The CMS August 2007 Directive: Implementation Issues and Implications for State SCHIP Programs
This State Health Policy Briefing discusses the August 17, 2007 letter from the Centers for Medicare and Medicaid Services (CMS), which has major implications for the State Children’s Health Insurance Program (SCHIP) and children’s health coverage. Among states and advocates alike, there is concern that aspects of the directive work against achieving the goals of SCHIP and the broader purpose of assuring that children have health coverage and access to quality care.
This paper examines the four requirements within the directive that are of greatest concern to states. It also provides details and context on CMS’s directive requirements, background on current state policy and practice related to each requirement, along with a discussion of the issues and implications for states in assessing the feasibility and implications of responding to the new requirements.
| shpbriefing_cmsdirective.pdf | 225.1 KB |
For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
