Health and Food Policy
Clients and collaborators – The health team works with government associations, nonprofit organizations and university-based programs to increase access to health care and nutrition for some of the nation’s most vulnerable citizens. Over the past several years, the team has worked on school food reform, reducing use of antibiotics in the food chain, reducing oral health disparities for special needs children in D.C., and creating strategies to operate HIV/AIDS services under the Affordable Care Act. See our recent clients and collaborators here.
Recent and continuing projects
Georgetown Health Justice Alliance – Barriers to oral health pose a significant health threat to low income individuals and families, with sometimes fatal consequences. Harrison is collaborating with the new Georgetown University Health Justice Alliance – a medical-legal partnership (MLP) between Georgetown’s Law and Medical Centers that is uniquely situated to develop and influence polices to eliminate barriers to oral health and help reduce health disparities. Clinic students and staff have been identifying polices that negatively impact access to oral health services in Washington, DC, particularly for children with special health care needs. Regular oral health care is particularly important for children with special health care needs because they are more likely to have special diets, take medications containing high levels of sugar, and have difficulty with oral health hygiene. The team has been conducting a national scan of oral health best practices for this population, including issues related to providers. The Medicaid program, and patient access barriers including transportation and education. In combination with DC-specific data and talks with local experts, students are conducting legal analysis to identify the most significant challenges to accessing care and to help determine which best practices are compatible with D.C.’s regulatory framework. Results of the analysis will lay the foundation for advocacy in future semesters.
Food and nutrition – Obesity rates continue to rise, particularly in young children and adults in low-income areas, which do not have equal access to fresh fruits and vegetables in their communities and suffer higher rates of obesity and diabetes. We partner with School Food FOCUS, which supports large school districts that want to purchase unprocessed local food. To do so, they must figure out how to adopt a local preference that complies with local, state, and federal procurement law. At the same time, school districts are working to increase their economies of scale of through cooperative purchasing and other contracting strategies. Recent projects include a collaboration between School Food Focus and Health Care Without Harm on partnerships between school districts and hospital systems. By June 2017, we will have worked with 19 school districts and several hospitals and hospital systems. Recent work:
- Geographic Preference Primer – Sandy Han
- Staying Legal on the Cutting Edge of Procurement – presentation slides by Will Thanhauser and Michelle Poncetta
Food and sustainability – As consumers, governmental entities like school districts have the potential to change how food is produced. For example, school districts are working with producers to purchase chicken that is raised with minimal use of antibiotics. They are also exploring standards to promote environmental sustainability, including reduction of pesticides and other chemicals that are harmful to agricultural workers. School districts that want to expand their food purchasing criteria to include sustainability must ensure they have the legal authority to do so under state law and federal conditions of funding for school meals.
HIV/AIDS and health reform – State health departments play a vital role in providing access to testing and treatment for HIV/AIDS and viral hepatitis; they receive a majority of funding from federal and state governments. The Affordable Care Act expands eligibility for Medicaid and private insurance to previously uninsured Americans including individuals living with HIV/AIDS. However, with more HIV/AIDS clients eligible for insurance, federal and state funding may be cut. State health departments are assessing the capacity to bill third parties like Medicaid and private insurance for the services they provide, but they need to know whether state law limits their legal ability to do so. Partnering with the National Alliance for State and Territorial AIDS Directors (NASTAD), we have provided an overview of five states and their laws related to state health department billing. We plan on continuing our partnership with NASTAD. Recent work:
- State Health Department Billing for HIV/AIDS and Viral Hepatitis Services: An Analysis of Legal Issues in Five States – Dinesh Kumar and Dean Hendrick
- Insurance Access for Pre-Existing Conditions – Dinesh Kumar and Dean Hendrick
- Immigrants and the Affordable Care Act – Dinesh Kumar and Dean Hendrick
State role in reform of health insurance – While the Affordable Care Act (ACA) made significant reforms to health insurance, states are at the forefront of implementing these reforms. With wide discretion on certain policy matters, the approach to regulating insurance under the ACA can vary from state to state. Understanding how and what actions states are taking is a critical step to inform federal and state policymakers of the changing insurance landscape. We have supported organizations like the Center on Health Insurance Reform (CHIR) in its efforts to monitor and analyze state implementation of the ACA.