November 9 Update

In This Week’s Update:

  • The Election and Health Care
  • COVID-19 State Updates: AZ, CA, CO, DE, NE, NC, NJ, PA & RI
  • Other State Updates: GA, NE, OR, PA, VA & WA
  • Webinar: Screening for Social Risk Factors Part II
  • New Drug Death Data
  • Health and Equity in Rural Places
  • Children with Special Health Care Needs and COVID-19


The Election and Health Care

As we wait for the election results, the new Health Affairs podcast, A Health Podyssey, offered last week a first take on health policy after the 2020 election. The episode explores the future of the Affordable Care Act (ACA), the potential for, and timing of, COVID-19 relief packages, and the other health care policy issues the next administration will face. Also last week, the National Association of Medicaid Directors published a letter it sent to Secretary Azar asking that the United States Department of Health and Human Services work with states and stakeholders to develop a set of publicly reported metrics to inform future decisions around the Public Health Emergency (PHE). In a companion blog post, NAMD explains how uncertainty around the extension of the PHE is driving the budget decisions of Medicaid directors at a time when states are struggling with significant deficits.


COVID-19 State Updates: AZ, CA, CO, DE, NE, NC, NJ, PA & RI

  • Arizona
    • Governor Doug Ducey announced $7 million to expand available rental assistance and help keep people in their homes. The funding comes from the Crisis Contingency and Safety Net Fund, established in March through a bipartisan state budget agreement that added $50 million for Arizona’s COVID-19 response.
    • The Arizona Health Care Cost Containment System, the state’s Medicaid program, received federal approval from the Centers for Medicare & Medicaid Services to increase Arizona hospital reimbursement rates by more than 30 percent to help stabilize health care providers. The Hospital Enhanced Access Leading to Health Improvements Initiative (HEALTHII) will result in a net increase in payments to eligible Arizona hospitals of approximately $800 million in the first year of implementation, a more than 30 percent effective rate increase over current reimbursement rates.
  • California – Governor Gavin Newsom announced that a West Sacramento hotel will now provide permanent supportive housing for individuals experiencing homelessness through a Homekey award as part of the seventh and final round of funding. The final round of funding totals $129.6 million awarded to nine jurisdictions for 17 projects totaling 982 units. To date, more than $835.6 million has been awarded to 48 jurisdictions for 93 projects totaling 6,055 units.
  • Colorado – The Department of Health Care Policy & Financing announced the distribution of nearly $600,000 in advanced payments to primary care providers known to have experienced revenue loss as a result of the COVID-19 PHE. The advanced payments were made possible through donations of $1.925 million from a unique partnership with the Colorado Health Foundation, Caring for Colorado Foundation, Delta Dental of Colorado Foundation, Rocky Mountain Health Foundation, and Rose Community Foundation. The state is able to draw down federal matching funds, bringing the total funds to $3.63 million. A second round of payments is planned prior to the end of the PHE in January.
  • Nebraska – Governor Pete Ricketts announced additional financial assistance for long-term care (LTC) facilities as they serve Nebraskans during the coronavirus pandemic. Nebraska is allocating another $15 million to help nursing homes and assisted-living facilities cover additional costs they’ve incurred during the pandemic. The state is applying to the federal government to match these funds with $25 million to provide a total of $40 million of new financial assistance for LTC facilities in Nebraska.
  • North Carolina – The North Carolina Department of Health and Human Services (NCDHHS) launched an online portal for primary care providers to request reimbursement for COVID-19-related costs for individuals without insurance. Primary care providers can receive $150 for each in-person or telehealth visit of eligible COVID-19-related care for uninsured individuals living in North Carolina. NCDHHS is reimbursing providers on a first-come, first-served basis for up to $7.8 million in total support. Funds are available through December 30, 2020, or until they’ve been spent.
  • Pennsylvania – Governor Tom Wolf announced that nearly $20 million is now available to assist Pennsylvanians currently experiencing homelessness. Under a new grant program called ESG-CV Code Blue, applicants may apply for funding for emergency shelter and temporary emergency shelter to expand shelter for those experiencing homelessness. The program will prioritize the use of these funds to assist homeless providers and communities prepare for, prevent the spread of, and respond to COVID-19 through the use of emergency shelter and temporary emergency shelter components.
  • Delaware, New Jersey, and Rhode Island – Delaware Governor John Carney, New Jersey Governor Phil Murphy, and Rhode Island Governor Gina Raimondo announced that their states will be working together on asymptomatic COVID-19 testing. Together, they identified priority populations for asymptomatic testing, outlined key strategies for testing in those populations, and developed an approach to financing the benefits and necessity of testing. These populations include, but are not limited to, skilled nursing and assisted-living populations, other congregate settings, immunocompromised individuals, workers with high-exposure risk, people experiencing homelessness, and asymptomatic people with known exposure.


Other State Updates: GA, NE, OR, PA, VA & WA

  • Georgia – CMS announced its approval of the state’s Section 1332 waiver for a reinsurance program beginning plan year 2022 and transitioning the state’s individual market from the federally facilitated exchange to a private sector platform called the Georgia Access Model beginning in Plan Year 2023. State Health and Value Strategies (SHVS) has updated its map of Section 1332 waiver activity to reflect this development.
  • Nebraska – Governor Pete Ricketts announced the appointment of Kevin Bagley as the new Director of the Division of Medicaid and Long-Term Care at the Nebraska Department of Health and Human Services.
  • Oregon – The Oregon Health Insurance Marketplace is estimating that thousands of Oregonians may be newly eligible for help paying for health insurance and is reminding residents to visit to check if they qualify for financial help.  
  • Pennsylvania – The Pennsylvania Department of Aging hosted the 2020 Alzheimer’s Disease and Related Disorders (ADRD) Forum. This year’s forum focused on racial disparities and inequalities in early detection, diagnosis, and treatment. It opened with messages from Governor Tom Wolf and Secretary of Aging Robert Torres, both of whom emphasized the need to address the higher risk of Alzheimer’s disease and other dementias in ethnic communities.
  • Virginia – Governor Ralph Northam signed Senate Bill 5038 and House Bill 5043, which establish a statewide mental health awareness response and community understanding services alert system. These measures promotes a behavioral health response to individuals in crisis, including by limiting the role of law enforcement, and is named after Marcus-David Peters, who was killed by a police officer while experiencing a behavioral health crisis in 2018.
  • Washington – The Washington Health Benefit Exchange, the state-based exchange, announced that since Nov. 1, over 182,000 Washingtonians have signed up for 2021 coverage, including about 2,400 new customers. Among the new customers, 30 percent have selected new Cascade Care plans. These plans offer deductibles that are on average $1,000 less than other plans and cover more services prior to meeting a deductible, including primary care visits, mental health services, and generic drugs.


Webinar: Screening for Social Risk Factors Part II

Monday, Nov. 16, 2020, 3:00 to 4:00 p.m. EST

This webinar is the second in a two-part series highlighting two issue briefs recently published by SHVS for state officials on screening for social risk factors. This second webinar will share findings from Developing a Social Risk Factor Screening MeasureStates are increasingly requiring their Medicaid managed care organizations and accountable care organizations (ACOs) to screen for, and address, social risk factors in their populations. As they do so, some are seeking to hold their contracted plans and ACOs accountable through performance measurement. This webinar will examine the steps to create and implement such a measure, drawing on the experiences of Massachusetts, North Carolina, and Rhode Island profiled in the recently published issue brief.

Registration (required) at the following link:


Changing Trends in a Widening Drug Death Epidemic

The State Health Access Data Assistance Center (SHADAC) is hosting a webinar on Nov. 10 at 2:00 p.m. EST that will analyze and discuss changes in overdose deaths in recent years, especially in 2018. For nearly two decades, the United States has experienced a growing epidemic of drug overdose deaths. But even by standards of the rapidly evolving opioid crisis, mortality data from 2018 illustrate a stark transformation: while the U.S. recorded rare declines in death rates from prescription opioids and heroin, overdose deaths from synthetic opioids continued their rise. The year also highlighted the dramatic ascent of emerging substances in the changing crisis, as overdose death rates from cocaine and psychostimulants (e.g., methamphetamine) reached record highs and outpaced overdose deaths from prescription opioids. Using the latest available data, Senior Research Fellow Colin Planalp will detail changing trends—both in terms of substances and subpopulations of concerns—across the nation and among the states. Mr. Planalp will also be joined by SHADAC Research Fellow Robert Hest, who will explain how to access, and use, the data on opioid-related overdose deaths through the SHADAC State Health Compare website.

Melding Health and Equity in Rural Places

The Aspen Institute is hosting the fourth Rural Opportunity and Development Session virtual exchange on Nov. 10 at 3:00 p.m. EST. The ROAD Sessions highlight and unpack rural development ideas and strategies that are critical in response to COVID-19 and to long-term rebuilding and recovery. The topic of the upcoming session is melding heath and equity in rural places and will explore how rural health care systems can support economic development and healthy communities. Some rural health professionals are transforming the way they work and increasing opportunity by integrating other components critical to better livelihoods—such as preventative wellness, community agriculture, and economic development action—and focusing on those with lower incomes and in communities of color. The session will also discuss how new data tools are making it possible to quantify and visualize health equity disparities within communities.


Supporting Children and Youth with Special Health Care Needs During COVID-19

Manatt Health hosted a webinar, in partnership with the American Academy of Pediatrics, Family Voices, and the Georgetown University Center for Children and Families, that explored how state Medicaid agencies can make permanent the temporary regulatory flexibilities that have expanded access to services for children and youth with special health care needs during the pandemic. Children who receive health services in school settings to support their education are losing access to those services as schools limit—or eliminate altogether—in-person instruction as a result of COVID-19. In addition, a pre-COVID-19 shortage of home health providers has worsened due to the pandemic, placing a significant burden on families who rely on home health services or who choose, for safety, not to have home health providers come into their homes. The result can be gaps in care and caregiver burnout, putting children and youth with special health care needs at risk of regression and long-term negative health outcomes. The webinar explored opportunities for collaboration between state agencies, providers, schools, and families to improve access to services, and discussed how to address loss of services as a result of school closures, among other topics.