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Georgians for a Healthy Future and the Georgia Council on Substance Abuse are teaming up to launch a new public health advocacy campaign — Somebody finally asked me! — to prevent addiction and its harmful effects among Georgia’s youth…   More than 300,000 Georgians have enrolled in health insurance since last October, when new coverage opportunities became available through the Health Insurance Marketplace. These big coverage gains present an opportunity to raise awareness about the importance of prevention, both among consumers and policymakers. We are already seeing the lifesaving impact that services like cancer screening, blood pressure checks, and mammograms are having. One screening tool not broadly talked about is Screening, Brief Intervention, and Referral to Treatment (SBIRT).       SBIRT is a cost-effective, evidence based way to identify individuals who are at risk of developing a substance use disorder and can often prevent the development of addiction or refer those in need to treatment. Studies have shown every $1 invested in SBIRT yields $4 in savings. This important set of preventive tools should be available to all Georgians, particularly to our state’s youth.     This important set of preventive tools should be available to all Georgians, particularly to our state’s youth. The rise in heroin use among Georgia adolescents has gained widespread attention in recent months, but the problems goes beyond just heroin. By the time a student reaches ninth grade, 1 in 5 will display signs of alcohol use, a rate which rises to 2 in 5 by the twelfth grade. Approximately 20 percent of twelfth-graders are also engaging in drug use. We know that drug and alcohol use that starts in adolescence all too often becomes a lifelong habit some people even find themselves to purchase Melatonan 2. In fact, 90% of adults with a substance use disorder began using alcohol and/or drugs before the age of 18 and half under the age of 15. With an increased awareness and use of SBIRT, we can work together to prevent drug and substance use disorders among Georgia’s youth and help them lead healthier and more productive lives by doing a drug intervention and informing them about the non 12 step rehab and how they could end up if they don’t stop on time. To raise awareness about substance use disorders among Georgia’s youth as a public health challenge that can be addressed through prevention, Georgians for a Healthy Future and the Georgia Council on Substance Abuse (GCSA) have teamed up to raise awareness of and advocate for widespread use of SBIRT.     To do this, we have created palm cards and book marks to aid those who regularly interact with youth to become better acquainted with SBIRT.                                                        If you are interested in these or other SBIRT materials from our campaign, please contact Laura Colbert, at lcolbert@healthyfuturega.org This education and advocacy campaign is in partnership with Community Catalyst and supported by a grant from the Conrad N. Hilton Foundation, alongside similar initiatives in Wisconsin, Ohio, New Jersey, and Massachusetts.

Georgians for a Healthy Future partnered with Seedco at a briefing in Atlanta on October 16 to present and discuss findings from a comprehensive evaluation of the impact of health insurance navigators on consumer experiences during the first open enrollment period. The evaluation was conducted by a team of researchers at the University of Georgia, and its key findings include:

 

 

 

-Navigators succeeded in assisting consumers from diverse communities and in reaching those in need of affordable health services

-Rates of achieving enrollment or application success with navigators differed by region, by demographics, and by consumer financial status

-Navigator interpersonal communications, and especially follow-up, was the biggest factor in consumer satisfaction

 

As we gear up for the next open enrollment period, which begins on November 15, 2014, the findings from this report can inform the work of enrollment assistance personnel and community-based organizations in Georgia and across the country. Selected recommendations from the report include:

 

-Continue partnering with community agencies that serve diverse populations

-Publicize the navigator role and concrete ways to access free in-person assistance

-Follow up with consumers after they receive in-person assistance

 

 

For a summary document highlighting and describing these and other key findings and recommendations, click here. To read the full study, click here.

 

 

 

Georgians for a Healthy Future is excited to welcome Nykita Howell, our new Health Insurance Navigator, who joined us this week! In this role, Nykita provides Marketplace enrollment assistance to Georgia health care consumers. Prior to joining Georgians for a Healthy Future, Nykita worked in the fields of clinical and community based research and as a navigator for the first open enrollment period of the Health Insurance Marketplace. Her research efforts have been on studies focused on retention strategies for an NIH-funded cohort based at Umass Medical School, and a church-based diabetes project housed at Mercer University. Her work as a navigator prior to joining Georgians for a Healthy Future included building community partnerships and educating consumers over a seven county area. She holds an MPH from Mercer University School of Medicine and is a Certified Health Education Specialist. Prior to her graduate studies, Nykita received her B.S. in Biology from Clark Atlanta University, in Atlanta, GA. If you or anyone you know needs assistance navigating the health care system, please contact Nykita at nhowell@healthyfuturega.org or 404-567-5016. Remember, open enrollment begins Nov. 15th—just one month away!

When consumers enroll in a health insurance plan, they gain access to a network of medical providers. Insurance companies contract with a range of providers, including both primary care and specialty physicians, to deliver health care services included within the plan’s benefit package. This network of providers must be adequate to ensure that consumers enrolled in the plan have reasonable access to all covered benefits. This is what is meant by network adequacy. More specifically, to be considered adequate, a network must provide adequate numbers, types, and geographic distribution of providers; must ensure that access to care is timely; and must include essential community providers that serve predominantly low-income, medically underserved individuals. Additionally, accurate information about providers must be made available to consumers.

 

Network adequacy has become a hot topic over the past several months because many consumers who enrolled in new health plans through the Health Insurance Marketplace found that their plan came with a narrow network of providers. Provider directories weren’t always accurate or up-to-date, and consumers expressed a fair amount of confusion over which providers were in their plan’s network.

 

At the same time, the National Association of Insurance Commissioners (NAIC), which develops model laws and rules that states often adopt, has been working to update its network adequacy model law. Stakeholders ranging from insurers to medical providers to patient and consumer advocates are weighing in on this process, making network adequacy a hot topic in the policy arena too. Georgians for a Healthy Future has been monitoring this process through the participation of our executive director as one of the consumer representatives to the NAIC. Earlier this summer, the consumer representatives submitted comments to the NAIC focusing on developing a stronger standard and better oversight of network adequacy, an end to “balance billing” by out-of-network providers in in-network facilities, and greater transparency of provider networks.

 

Georgians for a Healthy Future will continue to monitor this process and will advocate at all levels, in conjunction with state and national partners, to ensure consumers have meaningful access to care.

 

If you are an individual consumer enrolled in a commercial health plan and the provider directory you were given was incorrect or if you have concerns about your ability to access covered services under your plan, please contact the Georgia Office of Insurance & Fire Safety, Consumer Services Division by calling (800) 656-2298 or use the Consumer Complaint Portal at www.oci.ga.gov/ConsumerService. Please also consider sharing your story with Georgians for a Healthy Future so we can get a better picture of what is happening in our state.

 

For more information on network adequacy, please see the following reports and resources:

From Georgetown Center on Health Insurance Reforms: Reforming State Regulation of Provider Networks: Efforts at the NAIC to Re-Draft a Model State Law

 

From Robert Wood Johnson Foundation and Georgetown University Health Policy Institute: ACA Implications for State Network Adequacy Standards

 

From Families USA: Network Adequacy and Health Equity: Improving Private Health Insurance Networks for Communities of Color

 

Covering Kids & Parents: Health Insurance for the Whole Family 

New from GHF!

 

All kids need reliable access to quality health care.  Children need to see the doctor even when they are healthy:  shots for school, well-child visits, and dental care are all important for kids to grow up healthy and strong.  Their parents need coverage too to stay on track with regular screenings and preventive care, to access the health care system if they become sick, and to experience the financial peace of mind that comes with being covered.

 

Thanks to new health insurance options available through the Marketplace, the uninsured rate among parents is dropping. Still, too many of Georgia’s low-income parents fall into what has become known as the “coverage gap,” meaning they don’t earn enough to qualify for subsidized private insurance and they earn too much to qualify for Medicaid because Georgia has so far declined to join the 27 states (and counting!) who have expanded Medicaid.

 

In an effort to provide accurate information to parents about the coverage options for themselves and their children, GHF has created a set of fact sheets about health insurance coverage for kids and parents in Georgia.  These fact sheets are intended to be a resource for individual consumers and for organizations who represent or provide services for Georgia families.

 

Affordable Health Care for Your Children and For Uninsured Parents help parents understand the coverage options for themselves and their children. If you work with low- to moderate-income families through a charity care clinic, at a school or church, or in a community-based organization, you may want to provide these resources to the families you serve.

 

Covering Kids paints a picture for policy makers and the media who want to better understand children’s health care coverage in Georgia.  If you work with policy makers or want to talk to your legislators about health care coverage for kids, this fact sheet will be a helpful resource.

 

A fourth fact sheet serves as a reference for those who need to know the income limits for the Medicaid and PeachCare programs.

 

You can view and download these new fact sheets on the GHF website. If you would like hard copies to distribute to your members, clients, or community partners, please contact Laura Colbert, GHF’s Community Outreach Manager.

 

 

 

Last week, the U.S. Department of Health and Human Services (HHS)awarded health insurance navigator grants to 90 organizations in states with federally facilitated or partnership marketplaces. Health insurance navigators help consumers understand and compare health insurance options, enroll in coverage, determine eligibility for tax credits, and utilize new coverage once enrolled. Georgians for a Healthy Future is excited to announce that, for the second year in a row, we are part of a consortium of 12 nonprofit organizations, led by the national nonprofit organization Seedco, which received one of two grants for Georgia!

 

With the next open enrollment period just 58 days away, we are already getting ready. In the coming weeks Georgians for a Healthy Future will bring on a full-time health insurance navigator who will work closely with consortium partners to provide outreach, education, and enrollment assistance to Georgia individuals and families. More than 300,000 Georgia consumers signed up for coverage during last year’s open enrollment period, but hundreds of thousands more who are eligible for affordable coverage remain uninsured. Reaching these uninsured Georgians will require targeted outreach strategies and new partnerships with local community-based organizations throughout the state. Additionally, consumers who enrolled during the last open enrollment period will need assistance navigating re-enrollment and may have questions about how to understand and use their new coverage. Health insurance navigators played a critical role during the first open enrollment period and are poised to assist consumers again this fall, when the second open enrollment period begins.

 

Georgians for a Healthy Future is honored to participate in these efforts!

What health care rights and protections do legally married same-sex couples have in states like Georgia that don’t currently recognize same-sex marriage?

 

Can health insurance navigators help consumers find LGBT-friendly plans? (Hint – yes they can!)

 

How can a consumer file a complaint if they experience discrimination?

 

What new health care rights and protections do transgender individuals have?

 

The Affordable Care Act makes health insurance and health care more understandable, more accessible, more affordable, and more comprehensive for Georgians, no matter their gender identity.  Georgians for a Healthy Future and Georgia Equality have teamed up to develop a new set of LGBT specific fact sheets to answer some of these challenging questions that LGBT individuals and families face as they seek out, enroll in, and use their health coverage.

 

These fact sheets are intended to be a resource for individual consumers and for organizations who represent or provide services tailored to LGBT Georgians. You can view and download these new fact sheets below. If you would like hard copies to distribute to your members, clients, or community partners, please contact Laura Colbert, Georgians for a Healthy Future’s Community Outreach Manager.

 

Health Insurance Options For Georgia’s LGBT Community

 

Transgender Health Care

 

Love and Marriage: Health Insurance Rights for LGBT families

Young people in Georgia are gaining access to health insurance at historic levels, creating new opportunities to increase access to essential prevention and treatment services. At the same time, misuse of and addiction to alcohol and drugs blunt the potential of too many young Georgians. To fight this drug epidemic, Georgians for a Healthy Future and the Georgia Council on Substance Abuse are launching an initiative to expand services to prevent addiction in youth. We encourage you to help our youth because they are the future of the nation, you can simply click here on how to. Together, the two organizations will run a three-year project in Georgia to improve access to effective screening and intervention services that can minimize the destructive consequences of alcohol and drug misuse and addiction among our youth. This new effort, focused on youth ages 15 to 22, will combine a cost-effective public health approach called Screening, Brief Intervention and Referral to Treatment (SBIRT) with the power of consumer-led advocacy. Georgia is one of five states selected to participate in the national project managed by Community Catalyst, a national, non-profit consumer advocacy organization, and funded by a grant from the Conrad N. Hilton Foundation. The project here aims to improve access and coverage for early screening and intervention services by increasing both the number and type of locations where youth can access those services, and increasing the number and type of professionals who can conduct screening and brief intervention. For the full project launch announcement, click here.

 

 

Please save the date for an evening of celebration and conversation with Georgians for a Healthy Future on August 7th. It’s been five years since we launched in 2009 with a commitment to provide a strong voice for Georgia health care consumers and communities as health policy is made in our state, and it’s been an action-packed five years!

 

 

Please join Georgians for a Healthy Future’s board, staff, and our longtime champions as we reflect on our successes and challenges over the past five years and look ahead to the next five. To purchase tickets, click here.

 

 

Georgians for a Healthy Future would like to thank the law firm Thompson Hine for supporting this event by opening up their space in Buckhead for us and providing free parking to all attendees!

 

 

The 2014 Georgia Legislative Session has ended. Thank you to so many of you for reaching out to your legislators during this past session to let them know that covering Georgia’s uninsured and improving access to health care for all Georgians are important priorities for you. Thank you to the dozens of committed advocates who joined us for Cover Georgia day at the Capitol, and thank you to the more than 8,000 of you who signed the Cover Georgia petition to express your support for the Medicaid expansion.

 
 

This was a disappointing legislative session for health care consumers. HB 990, which prohibits Medicaid expansion without prior legislative approval, and the portions of HB 707 (amended onto HB 943) that would prevent state entities from serving as health insurance navigators, prohibit the state from setting up a health insurance exchange, and limit the ability of state and local employees to advocate for the Medicaid expansion passed through the General Assembly. While some of the most harmful elements of HB 707 were removed before its final passage, this bill sends a horrible message to Georgia health care consumers who seek information about how to enroll in and utilize the new health insurance options available to them through the Affordable Care Act.

 
 

On the upside, hundreds of Georgians are enrolling each day in health insurance. At last count, more than 139,000 Georgians have enrolled in health care coverage through the Health Insurance Marketplace, and Georgians for a Healthy Future is actively working alongside our coalition partners to maximize enrollment leading up to the March 31^st deadline. And despite the setbacks of the 2014 Legislative Session, the Cover Georgia coalition will continue to advocate for covering our state’s uninsured, strengthening our state’s health care delivery system, and growing the economy by implementing the Medicaid expansion.

 

 

 

Thank you again for your continued support and advocacy!