Food is Medicine: CHLPI Presents Policy Roundtable on Integrating Food Interventions into Healthcare

Food is Medicine: CHLPI Presents Policy Roundtable on Integrating Food Interventions into Healthcare

On December 2, 2015, The Center for Health Law & Policy Innovation (CHLPI) of Harvard Law School will host Beating Type 2 Diabetes: Integrating Food Interventions into Healthcare, the final event of a 3-part series aimed at improving the federal response to diabetes in Washington, D.C.

The event will bring together a wide range of diabetes stakeholders, ranging from government agencies to advocacy leaders, to discuss how federal food and health policy can improve nationwide health outcomes for people at risk for or living with type 2 diabetes.

“There is increasing awareness among healthcare providers and advocates that food can play a crucial role in helping people with diabetes and prediabetes stay healthy and avoid hospitalizations and emergency room visits,” said Robert Greenwald, JD, Director of CHLPI and Clinical Professor of Law at Harvard Law School. “With this roundtable, our hope is to engage decision-makers and ignite a federal response that could reduce healthcare costs and—more importantly—significantly improve the lives of many diabetes and prediabetes patients. For people with diet-related chronic illness, food is medicine.”

Read the full press release on the policy roundtable here.

10/21 Webinar | Beating Type 2 Diabetes: Recommendations for Federal Policy Reform

Wednesday, October 21, 2015   2:00PM – 3:00PM EST

Across the United States, more than 29 million people have been diagnosed with type 2 diabetes, at a cost of more than $245 billion per year. Now is the time for action to turn the tide on the type 2 diabetes epidemic and the federal government has key roles to play in this fight.

In this webinar, experts at the Center for Health Law and Policy Innovation at Harvard Law School will outline the important steps that can be taken at the federal level, to both prevent new type 2 diabetes diagnoses and ensure that people living with diabetes receive the critical care and services they need. From evidence-based enhancement of services covered by health insurance to smart investment in child nutrition, we can urge our federal government to make the changes that matter when it comes to diabetes prevention and management.

Presenters:

  • Sarah Downer, JD, Clinical Instructor on Law, Health and Food Law and Policy Clinics, Center for Health Law and Policy Innovation
  • Jamille Fields, JD, MPH, Clinical Fellow, Center for Health Law and Policy Innovation
  • Emma Clippinger, JD, Clinical Fellow, Harvard Food and Law Policy Clinic

Moderator:

  • Christopher Kinabrew, MPH, MSW, Chief Strategy Officer , National Network of Public Health Institutes

RSVP to Beating Type 2 Diabetes: Recommendations for Federal Policy Reform here.

CHLPI Presents Policy Roundtable on Integration of Community Health Workers into Diabetes Care

On Wednesday, September 30th, the Center for Health Law & Policy Innovation (CHLPI) of Harvard Law School, in collaboration with Peers for Progress and the NCLR (National Council of La Raza), will host Beating Type 2 Diabetes: A Policy Roundtable on Seizing Current Opportunities to Integrate Community Health Workers into Diabetes Care.

The event will convene government agency representatives and diabetes stakeholders from across the country to discuss the important role that community health workers (CHWs) can play in improving health outcomes for people at risk or living with type 2 diabetes.

“Community health workers are an integral part of a patient’s journey through the healthcare system,” says Robert Greenwald, JD, Director of CHLPI and Clinical Professor of Law at Harvard Law School. “Especially for patients with pre-diabetes or type 2 diabetes, community health workers bridge the gap between patients and the organizations that deliver diabetes education and care. The support of community health workers is crucial to ensure proper adherence to treatment and key lifestyle changes.”

Read the full press release on the type 2 diabetes policy roundtable.

New Publication: Food Banks as Partners in Health Promotion: Creating Connections for Client & Community Health

7.9.15 Food Banks as Partners in Health Promotion - coverIn July 2015 CHLPI released the white paper Food Banks as Partners in Health Promotion: Creating Connections for Client & Community Health.

Food banks are embedded in local communities across the country. They are central to the
economic well-being of clients, who often struggle to find regular access to food. Food banks partner with government agencies, donors, and private companies to serve the interests of the more than 46 million individuals in the United States at risk of hunger.

Food banks do not need to be experts in health care, but they can be important partners in health promotion for their clients and local communities. Feeding America has
increased national efforts to provide Foods to Encourage, or foods that align with the 2010 USDA Dietary Guidelines for Americans, at member food banks. Recent changes in health care delivery may enable food banks to play a more formal role in health promotion and tailor some services to food insecure populations with specific health needs. There are new incentives for health providers to increase community engagement in order to improve health outcomes for clients. For food bank directors and partner agencies, this means potential opportunities for partnership and new sources of funding.

This White Paper aims to describe some shifts in the health care landscape that open up new opportunities for the nation’s food banks. It will also discuss several of the ways
that food banks can take advantage of these developments to become a partner for health care providers. It outlines some top concerns for food banks seeking to form these partnerships, including capacity to invest resources in building new relationships and/or tailoring and expanding services.

Read the White Paper.

New Publication: Reconsidering Cost-Sharing for Diabetes Self-Management Education: Recommendations for Policy Reform

6.11.15 Reconsidering Cost-Sharing for DSME - coverThe Center for Health Law and Policy Innovation PATHS program just released the report Reconsidering Cost-Sharing for Diabetes Self-Management Education: Recommendations for Policy Reform (June 2015).

Diabetes self-management education (DSME) provides a valuable opportunity for individuals living with diabetes to gain the knowledge, skills, and motivation to effectively manage their condition, and thereby avoid or postpone the onset of serious and costly complications. However, reports from providers, educators, and patients like Joan indicate that the costs associated with DSME may be acting as a significant deterrent to participation in the program.

In this white paper, the Center for Health Law and Policy Innovation (CHLPI) at Harvard Law School therefore examines the role of DSME in diabetes treatment and whether the reduction or elimination of cost-sharing obligations associated with DSME would be a cost-effective strategy for increasing program enrollment. Based upon the findings of recent cost-benefit analyses, the authors conclude that insurers should provide coverage of DSME with little or no cost-sharing in order to both improve patient health and curb costs.

Read the Report.

CHLPI Launches Federal Report on Type 2 Diabetes Prevention, Management, and Policy Reform

The Center for Health Law and Policy Innovation (CHLPI) of Harvard Law School released the 2015 Providing Access to Healthy Solutions (PATHS) Federal Report, Beating Type 2 Diabetes: Recommendations for Federal Policy Reform, during an event today on Capitol Hill. The report, developed with the support and guidance of people living with and at-risk-for diabetes, health and social service professionals, food providers and producers, government officials and other stakeholders, offers specific recommendations to decrease the incidence of type 2 diabetes and to promote effective management of the disease in those who have already been diagnosed.

The Report release also includes the kick-off of a series of federal policy roundtables, with today’s roundtable, Beating Type 2 Diabetes: A Policy Roundtable on Increasing Access to the Diabetes Prevention Program and Diabetes Self-Management Education, focused on the need for stronger national laws and policies to support cost-effective diabetes prevention and self-management programs. The roundtables will gather thought leaders from across disciplines, including legislators, federal and state agency staff, health payers and providers, and diabetes advocates, to move the diabetes policy agenda forward as outlined in the Report.

“As diabetes is the 7th leading cause of death in the United States and causes more deaths per year than breast cancer and AIDS combined, CHLPI’s Report and today’s roundtable stress the significance of preventive measures to avoid type 2 diabetes and sheds light on policy reform to ensure that those living with the disease are provided with quality treatment,” says Robert Greenwald, JD, Director of CHLPI and Clinical Professor of Law at Harvard Law School.

Greenwald adds, “Without federal action, one in three Americans will be diagnosed with type 2 diabetes by 2050. The staggering total cost of the disease to the US is up to $245 billion dollars a year and continuing to climb.”

Read the executive summary.

Read the full report.

Read the full press release.

PATHS Toward Successful Policy Advocacy: Harvard Law School’s CHLPI Hosts Workshop at Together on Diabetes™ Summit

The Center for Health Law and Policy Innovation team presented a half-day Policy Advocacy Workshop at the Bristol-Myers Squibb Foundation’s Together on Diabetes™ Summit. Three Harvard Law School students reflect on the day and the important work performed by the attendees as they sought to refine and develop implementation plans for their policy goals.

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By: Kristen Gurley (JD ’15), Jason Nichol (JD ‘15), & Tommy Tobin (JD ’16)

Participants_Stretching

ATLANTA, GA: On February 23rd, the Harvard Law School Center for Health Law and Policy Innovation (CHLPI) hosted a policy advocacy workshop in advance of the Together on Diabetes™ 2015 Grantee Summit. The Summit convened Bristol-Myers Squibb Foundation grantees from across the nation to discuss health equity and the patient experience for people living with diabetes.

CHLPI and its Providing Access to Healthy Solutions (PATHS) project were among those funded through Together on Diabetes™, a philanthropic program of the Bristol-Myers Squibb Foundation that seeks to promote health equity and improve health outcomes.

The purpose of the Pre-Summit Workshop was to help attendees establish and refine the policy goals that will make the interventions and services tested in their innovative research both scalable and sustainably funded in the long-term. In setting the table for future action, CHLPI presenters instructed attendees about the development and mechanisms of policy action and advocacy.

In her opening remarks, CHLPI Clinical Instructor Sarah Downer emphasized that “policy is the legal and regulatory framework” within which the attendees work. Downer then reminded the room that “it’s important to remember that we can reform” this framework.

CHLPI aimed to empower attendees to use policy advocacy in an effective way to help move their own organization’s policy goals forward.

Presenters first provided an overview of the levels of government policy-making, including federal, state, and local. Two grantee organizations then told their own success stories of policy changes. Finally, the grantees gathered in small groups to articulate their policy goals and strategize potential pathways for policy advocacy.

Clinical Fellow Katie Garfield opened the Workshop with a presentation on building effective advocacy strategies. According to Garfield, policies and programs are two concepts that often get confused.

Garfield refined the distinction between the terms. She outlined that “programs” promote a specific activity, while “policies” are generally broader and more sustainable because they set up a framework that can continue supporting a specific activity or range of activities over time.

Small_Group_Discussion_Group_3-3In the Workshop, CHLPI presenters invited attendees to envision policy advocacy as a three-fold process. First, advocates should assess potential policy goals for impact and attainability. Second, advocates can identify who will be both influential and supportive in accomplishing each policy goal. Third, advocates and their partners can collaborate to develop and implement an advocacy strategy for achieving each goal.

Following Garfield’s remarks, two Together on Diabetes™ grantees presented case studies on policy reform, featuring Dr. Richard Crespo of Marshall University and Manuela McDonough of the National Council of La Raza (NCLR).

Dr. Crespo, a professor of community health, focuses on diabetes health promotion in the Appalachian region. He spoke of creating diabetes coalitions and advocating for preventive health policy changes in local areas across the region. Notably, Dr. Crespo talked of some the coalitions’ success with farm-to-school programs and how the Food Law and Policy Clinic (FLPC) (a division of CHLPI) and its students had provided advocacy guidance throughout the process. The FLPC students provided the analysis that his advocacy teams brought to local policy-makers. These students empowered advocates, who then reached out to local decision-makers and improved outcomes for those with diabetes in many rural communities.

Manuela McDonough of NCLR spoke of policy advocacy for Latino health. McDonough noted that Latino communities have disproportionally high rates of diabetes. With a Together on Diabetes™ grant, NCLR has launched a Compañeros en Salud program, a peer support initiative to encourage diabetes-related goal setting and self-management of the chronic disease. Together with Peers for Progress and other partners, NCLR’s culturally-competent peer support program has reached over 4,000 clients in Chicago. To advance NCLR’s broader policy goal of achieving recognition and sustainable funding for peer supporters (also known as Community Health Workers) to be permanent members of health care teams, McDonough described how NCLR and Peers for Progress used the success of the Compañeros en Salud program to convene a broad coalition of experts in chronic disease, staff from relevant government agencies, and leaders of community health worker networks. This coalition drafted a Call to Action targeted at policymakers, asking them to support development of state-level recognition or certification regimes for Community Health Workers.

Small_Group_Discussion_Group_2Following the presentations, the attendees were broken into small groups to discuss policy advocacy. The small group breakout session was designed to help participants refine and prioritize policy goals and begin initial steps to establish policy action plans.

CHLPI faculty and students facilitated the small group conversations. Participants were asked to articulate a policy goal and help others to examine the attainability and impact of their policy goals. Importantly, CHLPI facilitators assisted discussants to frame their policy goals in terms of the benefit of the goal balanced with the organization’s available budget, technical capacity, and administrative experience. To improve potential effectiveness, CHLPI encouraged attendees to think of leveraging the resources of partners to create efficiencies in the policy advocacy process.

The small groups were the centerpiece of the Workshop. Small group participants worked to identify their organization’s policy goal while other group members contributed ideas to help sharpen and refine the goal under discussion. After each individual established a policy goal, the small group worked collectively to brainstorm strategies for implementing the goal, forming an action plan. This process included targeting prominent stakeholders, considering practical and financial barriers to change, and finding potential partnership opportunities.

Though the groups had distinct policy goals and faced region-specific challenges, common threads emerged. Groups noted the importance of engaging local communities and forging partnerships with other groups with similar interests. At the conclusion of discussion, the small groups presented their ideas to the attendees and reflected on the evolution of the group’s dialogue.

In advance of the Together on Diabetes™ Grantee Summit, the PATHS Workshop armed attendees with an overview of the policy advocacy process and tools they could use to accomplish their policy goals. As Sarah Downer noted in wrapping up the day, the attendees were “a natural coalition of partners” who could work together to transform ideas into actionable goals and identify concrete steps toward improving the lives of those with diabetes in communities across the country.

CHLPI is available to continue to support these organizations. As CHLPI clinical students, we appreciated the opportunity to get involved. We’re excited to move forward supporting these organizations in their important work to advance public health. As the Summit emphasized, we’re all in the fight against diabetes together!

Progress on New Jersey Diabetes Legislation

By Katie Garfield (CHLPI Clinical Fellow, JD ‘11)

On Thursday, February 5, New Jersey took an important first step towards the goal of providing key diabetes services to its Medicaid beneficiaries. In a hearing session, the Assembly Health and Senior Services Committee of the New Jersey legislature approved the text of Assembly Bill 3460. If passed, this bill will improve diabetes care for vulnerable populations in New Jersey by providing Medicaid coverage for diabetes self-management education (DSME), the Diabetes Prevention Program (DPP), medical nutrition therapy (MNT), and expenses for supplies and equipment for the management and treatment of diabetes.

Several diabetes advocates, including Stephen Habbe (Advocacy Director, Northeast, American Diabetes Association (ADA)), Francine Grabowski (Program Manager, Cooper Diabetes Education Center; Lead Diabetes Educator, Camden Coalition of Healthcare Providers) and Michael Johnson (Director of Association Initiatives, The Gateway Family YMCA) testified in support of the bill. These advocates explained that, each year, diabetes takes a dramatic financial ($5.4 billion in medical costs and $2.4 billion in indirect costs) and personal toll on New Jersey. These advocates therefore urged the committee to support the inclusion of DSME, DPP, and MNT in the state’s Medicaid program as critical evidence-based diabetes interventions. Committee Chairman and bill sponsor, Assemblyman Herb Conoway Jr. also expressed strong support for the bill and its potential to reduce costs while extending the lives of individuals living with diabetes.

After hearing this testimony, the committee approved the bill to be passed out of committee almost unanimously (11-1). The bill has therefore moved on to the next step in the legislative process—consideration by the Assembly Appropriations Committee—where it will hopefully meet with equal success.

As highlighted in Stephen Habbe’s testimony, this legislation seeks to address some of the coverage gaps identified in the Center for Health Law and Policy Innovation’s New Jersey PATHS report. We are therefore very excited to see the bill pass this first legislative hurdle, and we will continue to provide updates on its progress through New Jersey’s State House.