June 3, 2008

Congress Closer to Blocking New Medicaid Rules, But Time is Short

Advocates have been expressing grave concerns about new federal rules crafted last year by the Bush Administration that would eliminate federal funding for 7 different types of Medicaid services. The rules would shift costs to already strapped states and communities by cutting off federal funds. Vulnerable consumers would lose access to critical services. Advocates are calling on Congress to act fast to finalize legislation including yearlong moratoria on all of the new regulations before they can impact access to services. (by Greg Mellowe, Florida CHAIN)  Read more

 

TAKE ACTION: Congress Must Protect Vital Medicaid Coverage!

 

Months of hard work and unrelenting advocacy by advocates paid off when the Senate voted 75-22 (a veto-proof majority) to delay seven harmful Bush Administration Medicaid regulations for one year. The House will vote on the bill in the next few weeks. Tell Congress to work quickly to protect health coverage and to delay all seven regulations before states have to make harmful cuts to Medicaid or other social service programs – just click here to send a message.  

Legislature fails to “Buy In”
Work Incentive Medicaid Coverage Initiative Update 

During a very difficult budget period, the “Medicaid Buy In” failed to successfully move through the Florida legislature this past session.  However, advocates for persons with disabilities who want to work have much to cheer about and big goals to look forward to. Special CHEERS to many including Senator Crist who has agreed to move this legislation forward in the next session! (by Olga Golik, Citrus Health Network) Read more

 

Health Plans Offer Feedback on Medicaid Reform

AHCA conducted the 3rd in its series of periodic “continuous improvement” sessions for HMOs and PSNs participating in Medicaid Reform. The discussions were intended to elicit plans’ feedback about their experiences during Reform implementation and expansion. Not surprisingly, as much of the program was designed with their needs in mind, much of the plans’ feedback was positive, unlike that from the one session to which consumers were invited. How the feedback provided factors into the next expansion push, and how any changes made to accommodate plans impact consumers, will be of keen interest. (by Greg Mellowe, Florida CHAIN) Read more

New Florida CHAIN Issue Brief: Health Plans' Persistently Consumer-Unfriendly and Divergent "Preferred Drug List" Posting Practices Exemplify Unresolved Challenges in Medicaid Reform

 

As with other benefits made available under Florida Medicaid Reform, the prescription drugs covered by health plans (PDLs) can deviate significantly from standard Medicaid. Although this flexibility has been touted as increasing consumer choice, meaningful choice is not possible given the lack of simple and direct access to usable information. Longstanding Reform problems with plans' PDLs on-line are unresolved. These problems may stem from AHCA's reluctance to impose requirements, and its apparent unwillingness to enforce even the weak requirements it has already imposed. (by Greg Mellowe, Florida CHAIN) Read more

Study Investigates “Other Half” of KidCare Applicants

As part of its 2007-8 evaluation of the Florida Healthy Kids Corporation, the Institute for Child Health Policy at the University of Florida was asked by to investigate why children whose parents apply for KidCare ultimately do not obtain coverage through the program. The findings warrant attention: almost half (49%) of the surveyed families that applied for KidCare were never enrolled, and this broad group is comprised of several subgroups, each of which is more likely to face some relatively distinct barriers and circumstances.  (by Greg Mellowe, Florida CHAIN) Read more

Oral Health for Underserved Populations: 2008 Legislative Session

 

The #1 chronic childhood disease in the U.S, tooth decay is 5 times more common than asthma. Over 4 million children are functionally impaired by dental pain with school performance and attendance, sleeping, eating, or concentrating. But increasing access to prevention and care has been a challenge in Florida. Gov. Crist developed a Proposal for the 2008 legislature to expand dental providers' capacity and the safety net to treat more underserved. Neither the House nor the Senate bills passed; however, many were educated and momentum developed that must be continued. (by Elise Linder, Collins Center for Public Policy) Read more

Health Insurance Costs Outpace Income, While Employer-Sponsored Coverage Declines - in Florida More than Other States

A new RWJF report finds a 30% combined increase paid by employees and their employers for family coverage over 4 years, while employee income increased only 3%. Florida mirrors and in a number of ways surpasses the national trend. A recent Economic Policy Institute analysis also found that employer-sponsored coverage has declined continually over 6 years, reflecting a “structural” change. Cover Florida and the Florida Health Choices programs signed into law last week are thus not surprising, and will soon sanction mass marketing of pseudo-coverage,making underinsurance a norm and precluding real reform. (by Greg Mellowe, Florida CHAIN) Read more

 Specialist Attrition Leaves Medicaid Reform Consumer Borrowing or Without Needed Care
 
So far, all of my decent specialists and primary physicians under Reform Medicaid have told me the plans are not fulfilling their promises to pay for treatment. This has made it impossible for them to accept these plans and they are all dropping out.  Only the worst doctors are continuing, it seems. My health is declining, and I fear that my only choice for decent health care will be to move out of the state and far away from my family. But I don't think I can afford that. Already I am borrowing money to see specialists who are not accepting my plan. 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: 3167-B Gardens East Drive, Palm Beach Gardens, FL 33410 info@floridachain.org     www.floridachain.org

Congress Closer to Blocking New Medicaid Rules, But Time is Short

 

As reported previously, for the past several months, advocates nationwide have been vocally expressing their concerns about new federal rules crafted last year by the Bush Administration that would eliminate federal funding for 7 different types of Medicaid services. All of these new rules would shift costs to states and communities by cutting off federal funds for services widely seen as important and necessary. As a result, given the bleak picture at the state and local levels, vulnerable consumers will lose access to critical services.

 

Medicaid-related services performed by school personnel, targeted case management services provided by child welfare agencies to children in foster care, and graduate medical education in teaching hospitals - to name a few - would all be eliminated. The State of Florida estimated that Florida’s Medicaid program would lose $665 million over the next 5 years under the new rules.

 

In response to the outcry, Congress has been considering legislation that would impose moratoria on (i.e., completely block) the implementation of the new Medicaid rules until at least April 2009. The House passed such legislation on April 23 by a huge (veto-proof) margin, but the Senate unfortunately didn’t consider the bill. Instead, with rules scheduled to go into effect beginning May 25, the moratoria were incorporated into a massive budget bill related to “emergency supplemental appropriations”.

 

Thanks to advocacy by providers and advocates, as well as awareness by Congress of the necessity of these services, both House and Senate passed versions of the bill that would block the implementation of all 7 regulations.

 

The President had attempted to dissuade the Senate from voting for the moratoria by pushing back the implementation date for the 2 regulations most opposed by providers and hospitals to at least August 1st.

 

At about the same time, a federal judge blocked one of the two rules from taking effect anyway, agreeing with charges that the Administration both overstepped its authority and improperly issued the rule on the very day that the prior moratorium took effect. The judge ordered that the rule be withdrawn and that the Administration refrain from any further activities to implement it.  Furthermore, a related legal challenge was recently filed asking a judge to stop another of the rules from going into effect.

 

Unfortunately, even though both House and Senate have each weighed in as to the necessity of the moratoria, the two chambers differ on other aspects of the bill, particularly funding for the war in Iraq. It is therefore not yet clear when the differences will be resolved and the bill can be sent to the President.

 

Time is running short, however, as the May 25th cut-off has already passed, and several of the rules will soon begin to take effect if no relief is forthcoming.  For example, the regulation cutting off federal funding for a number of Medicaid-related activities serving low-income  children such as care planning, service coordination; and monitoring of/referrals to health services – simply because they are performed by school personnel - will take effect June 30.

 

Advocates are calling on Congress to act fast to finalize legislation that includes yearlong moratoria on all of the new regulations before they can impact access to services (please see the accompanying alert from Children's Defense Fund, which urges advocates to ask Congress to work quickly to protect Medicaid coverage and to delay all seven regulations in order to avoid harmful cuts.).

 

Information used in this alert was provided by the Center on Budget and Policy Priorities and the National Conference of State Legislatures.

 

(Submitted by Greg Mellowe, Policy Director, Florida CHAIN)

 

Legislature fails to “Buy In”

Work Incentive Medicaid Coverage Initiative Update 

 

During a very difficult budget period, the “Medicaid Buy In” failed to successfully move through the Florida legislature this past session.  However, advocates for persons with disabilities who want to work have much to cheer about and big goals to look forward to. 

 

Cheers goes to Senator Crist and Rep. Reed who sponsored the bills, entitled Optional Payments for Medical Assistance. The proposed bills included the Medicaid Buy In changes requested by the Partnership for Work and Healthcare.

 

The Partnership is a coalition of over 30 organizations and hundreds of individuals throughout the state trying to change Florida law to allow people with disabilities to go back to work with less fear of losing their Medicaid coverage. This effort is called the Work Incentive Medicaid Coverage Initiative that is sometimes referred to as “Medicaid Buy In”. 

 

Cheers goes to the members of the Partnership who worked very hard this year in getting the word out about this new initiative, partners too numerous to mention!. Over 1,000 brochures were distributed, meetings were held around the state, a website was created with over 3,000 hits, and hundreds of emails were sent to our legislatures.  

 

Cheers goes to the Health Foundation of South Florida and National Disability Institute, Inc. who helped pay for much of the educational materials. Cheers to the Substance Abuse and Mental Health Corporation and the Eli Lilly Foundation for their early work in calling the partnership together and sponsoring the first meeting last July. Cheers to CHAIN Reaction for their ongoing help in promoting this!

 

Special CHEERS go again to Senator Crist who has agreed to move this legislation forward in the next session! Now that we have a sponsor, we need to start working on efforts to get this passed in the next legislative session! 

 

The website continues to be a resource for research on this issue and the latest updates. Be sure to sign in at www.partnershipforwork.com so you can stay informed.

 

If you want to get more involved by joining a working committee, contact Barbara Butz at Capstone Consulting to receiving notices of conference calls and the next meeting scheduled for June 19. Her email is barbara@askcapstone.com. Cheers to all of you that support efforts to change Florida law so everyone who wants to work, can!

 

 (Submitted by Olga Golik, Esq.,

Citrus Health Network, Inc.)

 

 

Health Plans Offer Feedback on Medicaid Reform

On April 28, the Agency for Health Care Administration (AHCA) conducted the third in a series of its periodic “continuous improvement” sessions. The only participants in the sessions were the health plans (health maintenance organizations [HMOs] and provider service networks [PSNs]) participating in Medicaid Reform. (PSNs are networks organized and operated by a health care provider or group of affiliated providers, where the providers deliver a substantial portion of the care and have a controlling interest in the governing body.) The roundtable discussions were intended to elicit feedback from plans about their experiences during initial Reform implementation and subsequent expansion into rural counties.

 

Not surprisingly, much of the feedback by the plans provided to AHCA was positive, unlike the one session to which consumers were invited. Indeed, plans seem one of the least likely sources of criticism of Reform, as much of the program was designed with their needs in mind. Yet the sailing has not been uniformly smooth for all plans, and some of the frustrations, especially on the part of PSNs, bubbled to the surface during the sessions.

 

For example, although the feedback from HMOs regarding choice counseling - and regarding virtually all aspects of implementation, for that matter - was almost universally positive, some PSN representatives complained that counselors were not well-educated about issues pertaining to consumers with special needs. They further observed that it has taken a full year in some cases to clear up some of their previously expressed concerns, characterizing the difficulty as an unintended consequence of the “arms length” distance that choice counselors are to maintain from plans in order to avoid the appearance of favoritism.  Attendees expressed concern that choice counselors didn’t (and to some extent still don’t) know the nuances of plans and their characteristics beyond the basic list of benefits, and that inaccurate or incomplete representation to consumers about the benefits of the PSN model was one result. For example, HMOs’ elimination of many copayments was reportedly emphasized by choice counselors as a primary basis for selecting a plan.

 

PSNs also discussed other aspects of Reform that they believe disproportionately burden them, such as complicated reporting forms with which many HMOs are already familiar, the need for continuous changes “on the fly”, and labor-intensive administrative requirements that small plans cannot absorb easily. They also lamented the fact that they must deal with both their own claims administrator and the Medicaid fiscal agent further essentially doubles the administrative complexity for PSNs. In addition, problems with Medicaid’s outgoing fiscal agent (ACS) were cited as a particularly significant source of ongoing hardship, particularly due to the lack of training and available technical support. PSNs complained that they were blamed by providers for these problems that they did not cause. 

 

PSNs also explained that they have been somewhat surprised to find themselves at such a competitive disadvantage compared with HMOs in terms of financing. PSNs do not operate on a capitated basis (i.e., they do not receive a fixed payment per enrollee like HMOs) for the first 5 years, but providers instead bill at the usual “fee for service” rate. HMOs, which are capitated, have the flexibility to shift surplus funds generated by lower utilization in some areas to fund the availability of additional benefits such as dental services or dermatology. The problem is exacerbated by PSNs’ generally small enrollments, as they lack the size necessary to create economies of scale. This inflexibility will likely also continue to prevent PSNs from participating in more tenuous initiatives such as expansion into rural counties. Language was added to a version of the Medicaid-related budget bill last Session that PSNs believed would level the playing field to an extent, but it did not survive the budget negotiation process.

 

Overall, PSNs seemed to feel that a sustained dialogue about the future of the PSN model is needed. In particular, there seem to be questions about whether PSNs are a viable alternative to HMOs under the current structure of the Medicaid Reform experiment. PSNs may struggle to maintain their identity and structural integrity, and at a minimum, it may be necessary to consider whether PSNs should be allowed to operate more like HMOs.

 

HMOs’ primary concerns, by contrast, related to the rapid pace of changes in areas such as quality, marketing and rate-setting, and the expectations that Reform plans measure more and perform better  than their counterparts in non-Reform. HMOs were also asked about their decision about whether or not to participate in the expansion to the rural counties in 2007. Numerous challenges had dissuaded all but two from joining the effort, including uncertainty about economic viability, inability to secure contracts with hospitals and specialty providers, and concern that the pool of consumers was too small to allow plans to reach “critical mass”.

 

In fact, the only concrete reason the plans who did participate could offer was that they wanted to “go along with the State” in its effort, with the implication being that there may not have even been a rural Pilot if not for sheer determination to avoid failure at the outset. Several other HMOs were apparently taking a “wait and see” attitude.  During expansion, however, the two HMOs found that building the network was not as difficult as they thought, because Jacksonville (in the initial Pilot area) already serves as a “medical hub” for the surrounding counties.

 

With Reform expansion off the table for the moment, how the feedback provided factors into the next expansion push, and how any changes made to accommodate plans impact consumers, will be of keen interest.

(Submitted by Greg Mellowe,
Policy Director, Florida CHAIN)

 

 

Study Investigates “Other Half” of KidCare Applicants

 

As part of its 2007-08 evaluation of the Florida Healthy Kids Corporation, the Institute for Child Health Policy at the University of Florida was asked by the Corporation’s Board to investigate why children whose parents apply for KidCare ultimately do not obtain coverage through the program. Administrative records for more than 65,000 children were reviewed, and 600 household representatives completed an extensive telephone survey.

 

First and foremost, the Institute’s findings confirm that is a significant issue that warrants attention: almost half (49%) of the surveyed families that applied for KidCare were never enrolled. Beyond this, their analysis revealed that this broad group of non-enrolling children is comprised of several different subgroups, each of which is more likely to face some relatively distinct barriers and circumstances.

 

Specifically, of the kids who did not obtain KidCare coverage, 14% were actually approved but their families did not accept the coverage, while 36% applied, but were found ineligible. The remainder - fully 50% - did not complete the application process.

 

Note: Florida ranked a dismal 50th in an analysis of children's health issues released today. Watch the Ch. 4 story that features Julieta Romano, HSC health care advocate and mother of four, and Daniella Levine, HSC president and CEO.

In terms of the relationship between income and enrollment, families above 200% of the poverty level (>$42,400 for a family of four) were most likely to not enroll. These children are not eligible for State-subsidized coverage in Florida (although many other states cover kids at considerably higher income levels). And until a few weeks ago, a restriction existed in State law limiting the percentage of uninsured children above 200% of poverty level whose families could “buy in” to Kid Care “full pay” coverage. The elimination of that restriction was part of the health insurance bill the Governor recently signed into law.

 

On the other hand, the remainder of the applicants (i.e., below 200% of poverty), are income-eligible. However, the study found that the lower the family’s income, the greater the likelihood that the child did not enroll in KidCare. Older children were a little less likely to obtain coverage than younger children.

 

In addition, the lowest-income families were also the most likely to be found ineligible. The nature of the ineligibility was not fully explored, but the study indicates that “[m]ost of these children were referred to the Department of Children and Families for Medicaid screening but did not comply with the DCF review process.”

 

But it is lowest-income children who are eligible for the Medicaid component of KidCare. In other words, as children get older, the income limit for Medicaid gets higher. The point of that observation is that the lowest-income kids are all Medicaid-eligible and so are the ones screened by the Department of Children and Families.

 

Perhaps the higher rates of ineligibility among lowest-income kids can be attributed to limited resources (which could include issues relating to the process such as obtaining documentation as well as issues not related to the process such as having to move frequently). Or perhaps some aspect of the DCF screening process serves an impediment to enrollment. Or both. The study does not address this, but it may be worth noting that younger children (ages 0-5) are also more likely to be determine ineligible, and again these are children are most likely to be eligible for the Medicaid component and routed through DCF.

 

The Florida KidCare Coordinating Council, a diverse group of child advocates, health care providers, local government representatives and others who are responsible under Florida law for making recommendations concerning the implementation and operation of KidCare.  They have consistently recommended that KidCare be streamlined by creating a single administration for eligibility across all components of the program.

 

The study also explored the “opposite” situation, namely that applicants who had not been determined to be ineligible nevertheless believed that they were ineligible for KidCare coverage. In fact, 29% of those with incomplete applications AND 18% of those who were eligible but did not accept coverage reported receiving a notice stating that their child was ineligible, which obviously should not be possible. As the authors note, “this suggests that some families may be misunderstanding communication that they receive from the program and, therefore, prematurely discontinue the application process.” 

 

Among those who never completed the application process, respondents cited the following as the main reason for that outcome: they never heard back from the program (24%), they couldn’t provide the background documentation (9%), they found another source of coverage (8%), or they sent in the materials but the program said they did not send them in (8%).

 

There is no indication of how these responses have changed over time, but a number of these issues have been the focus of continuous KidCare improvement efforts for a number of years. Indeed, 87% of respondents agreed that the application form was easy to understand and a clear majority agreed that the process was made “about as easy it could be”.

 

That said, however, the study points out the importance of continuing those efforts. Among survey respondents (none of whom enrolled a child in KidCare despite applying), 63% reported that no other source of coverage had been obtained for their children, and the bulk of those kids had been without coverage for more than a year. And the rate of coverage among those whose parents did not complete the application was lowest of all.

(Submitted by Greg Mellowe,
Policy Director, Florida CHAIN) 

  

 

Oral Health for Underserved Populations: 2008 Legislative Session

 

The Surgeon General’s report of 2000 stated that tooth decay was the number one chronic childhood disease in the country, 5 times more common than asthma.  Unfortunately, not much has changed in the past eight years even though early tooth decay is preventable. Children that have dental pain are unable to function in school and nearly 52 million school hours are missed annually by children because of oral health problems.  In the United States, over four million children suffer dental disease bad enough that they have functional impairments from dental pain such as not sleeping or eating well, or not being able to concentrate. That is why prevention and early intervention is so important.  Access to dental care can drastically change these outcomes.

 

But increasing access to dental care has been a challenge in Florida. Florida Department of Health data shows that Florida ranks 29th in the United States at one dentist per 1,961 people.  Florida averages one dentist per 9,747 Medicaid children.  Only about 10% of Florida dentists participate in Medicaid and 52% of Florida’s counties have one or zero Medicaid dentists.  Florida’s dentists are also retiring faster than new dentists come in.  Florida ranks 11th in the states for number of dentists who are aged 55 and older.

 

Some state statutes create barriers for dentists, hygienists and other medical professionals to provide more services in public health settings. For example, Florida is one of three states not to offer licensure by credential where dentists from out of state can be licensed to practice in public or private settings. Florida is one of only nine states that does not allow hygienists to place sealants without the presence of a dentist. Sealants have been shown to be effective in reducing cavities and tooth decay in children and are a key tool for preventive dental care.

 

Governor Crist developed a Dental Health Proposal for the 2008 Florida legislative session, which tried to address the need to expand the capacity of dental providers and the safety net health care system to treat more underserved children and families. With the support of some legislators in the House and Senate, bills were introduced to:

  • Create a new category of “public health supervision” for hygienists to provide direct access to preventive services in public health settings in order to maximize the existing workforce of hygienists in public health settings.
  • Permit hygienists to place sealants without a dentist present in public health settings in order to maximize the effectiveness and quantity of the treatment children receive.
  •  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.

Governor Crist also recommended $21.8 million to increase reimbursement fees to dentists by an average of 20%.  He also 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 well child visits.

 

Neither the House nor the Senate bills passed; however, a great deal of attention was focused on oral health needs and the capacity of the dental provider community to provide treatment.  Building on that momentum, it is important that legislators, policymakers and community stakeholders continue to be informed about the impacts that poor and no access to dental care has on children and families.  Early intervention and prevention are key to educating the entire community about living healthy, and good oral health is part of that for all of us.

 

(Submitted by Elise Linder, Assistant Director,
Community Voices Miami,

Collins Center for Public Policy)

 

 

Health Insurance Costs Outpace Income, While Employer-Sponsored Coverage Declines - in Florida More than Other States

 

Last month, the Robert Wood Johnson Foundation released “Squeezed: How Costs for Insuring Families Are Outpacing Income”, a report prepared for them by the State Health Access Data Assistance Center. Using data obtained from ongoing federal surveys of individuals and employers to examine trends in employer-sponsored health insurance, the researchers found that:

  • The combined amount paid by employees and their employers for family coverage increased by 30 percent nationwide in 4 years: from $8,281 in 2001 to $10,728 in 2005.
  • However, employee income increased by only 3 percent during the same time period.
  • The average cost employers paid for their share of family coverage increased by 28 percent: from $6,360 to $8,143.

The situation in Florida mirrors and in a number of ways surpasses the national trend. For example, the total (again including both employer and employee contributions) annual premium for family coverage increased 29% from 2001 to 2005, from $8,409 to 10,852. That equates to an average monthly premium increase of $204 during that time span.

 

In addition to the skyrocketing overall cost of coverage, the portion absorbed by employees also increased as Florida employers buckled under the strain of the increased costs. Of the total premium amount, the average portion contributed by employees increased from 28% to 32%, in contrast to a far less burdensome increase of less than 1% reported for the nation as a whole. Yet during the same period, Florida workers’ incomes increased by only 2%.

 

The untenable nature of this situation is evidenced, in part, by the drop in the percentage of Florida companies offering health insurance.  While almost 57% of the state’s employers offered coverage in 2001, that rate had fallen by 5½% to just over 51% by 2005. Florida’s service sector-dependent economy makes the problem more severe here than in most of the rest of the nation, which as a whole experienced a disconcerting but not nearly as severe 2% drop in “offering” rate, with the percentage of employers making coverage available falling from 89 to 87%. 

 

On a related note, Economic Policy Institute researchers reported that their own analysis showed that, although a majority of the nation’s workers continue to obtain health coverage through their own employers, there has been a continuous decline in employer-sponsored coverage in each year from 2000 to 2006.  Due to a variety of factors, particularly increasing costs, the percentage of workers covered through their employers dropped from 51.1% to 48.8% over the 6 year period. The authors note that this decline has been unaffected by the status of the economy, and instead reflects a more “structural” change in the health insurance industry and the way workers obtain coverage.

 

Perhaps of equal significance, the researchers noted that, whatever forces are behind this structural shift eroding the system of employer-based coverage, changes in the nature of the workforce (such as the decline in manufacturing jobs) are not the primary causes. The bulk of the reduction in job-related coverage rates were actually within the same types of jobs, not between different types. Other factors, such as the aging of the workforce, have increased the cost of health coverage somewhat, but the authors found that coverage rates have declined among all worker age groups.

 

Given the findings of these reports and their implications for the future of employer-sponsored coverage in Florida, the recent emergence of the Cover Florida and the Florida Health Choices programs signed into law last week is not surprising. These initiatives will soon sanction the mass marketing of pseudo-coverage to uninsured individuals as well as to small businesses and their employees. If businesses continue to opt out (or be forced out) of providing real coverage that their workers can afford, and if true health insurance reform is further delayed, becoming underinsured through one of these new efforts may be one of the only “alternatives” to going without coverage altogether for countless Floridians.

 

NOTES:        

1) All figures are reported in 2005 dollars (i.e., adjusted for inflation).

2) The study considered only private sector employees.     

 

(Submitted by Greg Mellowe,

Policy Director, Florida CHAIN)

 

REAL STORIES FROM FLORIDA HEALTH CARE CONSUMERS

 

Specialist Attrition Leaves Medicaid Reform Consumer Borrowing or Without Needed Care

 

To whom it may concern:
 
I wrote you previously on my issues with Reform Medicaid here in Broward County. There have been more developments, and for the worse.
 
So far, all of my decent specialists and primary physicians under Reform Medicaid have told me that the coverage plans are not fulfilling their promises to pay for their patients' treatment. This has made it impossible for them to accept these plans and they are all dropping out of those plans.
 
Even in the up-to-date booklets listing doctors accepting these plans, those doctors have been telling me that they are no longer accepting the Reform Medicaid plans anymore. Each month, I call up customer service and they give me names of doctors that are accepting plans at that moment; most, however, have already dropped out by the time I try to schedule an appointment! Only the worst doctors are continuing to accept the plans, it seems.
 
I had an excellent endocrinologist under my plan. She just sent me a notice that she is no longer accepting any Reform Medicaid plan, including mine. I called her, and she said that the payments are not going directly to her and she can no longer afford to accept my plan.


I also had two primary physicians under Reform Medicaid who were both excellent doctors. After a couple of months, they explained to me why they had to drop the plans -- they said they would go out of business if they didn't.
 
They also said that the additional paperwork their offices had to do under Reform Medicaid wasn't worth it.
 
All of these doctors had previously accepted straight Medicaid for many years, and were all upset for their patients that they had to lose them due to the deficiencies of the Reform Medicaid plans.
 
I contacted the governor's office three times and spoke with a representative of Gov. Crist, and each was told to take it up with the Reform Medicaid consultants. I was also told that I always had the choice of other plans under Reform Medicaid; however, I have already tried out a few of the choices and found out that my current plan had been rated the best. Also, my booklet listed more member physicians under this plan, but when I tried to make appointments for some of them, they had already dropped the plan.
 
I understand that Reform Medicaid will soon be extended to the rest of Florida outside of Broward County.
 
My health is declining, and I fear that my only choice for decent health care will be to move out of the state and far away from my family here in south Florida. But I don't think I can afford that. Already I am borrowing money to see specialists who are not accepting my plan. That's how bad it is.
 
Thanks for listening to my story. I hope someone in the Legislature hears this and realizes that Reform Medicaid in its present form cannot be foisted upon the other one million Medicaid recipients in Florida. 

 
Amy Silverman

Florida CHAIN Seeks Stories

 

Florida CHAIN welcomes contributions from health care consumers who are interested in sharing their experiences with readers of CHAIN Reaction. If you have a story to share, please contact  lisam@floridachain.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   

 

Notices

 

Free Dental Clinic To Help the Hurting

July 7– 10  8:00 am – 4:00 pm  Jacksonville

The homeless on the street, a single mom living in an overcrowded multi family housing community, even a mom and dad who go to work every day to take care of their children, all have one thing in common. Florida Baptist Convention Dental Mobile Home , a state of the art, multimillion dollar medical clinic will be in Jacksonville for 5 days this year. Dental and medical professionals and other volunteers, medical supplies, soft food, tax deductible donations needed. There will be a kids zone for fun. Contact Bill Kolb at               904-381-6229        or               904-502-6007        or at wkolb@comcast.net

CENTRAL FLORIDA

 

National Alliance on Mental Illness (NAMI) Annual Convention
June 13-16   Orlando 
This convention draws together over 2,500 mental health advocates, healthcare professionals and consumers from throughout the United States and the world. Register by May 16 for early rate of $225.

 

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 

Events

 

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

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       .

 

Florida Mental Health Summit 
July 8   Renaissance Vinoy Resort, St. Petersburg  
Presented by the Council of State Governments Contact pgoins@csg.org or               859-244-8142       

 

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

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.

 

2008 Minority Health Disparities Summit

Event: Aug 13-15   Grand Hyatt, Tampa Bay

The Florida Department of Health (DOH), Office of Minority Health (OMH) announces the Summit. This year’s theme is “Bridging the Gap: Embracing Solutions to Eliminate Health Barriers.” It will examine health barriers that contribute to health disparities. The goal is to present solutions and/or interventions to these barriers to help bridge the health gap in Florida. Individuals can register for the conference in June for $100, or $110 after July 18. CEUs for select sessions. Rooms may now be reserved at the Grand Hyatt Tampa Bay for $117 per night by calling               (813) 871-1234        or               (800) 233-1234       . Poster presenters, exhibitors and sponsors needed. Contact Thometta_cozart@doh.state.fl.us or               (850) 245-4444       , ext. 2035.

 

 

Notices

Pinellas residents can get free discount drug cards, which may not be used in conjunction with any health insurance plan, including Medicare and Medicaid, but will help those seeking discounts on drugs. 

SOUTHWEST FLORIDA

  

SOUTHEAST FLORIDA

  

Events

 

Women and Family Health Fair

June 7   10:00 am – 2:00 pm  La Hermosa Baptist Church, 28140 SW 152 Ave, Homestead

Free food, entertainment and health screenings.Sign language interpreters will be provided free of charge upon request. Auxiliary aids and services will be provided upon request including printed material in alternative formats. Requests should be addressed to               305-576-5001        x16 or patriciam@hscdade.org seven days in advance.

 

HSC’s Advocacy Corps Trainings

May 17 – July 26, Alternate Saturdays from 10 am-1 pm

Human Services Coalition, 260 NE 17th Terrace, Suite 200, Miami

The goal of the Advocacy Corps is to develop a group of skilled, trained advocates around issues such as healthcare, who can become leaders in communicating with elected officials about issues that matter to them and to their communities. Participants will hone their communication skills, learn more about important issues they read about in the newspaper, and become more involved in holding elected leaders accountable. Selected topics include: June 14 Children’s Health Insurance/Writing Letters to Newspaper Editors; July 12 Medicaid Getting Others to Join You. Breakfast will be served Sign language interpreters will be provided free of charge. Auxiliary aids and services will be provided upon request including printed material in alternative formats. Requests should be made seven days in advance. For more information – including topics – or to RSVP – contact               305-576-8050       , Ext. 12 or roxannep@hscdade.org

Haitian American Nurses Association of Florida (HANA) Health Fair
June 14   9:00 am- 2:00 pm   Bethel Evangelical Church, 17601 NW 2nd Ave, Miami
Join HANA and its collaborators at this free fair, as a participant or partner/sponsor. Education and service screenings, and Healthy Kids and Medicaid info will be provided for 300-500 people of all ages. Contact info@hana84.org or               305-609-7498       .

Health Council of South Florida 40th Annual Meeting
June 16  11:00 am-3:00 pm, Biltmore Hotel, Coral Gables

The meeting will address healthcare professional shortages. $65.00 per guest. Contact awheelock@healthcouncil.org or               305-592-1452       , ext 100

 

Project Yay Town Hall Meeting to Save Children’s Healthcare

June 18  9:00 am    Peach Education Foundation Bldg, 1900 Biscayne Blvd, Miami

Sign language interpreters will be provided free of charge upon request. Auxiliary aids and services will be provided upon request including printed material in alternative formats. Requests should be addressed to               305-576-5001        x32 or megb@hscdade.org seven days in advance.

Haitian American Nurses Association of Florida (HANA) Complimentary Networking Dinner

June 21  6:30 pm  Miami Dade College, North Campus, Rm 4106 (bldg 4 inside the cafeteria)

Guests may bring cans of food, carnation milk or any other non-perishable items/goods to help eliminate the suffering of hunger for the people in Haiti

Sponsored by Primary Medical Staffing, inc. (PMSi). RSVP by June 18 to -305-609-7498 or info@hana84.org 

 

Notices

 

Survey seeks Florida public feedback about U.S. healthcare

Healthcare for All - Florida (HCFAFL), a grassroots nonpartisan group, has launched a survey that gives the public an opportunity to voice their opinions about the U.S. healthcare system. Take the survey now!

 

Ovarian Cancer Survivors Sought to Teach Students

The Florida Department of Health and the Ovarian Cancer National Alliance are looking for ovarian cancer survivors who might be interested in participating in the Survivors Teaching Students (STS) Program. They are looking for about 5 women from Miami-Dade, Broward, Palm Beach, and/or Martin counties. Pass this along. Contact Mary Shafer               (850) 245-4444        ext 3854 or Mary_Shafer@doh.state.fl.us

 

Women Beyond Cancer is a national non-profit organization that provides free retreats for women dealing with cancer. Its Chairwoman lives in Miami Beach and is interested in letting others know about their services, and in being part of the Collaborative. Contact murfeebrwn@aol.com

 

FLORIDA AUDIO CONFERENCES AND WEBCAST

STATEWIDE NOTICES  

 

NATIONAL EVENTS & NOTICES

 

CONFERENCES AND EVENTS 

    

AcademyHealth State Health Research and Policy Interest Group Meeting

June 7  10:00 am-5:00 pm  Washington, DC, Marriott Wardman Park

This is an opportunity to hear presentations and research regarding the latest efforts to improve state health policy, including expanding access to care and improving quality of care delivered. Cosponsored by The Commonwealth Fund, the meeting goes beyond presentations to engage the audience in interactive, roundtable discussions with a focus on learning from, and with, peers. The meeting will feature sessions on evaluating state health reform efforts, the politics of health reform, state health research applications, and care coordination and delivery for vulnerable populations.

 

Diversity and Disparities: Parallel Challenges for 21st Century Health Care   

June 19-20   San Antonio, TX

The 8th National Leadership & Educational Conference of The Institute for Diversity in Health Management will feature scholars, thought leaders, expert practitioners and nationally recognized authorities on workforce diversity and the causes and effects of health care disparities. Panelists and speakers from leading health care organizations will share best practices and lessons learned in diversity strategy development and implementation to promote equity in care and medical outcomes.

 

Promote optimum health for Black women - physically, mentally and

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. 

Diversity and Disparities: Parallel Challenges for 21st Century Health Care   

June 19-20   San Antonio, TX

The 8th National Leadership & Educational Conference of The Institute for Diversity in Health Management will feature scholars, thought leaders, expert practitioners and nationally recognized authorities on workforce diversity and the causes and effects of health care disparities. Panelists and speakers from leading health care organizations will share best practices and lessons learned in diversity strategy development and implementation to promote equity in care and medical outcomes.

 

Building Capacity to Eliminate Health Disparities: The Founding Conference of the Academy for Health Equity

June 26-27  Denver

The inaugural founding conference of the Academy for Health Equity is critical to developing the knowledge-base for those engaged in health disparity activities by facilitating trans-disciplinary translation exchanges of the latest research and practical applications.

 

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.

The Annual Conference on Assessment Initiative

Poster session abstract deadline: July 18  e-mail to Nelson Adekoya at nba7@cdc.gov

August 18-20   Atlanta, GA

Sponsored by CDC, this meeting will focus on sharing information on innovative systems and methods that improve the way data are used in public health programs, services, and policies at the local and state levels. Sessions will address data dissemination, health assessment research, applied data analysis, presentation techniques, and community health-assessment processes and outcomes.

 

Participate in a Medical Homes Summit

July 24-25   Washington, D.C.

On behalf of the National Academy for State Health Policy (NASHP) and the Patient Centered Primary Care Collaborative, The Commonwealth Fund invites states to apply to participate in the Medical Homes Summit.  This Commonwealth Fund-supported summit is designed to help state policymakers improve the quality and availability of medical homes for Medicaid and State Children Health Insurance Program (SCHIP) beneficiaries. The summit will host teams from up to 10 states that are developing or have committed to developing medical home initiatives. Participants will meet with peers and nationally recognized experts to examine promising practices, brainstorm new approaches, and begin to apply the lessons learned to participating states' plans.

 

Influence of Early Life Events on Later-Life Outcomes

Paper submission deadline: Aug 1
March 12-13, 2009  Ann Arbor, MI

There is recent and growing evidence that events very early in life have large and lasting impacts on economic, social, psychological, and health outcomes later in life. The National Poverty Center (NPC) at the University of Michigan is sponsoring the second in a series of conferences on this topic. Submit four copies of a 3-4 page abstract and CV to the NPC, University of Michigan, G. R. Ford School of Public Policy, Weill Hall, 735 South State St., Ann Arbor, MI 48109. The abstracts will be reviewed by the conference organizers, and the most promising papers will be chosen to be presented at the conference. Travel, lodging and meal expenses for one author per selected paper will be provided by the NPC. 

Becoming the Healthiest Nation in a Healthier World

Conference: Sept 9-12   Sacramento

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 conferences

 
Building Sustainability into Grant-Funded Programs: Making the Case Using Data, Partnerships and Health Improvement Strategies

June 19 2:00-3:00 (ET)

Grant funding is often used to start, or expand, community health programs and services. What happens to those programs and services when grant funding ends? Learn how one community collaborative used data, partnerships and health improvement strategies to secure sustainable funding after grant support expired. $40 (members) and $80 (non-members)

 

Cutting through the Clutter: Building Awareness of and Identity for Community Benefit
July 17 2:00-3:00 (ET)

In health care, our primary goal of patient-centered care is enmeshed in volumes of quality reporting and regulation. Important issues related to patient safety, regulatory compliance, performance improvement and cost containment take a fair amount of our focus on the job. In competing for “air time” in this noisy environment, community benefit information is considered “nice to know,” rather than “need to know.” How can we get the attention of our co-workers, when the volume around all our other strategic priorities is so loud? $40 (members) and $80 (non-members)

 

Conducting High Quality Community Health Assessments: Two Communities Illustrate Contrasting Approaches
August 21 2:00-3:00 (ET)

$40 (members) and $80 (non-members)  

NOTICES

 

The American Journal of Public Health (AJPH) Theme Issue

Submission deadline: Aug 1

This issue will feature current research and contributions of environmental justice and community-based participatory research projects to the fields of environmental and occupational health. Key topics to be addressed include exposure assessment, especially as it relates to cumulative risk; environment-related diseases; community based approaches to improving exposure and disease surveillance for populations that are hard to track; and evaluation of partnerships designed to promote health research, education, and prevention/intervention programs for low-income, immigrant, and minority populations who may be disproportionately exposed to environmental and occupational stressors. All manuscripts will undergo the standard peer review process by the AJPH editors and peer referees as defined by AJPH policy. Submit manuscripts to http://submit.ajph.org/  

 

Wal-Mart Expands Program Providing Drug Discounts

Wal-Mart Stores has announced that it would expand its discounted prescription drug program to offer 90-day supplies for $10. It also said it would lower the price of more than 1,000 over-the-counter drugs. The company is in the third phase of a program that began in 2006 to provide a 30-day supply of generic prescription drugs for $4.

 

CAMPAIGNS & INITIATIVES

 

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             

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

 

Funding to Examine Effects of Public Reporting and Pay-for-Performance on Health Care Quality       

Deadline: June 12 (Brief Proposals)

Robert Wood Johnson Foundation seeks proposals for projects to examine the effects of public reporting and pay-for-performance on health care quality.

Interdisciplinary teams that include investigators focused on public reporting and pay-for-performance are encouraged to apply. Preference will be given to those applicants who may be either public entities or nonprofit organizations with 501(c)(3) tax- exempt status. Proposals should demonstrate the potential to produce high- quality, scientifically sound research. Up to $4 million in total funding is available for grants of up to three years for policy-relevant research.

 

Hablamos Juntos Seeks Innovator Health Facilities To Implement Symbol-Based Signage

Deadline: July 1

The Pioneer Portfolio supports innovative ideas and projects that may lead to important breakthroughs in the future of health and health care.  Four volunteer health facilities are sought, ready to implement new signage or wayfinding systems using symbol-based signage and to help develop best practices for health environments. Facilities selected will be rewarded with award-winning wayfinding systems, a practical solution in health care signage for multilingual and literacy challenged populations.

 

American Academy of Pediatrics: Community Access to Child Health Program Planning Funds
Deadline: July 31

The Community Access to Child Health (CATCH) Program, a national program of the American Academy of Pediatrics, is designed to improve access to health care by supporting pediatricians and communities that are involved in community-based efforts for children. The CATCH Planning Funds program provides grants in amounts from $2,500 to $12,000 for pediatricians in the U.S. and its territories to develop community-based initiatives that increase children's access to medical homes or to specific health services not otherwise available. Planning project activities must lead to sustainable, community-based child health initiatives that increase access to care, especially for underserved children, and address health disparities among children.  

Continuing listings, in order of submission deadlines 

   

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.

 

CVS Caremark Charitable Trust Grants to Improve Lives of Children with Disabilities

Deadline: June 15

The trust focuses primarily on supporting charitable organizations that are making a difference in the lives of children with disabilities. Resources are also allocated to help support organizations focused on providing healthcare to the uninsured. All applications must be submitted online.

 

Children's Dental Health Grants

Deadline: July 17

The American Dental Association Samuel Harris Fund for Children's Dental Health Grants Program awards grants to oral health promotion programs designed to improve and maintain children's oral health through community education programs. Maximum Award: $5,000. Eligibility: community-based, not-for-profit, oral health promotion programs in the United States.

 

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.

Community-Based Child Health Initiatives
Deadline: July 31
American Academy of Pediatrics 2009 CATCH Resident Funds grants will be awarded on a competitive basis for pediatric residents to plan community-based child health initiatives. CATCH Resident Funds grant projects must include planning activities but also may include some implementation activities. Maximum Award: $3,000. Eligibility: Pediatric residents working with their communities.

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. 

 

GE Healthcare Charitable Giving Program

Deadlines: 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.

 

2009-10 Packer Policy Fellowships

Deadline:  Aug 15
This Australian-American Health Policy Fellowships Program offers a unique opportunity for outstanding, mid-career U.S. health policy researchers and practitioners to spend up to 10 months in Australia conducting original research and working with leading Australian health policy experts on issues relevant to both countries.

 

Department of Health and Human Services Understanding and Promoting Health Literacy (R21)
Letters of Intent Receipt Date(s): Aug 22, 2008; April 24, 2009; December 24, 2009
Application Submission/Receipt Date(s): Sept 24, 2008; May 25, 2009; Jan 25, 2010

 

2009-10 Harkness Fellowships in Health Care Policy and Practice
Deadline: Sept 5
The Commonwealth Fund Harkness Fellowships provide a unique opportunity for mid-career professionals--academic researchers, clinicians, managers, government policymakers, and journalists--from Australia, Germany, the Netherlands, New Zealand, and the United Kingdom to spend up to 12 months in the United States conducting a policy-oriented research study, working with leading U.S. health policy experts, and gaining an in-depth knowledge of the participating countries' health care systems.

 

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.

2008-2009 Robert Wood Johnson Foundation Health & Society Scholars  
Deadline: Oct 3
This program is designed to build the nation’s capacity for research, leadership and policy change to address the multiple determinants of population health. The program is based on the principle that progress in the field of population health depends upon multidisciplinary collaboration and exchange. Its goal is to improve health by training scholars who have completed doctoral studies by Sept 2009 and have significant research experience. Up to 18 2-year stipends will be awarded

Community-Campus Partnerships for Health Annual Award
The Community-Campus Partnerships for Health Award recognizes exemplary partnerships between communities and higher educational institutions that build on each other's strengths to improve higher education, civic engagement, and the overall health of communities. Nomination guidelines for the 2009 CCPH Award will be posted online at www.ccph.info in Fall 2008. Partnerships may nominate themselves and need not be members of CCPH. Nominations are accepted from any country or nation. The 2009 award will be presented at CCPH's 11th Conference, April 29 - May 2, 2009 in Milwaukee.

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. 

 

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.

 

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.

 

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.

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

     Children's Health

     Medicaid

     Medicare

     Uninsured

     Health Disparities

     Other

Technology and Audio Visual Materials

     Media Programming

     Web Sites, Web Features

          Florida

          Children's Health

          Medicaid

          Medicare

          Health Disparities

          Other

     Audio, Videos and Films: Web, Rent/Purchase. Theater 

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

     Florida Reports

     Children's Health

     Medicaid

     Medicare

     Federal/State Budgets

     Health Insurance, Health Care Costs

     Health Disparities

     Other Health Issues

 

FLORIDA CHAIN WEBSITE RESOURCE UPDATE

New Florida CHAIN Issue Brief: Health Plans' Persistently Consumer-Unfriendly and Divergent "Preferred Drug List" Posting Practices Exemplify Unresolved Challenges in Medicaid Reform

As with other benefits made available under the Medicaid Reform Pilot Program, the prescription drugs covered by health plans (called Preferred Drug Lists, or PDLs) are permitted to deviate significantly from standard Medicaid. Although this flexibility has been touted as increasing consumer choice, meaningfully informed choice is still not possible given the lack of simple and direct access to usable information about those options. In particular, longstanding problems in Reform with respect to accessing plans' PDLs on-line have still not been resolved. These problems may stem from AHCA's reluctance to impose requirements ensuring clarity, accessibility and uniformity of consumer information, as well as from its apparent unwillingness to enforce even the weak requirements it has already imposed.

ORGANIZATIONS AND SERVICES

 

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

 

Florida

 

The Florida Discount Drug Card
is designed to lower the cost of prescriptions for Florida residents who are 60 and older and without prescription drug coverage or who fall into the Medicare Prescription Drug Coverage gap; OR under age 60, without prescription drug coverage, and with an annual family income of less than 300% of the Federal Poverty Level. Qualifying incomes include those below: $30,636 (individual); $41,076 (family of two); $61,956 (family of four). It can give eligible participants a discount on virtually all drugs and be used at all participating pharmacies.

 

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

 

Community Clinical Oncology Program
State-of-the-art clinical trials in your community medical practice
CCOP is a network for conducting cancer prevention and treatment clinical trials by community medical practitioners. This network connects academic centers (Research Bases who design and conduct the trials) with community physicians (CCOP, MB-CCOP) who accrue patients to those trials.

 

The National Alliance on Mental Illness (NAMI)

has released a new brochure, Women and Depression, about the many dimensions of major depression in women. It can be downloaded. The 13-page brochure highlights symptoms, causes, women of color, life stages, and treatment, with additional sections on seeking professional help, self-help, preventing recurrent depression, and helping other women. Bulk copies for community education can be purchased on-line.

 

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

 

First Focus Children's Budget 2008
This new publication informs readers of the sad state of funding for children's programs. Over the past five years, only one percent of every new, real non-defense dollar has been spent on children. The book provides an analysis of the over 180 federally funded programs that assist America's children. Downloadable book, fact sheet, powerpoint presentation. (2008, First Focus)

 

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

 

Return on Investment Calculator for Medicaid Quality Initiatives

The Center for Health Care Strategies (CHCS) has launched the Return on Investment Forecasting Calculator for Quality Initiatives, a Web-based tool designed to help Medicaid stakeholders identify programs with the potential to both improve health care quality and control costs.  It can generate realistic return on investment (ROI) estimates for quality improvement initiatives.

 

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)

 

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)

 

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

 

Medicaid and SCHIP: Critical for Latino Families Facing Financial Hardship is a new fact sheet that discusses how Medicaid is important to low-income Latino families, especially during economic hard times. The fact sheet argues that having access to Medicaid benefits prevents Latino families from having to compromise their health care or finances. (4/10/08, national Council of La Raza)

 

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)  

 

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

Environmental Health Disparities Fact Sheets

These US EPA fact sheets address disparities in secondhand smoke exposure and asthma among African American and Hispanic American children. The intended audiences are parents and community-based organizations working on environmental health issues of specific minority populations.

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.

 

Slides, Resource Links Added to Community Health Assessment Toolkit
ACHI has added a downloadable slide set illustrating the Community Health Assessment Toolkit's six steps, checklists, and other features.  Use it as a quick orientation for yourself or share it to build understanding among your community partners. The slides are accessible without logging in.  We've also updated and expanded the resource links in each step. 

  

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

 

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.

 

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

Children’s Health Coverage Conversation Guide

Children’s Defense Fund offers help with opportunities to talk about important issues with your friends and family, such as children's health coverage. Health coverage is going to be discussed on the campaign trail, on the nightly news and as a key reason why working Americans are having a difficult time paying their bills. Beware, there is a lot of misinformation out there! This guide provides helpful responses you can use to explain why health coverage for all children is a step forward for children that will improve the lives of all of us.

 

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.

 

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)

 

Uninsured

 

Election Year Health Reform Messaging (ppt presentation)

This election season we are working hard to promote comprehensive health care reform. But how do we talk about health care in a way that resonates with voters? Drew Westen, psychologist and author of “The Political Brain”, and Celinda Lake, political strategist and President of Lake Research Partners, recently completed cutting-edge research that identifies persuasive narratives, messages, and counter-responses to support health care reform. This project, funded jointly by Families USA, Herndon Alliance, and AARP, developed and rigorously tested a set of principled stands on health care reform. Rather than just produce a set of key words or phrases, the project developed a menu of narratives and the counter-responses to predictable attacks on the narratives.

 

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

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.

 

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

 

State Expansion Resource Center from Minority Health Initiatives at Families USA features states that have expanded, or are working to expand coverage, on a more comprehensive scale. Here too you will find the most recent headlines.

 

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

 

Latest Health Policy Facts and Data

The Kaiser Family Foundation has launched Kaiser Fast Facts, featuring QuickTakes and Kaiser Slides - two sources of facts, data and slides about the nation's health care system and programs.

 

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.

 

Audio, Videos and Films: Web, Rent/Purchase, Theater

Viewpoints: The Health Care Debate

This new series online from Kaiser Family Foundation Broadcast Studio features interviews with leaders of organizations representing health care providers, insurers, policymakers, employers, labor unions and consumers sharing their views on shortcomings in the nation's health care system and how it could be improved.

The Alliance for Health Reform recently hosted a briefing, Racial and Ethnic Disparities: States and Feds to the Rescue?, which examined what states and the federal government are doing to reduce racial and ethnic health disparities, and how they can continue narrowing the health gap. For more information and to view the webcast or listen to the podcast, click here.

The Kaiser Family Foundation hosted a webcast, State Initiatives to Reduce Racial and Ethnic Health Disparities, that examined current state efforts to improve access to care and health outcomes for minority populations in Massachusetts, Georgia, and Ohio. Panelists on the webcast also discussed how these initiatives fit into a state’s larger reform efforts and the role of the federal government. For more information and to view the webcast, click here.

The Congressional Black Caucus Health Braintrust and the National Minority Health Forum’s webcast of the recent two-day meeting, Health Equity and Justice Now!, includes the opening session and panel discussions covering a range of topics such as health care costs, health disparities, health quality, health equity, and social justice. To view the webcast, click here.

The Partnership for Quality Care hosted a summit, “Confronting the Chronic Care Challenge,” that focused on improving value in delivering care to patients with chronic conditions. In particular, the second panel of the summit focused on changing delivery systems to reduce inequities in health care. To view the entire summit or specific panels, click here.

 

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.

Unnatural Causes: Is Inequality Making Us Sick? 

Hosted by the Black Women’s Agenda, the workshop featured a panel discussion of this 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.

 

Can Tax Credits Be a Linchpin for Health Reform? Lessons from the Factory Floor

In a policy field notoriously beset by ideological and partisan division, one of the few ideas enjoying support across the philosophical spectrum is the use of federal income tax credits to cover the uninsured. The only credit of this sort now available-the Health Coverage Tax Credit (HCTC), serving workers displaced by international trade-aids no more than 15 percent of eligible households.  (4/1/08, Urban Institute)

 

PERIODICALS AND BOOKS

 

The Public Health Observatory Handbook of Health Inequalities Measurement

This new South East Public Health Observatory handbook primarily focuses on the measurement and interpretation of health inequalities.

 

Ahora Hablo! Medical Edition,"Simple Steps to Communicate with Spanish-speaking Patients 

Unlike other medical Spanish books on the market, this book is pocket-sized and includes vocabulary for dental and vision care as well as many specialized areas such as obstetrics and cardiology.  It retails for $9.95.  It is being picked up independent and college book stores as well as hospitals and clinics. For more information: m.h.graham@ahorahablo.com or call 414-331-7178

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. The April-June 2008 will be online.

REPORTS AND STUDIES

New Listings

New Listings: Medicaid

Insured, Low-Income Florida Patients Face Hurdles to Health Care Access

Having health insurance is only one of the hurdles that patients have to clear in order to see a doctor these days, according to a new study of Floridians receiving Medicaid. When interviewers posing as Medicaid patients called doctors' offices that participate in the Florida Medicaid program, they were met in some cases by disconnected numbers, phone trees and time on hold before they could find out about scheduling an appointment. (May 2008, Journal of Health Care for the Poor and Underserved)

New Listings: Children's Health

New SCHIP Enrollees Have Unmet Health Care Needs And Waiting Period Would Negatively Affect Them

Even with prior private health insurance, patients enrolling in the state children's health insurance program (SCHIP) had unmet health care needs. Instituting a waiting period would further prolong these children's need to address asthma and other chronic health conditions. (5/6/08, Medical News Today)

 

U.S. Variations in Child Health System Performance: A State Scorecard

Some conclusions: Across states, better access to care is closely associated with better quality of care; there is wide variation in children's access to care and health care quality across the United States and leading states consistently outperform lagging states on multiple child health indicators and dimensions. (5/28/08, Commonwealth Fund)

 

In Focus: Addressing the "New Morbidity" in Pediatrics Through Developmental Screening
Pediatric practices--urged on by their professional societies, the public, private initiatives, and, in some cases, new state requirements - are beginning to rethink their approach to identifying developmental and behavioral delays. Past physician surveys have found that only about 20 percent of physicians routinely use developmental screening tests. Even this number, says the report is an "overestimate," with the true figure closer to "10 percent or less." These low screening rates mean there are many missed opportunities to intervene early and promote children's health, learning, and school readiness. (5/15/08, Commonwealth Fund Quality Matters)

 

The Successful Integration of Health and Health Care into Broader Early Childhood Initiatives  

focuses on the collaboration between health care and other child and family services. The brief summarizes the proceedings of a 2007 GCYF Annual Conference Institute. Presenters explored four programs that have been successful integrating health care services with other complementary systems to benefit young children and their families. The brief describes each of the four programs and identifies the methods they used to link health care to other systems. It highlights common themes across those programs and concludes with a series of recommendations for practitioners, policymakers and funders to use in promoting effective multi-sector partnerships to enhance child development. (April 2008, Grantmakers for Children, Youth and Families)

 

Pediatric Emergency Department Visits in Community Hospitals from Selected States, 2005

Rates of pediatric ED visits varied by demographic characteristics with rates being highest among the youngest children (0-4 years) and boys, as well as by children residing in micropolitan areas and the poorest communities. (May 2008, H-CUP Statistical Brief #52)

U.S. Variations in Child Health System Performance: A State Scorecard

Some conclusions: Across states, better access to care is closely associated with better quality of care; there is wide variation in children's access to care and health care quality across the United States and leading states consistently outperform lagging states on multiple child health indicators and dimensions. (5/28/08, Commonwealth Fund)

Hospital Emergency Departments Treat Mostly Poor Children
AHRQ’s analysis compared rates of emergency room visits by children from low-income communities, where the average household income was $36,999, with those of children from high-income communities with an average household income of over $61,000. The rate for those from low-income communities was 414 visits for every 1,000 children. For children from high-income communities, the rate was 223 visits for every 1,000 children. The study was based on more than 12 million emergency department visits by children under age 18 in 23 States. (5/22/08, AHRQ News and Numbers)

 New Listings: Medicare

Rx Watchdog Report: Trends in Prices of Prescription Drugs Used by Medicare Beneficiaries

According to a new report released by AARP, manufacturer prices of 185 widely used generic drugs in Medicare Part D decreased by an average of 9.6 percent in 2007. A report from AARP earlier this year showed that manufacturer prices of 220 of the most commonly used brand-name drugs by Part D enrollees increased by more than seven percent during the same period. "Americans who are not taking advantage of lower-cost generic prescriptions are wasting their hard-earned money," said John Rother, AARP Director of Public Policy. " (May 2008, AARP)

 

Improving Medicare Savings Programs Would Help Low-Income Seniors Cope with Higher Medical Expenses

Seniors pay a much larger share of their income in out-of-pocket health costs than non-seniors do. The burden is especially great for seniors with low incomes; taking into account medical expenses would push an additional 2.4 million seniors below the poverty line. (May 2008, Center on Budget and Policy Priorities)

 

Make Protecting Seniors from Rising Medicare Costs a Top Priority

A telephone poll conducted by Harris Interactive found that 89 percent of adults aged 18 and over believe that improving programs to protect low-income seniors against rising Medicare costs should be a top priority for Congress this year” (May 2008, National Council on Aging)

 

More Attacks on Social Security and Medicare

[T]he real problem is not the budget and these key programs [Social Security, Medicare and Medicaid] on which tens of millions of people depend. The real problem is the United States has a broken health care system, which is projected to get progressively more inefficient through time...Health care reform is not only necessary to extend health care coverage to the uninsured, it is also essential for preventing our health care system from strangling the economy. (5/5/08, Center for Economic and Policy Research)

 

Making Part D Work Better

The Part D prescription drug benefit has been a much-needed and welcome addition to Medicare coverage. But for some beneficiaries--particularly those transitioning from Medicaid to Medicare prescription coverage--the program can be confusing and even disruptive, sometimes causing delays in getting needed medications. (May/June 2008, Commonwealth Fund Digest)

 

Medicare's Much-Too-Hard Sell

The worst abuses have been...selling the comprehensive policies known as Medicare Advantage plans. The government pays these plans 13 percent more, on average, than the same services would cost in the traditional Medicare program....All told, the unjustified subsidies will cost the government more than $50 billion from 2009 to 2012. (5/21/08,  New York Times)

New Listings: Federal/State Budgets

27 States Face Total Budget Shortfall of at Least $47 Billion in 2009; 4 Others Expect Budget Problems (Updated May 2008, CBPP)

Congressional Budget Plan: A Brief Analysis of the Conference Agreement
Both the congressional budget plan and the President’s budget assume enactment of legislation that will largely consume the surpluses projected for 2012 and 2013, but the legislation assumed in the congressional plan differs substantially from what the President’s budget proposes. (5/22/08, CBPP)

New Listings: Health Insurance, Health Care Costs  

Reinsurance: A Primer

One reform several states are considering is state-subsidized reinsurance, where states help to pay the highest cost medical claims in order to decrease everyone's premium prices. For information about reinsurance, please see our latest issue brief. (April 2008, Minority Health Initiatives at Families USA)

 

Who Pays for Health Care When Workers are Uninsured?

The public, along with workers, foot the bill when employers fail to provide their full-time workers with health insurance. This study finds that the public, along with workers, foot the bill when employers fail to provide their full-time workers with health insurance. Eroding employer-sponsored health insurance is costing U.S. taxpayers $45 billion a year, which includes $33 billion to cover public insurance—such as Medicaid or the State Children Health Insurance for Program—for workers and their dependents, and $12 billion for uncompensated health care that would otherwise covered by the workers' private insurance. (May/June 2008, Commonwealth Fund Digest)

 

U.S. Companies Are Struggling to Offset the Costs of Health Care Coverage
According to an analysis by the New America Foundation, U.S. manufacturers spend twice as much on employee health care coverage than their foreign competitors, and they are unable to "pass those costs onto workers by lowering wages or onto consumers by raising prices.” (5/6/08, Los Angeles Times)

 

GAO Study Again Confirms Health Savings Accounts Primarily Benefit High-Income Individuals

A new GAO report -- which examines IRS data for tax year 2005, as well as employer surveys -- finds:  Health Savings Accounts (HSAs) are used disproportionately by affluent households; Affluent HSA participants contribute much more to the accounts than other participants; Many HSA participants appear to be using their accounts purely or primarily as a tax shelter rather than paying for out-of-pocket health care costs; Many employers offering high-deductible health insurance plans and HSAs did not contribute to their workers’ HSAs. (5/19/08, CBPP)

 

Achieving Universal Coverage and Health System Savings

The presidential election has focused public attention on the need...to ensure health insurance for all, to make health care more accessible and responsive to patients, and to slow the growth in health care cost. This issue brief sets forth a framework for expanding health coverage that offers Americans a choice of a product modeled on Medicare to those under age 65, made available through a national insurance connector. (5/13/08, Commonwealth Fund)

 

The Building Blocks of a Better Health System?
A health reform proposal developed by Commonwealth Fund researchers holds considerable promise as a practical framework for achieving universal health coverage while containing health care costs. (5/13/08, Commonwealth Fund)

Building Blocks for Reform: Achieving Universal Coverage with Private and Public Group Health Insurance

presents a new health reform framework, built on the current U.S. mixed private–public system, that "provides a pathway to universal coverage with a minimal increase in total national spending and relatively modest net federal budget costs." The authors estimate the plan would insure 44 million of the estimated 48 million Americans currently lacking health coverage. (5/13/08, Commonwealth Fund)

 

Health Plans Say They'll Risk Losing Members To Protect Profit Margins

Meanwhile, businesses and individuals are dropping coverage in the wake of higher insurance premiums. The nation's largest publicly traded health plans say they don't plan to temper premium increases for the sake of keeping members on their rolls -- particularly not while they are under pressure from Wall Street over what it sees as their disappointing earnings. (5/19/08, AMNews)

 

Igniting Health Care Payment Reform

A new model for health care payment, PROMETHEUS Payment®, seeks to promote and reward high-quality, efficient, patient-centered care by using a novel method to pay hospitals, physicians and other providers. RWJF is helping to fast-forward the PROMETHEUS approach from concept to reality with a $6.4-million commitment to expand and test the model in pilot communities. (May 2008, Prometheus Payment Design Team)

 

2008 Medical Cost for "American Family of Four" Exceeds $15,600

The new Milliman study determined that the average annual medical cost for a family of four increased by 7.6% from 2007 to 2008.  This was lower than the 8.4% average annual rate of increase for the period 2004-2007, but the burden of overall expense is steadily shifting to employees. "The employee's share of spending on health care services rose by double digits for the second consecutive year in 2008," said ...We estimate the employees' portion of healthcare premiums increased 10.1% in 2008 over 2007.["] (5/14/08, Milliman)

 

Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help

shows that working young adults are much less likely than older workers to have access to health insurance through their employers. Just over half (53%) of 19- to 29-year-olds were eligible for coverage offered by their employers, compared with about three-quarters (74%) of 30- to 64-year-olds. In the face of these challenges, new efforts on both the state and federal level to cover young adults are gaining momentum. Twenty states have passed legislation requiring insurers to extend dependent coverage to young adults older than 18 or 19. The new age limits range from 24 in Delaware, Indiana, and South Dakota to 30 in New Jersey. Some congressional bills have proposed allowing states to extend eligibility for Medicaid and SCHIP beyond age 18.  (5/30/08, Commonwealth Fund) 

Mental Disorders Cost Society Billions In Unearned Income

Major mental disorders cost the nation at least $193 billion annually in lost earnings alone, according to a new study funded by the National Institutes of Health's National Institute of Mental Health (NIMH). (May 2008, American Journal of Psychiatry)

 

Survey Reveals Gender Gap on Attitudes about Health Care Costs

More women than men say paying for health care is a challenge, according to a survey by the Guardian Life Insurance Company of America, a provider of employee and voluntary benefits. (5/20/08, EmployeeBenefit News)

 

Rising Health Care Costs Lead Workers to Delay Retirement

Older men who expect high health care costs for themselves or their spouses after age 65 retire about 13 months later than those who expect low costs. The difference for women is 12 months. For those receiving health insurance from their employers, continued work reduces the risk of high out-of-pocket health care costs. Working longer also increases retirement incomes, making health care costs more affordable. (5/14/08,  Urban Institute)

 

Economic Woes Affect Americans' Views of Health Care Reform

Americans view the state of the economy and the need to improve access to health care as closely linked, and believe that ‘making health care more affordable' should be the top priority for improving the U.S. economy, according to a poll [that]...shows a significant shift in the past eight months in what Americans think should be the highest domestic priority. (April 2008, Public Opinion Strategies)

 

One in Three People in the US Want To See "Radical Change" in Health Care

The proportion of US citizens who want "radical change" in their healthcare system reached 36% Republican pollster Bill McInturff told a briefing in Washington DC last week..."Every time we have gotten into the mid 30s or higher we have had a huge debate about healthcare.  (5/24/08, BMJ)

 

Rewards Are Many When Hospitals Put a Priority on Improving Community Health

Community outreach is one way that America's hospitals can reaffirm their rightful place as valued and vital community resources that merit broad public support. (5/12/08, AHA News)

 

A New Model of Charitable Care: The Robin Hood Practice

Seven years ago, I was a contented doctor in what I considered to be an above-average practice...I came to realize that I wanted something more for my patients and myself...I decided to create a cash-only, low-overhead, technology-enabled, retainer-model practice in which I could care for patients who could afford to pay out-of-pocket for enhanced service as well as uninsured patients who could pay little or nothing at all...It would be the ultimate self-sustaining nonprofit clinic. (5/2/08, Medscape Today)

 

Community Health Assessment: An Excellent Investment

A community health assessment yields valuable market information and builds relationships.  At its core, community health assessment is about collecting information on the health status of the population you serve, and using that information to inform decisions about hospital service lines and health promotion and prevention programs. (May 2008, H&HN)

 

Data Brief: Health Care Opinion Leaders' Views on Health Care Delivery System Reform

The 14th Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey asked a diverse group of experts for their perspective on health care delivery system reform. Survey participants call for fundamental change in the way the U.S. delivery system is organized, with nine of 10 favoring such reform. Favored policy strategies for reform include strengthening the primary care system, encouraging care coordination, and promoting care management of high-cost patients with complex conditions. Opinion leaders also cite payment reform as an important strategy to enhance primary care physicians' ability to provide coordinated, high-quality care, as well as to help prevent costly hospitalizations. (April 2008, Commonwealth Fund Commission on a High Performance Health System)

 

States in Action: A Bimonthly Look at Innovations in Health Policy

(April/May 2008, Commonwealth Fund)

 

More than Half of Americans on Chronic Meds

For the first time, it appears that more than half of all insured Americans are taking prescription medicines regularly for chronic health problems...Experts say the data reflect not just worsening public health but better medicines for chronic conditions and more aggressive treatment by doctors...In addition, there is the pharmaceutical industry's relentless advertising. With those factors unlikely to change, doctors say the proportion of Americans on chronic medications can only grow. (5/14/08, AP)

 

CAM and Chronic Condition Management

By 2010, some 141 million individuals are expected to have chronic conditions; this group accounts for 78 percent of all health care spending. Clearly, there is a dire need for sustainable, cost-effective and safe therapies. Many of the goals of chronic care...can be well-served through complementary and alternative medicine (CAM) modalities, which can be both safe and cost-effective. (5/20/08, H&HN)

 

Beyond the Triple Aim: Integrating the Nonmedical Sectors

Donald Berwick and colleagues once again do our health care system a favor with their proposal for the Triple Aim of improving the experience of care, improving the health of populations, and reducing per capita costs of health care. It would be hard to argue that we would not be much be much better off with their five financial and competitive dynamics[.] (5/19/08, Health Affairs)

 

Safety-Net Hospitals Penalized By Pay-for-Performance Bonuses

Pay-for-performance bonus payments for U.S. hospitals might penalize safety-net hospitals, which serve large numbers of low-income patients and lack funds to improve quality ratings. (5/14/08, Journal of the American Medical Association)

 

Chronic Disease Management: Does It Improve Health And Save Money?

A study reports on the first randomized trial providing a scientifically valid look at what one might expect from chronic disease management programs that serve low-income individuals. The study result provides good news for state Medicaid leaders struggling to meet the needs of individuals with chronic conditions and also suggests that some disease management efforts, even among relatively low-risk patients, may be an effective strategy. (May-June 2008, Health Affairs)

New Listings: Health Disparities 

 

Widening of Socioeconomic Inequalities in U.S. Death Rates, 1993-2001
In the United States, the gap between mortality rates of people with less than a high school education and college graduates has widened enormously in the time period between 1993 and 2001. According to this study, this gap has been attributed to significant decreases in death in the more educated from all causes, including heart disease, cancer, stroke, and other conditions, while death rates in the less educated remain unchanged. (5/13/08, PLoS ONE)

 

Uninsured Illegal Immigrants Often Go Without Conventional Health Care
Illegal immigrants, many of whom are poor, uninsured farm workers, often suffer from debilitating diseases without the benefits of conventional medicine, instead choosing to get their health care from "a parallel system of spiritual healers, home remedies and self-medication." (5/10/08, New York Times)

 

Illegal Farm Workers Get Health Care in Shadows

The people need help because they are in the United States illegally and because they are poor. Few have health insurance, but the backbreaking nature of their work, along with the toxicity of American poverty, insure that many are ailing. (5/10/08, NYT)

 

Death Gap Widens Between Educated and Those Not

Being well-educated can lengthen your life span, according to new study. The research, published in the May 14 issue ofPLoS ONE, shows that the gap in overall death rates between Americans with less than a high school education and college graduates increased rapidly from 1993 to 2001. (5/14/08, HealthDay News)

 

Only About 1 In 10 Adult Americans Have All The Skills Needed To Manage Their Health

Just 12 percent of America's 228 million adults have the skills to manage their own health care proficiently. These skills, known collectively as health literacy, describe people's person's ability to obtain and use health information to make appropriate health care decisions. They include weighing the risks and benefits of different treatments, knowing how to calculate health insurance costs, and being able to fill out complex medical forms. A person with poor health literacy may not get good results from their health care and increase the risks of medical errors. Based on data from the 2007 National Healthcare Disparities Report, which examines the disparities in Americans' access to and quality of health care, with breakdowns by race, ethnicity, income, and education. (5/14/08, AHRQ News and Numbers)

 

Restructuring Government to Address Social Determinants of Health

Government officials, community advocates, and researchers convened to discuss the federal government's role in addressing underlying determinants of health - the community factors in the social and physical environments that are the most influential contributors to the nation's poor health outcomes. Findings comprise this report. (February 2008, Prevention Institute and Trust for America's Health)

  

Woman's Race Determines Cancer Screening Behavior

Women's perception of their cancer risk appears to vary by race and may affect how likely they are to undergo screenings, particularly for colon cancer, according to a study. (5/13/08, Archives of Internal Medicine)

 

People with Less Education and Lower Income Spend More Time in Pain

A novel study that attempts to paint the most accurate and detailed description yet of how Americans experience pain has found that a significant portion of the population - 28 percent - are in pain at any given moment and those with less education and lower income spend more of their time in pain. (5/2/08, ScienceDaily)

 

Food Costs Likely To Boost Obesity in Poor

Some of the fattest people in America are among the poorest. And with food prices rising, the problem is likely to get worse...with the U.S. Department of Agriculture predicting food prices will be up 4.5 percent throughout the year, due to high fuel costs, weather problems, and the growing diversion of corn crops to make ethanol. (5/6/08,  Philadelphia Inquirer)

 

Hispanic Diabetes Disparities Learning Network in Community Health Centers

The sponsored a needs assessment study of community health centers with large populations of Latino/Hispanic patients to identify gaps in diabetes care and outcomes. The study found that health centers with committed leadership, employed staff physicians, and diabetes registries are more likely to meet successful diabetic treatment goals. The authors offered numerous recommendations that include: recruit family participation in the treatment process, recognize that translation with an English tool alone may not provide adequate access to care, and create an environment that is welcoming to Latinos/Hispanics.  (Agency for Healthcare Research and Quality)

 

Do Primary Care Physicians Treating Minority Patients Report Problems Delivering High-Quality Care?

found that physicians who see a large number of minority patients face socioeconomic barriers that prevent them from providing high quality care. Some of the barriers include: low Medicaid and private insurance reimbursement, difficulty securing specialty care for their patients, and inadequate time for patient office visits. (4/22/08, Health Affairs)

 

Identifying and Evaluating Equity Provisions in State Health Care Reform

outlines policies that promote equity in state health reform efforts. In particular, the authors discuss existing laws, regulations, and reform proposals in five states that have passed or are moving toward universal coverage. (April 2008, Opportunity Agenda and Families USA) 

 

Creating Equity Reports: A Guide for Hospitals

These showcase potential inequities in utilization, care processes, outcomes, and patient experiences. The authors also include case studies of hospitals that have already put equity reporting into practice. (Robert Wood Johnson Foundation)

 

Closing the Gap: A Proposal to Deliver Affordable, Quality Health Care to ALL Americans
For the sake of America's Well-being, economic viability and its future, it is essential that we not only close the gap between our nation's uninsured and uninsured citizens, but also between the status quo and the extraordinary health care system we are capable of having.  (3/13/08, Healthcare Leadership Council)

New Listings: Other Health Issues  

Performance Measures Using Electronic Health Records: Five Case Studies

The emergence of the electronic health record (EHR) has enabled health care providers to develop new indicators of quality and safety. In a new Commonwealth Fund report, a team of researchers describes the experiences of five provider organizations in developing, testing, and implementing quality-of-care indicators, based on data collected from their EHR systems. (5/12/08, Commonwealth Fund)

 

Strategies to Enhance Patient-Centered Communication

Despite the value many family physicians place on communicating with their patients, patients' expectations are often not met in routine primary care visits. Between 30 and 80 percent of patients' expectations are not met in routine primary care visits, in part because of inadequate communication between doctor and patient. This article in outlines "patient-centered" communication strategies developed to help providers restructure their patient encounters to communicate more effectively and better respond to patients' concerns. (May 2008, Family Practice Management)

 

Older Adults: Depression and Suicide Facts

Although they comprise only 12 percent of the U.S. population, people age 65 and older accounted for 16 percent of suicide deaths in 2004. (May 2008, National Institute of Mental Health)

 

Safety Net Hospital Emergency Departments: Creating Safety Valves for Non-Urgent Care

According to findings from site visits to 12 nationally representative metropolitan communities, many emergency departments at safety net hospitals-the public and not-for-profit hospitals that serve large proportions of low-income, uninsured and Medicaid patients-are attempting to meet patients' non-urgent needs more efficiently. (May 2008, Center for Studying Health System Change)

 

Air Pollution Linked to Deep Vein Thrombosis

Long-term exposure to air pollution appears to be associated with an increased risk of deep vein thrombosis, blood clots in the thigh or legs, according to a report in the May 12 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. (5/13/07, Newsmax)

Florida Reports

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)

 

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) 

 

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

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.

 

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

State Medicaid Coverage and Access to Care
In states where levels of Medicaid coverage are high, low-income adults enjoy better access to physicians and important preventive services than their counterparts in states where coverage levels are low and more restrictive, according to a new study. As states struggle with rising Medicaid costs, pressure increases to limit eligibility. But states' existing support for public health service and other safety net components likely would not offset any reductions in Medicaid eligibility. Expanding eligibility for Medicaid coverage, the researchers conclude, may be an effective strategy for states to improve access to care and preventive services for the poor. (4/15/08, Commonwealth Fund)

CBO Cost Estimate for Protecting the Medicaid Safety Net Act of 2008
The CBO cost estimate examines legislation that would place a one-year moratorium on seven new Medicaid regulations for services supplied by public providers; graduate medical education, school-based administration and transportation services; and rehabilitation services. CBO estimates that the increases in spending under the bill would cost $1.8 billion between 2008 and 2013, and the decreases in spending under the bill would save $1.9 billion between 2008 and 2018, largely due to the required delays in implementing the regulations. According to CBO, the legislation would not affect federal revenues or discretionary spending. (4/22/08, CBO)

 

Delaying Administration’s Medicaid Regs Will Not Weaken Program’s Fiscal Integrity
The Bush Administration has threatened to veto a House-passed bill that would place a moratorium on seven harmful Medicaid regulations that the Administration has issued over the past year. The Administration based its veto threat on the claim that the regulations are needed to close loopholes in current reimbursement policy and stop “blatant abuses of the Federal-State partnership.”  The claim is unfounded.In fact, the rules are not needed to ensure appropriate reimbursement of Medicaid services.  And, the rules make major changes in Medicaid policy that have no connection to the Administration's claims of fraud and abuse. (4/25/08, CBPP)

 Children's Health

First Focus Children's Budget 2008
This new publication informs readers of the sad state of funding for children's programs. Over the past five years, only one percent of every new, real non-defense dollar has been spent on children. The book provides an analysis of the over 180 federally funded programs that assist America's children. Downloadable book, fact sheet, powerpoint presentation. (2008, First Focus)

Completing the Recipe for Children's Health: New Variations on Key Ingredients
This paper offers a broad overview of the issues surrounding the social and environmental determinants of children’s health. These issues were explored during a discussion convened by the National Health Policy Forum on June 28, 2007, among a group of individuals concerned about the influences beyond medical care on the health of children. The paper considers the policy and financing tensions that exist across programs and populations that make addressing the full range of influences challenging. It also highlights some of the community-based initiatives that have been successful in providing services to children and families, as described during the workshop. Finally, this meeting report outlines several potential strategies that emerged from the discussion, which could be pursued in order to better coordinate health and social services for children. (3/14/08, National Health Policy Forum)

Medicare 

Medicare Part D: How Do Vulnerable Beneficiaries Fare?

Health insurance coverage for Medicare beneficiaries has been broadened by the addition of a prescription drug benefit-Medicare Part D. For some beneficiaries, however, particularly those who must make the transition from Medicaid to Medicare prescription coverage, the new program can be confusing or disruptive and result in delays in getting drugs or in adverse health outcomes. (5/1/08, Commonwealth Fund)

 

Retooling for an Aging America: Building the Health Care Workforce

The U.S. Health Care System Unprepared For Millions Of Baby Boomers Who Are About To Become Eligible For Medicare. The U.S. health care work force is "too small and woefully unprepared" to meet the geriatric care needs of the 78 million aging baby boomers, according to a recent report. It estimates that currently there is one certified geriatrician for every 2,500 seniors. In three years, the first of the baby boomers will turn 65 years old, and by 2030, all 78 million will have reached that age -- nearly double the number of people older than age 65 in 2005, according to the report. The U.S. would need 36,000 geriatricians by 2030 to meet the need. The report says there are 7,128 certified geriatricians today.  (4/14/08, Institute of Medicine)

 

Medicare Part D: State and Local Efforts to Assist Vulnerable Beneficiaries,

Health insurance coverage for Medicare beneficiaries has been broadened by the addition of a prescription drug benefit—Medicare Part D. For some beneficiaries, however, particularly those who must make the transition from Medicaid to Medicare prescription coverage, the new program can be confusing or disruptive and result in delays in getting drugs or in adverse health outcomes. In the fall of 2006, well after Part D was implemented, counselors, attorneys, program managers, health professionals, and others who have direct knowledge of beneficiaries' experiences identified a continuing need for accurate, easy-to-use information about private drug plan options and procedures associated with using the plans. This issue brief details counselors' responses to researchers' questions and suggests that certain policy and procedural changes could enhance program performance. (5/1/08, Commonwealth Fund)

 

Medicare Prescription Drug Benefit Improved Access To Medications For Most Seniors, But Sickest Seniors Continued Skipping Pills Because Of Cost Issue

The percentage of seniors who said they skipped taking medications because of costs declined after the Medicare prescription drug benefit took effect in January 2006, but the sickest beneficiaries still skip prescriptions because they cannot afford to pay for them, according to a new study. (April 23-30, 2008, JAMA)

Medicare Beneficiaries' Knowledge of Part D Prescription Drug Program Benefits and Responses to Drug Costs

Medicare beneficiaries who enroll in Part D are not fully informed about the cost-sharing requirements of the plan. More than 33% of enrollees report behaviors such as reducing drug adherence or switching to less expensive drugs in order to cope with costs. Medicare Part D benefits require complex and high levels of cost sharing that is designed to limit drug costs. This includes a gap in coverage that began at $2,250 in total drug costs in 2006 and ended after beneficiaries spent $3,600 out-of-pocket. The authors note that, "In 2006, 85 percent of stand-alone prescription drug plans and 72 percent of Medicare Advantage Prescription Drug plans included a coverage gap, meaning that beneficiaries were responsible for all of their drug costs during the gap. In addition, 91 percent of stand-alone prescription drug plans and 93 percent of Medicare Advantage Prescription Drug plans in 2006 had tiered cost sharing prior to the coverage gap, under which beneficiaries paid more for higher-tier drugs such as brand-name medications. Failure to understand these complex benefit structures may limit beneficiaries' abilities to anticipate or manage their medication costs." (April 23-30, 2008, JAMA) 

Cost-Related Medication Nonadherence and Spending on Basic Needs Following Implementation of Medicare Part D
Cost-related medication nonadherence (CRN) has been a persistent problem for individuals who are elderly and disabled in the United States. The impact of Medicare prescription drug coverage (Part D) on CRN is unknown. In this survey population, there was evidence for a small but significant overall decrease in CRN and forgoing basic needs following Part D implementation. However, no net decrease in CRN after Part D was observed among the sickest beneficiaries, who continued to experience higher rates of CRN. (April 23-30, 2008, JAMA)

Medicare Part D: A Successful Start With Room for Improvement
Medicare Part D represents a bold experiment to publicly fund, but privately sell and administer, prescription drug insurance. Part D is only a relatively small part of the overall Medicare program; Medicare spent $432 billion overall in 2007, of which Part D accounted for only 11.6% ($50 billion). However, the Medicare program is so large that Part D alone should account for 1% of the entire economy in less than 2 decades. Furthermore, there is little room for more spending, given the trustees' recent forecast of $12 trillion in unfunded liabilities over the next 75 years—a debt just slightly smaller than the entire US economy. So much appears to be riding on Part D's success or failure, including possible models for the provision of health insurance to the currently uninsured. (April 23-30, 2008, JAMA)

Federal Budget/Health Care

Health Insurance, Health Care Costs

Bipartisan Universal Health Plan Would Pay for Itself
A bipartisan plan for universal health care coverage would pay for itself and eventually could create modest budget surpluses, according to a congressional report...by the nonpartisan Congressional Budget Office and Joint Committee on Taxation [that] said the health care plan could be fully operational by 2012 and become "budget-neutral" by 2014. That means the plan would bring in as much revenue as it costs to implement. (5/1/08, AP)

Poll: Many Americans Struggling to Pay for Health Care

Health care costs caused many people to postpone or go without treatment in the last year, according to a new Kaiser Family Foundation poll. Forty-two percent of respondents said that because of costs, they or a member of their household had delayed or skipped medical care or tests, not filled a prescription or reduced dosage, or had difficulty obtaining mental health care. Two-thirds of those people said that their medical condition had worsened as a result. (5/1/08, KFF) 

Study Warns Job Losses Will Strain Government Health Programs

Leading health researchers projected Monday that each percentage-point rise in unemployment during the economic downturn would swell the uninsured by 1.1 million, stoking demand for government health coverage just as states face pressure to cut benefits. While governments at all levels have faced a similar situation in past recessions, the researchers warned that the impact of this downturn might be worsened by its proximity to the last recession, in 2001, and by the cumulative effect of rising health costs. The study projected that each rise in unemployment of one percentage point would also add 600,000 children and 400,000 adults to the two primary state and federal health insurance programs for the low-income uninsured. That would require an additional $3.4 billion for Medicaid and the State Children’s Health Insurance Program, with $1.4 billion of it from the states.

The money will not be easy to find.  (4/29/08, Urban Institute/KFF)

 

Uninsured Kids in Middle Class Have Same Unmet Needs as Poor

Nationwide, uninsured children in families earning between $38,000 and $77,000 a year are just as likely to go without any health care as uninsured children in poorer families. More than 40 percent of children in those income brackets who are uninsured all year see no physicians and have no prescriptions all year, according to new research. (5/5/08, University of Rochester Medical Center)

 

Even the Insured Feel Strain of Health Costs

The economic slowdown has swelled the ranks of people without health insurance. But now it is also threatening millions of people who have insurance but find that the coverage is too limited or that they cannot afford their own share of medical costs. (5/4/08, NYT)

 

Who Pays for Health Care When Workers Are Uninsured?

Employer-sponsored insurance coverage forms the backbone of the U.S. health insurance system, yet there are crucial weaknesses that have contributed to a growing number of uninsured Americans. Ultimately, the lack of employer-based coverage generates public costs in the form of taxpayer bills to fund public insurance or uncompensated care programs for care that would otherwise be paid for through insurance. (5/2/08, Commonwealth Fund)

 

Rising Unemployment Increases the Burden on Public Health Programs
"Leading health researchers projected Monday that each percentage-point rise in unemployment during the economic downturn would swell the uninsured by 1.1 million, stoking demand for government health coverage just as states face pressure to cut benefits." (4/29/08, NYT)

 

People Are Marrying for Health Insurance
According to a recent survey, "7% of Americans said they or someone in their household decided to marry in the last year so they could get healthcare benefits via their spouse." (4/29/08, KFF)

 

Cost of Insurance Far Outpaces Income
Americans who get health insurance for their families through their jobs have seen their premiums increase 10 times faster than their income in recent years, according to a new analysis of government data. The study shows that a growing share of workers' earnings is being absorbed by the increasing cost of health insurance. (4/29/08, RWJF)

The Erosion of Employer-Provided Health Care
It is widely recognized that the means through which most working-age Americans receive health care coverage-the employer-based system-is undergoing fundamental change. Though a majority of workers and their families are still covered through employers, a variety of factors, most prominently increased costs, have led to a steady slide in coverage. (4/22/08, Economic Policy Institute)
 
New Analysis Shows Effect of Rising Unemployment on Health Coverage, Medicaid and SCHIP Spending and Enrollment
As the country faces another economic downturn, many states are scrambling to deal with the impact of poor economic conditions on programs, like Medicaid and the State Children's Health Insurance Program (SCHIP), that are reliant on state funding.  To be better able to cope, states are looking for fiscal relief from the federal government as well as obtaining a moratorium on federal regulations that would reduce Medicaid funding for states from the Congress. (4/28/08, KFF)

Cash before Chemo: Hospitals Get Tough
Hospitals are adopting a policy to improve their finances: making medical care contingent on upfront payments...pointing to their burgeoning bad-debt and charity-care costs, hospitals are asking patients for money before they get treated. Hospitals say they have turned to the practice because of a spike in patients who don't pay their bills. Uncompensated care cost the hospital industry $31.2 billion in 2006, up 44% from $21.6 billion in 2000, according to the American Hospital Association. (4/28/08, Wall Street Journal)

 

Understanding the Uninsured: Tailoring Policy Solutions for Different Subpopulations
People without health insurance are heterogeneous, and understanding this diverse group is important for policymakers looking to design solutions to the problem. Different approaches are needed for different subpopulations of the uninsured. Toward this end it is helpful to place the uninsured into subgroups based on their program eligibility, income and demographics. (April 2008, National Institute of Health Care Management Foundation)

 

Health Care Opinion Leaders' Views on Health Care D
The 14th Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey asked a diverse group of experts for their perspective on health care delivery system reform. Survey participants call for fundamental change in the way the U.S. delivery system is organized, with nine of 10 favoring such reform. Favored policy strategies for reform include strengthening the primary care system, encouraging care coordination, and promoting care management of high-cost patients with complex conditions. Opinion leaders also cite payment reform as an important strategy to enhance primary care physicians' ability to provide coordinated, high-quality care, as well as to help prevent costly hospitalizations. (4/21/08, Commonwealth Fund)

 

Are We Heading toward Socialized Medicine?
With health reform at the forefront of the national campaign, some charge that proposals to restructure our health care system represent dangerous steps moving the country toward government-run health care and socialized medicine. The authors find this rhetoric inapplicable to the recent SCHIP bill and proposals from most presidential candidates. The core issues in health reform do not involve the size of government, but rather proposals' effect on the number of uninsured, access to quality care, cost growth, and consumers' health care choices. (4/16/08, Urban Institute)

Health Disparities

 

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

This 2007 Harvard School of Public Health/Robert Wood Johnson Foundation survey of 4,334 randomly selected U.S. adults compared perceptions of the quality of physician care among fourteen racial and ethnic groups with those of whites. On each measure examined, at least five and as many as eleven subgroups perceived their care to be significantly worse than care for whites. (Mar/April 2008, Health Affairs)

The Widening Health Care Gap Between High- and Low-Wage Workers

Rising health care costs affect everyone, but pose a particular problem for low-wage workers and their families. Few of these workers are eligible for public insurance programs or can afford to purchase private insurance, and they are less likely than high-wage workers to work for companies offering health coverage. Using data from the Medical Expenditure Panel Survey, this report finds that, between 1996 and 2003, low-wage workers were more likely than high-wage workers to be uninsured and to spend a proportionally higher share of family income on out-of-pocket health costs. They were less likely to have a usual source of care, less likely to have received preventive services, used fewer health care services overall, and were less likely to use the latest generation of medical technologies (e.g., prescription drugs approved within the prior 20 years). They were also more likely to report worse general and mental health than high-wage workers. (5/2/08, Commonwealth Fund)

 

Moving Beyond Access: Achieving Equity In State Health Care Reform

The Institute of Medicine’s 2003 Unequal Treatment report raised the public’s and policymakers’ awareness of racial and ethnic health care disparities, but federal policy-makers have implemented few of the report’s more than two dozen recommendations. State health care reform efforts, however, are gaining support around the country and have great potential to reduce health care inequality. This paper offers a policy framework to explore how states can move toward eliminating disparities by addressing health care access and quality, state health care infrastructure, patient and community empowerment, state policy infrastructure, and social and community determinants of health. (Mar/April 2008, Health Afairs)

 

New Evidence Regarding Racial And Ethnic Disparities In Mental Health: Policy Implications
Minorities have, in general, equal or better mental health than white Americans, yet they suffer from disparities in mental health care. This paper reviews the evidence for mental health and mental health care disparities, comparing them to patterns in health. Strategies for addressing disparities in health care, such as improving access to and quality of care, should also work to eliminate mental health care disparities. In addition, a diverse mental health workforce, as well as provider and patient education, are important to eliminating mental health care disparities. (Mar/April 2008, Health Affairs)

 

The Reversal of Fortunes: Trends in County Mortality and Cross-County Mortality Disparities in the United States

A new study of mortality patterns across the United States in the four decades leading up to 1999 shows that life expectancy is stagnating and even falling for many parts of the population. The researchers also found that while the differences in life expectancy across counties narrowed at first, they widened again over those four decades. (4/22/08, PloS Medicine)

 

Is the Association between Childhood Socioeconomic Circumstances and Cause-Specific Mortality Established?

The new studies confirmed that mortality risk for all causes was higher among those who experienced poorer socioeconomic circumstances during childhood. (May 2008, Journal of Epidemiology and Community Health)

Life Expectancy Drops for Some U.S. Women

Historic Reversal, Found in 1,000 Counties, May Be Result of Smoking and Obesity

For the first time since the Spanish influenza of 1918, life expectancy is falling for a significant number of American women...The downward trend is evident in places in the Deep South, Appalachia, the lower Midwest and in one county in Maine. It is not limited to one race or ethnicity but it is more common in rural and low-income areas. (4/22/08, Washington Post)

One Size does Not Fit All: Meeting the Health Care Needs of Diverse Populations

As the diversity of our nation continues to grow, hospitals are encountering more patients with language and cultural barriers.  The multiplicity of languages, dialects, and cultures can be overwhelming to hospitals and their staff.  The Hospitals, Language, and culture...study set out to better understand how the challenges associated with cultural and language...barriers are being addressed at 60 hospitals across the country. (2008, Joint Commission)

Do Primary Care Physicians Treating Minority Patients Report Problems Delivering High-Quality Care?

[C]onstrained resources help explain the greater quality-related difficulties delivering care reported by these physicians--such as coordination of care, ability to spend adequate time with patients during office visits, and obtaining specialty care--that relate directly to physicians' ability to function as their patients' medical home. (4/22/08, Health Affairs)

Identifying and Evaluating Equity Provisions in State Health Care Reform

This new report highlights state policies that promote equitable health care access and quality - particularly among racial and ethnic minorities, immigrants and people who lack a proficiency in English -- by expanding health coverage and access to care, improving quality, empowering patients, upgrading health system infrastructure and addressing social and community-level determinants of health. The report also provides an evaluation of current laws, regulations and proposals in five states -- California, Illinois, Massachusetts, Pennsylvania and Washington state -- and identifies additional steps states can take to increase equity in health care. (4/24/08, Commonwealth Fund)

 

Life Expectancy Worsening or Stagnating for Segment of the U.S. Population
Overall life expectancy in the U.S. increased more than seven years for men and more than six years for women between 1960 and 2000. A new, long-term study of mortality trends in U.S. counties over the same four decades reports that these gains are not reaching many parts of the country; rather, the life expectancy of a significant segment of the population is actually declining or at best stagnating. (4/25/08, ASPH Friday Letter)
 
Greater Wealth Tied to Lower Stroke Risk
For people aged 50 to 64 years, being wealthy seems to protect them against having a stroke, according to new research. (4/25/08, Reuters)

Pulling Apart: A State-By-State Analysis of Income Trends
An in-depth analysis of inequality trends over the past two business cycles shows that income inequality has been growing wider, further separating those at the very top from our nation's poor and middle class. In this paper, the Center on Budget and Policy Priorities explains the causes of rising inequality and offers suggestions for reducing these trends and lessening their negative impact. (4/9/08, CBPP)

Identifying and Evaluating Equity Provisions in State Health Care Reform
Rapidly escalating health care costs, a rising number of people without health insurance, inconsistent health care quality, and a paucity of federal action to address these problems have prompted legislatures and governors in nearly two dozen states to consider significantly changing their approaches to health insurance coverage and health system regulation.  Few of these reforms, however, have focused on the problem of health care inequality, even though millions of people in the United States—principally racial and ethnic minorities, immigrants, and those who lack proficiency in English—face barriers to high-quality health care.  By expanding health insurance coverage and addressing issues of access, quality, and cost, state-level health care reforms have the potential to achieve equity in health care. (4/28/08, Opportunity Agenda and Families USA)

Do Primary Care Physicians Treating Minority Patients Report Problems Delivering High-Quality Care?

Primary care physicians who treat a disproportionate share of black and Latino patients provide more charity care, see more patients, depend more heavily on low-paying Medicaid, and earn lower incomes than physicians seeing mostly white patients, a new study finds. Such practice constraints can have a profound effect on the ability of physicians to deliver high-quality care to patients. For instance, physicians treating large numbers of minority patients typically spend less time with each patient and have a harder time obtaining specialty care referrals than do other physicians. Expanding insurance coverage, raising Medicaid payments to equal Medicare payments, and increasing the resources available to physicians who serve low-income and minority populations could all go a long way toward reducing disparities in quality. A free downloadable companion chartpack is also available. (4/22/08, Commonwealth Fund)

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 

 

Building a Community Network for Behavioral Health Care
In 2004, almost one-quarter of all adult stays in U.S. community hospitals involved depressive, bipolar, schizophrenia and other mental health disorders or substance abuse disorders, according to the Agency of Healthcare Research and Quality. Yet only 27 percent of community hospitals have an organized, inpatient psychiatric unit. Joint ventures or partnerships with community mental health centers or other psychiatric treatment facilities are an option. (April 2008, H&HN)


More Specialists Refuse to Work in Emergency Rooms and Treat Uninsured Patients
As "one more sign of a deteriorating safety net," an increasing number of specialists are refusing to work in emergency rooms, requiring patients who are in need of emergency specialty care to either wait for hours or transfer to a larger hospital. Their dwindling numbers affect the uninsured and the insured alike. (4/25/08, Los Angeles Times)

 

Stand-Alone Emergency Departments
An examination of the increasing number of stand-alone emergency departments, which have "spurred questions about their limited services, their ability to decrease the overall burden for area hospitals and their impact on health care spending." The number of such centers increased from 146 to 179, or by 23%, from 2005 to 2006. About a dozen more are in planning stages. The free-standing centers are open 24 hours a day and often offer shorter wait times than hospital-based EDs. (4/28/08, USA Today)

 

Hospital Insolvency: The Looming Crisis

More than half of U.S. hospitals are "teetering on the brink of insolvency" or have become insolvent because they do not treat an adequate number of patients to provide sufficient revenue, according to a recent study. (March 2008, Alvarez and Marsal)

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

  
Powered by image