Sima Ladjevardian, Region Six Director for the US Department of Health and Human Services (HHS), outlined the agency’s health policy priorities for the region during a presentation at the 2023 Texas State of Reform Health Policy Conference in Austin last week.
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HHS Region Six encompasses Texas, New Mexico, Oklahoma, Arkansas, and Louisiana. Ladjevardian said coming out of COVID-19, federal agencies remain focused on protecting public health, reducing healthcare costs, expanding access to care, and addressing behavioral and maternal health. Woven into these priorities is the promotion of health equity.
“So on the equity level, we have put in a lot of effort and money making sure that we bring attention [to] and close this maternal disparity,” Ladjevardian said. “There’s been funding going for doula services, [and] funding going to rural health because there is sadly the lack of services in those areas now.
We’re also putting a lot of attention on community health workers, because in communities when you don’t have that kind of care, the community health workers can really come in and provide a trust situation for everyone.”
The Consolidated Appropriations Act, the federal government’s $1.7 trillion yearlong spending package, will provide renewed funding to states for healthcare programs. Ladjevardian highlighted some of the key provisions in the omnibus spending that impacts the health of Texans.
With the president’s signing of the federal omnibus budget, Medicaid disenrollment was uncoupled from the COVID-19 public health emergency so that states may resume redeterminations for Medicaid beginning April 1st, 2023, ending continuous Medicaid enrollment. With the ending of the COVID-19 Public Health Emergency (PHE) on May 11th, 2023, the federal government will begin phasing down its enhanced matching funds for Medicaid, which were increased as part of the PHE.
The omnibus bill also includes Medicaid funding for mental health, and makes the temporary 12-month postpartum coverage option for states permanent.
“As far as Medicare is concerned, telehealth is going to be covered,” Ladjevardian said. “We’ve seen during the pandemic how important telehealth has been and I know [the conference] just had a conversation earlier, especially on the mental health side, [about] how important it is to continue to have telehealth. There is tremendous money coming in for substance use, and mental health investment for workforce.”
She cited political divisions, along with natural disasters, health disparities among tribal communities, and the workforce shortage as some of the challenges states in her region are facing.
Texas remains one of the few states that has not implemented the Medicaid 12-month postpartum coverage option, but legislation this session to extend this coverage to the full 12 months (Texas currently covers up to six months) has gained support.
The Biden/Harris administration has made behavioral health a priority and HHS Secretary Xavier Becerra announced the start of a national listening tour earlier this year to strengthen mental health issues that were exacerbated by the pandemic. Secretary Becerra has conducted listening sessions in communities across the country, which resulted in HHS’s Roadmap for Behavioral Health Integration. Ladjevardian has also been conducting listening sessions in the Region.
She recently visited all five 988 crisis response centers in Texas and said it was heartwarming to learn of the impact the state’s efforts were having. According to Ladjevardian, crisis centers nationwide maintained a 98% response rate to some 2.1 million contacts made since 988 went online, including a 1,145% increase in text responses.
Ladjevardian said her attention over the coming year is focused on implementing the federal policies and ensuring support gets to the people in need.
“So whether it’s the Inflation Reduction Act, literally going to every senior home that we know and letting them know, ‘Hey, these [prescription drug benefits] are available, please make sure you take advantage of it,’ [and] encouraging other pharmaceuticals to potentially follow suit,” Ladjevardian said. “Also [ensuring that] funding from the bipartisan Safer Communities Act coming in [for mental and maternal health] goes to the states—so just making sure that it gets to the right people that actually need it. That’s really what is going to be our focus for the next 12 months.”