COLUMBIA, S.C. (WCSC) - A push to majorly restructure how health services are delivered to millions of South Carolinians cleared a big hurdle Wednesday at the State House.

After a five-plus-hour debate, the House of Representatives approved a bill, H.4927, to merge several state agencies into one, a week after the Senate passed similar legislation.

The bill is the second step in a massive reorganization that started last year, when the legislature passed a new law to split the Department of Health and Environmental Control, DHEC, into two new state agencies.

As part of that legislation, the state’s Department of Administration contracted with Boston Consulting Group last year to study whether more changes to agency structure would benefit South Carolinians.

Boston Consulting Group’s study of South Carolina’s healthcare delivery system found it is the most fragmented model in the country.

Lawmakers said that leads to people falling through the gaps when these agencies fail to coordinate as well as they could.

“They’ll come in with a mental health issue and a drug problem, and … it’s one of these where they’re sent somewhere else. So there’s no economy of scales right there, but also two, it’s the worst thing we can do for our constituents if we’re putting money in this to get them well,” Rep. Bill Herbkersman (R-Beaufort) and the sponsor of the House bill, said during Wednesday’s debate.

This bill is intended to streamline that by combining six separate state agencies into one, a new “Executive Office of Health and Policy.”

This office would merge the existing Departments of Alcohol and Other Drug Abuse Services, Disabilities and Special Needs, Health and Human Services, Mental Health, and Aging, plus the new Department of Public Health that will be created this summer when DHEC splits.

Under the bill, a new Secretary of Health and Policy would lead the new agency. That person would be a member of the governor’s cabinet and appointed by the governor, with senators’ approval.

“So that we can streamline the state agencies’ structure and roles,” Rep. Jay Jordan (R-Florence, said.) “This will hopefully allow to build a strategic plan and an operating approach so these healthcare services can be delivered in a more efficient manner.”

But members of the ultraconservative Freedom Caucus opposed the consolidation, saying it would give one person, the new agency’s secretary, too much power.

“What it’s going to end up being is centralization of power. It’s putting all the medical bureaucrats under one chief bureaucrat,” Rep. Josiah Magnuson, R – Spartanburg, said.

Many of their concerns focused on giving this new secretary the authority to command sheriffs and local law enforcement to enforce mandates during times of public health emergencies, an authority the director of DHEC has under the current structure.

Magnuson proposed an amendment that would allow the secretary to request law enforcement’s assistance but not compel it. That change was not adopted.

Rep. Micah Caskey, R – Lexington, noted law enforcement is not trained to determine what does and does not qualify as a public health emergency.

Caskey pointed to previous pandemics, epidemics, and outbreaks, when such enforcement has been needed to address these emergencies, including the 2013 tuberculosis outbreak in Greenwood County. During that period, DHEC issued a public health order that mandated people who tested positive for the disease comply with certain directives or else face arrest.

“Public health authorities need authority to act because they are not law enforcement officers themselves. They cannot take independent action to compel or restrict behaviors, which are subject to the public health directives that they have issued,” Caskey said.

The House ultimately approved the bill in a 100-17 vote, but the legislation must still clear a few more steps to reach the governor’s desk because the House and Senate passed separate bills, though they include similar language.

Gov. Henry McMaster has urged this consolidation, calling it one of the most important bills the legislature can take up this year.

Copyright 2024 WCSC. All rights reserved.

COLUMBIA, S.C. (WCSC) - After a court ruling in Alabama left in vitro fertilization services there in limbo, other states, including South Carolina, are grappling with whether the same could happen to them.

Now lawmakers in Columbia are taking action.

On Thursday, legislators gathered to announce bills they have filed in light of the Alabama ruling, with some sharing their own experiences with what can be a challenging and expensive procedure that is ultimately worth it for so many families.

It’s why they said they filed bills to protect IVF across South Carolina.

“To rip away the ability of parenthood is heartless, cruel, and unacceptable. This is personal for me. But for IVF, my family would not have the opportunity to expand,” Rep. Kambrell Garvin (D-Richland) and the lead sponsor of the House bill, said during a news conference.

This week, bills have been filed in both the House and the Senate and referred to their respective judiciary committees.

The bills’ sponsors are predominantly Democrats, with some Republican support.

But one leading Republican lawmaker said this legislation is not needed.

“What played out in Alabama can’t play out in South Carolina,” Senate Majority Leader Shane Massey (R-Edgefield) told reporters Wednesday.

Massey said he was not concerned, pointing to how Alabama has enacted a ban on abortion from conception, while South Carolina has a ban from six weeks into a pregnancy.

“That is what was a big part of the Supreme Court opinion down there. That’s not what our law is,” Massey said. “I am confident that IVF is protected in South Carolina.”

But supporters of these bills point to South Carolina’s existing abortion law, the six-week ban, also known as the “Fetal Heartbeat Law.”

It defines “unborn child” as “an individual organism of the species homo sapiens from conception until live birth,” and “conception” as “fertilization of an ovum by sperm.”

They said by those definitions, conception is happening outside the uterus through IVF.

“If the court looked at our statutes the way that the Alabama Supreme Court looked at their statute, there is, in fact, an interpretation that would lead them to be able to say the very same thing, that IVF in this state would be wrong because they could consider an embryo to be a child,” House Minority Leader Todd Rutherford (D-Richland) said.

These bills aim to protect IVF by codifying in state law that any fertilized human egg or human embryo that exists in any form outside the uterus shall not be considered an unborn child.

Without this addition, they argued IVF could be threatened in South Carolina.

“Family matters. We need to protect a family’s right to have in vitro fertilization,” Sen. Margie Bright Matthews (D-Colleton) and the lead sponsor of the Senate bill, said during Thursday’s news conference.

Gov. Henry McMaster told reporters Thursday afternoon that he had not yet read the bills or the Alabama court’s decision.

“But I think anything to allow and protect the ability of parents, people who want to be parents, to be parents, to have beautiful babies is a good thing,” McMaster said.

COLUMBIA, SC, February 28, 2024 — The South Carolina Alliance of Health Plans is proud to announce that Board President, Courtnay Thompson, Market President at Select Health of South Carolina, has been selected to Modern Healthcare Magazine’s inaugural class of “40 Under 40”  notable young executives who are influencing the future of healthcare.  (https://www.modernhealthcare.com/awards/40-under-40-2024).

 

Ms.Thompson was Select Health’s youngest market president when she took the job in 2018. She has shown exceptional leadership in all of her roles at the company. Courtnay credits female colleagues with mentoring her, and she hopes to carry that forward for others. Her approach is often influenced by her background in nursing, as well, she said.

 

"We are very proud of Courtnay for receiving this national industry award.  As the South Carolina Alliance of Health Plans' President, she provides excellent leadership and encourages strong collaboration among our members to advance the organization.  We are pleased that Modern Healthcare recognized her early leadership on a national scale, and we are confident that Courtnay's impact will be even greater in the years to come."  Jim Ritchie, Executive Director, SCAHP.  

By Daniel Chang and Andy Miller | KFF Health News

As a part-time customer service representative, Jolene Dybas earns less than $15,000 a year, which is below the federal poverty level and too low for her to be eligible for subsidized health insurance on the Obamacare marketplace.

Dybas, 53, also does not qualify for Medicaid in her home state of Alabama because she does not meet the program requirements. She instead falls into a coverage gap and faces hundreds of dollars a month in out-of-pocket payments, she said, to manage multiple chronic health conditions.

“I feel like I’m living in a state that doesn’t care for me,” said Dybas, a resident of Saraland, a suburb of Mobile.

Alabama is one of 10 states that have refused to adopt the Affordable Care Act’s expansion of Medicaid, the government health insurance program for people who are low-income or disabled.

But lawmakers in Alabama and some other Southern states are reconsidering their opposition in light of strong public support for Medicaid expansion and pleas from powerful sectors of the health care industry, especially hospitals.

Expansions are under consideration by Republican legislative leaders in Georgia and Mississippi, in addition to Alabama, raising the prospect that more than 600,000 low-income, uninsured people in those three states could gain coverage, according to KFF data.

Since a 2012 Supreme Court ruling rendered the ACA’s Medicaid expansion optional, it has remained a divisive issue along party lines in some states. Political opposition has softened, in part because North Carolina’s Republican-controlled legislature voted last year to expand the program. Already, more than 346,000 residents of the Tar Heel State have gained coverage.

And lawmakers in nearby states are taking notice.

“There has certainly been a lot of discussion of late about Medicaid expansion,” said Georgia House Speaker Jon Burns, a Republican, in a speech to the state chamber of commerce shortly after the legislative session began on Jan. 8.

“Expanding access to care for lower-income working families through a private option — in a fiscally responsible way that lowers premiums — is something we will continue to gather facts on in the House,” Burns said.

In addition to Georgia, state House speakers in Alabama and Mississippi have indicated a new willingness to consider coverage expansion. All three states have experienced a large number of hospital closures, particularly in rural areas.

Medicaid expansion has become “politically safer to consider,” said Frank Knapp, president of South Carolina’s Small Business Chamber of Commerce. In his state, Republican lawmakers are weighing whether to appoint a committee to study expansion.

It’s the kind of momentum some health policy analysts view as a favorable shift in the political discourse about expanding access to care. And it comes as a new crop of conservative leaders grapple with their states’ persistently high rates of poor, uninsured adults.

An additional incentive: Under President Joe Biden’s 2021 American Rescue Plan Act, the federal government pays newly expanded states an additional 5 percentage points in the matching rate for their regular Medicaid population for two years, which would more than offset the cost of expansion for that period.

But even as new discussions take place in legislatures that once froze out any talk of Medicaid expansion, considerable obstacles remain. Republican Mississippi Gov. Tate Reeves, for example, still opposes expansion. And several nonexpansion states appear to have little to no momentum.

“A lot of things need to come together in any given state to make things move,” said Robin Rudowitz, director of the Program on Medicaid and the Uninsured at KFF.

Under Medicaid expansion, adults earning up to 138% of the federal poverty level, or about $35,600 for a family of three, qualify for coverage.

Expansion has reduced uninsured rates in rural areas, improved access to care for low-income people, and lowered uncompensated care costs for hospitals and clinics, according to KFF analyses of studies from 2014 to 2021. In states that have refused to expand Medicaid, all of those challenges remain acute.

Alabama’s legislative session began Feb. 6. Republican House Speaker Nathaniel Ledbetter has suggested that he’s open to debating options for increased coverage. So many hospitals are in “dire straits,” he said at a Montgomery Area Chamber of Commerce meeting in January. “We’ve got to have the conversation.”

Expansion could make as many as 174,000 uninsured people in Alabama eligible for coverage, according to KFF data. Still, Ledbetter prefers a public-private partnership model, and has looked at Arkansas’ program, which uses federal and state money to pay for commercial insurance plans on the Obamacare marketplace for people who would be eligible for Medicaid under expansion.

In Alabama, lawmakers have introduced a plan that would levy a state tax on gaming revenue and could help fund health insurance coverage for adults with annual incomes up to 138% of the federal poverty level.

Robyn Hyden, executive director of advocacy group Alabama Arise, which supports Medicaid expansion, has seen progress on efforts to increase coverage. “The devil’s going to be in the details,” she said.

Mississippi’s new House speaker, Jason White, a Republican, has said he wants to protect hospitals and keep residents from seeking regular care through the emergency room. More than 120,000 uninsured people in Mississippi would become newly eligible for Medicaid under expansion, according to KFF data.

White told KFF Health News in a written statement that improving access to health care is a priority for business leaders, community officials, and voters.

“The desire to keep Mississippians in the workforce and out of the emergency room transcends any political party and is a vital component to a healthy workforce and a healthy economy,” he said. State legislators are determined to work with Reeves on the issue, he said.

Burns, the Georgia House speaker, has said that he’s open to a proposal for an Arkansas-style plan. Republican Gov. Brian Kemp said he would reserve comment until after the legislative process, according to spokesperson Carter Chapman.

He emphasized Kemp’s commitment to his recently launched plan requiring low-income adults to work, volunteer or receive schooling or vocational training for 80 hours a month in exchange for Medicaid coverage. As of mid-January, the cumulative enrollment was right around 3,000. Expansion could make at least 359,000 uninsured people in Georgia newly eligible for Medicaid, according to KFF data.

In South Carolina, Republican lawmakers are considering legislation that would allow them to form a committee to study expansion. State Sen. Tom Davis, a Republican from Beaufort who sponsored the bill and previously opposed expanding Medicaid, said he’s not endorsing or opposing Medicaid expansion at this time.

“We need to have a debate,” Davis said during a committee meeting in January.

The state legislature would likely have to work with Gov. Henry McMaster, a Republican, who, according to spokesperson Brandon Charochak, remains opposed to Medicaid expansion.

North Carolina started enrolling residents under its expansion Dec. 1. They included Patrick Dunnagan, 38, of Raleigh. The former outdoor guide said he hasn’t been able to work for years because of kidney disease and chronic pain.

He has relied on financial support from his family and said his medical debt stands at more than $5,000. Medicaid coverage will provide financial security.

Dunnagan said people with chronic health conditions in nonexpansion states “are accumulating medical debt and not getting the care they need.”

Bills proposed in Texas’ legislature didn’t get a vote last year. And the state doesn’t allow voter-initiated referendums, which have been a route to expansion in some Republican-led states. An estimated 1.2 million uninsured people would be eligible for coverage — more than in any other state still holding out — if Texas expanded.

CHARLESTON, S.C. (WCSC) - Hospital care at home could stay a reality in South Carolina thanks to a new bill working through the State Legislature, and one Lowcountry hospital is hoping for just that.

The bill’s sponsor, South Carolina Senator Tom Davis, says during the COVID-19 Pandemic, a lot of healthcare regulations were suspended, including the extent of care hospitals can offer at home.

“COVID was sort of a whole experimental process, it pushed the envelope as to how can we do things differently, are these rules and regulations really necessary, can we do things and provide more options?” Davis says.

Right now hospital care at home is still allowed, but Davis says they’re working against the clock to get Bill S.858 signed into law before the regulations come back.

Roper and Berkeley Hospitals Regional President Troy Powell says their Hospital at Home Program typically offers care to patients with chronic conditions, or to patients recovering from surgery.

A nurse or community paramedic will visit the patient’s home at least twice a day. The patient is also constantly monitored with a “biosticker,” which is a patch that collects data like blood pressure and oxygen saturation and feeds it back to a monitoring center, he says.

Powell is hoping the bill is signed into law because hospital-at-home care produces better outcomes for patients by lessening the risk of infection, delirium, and falls.

“Also, what the patients are reporting is much better. They’re much more comfortable being in their home, being able to eat their meals, not being woken up at all times of the night because we’re able to monitor it,” Powell says.

After getting part of her colon removed, Tracy Marley received hospital-at-home care from Roper. She says she felt safe and confident she was in good hands.

“It was tremendous, I got to sleep in my own bed, I wasn’t disturbed at night, I got to eat my own food,” she says.

Davis says they’re holding subcommittee hearings on the bill next week and will hopefully get it on the Senate floor in the next three weeks. He says he’s optimistic to get the bill passed before adjourning in May.

Copyright 2024 WCSC. All rights reserved.

South Carolina lawmakers are taking sweeping action to consolidate, with the goal to hopefully improve the delivery of health care services in the state.

The SC Senate on Wednesday, Feb. 21, 2024 overwhelmingly gave final approval to a bill that restructures the giant Department of Health and Environmental Control, known as DHEC, by combining the state agency’s public health functions with those of five other health care agencies.

The bill also creates a separate environmental division, which currently is a part of DHEC.

“It’s all about improving healthcare outcomes for South Carolinians,” Sen. Tom Davis, R-Beaufort, told SC Public Radio.

“The bill brings South Carolina’s delivery of public health services from the 20^th century to the 21^st century,” David added.

If it becomes law, the measure calls for the following agencies to join with DHEC’s Division of Public Health: Commission on Aging, Alcohol and other Drug Abuse Services, Disability Services, Health and Human Services, and Mental Health.

A new cabinet-level secretary, appointed by the governor and confirmed by the Senate, would run the new Executive Office of Health and Policy.

For years, many state leaders have maintained that South Carolina’s delivery of health care and human services have been too fractured with little planning and cooperation among the involved agencies.

The Senate approved bill was two years in the making.

It followed dozens of public hearings and subcommittee meetings. It now goes to the S.C. House of Representatives where a similar bill is pending.

Restructuring DHEC and the state’s healthcare services is one of the top priorities in this year’s General Assembly session.

New guardrails for Medicare Advantage plans' use of AI may not be clear enough, experts told members of the Senate Finance Committee. 

CMS sent a message to Medicare Advantage plans Feb. 6, clarifying how new prior authorization rules set forth by the agency apply to AI. The agency wrote that AI programs can be used to assist in coverage determinations, but it is the plans' responsibility to "ensure that the algorithm or artificial intelligence complies with all applicable rules for how coverage determinations by MA organizations are made." 

The agency will also up its auditing of denials in Medicare Advantage plans, according to the message. 

Lawmakers have urged CMS to do more to regulate the use of AI by Medicare Advantage plans. The Senate Finance Committee held a hearing probing the use of AI in healthcare Feb. 8. 

At the hearing, Michelle Mello, PhD, professor of health policy at Stanford University, told the committee CMS should implement more specific guidelines on requirements for meaningful human review of claims denied by algorithms. 

"Audits by CMS need to look very closely, as I believe they intend to, at denials where algorithms were involved," Dr. Mello said. 

UnitedHealthcare and Humana, the largest Medicare Advantage insurers, are facing lawsuits alleging they wrongfully denied members care using an AI-powered algorithm. A spokesperson for Optum, the UnitedHealth Group subsidiary that operates the algorithm, told Becker's the tool is not used to make coverage determinations. 

A spokesperson for Humana told Becker's its augmented intelligence maintains a "human in the loop" whenever AI is used, and "adverse coverage decisions are only made by physician medical directors."

Ziad Obermeyer, MD, Blue Cross of California Distinguished Associate Professor of Health Policy and Management at the University of California Berkeley, told the committee AI learns from historical data and can reinforce existing trends rather than improve them. 

"[AI] trolls through millions of records, and sees there are some privileged people with great insurance who stay in nursing homes longer than they should, and there are also vulnerable, underinsured people who are often kicked out too early," Dr. Obermeyer said. "Rather than undoing that problem, the AI reinforces it and encodes it as policy." 

Well-designed AI programs could make these decisions better than humans, Dr. Obermeyer said. 

"It could look at the patient's X-ray, it could look at the public transportation in their neighborhood, it could look at the layout of their house, and integrate all those things into a far better judgment than a doctor is able to make on who needs to be in that nursing home and who doesn't," he said. 

Sen. Elizabeth Warren, a frequent critic of Medicare Advantage, said CMS should prevent MA plans from using AI in prior authorization until it can confirm algorithms do not result in wrongful denials of care. 

"It takes the bad information and accelerates it, or [accelerates] the information that is bad practice," Ms. Warren said.

Algorithms and artificial intelligence-powered software tools can be used to support Medicare Advantage plans in making coverage decisions for members, but payers are still bound by CMS' internal benefits requirements and nondiscrimination rules under the ACA, the agency said in guidance to insurers regarding its final 2024 MA rule.

"We are concerned that algorithms and many new artificial intelligence technologies can exacerbate discrimination and bias," the agency wrote Feb. 6. "MA organizations should, prior to implementing an algorithm or software tool, ensure that the tool is not perpetuating or exacerbating existing bias, or introducing new biases."  

The guidance comes as scrutiny of payers' use of AI increased in 2023. UnitedHealthcare, Humana and Cigna are facing lawsuits alleging they used AI tools or algorithms to wrongfully deny care to Medicare Advantage members.

Four key takeaways:

1. Because of how rapidly software technologies are evolving and overlapping definitions, CMS clarified its perspective on the difference between algorithms and artificial intelligence. Algorithms "can imply a decisional flow chart of a series of if-then statements," while AI is a "machine-based system that can — for a given set of human-defined objectives — make predictions, recommendations or decisions influencing real or virtual environments.

2. Payers can use algorithms to support coverage decisions, but it is their responsibility to ensure that an algorithm or an AI-based tool is compliant with the agency's coverage decision requirements. For example, MA carriers must base coverage decisions on an individual member's medical history, physician recommendations or clinical notes, not on a larger data set.

3. Algorithms can be used only to help predict length of stay for post-acute services and not as the basis for terminating coverage. Terminating coverage can be determined only by first reexamining a member prior to the termination notice. For inpatient admissions, algorithms and artificial intelligence alone cannot be used as the reason to deny admission or downgrade to an observation stay.

4. MA organizations may deny coverage for basic benefits only for reasons such as network limitations or noncompliance with prior authorization rules. Algorithms should be used only to ensure compliance with internal coverage criteria. AI cannot be used to shift coverage criteria over time, and predictive algorithms cannot apply internal coverage criteria that are not public.

A Texas federal judge on Monday dismissed a lawsuit challenging the Biden administration’s Medicare drug price negotiations filed by the pharmaceutical industry lobbying group Pharmaceutical Research and Manufacturers of America (PhRMA). 

The decision marks a small victory for the Biden administration, as it’s the first time a court has outright dismissed a challenge to Medicare’s new price negotiation powers.  

There are eight other lawsuits filed by drug companies and other plaintiffs, and the legal fight could stretch for years. The federal government sent out its initial offer to drug companies earlier this month, and while the negotiations will end in August, the prices won’t take effect until 2026.

Judge David Alan Ezra in the Western District of Texas granted the Biden administration’s request to dismiss the lawsuit, ruling that the plaintiffs lacked standing. 

PhRMA was joined in the lawsuit by the National Infusion Center Association (NICA) and the Global Colon Cancer Association, but Ezra dismissed the NICA from the case because he said the court lacked jurisdiction.  

As the NICA was the only plaintiff that resided in Texas, the entire case was dismissed. However, it was dismissed without prejudice and could be brought up again.  

“We are disappointed with the court’s decision, which does not address the merits of our lawsuit, and we are weighing our next legal steps,” PhRMA spokesperson Nicole Longo said in a statement to The Hill.

PhRMA represents some of the largest drug companies in the world. The group sued the administration in June, arguing Medicare negotiation is unconstitutional and violated drug companies’ due process.

Harrisburg, PA - The Pennsylvania Department of Human Services (DHS) today released recommendations from its Blueprint Workgroup, an interdisciplinary group comprised of representation from state and local governments, health care, education, service providers, managed care, and family advocates. The workgroup sought to evaluate challenges children and youth with complex, co-occurring physical and behavioral health care needs and their families experience like accessing care and services that adapt to a youth’s changing circumstances and needs, lessening the likelihood of child welfare system involvement, reducing trauma experienced by instability, prioritizing emotional wellbeing, and supporting family- and youth-driven care and choice.

“The detailed recommendations outlined by the Blueprint Workgroup set a course that now allows DHS and partners at the local level and systems of care to begin the work necessary to see how we make change happen so children with complex needs get the care that improves their quality of life, and the family is supported as they navigate these systems,” said Dr. Val Arkoosh, Secretary of DHS. “Systems of care should uplift those we seek to help, not create confusion and consequences from lack of coordination. The Blueprint Workgroup recommendation align our focus around the children and families we must always prioritize, and I am grateful for the work to this point and moving forward that will build a better future for children and families in Pennsylvania.” 

One in six children have a diagnosed behavioral or developmental disorder, and rates of depression and anxiety are growing among children and young adults. Youth with co-occurring physical health, behavioral health, and/or intellectual disability or autism-related needs are considered complex cases because they require close coordination between multiple care and service providers in order to ensure the child and their family are receiving comprehensive supports and services that meet their unique and evolving needs.  

Care coordination for these cases involve multiple county and state-level entities that coordinate health care, education, and disability services, and, at times, the child and their family may be involved with child welfare, foster care, and justice systems. Children and youth with complex needs are also more likely to have experienced abuse, neglect, and trauma, disruptions to their education, communications challenges, and a complex diagnostic history causing delayed or incorrect services. These circumstances create opportunities for confusion and lack of communication that can affect care. 

Children and youth with complex needs deserve access to the care and supports they need without barriers, delays, or risks of new or additional trauma, and their families and guardians deserve support as they navigate systems of care for their child. The Blueprint Workgroup was established to help guide systems of care towards a renewed focus on youth and family engagement, respect for individual choice, support for the caring workforce, better collaboration and integrated planning between systems that serve youth with complex needs, and timely, accessible, and coordinated service delivery for youth that is responsive to their evolving needs. 

Recommendations from the workgroup include: 

• Prioritizing prevention through early identification of needs, accurate and timely diagnosis, and prompt service intervention; 

• Improving information sharing and resource navigation among child-serving systems of care; 

• Developing clear and strong guidance to inform multi-system case planning and management that prioritizes family engagement, evidence-based practices, peer supports between families, streamlining processes for families, and avoids trauma or re-traumatization that can occur when a case information has to be presented by the youth or their family repeatedly;  

• Supporting a qualified, dedicated workforce, assessing payment models, and increasing efficiencies for people working in this system where appropriate; 

• Conducting a system needs and gaps analysis across child-serving systems to determine opportunities for improvement and establishing multidisciplinary care coordination teams where needed; and,  

• Building further understanding of trauma and embed trauma-informed care and principles across systems that serve and interact with children and youth with complex needs and their families.  

Moving forward, DHS and Blueprint Workgroup members will begin work to determine work necessary to implement recommendations and identify barriers to implementation at the state and local level. The recommendations outlined in the workgroup’s report are a first step to strengthen supports for children and youth with complex needs and their families. Pennsylvania was also recently selected as one of eight states participating in a children’s behavioral health policy collaborative organized by Health Management Associates, the National Association of State Mental Health Program Directors, the National Association of Medicaid Directors, the Child Welfare League, and the American Public Human Services Association. The convening will build on this work by helping better align multi-system work to support youth with behavioral health needs. 

To learn more about the Blueprint Workgroup and DHS’ work to support children and youth with complex needs, visit https://www.dhs.pa.gov/Services/Children/Pages/Complex-Case-Planning.aspx.

MEDIA CONTACT: Brandon Cwalina - ra-pwdhspressoffice@pa.gov

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