The Centers for Medicare and Medicaid Services Innovation Center has announced the winners of the Health Care Innovation Awards. The agency sought projects that would identify, test and spread innovative health care delivery and payment models to help providers improve the treatment of Medicare and Medicaid patients while cutting costs.
The grants will provide a total of $322 million to organizations whose proposals promised public-private partnerships designed to enhance primary care services and coordinated and preventive care aimed at reducing hospital and emergency department visits. The one-time grants will run for three years.
One winning proposal is the Upper San Juan Health Service District in Pagosa Springs, Colo., which received $1.724 million to expand access to specialists and improve acute care to a rural population. The grant will provide cardiovascular early-detection and wellness programs, implement a telemedicine acute stroke care program, use telemedicine and remote diagnostics for cardiologist consultations, and upgrade and retrain its EMS division to manage urgent care transports and in-home follow-up patient care for more than 3,400 people.
Another is Palliative Care Consultants of Santa Barbara, Calif., which plans to create new options for frail elderly to access rapid assessment and treatment in their homes through rapid response teams (RRTs). Within one hour of receiving a call for help, specially trained first responders will arrive at the homes of seniors who become ill. The RRTs will initiate an assessment and triage process and provide immediate treatment, reducing the need for a trip to the ED. The organization will receive $4.25 million and expects to save approximately $3.23 million over three years while training about 32 workers and creating 20 jobs.
Descriptions of all the winning proposals are at innovations.cms.gov/Files/x/HCIA-Project-Profiles.pdf.
Crisis Standards of Care Released
Calling current nationwide efforts to manage catastrophic events “rudimentary,” the Institute of Medicine (IOM) released new guidelines for use by states and localities preparing and implementing standards of care to be used in crises when health providers are overwhelmed and resources are scarce.
“Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response” builds on the agency’s 1999 study on developing such standards of care. The new report recommends a systems-based approach that assigns responsibility and resources to the different health care providers who would serve sick and injured community members during these events.
According to the guide, organizations must first identify their core response function and who will perform each task; templates contained in the guide are targeted to meet this need. The guide also provides tools for responders to use in educating communities and individuals about how to help themselves until outside assistance arrives.
The IOM is a nonpartisan, independent organization that reports to Congress on pressing health care policy issues. This report was requested by the U.S. departments of Health and Human Services, Transportation and Veterans Affairs. A copy is available at nap.edu/catalog.php?record_id=13351.
FCC Issues T-Band Waivers
The much-criticized narrowbanding requirement that public safety radio licensees in the 470–512 MHz band, or T-Band, migrate to 12.5 kHz channel bandwidth or use a technology that achieves the same by Jan. 1, 2013, was waived by the Federal Communications Commission (FCC) in April. Many organizations resisted the transition due to the expense of purchasing new equipment required for narrowbanding.
The FCC required narrowbanding in 1995 to make more efficient use of the available spectrum. The agency set no deadline at the time, assuming organizations would transition when they replaced their old equipment. When, in the FCC’s judgment, organizations failed to act, the agency took action in 2003 and 2004 and established the 2013 deadline to convert to narrowbanding.
Meanwhile, working on a different issue and timetable, Congress passed the Middle Class Tax Relief and Job Creation Act of 2012, which created a public safety broadband spectrum called the D Block. The legislation requires that within nine years, the FCC must auction the T-Band spectrum; two years after that, the FCC must relocate public safety radio users to the new D Block. The FCC waiver was issued in the wake of that legislation.
For more information, visit fcc.gov/document/waiver-narrowbanding-deadlines-t-band-470-512-mhz-licensees.
New DHS Budget in Progress
The fiscal year 2013 Department of Homeland Security (DHS) appropriations bill, passed in the House in June and currently in the Senate awaiting approval, contains funding for several important responder grant programs.
— Although the Assistance to Firefighters Grant (AFG) and Staffing for Adequate Fire and Emergency Response
(SAFER) were originally to receive only $335 million each, supporters introduced successful amendments in the House that increased that number by $5 million, giving the grant programs $675 million to split.
— The U.S. Fire Administration (USFA) would receive $42.46 million, a reduction of $1.58 million from fiscal year 2012.
— Urban Search and Rescue would receive $27.51 million, almost $14 million less than 2012, though $7.67 million was restored the same evening the bill passed the House.
— The Federal Emergency Management Agency’s (FEMA’s) budget would see an increase of more than $400 million over 2012 funding, at more than $1.7 billion.
Meanwhile, the Senate Appropriations Committee approved its own fiscal year 2013 DHS appropriations bill in May that provided $337.5 million each for AFG and SAFER, $44.02 million for USFA and $1.54 billion for FEMA state and local grant programs.
The two Houses must reach agreement before the DHS funding bill can go to the president to be signed into law. The current authorization of the USFA expires Sept. 30.