Illinois – Medical Homes – The National Academy for State Health Policy

MaryAnne Lindeblad

Medicaid Director
Health Care Authority

Sessions:

Closing Remarks

MaryAnne Lindeblad brings a broad health care and administrative background to the top position in the Washington State Medicaid program. Lindeblad, has been an active health care professional as well as a leader spanning most aspects of health care including acute care, long-term care, behavioral health care, eldercare and services for people with disabilities. Prior to her appointment as State Medicaid Director, she served for two years as the Assistant Secretary for Aging and Disability Services Administration in the Department of Social and Health Services. Previously, she was Director of the Health Care Services Division of the Medicaid program.
Lindeblad held a variety of leadership positions over the years, including Assistant Administrator of the Public Employees Benefits Board. During the 1990s, Lindeblad also worked in the private sector, serving as Director of Operations for Unified Physicians of Washington.

In 2010, she was selected for the inaugural class of the Medicaid Leadership Institute. In 2015 she was inducted into the Eastern Washington University Chapter of the Upsilon Phi Delta Society. She currently chairs the executive committee for the National Academy for State Health Policy, previously served on the board of the National Association of Medicaid Directors, and the Olympia Free Clinic. Lindeblad holds a bachelor of science in nursing from Eastern Washington University and a masters in public health from the University of Washington

Erin C. Fuse Brown

Faculty Member Erin Fuse-BrownLaw School

Sessions:

Adolescents and Behavioral Health: Recovery, Resiliency and the Journey Ahead

Barbara Paulson is the DC Department of Behavioral Health Deputy Director, Child and Youth Services. She is a seasoned behavioral health clinician with over 30 years of experience providing direct services to children, adolescents and their families. This includes delivering care as a private practitioner.

Barbara has held a variety of senior leadership positions. She served as the site director for Family Services in NW Ohio, Program Deputy Director for Family and Child Services of Washington, D.C. and as Clinical Program Administrator for Prevention and Early Intervention at the D.C. Department of Behavioral Health. During her tenure at the Department, she led the School-based Mental Health Program and developed the Healthy Futures program, the early childhood mental health program which now currently operates in over 60 locations.

She is nationally recognized for her expertise in school mental health programs and policies, early childhood mental health consultation and education and substance use prevention. Barbara has presented at numerous national conferences on the Healthy Futures early childhood mental health consultation program and school mental health. She has provided numerous additional trainings and workshops for educators, clinicians, and community based providers.

Barbara is a Licensed Independent Social Worker in the District, and an LCSW in Maryland. Barbara received her Bachelor’s degree from Bowling Green State University in Child and Family Community Services and her Master’s degree in Social Science Administration from Case Western Reserve University in Cleveland, Ohio.

Steve Pearson

Steve Pearson

Founder and President
Institute for Clinical and Economic Review

Sessions:

State-Only Summit on New Prescriptions to Lower Rx Costs

Steven D. Pearson, MD, MSc is the Founder and President of the Institute for Clinical and Economic Review (ICER), an independent non-profit organization that evaluates the evidence on the value of medical tests, treatments, and delivery system innovations to encourage collaborative efforts to improve patient care and control costs. Dr. Pearson is also a Lecturer in the Department of Population Medicine at Harvard Medical School.

Previously, he has served as a Visiting Scientist in the Department of Bioethics at the NIH, a Special Advisor on Technology and Coverage Policy at the Center for Medicare and Medicaid Services, and the Vice Chair of the Medicare Evidence Development and Coverage Advisory Committee (MedCAC). His publications include over 125 peer-reviewed articles and commentaries on the role of evidence in the health care system, and the book No Margin, No Mission: Health Care Organizations and the Quest for Ethical Excellence, published by Oxford University Press.

Michelle Mello

Professor
Stanford Law School

Sessions:

State-Only Virtual Summit: New Prescriptions to Lower Rx Costs

Michelle Mello is Professor of Law at Stanford Law School and Professor of Medicine in the Center for Health Policy/Primary Care and Outcomes Research in the Department of Medicine at Stanford University School of Medicine. She conducts empirical research into issues at the intersection of law, ethics, and health policy. She is the author of more than 200 articles on medical liability, public health law, pharmaceuticals and vaccines, biomedical research ethics and governance, health information privacy, and other topics. The recipient of a number of awards for her research, Dr. Mello was elected to the National Academy of Medicine at the age of 40. From 2000 to 2014, she was a professor at the Harvard School of Public Health, where she directed the School’s Program in Law and Public Health. She holds a J.D. from the Yale Law School, a Ph.D. in Health Policy and Administration from the University of North Carolina at Chapel Hill, and an M.Phil. from Oxford University, where she was a Marshall Scholar.

Trish Riley

Executive Director
NASHP

Sessions:

Opening Plenary: Keynote Address from Massachusetts Governor Charlie Baker and State Leaders’ Respond with a Snapshot of their Efforts to Address Health Care Costs, Access, and Delivery

Tuesday Plenary: State Health Policy Meets the Pandemic: Forging the Path Forward

Wednesday Plenary: Legislatures Confront the Pandemic’s Aftershock – High Unemployment, Less Revenue, and Ongoing Health Threats

Trish Riley, Executive Director of the National Academy for State Health Policy, built that organization as CEO from 1988-2003. She led Maine’s Governor’s Office of Health Policy and Finance, and was Federal liaison during the ACA deliberations. Riley held appointive positions under five Maine governors. She served on the Kaiser Commission on Medicaid and the Uninsured, and was a member of MACPAC, an Institute of Medicine’s Subcommittee and served on the Board of the NCQA.

Pam MacEwan

Chief Executive Officer
Washington Health Benefit Exchange

Sessions:

Tuesday Plenary: The Path Forward: Lessons from COVID-19

Pam MacEwan is the Chief Executive Officer for the Washington Health Benefit Exchange. Prior to joining the leadership team at HBE, Pam served as Executive Vice President for Public Affairs and Governance for Group Health Cooperative. She directed Medicare and Medicaid program performance and strategy, government relations, public policy, communications, and consumer governance serving on Group Health’s leadership team for 16 years. Previously Pam served as a Commissioner with the Washington Health Services Commission implementing the Health Services Act. She worked with a broad coalition to pass health reform legislation. Pam has served on several health policy initiatives in the public and private sector, chairing the Association of Washington Health Plans, serving on the Washington State Hospital policy committee, the King County Health Action Plan, and the Children’s Health Initiative. She holds an MAT in history from Brown University and a BA in economics from The Evergreen State College.

Todd Landry

Director
Office of Child and Family Services, Department of Health and Human Services

Sessions:

Telehealth for Vulnerable Populations

Dr. Todd A. Landry is the Director of the Office of Child & Family Services for the State of Maine. Dr. Landry holds a Bachelor’s degree in Chemistry from Lamar University, Beaumont, Texas and a Master’s degree in Business Administration (MBA) from the Cox School of Business at Southern Methodist University, Dallas, Texas. He earned his Doctorate degree in Educational Leadership from the Simmons School of Education and Human Development at Southern Methodist University, Dallas, Texas, in 2018. Landry most recently was chief executive officer of Lena Pope in Fort Worth, Texas, a nonprofit that serves children and families with an array of prevention and early intervention services, including childcare, public education, mental health counseling, and juvenile justice. He previously served as director of Nebraska’s Division of Child and Family Services and sits on national boards, including the Child Welfare League of America.

Molly Voris

Senior Policy Advisor for Public Health and Health Care
Office of Governor Jay Inslee

Sessions:

Opening Plenary: Keynote Address from Massachusetts Governor Charlie Baker and State Leaders’ Respond with a Snapshot of their Efforts to Address Health Care Costs, Access, and Delivery

Molly Voris (pronouns she/her) is the Senior Policy Advisor for Public Health and Health Care for Washington Governor Jay Inslee. In this role, she leads policy development and advises the Governor on health care issues, including advising the Governor on COVID-19 policy since the beginning of the pandemic.

Prior to her role in the Governor’s Office, she served as the Chief Policy Officer for the Washington Health Benefit Exchange for nine years. Molly previously worked at the National Governors Association on state health insurance coverage issues when the ACA was enacted, and at the Kaiser Family Foundation on Medicare issues when Medicare Part D was enacted.

Molly has an M.P.H. from George Washington University and bachelor degrees in political science and Spanish from the College of Charleston in South Carolina. She lives in Olympia, Washington with her spouse, three kids and their dog.

Norm Thurston

Executive Director
National Association of Health Data Organizations

Sessions:

Bridging Data and Policy: Utilizing Data as a Tool for Driving Policy Change (Joint Session planned by NASHP and NAHDO)

Dr. Thurston has a Masters and Ph.D. in economics from Princeton University, and an undergraduate degree in Spanish and Agribusiness Management from Brigham Young University. His areas of specialty include insurance markets, health care provider markets, labor markets, and public finance/economics. Dr. Thurston is currently the executive director at the National Association of Health Data Organizations (NAHDO). NAHDO is a national non-profit membership and educational organization dedicated to improving the collection and use of healthcare data. Dr. Thurston was a policy analyst and health economist for the Utah Department of Health from 2003 until 2019. From 2013 to 2019 he was the Director of the Office of Health Care Statistics which is responsible for the collection, analysis, and dissemination of data related to health care cost and quality for the State of Utah. In previous roles he served as policy adviser and executive staff for health system reform efforts in the State of Utah. Before joining the state, Dr. Thurston worked for eight years as an assistant professor of economics at Brigham Young University. He has published several articles on health care markets in nationally recognized economics journals. He is a life-long resident of Utah, growing up in Morgan County. He has native-level fluency in Spanish and was a Fulbright Scholar teaching economics in Argentina in 2001. He and his wife Maria have three children and two grandchildren. Dr. Thurston was elected to the Utah House of Representatives in 2014 from District 64 (Provo, Springville).

John Straus

Founding Director
Massachusetts Child Psychiatry Access Program

Sessions:

Adolescents and Behavioral Health: Recovery, Resiliency and the Journey Ahead

Dr. Straus is a primary care pediatrician and the founding director of the Massachusetts Child Psychiatry Access Program (MCPAP). Begun in 2004, MCPAP was the first statewide program designed to address the shortage of child psychiatrists. Dr. Straus was responsible for the expansion of MCPAP to include MCPAP for Moms to address perinatal depression, mental illness, and substance use. MCPAP is the model for the implementation of access programs in 38 other states and for the federal legislation in the 21st Century Cures Act which led to the 21 state pediatric HRSA grants and 7 state maternal HRSA grants. He is president of the National Network of Child Psychiatry Access Programs, a non-profit dedicated to providing technical assistance and support to child psychiatry access programs. In 2019, Dr. Straus designed the Massachusetts Consultation Service for Treatment of Addiction and Pain (MCSTAP) to assist adult PCPs with their patients with SUD and chronic pain issues.

Drew Gattine

Representative
Maine State Legislature

Sessions:

Bridging Data and Policy: Utilizing Data as a Tool for Driving Policy Change (Joint Session planned by NASHP and NAHDO)

Telehealth for Vulnerable Populations

Wednesday Plenary: Legislatures Confront the Pandemic’s Aftershock – High Unemployment, Less Revenue, and Ongoing Health Threats

Rep. Drew Gattine is in his fourth term in the Maine House of Representatives. He is House Chair of the Appropriations and Financial Affairs Committee and previously chaired the Health and Human Services Committee.

Rep. Gattine has over 25 years of experience in implementing and operating programs designed to deliver more effective and efficient health care. He is nationally known on the topic of program integrity and has presented at numerous national conferences on this subject. He is also a former state assistant attorney general.

Rep. Gattine is passionate about helping vulnerable people access high quality health care and live better lives. His service has been recognized by organizations such as AARP, Disability Rights Maine, Maine Council on Aging, Maine People’s Alliance, Cancer Action Network Maine and The Maine Primary Care Association.

Rep. Gattine lives on a small family farm in Westbrook with his wife, Elizabeth. They have two children and a bunch of animals.

Ana Novais

Deputy Director of Health
Rhode Island Department of Health

Sessions:

The Urgency of Racial Inequities and What States Can Do Now

Ana Novais holds a master’s degree in Clinical Psychology, UCLN, Belgium, and is a graduate of the Northeastern Public Health Leadership Institute, University at Albany, and Leadership RI. Ana has worked in public health for more than 30 years, including 5 years in Cabo Verde, 5 years in Portugal, and 23 years in the US.

Ana has worked for the Rhode Island Department of Health since 1998, first as a children’s health Education and Outreach Coordinator and later as Chief of the Office of Minority Health and Director of the Division of Community, Family Health, and Equity. In this role, Ana led the department’s efforts to develop and implement a framework for achieving health equity at the state and local levels through Rhode Island’s “Health Equity Zones” initiative.

In her current role as Deputy Director, Ana is charged with implementing the Department’s strategic priorities across all divisions and assuring the alignment of departmental resources and operations with these priorities.

Melissa Jordan

Interim Division Director
Florida Department of Health

Sessions:

Bridging Data and Policy: Utilizing Data as a Tool for Driving Policy Change (Joint Session planned by NASHP and NAHDO)

Melissa Jordan has worked at the Florida Department of Health, primarily in the field of applied epidemiology, since 2003. Since November of 2019, Melissa has served as the Interim Division Director of Community Health Promotion, managing an office of approximately 300 public health professionals and an annual budget of approximately $1 billion in state and federal funding. In this role, she is responsible for a wide range of health promotion activities including tobacco and chronic disease prevention, family health services, and WIC. She is leading Florida’s public health efforts to improve drug overdose surveillance and implement innovative prevention strategies.

Karl Fernstrom

Manager, Health Data Services Center
Minnesota Department of Health

Sessions:

Bridging Data and Policy: Utilizing Data as a Tool for Driving Policy Change (Joint Session planned by NASHP and NAHDO)

Karl Fernstrom, Manager of the Health Care Data Service Center in the Health Economics Program at the Minnesota Department of Health: Karl Fernstrom leads the operational efforts for the acquisition and maintenance of health care administrative data for the Minnesota Department of Health which includes the MN APCD, MN HDD, and CMS data streams. In this role he also oversees the creation and release of MN APCD Public Use Files, collaborates with the Health Services Research unit on emerging research questions and policy issues relevant to health care research and health reform within the state. His background is in chronic disease epidemiology with areas of focus on conducting research using electronic health record and administrative data.

Julie Evers

Medicaid Health Systems Administrator, Bureau of Long Term Services and Supports
Ohio Department of Medicaid

Sessions:

From Case Zero to Hero: Transforming Long-Term Care in the Age of COVID-19

Julie has 30 years of experience in long term care policy with the Ohio Department of Medicaid. Her policy experience includes long term care facilities, home health, reimbursement and electronic visit verification. Recently she has been focused on issues facing long term care facilities as they address the impact of the COVID-19 pandemic.

Vinita Bahl

VP of Data Analytics
Center for Improving Value in Health Care

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Sessions:

Bridging Data and Policy: Utilizing Data as a Tool for Driving Policy Change (Joint Session planned by NASHP and NAHDO)

Vinita is Vice President of Data and Analytics at CIVHC and has decades of experience directing analytical work at a variety of health care organizations. Prior to joining CIVHC in 2019, Vinita served as Director of Performance Assessment & Clinical Effectiveness at the University of Michigan Health System. Vinita has expertise in the design and development of performance measurement systems, development of analytic capabilities to respond to new payment and care delivery models, analysis to drive performance improvement, and design of public reports. She holds Masters of Public Policy and Doctor of Dental Medicine degrees from Harvard University.

Michelle Alletto

Chief Program and Services Officer
Texas Health and Human Services

Sessions:

Addressing Health Equity during a Budget Crisis

Michelle Alletto serves as the Texas Health and Human Services Chief Program and Services Officer. She provides oversight to the programs that make up the full Texas HHS medical and social service array including Medicaid, food assistance and women’s health programs, residential care for people with intellectual and developmental disabilities, and behavioral health services.

Michelle has over a decade of experience working in public health and management. Recently, she worked with the Milbank Memorial Fund, advising a multi-state collaborative on Medicaid long-term services reform. She previously served as deputy secretary for the Louisiana Department of Health (LDH), the deputy director for the LDH Birth Outcomes Initiative, and the assistant director for public policy at the Association of Maternal and Child Health Programs in Washington, D.C.
Alletto holds a master’s degree in public administration from the Maxwell School of Citizenship and Public Affairs at Syracuse University.

Katie Wunderlich

Executive Director
Maryland Health Services Cost Review Commission

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Curbing Costs to Achieve Affordability in the Health Care System

David Seltz is the first Executive Director of the Massachusetts Health Policy Commission (HPC). The HPC is a first-in-the-nation independent state government agency charged with bending the health care cost curve and providing data-driven policy recommendations regarding health care delivery and payment system reform. Prior to this role, Mr. Seltz was the Special Advisor on health care for Governor Deval Patrick (MA) and Senate President Therese Murray. Through these positions, he advised the passage of historic health care access reform legislation in 2006, a forerunner to the Affordable Care Act of 2010. Subsequently, he worked on landmark cost containment legislation in MA, which has also become a model of success for many states. Mr. Seltz is a 2003 graduate of Boston College and originally from Minnesota. He was a recipient of Modern HealthCare’s 2015 Up and Comer Award and serves as a member of the Executive Committee to the National Academy of State Health Policy (NASHP).

Erinn Sanstead

Data Analyst
Minnesota Department of Health

Sessions:

Bridging Data and Policy: Utilizing Data as a Tool for Driving Policy Change (Joint Session planned by NASHP and NAHDO)

Erinn Sanstead researches, develops, and evaluates procedures and strategies to produce Minnesota All Payer Claims Database Public Use Files (PUFs). In this role, she provides technical assistance on appropriate uses of administrative health care claims data and conducts data validation to assess PUF validity, completeness, and security. Her background is in infectious disease epidemiology with experience in decision modeling and cost effectiveness analyses.

Rachel Sachs

Professor
Washington University School of Law

Sessions:

State-Only Virtual Summit: New Prescriptions to Lower Rx Costs

Rachel Sachs is an Associate Professor of Law at Washington University in St. Louis. Her research explores the interaction of intellectual property law, food and drug regulation, and health law. Her scholarship has appeared in journals including the Harvard Law Review, the Michigan Law Review, the New England Journal of Medicine, and the Journal of the American Medical Association. Sachs was previously an Academic Fellow at the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics and a Lecturer in Law at Harvard Law School.

Gail Propsom

Chief
Quality Management and Special Initiatives Section, Wisconsin Department of Human Services

Sessions:

From Case Zero to Hero: Transforming Long-Term Care in the Age of COVID-19

Gail Propsom has worked for the Wisconsin Department of Health Services in a policy capacity for almost 30 years, developing and implementing policy on such varied issues as welfare reform, child support, employment and training, juvenile justice and child welfare. Since 2001, she has worked on long term support policy, including Olmstead implementation, Real Choice Systems Change Grants and Money Follows the Person. She currently manages a Section that oversees program quality, data analytics and several special projects, including implementation of the Home and Community-Based Services Settings rule, Money Follows the Person, housing issues for people with long-term care needs and efforts to support tribal involvement in long-term care.

Norman Oliver

Virginia State Health
Commissioner State of Virginia

Sessions:

Tuesday Plenary: The Path Forward: Lessons from COVID-19

The Urgency of Racial Inequities and What States Can Do Now

Dr. Oliver is the State Health Commissioner at the Virginia Department of Health. Prior to this appointment, Dr. Oliver served as the Deputy Commissioner for Population Health for VDH. Before accepting the Deputy Commissioner position, he was the Walter M. Seward Professor and Chair of the Department of Family Medicine at the University of Virginia School of Medicine.

Dr. Oliver has a long record of accomplishments in research and community health work, regarding health inequities. Most recently, his research interests have focused on the area of improving our understanding of the role of racial discrimination, bias, and prejudice in establishing and maintaining these health inequities and the understanding of the interplay between race and socioeconomic position in these disparities.

Dr. Oliver attended medical school at Case Western Reserve University, where he also obtained his Masters degree in medical anthropology. He trained in family medicine at Case, and he then practiced broad-spectrum family medicine in rural Alaska for 2 years before joining the UVA Department of Family Medicine in 1998.

René Mollow

Prior to his work with Aging and People with Disabilities, Mike led the Department’s Office of Rates, Contracting and Research. During his tenure, Mike provided leadership on financial management, effective use of data in administering programs and establishing fair, competitive rates for long-term care providers.

During his leadership role for the Provider Audit Section, Mike adopted a data analytics approach towards assessing risk of errors, fraud and abuse in Oregon Health Plan’s medical programs. Under Mike’s leadership, millions of tax dollars were recovered and ultimately were used to fund needed services for Oregonians.

Originally from Baltimore, Maryland, Mike graduated from University of Oregon with a BS in Business Administration.

Patti Killingsworth

Chief of Long-Term Services and Supports
TennCare

Sessions:

Tuesday Plenary: The Path Forward: Lessons from COVID-19

Stand By Me: Supporting Long-Term Care Workers

Patti Killingsworth is an Assistant Commissioner for TennCare and the Chief of Long-Term Services & Supports (LTSS). She is a nationally recognized leader and highly sought-after expert and adviser in home and community-based services (HCBS), managed long-term services and supports (MLTSS), value-based purchasing for LTSS, and initiatives to improve care for beneficiaries dually eligible for Medicare and Medicaid. She has worked in Medicaid programs for over two decades, leading system redesign initiatives in multiple states. Her commitment is to transforming LTSS systems to better meet the needs of older adults and people with disabilities and their families, promoting the development and expansion of cost-effective HCBS options, and ensuring that that the voice and perspective of older adults, people with disabilities, family members, and other key stakeholders is brought to bear in policy and program decision-making processes.

Ashley Harrell

Senior Program Advisor
Department of Medical Assistance Services, Virginia

State-Only Virtual Summit: New Prescriptions to Lower Rx Costs

With over 20 years of experience in the business and policy of health care, Sarah leads the strategic operations of the Institute for Clinical and Economic Review, a leading non-profit health policy research organization, as Executive Vice President and Chief Operating Officer.

Prior to joining ICER, Sarah spent six years in the corporate communications and investor relations department at a commercial-stage biopharmaceutical company, and several years with a health care communications firm. Sarah began her career in clinical research at Beth Israel Deaconess Medical Center in Boston.

Sarah holds a Master of Public Policy degree with a concentration in health policy from the Heller School at Brandeis University and received a bachelor’s degree in biological sciences from Smith College. Sarah speaks frequently at national conferences on the topics of prescription drug pricing policy, comparative effectiveness research, and value-based health care.

Stacie Dusetzina

Professor
Vanderbilt University School of Medicine

Sessions:

State-Only Virtual Summit: New Prescriptions to Lower Rx Costs

Stacie Dusetzina is an Associate Professor of Health Policy and Ingram Associate Professor of Cancer Research at Vanderbilt University School of Medicine. She is a health services researcher focusing on the intersection between health policy, epidemiology, and economics related to prescription drugs. She received her PhD in Pharmaceutical Science from the University of North Carolina at Chapel Hill (UNC) in 2010 and post-doctoral training at the Department of Health Care Policy at Harvard Medical School in 2012.

Dr. Dusetzina’s work focuses on prescription drug prices and affordability for consumers, with a special focus on high-priced or complex drugs. Her body of work has led to her participation in the President’s Cancer Panel’s workshops on Access to Cancer Drugs, her appointment to a National Academies of Sciences, Engineering, and Medicine committee on Ensuring Patient Access to Affordable Drugs, and testifying before the Senate Aging Committee on the same topic in 2019.

Shannon Dowler

Chief Medical Officer
North Carolina Medicaid, Division of Health Benefits, North Carolina Department of Health and Human Services

Sessions:

Primary Care and Prevention: The Limits and Potential of Telehealth

Dr. Dowler joined NC DHHS as the Chief Medical Officer for North Carolina Medicaid in 2019. Her past experience with Medicaid includes chairing the Physician Advisory Group for Medicaid (an independent legislated non-profit whose sole purpose is advising Medicaid on clinical policy) for many years. In the COVID pandemic she has led efforts across DHHS related to Telehealth and Health Equity with a focus on increasing testing in Historically Marginalized Populations.

Dr. Dowler obtained her medical degree from East Carolina (Brody) School of Medicine and completed a Family Medicine Residency and Fellowship in Asheville at MAHEC. She has spent her career in the service of non-profits including: the local health department providing full spectrum care (OB without deliveries) as well as a long standing role in the STD clinic, as CMO for a large FQHC in WNC, and most recently served as Associate Chief Quality Officer and Chief of Community Medicine for Mission Health System.

Steven Costantino

Director of Healthcare Reform and Financing
Delaware Health and Social Services

Sessions:

Curbing Costs to Achieve Affordability in the Health Care System

Steven M. Costantino is currently the Director of Health Care Reform for the Delaware Department of Health and Social Services. His emphases is on driving payment and delivery transformation to more value-based and integrative care models across multiple payers of services. He is actively engaged in the development and implementation of a health care quality and cost benchmark for the State of Delaware Department of Health and Social Services. He was the lead on approval of a 1332 waiver application to CMS for reinsurance. He is also actively involved in the development of an MCO/ACO application process for Medicaid.

As Commissioner and of the Department of Vermont Health Access and Medicaid Director (2015-2017), he provided leadership and strategy for many of Vermont’s expansive Health Care Reform

As Secretary of the Executive Office of Health & Human Services (2011-2015), he applied his extensive experience in government and a variety of fields relating to health and human services to improve the quality of life of Rhode Island residents.

He was elected to the Rhode Island House of Representatives from 1995 to 2010. He was appointed to the House Committee on Finance in 1999 and rose to the position of Chairman in 2004, retaining that leadership position for seven years.

He was Executive Director of the Drug and Alcohol Treatment Association of RI from 1986 to 1995.

He is a graduate of Dartmouth College obtaining a Masters in Health Care Delivery Science, class of 2020.

Eileen Cody

State Representative,
Washington’s 34th District Washington State House of Representatives

Sessions:

Legislatures Confront the Pandemic’s Aftershock – High Unemployment, Less Revenue, and Ongoing Health Threats

Representative Eileen Cody was raised on her family’s farm in Iowa. After graduating from high school, Eileen earned an Associate’s degree in nursing from the College of Saint Mary and a Bachelor of Science degree in nursing from Creighton University.

Eileen recently retired after working at Kaiser Permanente (formerly Group Health Cooperative) in Seattle for the past forty years. In addition to her work at Kaiser Permanente, Eileen is a founding member of District 1199 NW/SEIU Hospital and Health Care Employees Union.

First appointed and subsequently retained to the House of Representatives in 1994, Eileen has dedicated her legislative career to achieving affordable, quality healthcare for all residents of Washington state. Eileen currently serves as chair of the House Health Care and Wellness committee. Most recently, Eileen was instrumental in the creation and passage of Cascade Care, Washington state’s public option plan.

Emma Chacon

Operations Director
Division of Medicaid and Health Financing, Utah Department of Health

Sessions:

Medicaid in an Era of Policy Unpredictability and Enrollment Shifts

Emma Chacon is the Operations Director with the Division of Medicaid and Health Financing, Utah Department of Health. This position serves as a deputy to the State Medicaid Director. In her role, Ms. Chacon oversees, all aspects of Utah’s Medicaid and CHIP programs including the claims processing, program integrity, coverage and reimbursement policy, eligibility policy, managed care, and long term services and supports.

Addressing Health Equity during a Budget Crisis

Jennifer Sullivan, M.D., M.P.H. was appointed as Secretary of the Indiana Family and Social Services Administration by Governor Eric J. Holcomb effective January 9, 2017. Prior to this appointment, she served as the Deputy State Health Commissioner and Director for Health Outcomes at the Indiana State Department of Health. Dr. Sullivan is currently a Professor of Clinical Emergency Medicine and Pediatrics at Indiana University School of Medicine. She served as the Division Chief for Pediatric Emergency Medicine and was the Program Director for the Emergency Medicine and Pediatrics Residency from 2007-2015. Dr. Sullivan continues to work clinically in the Riley Hospital for Children Emergency Department.

She earned her undergraduate degree from the University of Houston Honors College and her Masters in Public Health at the Richard Fairbanks School of Public Health at Indiana University. She earned her Medical Doctorate at Indiana University School of Medicine and is board certified in Emergency Medicine and Pediatrics.

Dr. Sullivan is dedicated to building effective and efficient delivery of health care and social services to Hoosiers. She takes a public health approach to policy decisions and is committed to strategic alignment across government and the private sector to improve health outcomes and fill unmet social needs. She was recognized in 2019 as the recipient of the APHSA Friedman Health and Human Services Impact Award and is a 2017 Indianapolis Business Journal Woman of Influence.

FSSA is a health care and social service delivery and integration agency. The mission of FSSA is To compassionately serve our diverse community of Hoosiers by dismantling long-standing, persistent inequity through deliberate human services system improvement.

Judy Theriot

Medical Director
Kentucky Department for Medicaid Services

Sessions:

Primary Care and Prevention: The Limits and Potential of Telehealth

Judith Ann Theriot, MD, CPE, is the Medical Director for the Kentucky Department for Medicaid Services and has served in that capacity since May 2019. Prior to that, she was the Commission for Children with Special Health Care Needs’ Medical Director from July 2013 through May 2019. Dr. Theriot attended medical school at the University of Louisville (UofL) then went on to complete her Pediatric residency and a chief resident year before joining the faculty at UofL. Dr. Theriot served as the director of the General Pediatrics Clinical Research Unit and prior to that as the medical director of the Children and Youth Project; a multidisciplinary primary care clinic serving the inner-city high-risk children of Louisville Kentucky. Dr. Theriot is a certified physician executive and is a professor of Pediatrics at UofL. In addition to her administrative duties with Medicaid, she continues to see patients weekly in clinic at UofL and teach pediatric residents.

Marylou Sudders

Secretary
Executive Office of Health and Human Services

Sessions:

Opening Plenary | Keynote Address from Massachusetts Governor Charlie Baker and State Leaders’ Respond with a Snapshot of their Efforts to Address Health Care Costs, Access, and Delivery

Marylou Sudders serves as the Secretary of Health and Human Services for the Commonwealth of Massachusetts, overseeing 12 agencies and MassHealth, with a combined budget of $24 billion and 22,000 public employees delivering essential services that touch the lives of 1 in 4 state residents. Since joining Governor Baker’s cabinet in January 2015, Sudders has advanced strategic policy priorities, including: restructuring MassHealth into a population-based health coverage system, reforming the child welfare system, addressing the opioid epidemic, integrating physical and behavioral health care, and strengthening community-based services. Sudders co-chairs the Governor’s Interagency Council on Housing and Homelessness, the Governor’s Interagency Council on Aging, and chairs the Autism Commission and the board of Massachusetts Health Connector, the state’s health insurance marketplace. Sudders has held leadership roles across the public and private sectors, including serving as the Massachusetts Commissioner of Mental Health, a non-profit CEO, and associate professor and program chair at Boston College School of Social Work, a top ten nationally-ranked program. Sudders holds a bachelor’s degree with honors and a master’s degree in social work from Boston University, and honorary doctorates from the Massachusetts School of Professional Psychology and Bridgewater State University. She is the recipient of many civic, social work, and professional honors.

Tim Peterson test

Speaker

Tim has over 20 years of experience implementing state government systems, including end-to-end management of the entire software development lifecycle from contract negotiations and project initiation, through implementation, certification, and post-production operations. For the past several years, Tim has serves as the project manager for Montana Program for Automating and Transforming Healthcare (MPATH) initiative. The MPATH project is replacing Montanas 33 year old legacy Medicaid Management Information System (MMIS) using a modular strategy leveraging existing COTS/SaaS solutions. Tim led the development of Montanas modularity replacement strategy that resulted in the Modularity Blueprint for the replacement of the remaining legacy components supporting the Montana Healthcare Programs. Additionally, he recently led the implementation of the Departments Population Health Data Analytics module to support Montanas Medicaid program.

Mark Greenberg

Speaker

Mark Greenberg is a Senior Fellow at the Migration Policy Institute in Washington, D.C. His work focuses on immigration issues affecting children and families and implications of immigration enforcement and policy for health and human services programs and agencies.

From 2009-17, Mr. Greenberg worked at the federal Administration for Children and Families (ACF) and was ACF Acting Assistant Secretary from 2013-17. ACF includes the Office of Refugee Resettlement and a wide range of other programs assisting low-income and vulnerable children, families and communities. Previously, Mr. Greenberg was Executive Director of the Georgetown Center on Poverty, Inequality and Public Policy; Executive Director of the Center for American Progress’ Task Force on Poverty; Director of Policy for the Center for Law and Social Policy; and a legal services lawyer at the Western Center on Law and Poverty and Jacksonville Area Legal Aid.

Preconference:

From Plain to Supreme, a Children’s Coverage Menu

Marie Zimmerman

Moderator

Sessions:

Meeting the Behavioral Health Needs of Diverse Populations

Tisha Holmes

Speaker

Dr. Tisha Holmes is an Assistant Professor in the Department of Urban and Regional Planning at Florida State University. She conducts interdisciplinary work on planning for hazards and risks in order to reduce physical and social vulnerabilities and seek ways to build resilience in vulnerable, marginalized communities. Her research also emphasizes active community participation in research, education and decision-making processes to address the present and potential impact of climatological risks.

Holmes is collaborating with researchers in FSU Geography and the Center for Climate Ocean Atmospheric Prediction Studies (COAPS) to evaluate efforts of climate change adaptation planning in US local public health agencies and their engagement with vulnerable populations through the CDC’s Building Resilience Against Climate Effects (BRACE) program. She is also conducting research on adaptation approaches to sea level rise in Florida and developing work on climate resilience planning in the Caribbean.

Sessions:

Some Like it Hot: Climate Change and Health

Joe Bryant

Speaker

Joe Bryant is currently the Health Care Policy Advisor to Governor John C. Carney (Delaware). Joe has been in his current position since 2017. During his time in the Carney Administration, Joe has successfully championed many of the Governor’s top health policy initiatives. In addition to his work in the Governor’s Office, he serves as a Captain in the Delaware Army National Guard.

Joe graduated with a B.A. from Maryville College (TN) in 2008. As a senior, he successfully defended his thesis paper, “Concussions in sports: How educated are athletes about this diagnosis?” In 2012, he graduated from the University of Maryland Eastern Shore, with a M.S. in Rehabilitation Counseling.

Prior to his current position, Joe worked as a Constituent Relations Liaison during Rep. John Carney’s time in the U.S. House of Representatives. He was Rep. Carney’s liaison for matters concerning the Centers for Medicare and Medicaid Services and Social Security Administration. In addition, Joe has several years of experience as a professional mental health counselor.

Morning Plenary:

States on Fire: Innovations to Increase Access and Lower Costs

Wilmarie González

Speaker

Wilmarie González has been working for almost 14 yrs. as a PA public servant, first with the Department of Aging, and now with the Department of Human Services as a top executive collaborating with local, state and federal agencies. Wilmarie has represented the state before legislative and executive branches in strengthening advocacy systems. Wilmarie has led teams in state studies and evaluations on elder abuse, financial exploitation, and guardianship issues impacting the aging population; Wilmarie has been a featured speaker at local, state and national forums covering topics from advocacy, protection, quality strategy, performance measures, and state funded programs.

Wilmarie is leading the new MLTSS Community HealthChoices programs quality strategy impacting Medicaid and Medicare services for the dual population. It includes establishing sound quality components that include early implementation strategy, performance measures, performance improvement projects, long-term evaluation while collaborating with internal and external stakeholder engagement.

Wilmarie has served as a board member in national, state and local organizations influencing public policy, education, older adults, and the arts. Former member of the PA Supreme Court Elder Law Task Force and Advisory Council on Elder Justice in the Courts, and current member of the PA Judicial Conduct Board.

Wilmarie is a graduate of Rosemont College with a Masters in Management, and Eastern University with a Bachelors in Organizational Management.

Tom Curtis

Speaker

Tom Curtis serves as the manager of Quality Improvement and Program Development for Medicaid managed care at the Michigan Department of Health and Human Services (MDHHS). In this role, he is responsible for establishing, administering, and evaluating Michigans managed care performance monitoring, improvement, and innovation activity in Medicaid. This role includes supporting the department’s Health Equity, Social Determinants of Health, Payment Reform, and Behavioral/Physical Health Integration policy efforts in the Medicaid managed care program. Tom worked previously as the State Administrator for Michigan’s State Innovation Model (SIM) project, and as a Senior Quality Analyst with the MDHHS Managed Care Plan Division, where he developed performance improvement partnerships with Medicaid health plans. Tom worked for many years on local community engagement and organizing efforts before joining MDHHS.

Kierra Barnett

Speaker

Kierra S. Barnett is a PHD candidate in the College of Public Health at The Ohio State University and a Graduate Research Associate at the Kirwan Institute for the Study of Race and Ethnicity. Kierra’s work focuses on the impact of social determinants of health (i.e. socioeconomic conditions, education, and natural, built and social environments) on racial and ethnic health disparities. Her dissertation research specifically explores John Henryism (an active coping mechanism against stressors), socio-economic status, and health disparities among Blacks.

Having joined the Kirwan Institute in 2013, Kierra has collaborated with state, county and city public health departments, as well as non-for-profit organizations, to assess health outcomes, such as infant mortality, and make policy and practice-based recommendations to address the disparities. After completing her doctoral degree, she intends to continue her scholarship to better understand health among Black populations across the socio-economic gradient.

Kierra also holds a Masters of Public Health from OSU and a Bachelors of Science in Community Health from the University of Illinois.

Sessions:

I Can See Clearly Now: Implicit Bias in Policymaking

Chris Taylor

Speaker

Chris Taylor is the Chief Inclusion Officer for the state of Minnesota. In his role, he facilitates change across the state system of government, creating more inclusive state agencies and promoting equity in state programs and services.

Taylor received his Bachelor’s degree from the University of St. Thomas and a Master’s degree from the Cooperstown Graduate Program for Museum Studies. He is currently working on a Doctorate of Education in the Organization Development and Change program at the University of St. Thomas.

Sessions:

I Can See Clearly Now: Implicit Bias in Policymaking

Aletha Maybank

Speaker

Aletha Maybank, MD, MPH recently joined the AMA in April 2019 as their inaugural Chief Health Equity Officer and Vice President. Her role is to embed health equity in all the work of the AMA and to launch a Center for Health Equity.

Prior to this in 2014, Dr. Maybank became an Associate Commissioner, and later a Deputy Commissioner, and lunched the Center for Health Equity, a new division in the NYC Department of Health and Mental Hygiene geared toward strengthening and amplifying the Health Department’s work in ending health inequities. Under her leadership, and in a short amount of time, the health department made great strides in transforming the culture and public health practice by embedding health equity in the health department’s work. This work has been recognized and adapted by other City agencies and has captured the attention of the CDC and WHO.

She also teaches medical and public health students on topics related to health inequities, public health leadership and management, physician advocacy, and community organizing health. Currently, Dr. Maybank serves as President of the Empire State Medical Association, the NYS affiliate of the National Medical Association. In 2012, she co-founded “We Are Doc McStuffins,” a movement created by African-American female physicians who are inspired by the Disney Junior character, Doc McStuffins.

Dr. Maybank holds a BA from Johns Hopkins University, an MD from Temple University School of Medicine, and an MPH from Columbia University Mailman School of Public Health. She is a pediatrician and board certified in Preventive Medicine and Public Health.

Lunch Plenary:

A Commitment to Advance Health Equity

Dee Jones

Speaker

Dee Jones is the Executive Director of the North Carolina State Health Plan, which provides health care coverage to more than 725,000 teachers, state employees, retirees and their dependents. Jones has responsibility for the day-to-day strategy and operations of the Plan, working closely with the State Treasurer and the Plan’s Board of Trustees to monitor the financial condition of the Plan, implement quality improvements and maintain cost-effective programs for Plan members.

Before joining the Plan in 2017, Jones held executive leadership roles within the State at NC Department of Health and Human Services and NC Department of Administration. In addition, her private sector senior leadership experience across strategic operations and financial roles includes 11 years with Time Warner Cable and six years at Siemens Energy & Automation.

Dee holds an M.B.A./Accounting degree from the University of Phoenix and B.A. degrees in Accounting and Business Management from NC State University.

Morning Plenary:

States on Fire: Innovations to Increase Access and Lower Costs

Elisabeth Arenales

Speaker

Elisabeth Arenales has been the Senior Policy Advisor on Health for Governor Jared Polis since January 2019. Prior to working for Governor Polis, she spent twenty years as the Health Program Director for the Colorado Center on Law and Policy. CCLP is Colorado’s unrestricted legal services program and focuses on family economic security. Elisabeth is recognized as a health policy expert and has a strong track record of protecting, preserving, and expanding access to health care, particularly for lower-income Coloradans. She has helped to shepherd legislation and programs that increased coverage, reduced health access barriers and led to significant changes in the Colorado health landscape.

Preconference:

The Latest State Actions to Tackle Rx Prices, And What’s Next?

Morning Plenary:

States on Fire: Innovations to Increase Access and Lower Costs

Lisa Beauregard

Speaker

Lisa Beauregard is the Director of the Home and Community Based Services Policy Lab at the Massachusetts Executive Office of Elders Affairs where she previously served as a research analyst. She competed a Ph.D. in Public Policy at the John W. McCormack Graduate School of Policy and Global States at the University of Massachusetts Boston in 2019. Previously, Dr. Beauregard received a Masters in International Political Economics from The Catholic University of America and a Bachelors of Arts, cum laude, in Political Science, from the College of the Holy Cross.

Jessica Rhoades

Speaker

Jessica Rhoades is an accomplished health care policy and advocacy leader with broad expertise and experience in Medicaid, the Affordable Care Act, health insurance and payment and delivery system reform. She has served as health care policy advisor to two governors. She also served as Policy Director for the Montana Department of Public Health and Human Services, where she oversaw the state’s Affordable Care Act and Medicaid expansion and served as Montana’s State Innovation Model Design Director, resulting in Montana’s largest ever public-private value-based payment initiative. Her work in the private sector includes working in public affairs for a national health care provider covering 14 states. Most recently, Rhoades led the effort to pass Montana’s reinsurance legislation and waiver submission.

Erica Phillips

Speaker

Ms. Phillips is a business development professional with 30+ years experience helping organizations apply data to solve complex problems.

Erica joined Esri, the global leader in Geographic Information Systems (GIS) 3 years ago as the lead on Federal Health agencies. She works with agencies such as CDC, FDA, NIH and SAMHSA and with State Health Departments applying GIS to address public health issues such as the opioid crisis and access to health care. Erica advocates the idea that Place Matters for Health and utilizes Esris technology to support innovative approaches to public health challenges.

Prior to joining Esri, Erica worked for Nielsen Claritas and VNU/Mediamark focused on developing and supporting data-driven solutions. Highlights include the work she did with the Ohio Department of Health to define food deserts and the communities impacted by them.

A native New Yorker, Ms. Phillips is a graduate of Hunter College with a BA in Economics.

Sessions:

Some Like it Hot: Climate Change and Health

Ellie Hartman

Speaker

Ellie Hartman, Ph.D., BCBA-D, graduated from the University of Minnesota in Educational Psychology with a concentration in special education where she taught Behavior Analysis and Classroom Management and became a Board Certified Behavior Analyst – Doctorate (BCBA-D). Dr. Hartman was an evaluator for Wisconsin’s SSDI two for one pilot, Wisconsin’s Medicaid Infrastructure Grant (MIG), and the Administration on Intellectual and Development Disabilities (AIDD)’s Partners in Employment grant, called Let’s Get to Work in Wisconsin. Dr. Hartman is currently a Senior Scientist at the University of Wisconsin, Stout Vocational Rehabilitation Institute (SVRI) and is the Project Manager for Wisconsin PROMISE. As the Project Manager for Wisconsin PROMISE, Dr. Hartman, has been coordinating and leading the PROMISE inter-agency leadership and work groups, including facilitating a inter-agency Management Information System (MIS) for PROMISE program evaluation and data analysis. As a Senior Scientist at SVRI, Dr. Hartman works in close collaboration with the faculty and staff at SVRI and University of Wisconsin, Madison Rehabilitation Psychology and Special Education (RPSE).

Sessions:

Expanding the Menu: Data Sources for Policy Action

Chethan Bachireddy

Speaker

Chethan Bachireddy is the incoming Chief Medical Officer for the Virginia Department of Medical Assistance Services (Medicaid). He is a physician, researcher, and public servant dedicated to improving health for vulnerable populations. In his new role, he is engaging in efforts related to the opioid epidemic, maternal/child health, value-based payment, and the social drivers of health. Prior to coming to Virginia, he was a National Clinician Scholar at the University of Pennsylvania where his work focused on two areas: 1) improving health for populations with high rates of HIV infection, substance use disorders, mental illness, and justice involvement and 2) applying insights from behavioral economics and clinical trial design to test strategies and technologies to help form healthy habits. He hails from Deep East Texas, studied economics and neurobiology at Harvard, attended medical school at Yale, trained in Internal Medicine at Brigham and Women’s Hospital/Harvard Medical School, and completed a Masters in Health Policy Research at the University of Pennsylvania. He is excited to learn and collaborate to improve the health and well-being of the individuals, families, and communities who call Virginia home.

Sessions:

On Time Delivery: Optimizing Access to Care for Pregnant Women with SUD or Mental Health Conditions

Jeremy Vandehey

Moderator

Jeremy Vandehey, J.D. is the Director of the Health Policy and Analytics Division for the Oregon Health Authority, which is responsible for developing and implementing the state’s vision for health reform. His teams’ work includes policy analysis, health care cost and quality reporting, advancing evidence-based care and best practices, spreading the use of electronic health records, advancing payment reform, and purchasing health care for nearly 300,000 public employees. Before joining OHA, Jeremy served as Health Policy Advisor to Governor Kate Brown. Jeremy previously led government relations for Kaiser Permanente’s Northwest Region and served as the legislative director for OHA during the design and implementation of Oregon’s coordinated care organizations. Jeremy received his Juris Doctor from the University of North Dakota School of Law and his undergraduate degree in public policy and administration from Western Oregon University.

Sessions

An Offer You Can’t Refuse…or Can you? Hospital Consolidation

Jaime King

Speaker

Jaime S. King is the Bion M. Gregory Chair of Business Law and a Professor of Law at the University of California Hastings College of the Law. She is the Associate Dean and Co-Director of the UCSF/UC HastingsConsortium on Science, Law and Health Policy, the Co-Founder and Co-Director of the UCSF/UC Hastings Master’s Program in Health Law and Policy,and the Director of the J.D. Concentration on Law and Health Sciences. She is the Co-Founder and Executive Editor of The Source on Healthcare Price and Competition, a multi-disciplinary web-based resource about healthcare price and competition.Professor King received the Hastings Foundation Faculty Award for Outstanding Scholarship in 2015 and the Best Antitrust and Mergers Article of 2017 at the American Antitrust Institute Annual Meeting with her co-author Erin Fuse Brown.Professor King has testified before Congressional committees on health insurance mergers and price transparency and currently sits on the Board of the American Society of Law, Medicine, and Ethics. She holds a Ph.D. in Health Policy from Harvard University, a J.D. from Emory University, and a B.A. from Dartmouth College.

Sessions:

An Offer You Can’t Refuse…or Can you? Hospital Consolidation

Shannon Bresaw

Speaker

Ms. Bresaw serves as Program Director for the New Hampshire (NH) Governor’s Recovery Friendly Workplace (RFW) initiative and Vice President of Public Health for Granite United Way. As Program Director, Ms. Bresaw works in close coordination with the Governors Office, the NH Department of Business and Economic Affairs, and the Community Development Finance Authority to administer the initiative. Through this initiative, Ms. Bresaw and her team work to empower employers to challenge stigma and provide supportive work environments for people in recovery and those impacted by substance use disorders. Ms. Bresaw’s role focuses on program development, coordination and alignment, monitoring and evaluation, and sustainability planning. At Granite United Way, Ms. Bresaw oversees public health strategies and initiatives and works to align these efforts with existing collaborations, partnerships, and Community Health Improvement Plans. In addition, Ms. Bresaw provides overall leadership and coordination to statewide public health efforts on behalf of Granite United Way, with a particular focus on addressing NH’s current opioid crisis.

Born and raised in NH, Ms. Bresaw received her Master of Social Work Degree in 2004 from the University of New Hampshire, with a concentration in community and administrative practice. She has worked in the field of public health and substance use disorders since 2004. In her current role, Ms. Bresaw provides ongoing technical assistance and support to key sectors to ensure the use of best practice approaches in public health and prevention. Ms. Bresaw has significant experience in the development of strategic plans, logic models, evaluation plans, and work plans designed to impact crucial public health issues in our communities. Ms. Bresaw currently serves as Co-Chair of the Prevention Task Force of the Governor’s Commission on Alcohol and Other Drugs. She also serves as Vice President to the Board of the NH Public Health Association.

Preconference:

Navigating the Road Ahead: Supporting and Sustaining Recovery

Sarah Finne

Speaker

Sarah Finne, DMD, MPH brings over 30 years of experience from both private practice dentistry and public health supervision of a large school-based dental program in New Hampshire to her work in Dental Medicaid. Sarah remains active professionally as a member of the board and immediate past president of the Medicare-Medicaid-CHIP State Dental Association, as a member of the Association of State & Territorial Dental Directors, the ADA, and the International College of Dentists. She supports community oral health access through board membership with the NH Dental Society Foundation and the Greater Derry Oral Health Collaborative Corporation. Sarah holds a DMD degree from the University of Pennsylvania School of Dental Medicine as well as a Master’s in Public Health Administration from the University of Massachusetts-Amherst.

Sessions

Magnificent Smile: Innovations to Increase Oral Health Access

Sarah Brummett

Speaker

Sarah Brummett, is Director of the Office of Suicide Prevention at the Colorado Department of Public Health and Environment. The Office is legislatively mandated as the state coordinating body for suicide prevention, intervention and postvention efforts. The Office sets statewide priorities and works with state agencies and community organizations to develop and implement effective strategies, including a community grant program, means restriction education initiatives, the Zero Suicide initiative, education and awareness programs, emergency department and hospital outreach and education, the Colorado-National Collaborative, federal grant-funded initiatives, Mental Health First Aid, and a school grant program.

Before joining CDPHE, Ms. Brummett practiced family and appellate law in both Colorado Springs and the Denver Metro area. Ms. Brummett received her JD from the Sturm College of Law, University of Denver and also a Master’s of Forensic Psychology from the Graduate School of Professional Psychology, University of Denver.

Sessions:

On the Rise: The Emerging Dimensions of Suicide Prevention

Sabrina Corlette

Matthew Statman

Speaker

Matthew Statman LMSW, CAADC is Manager of the University of Michigan Collegiate Recovery Program, Adjunct Lecturer at the Eastern Michigan University School of Social Work, private social work practitioner and member of the Motivational Interviewing Network of Trainers. Matt earned his bachelors degree in Social Work from Eastern Michigan University and his masters degree from the University Of Michigan School Of Social Work. Matt is a person in recovery from a substance use disorder who has spent his career helping those with substance use disorders initiate and sustain recovery.

Mark Schulz

Speaker

Mark Schulz is the LTSS Systems Consultant for the Minnesota Board on Aging and a Legislative Liaison for Minnesotas Aging and Adult Services Division. In these roles he is reshaping the states long term care system to reduce its reliance on institutional care in favor of home and community-based service options and reforming those supports. He brings together key individuals and groups that have the talents and resources needed to develop, foster, fund and implement new, integrated community services at the local level.

Mark has served as an Ombudsman for Long-Term Care learning firsthand the complex reality our most vulnerable adults live with each day. Before that role, he served with the US military in various leadership positions with responsibility for small and large-scale, multi-faceted teams and complex financial situations. Mark received a JD from William Mitchell College of Law and a BS in engineering management from the United State Military AcademyWest Point.

Margarita Alegría

Speaker

Margarita Alegría is the Chief of the Disparities Research Unit at the Massachusetts General Hospital and a Professor in the Departments of Medicine and Psychiatry at Harvard Medical School, where she has served since 2004. Dr. Alegria was Director of the Center for Multicultural Mental Health Research at Cambridge Health Alliance from 2002-2015 and a former Director of the Center for Evaluation and Sociomedical Research at the University of Puerto Rico. Dr. Alegría is the Principal Investigator (PI) of four National Institutes of Health(NIH)-funded research studies and a grant funded by the William T. Grant Foundation. She has published over 200 papers, editorials, intervention training manuals, and several book chapters, focused on improving health care for diverse racial and ethnic populations. In October 2011, she was elected as a member of the National Academy of Medicine in acknowledgement of her scientific contributions to her field.

Speaker

Kate McEvoy is the Director of the Division of Health Services at the Connecticut Department of Social Services. In her role as Director of Medicaid and CHIP, Kate has had the privilege of overseeing major transformation in Connecticut HUSKY Health, migrating from capitated managed care arrangements to a self-insured, managed fee-for-service approach. This has streamlined and simplified the program for both members and providers, freed up resources for an extensive array of care delivery and value-based payment interventions, and enabled the program to reduce both per member, per month costs and overall spend. During Kates tenure, Connecticut has expanded Medicaid and utilized a broad range of tools and funding under the Affordable Care Act to cover new services, take a person-centered approach, and enable choice and self-direction for older adults and people with disabilities.

Kate is a graduate of Oberlin College with a B.A. in Economics and English, received her law degree from the University of Connecticut, and graduated from the CHCS/NGA Medicaid Leadership Institute. Her background is in community-based services for older adults, and she is the author of Connecticut Elder Law, a treatise that is republished each year. Kate is currently serving as the President of the Board of Directors of the National Association of Medicaid Directors, and on the executive committee of the Reforming States Group.

Karynlee Harrington

Speaker

Jodi Manz

Speaker

Jodi Manz, MSW serves as the Assistant Secretary of Health and Human Resources in the Office of Governor Ralph Northam, a role she continued after serving four years under former Governor Terry McAuliffe. As Assistant Secretary, Jodi supports the development of health and behavioral health policy in the Commonwealth. She staffs the Governors Advisory Commission on Opioids and Addiction, the Governors Executive Leadership Team on Opioids, and coordinates the substance use disorder crisis response among Virginias state agencies. She holds a Bachelors Degree in Religious Studies, and she spent several years working in Chicago before returning to Richmond to complete the graduate program in Social Work Administration, Planning, and Public Policy at Virginia Commonwealth University.

Jason Rachel

Speaker

Jason Rachel, Ph.D. is the Director for the Division of Integrated Care at the Virginia Department of Medical Assistance Services (DMAS). In this role, he is responsible for providing executive leadership in the management and implementation of both current and new integrated care programs. Dr. Rachel directs and oversees all operations, policies, contract compliance and quality monitoring activities within the division to provide high quality, person-centered coordinated care services. His former roles include serving as a Senior Research Leader at Truven Health Analytics providing technical assistance to state Medicaid home and community-based programs on their quality framework and as Virginia’s Money Follows the Person (MFP) Project Director at DMAS. Dr. Rachel received his doctorate in Health Related Sciences with a specialization in Gerontology from Virginia Commonwealth University, School of Allied Health Professions.

Jane Wishner

Speaker

Jane Wishner is New Mexico Governor Michelle Lujan Grisham’s Executive Policy Advisor for Health and Human Services. An attorney with extensive experience as a litigator, researcher and advocate, Ms. Wishner left the private practice of law to become the founder and first Executive Director of the Southwest Women’s Law Center in Albuquerque, New Mexico, where she led the Center’s systemic advocacy in the areas of discrimination, domestic violence, Title IX, reproductive health and women’s access to comprehensive health care coverage and services. She organized and led New Mexico’s consumer advisory group on implementation of the Affordable Care Act, served on the Market Regulation work group of the New Mexico Exchange Advisory Task Force and was a consumer representative on the Board of Trustees of the University of New Mexico Hospital, the state’s leading safety net hospital. Ms. Wishner left the Southwest Women’s Law Center to spend more time on health care policy work. She served as a qualitative researcher at the Urban Institute’s Health Policy Center in Washington, D.C., where she led several studies and co-authored numerous research reports, journal articles and briefs related to healthcare access, Medicaid, the private insurance market, opioid use disorder treatment, and the Affordable Care Act. Ms Wishner returned to New Mexico to work as the Policy Director for Michelle Lujan Grisham’s campaign for Governor, served on the Governor-Elect’s transition team, and joined Governor Lujan Grisham’s Administration in January 2019.

Sessions:

New Recipes to Control Rx Pricing

Jane Beyer

Speaker

ane Beyer began her career as a legal services attorney in Tacoma Washington. She served as legal counsel to the Washington State House of Representatives for twenty years, working on a broad range of health, behavioral health, long term care, human services and criminal justice issues. She was Washington State’s Medicaid director from 1995 through 1998, and Washington State’s Behavioral Health Commissioner from 2012-2015. She has served as the Senior Health Policy Advisor to Washington State Insurance Commissioner Mike Kreidler since January 2017.

She graduated with honors from the University of North Carolina School of Law and is admitted to practice in Washington State and the District of Columbia.

James A. Clair

Speaker

Jim provides executive consulting services to technology-enabled companies in the pharmacy services and SaaS space. He is presently an Executive Consultant to CSSHealth, a Buffalo, NY technology-enabled company that provides Medication Therapy Management and Adherence services to health plans and pharmacy benefit managers. He is the Chair of the Board of Directors for Reveal Rx, a technology company that enables the review of pharmacy claims by health plans and PBMs. He formerly was CEO of Goold Health Systems, a healthcare management/pharmacy benefits administrator that more than tripled in size during his tenure. GHS was sold to Change Healthcare in 2013, and Jim ran the GHS wholly-owned subsidiary as well as their PBM business until mid-2016. From 2017 to 2018, Jim was CEO of Tricast, LLC, a technology-enabled pharmacy auditing company that sold to a competitor in 2018Q2.

Heidi Haley-Franklin

Speaker

Heidi Haley-Franklin is the Vice President, Programs at the MN ND chapter of the Alzheimer’s Association in Minneapolis, MN. Heidi has over 20 years of experience working with individuals and families in private practice, group homes, long-term and home health care settings. In her current position, she oversees all of the Association’s programs and services, and provides clinical supervision and ongoing education to those who directly work with individuals impacted by Alzheimers disease and related dementias. Heidi holds a Master’s degree in Social Work from the University of St. Thomas in St. Paul, MN, a BA from the University of MN, Morris, and is a Licensed Independent Clinical Social Worker.

Sessions:

Dimensions of Dementia

Heather Sanborn

Speaker

After serving one term as a Representative in the Maine House, Heather ran for the State Senate and is currently serving her first term, representing part of Portland and Westbrook, Maine. A former public school teacher and attorney, Heather now owns and runs Rising Tide Brewing Company with her husband, Nathan, in Portland. Under Heather’s leadership, Rising Tide has created two dozen jobs and helped spur the revitalization of the East Bayside neighborhood of Portland. Rising Tide has been committed to giving back to the community, with significant on-going support for the Maine Island Trail Association, the Good Shepherd Food Bank, Full Plates Full Potential, Portland Trails and many other organizations. Heather also served for many years on the Portland Development Corporation board, a quasi-municipal organization that administers the city’s economic development revolving loan funds and job creation grant programs. Heather and her husband live in Portland with their teenage son.

Preconference:

The Latest State Actions to Tackle Rx Prices, And What’s Next?

Sessions:

New Recipes to Control Rx Pricing

Heather Winfield-Smith

Speaker

Heather Winfield-Smith is the Vaccine Supply and Distribution Section supervisor for the Hawaii Department of Health, Immunization Branch. In her role as Section Supervisor, she coordinates the Hawaii Stop Flu at School Program, a school-located influenza vaccination program that conducts annual clinics in over 180 participating schools, statewide. Heather also coordinates the Hawaii Vaccines For Children (VFC) Program which supplies hundreds of thousands of doses of vaccine annually to VFC-participating providers for administration to Hawaiis eligible children. Heather has a Master of Social Work degree from the University of Hawaii and over 20 years of experience working at the Hawaii Department of Health Immunization Branch. The health of Hawaiis children, families, and communities are the motivation for Heather’s work and she is honored to have a role in ensuring their protection from the potentially devastating outcomes of vaccine-preventable diseases.

Sessions:

Key Ingredients: Partnering with Schools for Student Success

Hazel Alvarenga

Speaker

Hazel Alvarenga is the State Opioid Coordinator in the Office of the Director at the Arizona Health Care Cost Containment System. Hazel assists the Clinical Initiatives Project Manager with the management of the State Opioid Response (SOR) grant with the aim to reduce the effects of the opioid epidemic in Arizona. Prior to her current role, Hazel served as the Opioid State Targeted Response (STR) Project Coordinator and Opioid Epidemiologist at AHCCCS. She holds a masters of public health degree in research epidemiology and global health from Loma Linda University and a bachelor’s degree in biological sciences from The University of California Irvine.

Preconference:

Navigating the Road Ahead: Supporting and Sustaining Recovery Across the Life Span

Gary Cohen

Speaker

Gary Cohen has been a pioneer in the environmental health movement for thirty years. Cohen is President and Co-Founder of Practice Greenhealth and Health Care Without Harm. He was also instrumental in bringing together the NGOs and hospital systems that formed the Healthier Hospitals Initiative. All three were created to transform the health care sector to be environmentally sustainable and serve as anchor institutions to support environmental health in their communities.

David Crall

Speaker

David Crall is the legislative analyst for the Oklahoma Senate Health and Human Services Committee, a position he has held since July 2017. David staffed the Oklahoma Attorney General’s Commission on Opioid Abuse in fall 2017 and drafted several pieces of legislation resulting from the work of Commission during the 2018 and 2019 legislative sessions. After voters legalized medical marijuana in Oklahoma through ballot initiative, David was the lead Senate staffer on the bicameral Medical Marijuana Working Group, which held public meetings with experts from the marijuana industry, state agencies, law enforcement, the medical field, the Oklahoma business community and NCSL throughout the summer of 2018 to study how best to implement the new medical marijuana program. David drafted the resulting Oklahoma Medical Marijuana and Patient Protection Act, which created a regulatory framework for the program, as well as various other pieces of legislation relating to medical marijuana.

David Cassetty

Speaker

David serves as the Deputy Commissioner of Insurance in Las Vegas, and oversees the consumer services and enforcement sections of the Division. Prior to assuming this position, David spent 4 years as the General Counsel for Vermont’s Department of Financial Regulation, managing 8 attorneys in the regulation of the insurance, banking and securities industries. David also has spent many years as an assistant attorney general, in Vermont and American Samoa, and started his law career in private practice in Florida, where he was board certified in appellate practice, mostly working on behalf of insurance companies.

Sessions:

That’s Not What I Ordered: Surprise Billing

Dave Richard

Speaker

Dave Richard is the Deputy Secretary, NC Medicaid, where he leads North Carolina’s $14 billion Medicaid and NC Health Choice programs for the states Department of Health and Human Services (DHHS).

Richard’s vision for Medicaid is to ensure a sustainable, person-centered and innovative Medicaid program for more than two million North Carolinians who use Medicaid. As the programs undergo transformation to even better fit the needs of state and its residents, he is committed to the fundamental goal of improving the health and well-being of all residents. Richard believes the right way to achieve success is to work closely with stakeholders in all aspects of Medicaid.

Prior to leading Medicaid, Richard was the Deputy Secretary for DHHS Behavioral Health and Developmental Disability Services and the State Operated Healthcare Facilities divisions. He joined DHHS in May 2013 as the Director of the Division of Mental Health, Intellectual and Developmental Disabilities and Substance Abuse Services. Richard joined DHHS after leading The Arc of North Carolina, an advocacy and service organization for people with intellectual and developmental disabilities, as its Executive Director for 24 years.

Richard has a bachelor’s degree in education from Louisiana State University.

Sessions:

A Two-Way Street: Disruptive Innovation in Transportation

Daphnne Brown

Speaker

Daphnne Brown is the Director of Family Involvement & Outreach for Families Together in New York State. She provides support to families, advocates and service providers on family driven care, systems advocacy, and family empowerment. Daphnne provides training and technical assistance to family-run and provider agencies in preparation for the transformation to Medicaid Managed Care. She has served as the family engagement consultant for the past 7 years on the NYS System of Care Expansion grant and currently trains family / youth peer advocates on the High Fidelity Wraparound process. Daphnne has a B.S. in Business Administration from SUNY College at Brockport and is a Credentialed Family Peer Advocate.

Sessions:

Meeting the Behavioral Health Needs of Diverse Populations

Daniel Tsai

Speaker

Daniel Tsai is the Assistant Secretary for MassHealth and Medicaid Director for the Commonwealth. Tsai was appointed in January 2015 by Governor Charlie Baker to oversee the state’s $16 billion Medicaid program, which covers over one in four residents in the Commonwealth. In his role, Tsai is responsible for ensuring a robust and sustainable MassHealth program that best meets the needs of members. That includes developing new policies, payment models, and operational processes that improve the way health care is delivered to 1.8 million low-and moderate-income residents and individuals with disabilities.

Before joining HHS, Tsai was a Partner and leader in McKinsey & Company’s Healthcare Systems and Services practice. He has significant experience on the design and implementation of innovative, state-wide health care payment systems for Medicaid, Medicare, and Commercial populations, and has worked closely with multiple state Medicaid programs, private payers, and health services companies. He received a Bachelor of Arts in applied mathematics and economics from Harvard University.

Assistant Secretary Tsai lives with his wife and son in Cambridge. He volunteers at a local community health center in Boston’s South End.

Sessions:

Which Way is the Wind Blowing? MCOs at a Crossroads

Connor McDonnell

Speaker

Connor McDonnell is a Housing Integrator with Oregon Housing and Community Services (OHCS) where he leads efforts to reduce homelessness and expand affordable housing options for Oregon’s most vulnerable residents. This work includes initiating the Oregon Rural Peer Network for Supportive Housing and crafting a Permanent Supportive Housing program in Oregon. Prior to OHCS, he worked in a homeless shelter as a housing case manager, for elected officials, and in various levels of government working in different capacities at the nexus of health and housing. He most recently came to State government by way of HUD where he is most proud of creating the HUD Resource Locator which maps out all the federal housing programs across the U.S. Connor has a Master’s in Public Administration from The Hatfield School at Portland State University and a B.S. in Psychology from Virginia Tech.

Sessions:

Improving Health through Housing

Colleen Sonosky

Moderator

Colleen Sonosky, JD is the Associate Director of the Division of Children’s Health Services in the Health Care Delivery Management Administration in the District of Columbia’s Department of Health Care Finance (DHCF). DHCF is the agency responsible for the administration of the Medicaid program and the Division of Children’s Health Services oversees policies and procedures for Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services benefit—the pediatric component of the Medicaid program for children under 21. Ms. Sonosky also serves as the District’s EPSDT Coordinator and CHIP Director and represents DHCF on the District-wide Child Fatality Review Committee, Interagency Coordinating Committee for Early Intervention, and the State Early Child Development Coordinating Committee (SECDCC) where she co-chairs the Health/Wellbeing Subcommittee. She has also served on many national work groups concerning maternal and child health, including CMS’ National EPSDT Improvement Working Group, National Academy for State Health Policy’s (NASHP) Future of Children’s Coverage Workgroup and is a Member of NASHP’s Steering Committee on Health System Performance and Public Health.

Previously, Ms. Sonosky was the Director of Public Policy Research for the March of Dimes Foundation, the Vice President of Policy at FirstFocus, and the Senior Director of Programs and Policy for the Children’s Defense Fund. From 1993 to 2003, she served as Assistant Director and a lead researcher on maternal and child health policy at the Center for Health Policy Research (now housed in the Department of Health Policy) at The George Washington University. Ms. Sonosky is an Adjunct Assistant Professor in the Departments of Health Policy and Prevention/Community Health at the George Washington University School of Public Health and Health Services, where she has taught courses on maternal and child health policy.

Sessions:

Key Ingredients: Partnering with Schools for Student Success

Clinton Lasley

Speaker

Mr. Clinton Lasley is the Director of the Division of Alaska Pioneer Homes operating six state owned assisted living homes including the states only State Veterans Home. Mr. Lasley has been with the Department of Health and Social Services for six years, serving first in the Division of Public Health before moving to the Division of Alaska Pioneer Homes in 2016. Born and raised in Alaska, Mr. Lasley has 25 years of business management and organizational leadership experience with a passion for elders and promoting public health.

Sessions:

A Little More Help Please? Improving Assisted Living

Speaker

Ben Steffen serves as the Executive Director of the Maryland Health Care Commission. The Maryland Health Care Commission is an independent regulatory agency whose mission is to plan for health system needs, promote informed decision-making, increase accountability, and improve access to health care and health care coverage in Maryland. The MHCC administers the certificate of need program, the establishment of Maryland’s Health Information Exchange, and cost and quality reporting initiatives for hospitals, nursing homes, and health plans. Prior to assuming this position, he served as the Director of the Commission’s Center for Information Services and Analysis. This Center has analytic and operational responsibilities for health care practitioner initiatives in the state including development of an All Payer Data Base and the Patient Centered Medical Home Program. Mr. Steffen serves as a spokesperson for the Commission at state and national levels on state health care expenditures, physician work force, physician uncompensated care, and information security. Before joining the MHCC, he served as a budget analyst in the Health, Housing, and Income Security Division of the Congressional Budget Office, among activities he worked on the modeling that produced the estimates of reforms that ultimately led to the Medicare Prospective Payment System. Mr. Steffen holds a Master’s Degree from American University and has completed post-graduate work at the University Of Michigan. He is a former Peace Corps volunteer to Nepal.

Sessions:

That’s Not What I Ordered: Surprise Billing

Amir Bassiri

Speaker

Mr. Bassiri is Chief of Staff to the Medicaid Director at the New York State Department of Health. Prior to joining the Department of Health in May of 2019, he worked as Senior Policy Advisor for Health in the Office of Governor Andrew Cuomo under the Deputy Secretary of Health and Human Services. His role in the Governor’s Office involved policymaking and implementation of strategic health initiatives, specifically related to the pharmaceuticals, insurance expansion, and Medicaid delivery system reforms.

As a California native, Amir earned his B.A. in both Economics and Psychology from the University of California, Davis, before earning a Master’s in Social Work (M.S.W) from Columbia University.

Preconference:

The Latest State Actions to Tackle Rx Prices, and What’s Next?

Alfred Johnson

Speaker

Alfred has served in various staff and management capacities in private industry, county and state government serving vulnerable populations since 1996.

Alfred has worked for the Division of Quality Assurance since 2001. Alfred has served the Division of Quality in a variety of roles, Assisted Living Surveyor, Assisted Living Regional Director, Director of the Bureau of Technology, Licensing and Education and currently Director of the Bureau of Assisted Living.

While in DQA, Alfred has been instrumental in establishing collaborative statewide working relationships with counties, care management organizations, advocates and industry representatives to help improve the quality of care in assisted-living settings.

Sessions:

A Little More Help Please? Improving Assisted Living

Alex Blandford

Speaker

Alex Blandford oversees and executes the CSG Justice Center’s health policy portfolio and works to improve access to health care for people in the criminal justice system through federal, state, and local policy. Prior to joining the CSG Justice Center, Alex was a project coordinator for the Institute for Evaluation Science in Community Health, which is housed in the Graduate School of Public Health at the University of Pittsburgh. As a project coordinator, she oversaw a variety of research projects, including one examining the Pittsburgh region’s emergency response to mental health crises, and another evaluating the region’s Crisis Intervention Team training for police officers. She earned her BS in psychology and BA in French from the Pennsylvania State University and her MPH at the Graduate School of Public Health at the University of Pittsburgh.

Preconference:

Navigating the Road Ahead: Supporting and Sustaining Recovery Across the Life Span

Alana Knudson

Speaker

Alana Knudson, PhD, serves as a Program Area Director in the Public Health Department at NORC at the University of Chicago and is the Co-Director of NORC’s Walsh Center for Rural Health Analysis. Dr. Knudson has over 25 years of experience implementing and directing public health programs, leading health services and health policy research projects, and evaluating program effectiveness. Her research and policy project findings have informed state, Tribal, and Federal health policy. She also has state and national public health experience having worked at the North Dakota Department of Health and for the Association of State and Territorial Health Officials (ASTHO). Dr. Knudson serves on the Board of Trustees for the National Rural Health Association, the Board of Directors for the Maryland Rural Health Association, and the Board of Directors for the Rural Health Foundation. She is also a member of the RUPRI Health Panel.

Sessions:

Navigating the Road Ahead: Supporting and Sustaining Recovery Across the Life Span

Ashley Billups

Speaker

A lifelong Oklahoman, Ashley has dedicated herself to the people of Oklahoma. Ashley currently works at the Oklahoma House of Representatives as a Legislative Assistant, after serving as Director of Constituent Services for Lieutenant Governor Todd Lamb and after running the Senate soundboard while working as Secretary for the President Pro Tempore of the Senate. She is pursuing her degree at Oklahoma State University, majoring in Biochemistry and Molecular Biology with a minor in Political Science. Ashley is active in her political party at the state level, recently served as the Speaker of the House of Oklahoma Intercollegiate Legislature, and volunteers with a nationally accredited animal rescue, Tornado Alley Bulldog Rescue. When she is not saving dogs, Ashley enjoys fishing, reading, and cooking (although not at the same time). Ashley visited Chicago this summer for a Women in Government conference and is ecstatic to return to Chicago so quickly to attend NASHP’s’ Annual Conference.

Forming Partnerships	Representatives from Illinois’s Title V program participated in stakeholders meetings to help develop Illinois Health Connect. Currently, Illinois Health Connect maintains several advisory subcommittees to offer feedback on the design and ongoing operation of the Illinois Health Connect. Participation on the advisory subcommittees is open to any interested patient or provider. The following stakeholder types are among those represented on the advisory subcommittees: Providers and provider professional associations Foundations Hospitals State agencies, including the Division of Alcoholism and Substance Abuse and the Division of Mental Health
Defining & Recognizing a Medical Home	Definition: According to the Illinois Health Connect website, “your medical home is the doctor’s office or clinic where you go to see your Primary Care Provider.” Recognition: Primary care providers in Illinois Health Connect sign a participation agreement that includes the following requirements, among others: Develop, “a symptom-based action plan of care to be shared with Enrollees with chronic diseases including asthma, diabetes, coronary artery disease, congestive heart failure and chronic obstructive pulmonary disease.” “Provide direct access to enrollees through an answering service/paging mechanism or other approved arrangement for coverage twenty-four hours a day, seven days a week (24/7). Automatic referral to hospital ER does not qualify.” “Perform periodic preventive health screenings in accordance with established standards of care.” “Schedule, or coordinate with a case manager to schedule, diagnostic consultation and specialty visits.” Ensure that, “routine, preventive care appointments [are] available within five weeks, and within two weeks for infants.” Ensure that, “urgent care appointments not deemed emergency medical conditions [are] triaged and, if deemed necessary, provided within 24 hours.” Under Illinois Health Connect, specialists may be considered primary care providers.
Aligning Reimbursement & Purchasing	Illinois Health Connect pays primary care providers enhanced fee-for-service rates in addition to the following ongoing care management fees: $2.00 per child (under 21) per member per month (PMPM) $3.00 per adult $4.00 per senior or disabled adult Illinois Health Connect primary care providers are also eligible for performance-based payments. In 2010 years, $3.3 million was been paid for achieving clinical targets. For 2011, 2012, and 2013, bonuses depended on performance in the following six areas: Recommended immunizations Developmental screenings Asthma management Diabetes management Breast cancer screening Lead screening Information on specific performance targets is available online.
Supporting Practices	Primary care providers participating in Illinois Health Connect receive several types of non-financial support, including: Semi-annual profiles that show aggregated screening rates and how a particular health care provider compares with his/her peers. Early Periodic Screening, Diagnosis, and Treatment (EPSDT) screening rates have dramatically increased, as have the use of other evidence-based services. These profiles are aligned with the Illinois Health Connect pay-for-performance criteria. Illinois Health Connect primary care providers have access to a database listing specialists who are willing to see Illinois Health Connect patients. Every week, Illinois Health Connect staff make 350 visits to provider offices to offer coaching or technical assistance on topics such as requirements for program participation, coding and billing, and enrollment. Illinois’s Enhancing Developmentally Oriented Primary Care (EDOPC) program is a joint initiative of the Illinois Department of Healthcare and Family Services (Medicaid), a health system, and two primary care provider associations (the state chapters of the American Academy of Pediatrics and the American Academy of Family Physicians). EDOPC offers online and in-office training on topics including developmental screening, perinatal depression, and autism. (Office trainings are eligible for continuing medical education credit.) Trainings include discussion of cultural and linguistic competency. Illinois Health Connect is exploring possibilities for creating a primary care extension program to support primary care providers in transforming into medical homes.
Measuring Results	Illinois Health Connect is taking a four-pronged approach to measurement. They are tracking: Patient experience of care, as assessed by surveys Cost savings, as calculated by actuaries Process and clinical outcomes improvements, especially at the population-level Provider satisfaction The Illinois Department of Healthcare and Family Services has announced that Illinois Health Connect saved the state approximately $150 million in fiscal year 2009. The state has also seen increases in developmental screenings, mammograms, and regular adolescent check-ups since implementing the program. The Commonwealth Fund has provided $100,000 in funding for the Robert Graham Center to study the impact of Illinois Health Connect and Your Healthcare Plus (a disease management program). The evaluation will draw on claims data from before and after program implementation, as well as data from Medicaid programs in other states. The grant was announced in 2011. Researchers from the Robert Graham Center presented on findings from this evaluation at the 2012 annual conference of the American Public Health Association, estimating savings for the 2007-2010 period at $531 million.

Illinois – Medical Homes

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