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Current Projects- draft

WHOLE PERSON CARE

  • Food is Medicine State and Federal Legislative Advocacy

CHLPI advocates for integrating medically-tailored nutrition services into health care delivery and financing. At the national level, CHLPI is a policy advisor to the Food is Medicine Coalition, a group of nonprofits that provide medically-tailored meals to individuals with severe health conditions. At the state level in Massachusetts, CHLPI co-leads a coalition of health care providers, payers, and community-based organizations engaged in implementation of the Massachusetts Food is Medicine State Plan. CHLPI works with external partners and legislative champions to drive legislative action on nutrition and health care policy at both the federal and state level. 

  • Scaling Community-Based Health Interventions: Legal Implications of Nonprofit Growth

In a rapidly evolving environment where community-based service providers are developing collaborations with the health care system, new funding streams of health care dollars are allowing nonprofits to grow and serve additional populations in unprecedented ways. CHLPI works with a coalition of community-based meal provider nonprofits to ensure that they understand the complex legal landscape that can present barriers to scaling innovative health care solutions.

This is an initiative of CHLPI’s Social Determinants of Health Law Lab, a special endeavor that seeks to explore the legal implications of health care reform and innovation. 
  • Policy Advocacy Training for Health Care System Stakeholders

CHLPI works with clients across the country who are engaged in projects and initiatives that will increase equity in cancer care. Currently, CHLPI is partnering with Levine Cancer Institute, a prominent cancer center in North Carolina, and the Oncology Nursing Society to lead in-person trainings on federal health care policy and advocacy for local health care providers. 

  • Public Health and the Environment: Radon Edition

Radon is the number one cause of lung cancer among nonsmokers, with roughly 20,000 Americans dying of lung cancer stemming from radon exposure each year. A number of states have enacted laws requiring testing for radon (and disclosure of results) in schools and residential buildings. However, radon mitigation can be costly. As a result, individuals and families may learn that they are being exposed to high levels of radon, but be unable to take action to reduce their risk. Building on similar efforts to combat other environmental risks, such as lead exposure, CHLPI is working with a partner organization to develop tools to support a nationwide campaign to address this issue and the inequities it creates.

  • Community Approaches to Reducing Sugar Consumption

Diets high in sugar are associated with increased risk of obesity, diabetes, cardiovascular disease, and certain types of cancer. These are all diet-related health conditions that take a serious toll on quality of life and have a significant impact on the cost of health care. In this project, CHLPI and its Health and Food Law and Policy Clinics will work together to empower communities across the country to implement policies that reduce consumption of sugar. 

  • Community Supported Agriculture in Health Care

Community Supported Agriculture (CSA) farm shares provide the mutual benefit of increasing access to fresh, healthy food while supporting local agricultural producers. The CSA model traditionally relies on advanced payments that provides working capital for farmers. Historically, low-income populations–communities that have higher rates of diet-related chronic disease and food insecurity–have lower CSA participation rates due to affordability, transportation, and knowledge of resources. CHLPI will assess current access, gaps, and barriers associated with low-income CSAs across Massachusetts and explore opportunities within food safety net programs as well as health care financing and delivery systems to improve access to CSA farm shares as an essential Food is Medicine service. 

  • Information, Technology, and the Social Determinants of Health

Information and technology are central to many innovative social determinants of health interventions. For example, effective partnerships between health care providers and social services organizations often require communication about the needs of patients and clients. With more communication comes increased responsibility to think critically about how information that relates to patients and clients is shared and protected. CHLPI is developing resources to support innovative community-clinical partnerships that comply with patient privacy laws and advocate to advance the exchange of information and technology in a manner that supports the social determinants of health. 

HEALTH CARE ACCESS

  • Federal Health Care Policy Analysis, Coalition Building, and Advocacy

CHLPI leads several national coalitions, including the Chronic Illness and Disability Partnership and the HIV Health Care Access Working Group, organized around issues of federal health care access, with a focus on the care and treatment needs of low-income people living with HIV, cancer, diabetes and other chronic health conditions. Current priority issues include challenging Trump Administration proposals to restructure state Medicaid programs by allowing for work requirements or drug testing, or by instituting capitated or block-grant financing systems. CHLPI’s federal health care work also involves promoting federal policy and legislation to ensure comprehensive access to care and treatment, such as efforts to secure widespread access Pre-Exposure Prophylaxis (or PrEP), in an effort to dramatically reduce the transmission of HIV and realize the goals of the recently announced Ending the HIV Epidemic campaign.

  • Strengthening Private Health Insurance

The Affordable Care Act and other health reforms have significantly improved the availability of affordable private health insurance through state Marketplaces. Despite this progress, individuals living with chronic illness and disabilities continue to face significant cost and coverage burdens as a result of discrimination in health insurance plan benefit design. Within this project, CHLPI has created a multi-year, multi-state data project that calculates the “value” of a health care plan to a person living with chronic illness and proposes ways this methodology can be used in the enforcement of nondiscrimination law. CHLPI has also conducted state-specific research and advocacy that supports expanded access to health care for vulnerable communities and that encourages state officials to incorporate more rigorous reviews of discriminatory insurance plans.

  • Transgender Health Care Rights

Transgender and gender-nonconforming communities regularly face discrimination in health care settings and often lack access to affordable, high-quality health care coverage that includes gender-affirming care. CHLPI is engaged in work to strengthen protections in health care settings (focusing on insurance and state-level administrative protections), pursuing traditional methods of enforcement through advocacy and litigation that eliminate discriminatory insurance policies, and helping to expand access to gender-affirming care in rural areas. 

  • Hepatitis C Grassroots Advocacy

Newly developed direct-acting antiviral drugs can cure up to 99% of people living with hepatitis C—the number one communicable disease killer in the United States, claiming more lives than the next 60 communicable diseases combined, including HIV. While the price of the cure has dropped dramatically over the past several years, many state Medicaid programs continue to implement unprecedented treatment access restrictions. These restrictions violate federal law. CHLPI partners with the National Viral Hepatitis Roundtable (NVHR) to highlight the extent of the problem and to animate advocacy campaigns to eliminate discriminatory coverage practices in Medicaid and the Corrections health care programs of various states. 

  • Hepatitis C Impact Litigation

CHLPI is engaged in a state-by-state impact litigation campaign to fight restrictive Hepatitis C Medicaid policies. The work of this project is typified by B.E. v. Teeter, No. C16-227-JCC, 2016 WL 3033500 (W.D. Wash. May 27, 2016), a decision by a federal district court ordering Washington to strike its Medicaid policy of imposing disease severity requirements for HCV treatment. CHLPI continues this campaign with litigation in other states. 

  • Infectious Disease, the Military, and the Law

CHLPI has partnered with the Hepatitis B Foundation on a campaign to end military practices that discriminate against people living with hepatitis B—a form of liver disease. Although the virus is communicable, there is a vaccine to prevent the transmission of hepatitis B (which all military personnel receive) and treatment that can cure the infection. Still, people living with hepatitis B face outdated military policies that do not reflect current understandings of the virus and its treatment. CHLPI will conduct critical analyses, develop advocacy tools, and work with a coalition of national organizations to drive legislative reform.

  • Medically Necessary Care versus Cosmetic Services: Expanding Access to Vitiligo Treatment

Vitiligo is an autoimmune disease that results in the appearance of white spots or patches on the skin. It can be psychologically devastating because of its visible effects, but there are effective treatments that can slow the spread of and even reverse the effects of the disease. CHLPI will work with a state-based partner to advocate for vitiligo treatment to be covered under the policies of a major health insurance company operating in Massachusetts. 

  • Protecting Public Health in Massachusetts

CHLPI continues its work as a consultant to the Massachusetts Department of Public Health’s Bureau of Infectious Disease and Laboratory Sciences (BIDLS), which encompasses, among others, the state’s HIV, viral hepatitis, tuberculosis, and sexually transmitted infections public health bureaus. This project allows CHLPI to act as an advisor to analyze health care laws, policies, and industry practices that are of interest to the client, and to advance frameworks that promote access to health care and public health in Massachusetts.