 17 of 2023, requires individuals to keep unattended weapons unloaded and locked with a locking device or stored in a locked box or container if it is reasonably known that a minor is likely to be present on the premises. As a reminder, my podcast, the Princeton Pulse, previously discussed a public health approach focused on firearm safety and injury prevention.
  • New Jersey – Governor Phil Murphy announced the allocation of over $95 million from New Jersey’s Opioid Recovery and Remediation Fund to support critical programs tackling the opioid crisis. At the recommendation of the state’s Opioid Recovery and Remediation Advisory Council and with input from the public, six programs addressing four priority areas—harm reduction, prevention and recovery support, treatment, and housing—have been identified to receive funding over the next two to three years.
  • New Mexico – Governor Lujan Grisham highlighted two healthcare bills which passed in the state Legislature. The Health Care Delivery and Access Act establishes a Medicaid-directed payment program for hospitals, which will leverage approximately $1.3 billion in federal matching funds to increase financial stability for hospitals across the state, particularly in rural areas. The Health Care Consolidation Oversight Act gives the Office of Superintendent authority to review business transactions for hospitals that might affect the availability, affordability and quality of hospital care and ensures oversight over mergers and acquisitions of hospitals in the state.
  • North Carolina
    • The North Carolina Department of Health and Human Services (NCDHHS) is launching a Community Partner Engagement Plan to ensure the voices of North Carolina communities and families continue to be at the center of the department’s work. This includes a new website and improvements to internal processes for engaging community partners, as well as groups with lived experience, to make policy changes that best serve the people of the state.
    • To combat rising cases of syphilis, including congenital syphilis, NCDHHS is raising awareness among providers and patients of a recent rate increase to support treatment for Medicaid enrollees. As of February 1, 2024, the Medicaid reimbursement rate has been increased to reflect the updated costs of the medication Bicillin L-A, which can be used to treat syphilis and is the only known effective treatment for preventing congenital syphilis.
  • North Dakota – North Dakota Health and Human Services Behavioral Health Division announced that Children’s Behavioral Health Service Grants are available through the System of Care initiative. The funding opportunity aims to support the development and implementation of community-based, youth and family driven, and culturally responsive services and supports for children, adolescents, and young adults with behavioral health conditions and their families.
  • Pennsylvania – The Pennsylvania Department of Human Services released recommendations from its Blueprint Workgroup, an interdisciplinary group representing state and local governments, healthcare, education, service providers, managed care, and family advocates. The workgroup sought to evaluate challenges children and youth with complex, co-occurring physical and behavioral healthcare needs and their families experience.
  • South Carolina – The South Carolina Department of Health and Human Services announced it has awarded 26 grants totaling $48.2 million to improve access to quality medical care. Launched in October 2023, the grant provides one-time infrastructure funds to create or improve facilities in rural or medically underserved areas. The grant program focused on essential healthcare services, including primary care, maternal and infant care, pediatrics and behavioral health.
  • Wisconsin – The Wisconsin Department of Health Services has awarded 13 grants worth $830,000 over the next two years to community organizations to help address the youth and young adult vaping epidemic. Funding for the grants comes from current payments to Wisconsin as part of a $14.7 million multi-year JUUL Settlement announced by the Wisconsin Department of Justice in September 2022.