Health

The Health Policy Group provides policy analysis and innovative programming for state health policy leaders in the legislative and executive branches. This group also develops many publications and health forums for state leaders.

State leaders need access to critical and timely health policy information. CSG staff works to provide officials with best practices and policy analysis, helping lawmakers identify the best health solutions for their states.

The opioid crisis has devasted families and communities across the nation. As a result, the federal government has begun drafting potential policy solutions that could help mitigate the effects of widespread opioid use. While Congress debates their options, they would do well to look to the states for guidance on the matter.

Several states have adopted innovative strategies that have allowed them to expand access to medication-assisted treatment, or MAT. MAT combines Food and Drug Administration-approved medication—methadone...

CSG Midwest
As part of what state officials say is the strictest set of lead and copper standards in the nation, Michigan will require all of the state’s public water systems to replace their lead service lines. Starting in 2021, the Detroit Free Press reports, each public water system must replace, on average, 5 percent of its lead service pipes per year over a 20-year period, with water customers paying for most of the estimated $2.5 billion price tag.
CSG Midwest
For his first job out of college, psychologist Mark Weist went to work at a mental health center, splitting his time between providing services at the center and a local school. The differences in the two settings were dramatic.
“At the mental health center, people weren’t showing up,” Weist, a professor of psychology at the University of South Carolina, said during a presentation at this year’s Midwestern Legislative Conference Annual Meeting. “We’d be scheduled to see six or seven families in a day, for example, and only somewhere between one and three showed up.
“But in schools, there was this tremendous pent-up need for services.”
That experience nearly 30 years ago has led Weist to become a national leader in efforts to bring the mental health system into the schools, allowing community practitioners to work alongside school psychologists, nurses, social workers and counselors. He listed multiple benefits of school-based mental health: better identifying students in need, improving service access and use, and reducing barriers to learning. 
CSG Midwest
Myriad signs point to the need for better connecting farmers to services that help them deal with stress, depression and other mental health challenges. First, there is the history of the problem: In a study examining various industries between 1992 and 2010, The National Institute for Occupational Safety and Health found that farm operators and workers had the highest suicide rate.
Second, many rural U.S. communities struggle with shortages of mental health professionals: 65 percent don’t have a psychiatrist and 47 percent lack a psychologist, according to a 2018 study in the American Journal of Preventive Medicine. Third, many of today’s agricultural producers are dealing with high levels of stress, due to factors such as low commodity prices and decreased farm incomes.

A growing number of states are shortening the leash on fake service animals. At present, approximately 20 states have enacted laws aimed at deterring individuals from fraudulently misrepresenting their pets as service animals. These laws are in addition to those that exist to deter harassment of or...

A new organization in Utah, the Utah Alliance for the Determinants of Health, has been formed to improve overall community health by addressing social needs such as housing instability, utility needs, food insecurity, interpersonal violence and transportation. These are all non-medical factors that influence a person’s health. Public health researchers suggest that social determinants of health may account for up to 60 percent of health outcomes.

Gag clauses are at the forefront of state policy decisions as state policymakers attempt to reduce the cost of prescription medications. Gag clauses are established in PBM-pharmacy contracts prohibit pharmacists from informing consumers, unless asked, about cheaper ways to purchase prescriptions or access more effective alternatives, i.e., a lower cost generic drug or newer brand name drug with better outcomes. From 2016 to 2018, 22 states enacted legislation to prohibit the use of gag clauses to provide consumers and pharmacists more ability to communicate about cheaper options. Another nine states have legislation still pending. Eight states have legislation regulating pharmacy benefit managers, or PBMs, through audits, licensing and maximum allowable cost statutes that do not directly address gag clauses. More than eight states have Maximum Allowable Cost (MAC) statutes and auditing and licensing procedures enacted, however they also address gag clauses or claw backs specifically in their bill.

In a 5-4 decision in National Institute of Family and Life Advocates v. Becerra, the Supreme Court ruled that a California law requiring licensed pregnancy clinics to disclose they don’t offer abortions and unlicensed pregnancy clinics to disclose the fact they are unlicensed likely violates the First Amendment. The State and Local Legal Center (SLLC) filed an amicus brief in this case asking the Court not to apply the highest level of scrutiny (strict scrutiny) to commercial speech or to every disclosure requirement adopted by states and local governments.

California law requires that “licensed covered facilities” that provide family planning or pregnancy-related services must disseminate a notice stating that publicly-funded family planning services, including contraception and abortion, are available. It also requires “unlicensed covered facilities” to disseminate a notice they are unlicensed. The author of the law noted there are nearly 200 licensed and unlicensed crisis pregnancy centers in California. These centers “aim to discourage and prevent women from seeking abortions.”

The National Institute of Family and Life Advocates (NIFLA) operates licensed and unlicensed covered facilities that don’t offer abortions. It argues these requirements violate its First Amendment right to free speech.

Former first lady Michelle Obama famously planted a vegetable garden at the White House to model good eating to youngsters. Famous restauranteurs such as Alice Waters have been involved in school garden projects for years. These garden programs feel good but now there is evidence that they may, in fact, do good.

A study soon to be published in Preventive Medicine found that students who grow vegetables in a school garden report increased availability of fruits and vegetables at home, particularly the youngest students. The study results were previewed by Journalist’s Resources, a project of the Harvard Kennedy’s School which curates scholarly studies and reports and makes them available on an open-access site.

Virginia Legislature Votes for Expansion

On May 30, the Virginia Senate voted, with 4 Republicans supporting the measure, to expand Medicaid eligibility to all individuals with income at or below 138 percent of the federal poverty line, according to the Washington Post. Later in the day, the House of Delegates approved the bill by 67 to 31. Gov. Northam, a pediatrician who campaigned in 2017 on expanding Medicaid, is expected to sign the bill.

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