U.S. Department of Health and Human Services Press Office
May 19, 2012
Even if you did not know Katie Beckett personally, you may know someone who has benefited from Katie's experience and her family's advocacy, which revolutionized Medicaid. Since 1982, the Medicaid program has included a state plan option to allow children with severe disabilities who require an institutional level of care to enroll in Medicaid, regardless of household income, so they can receive the medical services they need to be safely cared for at home. In response to Katie's death on May 18, U.S. Department of Health and Human Services Secretary Kathleen Sebelius released a statement acknowledging the more than half a million children with complex health needs who live at home instead of in institutions because of the "Katie Beckett Waiver." The Catalyst Center team joins Secretary Sebelius in extending our heartfelt condolences to Katie's family.

By Erik Wasson
On the Money: THE HILL'S Finance & Economy Blog
May 7, 2012
The price of the Super Committee's failure last fall to agree on $1.2 trillion in deficit-reducing measures over the next ten years was sequestration - automatic reductions in defense and nondefense discretionary spending that are scheduled to begin on January 1, 2013. On May 7, the House Budget Committee approved a bill that would "turn off" sequestration. The bill would shift cuts from the military to reductions in the Affordable Care Act (ACA) and social service programs, including food stamps and Medicaid. Three days later, the House of Representatives passed the Sequester Replacement Reconciliation Act of 2012. The Senate is not considering this bill, and should it land on President Obama's desk, he has vowed to veto it.  However, Jocelyn Guyer, co-director of the Georgetown University Health Policy Institute's Center for Children and Families, remains concerned. She discusses how two provisions of the bill will affect children's health coverage in her blog post House Passes Sequester Replacement Bill - Could Impact Kids' Health Care. The bill recommends the repeal of the Maintenance of Effort (MOE) requirement of the Affordable Care Act (ACA). This would allow states to end Medicaid benefits for all optional populations, including children with disabilities who are eligible for Medicaid benefits through waivers. The House bill also calls for the elimination of performance bonuses for states that increase outreach and make it easier for children to enroll in Medicaid and Children's Health Insurance Programs (CHIP).

States of Innovation: a Community Catalyst and Georgetown University Health Policy Institute Center for Children and Families Blog
By Siobhan Brown
May 14, 2012
States that are looking to decrease Medicaid benefits and charge premiums for some enrollees as a way to balance their budgets should take a lesson from the lyrics of a famous Johnny Mercer song: "You've got to accentuate the positive, eliminate the negative." Following Mercer's advice, Community Catalyst and the Center for Children and Families at the Georgetown University Health Policy Institute created States of Innovation to highlight states' efforts to decrease costs and improve care, including care for individuals with disabilities. In this post, Siobhan Brown, a Medicaid Policy Intern at Community Catalyst, describes how the North Carolina medical home program improved care and reduced costs by $2.1 million for Medicaid enrollees with diabetes by providing case management services. These services connected patients and families to community resources. Examples include helping a mother find scholarships to send her teen daughter to a diabetes camp and assisting patients in learning the necessary skills to manage their own health care effectively. Other medical home initiatives worked to decrease emergency room use and preventable admissions, including a decrease in asthma-related hospitalizations. Brown encourages other states to explore the Health Home Option of the Affordable Care Act (ACA) and use the enhanced match rate to create or expand medical home efforts that improve care and decrease costs for Medicaid enrollees in their states. Learn more about Children and the Medicaid Health Home State Plan Option.

By Tara Mancini
Say Ahhh! A Children's Health Policy Blog
May 16, 2012
In this health-care-spending version of the Discovery television show MythBusters, Tara Mancini, a research assistant at the Georgetown University Health Policy Institute, uses data from the Kaiser Commission on Medicaid and the Uninsured, the Urban Institute, and an analysis from Bloomberg Government to bust "the myths of out-of-control spending" and set the record straight about Medicaid growth and costs. She notes that private health spending, at an average annual growth rate of 5.5%, is more than twice the annual average Medicaid growth rate of 2.5%. Further, after Medicaid costs are adjusted for inflation and enrollment, the Bloomberg analysis found that Medicaid spending has been fairly level for the last 10 years, with increased spending primarily due to increased enrollment.

HHS Press Office
May 16, 2012
Illinois, Nevada, Oregon, South Dakota and Tennessee have all received level one Establishment grants, which provide a single year of funding to begin building each state's Affordable Health Exchange. Washington State, which is further along in the process, received a multi-year level two grant. These six states join 28 others and the District of Columbia in implementing this provision of the Affordable Care Act (ACA). In addition to announcing these awards, the U.S. Department of Health and Human Services (HHS) released an Exchange Blueprint, which includes guidance states may use to demonstrate how their Exchange will operate as a marketplace where consumers can compare and shop for affordable health insurance. The Blueprint includes an application for states that choose to develop a Partnership Exchange rather than a State Exchange. In a  Partnership Exchange, the federal government is responsible for operating the Exchange and the state can choose to perform certain Exchange functions, such as selecting the health plans that will be offered and/or providing in-person consumer assistance functions. If a state elects not to create its own Exchange, HHS provided guidance for how they will consult with stakeholders in states that opt for a Federally-facilitated Exchange.

U.S. Department of Health and Human Services Press Office
May 23, 2012
Since 2005, families raising children and youth with special health care needs (CYSHCN), professionals, and others have been turning to the state-based Family-to-Family Health Information Centers for assistance with health care financing options and other health care services and supports. In addition to providing this type of individualized assistance, Center staff who are also parents of CYSHCN, present skill-building workshops and develop partnerships within their states to improve systems of care. The Affordable Care Act (ACA) included two years of funding for the 51 Centers (one in each state and the District of Columbia). On May 23, U.S. Department of Health and Human Services Secretary Kathleen Sebelius announced the second round of funding. Twelve newly funded and thirty-nine continuing Centers will receive a combined total of $4.9 million for the award period June 1, 2012 through May 31, 2013. She lauded the Centers' efforts, stating, "These centers provide the information that families need to make health care decisions that are right for their children. Family-to-Family Health Information Centers are a good investment, and have a measurable and positive impact on families, and communities." See the list of awardees. Learn more about the Family-to-Family Health Information Centers and connect with the one in your state.

States Struggle to Meet Community Living Goals
By Jenni Bergal, Kaiser Health News
Disability Scoop
May 25, 2012
The focus of the Money Follows the Person program is to move Medicaid enrollees who want to live in their communities out of nursing homes, institutions, and other long-term care facilities. This includes individuals with physical and developmental disabilities. Medicaid helps fund the transition by paying for home and community-based services, modifications to make housing accessible, and other expenses to enable the move for the first year. This 2007 initiative of President George W. Bush's Administration, which has continued support through the Affordable Care Act (ACA), has met with varying levels of success, as states struggle to find housing, set up the necessary support services, and hire transition workers to provide training so individuals can learn life skills, such as personal hygiene and menu planning and hire caretaker staff. Despite successes in Texas and Ohio, advocates are unhappy with the slow rate of progress in other states, including California, North Carolina, Missouri, and Kentucky. The Centers for Medicare and Medicaid Services (CMS) oversees the program. A program evaluation by Mathematica Policy Research found it was 34% less expensive to provide community-based long-term care services than to provide care in a nursing home. However, this cost analysis did not include the cost of medical care.

Senate Takes Action to Secure Safety of Drug Manufacturing
Anna Dunbar-Hester
Health Policy Hub: The Community Catalyst Blog
May 25, 2012
With its reauthorization of the Prescription Drug User Fee Act (PDUFA), the Senate took a step toward ensuring not only the safety but also the supply of many of the prescription medications that Americans use to help manage chronic health conditions. Both name brand and generic drug manufacturers will pay fees that will be used to implement a variety of consumer protections. These include increased monitoring and inspection of overseas manufacturing sites. And to ensure the safety of generic drugs, generic manufacturers will now contribute to the Food and Drug Administration's (FDA) inspection and oversight fund. Pharmaceutical companies will implement "track and trace" systems to prevent the introduction of counterfeit drugs into the supply chain. To avoid drug shortages, this bill requires manufacturers to give the FDA advance notice if they plan to discontinue a medication. While Dunbar-Hester, the author of this blog posting, congratulates the pharmaceutical companies, the FDA, and the Senate on the reauthorization, she also expresses her disappointment that the name brand manufacturers can still pay generic manufacturers to delay production of less expensive versions of drugs. She also hoped that medical device manufacturers would be included and have to pay fees to fund similar safety measures for medical devices.

Date: Thursday, June 21, 2012
Time: 12:00 noon - 1:00 p.m. EDT
You are invited to participate in this third in a five-part webinar series about the Catalyst Center's latest technical assistance tool Public Insurance Programs and Children with Special Health Care Needs: A Tutorial on the Basics of Medicaid and the Children's Health Insurance Program (CHIP). This webinar will cover: Section 4 - Pathways to Coverage, and
Section 5 - Covered Services: What will Medicaid and CHIP Pay For? Participants on this webinar will learn about federal regulations for mandatory benefits and populations as well as optional coverage groups and services, EPSDT, waivers, and resources for learning more about the specifics of the Medicaid and CHIP programs in their state.

This is also an opportunity to hear how one Family-to-Family Health Information Center helps families, professionals, and others navigate pathways to coverage and covered services for children and youth with special health care needs.

Register for this webinar. Listen to recordings of first two webinars in this series.

The Maternal and Child Health Library at Georgetown University
May 2012
The Maternal and Child Health (MCH) Library at Georgetown University has developed a new edition of the Community Services Locator, an online directory for finding services for children and families in the communities in which they live. Service providers and families can use the locator to find available childcare and early childhood programs; education and special education programs; developmental assessment and learning services; family support; financial support; and health and wellness care.

Enhanced 2009/10 NS-CSHCN Public Use Data Set Just Released
Data Resource Center for Child and Adolescent Health
May 14, 2012
Child health researchers, students, policy makers, advocates, and others can now access the public use indicator data set and codebooks for the 2009/10 National Survey of Children with Special Needs (NS-CSHCN) on the Data Resource Center (DRC) website. See a list of frequently asked questions about the data set and email the DRC for technical assistance.

If you have suggestions for news items related to coverage and financing of care for CYSHCN please email Beth Dworetzky Catalyst Center Coverage editor and Catalyst Center Assistant Director by 12 noon on Friday.