| The latest news from and for state health care advocates |
March 2013
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In each edition, we'll feature an action, victory, campaign, or interesting tactic shared by a state advocate. Send us your updates. |
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In This Issue:
Buzz around the States
The Mississippi Health Advocacy Program ran a set of full-page ads (ad one, ad two) in the Clarion Ledger promoting the Medicaid expansion and urging lawmakers to move forward on the issue.
Jennifer Carter of Nebraska Appleseed testified before the state Health and Human Services Committee in support of a bill to pass the Medicaid expansion.
Advocates from the Center on Public Policy Priorities in Texas hosted a webinar for community groups to better understand the role and function of navigators under the Affordable Care Act.
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States in Focus
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The Takeaway
Political obstructionism can make health reform implementation difficult, especially in states with federally facilitated exchanges. When faced with an unsupportive governor, advocates in Wisconsin bypassed the foot-dragging and convened a group of stakeholders to directly engage HHS on exchange implementation.
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Wisconsin Advocates Take the Lead in Shaping Their Federal Exchange
How do advocates plan for the creation of a federally facilitated exchange (FFE) when state politicians are not willing to cooperate? Back in 2012, Wisconsin advocates concluded that Governor Scott Walker would not work with the Department of Health and Human Services (HHS) to plan for the creation of the FFE. Therefore, advocates formed the Wisconsin Access Network to ensure that the FFE will fit the needs of the Badger State.
The Wisconsin Access Network serves as a hub for communication between HHS and a diverse group of stakeholders in Wisconsin, including consumer advocates, providers, insurers, and disability advocates. These stakeholders can also collaborate with one another to share information about the challenges associated with creating an FFE. While the collaborative is jointly coordinated by the Wisconsin Primary Health Care Association, American Cancer Society Wisconsin, the Wisconsin Council on Children and Families, and the Wisconsin Alliance for Women and Health, it represents diverse and sometimes differing perspectives. Due to political foot-dragging on the exchange, a varied stakeholder group gives advocates more clout to engage with HHS than they would have if they acted alone.
To date, the Wisconsin Access Network has held in-person meetings, a webinar, and a stakeholder discussion on FFE implementation with the state’s HHS regional director. Members of the Network have also been participating in legislative discussions around implementation of the FFE in Wisconsin. All in all, the Network has allowed advocates to overcome political obstacles and play an active role in developing an exchange that works for Wisconsinites.
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New Jersey Advocates Engage Community Leaders in Delivery System Reform Work
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The Takeaway
Organizers have effectively engaged the Camden community around work to change how health care is delivered. Although not all health advocacy groups can replicate this model, New Jersey PICO suggests that advocates focus on working with local groups that have existing relationships in the community in order to identify, train, and support local teams who can work on delivery system reform.
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Engaging the public in efforts to change the way health care is delivered is a daunting task. Unlike campaigns to expand or protect coverage, this realm of policy work often evades public understanding. New Jersey PICO overcame this challenge by developing an organizing model that has effectively mobilized residents of Camden, New Jersey. This model provides community members with the opportunity to identify and create solutions to local health problems and to directly influence decisions being made by the city’s accountable care organization (ACO). (Click here for more on ACOs)
Using data from local hospitals, PICO New Jersey’s partners at the Camden Coalition of Healthcare Providers developed a map that identified “hot spots” with higher per capita medical costs and more frequent hospital visits. Organizers then talked to people living in those neighborhoods. Crystal McDonald of New Jersey PICO recommends that organizers have several one-to-one chats with community members who are willing to discuss their health care experience. Organizers should ask these individuals a variety of questions about where they go to see a doctor, how they get there, and how long they have to wait. But organizers should also focus on building relationships, understanding people’s experiences, and identifying the main barriers to health that residents in each community face.
Through the process of one-to-one talks, organizers selected people to create local teams of 10 to tackle specific local issues, such as lack of transportation or long waiting lines in emergency rooms. Building teams fostered a sense of community, encouraged creativity, and allowed individual leaders to develop specific skills. In addition to local efforts, organizers also identified two residents to become voting members of Camden’s ACO board. Moving forward, PICO New Jersey is working with other key partners, such as the Trenton Health Team and the Greater Newark Health Care Coalition, to develop similar outreach efforts in Trenton and Newark.
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Begin Outreach to Potential Navigators in FFE/Partnership States
Rumor has it that the federal government will shortly announce a grant opportunity for community-based organizations and other entities to apply to become navigators in federally facilitated and partnership exchanges. The application windows are often limited, so be sure to do your outreach ahead of time and make sure that interested entities register with the federal government. Feel free to use this flyer to do your outreach.
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Clip of the Month
Mississippi’s Road to Reform’s powerful new video makes the moral and economic case for the Medicaid expansion in Mississippi.
New Resources from Families USA and Stand Up for Health Care
Take me to back issues of the Beat!
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