Estimated read time: 6-7 minutes
This archived news story is available only for your personal, non-commercial use. Information in the story may be outdated or superseded by additional information. Reading or replaying the story in its archived form does not constitute a republication of the story.
WEST VALLEY CITY — It's not New Year's Eve yet, but Utah health policy leaders and advocates are already making resolutions and setting goals for 2023.
Medicare is available to more people and communities are becoming more aware of mental health issues. One group is continuing to address steps to improve maternal mortality, mental health, oral health and affordability of care in Utah.
Advocates and community leaders from throughout Utah's health care system gathered this week to discuss issues they hope to resolve and what they are doing to make a difference in the state's health system — either through their own organizations or through policy changes with the Utah Legislature.
It's the first time since the COVID-19 pandemic began that the conference, hosted by Utah Health Policy Project, has been held.
Lily Griego, regional director at the U.S. Department of Health and Human Services region that includes Utah, said the department is working to strengthen preparation for future viruses and public health emergencies, reduce health care costs overall and address disparities in maternal mental health. She cited a campaign announced recently by President Joe Biden to get more Americans vaccinated, specifically those in nursing homes.
"This has been an ongoing, fatiguing conversation — and we're not done yet," she said.
Griego said about 21% of adults in the country now have a mental illness, and self-reported anxiety symptoms have increased in the last few years.
Keeping Utah moms healthy
The United States is not keeping up with other developed countries for maternal mortality, Griego said, adding that the country is doing worse than many developing nations. She said the Biden administration is working to address maternal mortality and focus its efforts on equity and care for minorities, who have even worse maternal mortality rates.
Heather Dopp, a mother who works with Postpartum Support International Utah, said health providers need to be educated on trauma-informed care when they deal with new mothers whose emotions are causing them to be more vulnerable.
"These infants are a priority as well as the parents, so if you want the infant to thrive, the parent has to thrive, too," Dopp said.
She said evidence supports the benefits of doula care, as many women are significantly healthier after delivering a baby at home, but a doula is often too expensive for the average mom, and especially a low-income mom.
Ashley Finley, with Sacred Sister Doula, said she works to provide access to "anti-racist, culturally competent care," and said many of the mothers she works with are worried about a chance of death and don't want to go to the hospital, so they are forced to choose between a large expense for a doula, or going somewhere they don't feel safe for delivery.
"That is a heartbreaking decision to make," Finley said. She often does not charge women for her services because she wants to see her community thrive. There is currently one out-of-hospital doula in the state who can bill Medicaid patients.
Tonya Hales, who oversees Medicaid programs at the Utah Department of Health and Human Services, said about 10,000 women in Utah received Medicaid benefits while they were pregnant in 2022 through a program that gives presumptive eligibility for pregnant mothers. But even with this program, she said, Utah has a lower percentage than most states of births covered by Medicaid.
The Medicaid benefit is robust, she said, and provides preventive care — but the emergency Medicaid benefit, available for people who are not citizens and who are pregnant, does not cover any prenatal or postpartum care — just the delivery. She said expanding this emergency benefit would need to be covered completely by state funds and is not supported nationally.
Rep. Rosemary Lesser, D-Ogden, who previously worked as an obstetrician, said Medicaid provides coverage for pregnant women until 60 days after they deliver a baby. But, she said, medical issues can last longer than 60 days and it is hard for doctors to make sure the proper necessary care is provided before that deadline. She said continuous coverage after delivery is important, and stressed strengthening and utilizing community resources.
Covering the cost
One of the main priorities for health advocates right now is making health care more affordable and improving access to care for low-income Utahns.
Shireen Ghorbani, director of community health at Intermountain Healthcare, said it is a failure when families don't know if they can take their child to the hospital because they don't know if they can afford the bill.
Ghorbani said there are between 60,000 and 80,000 uninsured kids in Utah, and many of these children are difficult to insure because they are undocumented. She grew up without insurance and said she understands not seeing a doctor regularly can make it even harder as an adult to access health care and think about primary care needs.
"We know that those investments we make in a kid's life — early in that kid's life — change the trajectory and the outcome of that kid," Ghorbani said.
She expressed support for a bill in the last general session of the Utah Legislature, sponsored by Sen. Luz Escamilla, D-Salt Lake City, to provide insurance to all children. Ghorbani said the bill came close to passing and it is going to be run again in the upcoming session. She encouraged people in the room to support the bill.
Ghorbani said Intermountain Healthcare has been making progress in considering how to help people prioritize health, rather than reacting to illness, which could reduce overall costs.
Ben Tonga, director of Medicare Advantage at University of Utah Health Plans, said it is important to keep people in categories of low- to moderate-risk as long as possible to decrease insurance costs, which requires that people be engaged in their own health care. He said it takes more than just providing the tools, but also helping people engage.
He is Tongan and said his dad is hesitant to go to a doctor, but having a doctor or nurse that is Tongan would likely help him seek medical care. He said representation from many cultures can help people be more involved in their care and improve health outcomes.
One Utah Health Collaborative
Utah is seeking to address issues in health care through the One Utah Health Collaborative, a community-owned nonprofit organization announced by Gov. Spencer Cox in 2021.
Jaime Wissler, executive director at the organization, said Wednesday they are pushing to make hundreds of changes over the next 15 years, many of them gradually.
He said projects can only move as quickly as the slowest partner, which is often local and state governments. With the government's involvement, things might happen more quickly.
"Utah will be the national leader in cost-efficient, innovative health care, thereby strengthening our economic competitiveness and supporting a high quality of life for all Utahns," according to the overall mission of the collaborative, as stated on its website.
Wissler said the three main goals are to improve affordability, outcomes and equity. He said over 50 organizations have signed a pledge to support the goals and submitted commitments for how they plan to address an issue; in one example, Intermountain Healthcare committed to improving how many Utahns have health insurance.
"We recognize this is a massive undertaking," Wissler said. "We have to rely on each other, we have to rely on the experts."
He said Utah is one of the most innovative states in the U.S., but it is not as effective when the innovation is happening within specific organizations and not benefiting the entire state population.
