State agencies are facing significant challenges of rising health care costs, insufficient preventative care and the difficulties of linking or integrating health systems with human services programs. For years now, many APHSA members have worked with varying success toward integrating human services programs to better serve the public. Lack of resources has challenged ongoing efforts. Despite these challenges, the concepts related to organizational governance, service delivery and the technology and accountability systems needed to support integration have continued to be refined and implemented in many state and local human services agencies.
The passage of the Affordable Care Act in 2010 and the resulting intensified conversations about the relationships between health services and other government services have further focused many states' attention on how to either begin or enhance the horizontal integration efforts needed to achieve improved patient/client outcomes and reduced costs in both systems. Many of the people served by APHSA's member agencies are eligible for Medicaid or CHIP or will receive premium subsidies for health coverage through the new Health Insurance Exchanges. The key is to ensure the needs of children, adults and families served by these systems are effectively linked together. To that end, several states are opting to develop and/or enhance their eligibility and enrollment systems by connecting to the Exchanges, particularly in light of the recent exception to the cost allocation requirements.
Recognizing that states are positioned along a continuum in terms of how they are addressing horizontal integration, APHSA is convening the National Workgroup on Integration (NWI)– a workgroup that includes human services and health care leaders in agencies at the state and local level, industry partners (private companies involved in supporting business process consulting and IT services for government health and human services), and representatives of the federal government to discuss these issues. In an effort to assist all states in planning for interoperability and integration between the new IT frameworks, the workgroup will develop guidance that examines the opportunities, the challenges, the readiness factors, and recommendations for states as they explore this new frontier in government human services. Also in the near future, Webinars and other forms of technical assistance will be provided to states and localities along with monthly policy papers, reports, and policy guidance on issues related to horizontal integration of health and human services.
