FUNCTION 1: MAXIMIZE IOWA EFFORTS TO PREVENT A DISABILITY OR A CONDITION THAT LEADS TO A DISABILITY FROM OCCURING (PRIMARY PREVENTION)

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1 FUNCTION 1: MAXIMIZE IOWA EFFORTS TO PREVENT A DISABILITY OR A CONDITION THAT LEADS TO A DISABILITY FROM OCCURING (PRIMARY PREVENTION) PRIORITY INITIATIVE ACTIVITIES CODE Preventing Pre- Iowa Prematurity 1. Identified the intervention; secured a; b; d; e; Term Births and Prevention Pilot funding; and funded project h Birth Defects Project 2. Provided recommendations to private insurers and Medicaid based on pilot Improving the Iowa Medicaid program for pregnant women CDC/IDPH Prevention of Disabilities Grant Conference: Iowa s Human Growth and Development Curriculum evaluation. 1. Advocacy coalition member 2. Recommendation made to Governor and legislature to increase the amount of allowed income for Medicaid eligibility for pregnant women Co-wrote grant application. Provided consultation and oversight regarding pilot projects to increase the rate of low income women receiving early and regular prenatal care 1. Secured funding to facilitate implementation of this legal requirement in Iowa public schools 2. Sponsored conference a; h a; e OUTCOMES CURRENT STATUS PRIORITY RANKING Project successful. As a result, ; No Medicaid and Wellmark agreed to further action needed pay for the tested service. Medicaid income eligibility raised in Iowa Provided recommendations to IDPH based upon the project evaluation d; f 1995 Over 150 school representatives received information about best practices and discussed implementation strategies Periodic monitoring CDC shifted the focus of their grants; no additional funding was available and the pilots simply ended. POSSIBLE GRP. None needed. IDPH Maternal and Child Health Advisory Committee IDPH Maternal & Child Health Advisory Comm.; Iowa Medicaid Advisory Committee Iowa Dept. of Education Preventing Injury that Leads to Disability UI Symposium on Motor Cycle Helmet Policy Iowa Committee to Improve Child Passenger Safety Iowa Rural Child Passenger Safety (CPS) Demonstration Project Injury Prevention Policy in Iowa Conference co-sponsor f Mid 1990s 1. Convened the committee 2. Approved report with recommendations 1. Secured funding; funded 2 rural county pilot projects 2. Conducted evaluation 3. Developed report with recommendations based upon the pilot evaluation 1. Policy recommendations made to the Governor and the legislature regarding: a. Motorcycle and bicycle helmet legislation b. Amending IA s CPS law to bring it into agreement with AAP recommendations c. Lowering the BAC level to.08 for Iowa drivers a; b; c Mid 1990s d; e a; h Mid 1990s Over 100 participants including several state policy makers received important issue information. Provided report to the Governor s Traffic Safety Bureau, DOT and IDPH Pilot successful. Provided report with recommendations to the Governor s Traffic Safety Bureau and IDPH a. Iowa has yet to reinstate a helmet law b. Iowa s CPS law was amended to incorporate the AAP recommendations c. Motor vehicle driver BAC level was lowered to.08 Need to continue periodic environmental scan and review to identify and advocate for adoption of best practices in Iowa is needed. None needed Safe Kids; IDPH Brain Injury Advisory Council None needed Brain Injury Alliance of Iowa (BIAI); IDPH Council on Brain Injury; Iowa Falls Coalition; Iowa Injury Prevention Program/Council 1

2 Injury Prevention Policy in Iowa continued Iowa Falls Prevention Coalition 2013 Disability Policy Summit Establishing a State Injury Prevention Program d. Enacting legislation to establish a BAC level for boat drivers 2. Periodic environmental scans & reviews Member a; b Present 1. Secured funding; sponsored Summit 2. Coordinated conference planning and staffed the event. 3. Selected injury prevention as one of the 3 conference tracks 4. Prepared conference report on injury prevention : Provided a letter of support for IDPH application to CDC to establish an injury prevention program : Meeting with the Dir. Of IDPH to share Summit recommendation to establish an state injury prevention program and 2015: Recommendation made to Governor and legislature a; b; c; d; f; h a; c; h OUTCOMES CURRENT STATUS COUNCIL PRIORITY LEVEL d. Iowa passed drunk boating legislation Integration of activities to address the needs people with disabilities is now an active part of the Coalition s discussion Conference report with injury prevention recommendations was provided to the Governor and legislature IDPH has secured funding to support the development of an updated data report and establish a position to convene an advisory committee and draft a state injury prevention plan. The plan will be used to apply for CDC injury prevention program funding in 2016 Ongoing. Current focus is on older Iowans. Adding the disability perspective to expand strategies to address injury prevention in younger populations with disabilities will be important. Work on Summit recommendations concerning injury prevention are in progress and will need to continue. The disability perspective should be represented on the advisory committee and in the development of the state plan POTENTIAL PARTNER if grant funding is secured Brain Injury Alliance of Iowa (BIAI); IDPH Council on Brain Injury; Iowa Injury Prevention Program if funding is secured. Brain Injury Alliance of Iowa (BIAI); IDPH Council on Brain Injury; Iowa Injury Prevention Program if funding is secured. Brain Injury Alliance of Iowa (BIAI); IDPH Council on Brain Injury; Falls Prevention Coalition Comments Maximizing Child Health and Development EPSDT Collaborative 1. Established, convened and staffed the public-private collaborative to improve the rate and quality of EPSDT well-child health exams for children 2. Surveyed physicians to determine why their participation in the EPSDT program was so low 3. Gave the EPSDT program a new-user friendly identity 4. Conducted physician training 5. Established consumer informing and care coordination through IDPH a; b; c The rate of children receiving recommended preventive health care exams rose from 8% to over 90% Collaborative disbanded when the screening rate hit the 90% mark; program components established through the Collaborative remain in place. Completed. 2

3 EPSDT Collaborative continued Advisory Committee to the EPSDT Program Ad Hoc EPSDT School Health Screening Committee Development of an Iowa Standard Child Health Benefit Plan 2005 Summit on Access to Dental Care for Iowa Children Off to a Good Start Coalition 6. Established a quarterly newsletter for health care providers 7. Established a state health care provider website for the program 1. Council reviews program data and provides recommendations to the IME to address program issues annually : Letter to the IA Congressional delegation advocating against federal proposal to end the EPSDT mandate : Comments submitted to the IME about clarifying and strengthening EPSDT requirements in the new High Quality Health Care Initiative (Managed Care) RFP 1. Convener, staff 2. Findings/recommendations concerning funding of school health screening and coordination projects developed and provided to the IME Director 1. Co-convening agency of a panel of public private health providers and funders 2. Consensus Standard Child Benefit Plan with 3 buckets addressing all children, children at risk and children with special needs developed 1. Funded and sponsored Summit 2. Developed and disseminated consensus agenda developed by participants 1. Coalition founding member 2. Co-sponsor of the annual Off to a Good Start Framing Policy for Early Childhood Health Systems Integration 3. Co-wrote conference report with annual policy recommendations a; e; h Present a; c a; b; h a; b; c; d; e; f; h a; b; c; f; h OUTCOMES CURRENT STATUS COUNCIL PRIORITY LEVEL 1. Acceptance of a number of Council recommendations 2. Federal EPSDT mandate was not ended 3. No response from IME regarding comments submitted on EPSDT as part of the High Quality Health Care Initiative. IME responded by lifting a moratorium placed on development of new county administrative contracts opening the door to local public health and community school coalitions to offer health screening services Plan approved by Iowa health provider associations and provided to the IME, private insurers & state policy makers A number of agenda items have been implemented, e.g., separate hawk-i dental benefit, increase in Medicaid reimbursement rates, etc. 2. Served as the bases for creating the IDPH I-Smile program A number of policy recommendations were taken up and acted upon by the legislature Input to the IME and/or the MCOs regarding the EPSDT program will be critical under Iowa s new managed care system. It is unclear as to what degree the full EPSDT mandate and current quality initiatives are understood or will be implemented by Medicaid or the MCOs.. Discontinued due to lack of funding and coalition partner time. An active coalition will be needed to address child health policy needs in the future. POTENTIAL PARTNER None needed Iowa AAP; IAFP; Iowa Nurse Practitioner Assn. IDPH Maternal and Child Health Advisory Committee; Iowa Public Health Assn. Comments 3

4 PRIORITY o INITIATIVE ACTIVITIES CODE Promoting the Health of People with Disabilities Addressing disparities in access to health insurance for people with disabilities Improving the receipt of regular preventive health care for people with disabilities : Requested inclusion of an objective to reduce the uninsured rate for individuals with disabilities in Healthy Iowans Monitor percentage of Iowa adults without health insurance coverage through Iowa BRFSS and national child surveys (2004 Present) : Sponsored a Forum on Access to Health Care for Iowans with Disabilities Forum report prepared; shared with legislature along with a request for support of a resolution to adopt the forum principles for health care coverage for Iowans with disabilities : Signed on to national coalition letter of support for national health care reform to address insurance issues including pre-existing conditions : Added questions to Iowa BRFSS to further probe the insurance disparity issue for people with disabilities : Follow-up questions added to the Iowa BRFSS to determine changes in coverage for people with disabilities after implementation of the ACA 1. Monitoring receipt of preventive health care for Iowa adults with disabilities through the Iowa BRFSS and national child surveys (2004 Present) 2. Recommendation made to the IME Director to change Medicaid policy to cover preventive health care visits for adults with disabilities : Review of IME commissioned study of receipt of preventive health care by Iowans with disabilities across the life span : Convened a group to study the IME report and develop recommendations to address the identified issues. a; b; c; d; e; f; h a; b; c; d; e; present Present OUTCOMES CURRENT STATUS COUNCIL PRIORITY LEVEL 1. Objective on reducing rate of uninsured for people with disabilities was included in Healthy Iowans Insurance principles developed during Forum on Access to Health Care for Iowans with Disabilities adopted by the Iowa House by resolution. 6. Results of 2015 BRFSS survey concerning coverage of Iowans with disabilities will be available for review in January Results will be shared with state policy makers. 7. Results of 2015 BRFSS health insurance access survey to be reviewed by Council at January 2016 meeting. 2. Medicaid policy changed in 2007 to cover preventive health care visits for adults with disabilities 4. Some, but not all of the recommendations made to the IME from the group looking at the preventive health care study were implemented. Ongoing. Additional work is needed to obtain data, identify issues and options to address those issues, and to inform policy makers. Ongoing. Work in this area needs to continue particularly as it relates to implementation of the Task Force recommendations for improving preventive health care and then monitoring data to determine the results of implementation of the Task Force recommendations. POTENTIAL PARTNER Comments 4

5 Improving receipt of regular preventive health care for people with disabilities continued : Recommendations made to CDD and IDPH to utilize carryover and other funding to repeat and expand the 2008 Medicaid study of receipt of preventive health care by recipients with disabilities across the lifespan : Partnering with CDD and IDPH to convene and chair a Preventive Health Care Task Force for Iowans with Disabilities that will provide recommendations to improve the receipt of preventive health care by Iowans with disabilities OUTCOMES CURRENT STATUS COUNCIL PRIORITY LEVEL 5. IDPH and CDD secured funding and are repeating and expanding the Medicaid study of receipt of preventive health care by recipients with disabilities 6. Preventive Health Care Task Force to provide a report of findings and recommendations to the Council in POTENTIAL PARTNER Comments 5

6 FUNCTION 2: MAXIMIZE EFFORTS TO IDENTIFY A DISABILITY OR A CONDITION THAT LEADS TO A DISABILITY EARLY AND OFFER INTERVENTION THAT CAN ELIMINATE THE RISK OF DISABILITY OR MINIMIZE THE DISABILITY S EFFECTS PRIORITY INITIATIVE ACTIVITIES CODE Preventing Injury that Leads to Disability Maximizing Child Health and Development Preventing Injury in People with Disabilities EPSDT Collaborative : Council funded & hosted Summit on Disability and Health A Call to Action addressed intentional and unintentional injury in people with disability : Council funded & hosted Disability Policy Summit that included a track on injury prevention Present: Member, Iowa Falls Prevention Coalition : Request made to IDPH to include data related to injuries to Iowans with disabilities as part of their new Burden of Injury in Iowa Study : Home Modification issue studied. Legislation for an Iowa Home Modification Tax Credit presented to legislature. (See also Tertiary Prevention) : Recommended to CDD and IDPH that carryover funding available through the CDC grant be used to examine the incidence and prevalence of injury among Iowa Medicaid recipients with disabilities : Established, convened and staffed collaborative : Focus of work shifted from increasing receipt of preventive care visits to the quality of the preventive health exams provided : Medicaid completed a chart review stud, recommended by the collaborative, which look at quality including parental, developmental and socio-emotional screenings of young children. The study showed low rates for such screenings : Collaborative initiated parent and provider information and education activities to address the issue : Successful collaborative application made for an ABCD II grant from NASHP to address social-emotional & developmental screening a; c; e; f; h a; b; c; d; e; f 2003 Present OUTCOMES CURRENT STATUS COUNCIL PRIORITY LEVEL participants became aware of the injury issue for people with disabilities and received learned about programs that could be replicated in Iowa 2. Recommendations regarding injury prevention for those with disabilities provided to the Governor & legislature 4. IDPH was unable to address injuries in Iowans with disabilities because of the limitation of available data Health & Human Services Appropriation Bill included language requesting the MH/Disability Comm. & the Disability and Aging Resource Centers provide recommendations for the creation of an Iowa Home Modification Assistance Program. 6. CDD and IDPH have secured CDC carryover funding to look at injury data for Medicaid recipients with disabilities. Report will be available to Council review later in the fiscal year. 1. IME launched a preventive health care quality initiative based upon the work of the collaborative Ongoing. Additional work is needed to develop and implement strategies to address the injury issue among Iowans with disabilities Collaborative membership was expanded and the group became the Policy Board for the ABCD II grant POTENTIAL PARTNER Brain Injury Alliance of Iowa (BIAI); IDPH Council on Brain Injury; Iowa Injury Prevention Program if funding is secured. Completed; None needed. Comments 6

7 DUTY(S ) ABCD II Grant Advisory Committee to the EPSDT Program Newborn Hearing Screening Committee 1. Provided leadership for the grant writing team; drafted much of the grant application : Council convened a public private collaborative Board to oversee the project and develop recommendations to maximize the developmental and social emotional status of Iowa s young children receiving Medicaid : The Board developed and provided recommendations to the Council and the IME to address barriers and change policy to promote the development, including socioemotional development, of Iowa s young children receiving Medicaid : Provided testimony to a Senate Committee about implementing the ABCD II recommendations within Medicaid and creating a 1 st Five program within IDPH : The Council worked with the IME to implement the Board recommendations : Recommended to the IME that they provide state dollars to draw down federal matching funds to support an ongoing provider information and training initiative : Recommended to the Governor and legislature that the IDPH 1 st Five program be expanded statewide. 1. Council became the reviewers/advisors to Medicaid after the end of the ABCD II. 2. Reviews program data and provides recommendations to the IME annually to address program quality issues : Comments submitted to Medicaid requesting that the EPSDT mandate be included in the new Iowa Health and Wellness Plan Comments submitted to the IME about clarifying and strengthening EPSDT requirements in the High Quality Health Care Initiative RFP Served on IDPH Committee developing and implementing a newborn hearing screening program in Iowa a; b; c; d; e; h a; e; h Present OUTCOMES CURRENT STATUS COUNCIL PRIORITY LEVEL 1. ABCD II application was funded. 3. Medicaid accepted the recommendations from the ABCD II Board and began implementation 4. Legislative directive to Medicaid to implement the ABCD II recommendations was included in the Health and Human Services Appropriations Bill and continues there each year. 5. The IME has implemented all but 1 of the 20 ABCD II Board/Council recommendations 4. IME is providing state match dollars to continue the health care provider information and training initiative. 4. The legislature has expanded 1 st Five twice 2. Acceptance of a number of Council recommendations 3 The IME included the EPSDT mandate in the Iowa Health and Wellness Plan 4. No response from IME regarding comments submitted on EPSDT as part of the High Quality Health Care Initiative IDPH obtained grants from MCH and CDC to implement a newborn hearing screening program in Iowa Project completed. Advocacy will be needed to maintain the gains made in addressing child developmental and mental health needs. Input to the IME and/or the MCOs regarding the EPSDT program will be critical under Iowa s new managed care system.. Work taken over by IDPH committee POTENTIAL PARTNER None needed. Comments 7

8 Improving the Health of Iowans with Disabilities 2013 Disability Policy Summit Chapter on Disabilities, Healthy Iowans 2000 CDC/IDPH Prevention of Secondary Conditions Grant- -Planning A Select Summit on Disability and Health: A Call to Action 1. Secured funding; sponsored Summit 2. Coordinated conference planning and staffed the event. 3. Selected injury prevention as one of the 3 conference tracks 4. Prepared conference report on injury prevention The Council made a formal request to the IDPH Director to include a Chapter to address disabilities within the new Healthy Iowans plan 1. Collaborated with IDPH, UI College of Public Health and CDD in developing the grant application. 2. Served as the Council guiding the grant: a. Reviewed and provided advice on the development of a study to determine the prevalence of secondary conditions among Iowans with disabilities. b. Convened an expert panel to review the study findings, identify evidenced based interventions to address priority secondary conditions, and recommend interventions that should be implemented in Iowa. c. Provided advice about the design of a model to implement the evidencebased Living Well with a Disability Health Promotion program in Iowa. d. Provided input into the development of the Chapter on Disabilities as a part of Healthy Iowans Secured funding to support the conference. 2. Convened the conference planning committee that developed a 2-day conference with 4 tracks: a. Health promotion for people with disabilities b. Safety for people with disabilities c. Preventing/treating substance abuse in a; b; c; d; f; h OUTCOMES CURRENT STATUS COUNCIL PRIORITY LEVEL Conference report was provided to the Governor and legislature A Chapter on Disabilities was included in Healthy Iowans Iowa was first in the nation to include such a chapter. A Chapter on Disabilities was been included in Healthy People Grant funded by CDC. 2. Panel intervention recommendations approved by the Council and included in the next competitive application to CDC. 3. Living Well With a Disability program model successfully tested in Iowa. 180 participants received information about the topics, learned about interventions that could be replicated in Iowa, and participated in work sessions to identify Iowa specific issues and opportunities. Several identified interventions were implemented in Iowa Work on Summit recommendations concerning early identification and intervention with at risk children is in progress and needs to continue. POTENTIAL PARTNER None needed. None needed. None needed. Comments 8

9 A Select Summit on Disability and Health: A Call to Action continued CDC/IDPH Prevention of Secondary Conditions Grant Implementation people with disabilities d. Access to preventive and specialty health care for people with disabilities 1. Collaborated with IDPH and CDD in developing the grant application. 2. Served as the Council guiding the grant: a. Provided advice on the development of a statewide network to deliver the Living Well with a Disability health promotion program for adults with disabilities and chronic conditions. b. Provided recommendations about the piloting of a Continuing to Live Well with a Disability curriculum and a Staying Healthy and Living Well program for adolescents and young adults cross disability. c. Provided advice about the design, piloting and spread of a pre-service health provider training curriculum on communication and accommodation for people with disabilities. d. Provided letter of support for a successful UI College of Public Health request for funding to test a Pharmaceutical Case Management intervention. e. Provided letter of support for a successful UI College of Public Health application to CDC to test the effectiveness of a combined Pharmaceutical Case Management and Living Well with a Disability intervention. f. Oversaw the review and mid-course revision of the Chapter on Disabilities for Healthy Iowans OUTCOMES CURRENT STATUS PRIORITY RANKING 1. Grant was funded. 2. Living Well with a Disability network involving 9 communities across Iowa was developed. 3. Staying Healthy and Living Well curriculum was successful; program information was disseminated to all schools in Iowa. 4. Health provider pre-service training about communication and accommodation for patients with disabilities was successful in UI College of Medicine and was spread to additional pre-service training programs. 5. UI College of Public Health testing of the Pharmaceutical Case Management intervention was successful. 6. UI College of Public Health did receive a grant from CDC to test the effectiveness of the combined Pharmaceutical Case Management and Living Well with Disability interventions. 7. Mid-course revisions to the Chapter on Disabilities as part of Healthy Iowans 2010 were completed. Revisions incorporated recommendations that came out of the 2003 Disability and Health Summit.. POSSIBLE GRP. None needed. 9

10 Chapter on Disabilities, Iowa 5-Year Health Improvement Plan CDC/IDPH Disability and Health State Capacity Building Grant Council participated in an issues survey conducted by IDPH and made a recommendation to the IDPH Director to include a Chapter on Disabilities as part of a new 5-Year Health Improvement Plan 1. Collaborated with IDPH and CDD in developing the grant application to address: a. State capacity building; data gathering b. Health promotion interventions for people with disabilities c. Health provider training d. Accessibility of health environments for people with disabilities c. Emergency preparedness for people with disabilities 2. Served as the Council guiding the grant: a. Oversaw the implementation and assessed the success of implementing the Chapter on Disabilities for Iowans with Disabilities as a part of Healthy Iowans b. Reviewed the 2008 BRFSS data on access to health care for Iowa adults with disabilities and provided recommendations to disseminate the information to key policy makers who could address the issues. b. Provided recommendations about the design of a quality assurance initiative as a part of the Living Well with a Disability Program and monitored implementation results. c. Provided recommendations about the spread of the pre-service health provider training program. d. Provided guidance in the development and evaluation of a model pilot Community Access Project on Health Care Facility Accessibility OUTCOMES CURRENT STATUS PRIORITY RANKING IDPH elected not to include a Chapter on Disabilities in their new Health Improvement Plan 1. Application to CDC was funded. 2 b. Dissemination of BRFSS data on access to health care for people with disabilities was acted upon by the Department of Human Services. 2 c. Living Well with a Disability quality assurance initiative was successful and was implemented in other states. 2 d. Pre-service health provider training program was spread to 4 additional pre-service training programs in Iowa. 3 e. While the model Community Access Project for Health Care Accessibility met its goals, it proved to very labor intensive and as so was not considered a cost effective model for Iowa. Planning for new Iowa 5-Year Health Improvement plan is just beginning. Advocacy is needed to support the inclusion of a Chapter on Disabilities. POSSIBLE GRP. None needed. 10

11 CDC/IDPH Disability and Health State Capacity Building Grant continued 2012: Disability and Health Statewide Strategic Planning Meeting CDC/IDPH Improving the Health of Iowans with Disabilities Grant I e. Provided guidance in the development and evaluation of a model pilot Community access Project for Emergency Preparedness for Iowans with Disabilities 1. Planned and hosted a Disability and Health Statewide Strategic Planning Meeting to develop Iowa s first ever separate State Plan to Improve the Health of Iowans with Disabilities. 2. Drafted the new consensus state plan. 1. Collaborated with IDPH and CDD in developing the grant application to address: a. State capacity building; data gathering b. Conducting policy initiatives to improve the health and wellness of Iowans with disabilities b. Improving health promotion for people with disabilities, including health provider training. c. Improving access to health care, particularly preventive health care for people with disabilities. c. Improving emergency preparedness for people with disabilities 2. Served as the Council guiding the grant: a. See next page OUTCOMES CURRENT STATUS PRIORITY RANKING 2. e. Model Community Access Project on Emergency Preparedness was highly successful Over 70 health and disability agencies and consumers developed the outline for the first ever state plan. Goals addressed: a. Improve access to health care for Iowans with disabilities b. Build state and local public health capacity to address the health and wellness needs of Iowans with disabilities c. Increase the number of Iowans with disabilities who participate in health and wellness activities. d. Improve emergency preparedness and response for Iowans with disabilities. 2. State Plan served as the basis for development of Iowa s next competitive application to CDC for a disability and health grant Present 2 b. Health care access questions were included in the 2015 Iowa BRFSS survey. 2 c. Emergency preparedness questions were included in the 2015 Iowa BRFSS survey. 2 d. Funding to support further analysis of Medicaid claims data with regard to preventive health care was obtained. 2 e. Task Force to Improve Access to Preventive Health Care for Iowans with Disabilities was convened and is in progress. 1. Project will be completed by 6/30/15 3. See Outcomes column for work that still needs to be completed. POSSIBLE GRP. None needed None needed. 11

12 CDC/IDPH Improving the Health of Iowans with Disabilities Grant I continued CDC/IDPH Improving the Health of Iowans with Disabilities Grant II Iowa Community Transformation Grant b. Developed and advocated for questions to be added to the 2015 Iowa BRFSS to obtain health care access data that will be compared to similar questions included in the 2008 BRFSS. c. Developed and advocated for questions to be added to the 2015 Iowa BRFSS to obtain data about the percentage of Iowans with disabilities that have an emergency plan to be compared to data collected in d. Supported application to CDC for additional funding to repeat and expand a study of Medicaid claims data to look at utilization of preventive health care. e. Convened a Task Force to Improve Preventive Health Care for Iowans with Disabilities. f. Periodically reviewed program and provided recommendations for development, sustainability and spread. CDC will be initiating a new competitive application for a 3-5 year grant to improve the health of people with disabilities. IDPH will need assistance from an advisory group to develop the grant application. 1. Council formally requested that IDPH identify Iowans with disabilities as a target population in their grant application. 2. Council participated on the state grant advisory committee providing advice about the inclusion of Iowans with disabilities in state and community activities. OUTCOMES CURRENT STATUS PRIORITY RANKING 3. Additional work to be completed by the Council before the grant ends on 6/30/15: a. Review new BRFSS health care access data, identify successes and issues, and provide recommendations to address the identified issues. b. Review and dissemination of report and recommendations from the Preventive Health Care for Iowans with Disabilities. c. Review and assess the progress on the implementation of Iowa s State Plan to Improve the Health of Iowans with Disabilities. d. Review of all grant components and development of recommendations concerning spread and sustainability. e. Review new BRFSS emergency preparedness data and provide recommendations to further address the need for emergency preparedness New competitive application made. Plan for an advisory council to guide the grant will be in place The Council can assist in the application s development but will need to recommend and orient a new advisory group. POSSIBLE GRP. 1. Grant application was successful. None needed 12

13 IDPH Health Improvement Plan, The Council has been invited by IDPH to participate in the development of their new 5-year Health Improvement Plan to include submission of recommended priorities and development of objectives and strategies to meet the recommended priorities. OUTCOMES CURRENT STATUS PRIORITY RANKING 2016 The Council can participate in the initial phases of this planning process but may not be available to complete the work. POSSIBLE GRP. 13

14 FUNCTION 3: MAXIMIZE EFFORTS TO REDUCE A DISABILITY S EFFECTS ON AN INDIVIDUAL S HEALTH AND INDEPENDENCE (TERTIARY PREVENTION) PRIORITY INITIATIVE ACTIVITIES CODE Improving the Health of Iowans with Disabilities Affordable Care Act Implementing the Affordable Care Act in Iowa Telehealth Services for People with Disabilities 1. The Council signed on to 2 national disability organization letters to congress about assuring that the needs of individuals with disabilities were addressed within the ACA. 2. The Council met with representatives of the AUCD to provide a recommendation about the definition of behavioral services to be included in the ACA. The Council reviewed Iowa s proposed Health and Wellness plan and provided written testimony recommending several changes to better address the needs of Iowans with disabilities. 1. The Council studied the issue and met with Wellmark and Iowa Medicaid to share concerns and recommendations. 2. Improving Telehealth Services for Iowans with disabilities was one of the selected priorities coming from the Council s 2013 Disability Policy Summit 3. The Council supported legislation introduced in 2015 that defined telehealth services and required coverage of telehealth services for both public and private insurers. OUTCOMES CURRENT STATUS COUNCIL PRIORITY LEVEL Proposed definition of Behavioral Health Services was utilized in the ACA present Many, but not all, of the recommendations made by the Council and other disability organizations stakeholders were incorporated into the final Iowa Health and Wellness Plan. 3. A telehealth requirement was enacted for Medicaid but not private insurers. Program design, eligibility and effectiveness for Iowans with disabilities needs to be monitored. Additional work is needed to review the issues for people with disabilities with policy makers and advocate for change. POTENTIAL PARTNER None needed Improving Participation of Iowans with Disabilities 2013 Disability Policy Summit 1. Obtained funding, convened planning group and hosted Summit. Tracks included: Building inclusive, accessible communities that foster independence and access to healthcare Supporting children and families to optimize child health and development present Actions were taken on priority recommendations; the outcomes are described in various sections of this document Additional work is needed to promote implementation of all Summit recommendations including those that received a high priority. 14

15 Iowa Home Modification Assistance Children s Disability Services System in Iowa Preventing injuries that result in disability 2. Developed and disseminated Summit Report to the legislature and other stakeholders. 3. Convened a group of state disability councils to review and prioritize the Summit recommendations. 4. Acted on the priority Summit recommendations as described in various sections of this document. 1. Issue identified as the number 1 priority from the 2013 Disability Policy Summit 2. Council studied options to address the issue including a review of programs that existed in other states. 3. Council subcommittee met with the Iowa Finance Department and drafted a proposal for an Iowa Home Modification Tax Credit. 4. Council met with key legislators to obtain sponsors to introduce the proposal. 5. Council met with key disability agencies and groups to obtain support for the legislation and work out any differences of opinion on proposal contents. 6. At the request of bill sponsors in the Senate, the Council convened a group of key stakeholders to develop a proposal for the creation of both a low income Home Modification Grant program and a Home Modification Tax Credit for middle income individuals. 1. The issue identified as a priority from the 2013 Disability Policy Summit 2. Development of the system was identified as a priority recommendation from the Council to the Governor and legislature in present OUTCOMES CURRENT STATUS PRIORITY RANKING The 2015 Health & Human Services Appropriation Bill included language requesting the MH/Disability Comm. & the Disability and Aging Resource Centers provide recommendations for the creation of an Iowa Home Modification Assistance Program The 2015 Health & Human Services Appropriation Bill included language requiring a study and with recommendations to create the children s mental health services system in Iowa. Information will need to be provided to key stakeholder groups and legislators to enact legislation in POSSIBLE GRP. Children s Mental Health Coalition 15

16 Children s Disability Services System in Iowa continued Iowa Medicaid s Home and Community Based Waiver Program 3. The Council participated in the Children s Mental Health Coalition planning group in The issue identified as a priority from the 2013 Disability Policy Summit 2. Development of the system was identified as a priority recommendation from the Council to the Governor and legislature in OUTCOMES CURRENT STATUS PRIORITY RANKING With the advent of Medicaid Managed Care in Iowa, no action was taken by the legislature on this issue. Services for people with disabilities through Iowa s New Medicaid Managed Care System will need to be closely monitored. Issues will need to be identified and solutions proposed. POSSIBLE GRP. All state Councils and state and local providers and consumer groups. 16

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