One-year postpartum Medicaid coverage: Are states ready to offer  it soon?

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About Kerry Dooley Young

Kerry Dooley Young (@kdooleyyoung) is AHCJ's core topic leader on patient safety. She has written extensively about the Food and Drug Administration, medical research, health policy and quality measurements. Her work has appeared in Medscape Medical News, Congressional Quarterly/CQ Roll Call and Bloomberg News.

Photo by Toshimasa Ishibashi via Flickr.

April 1 marks the kickoff date for a federal option that makes it easier for states to extend postpartum Medicaid coverage to one year after childbirth from the current 60-day standard.

Journalists can now find out how well their states have prepared to take advantage of this Medicaid-expansion pathway, which Congress created as part of last year’s American Rescue Plan legislation. Here are several good websites to track the progress states have made in winning needed Centers for Medicare and Medicaid Services (CMS) permission for the one-year postpartum coverage.

  • The National Academy for State Health Policy (NASHP) has a website dedicated to tracking efforts to expand postpartum Medicaid coverage. It offers detailed summaries of the status of efforts within state legislatures to make the needed legal changes for the coverage expansion.
  • Kaiser Family Foundation (KFF): It’s always a good idea to check the website of the nonprofit Kaiser Family Foundation (KFF) when covering a Medicaid issue. KFF is keeping tabs on state efforts as well through its Medicaid Postpartum Coverage Extension Tracker.
  • American College of Obstetricians and Gynecologists (ACOG) : ACOG is advocating for wide use of the new pathway, calling “critical” as many states as possible implement the required state plan amendment for the April 1 start date, ACOG said on a webpage dedicated to building support for a permanent expansion.

There’s been significant interest in recent years in addressing the reasons why U.S. maternal mortality rates have risen, running counter to global trends of falling rates — at least in the years before the pandemic.

“No mother should have to fight for her coverage or care during pregnancy or while caring for a newborn,” CMS Administrator Chiquita Brooks-LaSure said in a Dec. 7 statement, noting that unnecessary postpartum illnesses and deaths “disproportionately harm people of color.”

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AHCJ launches search for new executive director as Smiley resigns

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About Felice J. Freyer

Felice J. Freyer is AHCJ's president and a health care reporter for The Boston Globe.

Andrew Smiley

Andrew Smiley, AHCJ’s executive director who led the association through the challenges of a continuing pandemic and critical personnel changes, is resigning effective Jan. 28.

We are grateful for Smiley’s excellent work since he took the post in September 2020. His accomplishments include increasing reserves, helping run a new fellowship program, quickly implementing a virtual platform to offer workshops during the pandemic, and hiring three top-notch staffers — Katherine Reed, director of education and content; Andrea Waner, director of engagement, and Erica Tricarico, managing editor.

Smiley said he had not expected to leave so soon but had been recruited into a “life-changing” new job. As we search for a replacement, the AHCJ board of directors has put in place a transition plan that will keep the association operating smoothly without any changes to our offerings and activities.

Katherine Reed                    Andrea Waner

Reed has agreed to serve as interim executive director and Waner will be interim deputy executive director. Senior Advisor and former Executive Director Len Bruzzese has agreed to increase his time with us, and Jeff Porter, recently retired education director, will assist with conference planning.

As a result, our daily Covering Health blog, our fellowship programs, the annual Excellence in Health Care Journalism awards, and planning for our annual conference will all continue apace. The conference will take place in Austin April 28 – May 1.

I have appointed a search committee, which I am chairing, to look nationwide for a new executive director. Search committee members also include immediate past president Ivan Oransky, former president Karl Stark, vice president Gideon Gil, board member Marlene Harris-Taylor, and Mark Horvit, a professor at the Missouri School of Journalism, where AHCJ is based.

I’m expecting many applicants will be drawn to the opportunity to lead a vibrant organization that supports and educates journalists at a time when our work has never been more important. I urge AHCJ members to spread the word and encourage prospective candidates to submit their applications. To apply for the job, go to https://hrs.missouri.edu/find-a-job/staff, click on “prospective employees” and search for job no. 39998.

CDC establishes new reference value for dangerous blood lead levels

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About Tara Haelle

Tara Haelle (@TaraHaelle) is AHCJ's medical studies core topic leader, guiding journalists through the jargon-filled shorthand of science and research and enabling them to translate the evidence into accurate information.

Photo by Dr. Matthias Ripp via Flickr.

The Flint, Michigan water crisis remains a prime example of the importance of public health journalism. Without the dogged reporting and local medical research by a persistent pediatrician, thousands of children would likely continue being harmed by unsafe lead levels in the water. The crisis also spotlighted the fact that lead remains a significant health threat to children and one that disproportionately affects already vulnerable kids, particularly Black children, those living in poverty, and immigrant and refugee children.

Lead poisoning can cause brain damage, learning and attention difficulties, memory problems, reduced growth and development, and behavioral problems in children, and the effects are irreversible.

Two years after the water crisis began, the Water Infrastructure Improvements for the Nation (WIIN) Act of 2016 authorized creation of the Lead Exposure Prevention and Advisory Committee (LEPAC), a committee that was officially formed in 2018 with four main objectives:

  • Reviewing federal programs and services available to lead-exposed people and communities.
  • Reviewing current research on lead poisoning to identify additional research needs.
  • Reviewing and identifying best practices, or the need for best practices, regarding lead screening and prevention of lead poisoning.
  • Identifying effective services for people and communities affected by lead exposure.

One of the biggest challenges of protecting children from lead poisoning is, as with many toxic chemicals, the lowest level of lead that can be tolerated without causing harm is unknown. It’s generally recognized that no “safe” level exists, but since it’s impossible to ensure children have zero lead exposure — it occurs naturally in our environment — we need a reference point to determine how much is too much. Until recently, the CDC had determined the blood lead reference value to be 5 µg/dL — the amount of lead in a child’s blood that indicates higher-than-average, and potentially dangerous, exposure.

But the Lead Exposure Prevention and Advisory Committee recommended in May 2021, based on their review of available evidence, that the reference value be adjusted down to  3.5 µg/dL, and the CDC has just adopted that recommendation and updated the reference value. That means children ages one to five who have at least 3.5 µg/dL of lead in their blood have higher lead blood levels than 97.5% of other U.S. children their age.

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Mental health topics to explore in 2022

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About Katti Gray

Katti Gray (@kattigray) is AHCJ's core topic leader for behavioral and mental health. A former Rosalynn Carter Mental Health Journalism Fellow, Gray is providing resources to help AHCJ members expand their coverage of mental health amid ongoing efforts to de-stigmatize mental illness and to place mental health care on par with all health care.

Photo by Finn via Unsplash.

Almost two years of pandemic lockdowns, re-openings, retreats from re-opening, and coronavirus variants — and another COVID-19 winter upon us — mental health challenges remain a hot topic.

Now that we’ve entered a new year, a bevy of stories already in the news cycle beg for follow-up coverage, including ones on the pros and cons of telemental health and, by extension, the future of video-conferenced and teleconferenced care. 

During the pandemic, the federal Centers for Medicare and Medicaid issued waivers expanding patient access to their clinicians via Zoom, phone calls, etc. Some lauded that move, which is expected, on some level, to become permanent. Others say telehealth is far from the preferred avenue of care for everyone, including some patients with more severe diagnoses, including drug-resistant depression, bipolar disorder and schizophrenia.

Along with those looming questions and trends, there are emerging and resurfacing news topics for reporters to tackle. From that pool, here are the discussions to listen for and probe in 2022:

  • There’s a renewed move afoot to change the term schizophrenia. Of 1,190 government officials, clinicians and members of the general public responding to this survey, published online in October 2021 and print in December 2021 in Schizophrenia Research, 74.1% said the term was stigmatizing; 71.4% wanted to change it to phrasing they contend might more accurately describe the symptoms of that disease. Among alternatives that those respondents preferred were “altered perception syndrome,” “psychosis spectrum syndrome” and “neuro-emotional integration disorder.” From the same journal, this 2015 paper assessed 41 previous studies, commentaries and such on whether to change the term. And this 2019 paper, “The debate about renaming schizophrenia: a new name would not resolve the stigma,” questioned whether a name change, which already exists in several Asian countries, would actually diminish stigma.

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Video games evaluated as possible treatment for COVID ‘brain fog’, other conditions

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About Karen Blum

Karen Blum is AHCJ’s core topic leader on health IT. An independent journalist in the Baltimore area, she has written health IT stories for publications such as Pharmacy Practice News, Clinical Oncology News, Gastroenterology & Endoscopy News, General Surgery News and Infectious Disease Special Edition.

Photo by Surface via unsplash.

Digital tech company Akili Interactive’s recent collaboration with two academic medical centers to evaluate a video game developed for children with attention-deficit/hyperactivity disorder (ADHD) in patients with COVID-19-related “brain fog”, has become one of the latest investigations of video games in medicine.

Over the past decade, some researchers worldwide have been studying the potential use of video games as a treatment, educational tool, or complementary therapy for a variety of ongoing or perplexing medical challenges, as well as for teaching medical trainees new skills. Journalists can find interesting stories in this area, provided they acknowledge that data and results so far have varied widely.

A glance at the research

In randomized controlled clinical studies, investigators at Vanderbilt University Medical Center and New York-Presbyterian/Weill Cornell Medical Center are testing the potential of Akili’s game EndeavorRx to target and improve cognitive functioning in patients following COVID-19 infection. In the game, approved by the U.S. Food and Drug Administration in June 2020 as a prescription treatment for children with ADHD, players help an alien avatar navigate a digital environment while being presented with on-screen prompts as a form of distraction, according to an article on medicine.com. Users work to earn rewards and unlock new environments.

The game has challenges and demands, said James Jackson, Psy.D., director of long-term outcomes for the ICU Recovery Center at Vanderbilt, in an interview with AHCJ. As people improve, the challenges and demands become harder. If they struggle, the tasks become easier. The hypothesis is that this dynamic nature of the game can help improve function in attention and processing speed, he said — key difficulties experienced by COVID long haulers.

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