Medical Legal Partnership News
Transforming Healthcare: Multidisciplinary Advocacy

Director's Note - Transforming Healthcare through Interdisciplinary Advocacy

Jay Sicklick, Esq.

This issue looks at the unique way our Medical-Legal Partnership has tackled transformative systemic advocacy – and ways that pediatric and family medicine clinicians can augment our existing work through changing the landscape in which care is provided.

Multidisciplinary advocacy can take many forms: working with a family to extend utility shut-off protection for a fragile newborn; extending Medicaid coverage for medically necessary therapy; successfully arguing for an out-of-district educational placement for a developmentally delayed elementary school student with special needs; or testifying at the state legislature in support of health related bills that can change the landscape of pediatric care. Our Medical-Legal Partnership has taken an aggressive approach to systems change – as evidenced by the work we highlight in the articles below. If you have any thoughts, suggestions or comments, please don't hesitate to email me.

Medical Director's Corner
Legislative Testimony: Health Care Providers and the Legislative Process 

Ada Fenick, MD

While federal actions make up the majority of the news, laws enacted on a state level have a huge impact on children. Annually, the state legislative session starts up in January and multiple bills that directly or indirectly affect children are proposed to legislators, supported by some of them, and moved through committees and ultimately to the legislature as a whole. For each bill, there is a time for public comment that includes a public hearing. Testimony can be provided both in person and in writing.

Perhaps obviously, the ideal way to give testimony is to know what bill you are interested in promoting (or fighting), go to Hartford and give oral testimony. Your three minute oral testimony, followed by Q&A from legislators, could include an emotional patient story, and should be accompanied by clear, understandable qualitative or quantitative data. 

Personal testimony by a physician is highly valued; not only are you an expert in the medical subject matter but you are thoughtful and highly trained. However, for people who are busy clinicians, the practicalities of may be overwhelming – it often means a full morning or afternoon of travel, a wait for your turn for testimony, and a very short time in the limelight.

An alternative is to provide written testimony, which can be read out and entered into the public record. While it may not carry the same punch as an in-person appearance, the opinion of our medical providers is highly valued. A few tips on writing testimony can be found on the AAP advocacy website training modules, and state advocacy priorities of the Connecticut Chapter of the AAP.  

Critically Important MLP Legislative Initiatives

MLP Works to Expand HUSKY Health Insurance to Undocumented Children

As a result of the most ambitious advocacy initiative ever undertaken by the MLP, the Connecticut General Assembly introduced and is debating the passage of Raised Bill 1053, a legislative proposal that seeks to expand Medicaid and HUSKY B (CHIP health insurance coverage) to all of Connecticut's most vulnerable children and youth under age nineteen. 

The Human Services Committee held a public hearing in which twenty eight individuals and organizations submitted favorable testimony, and voted the bill favorably out of Committee

While the initiative presents significant challenges, MLP Director Jay Sicklick is optimistic that the measure can pass this year. "While the bill does have up-front costs, defined as the expenditures necessary to gradually enroll the undocumented youth population, the downstream savings from which the state will benefit are immeasurable. Preventative and primary care is a right provided to all of the state's children, except those without legal documentation. It's time these children - who have the constitutional right to attend school - receive basic healthcare in a manner equal to their peers." 

Follow our team's advocacy, including an op-ed by Julia Rosenberg, MD in the Hartford Courant, on the CCA website.

 

Critically Important MLP Legislative Initiatives

MLP Works to End HIV in Young Adults: PrEP Initiative

Alice Rosenthal, Senior Staff Attorney

During the 2019 Connecticut General Assembly session, the MLP is championing a proposed bill that would allow youth to consent to PrEP, an HIV prophylaxis that reduces the risk of contracting HIV by more than 90 percent. The CCA team is led by Dr. Krstyn Wagner, an infectious disease specialist from New Haven's Fair Haven Health Center. 

Over 20 percent of new HIV infections are in people ages 13 - 22, and disproportionately black men. The Connecticut Department of Public Health campaign "Getting to Zero" aims to eliminate new HIV infections; an important component is preventing transmission youth who are most at risk.

Representatives Jeff Currey and Raghib Allie-Brennan introduced Raised Bill 6540, An Act Concerning the Prevention of HIV. An recent article in the CT Post discussed the proposed legislation. Under current Connecticut law, minors can consent to critical healthcare needs, specifically in the areas of reproductive health, mental health care and treatment, substance use care and the diagnosis and treatment of HIV and AIDS. HB 6540 would extend these protections to prevent the spread of HIV. 

After a lengthy and somewhat contentious public hearing, the Public Health Committee voted unanimously to move HB 6540 favorably out of committee. The next phase is passage in the House and Senate. 

We hope you will support this critical public health initiative. For more information, contact Alice Rosenthal. For information on minor consent laws, CCA's Adolescent Health Care: Legal Rights of Teens is an MLP publication that might assist you in your practice.        

boy in wheelchair crop

NEMT – Ongoing Battle to Secure Medically Necessary Transportation

Bonnie Roswig, Senior Staff Attorney

The Center's MLP has led the fight in recent years to ensure that Connecticut provides reliable, legally mandated non-emergency medical transportation (NEMT) to the state's Medicaid recipients. 

MLP aggressively supports Raised Bill 7166: An Act Regarding Non-Emergency Medical Transportation for Medicaid Beneficiaries. The objective of the bill is to codify performance standards so patients get to their appointments in a timely manner and health care providers can be assured that patients will get the care they require. The bill includes a provision that gives individuals the opportunity to sue if they have been harmed by the failure to provide appropriate NEMT service.

Our MLP continues to be actively involved in oversight of the State's NEMT program. The legislature's Human Services Committee was responsive to Bonnie and other public health professionals who testified in support of this legislation.

HB 7166 was favorably voted out of Committee, and a determination made by the Connecticut Office of Fiscal Analysis that not only won't the bill cost Connecticut money, it could actually result in financial gain in that it provides for imposition of fines for failure to provide appropriate NEMT service.

For questions, please email Bonnie Roswig. See the latest media coverage about the MLP's work on NEMT here

Join Us for the Second Annual Statewide MLPP Conference

The Power of Partnerships

April 11, 2019 from 12:30 – 4:45 pm
The VA Medical Center - Errera Community Center, West Haven Connecticut  
Click here for a complete agenda and to register.

Center for Children's Advocacy
65 Elizabeth Street, Hartford, CT 06105 and 211 State Street, Bridgeport, CT 06604
CCA MLP at Connecticut Children's Medical Center and at Yale New Haven Hospital

cca-ct.org/mlpp

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