Monthly Archive for October, 2011

Getting Back on Track with Family Friendly Policies

Published on October 31, 2011 in Debra Ness and Work & Family. 1 Comment

Debra Ness, President

Cross-posted from Huffington Post.

As National Work and Family Month drew to a close this time last year, working families were hopeful that the upcoming election would mean that the economy would turn around, families would regain control of their finances and economic security, and the country would finally get back on track after a crippling recession.

Sadly, we ended up with a deadlocked Congress, and legislators at every level who are determined to undermine the social safety net and basic workplace rights that are the fabric of our nation — and central to the economic security of families. The result has been workers continuing to struggle to hold onto their jobs, keep their homes, put food on the table and care for their families, including children and elderly relatives.

The past year has been hard for many working families, but it has also provided some promising and hopeful victories. Some family friendly policies, like paid sick days, have weathered the storm and will soon be available to hundreds of thousands more working people, helping them meet their families’ health needs while protecting their economic security.

Connecticut made history in June by becoming the first state to pass a paid sick days law that gives workers the right to earn job-protected paid sick days to use to recover from illness or to care for a sick child or family member. Soon after, the Seattle City Council followed suit by passing a similar law that resulted from an unprecedented collaboration between workers, forward-thinking businesses and advocates. And in Philadelphia, the City Council has taken a significant step toward ensuring workers in the city have the basic right to earn paid sick time.

So this year we have seen great momentum and support for at least one common sense, modest policy that can make a tremendous difference for working families. Other family friendly policies are already on the books in other states. Just in time for National Work and Family month, the National Partnership has launched a comprehensive database that makes it easier to identify all of these existing work and family policies. Check it out at www.nationalpartnership.org/wfdb.

This new work and family database makes clear that lawmakers around the country recognize the need for and benefits of policies that ensure working people can be good workers and good family members. But if our country is ever going to demonstrate that it truly values families, and if we are serious about getting the country and economy back on track, then we need national work and family policy standards.

More than 40 percent of the private-sector workforce doesn’t have a single paid sick day. Only 11 percent have paid family leave through their employers, and fewer than 40 percent have paid medical leave through employer-provided short-term disability insurance. The United States is the only developed country that does not guarantee workers paid leave.

It is time for the nation’s policies to catch up with the rest of the world, and with the needs of 21st century families. To start, we need a national paid sick days standard and national paid family and medical leave.

This year, we have seen that progress is possible, even in difficult economic and political times. The momentum must continue so that families and the country can get back on track.

Workplace Support a Critical Step toward Eliminating Poverty

Published on October 28, 2011 in Vicki Shabo and Work & Family. 1 Comment

Vicki Shabo, Director of Work and Family Programs

One of the biggest threats to the well-being of our nation’s women and families is poverty. Right now, more than 46 million Americans live below the poverty line, which is a little more than $22,000 for a family of four. And with high unemployment, job scarcity and insecurity, and increasing prices for basic necessities, millions more find themselves on the brink every day.

To address this growing poverty problem, Half in Ten – an exciting project of the Center for American Progress Action Fund, the Coalition on Human Needs, and The Leadership Conference on Civil and Human Rights – released a new report this week on where the country stands in key areas affecting families’ economic security, and where we need to go to cut poverty in half in the next 10 years.

The report, Restoring Shared Prosperity Strategies to Cut Poverty and Expand Economic Growth, focuses on the importance of creating good jobs, strengthening families and promoting economic security. It sends a powerful message about what the nation’s families need. And we couldn’t agree more.

At the National Partnership, we know that quality jobs that offer fair pay and paid sick days are critical to the economic well-being of families, so we were pleased to see that access to these basic workplace standards are among the benchmarks used in the report to measure the nation’s progress. In fact, Secretary of Labor Hilda Solis, Center for American Progress President John Podesta and Half in Ten Director Melissa Boteach all identified access to paid sick leave as a key indicator of poverty reduction at the report’s launch event.

For families already on the brink of poverty, a few paid sick days can have devastating consequences. And low-income working parents are much less likely than parents with incomes over 200 percent of the poverty line to have any form of paid leave.

As National Partnership President Debra L. Ness said:

“Basic workplace supports like paid sick days, paid leave and flexibility allow working people to keep their jobs while providing for their families – ultimately enabling them to lift themselves out of poverty or prevent it altogether. There could not be a better time to implement the report’s recommendations and reduce barriers to employment and job security. We applaud Half in Ten for prioritizing these policies and raising awareness of the immense challenges facing working people and their families.”

The policy prescriptions outlined in Half in Ten’s new report are critical to ensuring America’s families can live free from poverty – and standards like paid sick days, paid family and medical leave, and fair pay can immediately alleviate some of the challenges faced by millions. We look forward to next steps and supporting the campaign as it continues.

To read the full report and state fact sheets, visit http://halfinten.org/indicators/resources.

Welcome Progress, But the Final Verdict on ACOs Is Yet to Come

Published on October 28, 2011 in Debra Ness and William Kramer. 2 Comments

Debra Ness, President, National Partnership

Last week, the Centers for Medicare and Medicaid Services (CMS) may have done what once seemed impossible.  Its final rule on Accountable Care Organizations (ACOs) seems to have put an end to the rancor and bitter debate on this particular issue, shaping a framework that just about all parties can accept.

By responding thoughtfully to comments on the proposed rule, and balancing competing interests, the agency has given us a welcome respite from the pitched battles that are raging over so many aspects of health reform.  But the real measure of success will be whether successful ACOs are soon in place, providing better-coordinated, more patient-centered care for millions of patients and giving us all a way to get better value for our health care dollars.

William Kramer, Executive Director for National Health Policy, PBGH

We believe last week’s announcement will encourage more providers to participate in this program.  From the perspective of consumers, we applaud the strong emphasis on patient-centered criteria that should pave the road to better care.  And especially as advocates for our oldest, sickest and highest risk patients, we applaud this

effort to incentivize better primary care, increased coordination, and shared accountability across providers. From the perspective of purchasers, we believe that CMS has crafted a foundation to hold providers accountable for quality performance and cost savings, and created a path to move providers away from today’s perverse fee-for-service system.

We are very pleased that this final rule will require ACOs to use beneficiary experience of care and outcome measures to evaluate performance. We believe CMS landed in a better place with respect to the quality measures ACOs must report on.  While we appreciated the comprehensiveness of the original list of 65 measures, there were a number of measures that added minimal value.  The final list of 33 measures is a stronger set that focuses on highest impact measures and, very importantly, includes measures of patient experience, functional status and clinical outcomes, care coordination and safety.  We would, however, have liked pay-for-performance to occur sooner in the program, especially for measures that are already in use.  Finally, we are very pleased that this final rule continues to ensure full transparency, notification and choice for beneficiaries. These provisions are all essential to engaging consumers in a positive way and realizing the promise of successful ACOs.

Nobody got everything they wanted in the final rule and we, too, have concerns.  We are disappointed that the upfront anti-trust review process is no longer mandatory, but glad there is strong acknowledgement that there must be close monitoring for any signs of cost-increasing market concentration.  We are glad to see that the final rule requires CMS to share ACO applications and new types of data that will strengthen the ability of the Federal Trade Commission and Department of Justice to assess and monitor the market impacts.

It is also unfortunate that the provisions requiring beneficiary participation on ACO boards have been tempered, rather than expanded to include representation from a diverse range of community stakeholders, including purchasers, labor and community-based groups. It is now incumbent on CMS to closely monitor ACOs to ensure that they reflect the community interests they are intended to serve, and that consumers, beneficiaries and other key stakeholders are engaged in the design, governance and evaluation of their performance. Consumers and purchasers hope and expect that these provisions will be strengthened down the road if needed.

Every leader from every sector has a list like this – things they like, and things they don’t like, in the final rule. But the time for tallying who won and who lost, and by how much, is over. Now it’s time for all parties to come together to create successful ACOs that deliver care that is patient-centered, that improves quality and care coordination, and that lowers costs. The stakes are too high to let anything stand in our way, or to let opponents of reform exploit any remaining differences.

We said before this rule was released that it’s time for a new dynamic where we come together to implement the reforms the nation so urgently needs. ACOs are one of many promising models and initiatives that will be tested by the CMS Innovation Center over time. It is well past time to leave our broken, dysfunctional health care system behind and give the Accountable Care Organization model the test it deserves.

The final rule gives us a chance to do that. That’s all we could ask. CMS has done its part. Now it’s time for the rest of us to do ours. If we do, patients, their families and family caregivers, our economy and our nation will benefit.

Debra L. Ness is President of the National Partnership for Women & Families. William Kramer is the Executive Director for National Health Policy at the Pacific Business Group on Health. Together, they co-chair the Consumer-Purchaser Disclosure Project, a group of leading employer, consumer, and labor organizations working toward a common goal: to ensure that all Americans have access to publicly reported health care performance information.

Cross-posted from the Health Affairs Blog.

Dispatches from Denver

Published on October 13, 2011 in National Partnership Staff and Work & Family. 2 Comments
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Paid Sick Days on the Ballot in Denver

This year, we have achieved significant victories in our work to ensure more working people have the right to earn paid sick days. From Seattle to Connecticut, paid sick days standards have gained support and momentum. Now, one state and three cities guarantee workers this basic right. This November, the city of Denver could become the fourth.

On November 1st, Denver voters will consider a city ballot initiative that would let workers earn paid sick days to use when they or a family member is ill. Right now, more than 100,000 workers in Denver – 40 percent of workers and 72 percent of food service workers – don’t have access to a single paid sick day. When illness strikes, they must choose between a paycheck and their health, their families’ health and the public health. This initiative could help prevent these impossible choices.

Unfortunately, all of the great success and momentum around paid sick days has garnered much attention from opponents. And Denver is their next target. The business lobby and others are determined to defeat common sense paid sick days measures. Major national and local groups have poured money into advertisements and other scare tactics designed to convince Denver voters and local businesses to oppose paid sick days.

But we know the truth: Paid sick days are good for everyone. San Francisco has had a paid sick days law since 2006, and two-thirds of businesses there now say they support the law. They overwhelmingly report that their profits have not declined since its enactment. More importantly, most workers in the city say they have benefited from the paid sick days law. It has given those who need paid sick days the most – including parents and workers with chronic conditions – the time they need to care for their health and the health of their children.

This election, Denver workers and the community have the opportunity to reap these same benefits and improve the health and quality of life for families in the city by approving the proposed paid sick days standard. Denver families deserve it, and voters deserve the right to know all of the facts about the difference paid sick days can make in people’s lives.

NP Denver TeamThat’s why the National Partnership is headed to Denver – to volunteer with the tireless workers and activists who have come together in the Campaign for a Healthy Denver, and to support their effort to inform voters about the need for paid sick days. We will report from the front lines about our work, and we hope you will share our stories and spread the word about this critically important initiative. With wealthy opponents gearing up, we know this will be an uphill battle. We are hopeful that hard work, determination and common sense will prevail.

To follow our updates, check out PaidSickDays.org. We look forward to connecting with you there!

Sincerely,

The National Partnership Team in Denver
Rachel, Helen, Katie and Sara

Realizing the Full Potential of Health Reform

Published on October 11, 2011 in Debra Ness, Health Care, Quality and Reform. 0 Comments

Debra Ness, President

When it passed, we recognized the Affordable Care Act (ACA) as the greatest advance for women’s health in a generation.

This new law is already beginning to eliminate the punitive and predatory insurance practices that have penalized women and families for decades, and instead bringing us closer to the day when essential women’s services are fully covered, prevention is a priority, and care is coordinated so family caregivers don’t struggle to shoulder impossible loads. The benefits to women – and their families – are myriad. Health reform means insurers cannot charge women more because of our gender, or deny or cap our coverage when we get sick. It means coverage for breast and cervical cancer screenings and family planning services. It ends the days when young adult children were kicked off their parents’ insurance policies.

So why is a law that’s brought so much progress, and even more promise, in such great peril? Because too many lawmakers are putting politics ahead of the best interests of their constituents, who urgently need reliable, affordable, comprehensive and well-coordinated health care. They are more interested in throwing up roadblocks and scoring political points than focusing on what the country needs.

It’s time to take a step back and reconsider what’s best for women and families, for our economy and for the country. We need to realize the promise of health reform by allowing implementation to proceed. And we need to adopt the family friendly policies that will allow workers to access the health care services they need, while holding onto their jobs.

I read with interest a recent study by a Robert Wood Johnson Foundation scholar which found that more adults postpone or go without medical care for nonfinancial reasons than for financial reasons. The researcher, Jeffrey T. Kullgren, notes that: “Many patients also have nonfinancial reasons they can’t get the health care they need when they need it. They may live a great distance from the doctor, and traveling is a challenge. They may work jobs that make it hard to go to a doctor’s office during a normal business day, where leaving work would mean they wouldn’t get paid or might risk losing their job.”

That’s not a huge surprise when you consider that nearly 44 million workers in the United States don’t have paid sick days. A mere 11 percent have access to paid family leave through their employers, and fewer than 40 percent have access to paid medical leave through employer-provided short-term disability insurance. When workers are without these basic protections, they are forced to choose between their health and their financial security when illness strikes – and in this job market, it’s no surprise many choose to forgo treatment and preventive care rather than risking their jobs or their paychecks.

So instead of continuing the posturing and politicking and efforts to repeal health reform, let’s get to the business at hand – work together to implement the Affordable Care Act, and adopt paid sick days and paid family and medical leave. Then, we’ll be on track for healthier workers, healthier families, and a healthier country.

On the Right Track: Institute of Medicine’s Essential Benefits Report

Published on October 7, 2011 in Debra Ness, Health Care and Reform. 0 Comments

Debra Ness, President

America’s women and families want and need confidence that when they buy health insurance, it will cover comprehensive benefits that meet their needs. Thanks to health reform, we may soon get that.

The new law charged the U.S. Department of Health and Human Services with determining exactly what services should be considered “essential benefits” that must be covered by health insurance.  To help Secretary Kathleen Sebelius shape this package, the Institute of Medicine (IOM) created a committee to recommend a process and methodology for defining the essential benefit package – because how that package is designed, and what is included and excluded, will help determine whether reform delivers on its promise.

The committee’s report, released today, is hugely promising. It proposes a process for determining essential benefits that is a balanced approach that prioritizes public involvement.  Women and families will have a say, helping to ensure that the final package reflects their needs and values.

A primary aim of the Affordable Care Act (ACA) is to ensure that women and families can access better, more reliable coverage for a range of health care needs – from prevention to women’s health services to coverage of chronic conditions and more. The IOM committee’s report aims to do that and to strike a balance between comprehensiveness of coverage and cost.

We are pleased that the committee recommended that the essential benefits package not be used simply as a cost containment tool. Rather, members recognized that we must look at the broader picture of how to address skyrocketing health care costs. We urge the Secretary to not only consider the short term costs of any given benefit, but the long-term value of a package that pays for the items and service that women and families need to get and stay healthy.

Women will be better off if the Secretary establishes an essential benefits package that includes reproductive health services, care coordination and palliative care.  We are especially hopeful that the package will cover maternity care, well-woman and well-child visits, cancer screenings and the full range of reproductive health services and supplies. We want to see care coordination and primary care fully covered.  We hope it will to cover language access services, which have the potential to drive down costs associated with the unnecessary care that is common for limited English proficiency patients.

Importantly, the committee today also recognized that our definition of what constitutes an essential benefit may change in the future. We applaud the creation of the National Benefits Advisory Council, an independent, non-partisan advisory group comprising a variety of stakeholders – including consumers – to update the essential benefit package over time.

The work the IOM committee has done is good for women and for all consumers, but now we need to encourage the Administration to adopt its recommendations. Only then can we ensure that those who need help the most can access the health care they need – which is, after all, what reform is all about.

To learn more, go here and here.