This annual report from the Center for Connected Health Policy (CCHP) is the most current guide of Medicaid provider manuals, state laws, and regulations for telehealth in all 50 states and the District of Columbia.  Key findings this year include reimbursement for some form of live video in all states and DC, and 22 states with reimbursement for remote patient monitoring.  The report includes an interactive map of policies as well as an at-a-glance infographic.  Click here to access the guide.

Harrisburg, PA – On October 18, 2019, Pennsylvania Department of Human Services (DHS) Secretary Teresa Miller joined the Center of Excellence (COE) Regional Learning Network to meet with COEs in Central Pennsylvania and hear directly from their employees about the successes and challenges of fighting the opioid epidemic. Since 2017, Pennsylvania’s 45 COEs have expanded access to and improved engagement in treatment to more than 20,500 Medicaid recipients around Pennsylvania.

“It goes without saying that our goal is to save lives and help people get the treatment they need to live healthy lives,” said Secretary Miller. “We want to be sure we are doing everything we can to fight the opioid epidemic and give people the resources they need to be successful in recovery, and the COE model is making that possible for more Pennsylvanians.  We know, though, that there is still more work to be done. The Regional Learning Network gives us the opportunity to learn from COE employees since they are hearing directly from the people we are helping and can help inform our response to the opioid crisis moving forward.”

Prior to the COEs, as few as 48 percent of Medicaid beneficiaries diagnosed with opioid use disorder were receiving treatment. Of those, only 33 percent remained engaged in treatment for more than 30 days. Today, more than 70 percent receive treatment after being diagnosed with an opioid use disorder, and 62 percent remain in treatment for more than 30 days.

The Regional Learning Network is made up of representatives from each COE in a region. The networks meet regularly to determine best practices for addressing the opioid epidemic. Each year, all of the Regional Learning Networks come together for a Statewide Learning Network to share and explore best practices.

COEs provide treatment that is team-based and whole-person focused, with a goal of integrating substance use disorder treatment, behavioral health, and primary care. The centers’ care managers work to keep people with OUD engaged in treatment by coordinating follow-up care and community supports. Their work confronts the most common barriers to treatment and provides vital support to maintain recovery.

COEs work as a hub-and-spoke network, with the designated center serving as the hub. The spokes can include primary care practices, the criminal justice system, emergency departments, social services providers, and other treatment providers and referral sources. With a commitment to educating the community, the COE team works to ensure health care, education, and law enforcement organizations can identify those who need treatment and refer them to the center.

For more information on the state’s efforts to battle the opioid epidemic, visit www.pa.gov/opioids.

Rural communities face many challenges to addressing Chronic Obstructive Pulmonary Disease (COPD), a condition affecting the lungs that is a major cause of death and disability in the United States.  This new toolkit from the Rural Health Information Hub provides a rural-specific overview of the disease and treatment, resources for implementing effective COPD programs, and models of programs that have proven effective in rural communities.  The toolkit can be accessed here.

According to the 2018 National Survey of Children’s Health (NSCH), one in three children under the age of 18 have experienced stressful or traumatic events that are strongly related to a wide range of health problems throughout a person’s lifetime.  The NSCH is an annual survey conducted by the Health Resources and Services Administration collecting information on several of these experiences, including:  having divorced/separated parents or a deceased parent, living with anyone with a drug or alcohol problem or who is mentally ill, having a parent who served time in jail, seeing or hearing parental violence, and witnessing or being the victim of neighborhood violence.  Last year, the National Advisory Committee on Rural Health & Human Services examined adverse childhood experiences from a rural perspective and made recommendations to federal policymakers.   The data can be accessed by clicking here.

The U.S. Department of Health & Human Services released a guide for clinicians on tapering or discontinuing long-term opioid prescriptions.  Individual patients, as well as the health of the public, benefit when opioids are prescribed only when the benefit of using opioids outweighs the risks.  But once a patient is on opioids for a prolonged duration, any abrupt change in the patient’s regimen may put the patient at risk of harm and should include a thorough, deliberative case review and discussion with the patient.  While rates of prescribing have declined in recent years, the Centers for Disease Control and Prevention reports data showing opioid prescribing rates have been significantly higher in nonmetropolitan counties than in metropolitan counties.  The Guideline can be accessed here:  New Guidelines for Long-Term Use of Opioids.

Pennsylvania Partnerships for Children’s (PPC) work leading the Pritzker Children’s Initiative Prenatal-to-Age-Three state planning grant continues, with a full policy agenda expected by the end of the year.

The leadership team of the initiative recently traveled to Atlanta with the nine other states and the District of Columbia who are part of the planning grant process. The PA team was joined by various state officials, showcasing the partnership of advocates and the administration in this initiative. The group worked on refining the policy agenda and compared notes with Pritzker and other states on best practices moving forward.

Currently the agenda is comprehensive and ranges in topic from child care to prenatal/maternal health, and from home visiting to children’s health, including lead exposure, nutrition, insurance coverage and infant and toddler mental health.

Keep an eye out in the next few weeks, as our subgroups will continue meeting to finalize the agenda and the full table of advocates and state partners will meet again in person in November. In the meantime, PPC is partnering with the United Way of Pennsylvania to conduct a series of community engagement events throughout the state to gather parent and provider input. Next up on the calendar is an event in Johnstown on November 7, 2019.

At the conclusion of the planning grant process, PPC will be eligible to apply for an implementation grant to execute the policy agenda currently being developed. Of the ten states in the planning process, up to five will be selected for this phase of the work. We will keep you posted on our progress as we move closer to early 2020!

Did you know children are the most undercounted group in the census? In fact, 10 percent of all children under age 5 were missed in the 2010 Census. Pennsylvania Partnerships for Children (PPC) is the sole voice for young children in both the Keystone Counts coalition and as an affiliate of the Pennsylvania State Data Center, which is represented in the governor’s Complete Count Committee.

In the coming weeks and months, PPC will be producing a variety of print and digital deliverables our partners can use to get the word out the importance of a complete count and the serious consequences that would result from an undercount of young children.

In the meantime, check out these resources to help you with your advocacy efforts. You’ll find helpful fact sheets in English and Spanish, data and statistics, and more!

Harrisburg, PA – On October 9, 2019, Pennsylvania Governor Wolf’s Administration announced that, under the guidance of the Department of Human Services (DHS), it is expanding home visiting supports to first-time mothers and mothers of children with special needs covered by Medicaid. The expansion, made possible in collaboration with physical health Medicaid managed care organizations (MCOs), will guarantee at least two home visits to new parents and families with children with additional risk factors across Pennsylvania, expanding access to evidence-based models that promote and support healthy child and family development.

“There is no more important focus of my administration than giving all children and families a strong start,” Gov. Wolf said. “By expanding access to evidence-based home visiting programs, we will put more kids, parents and families on a path to a healthy, happy future.”

Since 2015, investments totaling nearly $16.5 million in state funds have helped increase the number of children and families who can receive home visiting supports in communities around Pennsylvania. Guaranteeing a minimum of two home visits to all first-time mothers and mothers of children with special needs through Medicaid continues this work.

“Being a parent can be a challenge for anyone,” said Secretary Miller. “Because children don’t come with an instruction manual home visiting programs create support systems for families to learn to better understand children’s needs, monitor milestones, and identify other opportunities for support that can continue to facilitate healthy long-term growth. A home visitor can be a major resource for parents to bond with their child(ren) and create bridges to success in early childhood and primary education.”

The home visiting expansion is effective January 1, 2020 through the MCOs’ 2020 agreement. Under the new agreements, MCOs will be required to establish an evidenced-based, standardized maternal, infant and early childhood home visitation program for all first-time parents and parents of infants with additional risk factors. All parents and children identified through this effort will receive at least two home visits at no cost, and depending on need, may be referred to other established home visiting programs to continue these services. DHS expects that these programs will be in place with eligible new parents receiving home visiting services s by July 1, 2020.

Evidence-based home visiting family support programs have a family-centered focus and strength-based approach that works with both the child and parent. A home visitor can help parents gain the skills and connect to resources necessary to improve their family’s health, safety, economic security, and success in early childhood education. Studies of various nurse-family partnership programs have shown positive impacts for the mother and baby during pregnancy and after birth, such as a decrease in domestic violence and smoking during pregnancy, a significant decrease in pre-term births, and a majority of babies being born at a healthy weight.

Home visiting can also improve parents’ child development knowledge and skills, help develop social support systems, and improve access to education, health, and community services. Examples of services include:

• Regularly scheduled home visits with trained family development specialists;
• Monthly parent meetings; and
• Routine screenings to identify post-partum depression and detect potential problems with vision, hearing, growth, and learning age-based milestone

Gov. Wolf is committed to helping the youngest Pennsylvanians. In September, his Ready to Start Task Force released its report, including two priorities tied directly to home visiting: to “increase availability of high-quality childcare and home-visiting service slots” and to “promote education, engagement, and support of parents and families as children’s first teachers.”

“This significantly expanded access to home visiting truly helps to fulfill our mission for increasing the ways to help our youngest residents get a strong, focused beginning,” Gov. Wolf said.

Read the Ready to Start Task Force report.

For more information on home visiting programs, visit dhs.pa.gov.

This toolkit from the National Academy for State Health Policy highlights state initiatives to help older rural adults age in place by increasing services that help people remain in their homes, expanding and professionalizing the caregiver workforce, and making delivery system reforms within Medicaid programs.  According to research referenced in the toolkit, more than 85 percent of older adults prefer to remain in their own homes and communities, and serving older adults in their homes is usually less expensive than housing people in facilities. This resource was funded by the Geriatrics Program in the Bureau of Health Workforce at the Health Resources and Services Administration.   The Toolkit can be accessed here.