Month: July 2016

Food Safety Nets Lacking for College Students

Child hunger receives a lot of attention because of the documented impact hunger can have on development, behavior and overall health. School meal programs can provide breakfast and lunch at no cost to eligible students and other programs may provide additional snacks or backpacks of food for weekends. Once students leave the K-12 system and move on to higher education the same types of supports are far less likely to exist.

The Wisconsin HOPE Lab surveyed 10 community colleges across the country in 2015, finding 20% of student respondents had gone entire days without eating a single meal. The HOPE Lab study also found that 31% of black students and 23% of Latino students experienced the worst levels of food insecurity, along with 19% of their non-Hispanic white peers. Campus surveys have found nearly 40% of undergraduate students in the City University of New York system are food insecure. About 13,000 students from Long Island attend CUNY schools.

Some colleges have noticed the issue and are taking action. As of July 5, 2016, there were 339 active member institutions of the College and University Food Bank Alliance. Colleges are setting up pantries and donation programs with local restaurants to distribute food to hunger college students. A college in California now accepts SNAP benefits on campus.  The CUNY system has started food pantries on several campuses to combat this growing trend.  Stony Brook University also has a pantry and the site manager noted that need is usually highest at the end of the semester when pre-paid meal plans run out. New York University is starting a food voucher program in the fall that would permit students to obtain meal vouchers six times a semester as a short-term solution if they are hungry and don’t have money, said John H. Beckman, a university spokesman. Some colleges, including N.Y.U., have adopted yet another approach, permitting students to donate “swipes” from their dining plans to others who can’t afford to eat. Many students aren’t eligible for SNAP benefits because of rules regarding the number of hours worked per week.

Unfortunately the problem has not been extensively been studied so little national data exists. California has introduced legislation that would encourage food pantries to work with college campuses to coordinate efforts. The perception of “ramen noodle eating college students” as part of the college experience is pervasive enough to keep many from taking this issue seriously.

Attention HWCLI Members and Partners!

Critical Follow-up to the CBO Planning Grant Application

Thanks to those of you who were able to attend this week’s CBO planning grant follow-up meeting.  For those of you who were unable to attend, I am happy to have a follow-up conversation about the next steps.

HWCLI is applying to lead our regional application for the NYS CBO Planning grant. The state will award each of 3 regional Consortia $2,500,000 for a one year planning initiative to support CBO infrastructure and capacity building in order to participate in the State’s Delivery System Reform Incentive Plan (DSRIP).

Our region includes the Island and  7 counties in Hudson area.

CBO participation in DSRIP, and in the ultimately transformed healthcare delivery system, is critical to ensure input from various communities, to implement  strategies to improve population and community health, and to address the determinants that influence health.

The purpose of the CBO planning grant is the development of financially sustainable infrastructure within community based organizations for value based contracting with performing provider systems.

The grant may only target CBOs that:

  • Have an annual budget of less than $5 million
  • Are not billing Medicaid or planning to bill Medicaid,
  • Are not directly providing health care services, and
  • focus on services to address the social determinants of health for the Medicaid and Medicaid eligible populations

We need your help!!

We are seeking:  Consortium Members.

If you are interested in being part of the regional consortium, please sign the attached MOU agreement and complete the following survey:

THIS SURVEY IS CRITICAL. IT WILL HELP TO ESTABLISH THE GOALS AND OBJECTIVES for our region, based on the information that you share. 

Please note we anticipate this survey to take 20-30 minutes.

I apologize in advance for the short notice, but we really need the surveys back by Tuesday, July 26th.  THANK YOU FOR YOUR WILLINGNESS TO PARTICIPATE and for your quick response.

Finally: Please plan to join our orientation webinar on Tuesday, July 26 at 10:30 a.m.

No registration is necessary and we’ll follow this message with an Outlook invitation.

Join WebEx meeting

Meeting number: 735 402 299

Join by phone
1-877-668-4493 Call-in toll-free number (US/Canada)
1-650-479-3208 Call-in toll number (US/Canada)
Access code: 735 402 299
Toll-free calling restrictions

The webinar will be a fast paced and highly informative overview— easily understood, interesting, and accessible whether you are well versed in the state’s reform efforts or totally new to the dialogue. It will contextualize the CBO Planning Grant within the context of the State’s goals for achieving and sustaining a system of health care financed by value based payment.

Our speaker, Josh Rubin from Health Management Associates, will:

  • address the national trend toward healthcare financing based on value and quality instead of volume (i.e. value based payment) and provide an overview of the goals for reform, nationally and within NYS
  • address the main elements of “accountable care” delivery and funding that underlie many NYS state initiatives, including the Delivery System Reform Incentive Plan (DSRIP) and explain what is behind changes to Medicaid funding
  • discuss how the resulting flexibility in addressing people’s needs can include flexibility to pay for CBO interventions and programs
  • describe the progression of options for healthcare financing that incentivize systems, like our Performing Provider Systems, to “do better more rapidly, in less traditional ways” and the potential for CBOs to contract directly with managed care providers as well as PPSs and others to do the kinds of things that are currently either under-resourced, lacking in the system, or available only where grants or contracts permit.
  • outline the core challenges faced by human service providers/CBOs in a value based payment system (i.e. the importance of knowing who is being served by the organization, being able to demonstrate need and document services, the importance of demonstrating evidence of CBO effectiveness, the capacity to support the cost of providing care, ability to understand and negotiate contracts, manage fiscal reporting, etc.)

We look forward to hearing from you via the survey and talking with you during the Q and A on Tuesday morning’s webinar.

We look forward to hearing from you!  Please contact us if you have any questions about this exciting opportunity to support our region’s most vulnerable communities.



Gwen O’Shea


Report: NY plans unjustly cut home care hours

Medicaid Matters NY , a statewide coalition dedicated to advancing the interests of Medicaid beneficiaries, along with the New York Chapter of the National Academy of Elder Law Attorneys, issued a report this week with findings of an extensive study of fair hearing decisions on reductions of home care service hours by Medicaid Managed Long Term Care (MLTC) plans.

The study examined fair hearing decisions during a 7 month time period. Between June 2015 and December 2015, the study found a sixfold increase in hearings that challenged home-care reductions. In more than 90 percent of those 1,042 hearings, the MLTC member won because either the companies lost or simply withdrew proposed cuts when challenged. The actual number of members that defeated the proposed reductions is likely higher because the data does not include fair hearings that were withdrawn because of settlement. In 8.7% of all of the hearing decisions, the member accepted a partial reduction as a settlement.

In (71%) of the 940 hearings decided fully in the members’ favor, the MLTC plan did not defend its proposed reduction at the hearing. The plan either withdrew its notice of reduction at the hearing (582 cases) or defaulted by failing to send a representative to make its case without formally waiving its appearance, resulting in a favorable decision for the member (89 cases). In the remaining 268 cases decided fully in the members’ favor, a written decision rejected the proposed reduction in hours based on defects with the notice, on the merits, or both. In at least 32% (87) of these decisions, which constitutes 8.3% of all 1042 decisions in the study, the sole basis of the decision was the plan’s failure to send the member legally adequate notice, or any notice at all. In these cases, the member automatically won. Many of the 181 other decisions that reversed a plan’s reduction on the merits also found the plan’s notice to be legally inadequate

The  high number of hearings decided because the plan did not show up or ultimately withdrew the proposed reduction is concerning because it seems to indicate the plan knew there was no justification for the proposed reduction in hours. The report notes “For every member who had the wherewithal to request, travel to, and present their case at a hearing, undoubtedly there were many who could not.” It’s unknown how many members accepted a reduction in hours out of concern for losing hours altogether or how many simply had hours reduced without  receiving proper notification or knowing their right to appeal.

The report recommends better oversight by New York State Department of Health and that they take proactive measures to attempt to identify other cases where hours may have unjustly been reduced and collect data to better monitor MLTC plans. Click here to read the full report.

Report Proposes VBP model for Children in Medicaid

The Schuyler Center, together with United Hospital Fund, recently released a new report: Value-Based Payment Models for Medicaid Child Health Services, that proposes a new, child-centered approach to value-based payment in Medicaid. The researchers conclude that because of the significant differences in children’s health care utilization compared to adults, a payment model should be used that promotes—and pays for—screening and effective interventions to address psycho-social risks that are not currently widespread in primary care. The report notes that, “Given the increased recognition of how profoundly social determinants of health (including Adverse Childhood Experiences) affect childhood development and adulthood health and social productivity, payment models need to consider how to motivate and support attention in this area.”

Click here for the full report

SNAP Program Expands As of July 1

During his State of the State speech in January, Governor Andrew Cuomo announced that he would use his administrative authority to increase the gross income test for SNAP (formerly known as food stamps) from 130% of the federal poverty line to 150%, thereby making 750,000 additional households eligible for federal nutrition benefits. The increase went into effect July 1, 2016.

The new changes will not impact households with an elderly or disabled member or those paying child or adult care costs. These households are already eligible up to 200% of FPL. The new rules will also not apply to households that have any member who is either temporarily or permanently sanctioned or disqualified from the SNAP program due either to an Intentional Program Violation (IPV), or to a SNAP work rules violation or voluntary job quit.

SNAP households that do not meet any of the above criteria that also have countable earned income will be eligible up to 150% of FPL which is $1,472 per month for a household of 1 and $3,032 per month for a household of 4. Households with no countable earned income remain eligible up to 130% of FPL.

More information about eligibility under the expanded guidelines can be found here