OPWDD Announces New Priority Categories for Housing Opportunities  

Last week OPWDD announced that they have revised the priority categories for offering housing opportunities in group homes that provide 24/7 support, to make sure that people living at home with their families have equal access to those opportunities based on their need. 

Last year, OPWDD began using a process called the Certified Residential Opportunities (CRO) protocol to create consistency in the management of certain housing opportunities. This process looked at overall need for these opportunities and helped us to plan ahead to meet this need using a priority system based on each person's circumstances, formerly known as Priority 1,2 or 3.  

The new priority levels, which will replace Priority 1, 2 and 3, are being identified as Emergency Need, Substantial Need and Current Need. Emergency Need will include people that have or are at risk of having no permanent place to live or whose health and safety are at risk. Substantial Need will include people whose family members or other caregivers are unable to continue to care for the person and people subject to court mandate, transitioning from a residential school, moving from a developmental center or leaving a skilled nursing facility. Current Need will include people who have a current need for housing, but the need is not an emergency. A full list of these changes can be viewed on the  OPWDD website. Read more here.

Trends in Medicaid: Looking Back At 15 Years of Kaiser Surveys of State Medicaid Programs

A new issue brief from the Kaiser Family Foundation highlights key trends from 15 years of findings from our annual budget survey of state Medicaid programs. The brief synthesizes findings on enrollment and spending trends as well as the multitude of policy actions taken by states across key areas: eligibility and application processes; provider rates and taxes; benefits, pharmacy and long-term care; and more recent data on managed care and delivery system reform. Each year states make a range of policy changes to Medicaid to comply with new federal rules and address an array of policy goals.

Three key findings emerge from the surveys:

Click here for the full report.

The report presents four central lessons for New York as the State considers quality measures for value-based payment for children: (1) Government and public programs, particularly Medicaid, have good reason to continue leading the development and use of children's health quality measures; (2) Establishing a process that creates incentives that go beyond what is currently measured can help the State incorporate increasingly ambitious goals; (3) Ensuring that children with special needs receive high-quality care under a value-based payment arrangement is critically important and potentially complex; and (4) Value-based payment quality measures could encourage child primary care providers to integrate or coordinate oral and behavioral health services and address social determinants of health.   Click HERE for the full report.

NYSDOH Issues Medicaid CAG VBP Recommendation Report for HARP Subpopulation

The New York State Department of Health (NYSDOH) has issued notice that its Behavioral Health Medicaid Clinical Advisory Group (CAG) has issued their recommendations for inclusion in value-based payment (VBP) programs.   The Behavioral Health Clinical Advisory Group (CAG) has produced a Recommendation Report for the  HARP subpopulation.  

The CAG reports have been posted for public comment on the Medicaid Delivery System Reform Incentive Payment (DSRIP) Web site here.   The public comment period commenced on June 24th and will end on July 24th.  

Doctors Wrestle With Mixed Messages When Deciding Whether To Prescribe Painkillers

Steve Diaz, an emergency medicine doctor at Augusta's MaineGeneral Health, says he knows what patients want when they come to him in pain. Drugs. And preferably strong ones.  

"The only thing they think of is, 'Do I get a pill?'" he said.

And with abuse of prescription painkillers like OxyContin, methadone and Percocet soaring, the instinct, public health experts say, should be to say no. Or at least, not necessarily. The Centers for Disease Control and Prevention put out  a new guideline this spring, advising doctors to prescribe the highly addictive drugs, known as opioids, in smaller doses and only when truly needed.

But another federal policy - a provision of the 2010 federal health law  linking hospital payments to patient satisfaction  surveys - may be complicating efforts to curb opioid prescribing as part of the nation's effort to address the painkiller abuse epidemic.

As part of these surveys, amidst questions about night-time noise levels and hospital staff proficiency, patients can evaluate how doctors managed their pain, and if clinicians did all they could to treat it. That's setting up a system, doctors say, where physicians' ratings can get caught between patient demands and sound medical judgment.  Read more here .