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Strengthening Maine's Safety Net
Maine's safety net is comprised of providers and health care organizations and the advocacy groups that disproportionately serve people who are uninsured and medically underserved. Publicly funded health insurance programs (such as MaineCare and Medicare) that serve low-income children and adults, people with disabilities, and seniors are vital components of the safety net as well.
The MeHAF approach to strengthening Maine’s safety net focuses in several key areas, including:
These areas were identified as leverage points by safety net providers and/or included in a MeHAF-commissioned environmental scan of Maine’s health care safety net. This study, "Primary Care Safety Net Environmental Scan", conducted by John Snow, Inc. and other research helped identify the following strategic initiatives for grants and program funding noted below. For more information on any of these projects, please contact Kim Crichton.
Promoting better management of and access to free or low-cost medications
Securing free or low-cost prescriptions is a significant challenge for many low-income and uninsured people in Maine and a major barrier to high quality health outcomes. In 2006, MeHAF issued a competitive RFP and awarded grants totaling $2.1 million to 19 hospitals, health centers, and uncompensated care programs. These grants fund projects for up to three years and support improvements in access to affordable medication and better management of prescription drugs for low-income Mainers.
As the initial work evolved, several grantees identified a key problem – many patients do not fill or take the medications they have been prescribed. As a group, the grantees asked MeHAF for assistance in identifying sources for training in evidence-based best practices in medication management. This led MeHAF to commission researchers from the University of Southern Maine's Muskie School to conduct a literature review and synthesis entitled
Improving Medication Management: A Review of the Evidence
.
Building on this 2007 report, MeHAF convened a broad stakeholder group comprised of providers, insurers, businesses, quality experts, consumers and policy leaders to work collaboratively toward better medication management. This group meets several times a year and is dedicated to working collaboratively on barriers and strategies to improve medication management throughout Maine.
Enhancing medication safety and management in Maine’s rural Critical Access Hospitals
MeHAF partnered with Maine’s Critical Access Hospitals (CAH), the Maine Quality Forum, the Muskie School of Public Service, and the State Office of Rural Health and Primary Care to support a CAH Patient Safety Collaborative focused on medication safety and effective medication management. Through this initiative, participating CAH are eligible for a $10,000 grant from MeHAF to support an in-depth planning process that will examine best practices, discuss assessment of medication safety needs, and develop plans for a CAH improvement project. Participating CAH hospital teams will develop a detailed institutional work plan, timeline and budget for a medication safety and management implementation project.
At the end of the planning process in the fall of 2008, participating hospitals will be eligible to apply to MeHAF for implementation funding of up to $50,000. This support will enable applicant CAH to implement the work plan developed during the planning process.
Supporting strategies to preserve MaineCare coverage under new Federal citizenship verification requirements
Under the Federal Deficit Reduction Act of 2006, Medicaid applicants are now required to document citizenship as part of the eligibility screening process. MeHAF issued a competitive RFP and funded advocacy groups and Maine’s Department of Health and Human Services in 2007-2008 to educate, coordinate outreach and, in some instances, directly assist MaineCare applicants to meet the new documentation requirements.
Expanding the network of Maine’s Federally Qualified Health Centers (FQHCs)
In 2003 MeHAF initiated a partnership with the State Office of Rural Health and Primary Care and the Maine Primary Care Association to expand the state’s federally qualified health centers network and promote better sustainability through enhanced federal support.
Since 2003, Maine has gained three new community health centers and several other existing centers have been able to expand services. With an investment of $156,567, MeHAF helped bring $2,674,552 in federal funds to Maine.
In 2008, MeHAF will commission a comprehensive evaluation of the statewide impact of this initiative.
Advancing telehealth to expand access to care in rural Maine
To better address the health needs of rural residents, MeHAF has worked with many other organizations to support telehealth as a way of expanding access to specialty care to rural Maine. Many of these projects faced regulatory, reimbursement and other barriers to full adoption. MeHAF commissioned the Center on Telehealth and E-Law to conduct a national study of state and federal telehealth policies. This study has served as a useful resource and guide to Maine policymakers.
The Maine State Health Plan outlined a goal to promote strategic use of telehealth services to improve access to and the quality of care. MeHAF partnered with staff from the Governor’s Office of Health Policy and Finance to convene a statewide telehealth work group to address the barriers to telehealth adoption.
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