Issue Explainer & Stakeholder Meetings | Medicaid Public Health Emergency Unwinding

Congress enacted the Families First Coronavirus Response Act (FFCRA) at the start of the COVID-19 pandemic, which included a requirement that Medicaid programs keep people continuously enrolled through the end of the month in which the COVID-19 public health emergency (PHE) ends, in exchange for enhanced federal funding. Compared to before the pandemic and in part due to this provision, the uninsured rate has dropped, and Medicaid has grown. When the continuous enrollment provision ends, there is a possibility of millions of people nationwide who could lose coverage and reverse the recent gains in coverage.

In Kentucky, during the PHE, the Kentucky Department for Medicaid Services (DMS) made sure that all Medicaid beneficiaries kept their coverage. The PHE ends on May 11, 2023, and some of the flexibilities put in place for providers and members will be discontinued (or “unwound”) and some will continue based on state policy changes.

Kentucky Voices for Health, KCHC Executive Partner, has developed an issue explainer “Make Sure You Keep Your Health Coverage” with important information and timeline on the unwinding.

Additionally, the Kentucky Department for Medicaid Services (DMS) is hosting three Stakeholder Engagement Meetings on March 16, Mach 22, and March 27, 2023 (links included in dates). The 1-hour virtual sessions will cover topics such as Medicaid's unwinding background, renewal process plans and partnerships, unwinding communications, outreach and engagement efforts, and more. 

Click here for more information and FAQ from DMS.

Rule Proposal | Child Nutrition Program Standards and Farm to School

The US Department of Agriculture’s (USDA) recently proposed rule to update child nutrition program standards is seeking input from child nutrition professionals, parents and families, students, educators, and vendors/producers in the school food supply chain by April 10, 2023. USDA will use this feedback to create a “durable rule” that will take effect starting in the 2024-2025 school year. 

The National Farm to School Network (NFSN), dedicated to making it easier for schools to purchase local food, eliminate barriers to equitable implementation, and improve the health of students, is one organization which has pointed out some of the wins for Farm to School that stem from the proposed rule. They indicate that, as it stands, the proposed rule for child nutrition standards would make it much easier for school nutrition operators to purchase from local farmers and suppliers. It would also make important strides in improving equity and nutrition for school meals.

•  Buying Local: Historically, school nutrition operators have been required to choose the cheapest bid possible when purchasing food, which made it difficult to prioritize buying local foods. The new USDA rule proposes allowing “locally grown, raised, or caught” to be used as procurement specifications within a competitive bid process. 
• Equity Strides: The proposed rule seeks input on two regulations on traditional foods and menu planning, specifically around how the child nutrition program can better support the incorporation of Tribal and traditional foods and community needs for Native students. 
• Better Career Access: The proposed rule would allow medium and large school food authorities to substitute 10 years of school nutrition program experience for a bachelor's or associate degree. 

View a chart outlining the proposed changes here; read the full proposed rule here.

Data Report | YRBS Data Summary & Trends

The Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Survey Data Summary & Trends Report: 2011–2021 provides the most recent surveillance data and 10-year trends on health behaviors and experiences among high school students in the United States (U.S.) related to adolescent health and well-being. These include sexual behaviors, substance use, suicidal thoughts and behaviors, experiences such as violence and poor mental health, social determinants of health such as unstable housing, and protective factors such as school connectedness and parental monitoring. The report also highlights disparities in these important outcomes by sex, race and ethnicity, sexual identity, and sex of sexual contact.

The report highlights that while some indicators have trended positively, it states that “indicators of health and well-being in this report including protective sexual behaviors (i.e., condom use, sexually transmitted disease (STD) testing, and HIV testing), experiences of violence, mental health,

and suicidal thoughts and behaviors worsened significantly”.

There are groups of youth which have fared worse than others, and this includes girls and young women. As the report states, “Across almost all measures of substance use, experiences of violence, mental health, and suicidal thoughts and behaviors, female students are faring more poorly than male students. These differences, and the rates at which female students are reporting such negative experiences, are stark.” Click here for the full report. 

Supporting families to nurture healthier babies

Some Louisville families are now getting additional support in an effort address the nonmedical factors that influence health outcomes, promote the healthy development of infants, and provide support to their parents during the critical first six months of life. DULCE is a national model that came to Kentucky through a grant from the Center for Study on Social Policy (CSSP). DULCE stands for Developmental Understanding and Legal Collaboration for Everyone.

Family Specialists are the key part of this model. They are trained in relational practice and problem solving. The Family Specialists become a member of the pediatric care team and attend well-child visits with families and providers. They get to know the families, provide peer support, and then work with the DULCE Interdisciplinary Team - including medical, legal, and early childhood professionals - to connect families with resources and support.

The DULCE model is being piloted at one Louisville pediatric site, Family Health Centers Iroquois, with hopes to expand in the future. Dr. Julia Richerson is one of the medical providers involved with the program. She says the model has seen great results in other states, including:

• DULCE families secured supports for which they were eligible at roughly twice the pace of control families.
• Better completion rates for well-child visits and immunizations.
• Reduced use of emergency room care by DULCE families.

There is a Community Partner Group that helps highlight resources of the community, as well as ways to make DULCE sustainable in the future. 

The 2023 Legislative Session is taking place and therefore there are many action items for your consideration and advocacy! 

HB 162, the Youth Mental Health Protection Act, sponsored by Rep. Willner (D-35) with primary co-sponsor Rep. Timoney (R-45), prohibits all licensed mental health providers from engaging in any practices that purport to change a minor’s sexual orientation or gender identity and prohibits agencies that refers or provides these harmful practices from receiving state funding. This is the Ban Conversion Therapy bill.

The Kentucky Coalition for Healthy Children issued the following Press Release in support of HB162 on February 8, 2023.

Take Action Now on HB 162

Join the Rally to #ProtectKYKids on Mach 2, 2023 at noon at the KY Capital Rotunda

Call or email your Representative and ask him or her to sign on as a co-sponsor of HB 162.

Find your legislator.

Call to leave a message for House Leadership, asking that HB 162 be assigned to a committee for action because it provides important protection for our Kentucky children and youth.

Legislative Message Line: 1-800-372-7282

HB 384, The bill to establish Healthy Farm and Innovation Food Fund and Board has been filed! With by-partisan sponsorship by Representatives Dossett (R-9) and Chester-Burton (D-44), HB 384 builds upon Kentucky’s current momentum to increase access to healthy food, so important in the prevention of chronic health diseases, creating stability and opportunities for direct farm impact food access programs such as Kentucky Double Dollars, Farms to Food Banks, and Fresh RX for MOMs and other food is medicine innovative programs.

Take Action NOW on HB 384 and call the legislative message line to leave a message for your state representative! Call 1-800-372-7181 to leave a message. You can leave your own message, but feel free to use the script below.

“Good morning/afternoon Representative! My name is ______ and I am your constituent. Today, I wanted to ask for your support of House Bill 384. House Bill 384 would create a structured state fund to help Kentucky address food and nutritional security and support local farmers. Please help Kentuckians by supporting House Bill 384! Thank you!”

HB141 establishes the Urgent-Need Insulin Program and the Continuing Access to Insulin Program, application process, the process by which insulin is dispensed to eligible individuals, the responsibilities of insulin manufacturers, among others. The bill was filed by Rep. Danny Bentley and also has bi-partisan support.

The Foundation for a Healthy Kentucky co-sponsored this year's Diabetes Day at the Capitol, a virtual and in person event on February 15, in which Rep. Bentley spoke about this bill. Click here for the recording of the virtual event.

Take Action Now on HB141

The KY#INSULIN4ALL Network has developed a sign on letter related to this bill.

KHN | Looming Cuts to Emergency SNAP Benefits Threaten Food Security in Rural America

CNN | Changes to US school meal program helped reduce BMI in children and teens, study says

NBC News |  CDC says teen girls are caught in an extreme wave of sadness and violence

Kentucky Teacher |  Commissioner’s Student Advisory Council members, Lt. Gov. Coleman present student mental health recommendations to Kentucky legislators

Follow along as we make healthy, kid-friendly recipes with a focus on seasonal ingredients.

Taste the very beginning of Spring with this Vegetable Sauté.