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Communications from SPW

Art + Narrative Therapy for PTSD – There’s An App for That!

Panels created in the Warrior Stories appA person who has been sexually assaulted often finds the experience difficult to talk about, for many reasons. There are feelings of shame and self-blame associated with the assault. But studies suggest that not talking may be ok as long as the traumatic memories are addressed through nonverbal treatment.

Art therapy is a way to tap into such memories, as they may be better accessed by sensory means. It is often combined with narrative therapy, which allows someone to express their story and see the problems in it as separate from themselves, making them easier to work through.

The Defense Department-sponsored Warrior Stories app was designed for processing combat trauma. Continue reading “Art + Narrative Therapy for PTSD – There’s An App for That!”

Rules May Complicate Pritzker Plan to Tax MCOs

Cover of Illinois FY 2020 budget proposal, with photo looking up into capitol doneGov. Pritzker’s budget proposal delivered last month calls for new taxes on cigarettes and insurance companies to fund Medicaid. Here is some context on where it came from and the challenges it faces.

The Department of Healthcare and Family Services operating budget of $25.1 billion is about $900 million more than for the current year. The vast majority of it is earmarked for Medicaid. The program, which covers 1 in 4 Illinois residents, accounts for close to a third of total state spending. Continue reading “Rules May Complicate Pritzker Plan to Tax MCOs”

Bringing MST home, to Congress

Sen. Martha McSally visiting women of the 386th Air Expeditionary Wing in Southwest Asia in 2015Sen. Martha McSally of Arizona captured the attention of Congress, and of the nation, last week when she revealed in a hearing that she had been raped by a superior officer while serving in the Air Force. It was a top story from NPR to Fox News.

“Like you, I am also a military sexual assault survivor,” she told the witnesses at a hearing of Senate Armed Services subcommittee on personnel, of which she is a member, on March 6th. She did not report the incidents, she testified, because she was ashamed and confused, and in later attempts to talk to Air Force officials about them felt “like the system was raping me all over again.” Continue reading “Bringing MST home, to Congress”

Will Benefits Updates Follow Wage Increase?

For every dollar the boss had and didn't work for, one of us worked for a dollar and didn't get it - Women's March signThe long fought-for $15 minimum wage bill was signed into law by Governor Pritzker on February 19. It raises the state’s minimum hourly wage from $8.25 to $9.25 next year, and then phases it in to $15 by 2025.

Although the federal minimum wage is still $7.25, much of the country has moved on. More than 60% of the working age population is estimated to live in areas with a higher-than-federal minimum. Chicago and Cook County have raised theirs, currently at $12 and $11, respectively. California, Massachusetts, and New Jersey will beat us to $15. As of January 2017, 29 states and a couple dozen cities had set their own minimum wage, and a dozen states automatically raise it every year to keep pace with inflation. Continue reading “Will Benefits Updates Follow Wage Increase?”

Imagine Medicaid with Informed Consumer Choice

Patient getting in-person assistanceDo you remember when the ACA Marketplace opened in 2013, and the whole thing was so complicated that special roles like “navigators” and in-person counselors, aka IPCs, had to be created to help people enroll? Even though few assisters remain due to significant funding cuts from the federal government, people still need help with healthcare choices, especially in our Medicaid program.

Most people have access to expert help figuring out their healthcare choices. With an employer, you have an HR person or representative to help you sort through your healthcare choices. On the private market, you have brokers and agents. In Medicare, you have Senior Health Insurance Program counselors and brokers. Granted, all those systems have their shortfalls, but the common thread is that there is a person you can reach for help.

Not so for Medicaid recipients – the people likely to need it the most. Continue reading “Imagine Medicaid with Informed Consumer Choice”

A Vision: Proper Care for Women Vets

Young African-American woman talking on her cell phone - perhaps with her healthcare providerWhen a woman goes to the doctor, or to a clinic, intake typically fails to ask her if she is veteran or an active member of the Armed Forces. Screening for military status is a way to obtain a vast amount of information. Failing to screen leads to poor health outcomes, because providers miss the fact that service heightens the likelihood of certain kinds of injury, stress, trauma, and other health conditions.

We envision: healthcare systems that routinely identify female veterans at 100% of all screenings and use this information to guide appropriate treatment.

Women who serve have needs for gender-specific care that many healthcare facilities are not able to provide. The deficiency lies in both lack of scientific knowledge of battlefield injury and trauma-informed care, as well as an absence of awareness of military culture and how it relates to health and well-being. Continue reading “A Vision: Proper Care for Women Vets”

Government Shutdown Exposes Americans’ Vulnerability

Sorry, we're closedFor many Americans, being able to afford medications is critical, and just one paycheck can be the difference between life and death even with health insurance.

The other day, we heard about a furloughed federal worker who was forced to ration insulin because of the government shutdown. “I can’t afford to go to the ER. I can’t afford anything,” she told NBC News.

With type 1 diabetes, the Wisconsin resident, who works for the Department of Interior, had recently been hospitalized for sepsis and respiratory failure during a bout of pneumonia. Afterward, her blood sugar had hit levels that made her worry about ketoacidosis and the risk of diabetic coma. Continue reading “Government Shutdown Exposes Americans’ Vulnerability”

Medicare In-home Services: Learn from Medicaid

A senior holds her glasses and handbag. New services may help more seniors stay at home.

As people age, they typically need more help doing everyday things, whether it’s getting the groceries or taking a shower or remembering to take their meds. In many cases, even limited assistance can allow a senior to remain in their home for many years, even decades.

The logical program to provide in-home services is Medicare, which pays for most of seniors’ medical care. But Medicare does not cover them. Medicare does cover skilled medical services like physical therapy or nursing care when you’re ill or recovering from an illness or surgery, but you must be certified by a doctor as homebound, and even then it will not cover non-medical home services such as help bathing or dressing or preventive aids such as grab bars. The result is that many seniors end up spending down their resources to be eligible for Medicaid to get the non-medical care they need in order to live at home. Our system makes middle class people become poor to get the care they need – and, ultimately, states pick up the tab. Medicaid has been covering a growing portion of long-term care in the U.S. – 53% in 2018.

But 2019 ushers in help at home services for Medicare – and the change may be the catalyst for a more dramatic transformation in healthcare delivery and effectiveness.

Continue reading “Medicare In-home Services: Learn from Medicaid”

“But What If the Terrorist Is You?”

Warrior Songs vol 2 cover art“They say that you’re my battle buddy, they say that you’re my friend, that I’ll never have to make you answer to business end, of this weapon I was issued, to give terrorists their due – but what if the terrorist is you?”

That’s Emily Yates singing a song of her own composition on a new album released in November. The album, Women at War: Warrior Songs Vol. 2, is a full-length CD devoted solely to the experiences of women in the military, and created by women. It is a work, as the promotional material says, “by women, about women, for women.” The 15 tracks tell the stories of 18 women veterans and two Gold Star family members.

Women make up more than 15% of the US military, but their presence and their contributions can be all but invisible in the public mind. And although they are subject to the same hardships, risks, and physical and mental traumas as their male comrades, those scars and harms are not on the radar of most people when they picture what a soldier has to face. This album makes it concrete for us. Continue reading ““But What If the Terrorist Is You?””

Will 2019 Bring a Medicaid Buy-in to Illinois?

Map of states exploring Medicaid buy-in, updated from unitedstatesofcare.org
Click to enlarge
When Governor-elect JB Pritzker and incoming legislators take office a few days from now, we hope among the top-of-mind issues for them will be healthcare – and the possibility of creating a public option that would allow Illinois residents to purchase a premium to participate in the state’s Medicaid program. Candidate JB Pritzker talked about his vision for such an initiative, which he called “IllinoisCares,” and his platform included a public health insurance option that would be available to all residents.

IllinoisCares would allow Illinois residents to purchase health insurance from the state, rather than a commercial plan. Forty-two states – including Illinois – already have Medicaid buy-in programs, but they are limited to working people with disabilities who have not been able to purchase affordable health insurance coverage that meets their health needs in the private market. Continue reading “Will 2019 Bring a Medicaid Buy-in to Illinois?”