Promising Trends Emerge in Recent Health and Human Services Bills

Promising Trends Emerge in Recent Health and Human Services Bills

Meeting of NCSL policy leaders covers the health workforce, prevention of child maltreatment, substance use disorders and more.

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Stacy Brayboy of the March of Dimes shares findings from her organization's 2023 maternal health "Report Card" at NCSL's recent Health and Human Services Chairs Meeting.

Growing the health care workforce remains a challenge across the nation, say the chairs and vice chairs of NCSL's Children, Families and Human Services Committee.

The chairs' recent meeting focused on the health workforce, prevention of child maltreatment, behavioral health, maternal and child health, Medicaid and other timely issues. Experts from the field, individuals with lived experience and federal partners provided a wealth of knowledge for attending state leaders as they explore strategies for addressing complex health and social issues.

"We touched on very delicate issues that are hard to challenge in our states and got some really great ideas of where we can move forward," says Illinois Sen. Laura Fine. "We talked about issues like mental health, substance use disorders, and what kind of policies we can focus on as legislators to make positive strides in our states to really help people in their quest to live a happy, productive life."

States have enacted at least 370 bills addressing the health care workforce so far in 2024. More than 100 address behavioral health, and 60 address other health care professions, such as occupational and physical therapy and pharmacy.

States are searching for solutions to ensure access to safe, quality care for mothers, says Stacy Brayboy of the March of Dimes. She shared several findings from her organization's 2023 "Report Card" examining factors that contribute to maternal and infant mortality and morbidity, including preterm births, geographic disparities, and socioeconomic and environmental issues. Recent state actions include bolstering the maternal health workforce across obstetrics and gynecology physicians, midwives and doulas. (For more on state strategies to address maternal health through workforce interventions, see the NCSL report Workforce Supports: Improving Maternal Health Outcomes.)

Allied health professionals work alongside physicians, nurses and other health care professionals to ensure safe, quality care for patients in a variety of settings. The Health and Human Services chairs discussed four occupations that have received increased attention in state legislatures recently: community health workers, EMS clinicians, peer support specialists, and pharmacists and pharmacy technicians. (For more on these occupations, see the NCSL series Allied Health Professionals: Considerations for State Legislatures.)

Some are considering expanding provider scope of practice-or the activities and services that health professionals are allowed to perform under their licenses-to address health workforce shortages. NCSL staff walked attendees through the Scope of Practice Policy Resource Center, which includes maps illustrating 23 scope of practice policy areas for the 50 states, Washington, D.C., and the territories. The maps show the services health professionals can perform, their authority to prescribe or alter prescriptions, and supervision and collaboration requirements with other health professionals. NCSL also maintains a database of all introduced scope of practice legislation from 2015 to the present.

HRSA Resources

Carole Johnson, administrator for the Health Resources and Services Administration, shared a list of programs in her agency that offer opportunities for collaboration with states:

• Maternal, Infant and Early Childhood Home Visiting Program.
• National Health Service Corps Loan Repayment Program.
• Healthy Start Supplement for Community-Based Doulas.
• HRSA-Supported Health Centers, including integrated mental health and substance use disorder services.
• 340B Drug Pricing Program.

Other Hot Topics: Child Welfare, Medicaid, Substance Misuse

Throughout the meeting, attendees and faculty discussed the idea of "whole kids, whole families," or what families need for children to thrive. Christine Calpin from Casey Family Programs and Clare Anderson from the University of Chicago's Chapin Hall research center outlined evidence-based policy options, including paid family leave and the use of TANF funds, to prevent child maltreatment and unnecessary removals from a child's home. Some strategies are universally applicable to families, while others focus on underserved populations, including families in rural areas or families experiencing poverty. (Legislation on foster and kinship care, child protection and the prevention of child maltreatment can be found in NCSL's Child Welfare Legislation Database.)

Remaining sessions touched on several hot topics in health and human services, including Medicaid and systems of care for people with disabilities, and substance misuse prevention and treatment.

Medicaid's complexity can make it difficult to navigate, particularly for individuals with disabilities or limited access to supportive services. The "Medicaid and Systems of Care for People with Disabilities" session highlighted several of these challenges along with opportunities for state policymakers to address gaps in their Medicaid services. (Information on legislative actions relating to state Medicaid programs can be found in NCSL's Medicaid Toolkit.)

Substance misuse intersects numerous health and human services policy areas. Anna Jones with Community Bridges Inc. illustrated how each of the four levels of recovery housing might best suit an individual depending on where they are in their recovery process.

Attendees also learned the "ABCs of Substance Use Disorder Treatment" from Robert Baillieu of the Center for Substance Abuse Treatment and Rob Morrison of the National Association of State Alcohol and Drug Agency Directors. Baillieu and Morrison discussed how demand for treatment options has soared and how states can respond, including by using telemedicine to prescribe essential medications, permitting take-home doses of methadone and supporting long-term recovery. (Information on legislative trends in substance use can be found in NCSL's Substance Use Disorder Treatment Legislation Database, and information on recovery housing can be found in NCSL's Housing and Homelessness Legislation Database.)

Kelsie George is a senior policy specialist with NCSL's Health Program; Cameron Rifkin is a policy associate with NCSL's Children and Families Program.