Accountable Care Community: Shared Accountability for the Health of a Community

Janine Janosky, PhD. is being honored as a Champion of Change for helping Americans live healthier lives, reduce disease and contribute to lowering health care costs by focusing communities on public health and prevention.

I am Vice President at the Austen BioInnovation Institute in Akron (ABIA) and head the Center for Community Health Improvement.   I lead a multi-institution collaboration known as the Accountable Care Community (ACC).  It expands the concept of an Accountable Care Organization (ACO). This ACC initiative positively impacts the health of the local community and serves as a national model for collaborative, integrated, multi-institutional approach that emphasizes shared responsibility for the health of the entire community. 

Our Accountable Care Community initiative is supported through a Community Transformation Grant from the Affordable Care Act’s Prevention and Public Health Fund.  The Community Transformation Grant program, created by the health care law, supports innovative community-level efforts to collaborate to prevent chronic diseases such as cancer, diabetes, and heart disease.

Through the ACC, we have been successful in improving the health of those in our community by promoting healthier lifestyles through disease prevention and health promotion, reducing chronic disease, increasing access, and improving health equity. The ACC impacts population health by lessening the burden of disease, thus reducing health costs, and improving lives. One of the first ACC public health efforts was to zero in on diabetes since approximately 11 percent of adults in Akron have diabetes. In just 18 months we are already seeing positive result from the programs: More than half of participants lost weight, decreased body mass index (BMI), and reduced waist size; the average cost per month of care for individuals with diabetes was reduced by more than 10 percent per month, saving the program $3,185 per person annually; and we saw a drop in diabetes-related Emergency Department visits.

The multi-institutional partners within the ACC are diverse and include Akron Children's Hospital, Akron General Health System, Summa Health System, The University of Akron, Northeast Ohio Medical University, Summit County Public Health, Community Legal Aid, Akron Metropolitan Housing Association, Akron Public Library, Cuyahoga Valley National Park, United Way, Akron Urban League, and over 60 other community organizations, institutions, and agencies. The ACC framework improves population health through community and practice-based interventions for primary, secondary, and tertiary prevention and care management for chronic diseases including diabetes, hypertension, and others.

The ACC serves as a national model by providing and managing health and patient care across different institutions, expanding the efficiency of budgets and resource needs and uses while creating methods to monitor and evaluate health and performance indicators. The ACC is aligned with the integration of public health and healthcare, namely the movement toward population health.

Janine Janosky, Ph.D., serves as Vice President and Senior Fellow for the Center for Community Health Improvement at the Austen BioInnovation Institute in Akron, Ohio. The Austen BioInnovation Institute in Akron (ABIA) is leading a community-based integrated health and wellness initiative.

Treasury Tax Ruling Recognizing All Legal Same-Sex Marriages Garners Widespread Support

Ed Note: This is a cross post from the U.S. Department of the Treasury blog.

Last week marked a critical milestone for legally married same-sex couples nationwide.  In a ruling that implemented the Supreme Court’s June decision invalidating a key provision of the Defense of Marriage Act, Treasury and the IRS announced that all legal same-sex marriages will be recognized for federal tax purposes. 

The decision is notable because it provides same-sex couples with the certainty that their federal filing status will remain the same regardless of where they move throughout the country.  The ruling determined that, if a same-sex couple’s marriage took place in a state or jurisdiction where it is legally recognized, the couple will be treated as married for all related federal tax provisions.  This even applies if the couple relocates to a state where same-sex marriage is not recognized.

U.S. Treasury Secretary Jacob J. Lew further outlined the significant impact of this ruling last week, by explaining that it “provides access to benefits, responsibilities and protections under federal tax law that all Americans deserve.”

This decision garnered an overwhelmingly positive response across a broad spectrum of individuals, advocacy groups and media outlets, including:

Affirmations (Michigan): Spokesperson Cassandra Varner.  “The IRS has sent a clear message to the United States about same-sex couples being treated equally when it comes to federal taxes….  Being treated equally is not some casual luxury same-sex couples should hope for. It's a fundamental right that every human deserves."

Charlotte Observer (Editorial).  “Just as we lauded the DOMA ruling for overturning a law that denied gays protections the U.S. Constitution guarantees, we applaud this Treasury move.  It gives gays the same federal tax benefits that opposite-sex couples receive.”

Congressional LGBT Equality Caucus Co-Chair and U.S. Representative Mark Pocan (D-WI).  “I applaud the Department of Treasury for siding with equality and treating all legally married couples in America the same. Loving same-sex couples should not be afraid they could lose their federal benefits or protections simply by moving to another state. Today’s decision continues our nation’s forceful progress toward recognizing the rights and responsibilities of all loving couples.”

Empire State Pride Agenda: Executive Director Nathan M. Schaefer.  “We’re grateful to President Barack Obama and Department of Treasury Secretary Jack Lew for their leadership and for their swift and thoughtful implementation of the Supreme Court ruling on DOMA. All legally married couples now have access to the same federal tax purposes, and we’re one big step closer to full equality under the law.”

Equality Pennsylvania: Executive Director Ted Martin.  “Since the Supreme Court struck down the so-called Defense of Marriage Act, the Obama Administration has shown historic leadership, evaluating all federal policies and taking critical steps to ensure that all legally married couples have equal protection under the law.  To be sure, this ruling is a tremendous and historic step forward, and across Pennsylvania, thousands of loving, committed same-sex couples are celebrating…" 

Family Equality Council: Executive Director Gabriel Blau.  “This announcement is yet another giant step forward for our families. The Federal Government will now acknowledge same-sex couples, and their children, as a family under the tax code regardless of their zip code…  This is a significant win for the millions of our families who work hard, pay taxes and deserve to be recognized equally by the Federal Government.  Once again the Obama Administration has demonstrated that they value the lives and contributions of the 3 million LGBT parents in the US raising 6 million children, and will no longer financially penalize them for who they are.”

Freedom to Marry: Founder and President Evan Wolfson.  “This announcement makes today a day of celebration and relief for married same-sex couples all over America.  At long last, the IRS will treat them as what they are: married.  Freedom to Marry commends the administration’s swift implementation of the Supreme Court’s landmark ruling for federal equality in an area that will have a direct, tangible impact on families’ financial health.  The fact that this new respect applies only to married couples – not those joined by domestic partnerships or civil unions – highlights the need for an America where everyone can marry the person they love in any state, and have that marriage respected at all levels of government.”

Gay & Lesbian Alliance Against Defamation (GLAAD): Spokesperson Wilson Cruz.  "Today, America moves one step closer to 'liberty and justice for all.'  Equal federal tax protections will not only endow legally married same-sex couples with the respect and dignity they deserve, but will also provide critical financial security for countless loving families."

Human Rights Campaign (HRC): President Chad Griffin.  “With today’s ruling, committed and loving gay and lesbian married couples will now be treated equally under our nation’s federal tax laws, regardless of what state they call home.  These families finally have access to crucial tax benefits and protections previously denied to them under the discriminatory Defense of Marriage Act.” 

Minnesota Revenue: Revenue Commissioner Myron Frans.  "I think the impact for Minnesota is we have clarity for all married couples and uniform treatment, consistent treatment for all married couples, regardless of where they're residing.” 

New York Times (Editorial).  “The I.R.S. change is the broadest to come out of the landmark court ruling, affecting virtually every married same-sex couple in the United States.  The move to recognize all same-sex couples’ marriages will reduce the harm to those who get married in one of the states where same-sex marriage is legal but reside in a state that does not recognize their unions. ”

Washington Post (Editorial).  “In what is arguably the federal government’s most significant rule change since the Supreme Court’s watershed June decision striking down the federal Defense of Marriage Act (DOMA), the Treasury Department and its Internal Revenue Service (IRS) have mandated that all legally married same-sex couples be treated as such for the purposes of federal taxation.  Although 37 states still don’t recognize gay marriage, the federal government has taken a powerful step in equalizing standards for same-sex couples, no matter what state they call home…  It’s heartening to see the federal government prioritize this issue and mobilize itself so quickly to implement the Supreme Court decision… the updated IRS standards are a welcome addition and an important step in the nuts-and-bolts implementation of equality.”

Betsy Bourassa is a Media Affairs Specialist at the U.S. Department of the Treasury.

Rosh Hashanah Greetings From the White House

Shanah Tovah from the White House!  At sundown on Wednesday evening, the Jewish community here in the United States and all over the world will begin celebrating Rosh Hashanah, the Jewish New Year. 

Over the course of the High Holidays, we reflect on the past year and recommit ourselves to our core values.  This year, the American Jewish community had the opportunity to do this as Jews and as Americans.  That is because Rosh Hashanah this year falls just one week after our entire nation had the occasion to reflect on our values during the historic 50^th anniversary of the March on the Washington. 

 In his 2013 video message for the High Holy Days, President Obama says:

“Fifty years ago last week, Rabbi Joachim Prinz stood with Dr. King on the steps of the Lincoln Memorial.  Representing the thousands of Jews there that day, he told the marchers, “When God created man, he created him as everybody's neighbor. Neighbor is not a geographic term. It is a moral concept.”

“For millions of Jews, this moral concept is at the heart of Rosh Hashanah and Yom Kippur.  As the high holidays begin, it’s a chance not just to celebrate with friends and family, but to ask some of life’s most piercing questions.  Am I treating strangers with kindness?  Am I living not just for myself, but for others?  Am I doing my part to repair the world?  Where we fall short, the New Year is a new opportunity to get things right. 

“And where we still have work to do, the New Year is a chance to reaffirm our commitments.  At home, we must continue building an economy that gives all people willing to work hard a fair shot at a middle-class life.  Beyond our borders, we must stand for the security of our allies, even as we take new steps in the pursuit of peace.  I was proud to visit Israel earlier this year to renew the unbreakable bond between our two countries, and to talk directly with young Israelis about the future we share. 

 “Just like the generations that came before us, we live in challenging times.  But I know that if we work together we can make this moment one of hope for all our neighbors – in America, in Israel, and around the world.  In that spirit, Michelle and I wish you and your family a sweet, happy, healthy, and peaceful New Year.”

 Matt Nosanchuk is an Associate Director in the White House Office of Public Engagement