the state of health in the commonwealth 2008 review & future goals
TRANSCRIPT
The State of Health in the Commonwealth
The State of Health in the Commonwealth
2008 Review & Future Goals2008 Review & Future Goals2008 Review & Future Goals2008 Review & Future Goals
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Council on Virginia’s Future HHR Council on Virginia’s Future HHR MeasuresMeasures
Council on Virginia’s Future HHR Council on Virginia’s Future HHR MeasuresMeasures
Measure Performance
Comments
Adoption Improving Adoptions are increasing; however, VA has one of the lowest adoption rates beyond 24 months
Foster Care Maintaining 3.9 per 1,000 children2nd best in the nation
Child Abuse & Neglect
Maintaining 3.5 cases per 1,000 children
Teen Pregnancy Improving 36.1 births per 1,000 females22nd lowest teen pregnancy rate
Obesity Worsening 25.1% for adults25th lowest obesity rate
Infant Mortality Maintaining 7.2 deaths per 1,000 live births18th highest rate
Suicide Maintaining 11.14 suicides per 100,000 population18th lowest suicide rate
Health Insurance Maintaining 12.8% uninsured rate21st in the nation
Immunization Improving 81.5%21st in the nation
Smoking Improving 19.3% for adults21st lowest
Life expectancy Improving Average life span of 76.8 years28th in the nation
Key measures
drive HHR’s focus
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HHR Strategy & VisionHHR Strategy & VisionHHR Strategy & VisionHHR Strategy & Vision
Focus on 6 main areas Access to Care Healthcare Workforce Long-Term Care Quality and Transparency Prevention Mental Health Transformation
Ultimately want the Commonwealth to be in the top ten healthiest states in the nation
Focus on 6 main areas Access to Care Healthcare Workforce Long-Term Care Quality and Transparency Prevention Mental Health Transformation
Ultimately want the Commonwealth to be in the top ten healthiest states in the nation
Virginia’s Overall Health Ranking
Among the 50 States
1998 10
1999 14
2000 14
2001 15
2002 18
2003 21
2004 20
2005 24
2006 21
2007 22
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2008 Results & Current 2008 Results & Current ActivitiesActivities
2008 Results & Current 2008 Results & Current ActivitiesActivities
Area 2007/2008 Accomplishments & 2008 Session Results
Access to Care Prenatal coverage expanded to 200% FPL in FY2010 and 60 day continued coverage of infants in FAMIS
Mission of Mercy project - $25,000 per year Safety net funding - $3.5M in FY2009 and $1.75M in FY2010 Virginia Breast and Cervical Cancer Detection Program - $300,000 in FY2010 Evaluate Medicaid provider access biennially – DMAS will complete Study VA uninsured program – VHCF will complete
Healthcare Workforce
Workforce data center – DHP has received a $275,000 grant from the Governor’s office of Workforce Development Federal designation - VDH has been awarded $69,232 by the Williamsburg Community Health Foundation to systematically review, identify, and designate all Greater Williamsburg areas Currently considering proposals for Direct Support Professional career ladders through DSS using TANF dollarsExpanded medical school enrollment by 30% through bond package
Long-Term Care
Older Dominion Project
Transparency HB603 and SB396 = Commissioner of Health will maintain a website with the reimbursement that is paid for at least 25 of the most frequently reported health care services
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2008 Results & Current 2008 Results & Current ActivitiesActivities
( continued )( continued )
2008 Results & Current 2008 Results & Current ActivitiesActivities
( continued )( continued )Area 2007/2008 Accomplishments & 2008 Session Results
Prevention HB242 = Requires local school boards to provide a physical fitness program with a goal of 150 minutes per week for all students
HB 246 = Requires the Department of Education to develop a database of local school divisions' best practices regarding nutrition and physical education, including results of wellness-related fitness assessments. The database shall be accessible to all local school divisions and the Department of Health, and no school division shall be required to submit information to the database
Awarded CDC funding for student survey Awarded $100,000 NGA grant to combat childhood obesity
Mental Health
$42 Million over SFY09-10 to increase- Emergency Health Services, CSB Case Managers, Availability of Outpatient Clinicians at CSBs. Accountability & Oversight of CSBs, Frequency of Jail Diversions. Availability of Crisis Intervention Training
HB499 and SB 246= comprehensive changes in the mental health system addressing:
- Commitment criteria, Disclosure of information, Extension of emergency custody period, Role of the independent examiner, CSB attendance at hearings. New mandatory outpatient procedures
Bond package including replacement of Western State and renovation/replacement of two Lynchburg and Chesapeake MR facilities
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2008 Results & Current 2008 Results & Current ActivitiesActivities
( continued )( continued )
2008 Results & Current 2008 Results & Current ActivitiesActivities
( continued )( continued )Area 2007/2008 Accomplishments & 2008 Session
Results
Foster Care Permanency
“For Keeps”
$24 Million Over Biennium to Increase:- Foster care and adoption payment rates, Funding for Child Welfare Worker Training, Increase Recruitment and Retention of Foster Families, Collection of Outcomes Data
Budget also includes incentives to:- Increase use of community-based care- Increase use of Medicaid in CSA program
HB811 and SB251 = Provide TANF payments to kin who care for children who are removed from homes because of abuse or neglect HB825 and SB493 = Mandate training for foster care workersCreation of the First Lady’s FOR KEEPS Initiative to raise awareness Secured contract with Annie E. Casey Foundation to assess Virginia’s foster care system performance and identify areas for improvement Establishment of FACES Established the CORE Team to implement reforms
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Future Goals:Future Goals:Access to CareAccess to Care
Future Goals:Future Goals:Access to CareAccess to Care
Medicaid:Continue acute and LTC integrationExpand managed care statewide
and in mental healthBrain injury waiverRebid Medicaid Management
Information System (MMIS)Web-based claims submissions
Medicaid:Continue acute and LTC integrationExpand managed care statewide
and in mental healthBrain injury waiverRebid Medicaid Management
Information System (MMIS)Web-based claims submissions
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Future Goals:Future Goals:ContinueContinue Workforce Workforce
EffortsEfforts
Future Goals:Future Goals:ContinueContinue Workforce Workforce
EffortsEfforts Nurse Practitioner scope of practice
Convening workgroup of stakeholders Develop legislation prior to 2009 session
Expanding the scope of dental hygienists in underserved areas of the state
Clinical and practicing social workers Evaluating loan repayment programs to improve
LDSS and CSB workforce Improve training for child welfare workers (Casey
Family Programs)
Nurse Practitioner scope of practice Convening workgroup of stakeholders Develop legislation prior to 2009 session
Expanding the scope of dental hygienists in underserved areas of the state
Clinical and practicing social workers Evaluating loan repayment programs to improve
LDSS and CSB workforce Improve training for child welfare workers (Casey
Family Programs)
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Future Goals:Future Goals: Long-Term CareLong-Term Care
Future Goals:Future Goals: Long-Term CareLong-Term Care
Older Dominion Project
Aging Strategic Plan Long term care “Aging Well” communities
Individual Planning Community Planning
State agency impacts
Older Dominion Project
Aging Strategic Plan Long term care “Aging Well” communities
Individual Planning Community Planning
State agency impacts
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Future Goals:Future Goals:PreventionPreventionFuture Goals:Future Goals:PreventionPrevention
Smoking: Decide on policy
Allow smoking after a particular time (i.e. after 9:00 p.m.)
Carve out bars from restaurants and allow only in bars by changing ABC licensing structure
Convene a workgroup of stakeholders and legislators, including those opposed
Smoking: Decide on policy
Allow smoking after a particular time (i.e. after 9:00 p.m.)
Carve out bars from restaurants and allow only in bars by changing ABC licensing structure
Convene a workgroup of stakeholders and legislators, including those opposed
Obesity:
1. Bills from this 2008 that did not pass Competitive foods nutrition
standards Transfats Requirements/hours/types of
physical activity
2. Health Impact Assessments Score the health assessment of a
project VDH staff would implement Share with local governments and
allow them to decide what is best for their community
Could make statewide policy with disincentives and incentives Tax breaks Prevent a project from moving forward
Obesity:
1. Bills from this 2008 that did not pass Competitive foods nutrition
standards Transfats Requirements/hours/types of
physical activity
2. Health Impact Assessments Score the health assessment of a
project VDH staff would implement Share with local governments and
allow them to decide what is best for their community
Could make statewide policy with disincentives and incentives Tax breaks Prevent a project from moving forward
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Future Goals:Future Goals:Mental HealthMental Health
Future Goals:Future Goals:Mental HealthMental Health
Support Implementation of Mental Health Reforms Training across courts, CSBs, law enforcement, and private providers Monitor work of Commission on Mental Health Law Reform
Higher Education Conference on Disclosure of Student Information November Discussion of FERPA, MH law changes, services Include student life, faculty, CSBs Small and large universities
Commonwealth Consortium for Criminal Justice/Mental Health Transformation Training kick-off in May Goal: establishing local plans for jail diversion/improving mental health
services for individuals encountering the criminal justice system Involves local, regional law enforcement, CSBs, General District Courts,
and state agencies Substance Abuse in SW Virginia Prisoner Reentry Workgroup
Improve upon existing MOU between DMHMRSAS, VACSB, and DOC
Support Implementation of Mental Health Reforms Training across courts, CSBs, law enforcement, and private providers Monitor work of Commission on Mental Health Law Reform
Higher Education Conference on Disclosure of Student Information November Discussion of FERPA, MH law changes, services Include student life, faculty, CSBs Small and large universities
Commonwealth Consortium for Criminal Justice/Mental Health Transformation Training kick-off in May Goal: establishing local plans for jail diversion/improving mental health
services for individuals encountering the criminal justice system Involves local, regional law enforcement, CSBs, General District Courts,
and state agencies Substance Abuse in SW Virginia Prisoner Reentry Workgroup
Improve upon existing MOU between DMHMRSAS, VACSB, and DOC
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Future Goals:Future Goals:Modernizing Modernizing
InfrastructureInfrastructure
Future Goals:Future Goals:Modernizing Modernizing
InfrastructureInfrastructureStatement of Work
VDSS, VDH, DMHMRSAS Operational and programmatic review of
the current operations Compare senior/middle management skills
sets to current management skill sets Examine IT systems
Improve Eligibility Processes For consumers and local workers
Statement of Work VDSS, VDH, DMHMRSAS Operational and programmatic review of
the current operations Compare senior/middle management skills
sets to current management skill sets Examine IT systems
Improve Eligibility Processes For consumers and local workers
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Future Goals:Future Goals:Health Benefits Health Benefits
TaskforceTaskforce
Future Goals:Future Goals:Health Benefits Health Benefits
TaskforceTaskforceTaskforce convened in April 2008 Improve state pharmaceutical spend:
State employees Medicaid enrollees Prisoners
Explore levering all three populations during contract negotiations
Wellness and prevention initiatives
Taskforce convened in April 2008 Improve state pharmaceutical spend:
State employees Medicaid enrollees Prisoners
Explore levering all three populations during contract negotiations
Wellness and prevention initiatives
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Future Goals:Future Goals:Health Insurance Health Insurance
ExpansionExpansion
Future Goals:Future Goals:Health Insurance Health Insurance
ExpansionExpansion State code 32.1-335 allows for the
appointment of a technical advisory panel (DMAS) with the authority to establish pilot health care projects for the uninsured
Riverside Foundation says yes to the use of their voluntary contribution for a pilot authorized in Code by the GA
Use results from that pilot to advance program in 2009 General Assembly session
State code 32.1-335 allows for the appointment of a technical advisory panel (DMAS) with the authority to establish pilot health care projects for the uninsured
Riverside Foundation says yes to the use of their voluntary contribution for a pilot authorized in Code by the GA
Use results from that pilot to advance program in 2009 General Assembly session