| Catalyst Center Quarterly |
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Time has sped up considerably since those enormous piles of snow (although some remnants still linger... ) and suddenly it's summer! The Supreme Court is winding down after its momentous decision last week (see the ACA is Upheld Again) and people are digging out the sunscreen. But we're not slowing down! This issue of Quarterly brings you a brief about the TEFRA option for expanding access to Medicaid for children with disabilities, including how it helps address health care inequities among children with the most functional difficulties. June 30 marks the close of another Catalyst Center grant year--see What have we done for you lately? for an update on this past year. We also share with you a couple of new initiatives we're undertaking, plus a webinar that delves into some recently produced fact sheets explaining how ACA provisions can help families raising children with special health care. So pull up a lounge chair and enjoy this bit of summer reading.
Sincerely,
Sally, Meg, Beth, Angela, Kate, Kasey, Yiyang, Melissa, Renee, and Edi |
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 The ACA is upheld again - the requirements for children with special health care needs remain constant
The ACA turned 5 years old in March of this year. In its short life, it has faced two major challenges. The most recent Supreme Court decision in King v. Burwell, coming almost three years to the day after the 2012 National Federation of Independent Business v. Sebelius ruling that the ACA is constitutional, once again supported the ACA. On June 25, the U.S. Supreme Court Justices ruled that tax credits and subsidies should be available in every Health Insurance Marketplace, whether it is run by the state, the federal government, or as a partnership between the two. The Catalyst Center welcomed this news. The national health care reform law provides important protections for children and youth with special health care needs (CYSHCN). As we pointed out after the June 2012 ruling, there is still work to be done to ensure that CYSHCN have access to coverage that is universal and continuous, adequate, and affordable.
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Expanding access to Medicaid coverage: The TEFRA option and children with disabilities
We have produced a policy brief that clarifies the differences and similarities between TEFRA and Home- and Community-based Services waivers. We also discuss how TEFRA can help reduce health care coverage inequities among children with disabilities whose family incomes are too high to qualify for Medicaid while allowing children to be cared for at home rather than in institutional settings. TEFRA provides wrap coverage for children with disabilities who have private insurance and access to the federally mandated EPSDT benefit. It allows families to keep working without worrying that increases in household income will mean the loss of the Medicaid benefit for their children with disabilities. Read the policy brief: Expanding Access to Medicaid Coverage: The TEFRA Option and Children with Disabilities.
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What have we done for you lately?
June 30 marks the end of the 2nd year of the Catalyst Center's 5-year cooperative agreement with the Maternal and Child Health Bureau (MCHB). Here's an update on what we've done in the past year to improve health insurance and financing of care for CYSHCN: - Created an Educational Worksheet stakeholders can use to learn the difference between TEFRA and the Family Opportunity Act Medicaid Buy-In Program and the number of families that might benefit from these programs in their state;
- Produced a fact sheet about health insurance inequities among Latino families raising children and youth with special health care needs (CYSHCN) and the provisions of the Affordable Care Act (ACA) that reduce disparities;
- Wrote a brief about the strategies selected family leadership organizations use to address health care coverage inequities in the communities they serve;
- Interviewed 45 state Title V programs about the strategies they use to finance coverage and care for CYSHCN in the era of health care reform;
- Gave 19 presentations to a broad range of stakeholders; 15 were specifically about the impact of the ACA on CYSHCN;
- Provided individual, targeted technical assistance to 92 stakeholders in 35 states (including Puerto Rico and the District of Columbia) about financing the care and coverage of CYSHCN and the impact of the ACA on CYSHCN;
- Collaborated with the AAP to host a second learning community to address issues related to quality of care, performance metrics, and innovative financing strategies to improve payment for services used by CYSHCN under the ACA;
- Finalized our Impact Assessment Survey, received IRB approval, and started data collection (See Catalyst Center impact assessment survey below );
- Received IRB approval to conduct interviews with individual families from each state and the District of Columbia (D.C.) about how inequities have impacted their ability to enroll in and maintain health coverage for their CYSHCN (See Inequities in insurance coverage...below );
- In partnership with the National Center for Medical Home Implementation, created four plain-language fact sheets that explain specific provisions of the Affordable Care Act (ACA) which benefit CYSHCN (please join us for a free webinar about these fact sheets on July 20).
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Catalyst Center impact assessment survey
The Catalyst Center is conducting an Impact Assessment Survey to help us demonstrate the impact of our work towards advancing the MCHB goal that families of children and youth with special health care needs (CYSHCN) have access to adequate public and/or private insurance to pay for the services they need.
We are asking everyone who has received technical assistance from the Catalyst Center, either in person, on the phone, by e-mail, or virtually through webinars and publications, to provide feedback about the differences our work has made towards
- Insuring CYSHCN;
- Strengthening existing partnerships or creating new partnerships to improve health insurance and coverage for CYSHCN;
- Reducing health insurance inequities among CYSHCN; and
- Advancing your knowledge of the Affordable Care Act (ACA).
If you receive an email from our Catalyst Center CYSHCN@bu.edu account requesting your input, please click on the link in the e-mail and take 10 minutes to complete the online survey. Your response can be anonymous, or you can provide your name and contact information if you would like us to follow-up with you about your feedback.
Of course, we accept feedback about our work at any time. We want to be as helpful as possible to you. If you have questions, comments, or suggestions, please contact Beth Dworetzky, the project director at bethdw@bu.edu or phone her at (617) 638-1927.
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Inequities in insurance coverage and financing of care among children with special health care needs (CSHCN): Family perspectives
Having health insurance is important to all CYSHCN, but research tells us some groups experience higher rates of uninsurance, including African American or Latino CYSHCN, those living with the most functional difficulties, CYSHCN living in low-income families, families with mixed immigration status, or families in which the household language is not English. The Catalyst Center is working to identify barriers to coverage and paying for care for CYSHCN with the highest rates of uninsurance. We also want to learn about the services organizations (e.g., Family-to-Family Health Information Centers, consumer assistance programs, faith-based organizations, etc.) provide to help families overcome these barriers.
We will be sending recruitment materials to you, our stakeholders and partners. Please help us recruit family members of CYSHCN who represent the groups described above to participate in a telephone interview. If you know families who would be interested in speaking with us, we would appreciate your help in reaching out to them.
Watch your inbox for a recruitment flyer that we hope you will share with your extended networks of families and providers to help spread the word about this project. If you have any questions, please e-mail Kasey Wilson at wilsonka@bu.edu
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Webinar: Navigating the Affordable Care Act (ACA) - Help for  families of children with special health care needs
Date: July 20, 2015
Time: 1:00 to 2:00 pm ET (12:00- 1:00 pm CT; 11:00 am - 12:00 pm MT; 10:00 - 11:00 PT)
Join us for a free webinar where experts from the Catalyst Center and the National Center for Medical Home Implementation will share information, based on recently developed fact sheets on how the following ACA provisions can help families raising children with special health care needs:
- Medicaid "wrap-around" coverage for privately insured children with special health care needs
- Concurrent care for children with life-limiting diagnoses
- Habilitative benefits in the State Health Insurance Marketplace plans
- Section 2703 Health Homes for funding care coordination
Learn more/register: Navigating the Affordable Care Act (ACA) - Help for Families of Children with Special Health Care Needs
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The Catalyst Center, the National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs, is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U41MC13618, $473,000. This information or content and conclusions are those of the Catalyst Center staff and should not be construed as the official position or policy of nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government. LT Leticia Manning, MPH, MCHB/HRSA Project Officer. For more information, please visit us at www.catalystctr.org or contact Meg Comeau, Co-Principal Investigator, at mcomeau@bu.edu.
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