Archive 033108

March 31, 2008 Florida Session Update: Budget Fears Closer to Becoming Reality As the first month of the 2008 Regular Session draws to a close, literally dozens of bills with potentially significant impact on consumers and their health are winding their way through. Florida faces a $3 billion shortfall for 2008-09, on the heels of 2007-08, during which the budget has already been cut twice mid-year. Last week, committees in both the House and Senate released their initial health and human services (HHS) budget proposals, and as feared, an array of critical health care programs and services are proposed to be cut or eliminated. (by Greg Mellowe, Florida CHAIN) Read more Florida Consumer Health Care Stories Needed If you are or someone you know would be willing to tell your story to our staff, or speak out about challenges accessing health care, your help will be invaluable to advocacy efforts. Consumers can share their stories anonymously; work with us on an opinion piece for a newspaper; or learn how to speak to a group, the media, or a legislator. Personal experiences have powerful influence, so we want to do all we can to highlight them. Please help us by identifying those willing to share, and calling Florida CHAIN at 954-791-7314 or emailing lisam@floridachain.org.
	TAKE ACTION: Protect Florida Prenatal and Infant Health Care - Proposed Cuts Will Cost Far More in Lives and State Funds The Florida House Healthcare Council is considering cutting $3 million services from Healthy Start’s already underfunded prenatal and infant health care program, and rolling back Medicaid eligibility from 185% to 150% of the federal poverty level for pregnant women. Thousands of the state's most vulnerable families - who are facing job losses, foreclosures and a lack of health care coverage during this economic down-turn – will lose critical services. (Thanks to Florida Association of Healthy Start Coalitions for this alert information.) Read more and click to send a prepared message to the House Healthcare Council. TAKE ACTION: KidCare Bill Moves to House Healthcare Council with Improvements, Drawbacks On March 25, HB 1457 passed the House Healthy Families Committee with several KidCare improvements that would make it easier for eligible children to enroll or remain in the program. However, the bill lacks some key provisions included in the version supported by child health advocates, and also includes language would harm the current program. Fortunately, the sponsor and chair are considering including these provisions. (Thanks to Florida Child Health Care Coalition for contributing to this alert) Read more and send a strong message provided to the House Healthcare Council TAKE ACTION: Autism Evaluation & Treatment Bill Gains Support Momentum is building behind legislation that would require Florida insurance companies to cover the evaluation and treatment of autism spectrum disorder. The “Window of Opportunity Act” would require group health insurance policies or group health benefit plans to cover well-baby and well-child screening; a variety of therapies; treatments by psychiatrists or psychologists; any other necessary medical care, and applied behavior analysis. (by Alisa Snow, Alliance for Pediatric Therapies) Read more and sign a petition supporting this legislation. TAKE ACTION: Oral Health Bill Could Stem #1 Chronic Disease in Children Senator Peaden has introduced Bill 2760, which would improve access to dental services, a much needed part of the health care system. Tooth decay is the #1 chronic disease in children, five times more common than asthma. Governor Crist has also put forth an oral health plan and the Florida House and Senate bills pending in committees are all supportive. *Read more and take action with a sample letter to key legislators.*

	Cigarette User Fee Coalition Grows as Bill Awaits Action The Healthy Florida Alliance is a coalition of more than 25 organizations working to increase Florida’s cigarette user fee by $1.00 per pack. This would both reduce youth smoking by 20% and generate a billion dollars a year to increase health care access and research. Sen. Deutch and Rep. Waldman have filed a bill to accomplish exactly that (HB 299/SB 2790). Unfortunately, the bill has yet to advance in either the House or the Senate, despite bipartisan sponsors – but the issue will likely end up as part of the overall budget discussion. (by Greg Mellowe, Florida CHAIN) *Read more*

	Reform Expansion May Be Less Likely in ’08, But Automatic in “09? Rumors persist that Medicaid Reform expansion will be introduced in the House, urged by House Speaker Marco Rubio and Health Care Council Chair Aaron Bean. A number of HMOs in Reform have expressed interest in expanding into Florida’s largest Medicaid market. In fact, wedged between program changes in the proposed 2008-9 Health and Human Services budget, is a directive stating that the Medicaid Reform Pilot Program will expand to (i.e., start enrolling consumers in) Miami-Dade and Monroe Counties as of July 1, 2009 AND then will expand to Hillsborough, Pinellas, Polk, Pasco, Manatee, Highlands and Hardee Counties as of July 1, 2010. (by Greg Mellowe, Florida CHAIN) Read more Medicaid Reform Technical Discussion is Really About Access to Care Earlier in March, AHCA held one of its infrequent sets of public meetings seeking feedback on Medicaid Reform. Much of the discussion, technical and almost devoid of mention of consumers, pertained to one of the most pressing and persistent consumer concerns in Reform: so-called “prior authorizations.” The extent to which delays in securing prior authorizations have been reduced cannot be measured, and AHCA apparently still has no plans to measure it, despite the fact that the Inspector General’s report identified this as a problem 6 months ago. (by Greg Mellowe, Florida CHAIN) *Read more* The Florida CHAIN website has been updated to include timely, extensive resources on Medicaid Reform. *Click here to access*: Background Materials; Issue briefs explaining the harmful implications of expanding into Miami Dade; Office of Inspector General (OIG) Report; University of Florida Evaluation Website Link; Georgetown University Policy Briefs; Newspaper Editorials and Opinion Pieces; Alternatives to Medicaid Reform including summary and powerpoint presentations from the Feb. 28, 2008 "Exploring Alternatives to Medicaid Reform" Symposium; Consumer Experiences; List of Medicaid Reform Advocates Coalition Members; List of Medical Care Advisory Committee Members.

	Time for Even the Apathetic to Consider Candidates’ Health Care Proposals (1^st in a Series) Both the need to reform our health care system and the presidential primary elections (along with the economy, which impacts both) are staples of the news coverage of recent months. Each of the three remaining presidential candidates has presented a general proposal for reforming the way our health care is delivered and regulated. These are compared ina side-by-side chart excerpted from KFF's Health08 website. (by Greg Mellowe, Florida CHAIN) *Read more*

	TAKE ACTION: Bill Filed for Medicaid Buy In! Great News for advocates of persons with disabilities! The Work Incentive Medicaid Coverage Initiative is trying to change Florida law to allow people with disabilities to go back to work with less fear of losing their Medicaid coverage, as 39 other states already do. The Optional Payments for Medical Assistance bill, HB 1311 and SB 2684, must now be scheduled to be heard in committees. (by Partnership for Work & Healthcare) Read more and contact key legislators to urge them to schedule these bills. TAKE ACTION: Legislators Can Provide Mental Health Fairness in Coverage NOW The more than 3 million Florida citizens who have common, treatable mental health problems need fairness in medical insurance. Over the years, 46 other states have enacted legislation to protect insurance coverage rights for those with mental illness. Your help is urgently needed to see that Florida’s 2008 legislative session passes such a bill. (by Angela D. Vickers, JD, Mental Health Advocate & Educator) Read more and contact key legislators to schedule HB 19 in the Healthcare Council


	Dying for Coverage in Florida - New Study on the Danger of Being Uninsured More than six people die each day in Florida because they do not have health insurance - just one finding from a new Families USA report. This first-ever state-specific report of its type is based on a ground-breaking national study by the Institute of Medicine, which forged the direct link between a lack of health coverage and deaths from health-related causes. *Read more*

	FOCUS on KidCare to Better Serve Families FOCUS (Federation of Congregations United to Serve) had a great meeting February 25 at St. Andrew’s Catholic Church with State Sen. Gary Siplin (D), Rep. Bryan Nelson (R), and Rep. Geraldine Thompson (D) regarding Florida's effective children's health insurance program—KidCare. 158 people attended and families and providers testified, affirming the need for reform so families can get this coverage and keep it. *Read more*




	CHAIN Reaction is a bi-weekly publication of Florida CHAIN (Community Health Action Information Network), a statewide consumer advocacy organization that works toward access to quality health care, empowering people to actively shape their world by participating in civic life and caring for each other’s well being. Florida CHAIN: 2812 N. 34th Avenue, Hollywood, FL 33021 info@floridachain.org www.floridachain.org


	Session 2008 Update: Budget Fears Closer to Becoming Reality As the first month of the 2008 Regular Session draws to a close, literally dozens of bills with potentially significant impact on consumers and their health are winding their way through the legislative process, although that winding is likely already winding down, as the House has already closed out its committee process. The only legislation that must pass, as required by the Florida Constitution, is the State budget. And so far, the State’s budget woes have far overshadowed everything else. That’s because, as we continue to weather a severe economic downturn (or even recession), Florida’s unstable, sales tax-dependent revenue base has been severely eroded just at the time it is most needed to provide critical services for people in need. Florida faces a $3 billion shortfall for 2008-09, which comes on the heels of 2007-08, during which the budget has already been cut twice mid-year. Last week, committees in both the House and Senate released their initial health and human services (HHS) budget proposals, and as feared, an array of critical health care programs and services are proposed to be cut or eliminated. In contrast with the Governor’s budget recommendations, these legislative proposals do not call for tapping reserve funds or reliance on new or one-time sources of revenue. The elimination of sales tax exemptions granted to special interests is another idea rejected by legislative leaders. As a result, the only remaining option appears to be deep cuts to critical health and social service programs. Specifically, both the House Health Care Council and the Senate HHS Appropriations Committees’ proposals each call for cuts totaling hundreds of millions of dollars in State funds which, together with an even greater amount of federal and other funds. The two bodies differ somewhat in terms of which programs would be reduced by how much, although the total cuts in the House are greater – in excess of a billion dollars. For example, although both House and Senate plans would also dismantle much of the Medically Needy program, which provides short-term Medicaid coverage for persons with catastrophic illnesses who exhaust their resources, the Senate would go further. Both spare pregnant women and children, but while the House would eliminate inpatient services for everyone else, the Senate would otherwise eliminate the program entirely. Both chambers would make unprecedented reductions in Medicaid reimbursements for hospital inpatient and outpatient services, HMOs, managed care mental health services and transportation, although the House’s cuts are deeper. The House proposal would even slash payments to county health departments by 39%. For example, the House proposal calls for the elimination of dentures, glasses and hearing aids for adults under Medicaid, as well as podiatry and chiropractic services. (The Senate’s version eliminates “only” dentures and hearing aids.) The House also eliminates hospice services and cuts support for Healthy Start Coalitions by 12%. But the Senate proposes to do away with the MEDS-AD program, which provides Medicaid coverage for the most vulnerable seniors with incomes well below the poverty level. It should be noted, however, that despite the fact that potential scenarios were analyzed by the Legislature’s economists in the Medicaid Impact Conference, neither chamber proposed lowering the eligibility level for pregnant women. Similarly, there apparently is no proposal to force most consumers now in the Medipass program into HMOs, although the fees provided to facilitate access to care under Medipass is to be cut in half. The House version includes modest increases, which pale even further in light of the other decreases for KidCare enrollment spots and Medicaid reimbursements for specialists and dentists. As for the status of the many consumer health-related bills that are pending, among those we’re watching most closely are proposals aiming to: Fix problems in Medicaid Reform (SB 1570 & also SB 1566/HB 859) – Both of the Senate bills have passed through their first Senate committee, but each has 3 more committee stops scheduled. Also, there is unfortunately no House version of SB 1570. Increase the user fee on cigarettes by $1.00 per pack and use the additional revenue generated (estimated at $1.03 Billion in 2008-09) for health care (SB 2790/HB 299) – The Senate version was referred to a whopping 5 Senate committees, and has not yet been scheduled to be heard in the first of them. The House version has not moved. Nevertheless, the issue may come up again during the budget process because of its revenue-generating potential, given the State’s dire economic straits. Eliminate barriers to help kids keep and retain coverage under the Florida KidCare program (SB 2472/HB 1275) - This version of the bill, supported by advocates and endorsed by the health plans, has not been scheduled for a committee hearing either. However, on March 25, a version of the bill with which advocates have some concerns (HB 1457) was approved by the House Healthy Families Committee. This version omits some important provisions while dissolving the helpful KidCare Coordinating Council. There is hope that some of the missing pieces from the consensus bill can still be added. Increase access by low-income Floridians, especially Medicaid consumers, to oral health services (SB 2760/HB 1367) – This bill codifies some of Governor Crist’s proposals for closing the gap through a number of different initiatives. Some aspects of the bill are opposed by dentists, however, on the grounds that they promote a two-tiered system of care. The Senate bill advanced out of the Health Regulation Committee last week. Require that insurers place coverage for behavioral and physical health conditions on the same level (mental health parity) (CS/SB 164/HB 19) – Both bills have been moving through the committee process. Although Congress could soon supersede this effort by enacting parity legislation at the federal level, advocates are urging State leaders to take this long overdue step. Ensuring transparency on the part of health care providers or hospitals regarding their charges and the availability of charity care (CS/SB 1488 & HB 1435) - These 2 bills are somewhat different from one another. The weaker SB 1488 was approved by the Health Regulation Committee on March 26. Require insurers to provide appropriate coverage for children with autism, including screening and treatment (CS/SB 2654/ HB 1291) - Both bills have also passed through their first committees of reference. Allow persons with disabilities who go to work to use Medicaid funds to purchase private coverage (SB 2684/HB 1311) - No committee hearings have been scheduled. Avert the scheduled implementation of the Prepaid Therapy Program (SB 2238/HB 1319), which will otherwise divert Medicaid funds from and unnecessarily limit access to essential therapeutic services to some children - No committee hearings have been scheduled. A few other important bills about which CHAIN has not taken a position include proposals to: Use the State’s leveraging power to negotiate with insurance companies to provide coverage for $150 a month), but doing so by eliminating mandates and allowing State officials to decide whether the coverage offered is adequate (CS/SB 2534). This bill was approved in the Banking and Insurance Committee last week, and the bill has only one more committee hearing to clear this week before heading to the Senate floor. There is no House version per se, but a somewhat related bill is moving. Allow community mental health centers to create their own Medicaid managed care networks that enroll only consumers with psychiatric disabilities (SB 846/HB 691) – The House version passed in the Health Innovation Committee, while its Senate companion passed in Health Policy last week. (Submitted by Greg Mellowe, Florida CHAIN) TAKE ACTION: Autism Evaluation & Treatment Bill Gains Support Momentum is building behind legislation that would require Florida insurance companies to cover the evaluation and treatment of autism spectrum disorder. The “Window of Opportunity Act” would require group health insurance policies or group health benefit plans to cover well-baby and well-child screening; a variety of therapies; treatments by psychiatrists or psychologists; and any other necessary medical care. The legislation would also mandate coverage for a type of treatment called applied behavior analysis. The Senate bill, SB 2654, is sponsored by Sen. Steve Geller (D-Hallandale Beach) and co-sponsored by 10 senators, as well as the Senate Banking and Insurance Committee, which unanimously passed the bill March 18. According to a Senate bill analysis, some insurance carriers cover prescription drugs but they may not cover other benefits such as physical therapy or occupational therapy, depending on the patient’s symptoms. Some plans exclude developmental disorders such as autism and mental retardation. Insurance company representatives say the coverage should be optional, not mandated by the state. The legislation would be a godsend, according to parents across the state. Many parents explain that their insurance carriers consider autism a mental health problem and won’t cover treatments for it. As a result, parents pay out-of-pocket for needed therapies, medications and other treatments proven to help autistic children develop and function. Bankruptcies and divorce are common among families with autistic children, due to the emotional and financial strain of medical treatments. The legislation faces a struggle in the House. HB 1291 narrowly passed the Health Innovation in a 4-3 vote, with some committee members opposed to insurance mandates. Even so, the legislation sponsored by Rep. Ari Porth (D-Coral Springs) has earned 25 co-sponsors, both Democrats and Republicans. Unlike the Senate bill, Porth’s legislation requires state agencies to establish a system of early intervention services for children by age 2 that includes physical, cognitive, communication, social or emotional, and adaptive developmental delays or disabilities. The potential price tag of this provision -- during a dismal budget year -- is the reason some legislators predict the bill won’t pass during this legislative session. Even so, the legislation is drawing national interest from groups such as Autism Speaks. Advocates including the Autism Society will rally in support of the bill during Autism Awareness Day on April 1 at the state Capitol. Additionally, the governor’s Task Force on Autism Spectrum Disorders will have its first meeting in Tallahassee on April 2-3. A petition drive that originated in Jacksonville has netted signatures of more than 1,200 people who support the autism insurance legislation. (The website is: http://www.thepetitionsite.com/1/insurance-for-autism). Other states have passed insurance mandates for autism spectrum disorder, including New York. Connecticut, Maine, Missouri, New Hampshire and Texas took a different approach to providing autism coverage by passing mental health parity laws. That may very well be an approach here in Florida. Several mental health parity bills are moving through committees, including HB 19 by Rep. Ed Homan (R-Temple Terrace) and SB 164 by Sen. Victor Crist (R- Tampa). It would require health plans to cover mental health and substance abuse disorders as they would for other diseases, illnesses, and medical conditions. A whopping 40 of 160 House members have signed on as sponsors. (Submitted by Alisa Snow, Alliance for Pediatric Therapies, alisa@snowstrategies.com, 850-443-1319 )

TAKE ACTION: Oral Health Bill Could Stem #1 Chronic Disease in Children

Senator Peaden has introduced Bill 2760, which will likely be heard this week. This bill is about improving access to dental services, a much needed

part of the health care system.

Tooth decay is the #1 chronic disease in children, five times more common than asthma. Governor Crist has also put forth an oral health plan and the Florida House and Senate bills pending in committees are all supportive. Below are a sample letter to take action, and details about this plan.

Please take a few minutes to read through this information and contact your legislators to help them understand why this legislation is so important for the children and families of Florida.

Click here to find your Florida representative’s contact information.

Click here to find your Florida senator’s contact information.

Send them this message:

Dear Florida Legislator:

Tooth decay is the #1 chronic disease in children, five times more common than asthma. This disease is preventable with access to dental care and early intervention and prevention. The 52 million school hours lost each year when

children suffer from tooth and mouth pain can be avoided. Please help Florida's children and their families have better access to much needed

dental services.

Please support SB 2760 and HB 1367 to: Bring more dentists to Florida to work in public health settings, Allow dental hygienists to apply sealants on permanent teeth (a relatively low cost best practice that many states have implemented), Increase reimbursements to dentists who want to but currently cannot afford to provide services to children with Medicaid or who may want to work in a public health setting.

The reasons:

1.What contributes to the breakdown in dental care for Florida's underserved?

a. Low-income patients receive care primarily through publicly funded programs such as County Health Departments and Federally Qualified Health

Clinics. However, Florida's public health nfrastructure is inadequate to provide access to dental services.

b. A main reason for this problem is that current rules create barriers for dentists, hygienists and other medical professionals to provide greater care

in public health settings.

i. FL is one of 3 states not to offer "licensure by credential" where dentists from out of state are licensed to practice in public OR private

settings.

ii. FL is one of 9 states to not permit hygienists to place sealants without the presence of a dentist. Sealants are a critical aspect of preventive

dental care.

c. Access to dental care for Medicaid clients is also very low. In part, this

is because of issues regarding reimbursement for practitioners.

i. FL dentists have not had an increase in reimbursement through Medicaid in

decades.

ii. Although non-dentist health professionals may currently conduct oral health screenings and apply fluoride varnish for young children, these professionals are not currently reimbursed for this service through Medicaid.

2. This proposal amends Florida statute to:

a. Create a new category of "public health supervision" for hygienists to provide direct access to preventive services in public health settings.

This will maximize our existing workforce of hygienists in public health settings.

b. Permit hygienists to place sealants without a dentist present in public health settings. This will maximize the effectiveness and quantity of the

treatment children receive.

c. Enhance the recruitment of dentists to work in public health settings by creating a licensure by credentials process for dentists from other states

to practice in public health settings.

i. Participating dentists will become eligible for a full FL dental license after a period of service of three years in FL's underserved in public clinics. Previous service as a dentist within the United States armed services, and current service as a teacher within Florida's health educational settings will count toward this period of time.

d. Require that 2 of the 7 Board of Dentistry member dentists to have public health experience. This is to ensure that the Board considers the unique aspects of public health dentistry in decision-making.

3. The Governor's dental package also includes funding to improve access to dental care in Medicaid:

a. Governor Crist has recommended, in his 2008/09 budget, $21.8 million to increase reimbursement fees to dentists by an average of 20 percent.

b. $600,000 is recommended to create a community dental services program for

Medicaid eligible persons with disabilities living in rural areas to utilize existing dental services that are provided through local institutional

facilities.

c. Finally, the Governor has recommended that physicians, physician's assistants, and Advanced Registered Nurse Practitioners be reimbursed by

Medicaid when they provide oral health screenings, parent consultations, fluoride varnish treatments, and dentist referral services to young children

during their Well Child visits. This measure is cost neutral within the existing Medicaid budget.

4.What this bill does NOT do:

a. This bill addresses the provision of care only in public health settings. It does NOT address the private marketplace and will have minimal (if any)

impact on the private practice of dentistry in FL.

b. In other words, if all provisions of this proposal go into effect, FL will still be among the most restrictive states in the nation when it comes to

the practice of dentistry in the private marketplace.

THANK YOU for TAKING ACTION!

Cigarette User Fee Coalition Grows as Bill Awaits Action

March of Dimes, Federation of Physicians and Dentists Become Newest Members

The Healthy Florida Alliance (HFA) is a coalition of more than 25 organizations working to increase Florida’s cigarette user fee by $1.00 per pack. Such an increase in the user fee would both reduce youth smoking by 20% and generate a billion dollars a year to increase health care access and research, particularly for smoking-related illnesses. As a result of the efforts of HFA members, other key stakeholders and particularly sponsors Sen. Ted Deutch and Rep. Jim Waldman, a bill to accomplish exactly that has been filed this Session (HB 299/SB 2790).

As we approach the Session’s midpoint and committee meetings draw to a close, unfortunately, the bill has yet to advance in either the House or the Senate, despite having garnered both Republican and Democratic sponsors. Leaders, however, have rejected the proposal as an unnecessary tax increase. In the Senate, the bill was actually referred to 5 different committees. Governor Crist also has publicly questioned the need to increase the cigarette user fee.

Nevertheless, the cigarette user fee has already been the subject of much discussion this Session, as legislators ponder their options in light of the $3 billion budget shortfall. Articles and editorials have run in several major Florida papers highlighting the need for and benefit of the fee increase. The issue will likely end up as part of the overall budget discussion, so we remain hopeful that the opportunity is not exhausted for this year.

Finally, HFA continues to increase its ranks, recently welcoming both the Florida March of Dimes and Federation of Physicians and Dentists as newest members. We continue to encourage health care organizations and anyone the toll smoking takes on Florida to join the Alliance.

Please help us turn the volume up to expand health care access to Floridians by becoming an HFA partner. To join HFA or for more information on the tobacco tax, visit www.healthyfloridaalliance.org or contact Linda Vaughn at lindav@floridachain.org or 850-294-2285 .

(Submitted by Greg Mellowe, Florida CHAIN)

Reform Expansion May Be Less Likely in ’08, But Automatic in “09?

Rumors have persisted over the past several months that a Medicaid Reform expansion proposal will be introduced in the House this Session, at the urging of House Speaker Marco Rubio and Health Care Council Chair Aaron Bean. Additionally, a number of HMOs in Reform have expressed interest in expanding into Florida’s largest Medicaid market. Florida does not need further permission from the federal government to expand Reform into Miami-Dade.

Last Thursday, the House Health Care Council reviewed its proposed Health and Human Services budget for 2008-09 (please see related article in this issue). In addition to reviewing the proposed funding amounts for health programs, the Council reviewed a draft of the proposed implementing bill, which makes changes to the way programs will operate once whichever cuts are approved take effect. Wedged between the program changes that pertain to next year’s budget is a directive stating that the Medicaid Reform Pilot Program will expand to (i.e., start enrolling consumers in) Miami-Dade and Monroe Counties as of July 1, 2009 AND then will expand to Hillsborough, Pinellas, Polk, Pasco, Manatee, Highlands and Hardee Counties as of July 1, 2010.

Those following the progress of the Reform experiment will note that:

1 No such (or similar) proposal is included within the Senate’s proposed HHS budget.

2. It seems that the expansion of the Reform Pilot is officially “off the table” for NEXT fiscal year (which begins July 1, 2008).

3. Given the acknowledged continuing challenges and concerns with the rollout of Reform that persist, it is unclear why a decision about expansion in 2009-10 and 2010-11 must be made today and not during the 2009 Session. It is also unclear why the requirement to expand the Pilot was made unconditional.

Additionally, in connecting his acknowledgement of concerns about Reform with his longstanding interest in moving expansion forward, Council Chair Rep. Aaron Bean had earlier talked about the need for a significant “reform of Reform”. The fact is, the House proposal tasks AHCA with only a few new and mostly vaguely assigned responsibilities related to Reform. In addition, like the responsibilities already assigned to AHCA, the data isn’t available to assess whether plans are complying. For example, the draft includes requirements that AHCA “monitor” quarterly but “evaluate” only annually the extent to which plans ensure “adequacy of access to health care providers” and ensure that consumers receive “specific information about covered prescription drugs” Reform participants.

By contrast, a proposed Senate bill filed this legislative session by Sen. Evelyn Lynn (SB 1570) includes more than a dozen specific fixes to problems identified by AHCA’s Inspector General last October and would prevent Medicaid Reform from expanding into Miami-Dade County until the many questions are resolved. Opposition in the House will likely doom that bill regardless of how far it advances in the Senate, however.

Budget negotiations will continue at different levels of the House, in the Senate and between the House and Senate as the Session wears on.

Prior to last week’s events, Florida CHAIN had developed an issue brief elaborating on the risks associated with expanding the Medicaid Reform experiment in 2008-09. Most of the issues raised, however, are equally applicable to any final decision made now about expanding Reform in the future.

It is true that the Agency for Health Care Administration (AHCA) has made changes since the Inspector General’s report identified a number of problems and unresolved challenges last October. However, the extent and effect of these changes is unclear, especially because AHCA has never once issued a written response to the IG’s report, and of course because the absence of usable data from which outcomes, cost-effectiveness and access can be evaluated persists. Evaluating Reform at the system level is not just a good idea; it is a fundamental promise made by the architects of Reform.

But beyond this, Reform has yet to deliver on most of its promises, and this can be established using the very limited information already available. Several of those as of yet unfulfilled promises are the focus of the issue brief. For example:

Using the State’s own assumptions, expanding Reform into Miami-Dade won’t save the State much money during the first year (less than $20 million, not even 1% of the State’s budget shortfall). But expansion will make irreversible and risky changes to the Medicaid system.

AHCA won’t have the data needed to analyze plan performance of Reform for some time. Only 4 of 13 HMOs had even started submitting service data from 2007 at last report. In addition, AHCA is in the process of switching over to a completely different Medicaid billing and information system, which won’t even officially launch until July.

Plans continue to be protected from the true impact of full risk adjustment (i.e., paying plans more for enrolling less healthy patients) and it is still not at all clear how well this will work. Even as of last month, plans were paid at rates up to 30% higher than they would have earned otherwise.

Concerns about transparency at the consumer level also remain unresolved. Even simple problems believed to already have been addressed, such as the lack of availability of Preferred Drug Lists on plan websites, are still concerns. Choice counselors can only do so much in an average of 8 minutes with consumers, especially given their lack of medical knowledge.

Despite the fact that consumers have performed more than 600,000 “healthy behaviors” throughout Reform, they have received an average TOTAL benefit of $3 in over-the-counter medications. The lag between earning and receiving the credit is so long that the incentive

In turning to the market for solutions, the State as a purchaser of services not only lacks sufficient information to justify expanding the Reform experiment, the limited information it does have gives rise to serious questions about whether the current effort can achieve its goals within a finite period of time.

(Submitted by Greg Mellowe, Florida CHAIN)

Medicaid Reform Technical Discussion is Really About Access to Care

Earlier in March, the Agency for Health Care Administration (AHCA) held one of its relatively infrequent (the first since December) sets of public meetings seeking feedback on the rollout of Medicaid Reform.

Much of the discussion, although technical in nature and almost completely devoid of any mention of consumers, pertained to one of the most pressing and persistent consumer concerns in Reform: so-called “prior authorizations”. Health plans require providers to obtain prior authorization for the provision of many services and medications as part of their efforts to regulate access to care. The result has been the frequent and inappropriate delay in the provision of medically necessary services. In short, it was a discussion about access to care under Reform.

Physicians, already laboring under the lowest Medicaid reimbursement rates in the southeastern U.S., can scarcely afford to routinely provide services for which they may never be reimbursed, although many regularly do so anyway. And although prior authorizations are universal to Medicaid managed care, they take on far more importance under Reform, because each plan offers its own unique set of benefits and services. What is and is not authorized is different under each.

In response to AHCA’s concerns about the format of the consumer feedback workshops held in November, these meetings were panel discussions facilitated by moderators. The panels were comprised mostly of health plan representatives and AHCA staff, with some providers and no consumers. In order to speak or even ask questions, audience members were required to sign up and wait until the final segment of the meeting.

As with most aspects of the evolution of Reform, little is recounted in writing, but the most progress appears to have been made in behavioral health. Although these changes are promising, they cannot offset the reality that spending on direct behavioral health care under Reform has been reduced by as much as 50%, according to the Florida Council on Behavioral Health, which also instigated the changes.

The meeting agenda also included discussion of billing and payment issues, which is also obviously crucial. Providers are now dealing with as many as 30 different Reform plans, each with its own forms and procedures for requesting prior authorizations and claim payments. One community mental health center reported that the different processes and forms used by the myriad plans increased administrative costs by $100,000 annually, illustrating that market efficiencies are making the provision of care anything but efficient at the provider and consumer level.

In behavioral health at least, forms are in the process of being standardized. In discussing the reasons why extensive efforts were necessary simply to achieve some uniformity in such a basic process, AHCA staff explained their perception that “Reform is an experiment, and we wanted to open it up and see what processes plans would develop.” AHCA admitted that progress will be even slower in the general medical arena, if it comes at all, as there are so many types of diagnoses and procedures.

Even more important than forms and procedures are the actual approaches the plans are using to evaluate requests for prior authorization. Some plans assert that they have improved to make authorization of routine, ongoing services much more of an automatic. Others assert that they are trying not to manage care by restricting access at the front end (when initially requested) but rather trying to weed out “over-use” through utilization review (analyzing what services are being provided to whom). The best that some others seemed to be able to offer is that they “adhere to the required time frames - period.”

The extent to which delays in securing prior authorizations have been reduced cannot be measured, and AHCA apparently still has no plans to measure it, despite the fact that the Inspector General’s report identified this as a problem 6 months ago. As a result, it may never be possible to gauge the impact of inappropriate delays on Reform participants’ health. It’s difficult not to wonder whether the decision to forego tracking these delays was intentional, especially since that data might shed light on how much harm has been caused by the desire to allow plans to push the limits of the Reform experiment.

(Submitted by Greg Mellowe, Florida CHAIN)

Time for Even the Apathetic to Consider Candidates’ Health Care Proposals (1^st in a Series)

Both the need to reform our health care system and the presidential primary elections (along with the economy, which impacts both) are staples of the news coverage of recent months. Only three major-party candidates with serious prospects for nomination remain, and their stories will likely remain plastered on newspaper front pages and TV screens until the field is narrowed to two (likely in August, with Florida’s role unclear). The presidential elections follow in November.

But just in case you’re someone who has managed to strategically avoid those headlines, now is the time to begin to remedy that. Each candidate has presented a general proposal for reforming the way our health care is delivered and regulated. This will be no easy task, given the history of health care reform initiatives in the past.

As a March 26 USA Today article encapsulates: “Each is reacting to a host of problems that are driving up costs for businesses and consumers: a 78% jump in insurance premiums since 2002?; a Medicare system heading for red ink as baby boomers age; and a shrinking percentage of employers offering coverage.” (See: http://www.usatoday.com/news/politics/election2008/2008-03-25-planshealth_N.htm.)

The Kaiser Family Foundation maintains the non-partisan website www.health08.org to highlight the similarities and differences in the three candidates’ positions. Kaiser consultants summarized the key differences in the USA Today article as follows:

The Democratic candidates want to cover all or nearly all people, often by expanding government programs. McCain says worry about costs first and expand coverage later.
McCain and many congressional Republicans would not require anyone to buy insurance or make insurers sell to those with existing medical problems. Democrats would require most, if not all, people to have insurance and insist that insurers sell to everyone who applies.
Republicans would lean more on tax incentives to get people to buy their own insurance and less on coverage through their jobs. Democrats would bolster the current system of employer coverage.”

The Health08 website includes a side-by-side chart comparing the views and proposals of the candidates in more detail. A portion of that chart is excerpted below for informational purposes only. It is the intent of Florida CHAIN to only modify information in the chart due to space limitations. Readers are strongly encouraged to view the full chart at http://www.health08.org/sidebyside.cfm. Florida CHAIN does not endorse or oppose any candidate for elected office.

(Submitted by Greg Mellowe, Florida CHAIN)

	John McCain	Hillary Clinton	Barack Obama
Party Affiliation	Republican	Democrat	Democrat
Overall approach to expanding access to coverage	Remove the favorable tax treatment of employer-sponsored insurance and provide a tax credit to all individuals and families to increase incentives for insurance coverage. Promote insurance competition. Contain costs through payment changes to providers, tort reform and other measures.	Every American required to have coverage, with income-related tax subsidies available to make coverage affordable. Private and public plan options would be available to individuals through a new Health Choices Menu operated through the Federal Employee Health Benefits Program (FEHBP). Coverage through employers and public programs like Medicare continues.	Require all children to have health insurance, and employers to offer employee health benefits or contribute to the cost of the new public program. Create a new public plan, and expand Medicaid and SCHIP. *** Create the National health Insurance Exchange through which small businesses and individuals without access to other public programs or employer-based coverage could enroll in the new public plan or in approved private plans.
Requirement to obtain or offer coverage	No provision. Opposes mandates for coverage.	Individuals must have health insurance coverage. Large employers must provide an employee plan or contribute to the cost of coverage. Most small employers are not required to offer or contribute to coverage costs but are provided incentives to do so.	Require all children to have health insurance. Require employers to offer “meaningful” coverage or contribute a percentage of payroll toward the costs of the public plan.
Expansion of public programs	Give veterans ability to use their VA benefits to pay for timely high quality care from providers in the best locations.	Medicaid and SCHIP safety net strengthened “for the most vulnerable populations” to plug gaps, such as lack of coverage for poor, childless adults.	Expand Medicaid and SCHIP. See *** above. ?Coverage would offer comprehensive benefits?and?would be portable.
Premium subsidies to individuals	Provide a tax credit of $2,500 (individuals) and $5,000 (families) to all ?for the purchase of insurance?	Refundable tax credit to help working families pay for coverage. The value of the credit would be set to ensure that premiums could not exceed a fixed percentage of family income?	Make federal income-related subsidies available to help individuals buy the new public plan or other qualified insurance.
Premium subsidies to employers	No provision.	Refundable small business tax credit to provide an incentive to offer employee coverage. (High-income small businesses would not qualify.)?	Federal subsidies would partially reimburse employers for their catastrophic health care costs if the employers guaranteed that? [the money] would be used to reduce employee premiums.
Changes to private insurance	Promote competition and individual choice of insurance by allowing insurance to be sold across state lines. Encourage innovative multi-year insurance products. Allow small businesses and self-employed to purchase insurance through any organization or association. Such entities would have to meet rigorous standards and certification. Coverage would be portable and would bridge the time between retirement and Medicare eligibility.	Require private insurers to provide coverage on a guaranteed issue and guaranteed renewable basis. Prohibit insurers from “carving out benefits” or charging higher rates to people with health problems or who are at risk of developing them. Limit premium variations on basis of age, gender or occupation. Require insurers to meet minimum loss ratio (including limiting marketing costs) and “ensure high value for every premium dollar.” Require all insurers that participate in federal programs to cover preventive services? and promote chronic disease management.	Prohibit insurers from denying coverage based on pre-existing conditions. Children up to age 25 could continue family coverage through their parents’ plan. In market areas where there is not enough competition, require insurers to pay out a “reasonable share” of premiums on patient care benefits. Prevent insurers from abusing monopoly power through unjustified price increases. Require health plans to disclose the percentage of their premiums that actually goes to paying for patient care as opposed to administrative costs

TAKE ACTION: Bill Filed for Medicaid Buy In!

Great News for advocates of persons with disabilities! The Work Incentive Medicaid Coverage Initiative is trying to change Florida law to allow people with disabilities to go back to work with less fear of losing their Medicaid coverage. 39 other states already do this!

Reps. Reed and Sachs are co-sponsors in the House and Senator Crist is the sponsor in the Senate. The bill is called Optional Payments for Medical Assistance and is HB 1311 and SB 2684.

A bill has been filed and we need your help calling members of the committees that are scheduled to hear it.

Contact your representatives below. If you only have time for two calls, call the chairs and ask them to schedule SB 2684 and HB 1311 in their committees. Be sure to tell them any relevant personal experiences that show how important it is to schedule and pass this bill:

Senator M. Mandy Dawson (850) 487-5112

Chair of Senate Health Policy Committee

Rep. Bean, Aaron (850) 488-6920

Chair of the House Health Care Council

Senate Health Policy Committee

Chair: Senator M. Mandy Dawson

Vice Chair: Senator Victor D. Crist

Senator Charles S. "Charlie" Dean, Sr.

Senator Paula Dockery

Senator Rudy Garcia

Senator Arthenia L. Joyner

Senator Burt L. Saunders

House of Representatives Health Care Council

Chair: Bean, Aaron

Vice Chair: Zapata, Juan

Background on Work Incentive Medicaid Coverage Initiative

This advocacy effort is coordinated by a statewide Partnership for Work and Healthcare consisting of over 30 organizations. Learn more about this "Medicaid Buy In" program at: www.partnershipforwork.com and sign in for updates.

The website provides talking points for meeting with legislators, sample letters to the editor, and other advocacy and educational materials. The proposed changes would increase the income and asset limits for persons on SSI or SSDI so they can go to work, make a living wage and still keep their health insurance.

Here are the elements suggested by the Partnership:

1) Unearned income would be capped and tied to existing Medicaid requirements to help control start-up costs.

2) Cash assets of $10,000 (individual) and $12,000 (married couple) would be excluded, as would IRS-recognized retirement accounts. Participants could be charged premiums of up to 7.5 percent of their income if their earned income exceeds the poverty level. The increased cost to the state for this program is low, since many proposed participants are already receiving Medicaid.

For more information, contact Barbara Butz, Capstone Consulting at 850-421-6605 , email capstonebarbara@aol.com, or go to http://www.partnershipforwork.com

(Submitted by Partnership for Work & Healthcare)

TAKE ACTION: Legislators Can Provide Mental Health Fairness in Coverage NOW

The more than 3 million Florida citizens who have common, treatable mental health problems need fairness in medical insurance. Over the years, 46 other states have enacted legislation to protect insurance coverage rights for those with mental illness.

The US House and US Senate bills of the 2008 Congress both support insurance fairness, but differ greatly in content. This makes it very unlikely that a federal mandate will be signed into law by our President this year. The legislation will have to start all over next year.

Help is urgently needed to see that Florida’s 2008 legislative session passes legislation that will bring fairness to Florida’s medical insurance.

If Florida House Healthcare Council Chair Rep. Bean does not quickly put FL House Bill 19 on his Healthcare Council’s agenda, the often repeated “excuse” will be “we ran out of time.”

In reality, big insurance businesses have for years blocked this legislation in Florida. They mistakenly fear an increase in overall patient costs and a decrease in their profits. They mislead small businesses into fearing this needed reform.

The many states that have passed fairness legislation have found that healthier, more productive workers actually save their employers’ money, job terminations, expensive replacements, decrease mistakes, and reduce absenteeism. A health workplace is cost effective.

Please contact Representative Bean and the Healthcare Council (below), and your local lawmakers. Tell them you support FL House bill 19 / FL Senate Bill 164. It is a matter of health, safety, and justice.

The message:

Dear Rep. ___________:

Florida will be healthier and wealthier when citizens with mental illness can promptly seek needed mental health treatment. Delays in mental illness recognition cause many citizens to turn to substance abuse, to end up losing their jobs, to become divorced or to lose their children, to end up in jail or prisons, or to attempt suicides. Far too many residents (including teens and young adults at particular risk) die by suicide each year.

The tragedies listed are all linked by national reports to untreated mental illnesses. When insurance policies do not fairly pay for needed mental health coverage, everybody loses. Money is wasted on jails and prisons. Many become unnecessarily disabled – instead of remaining taxpaying citizens. Families are destroyed. Intoxicated drivers place us all at risk.

Please support House Bill 19 – fairness in medical insurance for those with mental illnesses. Florida just cannot afford the tragic waste of lives and money.

Red lights are a “mandate,” and we are all better off for them.

Thank you for taking a courageous stand as a true Florida leader.

Sincerely,

______________

The Healthcare Council members are:

Chair: Bean, Aaron P.

(Submitted by Angela D. Vickers, JD,
Mental Health Advocate & Educator

Dying for Coverage in Florida - New Study on the Danger of Being Uninsured

More than six people die each day in Florida because they do not have health insurance.

That’s just one finding from a new Families USA report, Dying for Coverage in Florida.

Click here to read the report

The report is the first-ever state-specific report of its type, and is based on a ground-breaking national study by the Institute of Medicine, which in 2002 forged the direct link between a lack of health coverage and deaths from health-related causes.

The report also finds that:

Between 2000 and 2006, the estimated number of adults between the ages of 25 and 64 in Florida who died because they did not have health insurance was more than 13,600.
Across the United States, in 2006, twice as many people in that same age category died from a lack of health insurance as died from homicide.

Click here to read the report

Click here to read the press release from Families USA.

In its 2002 report, the Institute of Medicine estimated that 18,000 adults nationwide died in 2000 because they did not have health insurance. That estimate was later updated by the Urban Institute, which reported that at least 22,000 adults died in 2006 due to a lack of health insurance.

(Thanks to Families USA for the report and this notice)

FOCUS on KidCare

Campaigning to Better Serve Families

FOCUS (Federation of Congregations United to Serve) had a great meeting February 25 at St. Andrew’s Catholic Church with State Sen. Gary Siplin (D), Rep. Bryan Nelson (R), and Rep. Geraldine Thompson (D) regarding Florida's children's health insurance program—KidCare.

Youth leaders in support of KidCare

158 people attended, with great participation from new youth leaders at St. Andrew’s (see photo).

Leaders from St. Andrew's found that Florida KidCare is an effective program for families who are not offered insurance through their employer or who cannot afford it.

However, KidCare reform is needed so that families can get insurance and keep it. Families shared testimony about having their applications lost in the system, losing coverage, and receiving contradictory information from state offices. One family described getting an acceptance letter one week, and an expiration notice the next week, since approval had taken so long. One pediatrician gave testimony that she has told patients to travel back to New York to get treatment - because the child would suffer in Florida waiting for coverage.

Leaders have asked for:

more and better outreach efforts;
a simpler application process;
seamless transition between programs that cover kids of different age groups; and
continuous coverage through transitions.

Siplin, Thompson and Nelson committed to making KidCare reform a priority this legislative session and to assisting FOCUS leaders with meetings in Tallahassee. Leaders are planning a trip to Tallahassee during the legislative session at the end of March to meet with leaders and legislators who can influence the passage of reform legislation.

Thanks for your support.

Peter Phillips

Executive Director, FOCUS

142 E. Jackson St.

Orlando, FL 32801

407-849-5031

407-849-5033 (fax)

407-924-8906 (cell)

www.focusorlando.org

State Events
     North Florida
     Central Florida
     East Central Florida
     West Central Florida
     Southwest Florida
     Southeast Florida
     Florida Audio and Web Events
     Statewide Notices

National Events
Conferences
National Audio and Web Events

National Notices

National Campaigns

STATE EVENTS & NOTICES

NORTH FLORIDA

13th Annual Children's Week (2008)
March 29-April 6 Tallahassee
In addition, local events and activities will take place throughout the state Feb-April. Contact jason@childrensweek.org

Florida Children and Youth Cabinet Meeting

April 1 10:00 am - 5:00pm

State Capitol Cabinet Room, Lower Level, The Capitol, Tallahassee

Scheduled to coincide with the 2008 Florida State Legislative Session Children’s Week and the "Kids Only" Town Hall Meeting. If you would like to speak, get a form from: jennifer.stan@eog.myflorida.com

Florida Children and Youth Cabinet Meeting

May 19 9:00 am – 4:00 pm

UNF University Center, Rm 1058, 12000 Alumni Drive, Jacksonville

Notices

CENTRAL FLORIDA

Notice of Public Meeting on Senior Care

March 31 1:00-3:00 pm (EST) Dr. Nelson Ying Center, 1940 Traylor Blvd, Orlando

The Agency for Health Care Administration, in conjunction with the Department of Elder Affairs, announces the following public meeting to which all interested persons are invited: Section 409.912(5), Florida Statutes provides authorization for the Agency for Health Care Administration, in partnership with the Department of Elder Affairs, to implement an integrated, fixed-payment delivery program for Medicaid beneficiaries who are 60 years of age or older, or 21 years of age or older and dually eligible for Medicare and Medicaid. The program shall be implemented initially on a pilot basis in Brevard, Orange, Osceola and Seminole counties; and Miami-Dade and Monroe counties. Enrollment in Florida Senior Care shall be on a voluntary basis. The primary purpose of this meeting is to educate Medicaid service providers about Florida Senior Care. An overview of the program will be provided, as well as opportunity for public comment and questions. Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this meeting is asked to advise the Agency at least seven (7) days before the meeting by contacting: (850) 487-2618 . E-mail: managediltc@ahca.myflorida.com. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice). The Florida Senior Care website has been updated to reflect the addition of new Frequently Asked Questions (FAQs) and an upcoming public meeting. Please visit the Florida Senior Care website at or go to www.ahca.myflorida.com and click on the Florida Senior Care banner for more information.

2008 Florida Conference on Aging

Aug 11 -14 Orlando Resort at SeaWorld

Call (850) 222-8877 for more information

EAST CENTRAL FLORIDA

WEST CENTRAL FLORIDA

2008 10-day Florida Benefits Information Resource Network (F-BIRN)Training

First 3 days: April 15, 16, 17

Second 3 days: May 13, 14, 15

Last session (4 days): June 9, 10, 11, 12

Safety Harbor Resort, Safety Harbor (on the west bank of Tampa Bay)

The Partnership for Work and Healthcare is providing this training because too many people with disabilities either do not work or limit the number of hours they work, for fear of losing health care coverage. APD is announcing the third 10-day training session on The Changing Face of Benefits: Knowledge for Successful Employment! Presented by Sharon Brent of the National Disability Institute. This training will save staff time, by connecting you or your staff with knowledgeable benefits planners and other professionals who are certified to assist people with disabilities work AND maintain their benefits. If you support people with disabilities working, then you or someone on your staff needs to be a part of this training. Training is free. APD hotel rate is $89/night. Call: 850.488.9546 , 1.866.APD.CARES or 1.866.273.2273 .

Cancer, Culture & Literacy: 6th Biennial Conference
May 15-17 Sheraton Sand Key, Clearwater Beach
H. Lee Moffitt Cancer Center & Research Institute and the University of South Florida are proud to sponsor the sixth biennial Cancer, Culture & Literacy conference, to be held at the Sheraton Sand Key Resort, May 15-17, 2008. This conference provides a national forum for the exchange and dissemination of important information covering current research and education in the area of cancer, culture and literacy.

One Goal: Building the Future Together “Putting Families and Children First”

Proposal deadline: April 2

July 16-18 Hyatt Regency at Tampa City Center

This conference brings together early education and care providers and leaders from around the state to share innovative programs, practices and techniques for improving services and outcomes for all Florida’s children. Includes general sessions, concurrent presentations, and exhibits of appropriate materials. Presenter Proposal Form is on the website. The previous conference “Providing Childcare For Children With Disabilities And Special Health Care Needs” coordinated by the Florida Inclusion Advisory Council is now fully integrated with the One Goal Summer Conference. Registration fee of $45 waived for primary presenter only. Contact: 850/893-6270 or frankieallen_2000@yahoo.com.

SOUTHWEST FLORIDA

SOUTHEAST FLORIDA

Events

Worksite Forum: Worksite Wellness at the Broward Public Schools

April 2 2:00 pm Department of Health Beacon Center, 8323 NW 12th Street, Suite 212, Miami
The Worksite Wellness Committee of the Consortium for a Healthier Miami-Dade will present its next monthly Worksite Wellness Forum. Speakers will be Tina Severance and Liza Morandi, who lead the Wellness Program of the School Board of Broward County, which seeks to improve the psychological, mental and physical well being of its employees through education, health screenings and encouragement of healthy lifestyles. Complimentary Wellness Seminars and screenings are provided on a variety of personal topics that can be requested by calling the Wellness Coordinator. Tina and Liza and will provide us with an overview of how the program started, how it has developed, how it operates and the benefits it has provided to employees and to the
employer. For further info, call 305-577-4270 .

Budget Cuts and Children's Services: Your Input is Crucial

April 5 8:30 am - 1:00 pm Sheridan Vocational School, 5400 Sheridan St, Hollywood

You are invited to participate in a Budget Summit on Services for Children and Families to address the challenges presented by the needs for budget cuts at every level of government. The economic downturn, coupled with the passage of Amendment 1, means less government money even as the demand for services is guaranteed to increase. In order to minimize the impact on children and families, the major funders of children's services (CSC, CSB, SBBC, DCF, APD, ChildNet and United Way) in Broward want to hear from you. The day will start with an overview of economic indicators. Participants will then use the Children's Strategic Plan as an organizing tool to prioritize goals and objectives to provide guidance to policymakers. For more information, please call 954-377-1000 . To RSVP your participation, please register on the Broward Training Collaborative site: training.cscbroward.org no later than April 2.

Day of relaxation and resource gathering for cancer caregivers (family & friends)

April 5 10:00 am-2:00 pm Jungle Island, Miami

Featuring: resource tables, humor for healing presentation, nutrition workshops, Reiki presentation & demo, Yoga or Tai-Chi or chair massage (working on this) child-life specialists, AND post-event admission to the park. Contact: GBrown@aptiumoncology.com and amparo@twcmiami.org

24^th Annual Haitian American Nurses Association of Florida, Inc. (HANA) Gala

April 8 7:00 pm – 2:00 am J.W. Marriott Hotel, Miami

In celebrating 24 years of Community Service, the Haitian American Nurses Association of Florida, Inc. (HANA) extend this special invitation for you, your colleagues, friends and family to celebrate with all its members at the Annual Scholarship Fundraising and Awards Gala. This year's theme is "Caring for Self and the Environment." Music by Kreyol La. HANA is a 501c3 not-for profit organization, for more information HANA's activities, please browse through the website at hana84.org. We look forward for your support and your contribution. If you wish to advertise in the program booklet for the gala, please see the attached sponsorship package and invitation. To RSVP (by April 8) or find out about sponsorship opportunities, e-mail info@hana84.org or call 305-609-7498 .

Well Being/Being Well Conference

April 22 Miami Intercontinental Hotel

The UM/Sylvester Comprehensive Cancer Center has opened online registration for the Well Being/Being Well conference. Deepak Chopra and Shalala are keynote speakers. Choose from many breakout sessions to learn the latest about topics like genetics, cancer prevention, and clinical trials, to the power of mind over matter and men’s and women’s health from top physicians and scientists. Registration $100. Contact UM/Sylvester at 305-243-9949

United Against HIV: A Teen & Family Summit

April 26 9:30 am-3:00 pm Boynton Beach High School

This family event is geared to empower our community, families and youth to unite together to understand the importance of preventing HIV/AIDS, to know what resources are available to the community to be tested and educated, as well as how to be an advocate for this disease in your community. Presented by Sylvester HIV/AIDS Consortium.

Notices

FLORIDA AUDIO CONFERENCES AND WEBCAST

STATEWIDE NOTICES

Children's Week wants to partner with you!
This year, Children's Week partners are collaborating and taking the lead in organizing local advocacy events in each of Florida's 67 counties during February, March and April designed to promote the health, safety, and well-being of children and families in Florida. Thanks to successful partnerships with Comcast, Nemours, Publix Super Markets Charities, Florida Department of Health’s Step Up, Florida! program, Prevent Child Abuse Florida’s Winds of Change Campaign, the Association of Early Learning Coalitions, over 70 other leading non-profit and corporate organizations, and hundreds of local organizations statewide – Children’s Week will host tons of events and activities throughout the state this year. If you would like to help coordinate an event or activity in your area, or are already coordinating a Children's Week event, write jason@childrensweek.org

NATIONAL EVENTS & NOTICES

CONFERENCES AND EVENTS

Active Living Research Conference Seeks Abstracts

April 9-12 Washington DC

The theme of this year's conference is "Connecting Active Living Research to Policy Solutions." Abstracts on all topics related to active living policies and environments are welcome. In addition to policy-relevant research, Active Living Research welcomes abstracts about children and adolescents at greatest risk for obesity—African-American, Latino, Native American, Asian-American and Pacific Islander children and adolescents living in low-income communities.

Promote optimum health for Black women - physically, mentally and spiritually

Presentation Submission Deadline: April 11

Conference: June 19-21 Washington, DC

The Black Women's Health Imperative’s 25th anniversary event to celebrate 25 years of creating a lasting legacy of health and wellness for Black women. Topics include: Self-Help SisterCircle;, Program Tracks on Obesity, HIV and Mental Health; Walking for Wellness; Health Screenings and Physical Fitness Activities; Entertainment and family activities. Online registration begins January 7.

National Hispanic Medical Association 12th Annual Conference
April 17-20 Washington, DC
Policy, research, medical and clinical presentations focused on improving the health of Hispanics. Conference Goals are to: provide clinical updates on diabetes, cancer, HIV/AIDs, obesity, cardiovascular disease, asthma, Alzheimer’s disease, and renal disease; increase awareness about cultural competence, literacy, language services and medical care delivery to Hispanics; increase knowledge about Federal and State health policies that impact Hispanics; develop skills for health professionals in academic medicine, research, private sector and government; and make recommendations targeted at Hispanics for the national health policy agenda in the U.S. Expected: 100 Exhibitors; 200 Hispanic Medical Students; 700 Physicians; 140 Speakers/panelist/keynote speakers.

What's the Use of Race?
April 25-26

Center for the Study of Diversity in Science, Technology, and Medicine, Massachusetts Institute of Technology, Cambridge, MA

Annual Breast Cancer Advocacy Training Conference & Lobby Day

April 26-29 Washington, DC

Join the Florida Delegation at the Annual Breast Cancer Advocacy Training Conference & Lobby Day, with Florida Breast Cancer Coalition Research Foundation. RSVP intent to attend and T-shirt size by April 4 to: FBCCRF at ceo@fbccrf.org or 1-877-644-FBCC (3222)

Race and Class Inequalities in Health

Conference: June 24-27 Hyatt Regency Chicago

Society for Epidemiologic Research annual meeting

Making an Impact: Evidence-Based Community Benefit

July 15-16 St. Louis

Co-sponsored by the Catholic Health Association of the United States (CHA) and VHA Inc., in cooperation with the School of Public Health at Saint Louis University, this first-time program offering will introduce new public health evidence-based tools and knowledge to health care practitioners in order to enhance the effectiveness of community benefit programs and thus the overall health of communities.

Becoming the Healthiest Nation in a Healthier World

Conference: Sept 9-12 Sacramento, CA

This annual National Association of County and City Health Officials (NACCHO) conference will be the year's largest gathering of state and local public health officials in the United States, jointly sponsored with Association of State and Territorial Health Officials (ASTHO).

Sixth National Conference on Quality Health Care for Culturally Diverse Populations

Sept 21-24 Minneapolis

Held biennially since 1998, this is one of the most respected and well supported events on cultural competence and health disparities reduction in the United States. It is co-produced by Drexel University School of Public Health's Center for Health Equality, Resources for Cross Cultural Health Care, and the USDHHS Office of Minority Health Care. This year's theme is "Partnerships for the Future: Supporting Practitioners and Advancing the Field through Innovation, Policy and Research."

AUDIO AND WEB EVENTS

ACHI Audio-conference—Registration is now open

Local Health Care Access Initiatives: Key Factors for Success

April 15

Effective Product/Market Positioning Strategy: Using Health Status Assessment and Community Health Improvement to Enhance Your Bottom Line
May 15

NOTICES

Nominations for Robert F. Allen Symbol of H.O.P.E. Award

Deadline: April 25

Presented annually by the American Journal of Health Promotion, the Robert F. Allen Symbol of H.O.P.E. (Helping Other People Through Empowerment) Award honors individuals who have worked to promote cultural diversity within health promotion or who have demonstrated significant achievement in serving the health promotion needs of underserved populations.

CAMPAIGNS & INITIATIVES

Get Ready for Cover the Uninsured Week 2008

April 27-May 3

Forty-seven million Americans, including more than 9 million children, are living without health care coverage. It's time to start planning for the sixth annual Cover the Uninsured Week and help get America covered. There are many ways for you and your community to get involved in Cover the Uninsured Week 2008: Host an enrollment event at a hospital, community center or school; Organize a health coverage forum with community, business and faith leaders; Plan a seminar for small business owners; Distribute information about available low-cost and free health coverage programs to uninsured individuals and families.

Get involved with Cover the Uninsured Week and join thousands of others working together to help make health coverage for the uninsured a top priority.

Tell What You're Doing: Publicize your events and activities by adding them to our Event Map. Visit our Event Planning Center to sign up as an event planner and register your events today.

Plan an Event: Speak out on behalf of our nation's uninsured. There are many ways you can help:

Host an enrollment event at a hospital, community center or school
Organize a health coverage forum with community, business and faith leaders
Plan a seminar for small business owners
Distribute information about available low-cost and free health coverage programs to uninsured individuals and families

Free Materials Available: Use the free guides and toolkits to help you get started! Myths and Facts on the Uninsured. Too many people have misconceptions about the uninsured in America. Share our fact sheet to help educate leaders in your community. Free bookmarks, lapel stickers and promotional fans are available to help you promote the importance and availability of health care coverage. Place your order today! Download and share your state’s Guide to Finding Health Coverage at your event.

2008

April

Cancer Control Month
American Cancer Society
www.cancer.org

National Autism Awareness Month
Autism Society of America
mcolston@autism-society.org
www.autism-society.org

National Public Health Week – April 7-13
American Public Health Association
Kaitlin.Sheedy@apha.org
www.nphw.org

National Infant Immunization Week – April 19-26
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention
cdcinfo@cdc.gov
www.cdc.gov/vaccines/events/niiw/default.htm

2008 March for Babies – April 26-27
March of Dimes
marchforbabies@marchofdimes.com
www.marchforbabies.org

May

American Stroke Month
American Heart Association
inquires@heart.org
www.americanheart.org

Asthma and Allergy Awareness Month
Asthma and Allergy Foundation of America
info@aafa.org
www.aafa.org

Healthy Vision Month
National Eye Institute, National Institutes of Health
www.healthyvision2010.nei.nih.gov

Hepatitis Awareness Month
Hepatitis Foundation International
hfi@comcast.net
www.hepfi.org

Melanoma/Skin Cancer Detection and Prevention Month
American Academy of Dermatology
mediarelations@aad.org
www.aad.org

Mental Health Month
Mental Health America
infoctr@mentalhealthamerica.net
www.mentalhealthamerica.net

National High Blood Pressure Education Month
National Heart, Lung, and Blood Institute Health Information Center
nhlbiinfo@nhlbi.nih.gov
hin.nhlbi.nih.gov/nhbpep_kit/
www.ctf.org

National Women's Health Week - May 11-17
Office on Women's Health
U.S. Department of Health and Human Services
www.womenshealth.gov/whw

National Women's Check-up Day – May 12
Office on Women's Health
U.S. Department of Health and Human Services
www.womenshealth.gov

June

National Headache Awareness Week – June 1-7
National Headache Foundation
info@headaches.org
www.headaches.org

National Men's Health Week - June 9-15
Men’s Health Network
info@menshealthweek.org
www.menshealthweek.org

July

UV Safety Month
American Academy of Ophtalmology
eyemd@aao.org
www.aao.org/eyemd

August

Children's Eye Health and Safety Month
Prevent Blindness America
info@preventblindness.org
www.preventblindness.org

National Immunization Awareness Month
Centers for Disease Control
http://www.cdc.gov/vaccines/events/niam/default.htm

September

Healthy Aging® Month
Educational Television Network, Inc.
info@healthyaging.net
www.healthyaging.net/agingevents.htm

National Cholesterol Education Month
National Heart, Lung, and Blood Institute Health Information Center
nhlbiinfo@nhlbi.nih.gov
hin.nhlbi.nih.gov/cholmonth

National Pediculosis Prevention Month/ Head Lice Prevention Month
National Pediculosis Association, Inc.
npa@headlice.org
www.headlice.org

Ovarian Cancer Awareness Month
National Ovarian Cancer Coalition
nocc@ovarian.org
www.ovarian.org

Prostate Cancer Awareness Month
National Prostate Cancer Coalition
info@fightprostatecancer.org
www.fightprostatecancer.org

National Suicide Prevention Week – September 7-13
American Association of Suicidology
info@suicidology.org
www.suicidology.org

October

"Talk About Prescriptions" Month
National Council on Patient Information and Education
4915 Saint Elmo Avenue, Suite 505
Bethesda, MD 20814-6082
(301) 656-8565
(301) 656-4464 Fax
ncpie@ncpie.info
www.talkaboutrx.org

Healthy Lung Month
American Lung Association
info@lungusa.org
www.lungusa.org

Let's Talk Month
Advocates for Youth
tom@advocatesforyouth.org
www.advocatesforyouth.org

National Dental Hygiene Month
American Dental Hygienists' Association
media@adha.net
www.adha.org

National Domestic Violence Awareness Month
Domestic Violence Awareness Project
National Resource Center on Domestic Violence
ck@pcadv.org
dvam.vawnet.org

National Mammography Day – October 17

American Cancer Society
www.cancer.org

National Health Education Week – October 20 - 24
National Center for Health Education
ray@nche.org
www.nche.org

November

American Diabetes Month
American Diabetes Association
askada@diabetes.org
www.diabetes.org

Lung Cancer Awareness Month
Lung Cancer Alliance
info@lungcanceralliance.org
www.lungcanceralliance.org

National Alzheimer's Disease Awareness Month
Alzheimer's Association
info@alz.org
www.alz.org

National Hospice Palliative Care Month
National Hospice and Palliative Care Organization
jradulovic@nhpco.org
www.nhpco.org

Pancreatic Cancer Awareness Month
Pancreatic Cancer Action Network
information@pancan.org
www.pancan.org

Great American Smokeout – November 20
American Cancer Society
www.cancer.org

Gastroesophageal Reflux Disease Awareness Week – Nov 25-Dec 1
International Foundation for Functional Gastrointestinal Disorders
iffgd@iffgd.org
www.aboutgerd.org

December

World AIDS Day – December 1
Joint United Nations Programme on HIV/AIDS
unaids@unaids.org
www.unaids.org/en/default.asp

New listings, in order of submission deadlines

GE Healthcare Charitable Giving Program

Deadlines: Feb 1, May 1, Aug 1, Nov 1
The GE Healthcare Charitable Giving Program provides support to nonprofit organizations in the United States that focus on youth education and/or promote healthy lives. For the Youth Education grant category, the focus is on underserved communities with low graduation rates; core competencies (math, science, reading, writing); arts in education; and early childhood development programs. For the Healthy Lives grant category, the focus is on childhood obesity; women’s healthcare; and cancer, heart disease, and diabetes prevention and education programs. An application eligibility quiz is available on the website listed above.

Elimination of Health Disparities through Translation Research (R18) (RFA-CD-08-001)

Deadline: May 2

This funding opportunity announcement (FOA) encourages applicants to submit research grant applications that accelerate the translation of research findings into public health practice through implementation, dissemination, and diffusion research within health disparity populations.

Educational Foundation of America

Rolling Acceptance
The mission of the Educational Foundation of America is to improve individual lives and surroundings through education and awareness, in hopes of bettering humanity and the world we inhabit. The Foundation provides grants to progressive nonprofit organizations throughout the United States that offer specific programs with broad impact. The Foundation’s areas of interest include, but are not limited to, the environment, reproductive freedom, theatre, education, medicine, drug policy reform, democracy, peace and national security issues, and human services. Online letters of inquiry are accepted at any time through the website listed above.

Continuing listings, in order of submission deadlines

Innovating Worthy Projects Foundation
Requests are accepted from Jan 1 through Aug 31
The Innovating Worthy Projects Foundation provides support to nonprofit organizations throughout the United States that are dedicated to providing direct care or services for children with special needs, acute illnesses, or chronic disabilities. Preference is given to small organizations that might not otherwise be helped. Grants support new ideas and approaches to providing services as well as equipment purchases.

Advancing technology to improve healthcare sevices: Verizon Foundation

Applications accepted: Jan 1 through Nov 30
The mission of the Verizon Foundation is to improve education, literacy, family safety, and healthcare by addressing Verizon's commitment to deliver technology that touches life. The Foundation supports nonprofit organizations that benefit communities in the locations the company serves within the United States. One of the Foundation’s priority categories is Education and Literacy, with emphasis on innovative, technology-based approaches to literacy and K-12 education. In addition, through the Safety and Health category, the Foundation supports initiatives that contribute to the safety and well-being of families, with emphasis on domestic violence prevention and technology for healthcare and healthcare accessibility.

The Humana Foundation
Proposals accepted: Nov 1-June 15

The Humana Foundation supports nonprofit organizations in communities where the company has facilities in states including Florida. The Foundation is committed to serving the needs of children, families, and seniors in their quest to build healthier lives and communities. Special consideration is given to proposals that focus on the following areas: health and fitness efforts that lead to better lifestyles; literacy activities that lead to improved health experiences; and the development of technology, tools, and resources that lead to healthy communities.

Foster G. McGaw Prize to Honor Health Delivery Organizations for Community Service

Deadline: April 4

The Baxter International Foundation, the Cardinal Health Foundation, and the American Hospital Association invite applications for the 2008 Foster G. McGaw Prize. The prize honors health-delivery organizations (hospitals, health systems, integrated networks, or self-defined community partnerships) that have demonstrated exceptional commitment to community service.

Nominations for Robert F. Allen Symbol of H.O.P.E. Award
Deadline: April 25
Presented annually by the American Journal of Health Promotion, the Robert F. Allen Symbol of H.O.P.E. (Helping Other People Through Empowerment) Award honors individuals who have worked to promote cultural diversity within health promotion or who have demonstrated significant achievement in serving the health promotion needs of underserved populations.

Robert Wood Johnson Foundation Local Funding Partnerships

Application Deadline: July 8

Robert Wood Johnson Foundation Local Funding Partnerships (LFP) forge relationships between RWJF and local grantmakers to fund promising, original projects that can significantly improve the health of vulnerable people in their communities. Local grantmakers propose a funding partnership by nominating community initiatives that offer creative solutions to critical health or health care problems.

Public Welfare Foundation Social Change Programs Funded

Full proposal deadline: Aug 1

Letters of inquiry should be submitted at least six weeks before the deadline
The Public Welfare Foundation supports efforts to ensure fundamental rights and opportunities for people in need. The Foundation looks for carefully defined points where funds can make a difference in bringing about systemic changes that can improve the lives of countless people throughout the United States. The Foundation's 2008 funding priorities include Health Reform.

Blue Foundation for a Healthy Florida Announces Deadlines for 2008

Sept 12 (Winter Cycle)

The Blue Foundation board of directors has identified community-based health clinics and outreach services as a priority focus for the foundation's grantmaking. The greatest percentage of the Blue Foundation funding will be to identify, nurture, and sustain such activities to benefit uninsured and underserved population.

Research on Social Work Practice and Concepts in Health (R03)

Closing date for applications: May 7, 2009, Multiple deadlines

This funding opportunity announcement (FOA) issued by the Office of Behavioral and Social Sciences Research solicits Small Research Grant (R03) applications from organizations/institutions that propose to develop empirical research on social work practice, concepts, and theory as these relate to the NIH public health goal of improving health outcomes for persons with medical and behavioral disorders and conditions.

Planning Grant for Oral Health Promotion across the Life Span (R21)
Closing date for applications: May 7, 2010, Multiple deadlines
This funding opportunity announcement (FOA) is intended to encourage and support meritorious oral health promotion research directed at improving oral health and preventing diseases and/or their sequelae across the lifespan.

Community Participation Research Targeting the Medically Underserved (R01)
Expiration Date: May 15, 2010
The ultimate goal of this Funding Opportunity Announcement (FOA) with a special review issued by the Office of Behavioral and Social Sciences Research (OBSSR), National Institutes of Health (NIH) is to solicit Research Project Grant (R01) applications that propose research on health promotion, disease prevention, and health disparities that is jointly conducted by communities and researchers and targets medically underserved areas (MUAs) and medically underserved populations (MUPs) as defined by the Department of Health and Human Services (DHHS) Health Resources and Services Administration (HRSA).

Community Participation Research Targeting the Medically Underserved (R21)
Expiration Date: May 15, 2010
The ultimate goal of this Funding Opportunity Announcement (FOA) issued by the Office of Behavioral and Social Sciences Research (OBSSR), National Institutes of Health (NIH) is to solicit Exploratory/Developmental (R21) grant applications that propose research on health promotion, disease prevention, and health disparities that is jointly conducted by communities and researchers and targets medically underserved areas (MUAs) and medically underserved populations (MUPs) as defined by the Department of Health and Human Services (DHHS) Health Resources and Services Administration (HRSA).

Community Participation in Research (R01)
Expiration Date: May 8, 2011
This Funding Opportunity Announcement (FOA) issued by the Office of Behavioral and Social Sciences Research (OBSSR), National Institutes of Health (NIH) solicits R01 grant applications that propose intervention research on health promotion, disease prevention, and health disparities that communities and researchers jointly conduct.

The Effect of Racial and Ethnic Discrimination/Bias on Health Care Delivery (R01)

The Effect of Racial and Ethnic Discrimination/Bias on Health Care Delivery (R21)

The Effect of Racial and Ethnic Discrimination/Bias on Health Care Delivery (R03)

Expiration Date: May 8, 2011

Grant applications are encouraged from institutions/ organizations that propose to: (1) improve the measurement of racial /ethnic discrimination in health care delivery systems through improved instrumentation, data collection, and statistical/analytical techniques; (2) to enhance understanding of the influence of racial/ethnic discrimination in health care delivery and its association with disparities in disease incidence, treatment, and outcomes among disadvantaged racial/ethnic minority groups; and (3) to reduce the prevalence of racial/ethnic health disparities through the development of interventions to reduce the influence of racial/ethnic discrimination on health care delivery systems in the United States.

American Foundation for Suicide Prevention

Deadlines: June 15

AFSP will now accept and review applications for all categories of one- or two-year research grants and fellowships two times a year. The grant amounts for Standard Research Grants are now: max. $60,000 to $75,000; Young Investigator Grants max. $70,000 to $85,000); Pilot Grants max. $20,000 to $30,000). Distinguished Investigator Grants and Postdoctoral Research Fellowships remain at $100,000. AFSP research grants support studies that aim to increase understanding of the causes of suicide and factors related to suicide risk, or to test treatments and other interventions designed to prevent suicide. Investigators from all academic disciplines are eligible to apply, and both basic science and applied research projects will be considered.

Tobacco Prevention and Control
The National Association of County and City Health Officials is working to identify public health-related funding resources. October 2007’s guide features foundations that have listed Tobacco as a focus area. Click above to be directed to Florida's page.

Structural Interventions, Alcohol Use, and Risk of HIV/AIDS (R21)
Multiple deadlines
This Funding Opportunity Announcement (FOA) issued by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health, solicits Exploratory/Developmental Research Grant (R21) applications from institutions/ organizations that propose to investigate the effectiveness of structural interventions that reduce the risk of HIV/AIDS transmission by changing the environment of alcohol use.

Johnson Foundation: Wingspread Conferences
Letters of inquiry accepted at any time.
The mission of the Johnson Foundation is to cultivate ideas that sustain community – people living in harmony with one another and their environment. The Foundation pursues this mission through Wingspread Conferences, small meetings of thoughtful inquiry convened in an atmosphere of candor and purpose. The Foundation co-sponsors conferences with nonprofit organizations, educational institutions, or government agencies that work in the following areas: education, media, family, democracy and community, and sustainable development and the environment. The conferences are held at Wingspread, the Foundation's headquarters and educational conference center located near Racine, WI.

Fulbright Scholar Award

Multiple deadlines
Applications continue to be accepted for some Fulbright Scholar awards for lecturing, research or combined lecturing/research awards in public health during the 2008-2009 academic year. Faculty and professionals in public health may apply for awards specifically in their field, as well as one of the many "All Discipline" awards open to any field.

Medical Care Enhancement Funded by United Health Foundation
The purpose of the United Health Foundation is to improve health outcomes for all Americans. Through the Foundation's responsive grantmaking, support is provided to nonprofit organizations that serve people and communities in the United States. The Foundation’s priorities include enhancing the quality of health and medical care services by providing reliable, scientifically-based information to support decisions made by health professionals, communities, and individuals. An additional priority is to expand access to medical care and health-related services for individuals and families who live in challenging circumstances. Letters of inquiry are accepted throughout the year.

United Healthcare Children's Foundation Helps Underinsured Children
The Foundation offers support for children nationwide with assistance grants for medical services not fully covered by health insurance. Parents and caretakers can apply for up to $5,000.00 for health care services that will help improve their children's health and quality of life. Eligible children must be 16 or younger. Families must meet economic guidelines, live in the U.S. and be covered by a commercial health insurance plan. Examples of the types of medical services covered by include speech therapy; physical therapy and psychotherapy; medical equipment such as wheelchairs, braces, hearing aids and eye-glasses, and orthodontic and dental treatments. The Foundation has helped more than 375 families and provided nearly $1 million in financial assistance

Donors Forum of South Florida on-line database
The new online searchable Donors Forum of South Florida database has up-to-date information about funders in South Florida. This resource— which is also available in hard copy — presents continuously updated information about the giving interests and procedures of funders with a track record of investing in the South Florida area and working collaboratively with others. To order, email leot@donorsforumsf.org or call 305/371-7944 .

Directory Of Health Policy Fellowships

This Kaiser directory contains new listings for undergraduates, graduate students and professionals searching for summer, school-year, or post-doctoral positions.

Florida CHAIN Website Resources

Organizations and Services

Florida

Children's Health

Medicare

Prescription Medications

Health Disparities

Other

Manuals, Guides and Toolkits

Technology and Audio Visual Materials

Audioconferences and Webcasts

Media Programming

Web Sites, Web Features

Periodicals and Books

Reports and Studies

New Listings

New Listings: Medicaid

New Listings: Children's Health

New Listings: Medicare

New Listings: Federal/State Budget

New: Health Insurance, Health Care Costs

New: Health Disparities

New: Other Health Issues

Federal/State Budgets

Health Insurance, Health Care Costs

Health Disparities

Other Health Issues

FLORIDA CHAIN WEBSITE RESOURCE UPDATE

The Florida CHAIN website has been updated to include extensive resources on Medicaid Reform.

Click here to access:

Background Materials
Issue briefs explaining the harmful implications of expanding into Miami Dade
Office of Inspector General (OIG) Report
University of Florida Evaluation Website Link
Georgetown University Policy Briefs
Newspaper Editorials and Opinion Pieces
Alternatives to Medicaid Reform including summary and powerpoint presentations from the Feb. 28, 2008 "Exploring Alternatives to Medicaid Reform" Symposium
Consumer Experiences
List of Medicaid Reform Advocates Coalition Members
List of Medical Care Advisory Committee Members

ORGANIZATIONS AND SERVICES

Newly posted resources are at the top of each Topics List.

Florida

Florida Relay Service 711

The Florida Relay Service is the communications link for people who are Deaf, Hard of Hearing, Deaf/Blind, or Speech Impaired. Through the Florida Relay Service, people who use specialized telephone equipment can communicate with people who use standard telephone equipment. To call Florida Relay, dial 7-1-1, or use the appropriate toll free numbers: 800-955-8771 (TTY); 800-955-8770 (Voice); 800-955-1339 (ASCII); 877-955-8260 (VCO-Direct); 877-955-5334 (STS); 877-955-8773 (Spanish); 877-955-8707 (French Creole) In emergencies, Relay users should call 9-1-1 directly or the emergency services center in their community. Note: 711 can't be accessed from many buildings with a switchboard system because the PBX system won't recognize it, and consumers need to dial 1-800-955-8771 from them. Florida Relay customer service is available 24 hours a day 365 days a year: 1-800-676-3777 (English); 1-800-676-4290 (Spanish)

Southeast Florida Cancer Control Collaborative (SFCCC)

SFCCC works to reduce the cancer burden and cancer disparities in Southeast Florida, including Broward, Indian River, Martin, Miami-Dade, Monroe, Okeechobee, Palm Beach and St. Lucie counties. The SFCCC includes representatives from more than 60 public and private organizations, agencies and health care providers, as well as cancer survivor and advocacy groups. SFCCC aims to increase awareness about cancer prevention, early detection, and treatment among populations at high risk. The Collaborative meets quarterly at various locations in the region.

Children's Health

IPUT, Informed Parents United Together: Advocating for Universal Education and More!

This nonprofit agency works at an individual local network level to educate parents
and increase their advocacy for Inclusion of children and adults with disabilities in General Education environments. Check out the IEP Tool Box.

Medicare

Medicare Rights Center (MRC) has an Rx Hotline for Nonprofit Professionals as one component of its comprehensive independent source of health care information and assistance for older adults and people with disabilities. It helps with understanding or explaining the Medicare prescription drug benefit to clients. Call RxHelp, a national hotline dedicated for nonprofit professionals serving the Medicare population, operated from 10 am to 6 pm EDT. Dial 877/RXHELP-0 ( 877/794-3570 ).Other services include: a telephone hotline; a database of case advice; education and training; public policy work; electronic newsletters; and communications with local and national media outlets. To help you understand your Medicare health plan choices, the Medicare Rights Center offers Medicare Interactive (MI), a web-based Medicare counseling tool.

Access to Benefits Coalition

The nonprofit ABC is dedicated to ensuring that Medicare beneficiaries with limited incomes know about and make the best use of all available resources for accessing prescription drugs and reducing their costs. ABC is working through local community coalitions to inform beneficiaries and their families, as well as the professionals who serve them, about Medicare Part-D. Extra Help is provided online or in person; find out if you or someone qualifies by going to BenefitsCheckUpRx?. Publications include: Applying for the Low-Income Subsidy: A Tool Kit for Advocates; and Pathways to Success: Meeting the Challenge of Enrolling Medicare Beneficiaries with Limited Incomes

A Healthier US Starts Here: CMS Prevention and Wellness Initiative

This spring and summer, as part of the "A Healthier US Starts Here" initiative the US Department of Health and Human Services and CMS will join with local officials and partners, to raise awareness of the importance of preventing chronic disease and illness, promote Medicare preventive benefits and provide information about how beneficiaries can take action to maintain and improve their health.

Prescription Medications

The AZ&Me? Prescription Savings

This new AstraZeneca program provides medicines free of charge to community free clinics, community health centers and hospitals that serve the uninsured. AstraZeneca plans to provide medicines to hundreds of thousands of patients at approximately 150 facilities by the end of 2008. The new program builds on current AstraZeneca patient assistance programs by extending prescription drug assistance directly to the sites where uninsured patients interact with healthcare providers, supporting patients at one central place where they can get the medicine and care they need. In light of the updates to their patient assistance programs in the last year, AstraZeneca has decided to no longer participate in the Together Rx Access program after January 31, 2008. They offer AstraZeneca programs that provide medicines free of charge to those making up to $30,000 for an individual, or $60,000 for a family of four. More info: 1-866-325-8198

The Partnership for Prescription Assistance
is a service sponsored by the pharmaceutical industry that offers a single point of access to more than 475 patient prescription assistance programs, including more than 180 programs offered by pharmaceutical companies. Through referrals by organizations, more than 260,000 people in Florida have received assistance with their prescriptions medicines. They have launched a national campaign to raise awareness about the importance of SCHIP and its reauthorization, including a website and TV and print ads. They also have updated their FAQs and Fact Sheet to include SCHIP.

The Prescription Project

This project is led by Community Catalyst in partnership with the Institute on Medicine as a Profession. Funded by the Pew Charitable Trusts, the Project seeks to eliminate conflicts of interest created by industry marketing by promoting policy change among academic medical centers, professional medical societies and public and private payers. In addition the Project will advance state and national level policy solutions. The Project will sponsor a wide range of activities to achieve its goals, including research and policy analysis; national and community-based forums; outreach to the media; and meetings with key decision-makers, including deans of medical schools, health care administrators, business leaders, policy makers and consumers. These include the Prescription Project Weekly Reader, a readable, relevant way to keep members and friends of the Project informed about what is happening at the intersection of medical conflict-of-interest issues and prescription drugs.

Together Rx Access

is a prescription savings program sponsored by 10 pharmaceutical companies, including Pfizer. It provides savings on a wide range of prescription products at the pharmacy counter to eligible patients without prescription coverage. For more information, call 1-800-444-4106

Health Disparities

National Health Law Program (NHeLP) Resources

Language access continues to be a significant barrier to health care for individuals with limited English proficiency. Over 23 million individuals—almost 9 percent of the population—speak English less than “very well” and likely need assistance communicating in the health care arena. In an attempt to provide tools for health care providers and others, NHeLP has released a series of reports outlining promising practices for providing language services in health care settings. In mid-April, the National Health Law Program and the American College of Physicians released Language Services for Patients with Limited English Proficiency: Results of a National Survey of Internal Medicine Physicians. Other resources include Providing Language Services in State and Local Health-Related Benefits Offices: Examples from the Field, which outlines how state and local benefit offices can provide language services and Language Services Resource Guide for Healthcare Providers which offers information on how to provide language services including translator agencies, training programs, and health care symbols.

Refugee Health Information Network

RHIN is a national collaborative partnership, managed by refugee health professionals, whose objective is to provide quality multilingual, health information resources for those providing care to resettled refugees and asylees. RHIN places its greatest emphasis on identifying, collecting, and making quality available materials that have been produced in refugee languages. Sources of these materials include federal, state and local public health agencies; national organizations; health care agencies; community-based organizations; academic institutions and international organizations. RHIN also strives to identify news and events, as well as other information resources useful to health providers serving refugees.

Training Alliance for Communities of Color
This website is from National Health Policy Training Alliance for Communities of Color, a partnership between Families USA, the Joint Center Health Policy Institute (HPI), the National Association of Latino Elected and Appointed Officials (NALEO) Educational Fund, and the National Medical Association (NMA). Their mission is to empower community leaders, elected officials, and journalists from communities of color with pertinent information about health policy developments in order to: expand their capacity to address and catalyze action on crucial health and health care issues; bolster the skills of leaders from communities of color to play a more influential role in shaping and creating health policies that are of relevance to their respective communities; and engage diverse leaders in national health policy development.

The National Hispanic Resource Help-Line 1/800-473-3003 provides support for Latinos throughout the nation who need information about educational, health and human service providers. To become part of their database, click here.

Other

Partnership to Fight Chronic Disease (PFCD)

Any serious policy proposal that aims to improve health care in America and control rising health care expenditures must address chronic disease. That’s why a broad group of patients, providers, community organizations, business and labor groups, and health policy experts has joined together to form the – a national, bi-partisan coalition committed to raising awareness of the policies and practices that save lives and reduce health costs through more effective prevention and management of chronic disease.

MANUALS, GUIDES, TOOLKITS

Newly posted resources are at the top of each Topics List.

Children's Health

Alliance for Health Reform has developed an online toolkit on child health coverage. The toolkit provides links to resources that will improve the user’s understanding of how children get coverage in the U.S. and the importance of public programs and employer-sponsored health insurance to children.

Cover the Uninsured Storybook - The Success of SCHIP: How the State Children's Health Insurance Program Helps America's Working Families

This is a 15-page, downloadable booklet that shares the touching stories of 23 families that have benefited from coverage provided through SCHIP. Download it today to share with opinion leaders in your community. Order Free Materials: FREE English and Spanish promotional materials featuring the 1(877) KIDS-NOW hotline, which parents can call to find out if their uninsured kids are eligible for SCHIP or Medicaid, are available to augment your outreach efforts. Order fans, bookmarks, posters and more to distribute in your community while supplies last.

Helping Pediatric Practices Implement Parental Depression Screening
A new online manual helps pediatric clinicians successfully screen parents for depression, discuss with them the impact depression can have on their children, and refer parents for counseling. Rates of major depression peak during women's childbearing years. Research has shown that maternal and paternal depression can affect parenting behaviors and, ultimately, harm children's health and development. Because pediatricians have frequent contact with parents, they have opportunities to screen for depression and intervene when necessary. Accumulating data about the adverse effect of parental depression on child health, development, and behavior have provided an impetus among pediatric practices for changing clinical care.

Medicaid

The Basics of Medicare and Medicaid
The primers help explain Medicaid and Medicare, including an overview, how they work, who they serve and how they are funded. The Medicare primer is new, and the Medicaid primer has been updated with the most current information (Kaiser Family Foundation, "The Basics of Medicare and Medicaid," (3/19/07, Kaiser Family Foundation)

The Medicaid Matters web site is a resource for people working across the country to protect Medicaid, the health insurance that 50 million rely on. It stores a ready-to-use toolkit of messages, materials and dissemination ideas. Users are able to download, at no cost, tested messages emphasizing the importance of Medicaid and the threat now facing the program. Messages are enhanced by high quality, full color photography. One set of materials is designed to be ready to print. Once downloaded, they can be forwarded to any print house or copy shop without any further formatting. The second set of materials is designed so that components of the product can be adapted to suit the needs of that organization or constituency that wishes to use them.

Medicare

Toolkit: Medicare Private Fee-for-Service Plans

The toolkit contains links to resources on general information about Medicare private fee-for-service plans, advantages and incentives of using the plans and the difficulties that beneficiaries have faced with the plans, including enrollment fraud. The toolkit also includes a list of experts and Web sites for further information on the plans. (7/12/07, Alliance for Health Reform)

Medicare Advantage Tutorial on the basics of Medicare Advantage and types of MA plans, as well as trends in MA enrollment, characteristics of beneficiaries and the impact of MA plans on traditional Medicare. And an updated Medicare Health and Prescription Drug Plan Tracker with MA plan enrollment data for June, containing local, regional and national data on MA plans and stand-alone Medicare prescription drug plans. (7/17/07, Kaiser Family Foundation)

Medicare Rights Center Part D appeals manual
This free, comprehensive, easy-to-understand guide is for advocates who help people with Medicare get the drugs they need.This 25-page manual offers a complete overview of the entire appeals process, real-life case examples from MRC's Client Services department, a glossary of important Part D appeals terms, a sample appeals protocol for advocates, and links to important resources and documents. All in consumer-friendly language

New/Updated Resources Medicare Drug Plan Resources
In advance of the 2007 Medicare drug plans open enrollment period beginning Nov. 15, Kaiser Family Foundation has issued a series of new and updated resources based on ongoing research including consumer surveys:

Updated fact sheet providing state-specific data about Medicare drug plan options for 2007, including stand-alone drug plans and Medicare Advantage plans, and information on premiums, gap coverage, and availability to beneficiaries who qualify for full low-income assistance.

Updated Medicare Prescription Drug Benefit fact sheet, with a revised estimate that 4 million people will be affected by the coverage gap in 2006, as well as current enrollment and low-income subsidy participation and updated Medicare per capita drug spending.

Updated Talking About Medicare online consumer guide, reflecting 2007 benefit changes, to help people with Medicare and their families understand options and make decisions based on their personal situations; includes information about financial assistance for those with limited incomes, supplemental insurance options, and Medicare Advantage.

Uninsured

The Consumer Guide to State Health Reform

Community Catalyst and Families USA new Web-Based Guide to State Health Reform for Advocates. More and more states are prioritizing health care reform to address the coverage gaps that exist, the affordability crisis that continues to worsen, and the increasing costs of health care. Community Catalyst and Families USA are pleased to announce the release of a unique web-based guide to state health reform for consumer advocates working to strengthen and expand health care coverage in their states. A Consumer Guide to State Health Reform provides a detailed look at the building blocks of comprehensive health care coverage.

Fact Sheets and Primer on the Uninsured
The Kaiser Family Foundation has collected links to some resources on the topics of health coverage and the nation’s uninsured population to assist you in your work related to these issues:

The Uninsured and Their Access to Care

Covering the Uninsured: Growing Need, Strained Resources

Massachusetts’ New Law to Cover the Uninsured

Women's Health Insurance Coverage

The Uninsured: A Primer

Health Disparities

Disparities Toolkit for Collecting Patient Race, Ethnicity, and Primary Language Data

The updated version of this web-based toolkit is now available free of charge on the HRET Web site, thanks to HRET and AHA support. The new edition, which can be viewed online and downloaded as a PDF, is easy to navigate and offers important new material.

Women's Health Policy: Coverage and Access to Care Tutorial

The tutorial provides an overview of women's health care needs and concerns, and discusses important issues stemming from women's health coverage and access to care and reviews central policy challenges in improving women's access to care (Feb 2008, Kaiser Family Foundation)

HRET Disparities Toolkit
The updated HRET Disparities Toolkit gives hospitals, health systems, clinics, and health plans the information and resources needed for collecting race, ethnicity, and primary language data from patients. In order to make this invaluable Toolkit more accessible to all health care providers, the Toolkit is now available free of charge.

Race Matters

This toolkit was created to help advocates and leaders address race and power structures within their work to help create equitable opportunities for all. (Voices for America's Children and The Annie E. Casey Foundation)

A Patient-Centered Guide to Implementing Language Access Services in Healthcare Organizations

The guide was created to assist health care organizations in better serving their clients with limited English proficiency and decrease disparities in access to health care. (DHHS Ofc. of Minority Health)

Amigos en Salud Online Disparities Toolkit
Pfizer has created a free toolkit to help community health centers reduce racial health disparities. The program, called Amigos en Salud/Friends in Health, involves training community health workers to be a bridge between minority communities and the healthcare system.

Reducing Racial and Ethnic Disparities: A Quality Improvement Initiative in Medicaid Managed Care ToolkitCenter for Health Care Strategies
The toolkit examines the experiences of a workgroup - comprising 10 Medicaid health plans and a state primary care case management association - that adopted strategies to identify and address racial and ethnic health disparities in birth outcomes and immunizations, asthma care and diabetes care. (January 2007)

Families USA is offering Making Public Programs Work for Communities of Color: An Action Kit for Community Leaders, from its Minority Health Initiatives Department. The kit provides community leaders with information, tools, and resources to engage in health advocacy and improve the health and well being of their communities. Emphasizing the importance of public programs in reducing racial and ethnic health disparities, the kit contains: a summary and statistics of racial and ethnic health disparities and the role public programs can play in reducing them; an overview of Medicaid (and SCHIP) and Medicare, including their relationships to communities of color; fact sheets on improving health coverage for racial and ethnic minority groups; state and local case studies on health advocacy; advocacy tools including a powerpoint presentation, and lists of organizations and publications. Contact: 202/628-3030 or rpanares@familiesusa.org.

Other

GoingSmokeFree.org: A Toolkit for Implementing Smoke-Free Laws
The site is a clearinghouse for activities, events, and tools states and communities need to plan, implement and support new or expanded smoke-free laws. The Robert Wood Johnson Foundation, in partnership with the Campaign for Tobacco Free Kids and Americans for Nonsmokers' Rights, has created this free online resource to help states and communities implement smoke-free laws.

New Web Tool Provides Samples of Report Cards on Health Care Quality

With rising interest in information about the quality of care delivered by health care providers, HHS' Agency for Healthcare Research and Quality has developed a new Web tool demonstrating a variety of approaches for health quality report cards. The new Health Care Report Card Compendium is a searchable directory of over 200 samples of report cards produced by a variety of organizations. The samples show formats and approaches for providing comparative information on the quality of health plans, hospitals, medical groups, individual physicians, nursing homes, and other providers of care.

ACHI's Community Health Assessment Toolkit

Built with funding from the American Hospital Association and expert guidance from a 35-member ACHI working group, this will be online in November 2007. The Toolkit, a member service of the Association for Community Health Improvement, available to members of the American Hospital Association and the Society for Healthcare Strategy and Market Development, is a hands-on guide for both novice and experienced practitioners seeking to design, conduct and use assessments to improve the health of their communities.

Five Guidelines for Developing Customer-Friendly Websites
This new Covering Kids & Families publication is intended to help state agencies and other organizations do a

better job of helping people find information on the Web about Medicaid, SCHIP and other government services by producing a customer-friendly sites

TECHNOLOGY AND AUDIO/VIDEO RESOURCES

Audio Conferences and Webcasts

Dated events listed chronologically; standing webcasts listed last

ACHI Audio-conference—Registration is now open

Local Health Care Access Initiatives: Key Factors for Success

April 15

Effective Product/Market Positioning Strategy: Using Health Status Assessment and Community Health Improvement to Enhance Your Bottom Line

May 15

Unnatural Causes: Is Inequality Making Us Sick?

Hosted by the Black Women’s Agenda, the workshop featured a panel discussion of this soon-to-be-released PBS documentary produced by California Newsreel. View the entire panel discussion online.

Partnerships to Achieve Health Equity

This Society for Public Health Education summit featured a series of plenary sessions dealing with the elimination of racial and ethnic health disparities by focusing on health behavior dissemination, research, and implementation. Videos and transcripts available online.

Media Programming

Unnatural Causes: Is Inequality Making Us Sick?

This seven-part series for PBS broadcast and DVD release will, for the first time on television, sound the alarm about our glaring socio-economic and racial disparities in health--and seek out root causes. While we pour more and more money into drugs, dietary supplements and new medical technologies, it turns out there is much more to our health than bad habits, health care or unlucky genes. The social conditions in which we are born, live and work profoundly affect our well-being and longevity. The series is part of an ambitious Public Impact Campaign conducted in partnership with leading public health, policy, and community-based organizations, pointing out that investing in our schools, improving housing, integrating neighborhoods, better jobs and wages, and giving people more control over their work, are as much health strategies as smoking diet and exercise.

Web Sites, Web Features & Databases

Newly posted resources are at the top of each Topics List.

Florida

Florida Medicaid Reform Evaluation Project

The website provides information on the evaluation and access to key publications, talks, and presentations produced by the MRE team. The University of Florida (is conducting a five-year evaluation of the state’s Medicaid Reform Demonstration Project under a contract with AHCA, Florida’s state agency for health policy and planning. The evaluation will be conducted over the period of Florida’s Section 1115 Medicaid demonstration waiver (July 1, 2006 – June 30, 2010), as approved by the U.S. Department of Health and Human Services by the Department of Health Services Research, Management and Policy at UF. The overall objective is to assess whether Florida's Medicaid Reform accomplishes its stated objectives of delivering quality healthcare services while achieving better health outcomes and enrollee satisfaction at a more predictable lower cost. For further information, contact (352) 273-6073 or mre@phhp.ufl.edu

Florida's Community and Migrant Health Centers Brochure UPDATED 9/07

A low literacy brochure describing services offered at Florida's CHCs with a map of all CHC locations and phone numbers. English Brochure Spanish Brochure Haitian Creole Brochure

Annie E. Casey Foundation: 18th KIDS COUNT Data Book

This is the recently released new edition of this national and state-by-state effort to track the status of children in the United States. By providing policymakers and citizens with benchmarks of child well-being, the Foundation seeks to enrich local, state, and national discussions concerning ways to secure better futures for all children. Information is also available in an online database that enables users to generate custom graphs, maps, ranked lists, and state-by-state profiles. Both the book and the online database can be accessed on the website listed above.

First Steps: A Guide for Parents of Young Children with Developmental Disabilities

Florida Developmental Disabilities Council’s most popular publication ever has been revised and updated with critical info for any parent or family member of a young child with a developmental disability. The publication is a reliable source of info for parents at the beginning of a new journey. They will learn a new vocabulary, discover advocacy skills they never knew they had, and meet new people who will become important in their life as friends, teachers, doctors, therapists and caregivers. This is a valuable tool to help guide parents in the initial steps of their journey as well as a resource they can visit again and again as they, their child and their families grow through the coming years together. The publication is available in both English and Spanish, as well as in a full color version and a black and white version – both are in Acrobat Reader format (PDF) and available in two sections – Chapters 1 to 5 and Chapters 6 to 10 – for your convenience downloading the publications.

Summary of health-related bills passed by the 2007 Florida Legislature

Florida Health News, free online non-profit news service
The Florida Health Policy Center has announced the launch of an independent, free, non-profit news service: Florida Health News Inc. FHN will post health-related stories reported around the state, highlight the Florida impact of national stories, and track state health legislation. The news service also will feature original coverage of major health policy developments and a free Monday-through-Friday news service. You can visit the site and subscribe to the e-mail news service by clicking on the link: www.FloridaHealthNews.org. To send your comments, story tips and news of conferences and other events, or get more information, contact pat.curtis@floridahealthnews.org or 850/556-1668 .

Florida Health Insurance Coverage of Children 0-18 (2004-2005)
Kaiser Family Foundation has released information about this on-line resource.

Statehealthfacts.org Updates Data on Medicaid & SCHIP Coverage for Children
Statehealthfacts.org has updated information on eligibility levels for children in Medicaid and SCHIP and parents and pregnant women in Medicaid using survey data from the Kaiser Commission on Medicaid and the Uninsured (KCMU). The latest information on Medicaid and SCHIP enrollment practices for pregnant women and children and renewal practices is also now available. Overall SCHIP spending for FY 2006 and Federal SCHIP spending data from FY 1998 through FY 2006 are also now available. Recent additions to the site include new information on children's demographics and health insurance status from analysis of the Census Bureau's March 2005 and 2006 Current Population Surveys. These additions include the distribution of children by race/ethnicity, the distribution of children by citizenship status, and health insurance coverage among low-income children living near poverty.

Florida Association of Community Health Centers (FACHC)

The following resources have recently been added to the FACHC web site:

Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA-50) A new health literacy test than can be used to screen for low health literacy among Spanish speakers.

Health Coverage and Access to Care for Hispanics in "New Growth Communities" and "Major Hispanic Centers" A 2006 Report from the Kaiser Commission on Medicaid and the Uninsured

Spanish Language Mental Health Manual for Health Promoters Developed by the California- Mexico Bi-National Health Initiative.

Florida Health Care Website for Consumers
A new Web site for Florida health-care consumers officially launches today, courtesy of the Florida Hospital Association. The site offers links to information on doctors, hospitals and health-care plans as well as checklists to help consumers ask the right questions. It is intended largely as a portal to other, established sites. There are links to sites for Florida's Agency for Health Care Administration, the Centers for Medicare & Medicaid Services, and the Joint Commission on Accreditation of Healthcare Organizations, among others.

State of Florida Health Care Consumer Websites
The recently expanded FloridaCompareCare.gov aims to improve care and reduce costs by giving citizens the tools to compare outcomes and prices between health care providers and medical services. Through this website one can see data on certain conditions and procedures related to quality of care, pricing and performance at the state’s hospitals and ambulatory (outpatient) surgery centers. In 2005, Florida became the first state to publicly report infection and mortality rates in each hospital. In July 2006, Florida became the first state to publicly report separate pediatric quality of care data. In addition, adult data can now be broken out specific to ages 65 and over. Additional new breakdowns include types of facilities.
FloridaHealthStat.com provides health care information to assist consumers, health care professionals, and researchers in making well-informed health care decisions and in researching the status of health care in Florida. MyFloridaRx.com provides consumers with the retail prices of the most commonly used prescribed drugs by pharmacy across Florida. For questions or comments regarding any of Florida’s consumer websites, contact 850/922-7036 .

Medicaid Applications Online 24/7 and in Neighborhoods
Local partners can direct families to their area sites or online to apply for Medicaid and other benefits. The Web Application is generally preferable as the data makes it into the Florida system more quickly and there is a reduced chance of data entry errors.

Florida KidCare Applications can be completed online

Website Offers Free 24 Hour Health Information to Floridians to address concerns and inquiries

The Florida Department of Health (DOH) Secretary encourages health care consumers to visit www.FLHealthSource.com whenever they need information about a licensed health care professional. DOH’s Division of Medical Quality Assurance (MQA) maintains FLHealthSource.com. The site provides health care consumers with a host of information, including license status, office address, and disciplinary information for all health care professionals licensed in Florida. The site also provides additional information for the five profiled professions –medical doctors, osteopathic physicians, chiropractic physicians, podiatric physicians and advanced registered nurse practitioners (ARNPs).

Statehealthfacts.org provides free, up-to-date, and easy-to-use health data on all 50 states, covering more than 500 health topics.

Florida Progressive Information Network (FLPIN)

offers a nonpartisan communication system designed to link progressive organizers with progressive activists. Individuals may sign up free of charge to receive alerts on a variety of progressive issues from other organizations participating in the Network. In order to make FLPIN work, it must be used on a regular basis. The more information put in, the more valuable it is as a tool. Link FLPIN to organization websites. A training manual is at www.flpin.net/alert.pdf. For more information or assistance, contact jen@floridahumanist.org

Children's Health

Data Resource Center for Child and Adolescent Health
The Child and Adolescent Health Measurement Initiative (CAHMI) presents the Data Resource Center for Child and Adolescent Health. This resource is a no-cost, easy-to-use website that puts national, state, and regional survey findings right at your fingertips. You'll find: interactive data search tools; personalized technical help by email or telephone and information and examples to help you use data more effectively.

Online Parent SCHIP Information
To assist in the growing problem of America's uninsured children, medical insurance hub HealthInsuranceFinders has added information to assist parents in finding and understanding all of their health insurance options: a State Children's Health Insurance Program (SCHIP) section with an overview of State Children Health Insurance Programs for each state.

State By State National Survey of Children’s Health Data Resource Center Dataset
The DRC Child Health Indicators version of the 2003 NSCH Dataset is now available. Added to the data sets are the 65 Child Health Indicators for the DRC online data query and the National Chartbook. Also included are Healthy People 2010 relevant indicators and key socio-demographic variables.

Medicaid

Fact Sheets on Medicare, Long-Term Care Spending; Medicaid; Long-Term Spending Data
Fact sheets, Georgetown University Long-Term Care Financing Project: The Georgetown University Long-Term Care Financing Project has released two new fact sheets on Medicare and long-term care and Medicaid policy that aims to protect the incomes and resources of spouses of nursing home residents who are trying to enroll in Medicaid. The project also has updated its 2005 national long-term care spending estimates. (February 2007, Georgetown University Long-Term Care Financing Project)

Medicaid Fact Sheets Tool

Compare your state's Medicaid program and the population it serves to other states and the nation by visiting Kaiser's new interactive online State Medicaid Fact Sheets tool.

Interactive Tools on Medicaid

The Kaiser Commission on Medicaid and the Uninsured presents the State Medicaid Fact Sheets and the Medicaid Benefits Online Database, two interactive tools featuring the latest key data, information and services provided for each state’s Medicaid program. Both tools allow for easy access to the data which can then be printed, saved and emailed.

Medicare

CMS Updates Web Site to Help Medicare Beneficiaries Better Compare Drug Plans Price, Coverage, Quality

CMS has launched a revised version of the Medicare Drug Plan Finder Web site that allows beneficiaries to sort plans offered in their communities by annual costs based on prescriptions, monthly premiums, coverage levels in the so-called "doughnut hole" and other factors and view the information in one chart. (October 2007, CMS)

Online Interactive Medicare Advantage Comparison Tools
Before making the switch to Medicare Advantage, beneficiaries can compare plans to determine their needs. Then they can review each plan using the “Guidelines for Considering Medicare Advantage” from the Center for Medicare Advocacy. More information about Medicare Advantage managed care plans is online at Medicare.gov. More recent FAQs on private fee-for-service plans is available through CMS.

Uninsured

Interactive Online Side-by-Side Comparisons of Presidential Candidate Health Care Proposals
The online tool allows users to customize side-by-side comparisons by selecting as many as four candidates for comparison that can then be formatted into a printer-friendly format. [Kaiser Family Foundation]

Kaiser Commission on Medicaid and the Uninsured Updates Medicaid Benefits: Online Database with 2006 Data

Using this tool, Medicaid benefits can be compared across the 50 states, the District of Columbia and the US Territories or by specific service. The online tool contains Medicaid benefits survey data from 2003, 2004 and 2006 with information about benefits covered, limits, co-payments and reimbursement. It includes an interactive map, an expandable list of benefits, and the ability to compare data across the three survey periods.

Kaiser Commission on Medicaid and the Uninsured Updates Medicaid Benefits: Online Database with 2006 Data

Families USA’s State Coverage Expansions Resource Center

Many states are taking steps — expanding public programs, launching new state programs, and reforming private insurance — to make it possible for more people to get coverage. This new Resource Center will help you find out what the states are doing. Click here. The State Coverage Expansions map guides you to information on key state expansions, with fact sheets, links to legislation, and links to state advocacy groups. Comparing State Expansions is a series of tables that show you the key elements of these new proposals/laws state-by-state. How are states financing their expansions? Who is covered? What benefits do they get? Will small businesses be helped? All this and more is covered in the tables. If your state is doing similar efforts that are not yet on our map, click here to call or send Families USA an e-mail.

Health08.Org, A Hub for Information about Health Care and The Presidential Campaign

With health care emerging as one of the hot topics in the 2008 presidential election, this new ad-free Kaiser Family Foundation Web site will provide analysis of health policy issues, the results of regular public opinion surveys, and news and video coverage from the campaign trail. It will feature original content produced by Kaiser as well as health-related resources from various campaigns, other organizations, and news outlets. The site will offer summaries of candidates' health reform proposals, basic facts and information about the health system, the results of Kaiser tracking surveys examining the public's views on health issues and their perceptions of the candidates' views on health care, syntheses of health news coverage, podcasts and video from the campaign trail, and interviews with candidates and other key players in the health reform debate.

Uninsured Tutorial, Module, and Reference Library

This KaiserEDU.org page contains comprehensive resources including links to key research, policy analysis, and the latest data and statistics on the uninsured.

Health Care Coverage in America: Understanding the Issues and Proposed Solutions includes a corresponding PowerPoint presentation. (Cover the Uninsured)

Healthcare Coverage Options Database: Assistance for Obtaining Health Coverage

This Web site provides information on health insurance options for low-income U.S. residents. The site includes comprehensive information on large-scale programs like Medicaid, the State Children's Health Insurance Program (SCHIP), and the federal Health Care Tax Credit Program, as well as hundreds of smaller state, federal, and private programs.

Health Disparities

Unified Health Communication 101: Addressing Health Literacy, Cultural Competency, and Limited English Proficiency

is a free online learning experience designed to help health professionals improve their patient-communication skills, increase their awareness and knowledge of factors that affect their communication with patients, and implement patient-centered communication practices. The course, developed by the Health Resources and Services Administration (HRSA), comprises five modules and is estimated to take a total of 5 hours to complete. The course may be completed at the user's own pace and may be taken for credit (CEU/CE, CHES, CME, and CNE) or not for credit.

Guide to Health Programs (Guia de Programas de Salud)

This easy-to-use bilingual guide in Spanish and English is available for free to anyone looking for basic information on health insurance, nutrition, and other public programs. (California HealthCare Foundation, October 2007)

“Race, Ethnicity and Health Care” tutorial

Online from Kaiser Family Foundation.

Systematic Review of Current Disparities Research Interventions Identifies Successful Strategies for Reducing Racial and Ethnic Disparities in Health Care

Complete body of reviewed research available through new interactive tool. (10/11/07, Robert Wood Johnson Foundation)

The Context of Health: What Are We Really Doing To Change It?
Healthy People 2010 recognizes that communities, States, and national organizations will need to take a multidisciplinary approach to achieving health equity—an approach that involves improving health, education, housing, labor, justice, transportation, agriculture, and the environment. [95-slide ppt]

Think Cultural Health is a new web page that provides a wealth of resources and information on the issues of cultural competence in health care and health care disparities. (DHHS Office of Minority Health)

Robert Wood Johnson Foundation's new disparities Web page includes publications and information listed according to racial/ ethnic group, as well as by topic area.

National Cancer Institute Spanish Web Site

The National Cancer Institute (NCI) has launched a new Web site, cancer.gov en español tailored to the needs of the U.S. Hispanic/Latino community. The Web site is completely in Spanish and is one of the latest tools developed by the NCI in its efforts to address cancer health disparities. It is intended to meet the needs of Hispanic/Latino cancer patients, their families and health care providers, who are either Hispanic/Latino or serve such patients.

Facing Race 2007

The Applied Research Center (ARC) and COLORLINES Magazine have made various resources from their conference available on the ARC Web site, the ARC blog, and on the Facing Race wiki

US Racial Disparities Update

Kaiser Family Foundation issued a new data update that shows the percentage of whites, African Americans, and Hispanics in all 50 states and the District of Columbia that are uninsured, enrolled in Medicaid, and living in poverty. The data also provide a quick glance at disparities in rates of infant mortality, diabetes-related mortality, and AIDS cases between these racial and ethnic groups.

Faith Based Efforts and Resources

Families USA has posted a new page on the Minority Health Initiatives section of the Web

site with links to various to encourage faith leaders to become involved in health care advocacy.

Factline: Tracking Health in Underserved Communities
This website is sponsored by the National Library of Medicine and Meharry Medical College that highlights health disparities in underserved communities. Factline presents information about health disparities faced by women, members of minority groups, the elderly and others. The focus of the website is two-fold: presenting significant findings from scholarly research in public health on the subject of health disparities and providing bibliographic references to the literature in which these findings are established. The framework for the research is Healthy People 2010.

New Database for Medical Language Access
The Medical Leadership Council on Cultural Proficiency has unveiled a first-of-its-kind database designed to assist physicians and others in providing improved language access and culturally competent health care. With more than 350 initial entries, the searchable, internet-based, free-to-the-public database includes contact information for interpreters, nonprofit organizations, hospitals, public health departments and others that provide health information and services in languages other than English. Users, including physicians, nurses, social service workers, patients and the general public, can search for listings by county, by language, or by type of service.

2007 Federal Poverty Guidelines Now Available
The Southern Institute on Children and Families has made available the 2007 Federal Poverty Guidelines. Compiled from the 2007 HHS Poverty Guidelines, these guidelines provide income levels for families at 50%, 100%, 125%, 133%, 150%, 185% and 200% of the Federal Poverty Level. Information is provided for the continental United States and separately for Alaska and Hawaii.

Women's Health Insurance Coverage Fact Sheet
As the cost of health insurance continues to rise, women in particular may face difficult challenges affording coverage because they are disproportionately low-income and can have poorer access to employer-based insurance. This fact sheet describes the major sources of health insurance coverage for women ages 18-64, including employer-sponsored insurance and Medicaid. It provides information on the more than 17 million women who are uninsured and summarizes the major policy challenges facing women in the health insurance sector. (Feb 2007, Kaiser Family Foundation)

Comprehensive source of Hispanic data
Recent release from the Census Bureau with data and linkage to sources covering many areas.

Rural Communities Statistics and Information
The Rural Assistance Center has added to its Web site a new resource providing continuously updated demographics and statistics, documents and resources and contacts for all 50 states. RAC said the federally funded "State Resources" addition is designed to help health care providers and human services representatives in rural communities with activities such as locating and competing for funding opportunities and networking.

Immigrant Health Policy Reference Library
This new compendium summarizes data and research on immigrants’ health coverage and access to care. The library also includes a list of organizations that conduct analysis on the impact of major health policies on immigrants and presents research on specific populations, including Latino, African and Asian immigrants.

Other

Tracking the Presidential Candidates on Health Care
The Kaiser Family Foundation's health08.org website offers resources for following health care developments during campaign season. The website serves as a hub of information about health and the election, including original content produced by Kaiser and easy access to health-related resources from the campaigns, other organizations and news outlets.

Consumer Health Information for You and Your Family
Keeping up with the latest consumer health information from the U.S. Food and Drug Administration (FDA) just got easier. FDA has a new Web page to provides comprehensive and timely consumer information. A free monthly e-newsletter, FDA Consumer Health Information will alert consumers to content contained on the page.

Metropolitan Quality of Life Data
Diversitydata.org allows visitors to explore how metropolitan areas throughout the U.S. perform on a diverse range of social measures via a dataset of socioeconomic indicators in the form of tables, thematic maps, and customizable reports. The data cover various racial/ethnic, income and nativity groups. Multiple data sources have been used to show data for numerous domains such as housing opportunities, economic opportunities, residential integration, and health.

New Online Medical Dictionary Reference Tool

MediLexicon International Limited, corporate owners of Medical News Today, was pleased to announce on Nov. 11 the launch of a new medical dictionary tool. This dictionary search is a joint collaboration between MediLexicon and Lippincott Williams and Wilkins, who have provided the data.

American Community Census Data Online
The new poverty, income, and health insurance data from the U.S. Census Bureau released on August 29, 2006 is available online. This year, it has more state and local data than in previous annual surveys.

State Level Data on Health Coverage & the Uninsured

Kaiser Family Foundation's interactive web tool includes the health insurance status of the state’s population (those with various types of health coverage or who are uninsured), and demographic information (such as income, race/ethnicity, age, gender) for those who are uninsured, have employer-based insurance, or Medicaid. Information about Medicaid and Medicare beneficiaries can be found in those respective categories. Find data from other categories on the website that relate to Health Coverage & Uninsured.

The Johns Hopkins INFO Project's OneSource Database

This provides one-stop access to over 360,000 resources and six separate databases with a single mouse click or search term. OneSource users can quickly search for reports, articles, documents, posters and pamphlets, photos, web sites, Q&As and news articles through a single interface. An enhanced search and browse capability makes finding global family planning, reproductive health and population information faster and more simple than ever. Enter your terms in the search box. Select the resource type you want to look for, or search all six databases at once, and click Search.

Videos and Films

Sick People or Sick Societies?

We are healthier than ever before, and we live longer, but improvements in health are not distributed evenly. The rich outlive the middle classes, who outlive the poor. Swedes and Japanese live longer than Canadians, and Canadians, longer than Americans. Freelance journalist Jill Eisen discovers that the reasons have little to do with our health care systems. FREE download available for limited period.

Unnatural Causes: Is Inequality Making Us Sick?

This seven-part series for PBS broadcast and DVD release will, for the first time on television, sound the alarm about our glaring socio-economic and racial disparities in health--and seek out root causes. While we pour more and more money into drugs, dietary supplements and new medical technologies, it turns out there is much more to our health than bad habits, health care or unlucky genes. The social conditions in which we are born, live and work profoundly affect our well-being and longevity. The series is part of an ambitious Public Impact Campaign conducted in partnership with leading public health, policy, and community-based organizations, pointing out that investing in our schools, improving housing, integrating neighborhoods, better jobs and wages, and giving people more control over their work, are as much health strategies as smoking diet and exercise.

PERIODICALS AND BOOKS

Florida Dept of Health Women’s Health Newsletter

The FL Dept of Health website has a Women’s Health page with a new quarterly Women’s Health Newsletter.

REPORTS AND STUDIES

New Listings

New Listings: Medicaid

New Listings: Children's Health

CMS Reports 5.9% Increase in SCHIP Enrollment

More than 7.1 million U.S. children were enrolled in the State Children's Health Insurance Program at some point in fiscal year 2007, according to data released today by the Centers for Medicare & Medicaid Services. That's 5.9% or 399,600 more children than in FY 2006, the agency said. (3/12/08, AHA News Now)

Health Coverage for Children and Families in Medicaid and SCHIP: State Efforts Face New Hurdles
reports that, between July 2006 and January 2008, nearly two-thirds of states expanded access in these public programs. The report contains state-specific charts and tables that show changes in health coverage, income thresholds for parents applying for Medicaid, and the way that the August 2007 CMS directive affected states. (1/28/08, KFF)

New Listings: Medicare

Transitioning to Medicare Before Age 65
shows the importance that Medicare’s coverage for people with disabilities already provides for people approaching their 65th birthday. One in six persons receives Medicare coverage between ages 55 and 64, either because of disability or because of diagnosis of end-stage renal disease. One-quarter of those who qualify for Medicare because of a disability went without health coverage during the two-year waiting period for Medicare. (The two-year waiting period is written into law and starts when an individual receives the first check for Social Security Disability Insurance.) More than half of those who went without health coverage during the two-year waiting period had no coverage even before they became disabled. These individuals in particular would be helped if Congress acted to eliminate the two-year waiting period, the authors conclude. (3/25/08, Health Affairs)

Medicare Trustees Report shows Medicare’s Problems Daunting

The new reports confirm that policymakers will need to take action to keep Social Security and Medicare on a sound financial footing. Medicare’s financial problems are much more challenging and stem primarily from the continuing sharp rise in both public and private health care costs, not from deep structural problems with the program. (The trustees predict that, in 2019, the Hospital Insurance Trust Fund will not have enough money coming in from payroll taxes to pay for all the hospital care and other Part A services that people with Medicare will likely need. That means Congress will need to take some action to either raise more money or cut spending for Part A services. Some conservative policymakers want to cut spending by raising the eligibility age from 65 to 67, which will doubtless increase the ranks of uninsured older adults, a group that already has a difficult time finding quality, affordable insurance in the private market.) (3/25/08, CBPP)

From Politics to Policy: A New Payment Approach in Medicare Advantage

proposes a new method of setting benchmarks against which MA plans bid, benchmarks consistent with evidence that MA plan costs vary less geographically than fee-for-service Medicare expenses and also would eliminate payment floors for rural areas. This approach would pay plans in these "floor counties" less than under current law but more than under a local-neutrality proposal by the (3/4/08, Urban Institute in Health Affairs)

Survey Finds Most Baby Boomers Underestimate Disability Risk
Most Baby Boomers underestimate their risk of suffering a disability that would cause them to miss work for an extended period of time, according to a new survey conducted by Harris Interactive. Baby Boomers are unaware of the most common causes of disability and are not too concerned about their risk of becoming disabled. "When individuals underestimate their risk of disability, they are less likely to protect their income and are more vulnerable to the financial hardship that suffering a disability can cause." (3/11/08, AHIP)

Medicare Out-of-Pocket Costs: Can Private Savings Incentives Solve the Problem?
Examines whether incentives for private savings could relieve the burden of post-retirement health care costs, especially for low-income individuals. Although low-income seniors have lower medical costs on average than other seniors, these costs account for a far greater percent of their annual income. Enhanced savings offer only a partial solution to this problem, especially for low-income seniors. (3/19/08, Commonwealth Fund)

New Listings: Federal/State Budgets

Four Helpful Hints for States Dealing with Deficits

States, facing their worst fiscal problems in five years, should consider the following four policy options when dealing with deficits: (1) protect their revenues from the effects of federal tax changes, (2) tap their "rainy day funds," (3) don't rule out revenue increases, and (4) avoid "stimulus" tax cuts. (3/12/08, CBPP)

Facing Deficits, Many States are Imposing Cuts that Hurt Vulnerable Residents

To date, at least 17 states facing deficits (including Florida)have made or proposed budget cuts that threaten vital services for many residents, including some of the state’s most vulnerable residents. (3/13/08, CBPP)

New Listings: Health Insurance, Health Care Costs

Dying for Coverage in Florida

More than six people die each day in Florida because they do not have health insurance. A new Families USA report is the first-ever state-specific report of its type, based on a ground-breaking national study by the Institute of Medicine, which in 2002 forged the direct link between a lack of health coverage and deaths from health-related causes. The report also finds that:Between 2000 and 2006, the estimated number of adults between the ages of 25 and 64 in Florida who died because they did not have health insurance was more than 13,600. Across the United States, in 2006, twice as many people in that same age category died from a lack of health insurance as died from homicide. (March 2008, Families USA)

Poll: Voters Want Quick Action on Uninsured

More than three-quarters of voters want the next president and Congress to take quick action to help the more than 47 million Americans without health care coverage get it, according to polling data. 83 percent of voters feel immediate action on the issue is required, with 55 percent of voters saying it was "very important" and 28 percent listing it as "somewhat important." About a quarter of voters also said they fear not being able to pay for health care benefits (15 percent) or losing their coverage (11 percent). Other health-related concerns grabbing the electorate's attention include overhauling the current medical malpractice system, requiring Medicare to negotiate prescription drug prices and changes to entitlement programs. (March 2008, by American Viewpoint for Federation of American Hospitals)

Third EBRI/Commonwealth Fund Consumerism in Health Care Survey

Enrollment in consumer-driven and high-deductible plans still makes up a very small segment of the overall insurance market. Enrollment in consumer-driven plans with a tax-advantaged account represented 2 percent of privately insured adults in 2007, up from 1 percent in 2006. One of 10 insured adults had high-deductible health plans without accounts. Evidence shows that the percentage of consumer-driven plan enrollees with high incomes--above $100,000--swelled in 2007. Indeed, one of the major criticisms of these plans is that they attract wealthy and healthy participants rather than those with lower incomes and poorer health status. The survey found that consumer-driven plan enrollees are in better health, are less likely to smoke, and are more likely to exercise; they are also more likely to be white, male, and higher-income. And they are no more likely to have been uninsured prior to enrollment than adults in other plans. Over the three years of the survey, there have been no significant gains in the amount of information on provider cost and quality made available by health plans. (3/18/08, Commonwealth Fund)

ERISA Pre-emption: Implications for Health Reform and Coverage

provides an overview of state and local attempts at comprehensive health insurance reform and finds that ERISA limits states’ ability to carry out these reforms. For example, ERISA prevents states from establishing minimum levels of coverage for employer-based plans and limits their ability to fund health insurance subsidies for low-income adults through a tax. (Feb 2008, EBRI Issue Brief)

Moving Beyond Access: Achieving Equity In State Health Care Reform

The Institute of Medicine’s 2003 Unequal Treatment reportraised the public’s and policymakers’ awarenessof racial and ethnic health care disparities, but federal policy-makershave implemented few of the report’s more than two dozenrecommendations. State health care reform efforts, however,are gaining support around the country and have great potentialto reduce health care inequality. This paper offers a policyframework to explore how states can move toward eliminatingdisparities by addressing health care access and quality, statehealth care infrastructure, patient and community empowerment,state policy infrastructure, and social and community determinantsof health. (Mar/Apr 2008, Health Affairs)

Access for All America Report: Congress Should Increase Funding for Community Health Centers

Community health centers could save taxpayers as much as $40 billion per year in health care costs if the federal government is willing to invest $10.5 billion over the next eight years The report, titled "Access for All America," urges Congress to increase the funding for health centers between 12 and 15 percent each year. The centers would use the money to invest in new facilities and technologies, such as health IT, and the improvements would allow health centers to increase the number of patients to 30 million by 2015. (March 2008, National Association of Community Health Centers)

Study Finds Doctor-Owned Facilities Get the Best Insured Patients

Well-insured patients are more likely to be referred to a physician-owned, ambulatory surgical center rather than hospital outpatient departments, limiting access to the best care and possibly undermining hospitals' ability to cover uninsured patients, according to a study in the journal (March 2008, Health Affairs)

Warfare and Health Care

Martin Luther King Jr. described the horrific trendline four decades ago: "A nation that continues year after year to spend more money on military defense than on programs of social uplift is approaching spiritual death."... Nearly one in six Americans has no health insurance, and tens of millions of others are badly underinsured...The United States...now spends about $2 billion per day on military pursuits. (3/12/08, Perspective)

Drug Prices Climbing

Drugmakers increased their prices last year by an average of 7.4 percent for brand-name medicines most commonly prescribed to the elderly, according to the advocacy group AARP. The increase was about 2.5 times overall inflation, continuing a long-standing trend. (3/5/008, AARP by AP)

Who Really Pays for Health Care? The Myth of 'Shared Responsibility

discusses the "misconception" that employers and the government pay a significant share of U.S. health care costs. Concludes that employer-sponsored health benefits are a component of overall worker compensation, and the government increases taxes on the current population, borrows from future generations or cuts other necessary programs to pay for increases in health care costs. Also discusses how the "myth of shared responsibility" makes it difficult to remove employers as part of efforts to overhaul the U.S. health care system. (3/5/08, JAMA)

Four In 10 Americans Say They Have Trouble Paying For Drugs Or Skip Prescriptions Or Cut Pills Due To Cost

A new poll finds Americans greatly value prescription drugs' potential benefits for their families, but most believe they cost too much money and many struggle to pay for needed medicines. Four in 10 Americans (and half of those regularly taking at least one medication) report experiencing at least one of three cost-related concerns in their family: 16 percent say it is a "serious" problem to pay for prescription drugs; 29 percent say they have not filled a prescription in the past two years because of the cost; and 23 percent say they have cut pills in half or skipped doses in order to make a medication last longer. People are most likely to report one of these three issues if they lack drug coverage (52 percent), if they have low incomes (54 percent) or if they take four or more drugs regularly (59 percent). Forty four percent of Americans who ask their doctors about an advertised medicine are prescribed the drug. Nearly one-third of Americans inquire about specific prescription drugs after viewing ads for these products. (3/4/08, Harvard School of Public Health, USA Today and KFF, March 4, 2008)

New Listings: Health Disparities

2007 National Healthcare Quality Report

2007 National Healthcare Disparities Report.

examine improvements in health care quality between 1994 and 2005 and trends in health care disparities since 1994. The quality of health care continues to improve at a modest pace. However, the rate of improvement appears to be slowing. (3/4/08, AHRQ)

New study urges stroke checkup for Hispanics

Previous studies have shown that clogged carotid arteries increase the risk of heart attack and stroke in Caucasians and African Americans. Now, a new study shows that Hispanics with even a small amount of plaque in their arteries are four times more likely to suffer or die from a stroke or heart attack than Hispanics with no plaque. (3/21/08, Miami Herald)

The Gap Gets Bigger: Changes in Mortality and Life Expectancy, by Education, 1981-2000
It's no secret that over the last few decades, life expectancy in the United States has been rising. However, recent data shows that not everyone has benefited from this encouraging trend. New findings demonstrate that individuals with more than 12 years of education have significantly longer life expectancy than those who never went beyond high school. (March/April 2008, Health Affairs)

Minorities More Likely Than Whites To Rate Their Health Care As Fair Or Poor
Minorities are more likely than whites to rate the quality of their health care as fair or poor, according to a survey of 4,334 U.S. adults in 2007. The study found that 91% of whites rated their care as excellent or good. For most ethnic groups, the percentage that rated care as excellent or good was lower than that of whites, with the lowest ratings among Chinese-Americans at 74%, blacks born in Africa at 73% and Vietnamese-Americans at 72%. (March/April 2008, Health Affairs)

Racial and Ethnic Disparities in U.S. Health Care: A Chartbook
Research shows that minorities in the United States are in poorer health, have more trouble accessing care, are more likely to be uninsured, and receive lower-quality care more often than other Americans. Containing 75 charts and accompanying analysis, this unique resource presents emerging evidence linking many disparities to the overall performance of local health care systems. According to the research team, U.S. minorities may disproportionately live in regions where the quality of care is suboptimal. (3/13/08, Commonwealth Fund)

Black, Latino Children More Than 12 Times As Likely As White Children To Both Be Poor and Live In Poor Neighborhoods

Almost 17 percent of black children and 20.5 percent of Latino children in the United States live in "double jeopardy," meaning that they live in both poor families and poor neighborhoods, according to research released today in the March/April issue of the journal Health Affairs. In contrast, only 1.4 percent of white children live in double jeopardy. According to researchers, the type of neighborhood one lives in plays a significant role in racial and ethnic health disparities. (Mar/Apr 2008, Health Affairs)

Health Views Differ along Ethnic Lines

Minorities are more likely than white patients to rate their health care as fair or poor, a view that is particularly true among Chinese-Americans, blacks born in Africa and Vietnamese-Americans. Researchers have long stressed that improving patients' perception of their care is important to improving outcomes. That's because negative experiences can lead to less time spent with a physician and poor communications between doctor and patient. (3/10/08, AP)

Do Hospitals Provide Lower-Quality Care to Minorities than to Whites?

Research has shown that minority patients tend to have primary care physicians with less clinical training, see specialists with poorer clinical outcomes, and seek care at lower-performing hospitals than do white patients. However, a new Commonwealth Fund-supported study finds that when minority patients and white patients seek care at the same hospital, they receive the same standard of care. (3/11/08, Commonwealth Fund)

The Characteristics and Performance of Hospitals that Care for Elderly Hispanic Americans

is the first to examine where Hispanics receive hospital care and finds that a small number of hospitals care for most elderly Hispanics in the nation. The researchers document how hospitals that disproportionately serve Hispanics provide lower-quality care for common medical conditions. (Mar/Apr 2008, Health Affairs)

Disparities in Physician Care: Experiences and Perceptions of a Multi-Ethnic America

If public policies provided minority groups with better insurance coverage and language skills, many of the health care disparities found in this study would be narrowed. (Mar/Apr 2008, Health Affairs)

Evaluating Interventions to Reduce Health Care Disparities

Now that racial/ethnic disparities have been well documented, what can be done to reduce them in real-world settings? (Mar/Apr 2008, Health Affairs)

Challenges to Using a Business Case for Addressing Health Disparities

For health care organizations, the social case for reducing health disparities should be just as important as the business case. (Mar/Apr 2008, Health Affairs)

Geographic and Racial/Ethnic Disparities in Child Health

paints a disturbing picture of an "unequal geography of opportunity." (Mar/Apr 2008, Health Affairs)

Racial-Ethnic Inequality in Child Well-Being from 1985-2004: Gaps Narrowing, but Persist reports that, since 1985, racial and ethnic disparities in children’s health have decreased, which is largely due to behavioral changes such as decreases in violent crime and drug use, and increases in family income. Although these disparities have improved, the overall well-being of children in the U.S. is far below that of our international peers. (Jan 2008, Fdn. for Child Development)

Racial and Ethnic Disparities in Medical and Dental Health, Access to Care, and Use of Services in US Children found that minority children experience multiple disparities in these areas of health care, and certain disparities were particularly marked for specific racial/ethnic groups. For example, asthma and speech problems are particularly problematic for African Americans, and unmet medical and dental needs are more common for Native Americans. (Feb 2008, Pediatrics)

Black/White Differences in Very Low Birth Weight Neonatal Mortality Rates among New York City Hospitals

Black babies with very low birth weights are nearly twice as likely as their white counterparts to be born at New York City hospitals with high risk-adjusted neonatal death rates, according to a study published in Pediatrics and conducted with support from The Commonwealth Fund, the Agency for Healthcare Research and Quality, and the National Center for Minority Health and Health Disparities. (3/3/08, Pediatrics)

Using Healthy Eating and Active Living Initiatives to Reduce Health Disparities

This report, targeted at communities and public health organizations, recommends healthy eating and active living initiatives as a key approach to reducing health disparities, and outlines five strategic principles that have emerged from interviews with leading national programs and relevant literature for increasing the probability of successful and sustainable outcomes. (Feb 2008, Institute for Alternative Futures)

New Listings: Other Health Issues

Kaiser Health Tracking Poll: Election 2008

According to the latest poll, the economy has eclipsed health care and the Iraq war on voters' priority list, but health care plays a role in voters' priorities in two ways: as an independent issue and as part of the growing concern about the economy. The poll finds that among registered voters, health care ranks third as the issue that they want presidential candidates to discuss during the campaign. Party differences exist, with health care ranking second for Democrats, third for independents and fourth for Republicans. The public also links health care costs with the economy overall, with 64% of registered voters saying that significantly lowering the cost of health care would help the overall economic situation in the U.S. The March tracking poll also examines political independents and those who name health care as one of the most important issues in their vote for president. (3/7/08, KFF)

Substance Use, Mental Health Problems by State

Substance abuse and mental health problems affect every state, but to varying degrees, according to a new report from the Substance Abuse and Mental Health Services Administration.

Florida Reports

State of Breast Cancer Report Names Florida as One of the "Most Restrictive" for State Assisted Breast Cancer Treatment
Florida is part of a minority of states that still determines a woman ineligible for Medicaid-funded treatment unless she was screened through the state program, restricting access to care for those diagnosed elsewhere. The Florida Suncoast Affiliate of Susan G. Komen for the Cure is on a mission to lobby the state legislature to change laws affecting women seeking Medicaid-funded treatment for breast cancer. The affiliate also encourages survivors, their families and the Tampa Bay community to contact their local and state representatives, urging them to revisit the laws governing breast cancer treatment. The Report provides information on advancements in diagnosis, treatment and research that have made breast cancer a survivable disease for more than 2 million people in the United States. The report also explores cultural, social, educational and financial barriers – or disparities – that prevent many people from getting screening and receiving life-saving breast cancer care. (11/26/07, Susan Komen Fdn)

Florida Funding For Safety-Net Hospitals Could Be Affected By Proposed Property Tax Cuts

Proposed cuts to Florida property taxes could reduce funding for safety-net hospitals in fiscal year 2009. The "low-income pool" of local and state tax dollars, which receives federal matching funds to reimburse hospitals that provide care to low-income and uninsured residents not covered by Medicaid, is mostly funded by ad valorem property tax revenue. Gov. Charlie Crist (R) and state lawmakers have proposed cutting those taxes this year. (1/3/08, Tampa Tribune)

Too Great a Burden: Florida Families at Risk A Report on the Impact of Healthcare Costs on Florida Families

Over the past eight years, relentless growth in health insurance premiums and out-of-pocket costs has made spending on health care an increasing burden. For many Floridians, this means that health care is consuming an ever-growing share of their budgets, forcing them to make difficult sacrifices in other areas so they can make ends meet. And for many hard-working families, the burden of these health care costs has become too great to bear. (Dec 2007, Families USA)

Miami-Dade Health Profiles 2007

The Health Council of South Florida released the South Miami-Dade 2007 Health Profile in fall 2007. The South-Miami Dade Health Profile is the second in a series of area Health Profiles prepared for Miami-Dade County's Office of Countywide Healthcare Planning as part of the Building Better Communities General Obligations Bond Program which seeks to improve access to primary care throughout Miami-Dade County. A Health Profile of the Miami Beach Service Area was released in July, and one focusing on the North Miami-Dade Service Area will be released in December. Comparative data is included for Miami-Dade as a whole. The profiles provide a general overview of the population, health needs and resources available in the Service Areas.

(Florida) AHCA's Annual Report on Medicaid Reform

(delivered 10/1/07)

Annie E. Casey Foundation: 18th KIDS COUNT Data Book

2007 Miami-Dade County Community Health Report Card: Health improvement through benchmarking, priority setting and leadership engagement

Intended as a “call to action” for area health care advocates and policy makers, the report assesses how well systems and institutions are meeting residents’ needs. It analyzes and synthesizes 93 health indicators, examines pervasive continuing racial and ethnic disparities, and sets targets for ten priority need areas including access to health care and coverage.

Florida Children’s Action Agenda 2007/2008 Available Online
Florida state Senators Nan Rich and Durell Peaden and Representatives Loranne Ausley and J.C. Planas have released the final recommendations of the 2006 Florida Children’s Summit. The Summit participants learned a lot, and the next Summit in Fall 2008 will reflect that. In 2008 they will spend substantially more time in workshops hashing out recommendations and will secure experienced workshop facilitators who are knowledgeable about the topics they are facilitating. Also, they will institute a process to ensure that when leaving the 2008 Summit - or very shortly thereafter - all will know the Summit recommendations.

Report looks at uninsured in Florida
This report from the Research Institute on Social and Economic Policy at FIU documents and breaks down Florida's uninsured figures, finding 18.5% of the total Florida population uninsured. The report looks at employment and industry data related to lack of coverage, and proposes a partial solution.

Medicaid

Administration’s Medicaid Regulations will Weaken Coverage, Harm States, and Strain Health Care System
Over the last year, the Administration has issued a series of Medicaid regulations and an interim final rule, which implements a provision of the 2006 Deficit Reduction Act. Taken together these changes will reduce federal Medicaid spending by close to $15 billion over the next five years. Unless Congress acts to block them, the regulations will detrimentally impact children and people with disabilities, educational services, the foster care system, and health care services such as trauma care and neonatal intensive care, upon which entire communities rely. (2/13/08, CBPP)

HHS Failed To Show Budget Neutrality Before Approving Florida, Vermont Medicaid Waivers
HHS did not ensure that two Medicaid pilot projects in Florida and Vermont would be budget neutral before approving them. Under federal law, states can obtain a federal waiver for pilot programs to test new ways of delivering care under Medicaid if they can show that spending would not rise faster than it normally would. However, in approving the Florida and Vermont programs, "HHS approved spending limits that were higher than the limits that would have been granted if HHS had held the states to limits based on benchmark growth rates," the report found. In addition, "HHS' basis for approving the higher spending limits was not fully supported by documentation," according to GAO. (March 2008, GAO)

Rules Would Give State Medicaid Programs More Flexibility

The Centers for Medicare & Medicaid Services today published a proposed rule allowing states to change premiums and cost-sharing structures for certain Medicaid recipients, and impose higher cost-sharing for certain drugs and non-emergency care provided in a hospital emergency department. (2/20/08, AHA News Now)

Children's Health

Dental Decay: The Hidden Health Crisis
According to Maryland Senator Ben Cardin's staff, dental decay is now the most common chronic childhood disease in the US, affecting twenty percent of children aged 2 to 4, fifty percent of those aged 6 to 8, and nearly sixty percent of fifteen year olds. It is five times more common than asthma among school age children...Improper hygiene can increase a child's adult risk of having low birth-weight babies, developing heart disease, or suffering a stroke. (1/18/08,The Nation)

Medicare

Higher Spending Relative to Medicare Fee-for-Service May Not Ensure Lower Out-of-Pocket Costs for Beneficiaries
Medicare Advantage plans can cost beneficiaries more than traditional Medicare for home health care, nursing homes and certain hospital stays. However, CMS "protested GAO's approach to the report, saying it did not focus on the advantages" of enrollment in MA plans. (2/28/08, GAO)

Cost of Benefits to Seniors, Especially Health Care, Skyrocketed in 2007
"The cost of government benefits for seniors soared to a record $27,289 per senior in 2007," which is an increase of 24 percent above the rate of inflation since 2000, according to an analysis. (2/14/08, USA Today)

CMS Program Identifies 371.5 Million Dollars In Improper Medicare Payments In Three States

CMS has announced that $371.5 million in improper Medicare payments has been collected from or repaid to health care providers and suppliers as part of a demonstration program using recovery audit contractors (RACs) in California, Florida and New York in 2007. Nearly $440 million has been collected since the program began in 2005. (2/28/08, CMS)

First Rigorous Analysis Defines Impact Of Medicare Part D

The most thorough study to date of the impact of the Medicare Prescription Drug Benefit (Part D) found that this benefit led to a 13.1 percent decrease in out-of-pocket expenses for patients and a 5.9 percent increase in prescription use. (2/5/08, released early online, Annals of Internal Medicine)

Federal Budget/Health Care

Health Insurance, Health Care Costs

The Future of Employment-Based Health Benefits: Will Employers Reach a Tipping Point?
This article summarizes discussion at the Employee Benefit Research Institute's December 2007 policy forum, which sought to assess reports that the US employment-based health benefits systems has reached a "tipping point" because of ever-rising costs, with employers entering a period of fundamental change in providing health benefits to workers. (Feb 2008, EBRI Notes)

Poll Shows Americans Back Democratic Health Care Proposals
A poll conducted by NPR, the Kaiser Family Foundation and the Harvard School of Public Health found that most Americans support key elements of Democratic presidential candidates Hillary Clinton and Barack Obama’s health care proposals and want to do "something about the problem of 50 million Americans being uninsured." (2/29/08, NPR)

Health Policy Reform: The 2008 Elections and Beyond

A new Commonwealth Fund supplement outlines the problems plaguing our health system, as well as policy options to address them. The supplement draws on the work of The Commonwealth Fund Commission on a High Performance Health System and other research as it addresses 10 key questions facing the nation. (March/April 2008, Columbia Journalism Review)

State of the States 2008: Rising to the Challenge

This report outlines 2007 efforts to expand health insurance coverage and find new tools to address health care reform at the state level. While many states made progress, key contributors to uninsurance remain unchecked and historically difficult policy questions remain unanswered. According to the report, steady increase in the number of uninsured has been a hallmark of the last decade, precipitated by unprecedented declines in employer-based coverage. In 2007 the trend continued and, like last year, was exacerbated when public program funding remained flat, failing yet again to offset new losses. This one-two punch hits children particularly hard, swelling the ranks of uninsured kids by 700,000 in 2006 and accounting for more than one-quarter of the growth in uninsured. (Feb 2008, RWJF)

The U.S. Economy And Changes In Health Insurance Coverage, 2000–2006

The number of uninsured Americans increased by 3.4 million between 2004 and 2006, despite improving economic conditions. In the first four years of the decade, during a period of economic recession, the number increased by 6.0 million. The dominant factor in both periods was a decline in employer-sponsored insurance coverage.” (2/20/08, Health Affairs)

America Will Be Spending One Fifth Of GDP On Healthcare By 2017
A new US government analysis estimates that the country's spending on national health will continue to grow steadily and reach nearly 20 per cent of gross domestic product (GDP) by 2017, outpacing economic growth and inflation. (2/25/08, CMS, in Health Affairs)

Uninsured and Dying Because of It: Updating the Institute of Medicine Analysis on the Impact of Uninsurance on Mortality In 2002, the Institute of Medicine (IOM) estimated that 18,000 Americans died in 2000 because they were uninsured. Since then, the number of uninsured has grown. Based on the IOM’s methodology and subsequent Census Bureau estimates of insurance coverage, 137,000 people died from 2000 through 2006 because they lacked health insurance, including 22,000 people in 2006” (Jan 2008, Urban Institute)

Health Disparities

Hospitals Create Programs to Help Minority, Immigrant Populations Navigate Health System

Hospitals are creating education programs that focus on the challenges minority and immigrant populations face in navigating the U.S. health system. The Holy Cross Hospital Ethnic Health Promotion Program, which uses community leaders -- including foreign-trained physicians who cannot practice medicine in the U.S. -- and "laymen to teach prevention in the immigrants' languages and in the context of their various cultures." The goal of the program is to reduce "costly emergency room admissions," according to the Post. Each culture has a different way of interacting with health providers, and the "concept of going to a doctor for checkups is novel to many minorities and immigrants," the Post reports. Many immigrants delay seeking care for conditions that would have been treatable through office visits, and sometimes patients are unaware that their condition is treatable because it would not have been in their home country (Feb 2008, Washington Post)

Recent Trend Of Growing US Disparities In Health Not Inevitable

In the most comprehensive study to date addressing this debate, researchers at the Harvard School of Public Health (HSPH) found that, as overall health improved (as measured by a decline in mortality rates), inequities in health both shrank and widened between 1960 and 2002. The study demonstrates that the recent trend of growing U.S. disparities in health status is not inevitable. (2/26/08, PLoS Medicine)

The Fall and Rise of U.S. Inequities in Premature Mortality: 1960-2002
Heath inequities between rich and poor, as well as between different racial and ethnic groups, shrank in the U.S. from 1966 to 1980, then widened from 1980 to 2002, as measured in rates death in the young and in infants. Additionally, according to the study, if all people in the US had experienced similar health gains to the most advantaged groups (namely, whites in the highest income groups) between 1960 and 2002, 14% of premature deaths among whites and 30% of premature deaths among people of color would not have occurred. (Feb 2008, PLoS Medicine)

Business Group Wants To Reduce Health Disparities

The National Business Group on Health and the U.S. Department of Health and Human Services are teaming up to help employers become aware of racial and ethnic inequities in health care delivery. Health disparities are defined as persistent gaps between the health status of minorities and non-minorities in the United States. (2/12/08, Employee Benefit News)

Unequal Health Outcomes in the United States

A broad coalition of over 25 national health advocacy and civil rights organizations released a report to the United Nations Committee on the Elimination of Racial Discrimination, describing racial inequality in health care, health outcomes, and environmental health in the U.S. Through extensive research, this comprehensive report demonstrates that inequity in the health care infrastructure and in social and environmental conditions is the cause behind health disparities. (January 2008, report to the United Nations Committee on the Elimination of Racial Discrimination)

Health, United States, 2007

is a compilation of more than 150 health tables. Nearly one in five U.S. adults - more than 40 million people - report they do not have adequate access to the health care they need, according to the annual report on the nation's health released by the Centers for Disease Control and Prevention (CDC). The report also contains a special section focusing on access to care, which shows that nearly 20 percent of adults reported that they needed and did not receive one or more key services in the past year including medical care

America's Health Rankings: A Call to Action for People and Their Communities
This report ranked states' overall health based on 20 well-being factors, including poverty levels for children, violent crime, obesity, and racial and ethnic health disparities. The report indicated that health disparities remain between minorities and whites. In addition, the report shows that Hispanics have the lowest percentage of access to routine dental care and colon cancer screenings. (November, 2007, United Health Fdn., American Public Health Assn., Partnership for Prevention)

Other Health Issues

The Effects of Childhood Stress on Health across the Lifespan

[T]he beneficial aspects of stress diminish when it is severe enough to overwhelm a child's ability to cope effectively. Intensive and prolonged stress can lead to a variety of short- and long-term negative health effects. It can disrupt early brain development and compromise functioning of the nervous and immune systems. In addition, childhood stress can lead to health problems later in life including alcoholism, depression, eating disorders, heart disease, cancer, and other chronic diseases. (CDC)

Primary Care Professionals: Recent Supply Trends, Projections, and Valuation of Services

The number of American doctors specializing in primary care in U.S. residency programs has decreased from 23,801 in 1995 to 22,146 in 2006, according to a recent report by the GAO. Senator Bernie Sanders suggested the report reflects an increasing dependence on international providers for primary care and recommended Congress offer more scholarships to American students interested in specializing in primary care. (2/11/08, GAO)

2008 Federal Poverty Guidelines
HHS has released its updated guidelines. (1/23/08, Federal Register