May 24 Update

In This Week’s Update:

  • SHVS Resources On Collecting Race, Ethnicity, and Language Data
  • Treasury Clarifies Use For COVID-19 Relief Funds  
  • State updates: AL, AZ, CA, CO, FL, KS, MA, MD, MN, NC, NJ, NM, NV, NY, OK, PA, TX, VA, WA, & WI
  • Upcoming Webinar On Improved Behavior Health Crisis Resources
  • Health Equity From A Medicaid Medical Director’s View
  • Estimating And Examining The Cost Of Postpartum Coverage Expansion


SHVS Resources On Collecting Race, Ethnicity, and Language Data

Last week, State Health and Value Strategies (SHVS) published a new issue brief, Collection of Race, Ethnicity, Language (REL) Data in Medicaid Applications: A 50-state Review of the Current Landscape, which documents how states are collecting information about REL on their Medicaid applications. The brief provides an overview of REL data collection standards and examine state Medicaid application’s question structure, answer options, and instructional language. The brief also includes an overview of the frequency of different iterations of questions and responses and provide state examples to illustrate common and unique data collection practices. SHVS also updated its brief on Accessing Enhanced Federal Funding for HCBS Under the American Rescue Plan. This updated brief describes ARP’s HCBS enhanced FMAP provision, CMS’ recent implementation guidance, and considerations and next steps for state policymakers.


Treasury Clarifies Use For COVID-19 Relief Funds  

The United States Treasury released several updates related to the $350 billion Coronavirus State and Local Fiscal Recovery Funds included in the American Rescue Plan (ARP) for eligible state, local, territorial and Tribal governments to respond to the COVID-19 pandemic, including an interim final rule with comment period and an amalgam of guidance relating to the funds. These materials clarify recipients’ allotments, how the funding will be distributed, how recipients can access the funds, eligible uses of the funding, and the general reporting requirements recipients will need to meet. The interim final rule provides significant discretion to states and localities to use the funds for initiatives to overcome public health and economic impacts stemming from or exacerbated by COVID-19, specifically encouraging using funds to advance health equity. Eligible recipients must submit a request to receive funding.


COVID-19 Updates

  • Alabama – A public service announcement featuring University of Alabama head football coach Nick Saban encouraging vaccinations for COVID-19 will begin airing in the state this week. The PSA for broadcast, cable and digital media encourages people to get their COVID-19 vaccinations so that players and fans can safely enjoy loud and full stadiums in 2021.
  • California – Governor Gavin Newsom announced the state’s new Employer Vaccination Toolkit, which will ease the process for employers to request a workplace clinic or local provider partner, making COVID-19 vaccines even more accessible for their employees.
  • Maryland – Governor Larry Hogan, the Maryland Lottery, and the Maryland Department of Health announced the launch of the $2 Million VaxCash Promotion, which will award $2 million in cash prizes to a total of 41 Maryland residents who have been vaccinated.
  • New Jersey – Governor Phil Murphy announced several new vaccination incentives as part of “Operation Jersey Summer,” the statewide public awareness campaign aimed at vaccinating all eligible individuals in New Jersey against COVID-19. The new incentives include a State Parks Vax Pass, providing free access to New Jersey’s 51 state parks and facilities including Island Beach State Park; a free glass of wine at participating New Jersey wineries; and a chance to have dinner with Governor Murphy and First Lady Tammy Murphy.
  • New York – Governor Andrew Cuomo announced a new vaccination program that will provide free NYS lottery scratch-off tickets to individuals 18 and over with a grand prize of $5 million.
  • Oklahoma – With approval from CMS on its state plan amendment,  the state is redirecting over $68 million in emergency COVID-relief funding to nursing homes and facilities that care for people with disabilities.
  • Texas – The Texas Health and Human Services Commission is issuing new rules allowing nurse aide applicants to apply on-the-job work experience during the COVID-19 public health emergency to the 100-hour training requirement for certification.
  • Virginia – Governor Ralph Northam unveiled new public statewide health equity dashboards, providing a snapshot of the Commonwealth’s COVID-19 response and recovery efforts and making key data more accessible to Virginia residents. The Equity-in-Action dashboard is a snapshot of the progress Virginia has made across our COVID-19 response and recovery programs and other initiatives that advance the equitable distribution of resources and services. The Equity-at-a-Glance dashboard is a transparent assessment of social determinants of health and other factors contributing to health equity (accessible via the right-side panel). Future versions of these dashboards will include an expanded set of topic areas, such as workforce diversity and criminal justice metrics.


Other State Updates

  • Arizona – Governor Doug Ducey signed legislation to exclude fentanyl testing products from the list of illegal drug paraphernalia, allowing those who use drugs or suffer from addiction to identify drugs that have been laced with the lethal narcotic.
  • California – New data from Covered California, the state-based marketplace, shows a surge in enrollment as more than 76,000 people have signed up for coverage since Covered California launched a special enrollment period, which is more than 2.5 times as many as those that enrolled during the same time period in 2019.
  • Colorado – The state released a report on their Build Back Stronger listening tour. The tour was designed to gather input and help state leaders prioritize spending of the approximately $3.9 billion in ARP funds. This report is a synthesis and summary of the ideas generated during the listening sessions and a collection of ideas submitted.
  • Florida – The Agency for Health Care Administration announced that a toll-free helpline for immediate short-term mental health support and counseling services is now available for approximately 85,000 eligible Medicaid members not enrolled in a Medicaid health plan.
  • Kansas – Governor Laura Kelly vetoed legislation that would have allowed short-term limited duration health plans in the state and instead advocated for the state to expand Medicaid. The governor’s office also highlighted findings from a new national report that says expansion would create 23,000 new jobs in the state.
  • Massachusetts – The Massachusetts Health Connector, the state-based marketplace, announced that all nine health insurance carriers who participate in the marketplace have agreed to let their off-exchange members move from an off-exchange plan to an exchange-based plan mid-year without losing spent out-of-pocket costs in 2021. This flexibility can help Massachusetts residents access new lower-cost plans through the Health Connector.
  • Minnesota – Governor Tim Walz signed the Minnesota Department of Corrections Healthy Start Act into law, providing new resources to support the health and wellbeing of incarcerated mothers and their newborn babies. The Healthy Start Act allows the Commissioner of Corrections to place women who are pregnant or immediately postpartum into community alternatives such as halfway houses, supervise them in accordance with current statute, and provide them treatment and programming in the placement location for the duration of their pregnancy and for up to one-year post-birth to allow for the child to be near their mother for the first year of their lives.
  • Nevada
    • Governor Steve Sisolak reminded residents to review and submit ideas on the Every Nevadan Recovery Framework, the state’s strategic plan for the discretionary funds allocated directly to the state by ARP. The plan includes a focus on increasing access to health care and community-based services as well as a focus on supporting communities most impacted by COVID-19.  
    • The Silver State Health Insurance Exchange, the state-based marketplace, enrolled more than 7,600 Nevadans since the implementation of two special enrollment periods in 2021, including more than 4,500 enrollees since April 20 as a result of ARP implementation.
  • New Mexico – The New Mexico Human Services Department announced A Dose of Wellness, a new campaign to promote mental and physical well-being by offering positive tools and informational resources to help New Mexicans improve their health. The campaign is designed to increase public awareness, provide helpful resources, and reduce the stigma, misconceptions and false information surrounding health issues. It also aims to help New Mexicans identify risky or dangerous behaviors by offering screening tools and entry points for additional resources.
  • North Carolina – Governor Roy Cooper shared his recommendations for how North Carolina can most effectively invest in its recovery through ARP. Cooper noted that the $5.7 billion in federal funds offer an opportunity to invest in North Carolina and ensure a shared recovery from the global pandemic. The Governor’s recommendations include assisting families most impacted by the pandemic, upgrading infrastructure, helping more people get a degree or trade after high school, preparing the state’s workforce and promoting business development and innovation.
  • Pennsylvania – Governor Tom Wolf announced the availability of $5 million in funding to support local efforts reducing community gun violence in Philadelphia and other regions across the state experiencing recent surges in shootings, homicides, and other firearm-related crimes. Grant funding will be administered by the Pennsylvania Commission on Crime and Delinquency.
  • Washington – Governor Jay Inslee signed legislation that aims to increase the affordability of standardized health plans on the individual market. Among several provisions, Senate Bill 5377 establishes a state premium assistance program for certain individuals purchasing health insurance on the state exchange.
  • Wisconsin
    • The Wisconsin Department of Health Services (DHS) is creating an Office of Health Equity. The office will conduct research and policy analysis to address the social determinants, or root causes, of health. This includes, but is not limited to, access to housing, stable income, and health care.
    • DHS also continues to call for Medicaid expansion after new research released by Kaiser Family Foundation found significant health and economic benefits in states that had expanded Medicaid. In addition to making affordable health insurance coverage available to an additional 90,000 residents through BadgerCare Plus, adopting Medicaid expansion would bring $1.6 billion in new federal funding into the state. This new research comes as Wisconsin’s portion of federal funding from the ARP has been decreased by $700 million to $2.5 billion because of higher employment numbers.


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 ARP funding for states and localities to invest in a more equitable, comprehensive, and integrated system that connects individuals in behavioral health crisis with specialized and appropriate 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 ARP. 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 is required; click here to sign up for the event.

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


Fostering Health Equity: Perspectives from a Medicaid Medical Director

Medicaid is the primary source of health care coverage for over 77 million Americans, with Black and Latino communities making up approximately 46 percent of enrollees and as such, Medicaid programs are a significant player in reducing health disparities and advancing health equity. The Center for Health Care Strategies hosted a question and answer session with internist and pediatrician Nathan Chomilo, MD, Medical Director of Minnesota Medicaid and MinnesotaCare to get his perspectives on priority opportunities for addressing health equity for people served by the state’s Medicaid program. Medicaid medical directors have a unique leadership opportunity to address equity through their oversight of services covered by Medicaid and their connections with providers delivering those services. From their vantage point, medical directors have insight into provider and patient experiences, as well as the barriers that can hinder access and treatment.


Cost Estimate Tool: Calculating the State Cost of Extending Postpartum Medicaid

The American Rescue Plan provides states with the option to extend pregnancy-related Medicaid eligibility to one year after delivery through a state plan amendment starting in Spring 2022. Children’s Hospital of Philadelphia PolicyLab, as part of Thriving PA, a campaign of the Pritzker Children’s Initiative in Pennsylvania, led the creation of a cost estimate tool for Pennsylvania’s postpartum Medicaid extension. PolicyLab and Thriving PA partners solicited feedback on the cost estimate tool from stakeholders and experts in the commonwealth and across the country so that it can be used by policymakers or advocates in other states to estimate the cost of extending postpartum Medicaid coverage in their state. The tool remains a work in progress and PolicyLab welcomes continued feedback and plans to update the tool as CMS guidance is released.

 Related Resource: The American Rescue Plan Act’s State Option To Extend Postpartum Coverage


Spending on Postpartum Care

The Health Care Cost Institute (HCCI) published a new report examining spending in the postpartum period and finds most postpartum spending occurs beyond 60 days after delivery. For the report, the HCCI analyzed their unique dataset to characterize spending on care used by birthing parents with employer-sponsored insurance during the postpartum period. Because the postpartum period is defined differently depending on the entity and purpose, the HCCI’s analysis of postpartum utilization and spending covers a full year after birth. The report also includes estimates for shorter periods, specifically 60 and 90 days. To assess the potential need for health care services among birthing parents in the year after delivering a baby, HCCI analyzed the spending of health care services among the commercially insured population across a full year, focusing on birthing parents, not newborns.