553: States Lead Equity Initiatives, ASTHO Tunes Medicaid Parity Policy

ROBERT JOHNSON: 

This is the award-winning Public Health Review Morning Edition for Wednesday, November 29, 2023. I'm Robert Johnson. Now, today's news from the Association of State and Territorial Health Officials.

JESSICA FEPELSTEIN: 

Developing an agency-wide baseline knowledge of health equity core concepts is critical in making tangible advancement and addressing health disparities.

JOHNSON: 

ASTHO, the CDC Foundation, and the Michigan Public Health Institute are working with agencies to develop that knowledge inside their organizations and across their communities. ASTHO's Jessica Fepelstein says the work is happening as part of the STRETCH initiative, a 10-state learning community.

FEPELSTEIN: 

As part of their work in STRETCH 1.0, several states developed internal trainings around health equity with the aim of implementing them agency wide. Some states such as Nevada have created legislation to make these trainings mandatory.

JOHNSON: 

Fepelstein says some agencies also have used CDC disparities grant dollars to engage key communities.

FEPELSTEIN: 

As part of their 2103 funding, states like Tennessee have expanded training offerings for community health workers, and other states such as Maryland and Nevada have provided trainings to community-based organizations around procurement, data utilization, and grant management.

JOHNSON: 

Colorado and New Jersey have worked this year on health equity commissions. Another key tool according to Fepelstein.

FEPELSTEIN: 

This ensures that the state is working collaboratively across not only the health agency but all sectors of government to address health disparities. Several states already have health equity commissions in place while others are working to create them and these commissions are a crucial step in embedding health equity into a state's policies and practices.

JOHNSON: 

You can read more about the STRETCH initiative in a new ASTHO blog article now online; there's a link in the show notes.

ESTHER MUNA: 

Healthcare in the territories is not any cheaper than anywhere else.

JOHNSON: 

Dr. Esther Muna is territorial health officer for the Northern Mariana Islands. She helped ASTHO update its policy statement calling for Medicaid funding parity for the U.S. territories. Muna says there are two issues that need a congressional remedy.

MUNA: 

One is to permanently apply the equivalent F-map formula based on per capita income that is used by states to all the U.S. territories and the second one is to remove the annual cap on federal Medicaid funding to the territories.

JOHNSON: 

Muna adds the two fixes together would help reach the goal of a permanent and equitable solution for Medicaid services in the territories.

MUNA: 

So, when you increase the F-map, obviously you're spending more; the federal program is spending more, and so, when you have the cap, then you're exhausting it quickly, and what has happened for the CNMI specifically is the cap was exhausted back in June of 2023, which has really put a lot of pause in some of the services in the CNMI.

JOHNSON: 

ASTHO has released five policy statements on important public health issues. For our updates to existing policies, one is new, you can read them using the link in the show notes.

Also today, the non-profit group UsAgainstAlzheimer's has created resources for ASTHO members looking to do more work on this critical health concern. Daphne Delgado says the organization has resources for doing work in Black and Latino communities.

DAPHNE DELGADO: 

So, one of those, for example is we created a CDC co-branded practical guide on how organizations can communicate with Black and Latino communities specifically on brain health. In addition to that, we host a Brain Health Equity Nurse Fellowship Program, which takes a cohort of nurses and turns them into brain health ambassadors.

JOHNSON: 

Delgado says the National Alzheimer's Disease Index is another tool that uses Medicare data to evaluate and understand geographic and demographic impacts of the disease.

DELGADO: 

We've been able to produce reports using this platform, such as analyses of county and congressional district level impacts of dementia, looking at corresponding social determinants in those counties and congressional districts, and we're preparing to launch a lot more reports and highlighting those data in 2023 and 2024.

JOHNSON: 

You can read more about these tools by clicking the links in the show notes.

Finally, this morning, learn new strategies to improve access to emergency contraception during an ASTHO webinar on Wednesday, December 13. Get information about available options and ways to improve access through providers and clinics. You can hold your seat to the online event using the link in the show notes.

Before we go, we'd like to remind you to follow this newscast on your podcast player and ASTHO on social media. We're on LinkedIn, Twitter, and Facebook. That'll do it for today.

We're back tomorrow morning with more ASTHO news and information. I'm Robert Johnson. You're listening to the award-winning Public Health Review Morning Edition. Have a great day.