Medicaid’s role in addressing social needs and the worsening health disparities during the pandemic was the central focus of United Hospital Fund’s 2021 Medicaid Conference. Speakers highlighted the need to address homelessness, the increased use of telehealth, and the role of community-based organizations.
The conference, supported by The Commonwealth Fund, was held on July 15 via live webcast. It drew more than 600 unique viewers, consisting of providers, payers, state and local government officials, researchers, consultants, and consumer advocates. The webcast can be viewed here. (Free one-time registration required to view video.)
Keynoter Brett Friedman, director of Strategic Initiatives and Special Medicaid Counsel in the Office of Health Insurance Programs, New York State Department of Health, outlined a number of the state’s planned actions to improve health equity, including a pilot medical respite program for people experiencing homelessness who have been released from the hospital. The program provides temporary supportive housing that allows patients to recuperate and receive medical care in a safe setting. “No one should remain in a hospital setting because they have nowhere to live,” said Mr. Friedman.
The morning panel expanded on Mr. Friedman’s themes, with a lively discussion on “Medicaid’s Role in Providing Holistic Health Care for People Experiencing Homelessness in New York.” The panel was moderated by Bonnie Mohan, Executive Director, The Health and Housing Consortium, Inc. Ms. Mohan noted that children who experience homelessness are more likely to be homeless as adults—what she labeled “the unconscionable intergenerational cycle of homelessness.”
Panelists discussed gaps in Medicaid funding, and the increasing number of aging people experiencing homelessness. The services this population needs are often unavailable or inadequate, and they are a growing segment of the homeless population. Panelists included Lisa Green, Senior Vice President, Residential Services, The Bridge; Ron Lawson, Chief Operating Officer, Care for the Homeless; and Van Yu, MD, Chief Medical Officer, Center for Urban Community Services and Janian Medical Care.
As an illustration of the many challenges and inequities that make it difficult to provide health care to people experiencing homelessness, Mr. Lawson noted that, when his clinic tried to provide smart phones to patients during the pandemic so they could access telehealth services, it faced potential penalties for violating rules around unduly incentivizing patients.
Proposed solutions to these difficult problems included sufficient, flexible funding that is adaptive to evolving needs as well as supportive housing and better collaboration between state agencies and service providers.
The afternoon panel, “Addressing Community Needs Through Medicaid,” was moderated by two staff members from Maimonides Medical Center in Brooklyn: Kishor E. Malavade, MD, Vice Chair, Department of Population Health; and Shari Suchoff, Vice President, Population Health Policy and Strategy and Executive Director, Brooklyn Communities Collaborative. Their message: we need to take a more holistic approach to addressing health through community-designed solutions, and then get out of the way and let the community lead.
The panelists represented a range of organizations working with Maimonides to address social needs: Susan Beane, MD, Vice President and Executive Medical Director, Healthfirst; Debra Lesane Watson, previously with Caribbean Women's Health Association; and Jeffannie O’Garro, Alumna, Participatory Action Research Alumni.
Among the projects discussed was a hydroponics farm at a middle school in the Brownsville section of Brooklyn that grew out of an assessment by Participatory Action Research showing that food insecurity in the area stemmed from a lack of access to fresh fruits and vegetables. Students at the school plant and harvest crops and learn about farming.
To learn about presentations at previous UHF Medicaid conferences, click here.