The Joint Commission on Health care met May 18 for further discussion of its proposed workplan for the remainder of the year. Commission members also received a briefing from staff on the Commission’s Health Care Dashboard and a presentation by Secretary of Health and Human Resources John Littel about the Administration’s priorities in his secretariat.
The Commission’s 2022 workplan had been largely adopted at its December 2021 meeting, although several issues were subsequently referred to the Commission during the 2022 session. As directed at the Commission’s April meeting, the Executive Committee discussed these new items and opted not to proceed with the majority of the proposals this year, as staff are unable to take on additional studies, although the referrals could be considered for studies in 2023. The Commission is required to undertake a study of potential addition of obesity prevention or treatment services to Virginia’s Medicaid program, although this study’s due date allows it to be completed in 2023. The other matters – local health department effectiveness and lessons learned from the COVID-19 pandemic, vertically integrated health insurance carriers, prescription drug price benchmarking, and eating disorders – will be under consideration for inclusion in the Commission’s workplan for 2023.
Commission staff provided an overview of the four studies underway in 2022:
- Local health department structure and financing: This study is reviewing how programs and services compare across the state; whether the organization of local health departments is effective; and whether staffing and funding levels are commensurate with staff workload and community needs. Staff will be comparing Virginia’s structure to those of other states and assessing whether services provided are aligned with recognized public health standards.
- Affordability of assisted living facilities: Key areas of focus will be examining factors contributing to auxiliary grant bed availability (as well as challenges for assisted living facilities in accepting auxiliary grant recipients), reviewing alternative ways that other states structure and finance assisted living facilities (including how other states use Medicaid to pay for services in assisted living facilities) and assessing the feasibility of those models. Staff will be considering licensing requirements as they relate to questions of affordability.
- Reducing unnecessary emergency department utilization: This study will attempt to answer questions regarding why patients seek care in emergency departments and what strategies could ensure the provision of care in less costly settings. Commission members encouraged staff to examine issues related to the transition of patients from freestanding emergency departments to regular hospitals that may be operated by a different entity, as well as the effect of children and adults experiencing mental health crises whose admission to inpatient psychiatric care may be delayed for hours or even days.
- Provider data sharing to improve quality of care: This study will be cataloging existing provider-to-provider data sharing and assessing challenges that limit the effectiveness of existing data sharing. Members encouraged staff to examine how data sharing and connection between Community Services Boards and primary care providers could be improved, as well as data sharing between mental health providers and jails and prisons.
Commission members discussed the Health Care Dashboard, which was directed to be developed by the Commission as a way to track certain metrics to monitor trends and shape future Commission work. Some concerns were raised about which metrics were chosen and whether the dashboard duplicated work in other agencies; the Commission’s Executive Committee will review the dashboard in more detail with staff.
Secretary Littel offered an overview of key areas of focus for the Administration, noting that priorities were evolving as the Administration responded to the ongoing pandemic and other critical needs. In the near term, the Secretary is working to prepare for redetermination of Medicaid eligibility with the expected end of the federal public health emergency later this year. The Safe and Sound Task Force, which is addressing the crisis in foster care placements for children with high-acuity needs, is another priority; the lack of inpatient treatment options for children dovetails with the related, ongoing pressures on the state hospital system and the downstream effects on law enforcement personnel who are waiting, sometimes for days, with individuals who are subject to temporary detention orders for beds to become available. The Administration is seeking to address workforce needs in state hospitals, as well as IT and security needs at the facilities, in addition to expanding capacity in private hospitals and enhancing alternative transportation options. Secretary Littel is also working with Secretary of Education Aimee Guidera on mental health in higher education as well as in K-12 settings. The Administration is working to assist the Opioid Abatement Authority with staffing in preparation for distributing settlement funding. Secretary Littel also addressed the baby formula shortage, noting that although the state’s authority to speed production of formula is limited, the state is in contact with retailers to monitor supplies. He suggested that members encourage constituents who have concerns to contact their pediatrician; the Virginia Department of Health has provided additional information on its website.
The Commission’s next meeting is scheduled for August 17.
VACo Contact: Katie Boyle