Senators introduce ACA repeal legislation

On September 13, 2017, U.S. Senators Lindsey Graham, Bill Cassidy, Dean Heller, and Ron Johnson introduced legislation to scrap many provisions of the Affordable Care Act (ACA) while imposing funding caps on the traditional Medicaid program. The bill could become law under budget reconciliation rules that block a Senate filibuster. The bill could pass the Senate and House on a majority vote before September 30, 2017.

The non-partisan Congressional Budget Office (CBO) says that it can’t comprehensively analyze the bill’s potentially adverse impact on health insurance premiums and coverage until next month. Congress will be acting this month based on a preliminary CBO analysis expected to show long-term federal budget savings. [More]

Governors outline market stabilization strategy

On August 30, 2017, a bipartisan coalition of Governors issued a letter to Congress on steps needed to restore stability and affordability in coverage to 22 million Americans served through individual health insurance markets under the Affordable Care Act (ACA). The Governors’ letter sets the stage for testimony before a US Senate committee on September 7, 2017, by Massachusetts Governor Charlie Baker, Montana Governor Steve Bullock, Tennessee Governor Bill Haslam, Utah Governor Gary Herbert, and Colorado Governor John Hickenlooper. [More]

Upgrading Training in Child Welfare Agencies – Five Steps to Creating a Learning Organization

After the hiring process, training is the most important aspect in the development of a good case manager. Training is understood to be an important first step by management of administration in understanding the philosophy of child welfare and child protection, the policies and practices of the agency, and the functions necessary to become an effective and efficient case manager.
There are many moving parts to consider when implementing a successful training program. Child protection, child welfare, the clients, the agency’s operation, the laws, technology, paperwork, and stakeholders are not just complicated individually, but collectively such considerations can be overwhelming.
After the hiring process, training is the most important aspect in the development of a good case manager. Training is understood to be an important first step by management of administration in understanding the philosophy of child welfare and child protection, the policies and practices of the agency, and the functions necessary to become an effective and efficient case manager.
There are many moving parts to consider when implementing a successful training program. Child protection, child welfare, the clients, the agency’s operation, the laws, technology, paperwork, and stakeholders are not just complicated individually, but collectively such considerations can be overwhelming. [More]

CMS proposes reductions in Medicaid allotments to states for hospitals’ uncompensated care

On July 28, 2017, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule to implement $43 billion in reductions in federal Medicaid allotments to state Medicaid agencies for payment adjustments to hospitals serving a disproportionate share of low-income persons. The reductions in such allotments under the proposed rule will apply to federal fiscal years 2018-2025. Reductions nationwide will start at $2 billion in FY 2018 and will reach $8 billion per year in FY 2024 and FY 2025. [More]

U.S. District Court in Connecticut certifies nationwide class of Medicare beneficiaries in challenge to “observation status”

On July 31, 2017, the U.S. District Court for the District of Connecticut certified a nationwide class of Medicare beneficiaries who desire to challenge their placement on “observation status” during their hospital stays. Alexander v. Price, No. 3:11-cv-1703 (D. Conn. July 31,2017).

The plaintiffs in this long-running action argue that the decision to categorize Medicare beneficiaries as outpatients on observation status rather than inpatients should be subject to administrative review. Currently, Medicare does not allow beneficiaries to appeal this determination. [More]

National Academy of Medicine outlines strategies for high-need patients

On July 6, 2017, the National Academy of Medicine released a valuable report entitled, “Effective Care for High-Need Patients: Opportunities for Improving Outcomes, Value, and Health.” The report describes key characteristics of high-need patient populations, tools that can be adopted to identify evidence-based models of care for them, and strategies to promote successful implementation of such models in collaboration with a broad range of stakeholders at the federal, state, and community level. It stresses the importance of behavioral health issues, social determinants of health, and community-based supports for high-need patients who often struggle at home with functional limitations associated with aging, disabilities, and a wide range of long-term diseases examined in the report. [More]

House Ways and Means introduces legislation supporting Welfare to Work

On June 8, 2017, bipartisan legislation was introduced to support low-income Americans as they transition out of welfare and into the workforce. The legislation – entitled the “Accelerating Individuals into the Workforce Act (H.R. 2842)” and sponsored by Reps. Carlos Curbelo (R-FL) and Danny Davis (D-IL) – is intended to expedite the time it takes for families to obtain employment. In the opening statement by Ways and Means Committee Chairman Kevin Brady (R-TX), Brady cited the Bureau of Labor Statistics, which indicates that despite job openings at the highest level since the government began tracking in 2000, the labor force participation rate is at a near forty-year low. [More]

NGA calls for Congressional action on CHIP renewal

On May 11, 2017, the National Governors Association (NGA) released a letter to the Senate Finance Committee and the House Committee on Energy and Commerce calling for Congressional action to renew funding for the Children’s Health Insurance Program (CHIP) for five more years. The letter is signed by Virginia Governor Terry McAuliffe, NGA Chair, and Massachusetts Governor Charlie Baker, NGA Vice-Chair for Health and Human Services. [More]

Disrupting the school-to-prison pipeline with trauma-informed, school-based diversion programs

When schools practice harsh discipline and remove students from the school (e.g., through out-of-school suspensions, expulsions, arrests for minor offenses, etc.), it can lead to students’ involvement with the juvenile justice system. This school-to-prison pipeline disproportionately affects minority students, students with mental illnesses and behavioral issues, students with disabilities, and students with histories of abuse and neglect. [More]

Rural Areas – Sometimes It’s the Distance, Not the Journey

Providing services to children and families has always been a challenging and complex problem. Through agencies, these services are often contracted to local providers. Distance, travel, and method of transportation have always been a further complicating factor, especially in rural areas. As an Indiana governor suggested – “identify a problem, fix a problem, don’t embrace it.” [More]