How Alaska Supports Rural and Frontier Behavioral Health Services
/in Behavioral/Mental Health and SUD, Policy Alaska Blogs, Featured News Home Behavioral/Mental Health and SUD, Community Health Workers /by Rebekah FalknerStrengthening Oral Health in the U.S. through Integration and Workforce Development: Lessons from State and Federal Health Officials
/in Oral Health, Policy Blogs, Featured News Home Community Health Workers /by Allie Atkeson and Megan D’AlessandroCommunity Health Workers and Oral Health: Improving Access to Care Across the Lifespan in Minnesota
/in Community Health Workers Minnesota Featured News Home, Reports Community Health Workers, Oral Health /by Allie Atkeson and Ella RothCommunity Health Workers and Oral Health: Creating an Integrated Curriculum in Kansas
/in Community Health Workers Kansas Featured News Home, Reports Community Health Workers, Oral Health /by Allie Atkeson and Ella RothCommunity Health Workers Twitter Chat — Thursday, February 24
/in Community Health Workers Featured News Home Community Health Workers, Population Health /by NASHP StaffThe National Academy for State Health Policy (NASHP) is hosting a Twitter chat on Thursday, February 24th at noon ET to continue the conversation around states’ best practices for sustainably financing the community health worker (CHW) workforce, and strategies to partner with these essential workers throughout and beyond the pandemic.
To join the conversation, make sure you follow @NASHPhealth on Twitter and use the hashtag #CHWChat.
How to Participate
- Follow @NASHPhealth on Twitter.
- Join us on February 24th at noon EST and follow the conversation using #CHWtalk.
- Share your thoughts and ideas on policies and support resources.
- Use links to your website, programs, initiatives, and partners in your tweets to promote the good work you, your organization, and/or state are doing!
- Include #CHWtalk in all of your tweets so chat participants can easily follow you and others during this event.
How it Works
- Each question will be numbered Q1, Q2, Q3, etc.
- Start your responses with A1, A2, A3 etc. to correspond with the question.
- You only have 280 characters per tweet but you’re not limited to only one tweet per question. Use A1a, A1b, A1c, etc. to indicate either a multi-part answer or multiple responses to a given question.
The Questions
- Q1. What role have CHWs played during the pandemic?
- Q2. How do CHWs help increase access to public health / health care for historically marginalized populations?
- Q3. What are some innovative ways that CHWs work in the community to promote community health?
- Q4. How can CHWs collaborate with other stakeholders to address social determinants of health and reduce health disparities?
- Q5. How does your state or community work to support CHWs as a workforce?
- Q6. What steps are states and communities taking to ensure that CHWs are sustainably financed and paid livable wages?
- Q7. What are some creative efforts at the state, local, and community level to support CHWs?
- Q8. What work can be done at the federal level to support CHWs?
- Q9. What’s your #1 tip for state officials that want to support CHWs?
This chat is an excellent opportunity to highlight some of your exciting initiatives, innovations, and resources!
For questions, please contact Rebecca Cooper at rcooper@oldsite.nashp.org.
Lessons for Advancing and Sustaining State Community Health Worker Partnerships
/in Community Health Workers Featured News Home, Reports Community Health Workers /by Elinor Higgins, Elaine Chhean, Sandra Wilkniss and Hemi TewarsonState Community Health Worker Models
/in Community Health Workers Featured News Home, Maps Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Health System Costs, Long-Term Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home Community Health Workers /by NASHP StaffNASHP Resource Hub: State Strategies to Build and Support Palliative Care
/in Policy Reports, Toolkits Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Featured Policy Home, Health Coverage and Access, Health System Costs, Long-Term Care, Medicaid Managed Care, Palliative Care, Physical and Behavioral Health Integration, Population Health, Workforce Capacity Chronic and Complex Populations /by Kitty Purington, Wendy Fox-Grage and Salom TeshalePalliative care helps individuals with serious illness better manage the symptoms and stressors of disease. These services are interdisciplinary, person- and family-centered, and can help people at any stage of a serious illness.
States are uniquely positioned to influence how Americans think about access, and experience palliative care.
States Redesign Home Visiting Programs for a Telehealth World during COVID-19
/in COVID-19 State Action Center Michigan Blogs, Featured News Home Care Coordination, Chronic and Complex Populations, Community Health Workers, COVID-19, Health Equity, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Population Health, Social Determinants of Health /by Taylor PlattAs families face immense stress from the pandemic, states have rapidly reworked their home visiting programs to continue to support women and children. Because face-to-face services, including case management and family support and counseling, are no longer an option, health departments now deliver these vital services by telehealth. But with this new operating platform, states have needed to quickly address issues such as privacy requirements and billing, reimbursement, and enrollment processes as they launch their telehealth services.
Recently, the Centers for Medicare & Medicaid Services (CMS) released a toolkit in response to COVID-19 with guidance and steps for state Medicaid programs as they transition services to telehealth. The updated CMS guidance allows for greater flexibilities, including reimbursement for telephonic visits. To streamline the process, CMS stipulated that “no federal approval is needed for state Medicaid programs to reimburse for telehealth services in the same manner or at the same rate paid for face-to-face services, visits, or consultations.” However, a state plan amendment (SPA) is necessary to accommodate any revisions to payment methodology to account for telehealth costs.
Additionally, the Office of Civil Rights at the Department of Health and Human Services issued guidance that allows for enforcement discretion for noncompliance with the Health Insurance Portability and Accountability Act (HIPAA) regulatory requirements related to providers and telehealth, such as using non-HIPAA-compliant systems, such as the free version of Zoom.
How Michigan Converted its Home Visiting Service
Michigan, a state with a robust home visiting program prior to COVID-19, took quick action to support home visiting staff and the families they served to ensure continuation of services during the pandemic. The Maternal and Infant Health Program (MIHP) is administered and financed by the state Medicaid agency and is the largest home visiting program in the state. MIHP is available to all pregnant women enrolled in Medicaid and their infants up to age 12 months, with some exceptions. The program promotes healthy pregnancies and positive birth outcomes through a standardized, systemwide process of case management. When Michigan Gov. Gretchen Whitmer announced a state of emergency and stay-at-home orders in March 2020, the program quickly moved its home visiting services to telehealth.
The Michigan Department of Health and Human Services (MDHHS) updated guidance on telehealth visits for Medicaid beneficiaries. The provider bulletin allows for greater flexibilities on distant and originating sites and outlines the billing codes and modifiers providers should use. The MIHP operations team took numerous steps to ensure a smooth transition to telehealth services for their providers and families, including:
- Both the state Medicaid agency and the MIHP operations team had early and continued communication with providers, including making staff available to answer questions and provide support.
- The MIHP program created additional guidance specifically for MIHP providers. The guidance includes instructions on how to obtain and properly document verbal consent, billing procedures and codes specific to the MIHP program, and documentation procedures for all virtual visits.
- MDHHS held a provider webinar with detailed information related to telemedicine flexibility, including information targeted to MIHP providers and others.
- MIHP operations conducted a provider survey about how MIHP programs were continuing to provide services during this time, which netted a near 100 percent provider response rate. The survey revealed that a large majority of agencies adjusted successfully and quickly to the telehealth service delivery model. In addition, only a small number of agencies suspended services temporarily, primarily due to agencies shifting resources to cover COVID-19 emergency functions.
As states begin to reopen, many home visiting programs will begin to consider returning to face-to-face visits exclusively or as a part of their support programs. Considerations for the role of telehealth in home visiting is expected to factor into state decisions. While it is unclear how state home visiting programs will transition, some groups including The National Alliance of Home Visiting Models have encouraged all home visiting programs to continue to use telehealth to ensure the safety of women and their families, as well as home visitors. With the greater flexibilities allowed by CMS, states have the option to continue using telehealth for their home visiting programs during the pandemic. This allows for the continuation of important services for women and children and helps decrease the spread of COVID-19.
States will be weighing a number of considerations as they begin to open, including the benefits of telehealth for home visits and the costs associated with telehealth compared to in-person visits. These new policies will be important to monitor and will have implications for longer-term and possibly permanent use of telehealth to deliver essential services to families.
Additional Resources:
- NASHP Infographic: How State Medicaid Programs Can Use Telehealth to Serve Pregnant Women during COVID-19, May 2020
- NASHP Blog: States Rapidly Build their Telehealth Capacity to Deliver Opioid Use Disorder Treatment, April 2020
- Institute for the Advancement of Family Support Professionals: Rapid Response Virtual Home Visiting Collaborative
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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. 























































































































































