June 27 Update

In This Week’s Update:

  • Measuring Screening for Social Risk Factors
  • COVID-19 Vaccines for Children
  • SBM Race and Ethnicity Data Collection
  • LGBT Experiences Accessing Care
  • State Updates: AZ, CA, CO, IL, IN, KY, WV & WI

Report on Social Risk Screening

In a new report funded by the Robert Wood Johnson Foundation, the Social Interventions Research & Evaluation Network (SIREN) at the University of San Francisco California synthesizes existing research on social screening in U.S. healthcare settings with the goal of informing the intensifying national dialogue on the topic. The SCREEN study report summarizes findings in five digestible sections: prevalence of screening; validity of existing screening tools; patients’ perspectives on screening; providers’ perspectives on screening; and screening implementation.

Also, Last week State Health and Value Strategies hosted a webinar that featured state officials and Medicaid managed care entities from Rhode Island and Massachusetts who shared their experiences implementing social risk factor screening measurement. The webinar explored how to hold plans and provider entities accountable for identifying Medicaid members affected by social risk factors, such as homelessness and food insecurity. Both the slide deck and a recording are available on the SHVS website.

CDC Recommends COVID-19 Vaccines for Young Children

Following the announcement by the Centers for Disease Control and Prevention recommending making children six months through five years old eligible for COVID-19 vaccines, states will be looking to roll out the vaccine for very young children. As a reminder, SHVS published an issue brief Borrowing Proven Policy Strategies to Vaccinate Kids Against COVID-19: Lessons from Past Successes can Provide a Roadmap for Ensuring Equity in Immunization Efforts that highlights vaccine strategies that promote equity.

Improving Race and Ethnicity Data Collection for State Based-Marketplaces

State health officials are recognizing that marketplaces and participating insurers can help reduce health inequities. A first step is for marketplaces to improve data collection of enrollees’ race and ethnicity. A new blog post from the Commonwealth Fund authored by researchers at Georgetown University reviews current data collection of race and ethnicity among state-based marketplaces (SBMs). In the post, the researchers highlight how changes to the application process and working with insurers to fill gaps can improve SBM’s collection of information on race and ethnicity.

Experiences of Lesbian, Gay, Bisexual and Transgender Individuals in Accessing Care

Medicaid plays an important role in providing health insurance coverage to lesbian, gay, bisexual, and transgender (LGBT) adults. A new issue brief from the Medicaid and CHIP Payment and Access Commission uses data from the National Health Interview Survey (2015-2018), the National Survey on Drug Use and Health (2015-2019), and the U.S. Transgender Survey (2015) to examine two aspects of access among LGBT populations. The first set of analyses focus on the experiences of Medicaid-covered lesbian, gay, and bisexual (LGB) populations with accessing physical and behavioral health services compared to Medicaid-covered heterosexual adults. The second set of analyses compare the experiences of Medicaid-covered transgender and gender-diverse (TGD) populations to those covered by private insurance and those without insurance coverage.

State Updates

  • Arizona – The Arizona Health Care Cost Containment System (AHCCS) and Tucson-based PAXIS Institute announced a four-year partnership to expand the use of PAX Tools in the state of Arizona. PAX Tools are a collection of trauma-informed, evidence-based strategies that, when implemented by caring adults during typical interactions with children, improve cooperation and self-regulation. Beginning in June, AHCCCS will provide PAX Tools materials and training to community-based professionals across the state. 
  • California – The state announced $518.5 million in grants to help provide services and housing options to those with severe mental illness or substance use disorder. The funding will provide treatment beds for more than 1,000 people at a time, plus behavioral health services for many more. It is part of a $2.2 billion effort to expand mental health housing and services across California, especially for people experiencing homelessness.
  • Colorado – The U.S. Department of Health and Human Services announced approval of Colorado’s Section 1332 State Innovation Waiver amendment request to create the “Colorado Option.” The waiver allows Colorado to capture savings from mandated premium reductions and use those savings to fund a state subsidy program that enhances affordability for currently eligible populations. The waiver also creates a new program for undocumented persons.
  • Illinois – Governor Pritzker signed into law equity-focused nursing home rate reform legislation that will hold facility owners accountable by tying new funding to improving care. The reform principles include increased funding that is tied to staffing levels, a new pay scale for certified nursing assistants that increases wages based on years of experience and funding connected to improving key quality measures.
  • Indiana – The Indiana Family and Social Services Administration’s Division of Mental Health and Addiction (DMHA) announced the launch of the Recovery Capital Index (RCI), encouraging Hoosiers to participate in the survey to measure addiction treatment and recovery resources in Indiana. Recovery capital is the overall measure of internal and external resources available to an individual with a substance use disorder to ensure their continual success in recovery. The RCI provides a comprehensive picture of a person’s whole well-being using an online, automated 68-question survey. DMHA plans to use aggregate and geographically analyzed results from the RCI to drive future decisions about funding and resource allocation.
  • Kentucky – The Kentucky Department of Medicaid Services announced a public comment period for renewal of the state’s Supports for Community Living 1915(c) home and community-based services waiver. The comment period runs from June 24 to July 24. The current waiver, which is one of Kentucky’s six 1915 HCBS waivers, expires this year.
  • West Virginia – The West Virginia Department of Health and Human Resources, Bureau for Medical Services announced plans to submit a State Plan Amendment to seek approval to raise ground ambulance medical transportation services to 100 percent of the Medicare geographic prevailing fee. This will provide approximately 208 ambulance providers with a 10 percent increase in their reimbursement rates and an estimated additional $11.8 million per fiscal year.  
  • Wisconsin – The state submitted a section 1115 demonstration waiver application to expand postpartum Medicaid coverage for eligible members from 60 days to 90 days. This demonstration will allow for an additional month of coverage for pregnant and birthing people in Wisconsin whose household income is above 100% of the federal poverty level.