The Root Cause Coalition is dedicated to amplifying the voices of communities and driving impactful policy reforms. As a nonprofit committed to addressing the root causes of health disparities and poverty, we aim to educate our members on recent news and research that advocates for equitable healthcare access and influencing policy decisions that combat food insecurity and poverty. 

Read our April 22, 2024 news on social drivers and advocacy updates below:

Social Drivers in the News:

The influential adverse childhood experiences questionnaire should ask about gun violence
This article discusses why the Adverse Childhood Experience (ACE) questionnaire, a tool used by practitioners to gauge patient mental well-being, should be updated to include questions specifically pertaining to gun violence. Established in the 1980s, the ACE questionnaire employs a 10-item scale to examine experiences related to abuse, violence and neglect. This allows physicians to provided tailored care and trauma-based treatment for physical ailments such as obesity, diabetes, substance abuse and social problems. Updating the questionnaire to specifically include questions about exposure to gun violence would allow for a more precise assessment of community risk factors and resilience for the estimated three million children that bear witness to gun violence every year in America. 

Our Commitment to Health Equity Requires Investing in Trans Leadership
This article discusses the significant barriers to health and safety trans people face despite increased populations, visibility and representation. The lack of data on trans experiences hinders policy and funding decisions, prompting investments in initiatives like the U.S. Trans Survey (USTS) to gather crucial evidence. In an effort to combat these disparities, the Robert Wood Johnson Foundation aims to amplify and support inclusive narratives and supportive policies, championed by organizations such as the Transgender Strategy Center (TSC) and Transgender Law Center (TLC), strive to reshape societal norms and counter discriminatory legislation.
 
Evaluation of a Collaborative Model Between Managed Care and Affordable Housing on Acute Care Costs
This study evaluated a collaborative service model between a Medicaid managed care organization (MCO), Superior HealthPlan, and an affordable housing provider, Prospera Housing Community Services, based in Texas to examine changes in outcomes 12 months before and after implementation of the Prospera+Superior collaborative model. Using data from two groups of participants, 104 served by the collaborative model and 104 served by just the Superior MCO, the study found that the Prospera+Superior group had a 56% lower rate of emergency department/urgent care visits and spent $2,061 less in prescription costs than the Superior MCO-only group after 12 months. The findings show the clinical and economic benefits of forming multisector collaborate models between MCOs and other community providers.
 
Transportation Justice and Health
This article discusses ways to advance the impact of transportation interventions in health care and highlight the limitations of how health services currently conceptualize and use transportation. The article goes on to show that incorporating a transportation justice framework addresses transportation and mobility needs more comprehensively and equitably within health care research, delivery and policy. To prove this, the authors discuss existing research investigating transportation as a social driver of health and propose applying a more holistic transportation justice framework to systemic problems in health care.

SDoH Advocacy Update:

Final Rule Streamlines the Medicaid, Children's Health Insurance Program
The Centers for Medicare and Medicaid Services (CMS) recently released a final rule that will protect and improve how millions of eligible people apply for, renew and maintain health care coverage through Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). The final rule, first proposed in September 2022, includes a series of provisions to simplify enrollment and renewal processes by standardizing them nationwide. These provisions include eliminating both annual and lifetime limits on children’s coverage in CHIP and waiting periods for CHIP coverage so children can access health care immediately. It will also more seamlessly transfer children from Medicaid to CHIP when a family’s income rises and prohibit states from conducting renewals more frequently than every 12 months and requiring in-person interviews for older adults and those with disabilities. Additionally, the rule will require states to provide all individuals with at least 15 days to provide any additional information when applying for the first time and 30 days to return documentation when renewing coverage. To read the full rule, click here. 

H.R.7647 – Housing ACCESS Act
This bill was introduced by Representative Nanette Barragán [D-CA] to address the intersections between homelessness, mental health and substance use disorder. The bill would direct the Departments of Health and Human Services, Housing and Urban Development and the Treasury to issue joint guidance on simplifying connections and referrals between health care services and housing and homelessness service providers. The agencies would be tasked with developing a memorandum of understanding between state Medicaid agencies, public housing agencies, Continuums of Care and housing finance agencies to coordinate housing-related services and supports provided under state Medicaid programs with other housing resources. All agencies would be required to align eligibility criteria and determination processes as well as outcome measures, including housing stability and health outcomes disaggregated by race. The memorandum would also include information to encourage providers of housing-related services and supports to seek reimbursement for their services through state Medicaid programs. The bill was referred to the Committees on Energy and Commerce and Financial Services.

S.3949 – Pride In Mental Health Act of 2024
This bill, introduced by Senator Laphonza Butler [D-CA], would establish a grant program to improve lesbian, gay, bisexual, transgender, queer or questioning, nonbinary, intersex and Two Spirit youth mental health and substance use outcomes. Grant funding would be used to provide cultural competency training for caregivers and collect data on the behavioral health of LGBTQ+ youth. It would also be used to develop and disseminate behavioral health and crisis intervention resources to improve LGBTQ+ youth mental health and substance use outcomes and integrate behavioral health services for LGBTQ+ youth in school systems. Additionally, the bill would commission a report on mental health, mental health care and cultural competency in mental health care for LGBTQ+ youth in foster care and other social services programs. The bill was referred to the Committee on Health, Education, Labor, and Pensions.

H.R.3916 – SCREENS for Cancer Act
This bill, introduced by Representative Joseph Morelle [D-NY], would reauthorize the National Breast and Cervical Cancer Early Detection Program, which provides public education, outreach, patient navigation and care coordination to ensure equitable access to breast and cervical cancer screening and diagnostic services in low-income and uninsured communities. The program supports partnerships between the Centers for Disease Control and Prevention and state departments of health to address SDoH barriers to care and reduce disparities in rates of breast and cervical cancer in underserved populations. The bill passed the Committee on Energy and Commerce and will move to the House for consideration.