SDoH: How Safer Communities Act Can Provide Additional Funding

From my June 13 Monitor Mondays segment on the impact of gun violence on healthcare to the time I researched for this segment, there have been 67 deaths and 404 injuries. 

Since last report, our bloodiest day was July 4, with the Highland Park mass shooting resulting in eight dead and 29 injured. Across the country that day, 11 died and 70 were injured by guns. In our previous listener poll, the majority of our listeners confirmed that gun violence—although not a direct responsibility of healthcare—is similar to any public health approach and is a healthcare concern that cannot be ignored by our communities when we evaluate health disparities. 

Similar to how we track other social determinants such as poverty levels, our gun violence data now identifies the likelihood of gun violence by zip code. For example, in Delaware a gun death occurs every three days compared to Florida where it is every three hours. 

Last month, the Biden administration and Congress passed the first major gun safety legislation in almost 30 years.  I would like to recognize that this bill is partly about gun regulations and mostly about mental health support. 

  1. The bill expands an existing law which prevents people convicted of domestic abuse from owning a gun.
  2. Expands background checks on people between ages 18 to 21 seeking to buy a gun
  3. Requires more gun sellers to register as Federally Licensed Firearm Dealers
  4. Creates some statues on gun trafficking

Now the mental health and public safety portion:

  1. Significant increase in funding for mental health programs and school security
  2. $750 million is provided to help states implement and run crisis intervention programs
  3. Diversion of the $10 billion initial funds in the American Rescue Plan, much of what I reported on previously has not been spent now to address public safety and violence prevention
  4. The National Institute of Health has since redirected and released targeted grants to support four high violence areas in parts of Chicago, Detroit, and Virginia.
  5. The Department of Housing and Urban Development is opening $3.4 billion for local communities to incorporate community violence intervention strategies.

Now most applicable to us is, the U.S. Department of Health and Human Services (HHS) announced how Medicaid will reimburse certain community violence intervention programs like hospital-based violence interventions also known as trauma-informed care to individuals that have experienced violence.  

Regarding state Medicaid reimbursement, Illinois and Connecticut are the only states that have fully incorporated hospital-based intervention reimbursement into their plans, however I will include my link in the article this week on how other health systems may be able to coordinate with state Medicaid plans to access this additional funding ranging from mental health, physician reimbursement, rehabilitative services, and home health prevention for high-risk populations.

Programming Note: Listen to live reports on the social determinants of health every Monday on Monitor Mondays, 10 Eastern.

References

https://www.gunviolencearchive.org/reports/mass-shooting

https://www.whitehouse.gov/briefing-room/statements-releases/2022/07/11/fact-sheet-the-biden-administrations-21-executive-actions-to-reduce-gun-violence/

https://www.medicaid.gov/state-resource-center/downloads/allstatecall-20210427.pdf

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Tiffany Ferguson, LMSW, CMAC, ACM

Tiffany Ferguson is CEO of Phoenix Medical Management, Inc., the care management company. Tiffany serves on the ACPA Observation Subcommittee. Tiffany is a contributor to RACmonitor, Case Management Monthly, and commentator for Finally Friday. After practicing as a hospital social worker, she went on to serve as Director of Case Management and quickly assumed responsibilities in system level leadership roles for Health and Care Management and c-level responsibility for a large employed medical group. Tiffany received her MSW at UCLA. She is a licensed social worker, ACM, and CMAC certified.

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