Gray Administration HHS Transition Report

The Gray Administration yesterday released its transition team reports, including the attached “Transition Report of the Health and Human Services Committee,” co-chaired by Maria Gomez and Peter Edelman. Key findings and recommendations include the following:

Health Care Finance and HIT

The committee recommends the following:

 Lift the hiring freeze on DHCF

 Increase interagency communication (remove silos)

 Leadership should have both finance and policy expertise, and an understanding of the

services provided

 Modify the budgeting process and billing authority of agencies

o DHCF should have authority of agencies who bill Medicaid

o Coordinate all HEALTH spending in District, ie DOH and DHCF on HIV/AIDS

spending, all health related DC agencies and programming – DCPS, CFSA,

DYRS, OSSE, etc.

o Perhaps look at DDS as an example of what works

o How does money come back into other agencies that bill Medicaid?

o Analysis and connection to contracts and procurement?

 Analyze long-term care spending’s impact on Medicaid budget and the implantation of

home and community-based waivers

 Maximize reimbursement opportunities in the following areas:

o Health care reform


 Clarify and make more transparency the spending related to UMC

 Ensure that reimbursement is conducted in a timely manner

 Continue to improve the claim submission process – is this a process issue or a cash flow


 Consider the impact of every budget cut from the top down, from Federal match to

community access.

 Conduct a more holistic and systemic view of each cut with stakeholder input (ie cutting

hours for PCA’s while moving skilled nursing to the community)

 Send notices to beneficiaries (needs to be in a timely, efficient, culturally competent) any

time there is change to plan, benefits, access to services

 Divide up school based nursing contracts by more than a single provider (National

Children’s Medical Center) including Howard University

 Invest in providing dental treatment to working-age populations (35-65) for root canals

and similar services related to gum disease which can result in significant savings from

emergency room visits by these patients who suffer problems that could have been

averted through dental services.

 Greater investment should be made in ensuring annual dental screening of children and

working-age populations.

 Dedicate greater emphasis to aligning its HIV strategy with President’s National HIV

AIDS Strategy.

 Increase efforts to coordinate efforts of Departments of Mental Health with Department

of Health given the significant relationship between patients requiring mental health

services but who overuse emergency room and other inappropriate health services.

 Implement program for the All-inclusive Care for the Elderly (PACE) in DC to help with

addressing the current cost issues relating to long-term care. Seniors in the PACE

program age in place at home with the support of the PACE site during the day.

 Adopt modest co-pays around Emergency Room visits, as a way of deterring

inappropriate overuse of ERs.

Health Information Technology Recommendations- DCPCA

 Foster Health Information Exchange as a key city service.

 Establish an HIE Policy Board/Commission.

 Continue support for leadership by the Districts DHCF and DCPCA to implement and

build out the District’s HIE across various health care specialties and provider types.

 Develop regulation and governance that allows for appropriate and necessary data

transfer and reporting related to the HIE.

Health Care Financing Recommendations – DCPCA

 Use the progress made on EHR adoption and HIE development towards the

implementation of payment reform in the District.

 Support patient centered medical homes efforts through legislation and Medicaid

payment reform consistent with the intent of Federal health reform.

 Take advantage of both the Federal grant for medical homes planning and the 90%

Federal match for case management and care coordination.

Support the development of an innovative Accountable Care Organization with communitybased

primary care providers at the center, which both helps to preserve Howard University

Hospital and protects investments made into United Medical Center, as well as offers a potential

solution for offering affordable, quality care for Medicaid and Alliance beneficiaries.

Kevin Wrege

Founder & President

Pulse Issues & Advocacy LLC

Office: 202-625-1787

Mobile: 202-253-4929

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

Mayor Gray Transition Report HHS 2 16 11.pdf


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