Guest bio

Dr. Shannon Dowler is a family doctor born, raised and trained in North Carolina. She has spent the past twenty years pursuing health access, equity and quality in Western North Carolina. In 2019 she became theChief Medical Officer for North Carolina Medicaid.

You can also learn more about Dr. Dowler’s work by visiting shannondowlermd.com

Highlights from this episode

1. The amazing NC telehealth pandemic roll-out story, including rolling out a 3-year plan in 7 weeks to deploy 367 program flexibilities
2. Take-aways from communicating rapid changes to providers using data
3. Changes in barriers to telehealth over the last 2 years
4. Impact of implementing managed-care simultaneous to the telehealth rollout
5. Hybrid home health visits
6. Challenges and opportunities using telehealth to move the dial on quality measure
7. The danger of over-estimating the cost impact of expanded telehealth visits
8. Advice to solution providers innovating in the Medicaid telehealth space

Further Exploration

More talks by Dr. Dowler on a range of issues

• shannondowlermd.com
• Innovations In Reimbursement & Payment
• Perinatal Telehealth, COVID-19 Public Health Emergency Response
• NC Medicaid & Telehealth Moving Mountains, Great Vistas
• “Zooming” Ahead: Meeting Providers Where They Are

Guest bio

Blaire Bryant is the Associate Legislative Director for Health at the National Association of Counties. In this capacity she works with county officials across the nation to set NACo’s policies on matters related to health policy and the public health system. Blaire holds a B.A. in Biopsychology from the University of Maryland Baltimore County, and a Master’s Degree in Community Health Education from the University of Maryland College Park.

Highlights from this episode

1. The challenge of using jails and prisons for mental health care delivery
2. Key terms, especially pre-trial detainees, post-conviction, recidivism
3. NACO’s partnership with sheriff’s association
4. Constitutional issues around removing healthcare coverage for pre-trial detainees
5. Key differences between jails and prisons, especially the different continuity of care issues
6. Medicaid inmate exclusion policy- key issues, impact, efforts to change
7. NACO top objectives- educate federal partners and the general public on the inmate exclusion policy, advocate for change in federal policy to allow pre-trial detainees to continue to receive federal policy, provide resources for local level advocates to pursue change, and create one body of research that examines all the components in the issue
8. In depth discussion of recent legislative efforts
9. State options to improve right now, including suspending Medicaid enrollment vs terminating it, and options for 1115 waivers

Further Exploration

Blaire’s recommended reads

• NACo Joint Task Force Report with NSA on the MIEP
• NACo/NSA Task Force Home Page
• National Academies of Sciences, Engineering, and Medicine Report: , Decarcerating Correctional Facilities During COVID-19: Advancing Health, Equity, and Safety 
• Task Force Report Update Memo (American University)

Guest bio

Evan Ashkin, MD, is the founder of the Formerly Incarcerated Transition (FIT) Program, which aims to help recently released inmates with chronic illnesses to receive proper medical care upon rejoining their communities. Ashkin also serves as professor in the Department of Family Medicine at the UNC School of Medicine

Highlights from this episode

1. The challenge of using jails and prisons for mental health care delivery
2. Healthcare needs profile of formerly incarcerated individuals
3. Overview of the Transitions Clinic and NC FIT model
4. Common misunderstandings about care provided to incarcerated individuals
5. Importance of connecting formerly incarcerated individuals with community health workers are also formerly incarcerated
6. Medication assisted treatment (MAT) and the opportunity window to avoid overdose deaths
7. Lack of teaching about jail health in medical schools
8. Tips to get a re-entry program started in your state

Further Exploration

Information about the Transitions Clinic Network and the North Carolina Formerly Incarcerated Transition (FIT) program

Formerly Incarcerated Transition Program

https://transitionsclinic.org/

Meeting Health Needs at Reentry: North Carolina’s FIT Program

Ashkin serves as co-guest editor for November issue of NCMJ – Department of Family Medicine

They’re Out of Prison. Can They Stay Out of the Hospital?

 November 01, 2019, 80 (6) | North Carolina Medical Journal

Spotlight on the Safety Net | North Carolina Medical Journal

Prevalence of Chronic Health Conditions Among Adults Released From the North Carolina Prison System, 2015-2016 | North Carolina Medical Journal

Dr. Ashkin’s recommended reads

After Prison, Healthy Lives Built On Access To Care And Community

Allison Roth – Insane: America’s Treatment of Mental Illness

Michelle Alexander. The New Jim Crow: Mass Incarceration in the Age of Colorblindness

13th (film)