AzPHA Public Health Policy Update- November 2, 2017

ASU’s Executive Fellowship in Health Policy Accepting Applications

ASU’s College of Nursing and Health Innovation has developed a new fellowship program for health professionals interested in policy and advocacy and is taking applications through November 30th. The Executive Fellowship in Health Policy is a one-year cohort-based program, providing health leaders in-depth insights into the public policy world. Fellows will build connections and skills enabling them to lead change within their organizations to advocate for the work that they do and the populations they serve.

Fellows will also learn about health policy directly from the people who shape it. Through in-person immersions, webinar presentations, and online modules, lawmakers and health advocates from around the country will provide an intimate look at the politics and policy changes actively shaping our health systems today. Faculty mentors will guide and support Fellows to further develop their skills as effective health advocates through the creation of a tangible project based on a real-world situation from their organization.

The program has been developed by Faculty Director and Assistant Dean Heather Carter, EdD. Her vision for this new program is to empower health professionals to be more involved in the health policy arena. In addition to her work at ASU, Dr. Carter serves as an Arizona State Representative & Chairwoman of the House Health Committee.

The program is currently accepting applicants through November 30, 2017. Program tuition is $16K for the year, plus travel expenses for two in-person immersions located in Phoenix, AZ and Washington, D.C.

More information about the Fellowship and the application process can be found at efhp.asu.edu, or by contacting the project manager at efhp@asu.edu or 602-496-0414.

 

North Country HealthCare Receives Accreditation for Residency Program

Congrats to North Country HealthCare for achieving final accreditation last week from the Accreditation Council for Graduate Medical Education for their Family Medicine Residency Program.  The new program will improve access to comprehensive, affordable, culturally competent primary care across northern Arizona by increasing the number of practicing primary care physicians for years to come.

The program will engage family medicine residents in rotations throughout North Country HealthCare’s service region of Coconino, Mohave, Navajo and Apache Counties with rural rotations in Tuba City, Polacca and Whiteriver.

This novel residency program will help prepare family medicine physicians for autonomous practice in rural and frontier northern Arizona and will be the only graduate medical education program in the country with a required rotation in Indian Country.

A huge shout out to AzPHA member and NAHEC Executive Director Sean Clendaniel, MPH who’s the brain-child and work-horse behind the effort. Next we need to replicate the model in other areas of rural AZ. 

We all know that we have an acute physician shortage in rural AZ- and rural residency programs are probably the single most effective long-term tool we have to intervene- because where a physician does their residency has a huge impact on where they decide to practice.

 

Open Enrollment for Marketplace is Here through December 15

Open enrollment for the Marketplace insurance plans under the Affordable Care Act started today and runs through December 15.  We're recommending that folks that are interested in getting their health insurance through the federal Marketplace by going to  coveraz.org/connector first (rather than healthcare.gov) because the assisters and navigators at coveraz.org/connector are more familiar with the AZ products as well as our state's Medicaid programs.

Make sure everyone who needs coverage knows this: a convenient assister appointment is just clicks away, at coveraz.org/connector or by calling the Coalition’s statewide assistance line at 800-577-3536.

 

CMS Proposes New Rule Letting States Define their Own “Essential Health Benefits”

Late last Friday the Centers for Medicare and Medicaid Services released a proposed rule that would allow states to define the minimum essential health benefits that health insurers selling plans on the Affordable Care Act exchanges are required to offer. 

The proposed rule would give states greater latitude in choosing which benefits insurers must cover.  Perhaps most significantly, it would allow states to choose a benchmark plan from wider pool of existing plans including health plans from other states. Each state’s “benchmark plan” defines what essential benefits other Marketplace plans must cover. Right now, Governors choose each state’s benchmark plan from a list of existing state plans in various categories.  Governors Brewer & Ducey each chose the State of Arizona EPO Employee Health Plan as Arizona’s benchmark.

CMS' stated goal is to give states more flexibility that could potentially lead to more affordable health plan options in 2019. They concede the changes some states will make will result in less comprehensive plans and dropped services.

The ACA requires health plans on the individual and small group markets to cover 10 minimum essential health benefits including emergency services, hospitalization, prescription drug coverage, maternity care and care for mental health and substance abuse disorders.  What this new proposal essentially does is allow states to weaken (but not eliminate) the 10 essential services. The proposal bars states from making their essential health benefits more generous than they are currently.

For example, if the new rule is implemented, states could choose an employer plan with 5,000 enrollees that excludes inpatient mental health services or coverage for HIV or AIDS as their benchmark- and that plan would be considered OK.

The proposed rule is almost 400 pages long.  AzPHA is planning to work with other stakeholders in Arizona and coordinate comments to CMS on their proposed rule.

 

House Vote this Week Would Cut the Prevention & Public Health Fund

This week the U.S. House will be voting on a bill that will cut critical funding from the Prevention and Public Health Fund to offset the cost of funding community health centers and other important health programs that have expired.

Established in 2010 as the nation’s first funding stream dedicated to improving public health, the Fund invests over $9 million per year to protect Arizona from disease outbreaks and to reduce downstream health care costs.  We wrote a report that examines the Fund’s investments in Arizona, which include immunizations, smoking cessation, diabetes prevention, opioid treatment, and more.

While AzPHA supports reauthorizing funding for community health centers and the National Health Service Corps, we don’t support doing it at the expense of the prevention fund and the important public health programs that already depend on this funding.

Take the time to contact your representative and tell them to oppose the CHAMPION Act and any future effort to undermine the integrity of the Prevention and Public Health Fund!

 

HHS Acting Secretary Declares Opioid Epidemic a Public Health Emergency

Last week the Acting Secretary for HHS declared that the national opioid epidemic is a Public Health Emergency under Section 319 of the Public Health Service Act. Here’s the Secretary’s one sentence declaration.

Section 319 authorizes the HHS Secretary to lead federal public health and medical response to public health emergencies, determine that a public health emergency exists, and assist states in their response activities.

The Secretary’s declaration was only one sentence long- so there’s not much detail about what they might do, but among the things that HHS could do are: 1) waive or modify certain requirements under Medicare, Medicaid and HIPAA; 2) waive certain prescription and dispensing requirements; and 3) adjust Medicare reimbursement for certain Part B drugs.

The most meaningful things that they could do include;

  • Removing the Medicaid Institutions for Mental Diseases (IMD) exclusion to allow facilities to receive reimbursement for substance abuse treatment (the IMD exclusion prohibits the use of Medicaid financing for care provided to most patients in residential treatment facilities larger than 16 beds);

  • Allowing Medicaid to pay for substance abuse treatment in correctional facilities; and

  • Allowing physicians to treat more patients with Suboxone.

Right now we don’t know which if any of these things HHS will choose to do because they haven't disclosed their plans and the one sentence emergency declaration provides no detail.