June 1 Update

In This Week’s Update:

  • New CMS Administrator
  • Expert Perspective: Final rule on COVID-19 recovery funds
  • State updates: CO, DC, ME, MI, NC, OH, TX, VT, WA & WI
  • Impact of chilling effect on immigrant children
  • Webinar: Exploring states’ option for mobile crisis interventions
  • Health Equity Tracker
  • Medicaid waivers to address homelessness: Lessons from states


New CMS Administrator

Last week, the Senate confirmed and HHS Secretary Becerra swore in Chiquita Brooks-LaSure to be the next Centers for Medicare and Medicaid (CMS) Administrator, overseeing Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. Administrator Brooks-LaSure commented, “The COVID-19 pandemic has illuminated so many of the longstanding health disparities in this country, and CMS has the ability to advance health equity for all Americans through Medicare, Medicaid, and the health insurance marketplace. We’re going to build on the Affordable Care Act and continue to bring down health care costs for American families. Our agenda is ambitious – but the times call for bold action, and I look forward to working with President Biden and Secretary Becerra to strengthen CMS’ programs and build back better for the American people.”


Expert Perspective: Final Rule on State and Local Recovery

State Health and Value Strategies published an expert perspective, Treasury Issues Rules for $350 Billion Coronavirus State and Local Fiscal Recovery Funds, providing a short summary of the interim final rule, including eligible uses, key areas for comment and what to expect next related to the fiscal recovery funds. States will receive $195.3 billion to stabilize revenue downturns, address budget shortfalls, support public health expenditures, and address negative economic impacts of COVID-19 to lay the foundation for a strong and equitable recovery.


COVID-19 Updates

  • Colorado – Governor Jared Polis announced the Colorado Comeback Cash Vaccine Drawing, where vaccinated Coloradans will have the opportunity to win $1 million, with a total of $5 million in prizes given out. One winner will be selected each week for five weeks. Winners will be announced on June 4, June 11, June 18, June 25, and July 7. Coloradans must be vaccinated by June 30 to qualify to win on July 7.
  • North Carolina – A new tool created by the N.C. Department of Health and Human Services that maps social vulnerability and vaccination rates by census tract has helped North Carolina vaccine providers increase vaccinations by 50 percent in 89 underserved communities. The COVID-19 census tract mapping tool highlights areas of the state with the highest rates of social vulnerability and lowest rates of COVID-19 vaccination. 
  • Ohio – During Governor Mike DeWine’s COVID-19 briefing this week, he called on managed care companies to continue efforts to increase vaccine uptake among Ohio Medicaid enrollees. Currently, the vaccine uptake among Medicaid enrollees is 22 percent compared to a 45 percent uptake among Ohioans overall.
  • Texas – Governor Greg Abbott, the Texas Division of Emergency Management, and the Texas Military Department announced the expansion of the State Mobile Vaccine Program to include groups of five or more Texans who voluntarily choose to be vaccinated against COVID-19. Texans can call 844-90-TEXAS and select Option 3 to schedule a mobile vaccine clinic to vaccinate groups of friends, families, employees, volunteers, and more.
  • Wisconsin – The Wisconsin Department of Health Services updated the data displayed on the COVID-19 Summary Data page. The new Wisconsin COVID-19 Summary Statistics dashboard will continue to report COVID-19 cases and deaths, emphasizing seven-day averages, and will also display vaccination rates and disease activity. 


Other State Updates

  • District of Columbia – Mayor Muriel Bowser announced that the District is launching a pilot program to shift 911 calls for emergency mental health services from an automatic police dispatch to a dispatch including a mental health crisis response. During the pilot, the Department of Behavioral Health’s Community Response Teams will serve as specialized, rapid response units for mental health-related 911 calls instead of automatically deploying police officers.
  • Maine – The Maine Department of Health and Human Services is seeking stakeholder input regarding the American Rescue Plan Act’s temporary home- and community-based services (HCBS) federal medical assistance percentage increase and is hosting a live zoom listening session and soliciting written feedback. 
  • Michigan – The Michigan Opioids Task Force and Michigan Department of Health and Human Services released the annual report the state’s efforts to respond to the opioid crisis in 2020. The report outlines progress by the group, which was appointed by Governor Gretchen Whitmer as part of a goal to reduce opioid overdose deaths in Michigan in half from 2020 to 2025.
  • North Carolina – The North Carolina Department of Health and Human Services announced the selection of organizations to serve three regions of the state as part of the Medicaid Healthy Opportunities Pilot. The program will create a systematic approach to integrating and financing non-medical services that address housing stability, transportation access, food security, and interpersonal safety into the delivery of health care.
  • Washington – The Health Care Authority announced that the state’s Medicaid Director, MaryAnne Lindeblad, will retire on July 31 after holding the position since 2012.
  • Vermont – The Vermont Agency of Human Services is soliciting input on a spending plan to enhance, expand, and strengthen Medicaid HCBS. The Agency encourages all Vermont HCBS providers, associations, and advocacy organizations to complete a survey to provide input into the initial plan the Agency will submit to CMS.


Upcoming SHVS Webinar – American Rescue Plan’s New State Option for Community-Based Mobile Crisis Interventions

 Monday, June 14, 12:00 to 1:00 p.m. ET

State Health and Value Strategies is hosting a webinar on the American Rescue Plan Act funding for states and localities to invest in a more equitable, comprehensive, and integrated crisis system that connects individuals in behavioral health crisis with specialized and appropriate behavioral health treatment. During the webinar, experts from Manatt Health will provide an overview and considerations on the state option to provide community mobile crisis interventions services included in ARPA. Presenters will walk through key questions on the new option, review promising models for crisis mobile intervention services and share strategies for equitable design and implementation.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=ef05349f4b74281b270217f888011f2d3 

Related resource: American Rescue Plan Provides a New Opportunity for States to Invest in Equitable, Comprehensive and Integrated Crisis Services


Many Immigrant Families with Children Continued to Avoid Public Benefits in 2020, Despite Facing Hardships

The Urban Institute released a new analysis using data from its Well-Being and Basic Needs Survey to assess the chilling effects reported by adults in immigrant families living with children under 19. Among the key findings, adults in immigrant families with children reported chilling effects even as many faced significant hardships, financial concerns, and health needs in the household. For instance, nearly half (45.1 percent) reported someone in the family lost work or income because of the pandemic, 28.0 percent reported experiencing food insecurity, and more than 3 in 10 respondents said someone in the family was uninsured. Avoidance of public benefits among immigrant families with children could have both short- and long-term consequences because food insecurity, financial hardships, and problems accessing needed health care can have both immediate and future adverse effects on children’s health and well-being.

Related resource: Adults in Low-Income Immigrant Families Were Deeply Affected by the COVID-19 Crisis yet Avoided Safety Net Programs


Health Equity Tracker

Prompted by the COVID-19 pandemic, the Health Equity Tracker was created in 2020 to aggregate up-to-date demographic data from the hardest-hit communities. Housed at the Satcher Health Leadership Institute at the Morehouse School of Medicine, the Health Equity Tracker aims to give a detailed view of COVID-19 health outcomes by race, ethnicity, sex, socio-economic status, and other critical factors nationwide as well as by state and county. The tracker also measures comorbidities associated with COVID-19, including Chronic obstructive pulmonary disease, diabetes, and social and political determinants of health, including uninsured and poverty rates. In the future, it will include additional conditions, such as mental and behavioral health, as well as factors affecting vulnerable communities, including people with disabilities, LGBTQ+ individuals, and people of lower socio-economic status.


Medicaid Waivers and Tenancy Supports for Individuals Experiencing Homelessness: Implementation Challenges in Four States

The Affordable Care Act extended Medicaid eligibility to large numbers of individuals experiencing or at risk of homelessness. This legislative development and the growing recognition of homelessness as a significant social determinant of health have encouraged advocates and policymakers to seek new ways to use Medicaid to provide housing supports. Drawing on extensive document reviews and in-depth interviews in four early-adopter states, researchers, with support from the Robert Wood Johnson Foundation, published a study examining the implementation of Medicaid’s Section 1115 demonstration waivers to test strategies to finance tenancy support services for persons experiencing or at risk of homelessness. The researchers identified seven challenges to the successful implementation of tenancy support demonstration projects: resolving the housing supply and stigma, removing silos between health care and homeless services providers, enrolling and retaining the target populations in Medicaid, contracting with and paying tenancy support providers, recruiting and retaining key workers, ensuring Medicaid’s waiver durability, and reducing administrative crowd-out and waiver burden. The experience of the four states suggests lessons for Medicaid officials in other jurisdictions that are interested in pursuing tenancy support initiatives.