Archive for: West Virginia

The State of State Health Policy: Governors’ 2016 State of the State Addresses

February 22, 2016/in Policy Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, New York, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming Charts Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Healthy Child Development, Maternal, Child, and Adolescent Health, Medicaid Expansion, State Insurance Marketplaces /by NASHP Staff

State of State speeches provide governors with an opportunity to highlight recent policy successes as well as outline key plans and issue areas of focus for the coming year. These speeches are generally strong indicators of governors’ main priorities and sometimes also include specific proposal suggestions and funding recommendations for deliberation by legislatures.
Currently, 31 governors are Republican, 18 are Democrats and one is an Independent. Two states—Kentucky and Louisiana—elected new governors in 2015. So far this year, 40 governors have outlined policy priorities through state of state speeches and/or budget addresses.[1] The chart and descriptions below summarize some of the main health-related themes from these speeches.
See a state-by-state comparison

Six governors mentioned the issue of more broadly addressing population health and building healthy communities.

Alabama	Launching Great State 2019 Plan in honor of state’s upcoming 200th birthday; initiative will focus on addressing longstanding problems from healthcare to prison reform and will involve building opportunities for citizens, and promoting education, healthcare, access to technology, job growth and economic opportunity
Colorado	Highlighted poverty’s negative effects and mentioned state’s Two Generation initiative to address poverty that links with the state’s efforts to be the healthiest in the nation; initiative recognizes that residents’ health has economic and overall quality of life impacts; also importance of reducing children’s screen time and the need to promote healthier behaviors such as involvement in outdoor activities
Hawaii	Will be investing in issue of homelessness, which will include addressing the needs of the most vulnerable homeless, such as those with chronic health conditions
Illinois	Need to make more coordinated investments and transform towards focusing more intensely on prevention and public health and paying for outcomes rather than volume and services
New Hampshire	Noted that safe and healthy communities are the foundation of the state; to maintain the state’s high quality of life investments should continue in priorities that support economic growth
New York	Mentioned consumer health concerns regarding access to safe and healthy food and the need for meaningful food labeling

In addition to mentioning health care costs within the context of Medicaid, eight governors also spoke about state health care costs more broadly; often mentioning costs associated with state employee health benefits.

California	Noted that state has not allocated enough funding to cover future retiree health benefits for state workers
Delaware	Identified sharply rising health care costs as the state’s biggest challenge, particularly costs of state employee health plans; also importance of shifting from fee-for service health care to a system focused on high quality and affordable outcomes, and ensuring that individuals appropriately use care to help reduce overall costs
Georgia	Commented on the rising costs of mandated health care expenditures for state employees
Hawaii	Mentioned state employee health care obligations as one of the state’s biggest fixed expenses, but recent changes to how these obligations are funded will save costs in the future
Louisiana	Noted state budget crisis and need for new revenue to avoid severe cuts in assistance programs for disabled individuals and other health programs and potentially having to close safety net hospitals
Pennsylvania	Noted that if state does not address $2 billion budget deficit will have to make significant cuts to basic state services, including health programs such as prescription drug assistance for seniors, services for individuals with mental illness and disabilities, and home and community-based services
Vermont	Mentioned the rising cost of health care as the most significant challenge to the state’s budget and the overall economy as well as creates challenges for families and businesses; noted state’s current work to shift from fee-for-service to an all-payer model focused on better health outcomes and targeted provider spending
Wisconsin	Commented on the need to reform the administration of state employee health insurance to achieve savings

Alaska	Mentioned commitment to implement Medicaid reforms to improve the state’s Medicaid program
California	Noted positive benefits of state’s Medicaid program but that there has been a significant rise in state Medicaid costs; requests legislature consider proposal to restructure taxes on Medicaid managed care organizations
Georgia	Commented that state Medicaid costs have increased from $2.6 billion in FY2013 to $3.1 billion in FY2017
Iowa	Mentioned plans to move to a Medicaid managed care system to improve care coordination and address significantly rising state Medicaid costs
Kansas	Recent reforms and modernizations to Medicaid program have demonstrated cost savings and also resulted in more client services and increased provider reimbursement rates
Missouri	Access to in-home Medicaid services for individuals with developmental disabilities has significantly improved
Nebraska	Noted significant rise in state Medicaid costs
Tennessee	Highlighted the success of TennCare as a well-run system with high customer satisfaction ratings

In total, 17 governors mentioned the issue of Medicaid and/or Medicaid expansion in their speeches. Specifically, 11 governors provided general comments about their states’ Medicaid programs in their remarks, such as commenting on recent program improvements or the growth of overall program costs. Thirteen governors mentioned Medicaid expansion in their speeches. Eight were governors that have not implemented expansion, and five of these governors spoke about the need to expand Medicaid or find another state-specific solution to cover the uninsured (Missouri, South Dakota, Utah, Virginia, and Wyoming). Two governors (Kansas and Nebraska) expressed continued opposition to expansion. Kentucky’s newly elected governor mentioned plans to transform the delivery of publicly assisted health care and to make changes to the state’s traditional Medicaid expansion, although the proposed budget contains funding for expansion in its current form.

Alaska	Noted expansion has resulted in greater health coverage for residents and state has benefited from increased federal revenue from expansion
California	Mentioned expansion has resulted in greater health coverage for residents
Idaho	Highlighted the work of cabinet in exploring Medicaid expansion alternatives; also mentioned recently released plan to provide state-funded primary care
Indiana	Mentioned state’s unique expansion program has resulted in increased access to health care and is based on personal responsibility
Kansas	Noted continued opposition to implementing expansion
Kentucky	Mentioned plans to transform delivery of publicly assisted health care and to make changes to the state’s current Medicaid expansion; proposed budget contains funding for current expansion
Missouri	Suggested state should act to cover the uninsured through expansion; can develop a state-tailored solution that rewards work and incorporates personal responsibility
Nebraska	Noted continued opposition to implementing expansion
New Hampshire	Urged legislators to support continuation of the Health Protection Program, the state’s Medicaid expansion program, which has increased access to behavioral health services but will end in December 2016 without legislative action
South Dakota	Noted opposition to ACA but importance of considering expansion to make the best decisions for the state; current negotiations with federal officials to change reimbursement process for services provided to Indian Health Services enrollees could cover the state’s expansion costs; will not move forward on expansion without legislative budget authority or if any new general funds are needed; also detailed how cost projections for the expansion population were developed; encouraged any expansion legislation to include language to end expansion if the federal match is reduced
Utah	Noted flaws of ACA but urged legislators to find a state-tailored solution to covering the uninsured
Virginia	Urged legislators to consider Medicaid expansion through a bipartisan, state-tailored solution
Wyoming	Noted opposition to ACA overall but that state should craft tailored expansion plan; commented on loss of federal revenue from not expanding affecting hospitals and businesses, and uninsured individuals lacking coverage; cited many organizations that support expansion (e.g. state business alliance and chambers of commerce)

Two governors spoke about the topic of the ACA’s exchanges in their speeches.

Kentucky	Mentioned plans to cease operations of the state’s exchange, Kynect, and that individuals will enroll through the federal exchange
Massachusetts	Noted improvements in eligibility determinations and access to the state’s Health Connector in the past year

Health issues related to mental health and substance use disorders were the most commonly cited by governors in their speeches, with 26 governors mentioning these issues in some way. Governors’ frequently highlighted strategies that have been implemented or that they plan to implement to increase access to behavioral health services.

Arizona	Highlighted the issue of drug addiction; plans to convene a group of experts on substance abuse issues, recovering addicts and providers to identify appropriate treatments and reduce barriers to care
Colorado	State is working to improve access to mental health care through State Innovation Model project; also plans to address links between suicide, mental illness and guns
Delaware	State has significantly increased access to substance use treatment and is working with law enforcement to address overdoses; budget includes funding to provide team-based care for individuals in need of intensive treatment services; also plans for the Department of Health and Social Services to work with primary care providers to identify substance abuse issues earlier
Hawaii	Mentioned behavioral health issues as the underlying cause of many social, health and economic challenges and that mental health is the most pressing unmet health issue facing the state
Idaho	Local behavioral health crisis centers have been effective; proposed budget includes funding for an additional center
Indiana	Need to increase treatment options for drug addiction; will create task force on enforcement, treatment and prevention; also plans to build the first new mental health hospital in a generation
Missouri	Highlighted the importance of addressing the needs of individuals with severe mental illnesses; will be launching a crisis prevention program for individuals ages 21 to 35 with severe mental illnesses and substance use disorders
New Jersey	Recent passage of state laws that increase access to substance abuse treatment; state still needs to “double down” on drug addiction and to treat it as an illness; committed to providing $100 million to improve access to mental health and substance use treatment by providing higher reimbursement rates for services and providers; plans to increase funding for three Accountable Care Organizations focused on providing coordinated physical and behavioral health treatment for Medicaid patients
Oklahoma	In the past five years the highest amount of funding in the state’s history has been provided for mental health; legislation was passed to reduce prescription drug and substance abuse fatalities
Washington	Recent investments of over $700 million in the state’s mental health system to restore prior service cuts, but additional focus on the issue is still needed; proposed budget includes funding directed towards building a stronger mental health system
West Virginia	Substance abuse has become one of the most significant challenges in the state; have invested in treatment services and resources to publicize services, updated prescription drug monitoring efforts, and implemented other measures to reduce the oversupply of pain medication

Health issues related to mental health and substance use disorders were the most commonly cited by governors in their speeches, with 26 governors mentioning these issues in some way. The issue of heroin and other types of opioid abuse and overdoses were specifically mentioned by a number of governors in their remarks.

Indiana	Recently passed state law allowing healthcare providers to make an antidote available to address opioid overdoses and to allow Medicaid to cover inpatient detoxification
Kentucky	Plans to address heroin and opioid addiction; proposed budget includes funding for treatment programs and continuation of efforts to monitor prescription drugs
Maryland	State is working to address heroin and opioid addiction through a state-level task force
Massachusetts	Legislation being developed to address the heroin and opioid abuse epidemic by building capacity in prevention, education, and treatment efforts
Missouri	Need for a prescription drug monitoring program to address the opioid abuse epidemic
New Hampshire	State has worked to address the heroin and opioid abuse crisis but the issue remains the most urgent public health and public safety concern; efforts are underway to strengthen the state’s prescription drug monitoring program and improve access to treatment, but need further funding for law enforcement and efforts to strengthen prevention, treatment and recovery initiatives
New Jersey	Plans to launch a treatment intervention pilot program for individuals recovering from drug overdoses; individuals in recovery will help lead the intervention programs
Rhode Island	State views opioid overdoses as a public health crisis; aiming to reduce overdoses by one-third in the next three years by investing in treatment, overdose reversals, prevention and recovery
West Virginia	State has coordinated trainings for first responders on administering Narcan, an antidote for opioid overdoses; plans to introduce legislation to expand access to Narcan without a prescription
Vermont	Proposing funding to make a pilot program for overdose drug naloxone permanent; also funding for needle exchange programs, additional state staff resources and to develop a new treatment hub

Health issues related to mental health and substance use disorders were the most commonly cited by governors in their speeches, with 26 governors mentioning these issues in some way. Governors spoke about the issue of behavioral health within the context of better addressing the needs of justice-involved individuals, and providing mental health and substance use treatment services rather than incarceration when appropriate.

Arizona	Will be focusing on providing drug treatment and counseling to justice-involved individuals to help reduce recidivism
Georgia	Mentioned justice reforms have diverted justice-involved individuals with substance use disorders to treatment rather than incarceration when appropriate
Illinois	Bipartisan commission to reform the criminal justice system recommended enhancing cognitive behavioral therapy and substance abuse treatment programs in the corrections system
Iowa	As part of the state’s justice policy reforms, will be focusing on rehabilitation instead of incarceration and on looking at funding models for drug and mental health courts
Missouri	Proposing $1.6 million to reduce the number of severely mentally ill individuals cycling through jails and emergency rooms and to direct them to treatment instead
New Jersey	With reductions in the state’s prison population, one of the correctional facilities has been closed and will be converted into a certified drug abuse treatment facility for justice-involved individuals
New Mexico	Importance of addressing the behavioral health issues of justice-involved individuals; proposed budget includes funding for new crisis triage centers, mobile crisis response teams, and community behavioral health clinics
South Dakota	State has significantly increased the number of drug and DUI courts; more non-violent justice-involved individuals are receiving community treatment rather than being incarcerated
Tennessee	State has increased the number of drug recovery courts, resulting in reduced incarceration costs; proposing to invest more in these courts in order to offer services in all counties
Washington	Need to address issue of individuals with severe mental illnesses who cycle between jails and emergency rooms; proposed budget includes funding for four new 16-bed crisis triage facilities and three new mobile crisis teams

Five governors noted issues related to the health care workforce, primarily commenting on strategies to address shortages.

Alabama	Mentioned physician and dentist shortage in nearly all of the state’s counties, and outlined plans to increase funding for medical scholarships and loan forgiveness for students committing to serve in underserved areas; also aims to create tax credits for rural providers and increase funding for 12 new residency programs
Delaware	Noted that programs to train individuals in the health care field are expanding
Idaho	Commented on need to address state’s lack of primary care physicians by maintaining funding for physician residency slots and providing medical loan reimbursement; also requests that the Board of Education work with the medical community and higher education institutions to develop plans to address the growing need for healthcare providers
Mississippi	Mentioned current state legislation that would permit the state to enter into a compact with other states to allow medical licenses to be interchangeable across states
New Hampshire	Commented on how plans to expand employment training programs will help address healthcare workforce shortages; a task force will focus on developing innovative solutions to further address these shortages

Some governors mentioned other specific health topics in their speeches, either as recent accomplishments or as future plans. These included topics such as enhancements to autism coverage, improvements in health coverage eligibility determinations, or lowered prison pharmacy costs.

California	Mentioned that state will be providing health care coverage to children of undocumented workers; also state leads the nation in providing Medicaid home-based care, which also gives jobs to health care providers
Delaware	Noted plans to partner with a national nonprofit organization to improve access to contraceptive options by offering better training for health care providers
Hawaii	Mentioned that in recognition of the need for private sector resources for Maui’s public hospitals, recently transferred hospital management to Kaiser Permanente
Kansas	Will be forming a working group to address rural health care delivery issues
Michigan	Addressed the water crisis in Flint and proposes support for increasing children’s access to health care and treatment for health issues associated with elevated blood lead levels
Missouri	Highlighted passage of autism legislation to ensure that appropriate services are available through health plans; will expand services at existing autism centers and build a new center
Nebraska	Mentioned improvements at state’s Department of Health and Human Services have streamlined low-income residents’ access to nutrition assistance and other assistance programs
Tennessee	Mentioned that Department of Correction worked with TennCare to lower prison pharmacy costs annually by $5 million; proposed budget includes funding for a mobile seating and positioning unit in the Department of Intellectual and Developmental Disabilities
Wisconsin	Noting the importance of helping individuals cope with health and mental health care needs to retain workplace talent, mentioned a recently completed informational kit for employers to provide to employees caring for family members with dementia or Alzheimer’s disease

[1] In 2016, there will be no state of the state addresses in Arkansas, Montana, Nevada, North Carolina, North Dakota and Texas. As of mid-February 2016, the governors of Minnesota, Ohio and Oregon have not announced the date of their addresses. The governor of Maine did not have an address but instead submitted a letter on 2/8/16 to the state legislature.

Children’s Coverage Beyond CHIP: Policy Considerations for States

June 15, 2015/in Policy Florida, Kentucky, West Virginia Webinars CHIP, CHIP, Eligibility and Enrollment, Eligibility and Enrollment, Essential Health Benefits, Health Coverage and Access, Maternal, Child, and Adolescent Health, Medicaid Expansion, State Insurance Marketplaces /by NASHP

Date: Thursday, Jun 25, 2015
Time: 12:30 PM EDT

Download Webinar

Although federal funding for the Children’s Health Insurance Program (CHIP) was recently extended through FFY2017, it is unclear if CHIP will continue beyond that date. As a result, children may need to transition to other sources of coverage in the future. This two-year funding extension can provide state and federal policymakers with an opportunity to address important policy issues to ensure children continue to receive affordable and appropriate health care. Through this webinar, NASHP is bringing together a national expert and officials from three different state health and insurance agencies to surface issues and questions about the future of children’s coverage.
Some of the questions that will be explored on the webinar include:

What lessons from CHIP in terms of benefits and cost sharing could help inform efforts to reform other sources of coverage to better support pediatric health and developmental needs?
How can states ensure that coverage is affordable for families with children that transition from CHIP to exchange or other private market coverage? What policy options are available to prevent children from losing coverage due to affordability issues?
What are some of the possible approaches to address benefit or service gaps that children moving from CHIP to other sources of coverage might experience, particularly in terms of accessing dental coverage, habilitative services and for children with special health care needs?
What strategies can states implement to promote access to care and adequate pediatric provider networks, particularly for those in need of specialty care?

Anne Schwartz, Executive Director of the Medicaid and CHIP Payment and Access Commission (MACPAC), will kick off the discussion by sharing some of the key policy considerations the Commission has identified to maintaining accessible and comprehensive coverage for children in the future. Then Trish Riley, NASHP’s Executive Director will facilitate a discussion with three state officials—a CHIP director, an exchange official from a state operating a state-based marketplace, and a state insurance department representative from a state using the federally-facilitated marketplace—to explore challenges and potential policy solutions to ensuring there is appropriate, affordable pediatric and family coverage in the future.
Moderator: Trish Riley, Executive Director, NASHP
Background Presenter: Anne Schwartz, Executive Director, Medicaid and CHIP Payment and Access Commission (MACPAC)
State Speakers:

Carrie Banahan, Executive Director, Office of Kentucky Health Benefit Exchange (kynect)
Sharon Carte, Executive Director, West Virginia Children’s Health Insurance Program
Rich Robleto, Deputy Commissioner—Life & Health, Florida Office of Insurance Regulation

West Virginia – Medical Homes

April 1, 2014/in Policy West Virginia /by Medical Homes

The West Virginia Bureau of Medical Services (Medicaid) has actively partnered with the multi-stakeholder West Virginia Health Improvement Institute (WVHII) to promote medical home development. Recently, West Virginia completed a two-year Medical Home Performance Incentive Pilot developed by the WVHII’s Measurement Work Group. Three payers, including a Medicaid managed care plan and the state employee health plan, funded technical assistance to support NCQA Patient-Centered Medical Home recognition and participating practices were eligible to receive shared savings.
In January 2012, West Virginia was selected to join the North Carolina Infrastructure for Maintaining Primary Care Transformation (IMPaCT) Learning Community. As a part of this Learning Community, West Virginia was one of four states to receive technical assistance and guidance from North Carolina on how to develop a primary care support and quality improvement system. Through the IMPaCT initiative West Virginia created a shared vision for health care delivery in the state, described by stakeholders in a 2012 white paper. The white paper references medical homes as one possible strategy to support better health outcomes in the state.
Federal Support: West Virginia has received a planning grant from the Centers for Medicare & Medicaid Services (CMS) to develop a state plan amendment to implement Section 2703 of the Affordable Care Act (ACA), establishing health homes for Medicaid enrollees with chronic conditions. The state is working closely with the West Virginia Health Improvement Institute. Visit the Institute’s Health Homes webpage for more information about the planning process. To learn more about Section 2703 Health Homes, visit the CMS Health Homes webpage.
West Virginia is also participating in the Tri-State Child Health Improvement Consortium (T-CHIC), a CHIPRA Quality Demonstration Project funded by the Centers for Medicare & Medicaid Services (CMS), with Oregon and Alaska.
Last updated: April 2014

Forming Partnerships	The West Virginia Health Improvement Institute (WVHII), a partner of West Virginia Medicaid, provided a multi-stakeholder forum for development of the Medical Home Performance Incentive Pilot. The West Virginia Bureau of Medical Services is also leading a stakeholder advisory group for Affordable Care Act Section 2703 Health Homes that is open to all interested stakeholders. This advisory group includes four workgroups: Health Home Workgroup Community Care Coordination Workgroup Member Engagement Workgroup Measures and Outcomes Workgroup West Virginia participated in the North Carolina Infrastructure for Maintaining Primary Care Transformation (IMPaCT) Learning Community, where it was one of four states to receive technical assistance and guidance from North Carolina on how to develop a primary care support and quality improvement system. Through this project West Virginia built on partnerships developed through the WVHII to strengthen public-private collaboration. West Virginia strengthened important partnerships between health care practitioners, local health departments, MCO officials, and medical school leaders.
Defining & Recognizing a Medical Home	Recognition: Practices that participated in the Medical Home Performance Incentive Pilot were expected to apply for NCQA PCMH Recognition within nine months of the project start date.
Aligning Reimbursement & Purchasing	Providers and payers that participated in the Medical Home Performance Incentive Pilot agreed to share 5 percent of net savings (2.5 percent to providers, 2.5 percent to payers.) Providers also received compensation for lost revenue during learning sessions and NCQA PCMH application costs. Payer and provider participation in the Medical Home Performance Incentive Pilot was voluntary. The following payers participated: UniCare (Medicaid managed care) Highmark Blue Cross Blue Shield Public Employees Insurance Agency (state employees)
Supporting Practices	Practices that participated in the Medical Home Performance Incentive Pilot received a technical assistance package valued at $25,000 per practice, including: A practice assessment; Access to learning events (including face-to-face sessions, webinars, and monthly conference calls); Training and practice coaching to meet NCQA standards; and Preparation for measures reporting.
Measuring Results	The Medical Home Performance Incentive Pilot focused on the following outcomes: Clinical process measures Clinical outcome measures Utilization Cost Alignment with Meaningful Use In the West Virginia Health Improvement Institute’s (WVHII) 2012 annual report, WVHII reported that providers felt the pilot improved their workflows and care planning capabilities. While the costs for patients attributed to the demonstration rose 0.6% over the life of the pilot, costs for practices that did not achieve NCQA recognition rose by 2.0%.

West Virginia

November 5, 2013/in Policy West Virginia /by NASHP

In West Virginia:

As of July 1, 2011, there were 326,749 beneficiaries enrolled in the state’s Medicaid program, 166,555 of whom were enrolled in one of three commercial managed care organizations through Medicaid’s Mountain Health Trust managed care program.
Physical and oral health services are provided through the Medicaid MCOs; beneficiaries who do not voluntarily enroll in an MCO receive these services through fee-for-service Medicaid. Behavioral health services are reimbursed on a fee-for-service basis.
A Children with Disabilities Community Services Program, supported through a home and community-based services waiver, provides supports to severely disabled children in the community.

As of 2013, 220,597 individuals were eligible for West Virginia’s Early Periodic Screening, Diagnostic and Treatment Benefit (EPSDT), known in the state as HealthCheck. According to 416 data from 2013, the state achieved an EPSDT screening ratio of 100% and a participant ratio of 54%. 102,216 children received dental services of any kind, with 90,102 receiving preventive dental services.

Last updated September 2014

Medical Necessity	Medicaid provider manuals in the state define medical necessity as: “Services or supplies that are proper and needed to diagnose or treat a medical condition.”
Initiatives to Improve Access	Primary care providers participating in a Medicaid managed care organization’s provider network must provide 24-hour, seven-days-per-week access. West Virginia’s Medicaid agency encourages providers to deliver services using telehealth to improve access for beneficiaries. Providers with the appropriate infrastructure can receive reimbursement for services delivered via telehealth and must use a service code modifier when billing.
Reporting & Data Collection	Medicaid managed care organizations in West Virginia are required to report to the state quarterly on: EPSDT screening and referral rates, Well-child visit rates Dental visits, and Immunization rates.
Behavioral Health	West Virginia’s Medicaid program requires that a developmental screening be administered with a standardized screening tool at the 9-month, 18-month, and 30-month well-child visits. The HealthCheck Provider Manual instructs providers to conduct autism surveillance at all well-child visits. Primary care providers are also expected to use a standardized autism-specific screening tool to conduct screens at the 18-month and 24-month well-child visits.
Support to Providers and Families	Support to Families West Virginia hosts a HealthCheck website with information for parents on covered services and preventive health resources. The website has a tool that allows parents to enter their child’s birth date to find out what the family can expect at the child’s next well-child visit. Support to Providers The HealthCheck website also contains resources for providers, including a series of History and Preventive Health Screening Forms for each well-child visit on the periodicity schedule. Information updates notify providers of policy changes affecting HealthCheck. A Developmental Tool Kit and an Oral Health Tool Kit offer provider education to help providers satisfy the American Academy of Pediatrics’ Bright Futures guidelines. A detailed HealthCheck Provider Manual offers information on the EPSDT benefit and components of a well-child visit.
Care Coordination	West Virginia Medicaid employs six HealthCheck Outreach Workers who try to assist a medical home model of care delivery, connecting children with primary care providers who coordinate the child’s care. Managed care organizations have a number of responsibilities to coordinate care for Medicaid beneficiaries, including: Formally designating an individual or entity responsible for coordinating a beneficiary’s care, Developing systems to assure referrals and case management, Coordinating physical services with behavioral health services received through fee-for-service providers, Coordinating with school-related health services, Coordinating with delivery of community and social services, and Working with local health departments to avoid duplication of services. West Virginia is partnering with Oregon and Alaska on a CHIPRA demonstration grant to support a Tri State Children’s Health Improvement Consortium. The state is working with ten pediatric practices to support care coordination and transformation of those practices into patient-centered medical homes.
Oral Health	Children’s oral health services are provided through Medicaid managed care organizations (MCOs). Each MCO must have a Dental Director and each is required to educate its provider network about the state’s Infant and Child Oral Health Fluoride Varnish Program for Primary Care Practitioners program, which reimburses Medicaid primary care providers for applying fluoride varnish to young children. The MCOs are also responsible for ensuring continuity of dental and orthodontic care for Medicaid beneficiaries.

West Virginia

August 21, 2012/in Policy West Virginia /by NASHP

Finance — West Virginia

March 31, 2010/in Policy West Virginia /by EBPHIT_Admin

Federal resources from MITA, ARRA, and ONC will be sought by West Virginia. The state also plans to charge user fees. Refer to pages 44-47 of the state Strategic Plan.

Governance — West Virginia

March 31, 2010/in Policy West Virginia /by EBPHIT_Admin

A public utility model is being considered in West Virginia, though no specifics are available yet.

West Virginia

March 31, 2010/in Policy West Virginia /by EBPHIT_Admin

West Virginia’s HIE Strategic Plan is a pre-ARRA planning document developed in the context of the state’s 2007 Healthy West Virginia Strategic Plan. As such, it does not address all of the ONC’s domains but it does present a vision and strategy for developing HIE in West Virginia.

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