June 24, 2008
Healthy Florida Alliance Welcomes AARP as Member On behalf of the Healthy Florida Alliance, Florida CHAIN is delighted to announce that AARP has joined efforts to pass a $1 increase in the Cigarette User Fee to support Florida’s safetynet healthcare programs. They will engage their membership in this important statewide effort to ensure that more Florida families have access to affordable, quality healthcare. (by Linda Vaughn, Florida CHAIN) Read more
Congratulations to Senator Ted Deutch (D-Delray Beach) for winning the Healthy Florida Alliance Legislator of the Year Award. Senator Deutch was honored for his unfaltering efforts to pass the “Cigarette User Fee” during the 2008 Legislative Session and for his continued support for this life saving measure. (by Linda Vaughn, Florida CHAIN) Read more (L-R): Patricia Kodish, March of Dimes; Laura Goodhue,
Florida’s #50 in Child Health: Ranking May Surprise, But Story Behind It Is Familiar Last month, the Commonwealth Fund Commission on a High Performance Health System released its latest “State Scorecard” of children’s health, using 13 different measures of the effectiveness of states’ child health systems. Florida was ranked 50th overall among the states and D.C., with only Oklahoma receiving a lower overall rating. (by Greg Mellowe, Florida CHAIN) Read more
Florida Healthy Kids Corporation is working with Florida Covering Kids and Families at the Lawton and Rhea Chiles Center for Healthy Mothers and Babies at the University of South Florida, to implement an outreach campaign targeting organizations and associations whose members and clientele interact with families likely to be eligible for Florida KidCare, the state children’s health insurance program. (by Patrick Cannon, Ph.D., Florida Covering Kids & Families) Read more
Jacksonville Launches Effort to Address Disparate Infant Mortality Jacksonville will launch a two-year implementation effort on June 25, responding to recommendations from a community-led study targeting the city’s high rate of infant deaths. The recommendations, the culmination of a nine-month study by the Jacksonville Community Council, Inc., cite the city’s failure to address racism, poverty and socioeconomic disparities as factors contributing to Jacksonville’s poor birth outcomes. (by Carol Brady, NE Florida Healthy Start Coalition) Read more
Organizations: TAKE ACTION to Make Health Care High Priority on McCain’s and Obama’s Agendas Your organization's help is needed in signing on to a letter to the Florida Presidential Campaign Directors urging them to tell Senator Obama and Senator McCain to make comprehensive health reform the earliest and top domestic priority in their Administration, if elected President. Read the letter and sign on by Monday, June 30th.
Compilation of Leaders’ Views on Health Care Reform Set Stage for 2009 Kaiser Family Foundation has compiled a series of interviews with leaders of organizations representing "health care providers, insurers, policymakers, employers, labor unions and consumers" who discuss their perspectives on what needs fixing in America's health care system and how they believe it should be fixed. They address issues of health care coverage, access, quality and cost, and financing. (by Greg Mellowe, Florida CHAIN) Read some excerpts Last week, the Senate was blocked from moving forward with the bipartisan bill that would have improved Medicare and protected recipients from skyrocketing premiums. The vote was close – too close – and NOT ENOUGH Senators voted to improve Medicare. And nothing is more meaningful than when activists send in their own letters. See how our Senators Nelson and Martinez voted and TAKE ACTION!
Finally, Harmful New Medicaid Rules on Track to Be Blocked As you may have read previously, efforts undertaken by advocates to prevent 7 new Bush Administration-pushed Medicaid regulations from going into effect have been fairly intense and continuous over the last several months. That chapter may finally be drawing to a close, however, and with a largely hoped-for ending. (by Greg Mellowe, Florida CHAIN) Read more
Mental Health Challenges Experienced by Consumers and Providers Discussed in Medicaid Reform Policy Brief Throughout the course of the Medicaid Reform experiment, one useful source of information about its progress has been the policy briefs released periodically by the Health Policy Institute at Georgetown University, as commissioned by the Jessie Ball duPont Fund. The 5th brief elaborates on persistent concerns regarding a particularly vulnerable subgroup of Reform participants: individuals with severe mental illnesses. (by Greg Mellowe, Florida CHAIN) Read more
U.S. House, Senate Negotiators Reach Agreement on Key Provisions in Parity Bill
Parity did not make if past our Florida Legislature in the 2008 Session. However, MHA’s national President reports that, while further deliberations are expected, "Senate and House negotiators have bridged their differences on the requirements for health plans under a mental health parity bill. This compromise is a major step forward." (by Scott E. Barnett, MHA Greater Tampa Bay) Read more
Lines Blur Between Under-Insured and Uninsured
In a study reviewed in an article published on-line this month by Health Affairs, researchers for the Commonwealth Fund estimated that the number of under-insured adults in America increased by an astounding 60 percent between 2003 and 2007 - to 25 million. And a staggering 75 million of non-elderly adults (42% of the total) were either uninsured or under-insured at some point in 2007.(by Greg Mellowe, Florida CHAIN) Read more
During this long campaign year, you’ve likely heard from both governmental and private studies that nearly 47 million Americans don’t have health insurance. And, you might be thankful that you have health insurance and that’s not your problem. The truth is that the uninsured are your problem, my problem and America’s problem, one on which the U.S. spends $126 billion annually. (by Lori K. Parham, AARP) Read more and TAKE ACTION by joining Divided We Fail 
Florida Healthcare Advocates Convene to “Re-Frame” the Health Care Debate The Herndon Alliance Messaging Workshop, Talking About Health Reform, brought into focus how the right words can motivate people to advocate for progressive healthcare reform. Nearly 30 diverse health care advocates from around Florida gathered in Orlando for an exceptional opportunity presented by Herndon Alliance and cosponsored by Florida CHAIN, AARP, Hispanic Health Initiative and Human Services Coalition. (by Linda Vaughn, Florida CHAIN) Read more
(Clockwise from left): David Pizzi, BCBS of Florida; Sherry Prowda, Herndon Alliance; Annette DeSoto, Beyond the Divide; Persephone Taylor Gary, The Children’s Trust; Penelope Tiam Fook, March of Dimes; Michael Citro, Florida College of Emergency Physicians; Elizabeth Buckley, FOCUS; Linda Vaughn, Florida CHAIN
Even with Attorney, Medicaid Reform Falls Short for SSI Client in Plan Selection, Appointments, Transportation "Medicaid Reform has been a terribly frustrating experience for me. When I signed up for Medicaid, I wasn’t told that I would have to go into an HMO. I was automatically put into a plan which I didn’t know about. I showed up at the doctor for my appointment with serious infection problems. I was sent away and told that I was in HealthEase and that my doctor was not in the plan. And that was only the beginning. (Adapted from Coast to Coast Legal Aid client's experience) Read more
Florida CHAIN Board of Directors at Annual Retreat in June
Healthy Florida Alliance Welcomes AARP as Member On behalf of the Healthy Florida Alliance, Florida CHAIN is delighted to announce that AARP has joined efforts to pass a $1 increase in the “Cigarette User Fee” to support Florida’s safetynet healthcare programs. AARP is leading a nationwide effort to demand bipartisan action, answers and accountability on health care security and to enhance the quality of life for all as we age. They will engage their members in this important statewide effort to ensure that more Florida families have access to affordable, quality healthcare. AARP’s Leslie Spencer said, “Given the state of Florida's economy, it is vital that we work together to find ways to protect access to health care for all residents. AARP is pleased to work with the HFA to support a measure that not only will provide revenue for our healthcare programs but also potentially reduce tobacco consumption. This is a win-win proposition.” By joining the Health Florida Alliance, AARP is lending their considerable voice to the moral imperative of providing adequate, safe and reliable health care for low income seniors. (For more information about HFA and their health care priorities for allocating the revenue from the $1 increase, please visit www.healthyfloridaalliance.org).
Submitted by Linda Vaughn, Florida CHAIN Florida Senator Ted Deutch Named “Legislator of the Year” by Healthy Florida Alliance Congratulations to Senator Ted Deutch (D-Delray Beach) for winning the Healthy Florida Alliance Legislator of the Year Award. Senator Deutch was honored for his unfaltering efforts to pass the “Cigarette User Fee” during the 2008 Legislative Session and for his continued support for this life saving measure.
Photo caption (L-R): Patricia Kodish, March of Dimes; Laura Goodhue,
In accepting the award, Senator Deutch said, “It’s an honor to be recognized by such a diverse group of advocates for public health. Their goal of creating a healthier Florida by reducing smoking among young people and adults and through funding vital healthcare programs is shared by many Floridians and should be a priority of this state.” Terry Elder, AARP Associate State Director for Advocacy offered these words of appreciation: “On behalf of Florida’s older residents, we are pleased to honor Senator Deutch as a part of the Healthy Florida Alliance for his dedication to improving the health of all Floridians by sponsoring this important bill.” Expressing gratitude from the March of Dimes, Patty Kodish (Program Director, South Florida Division) said, “The March of Dimes is proud to be aligned with the Health Florida Alliance and to work with Senate Deutch who is steadfast in building the momentum needed to gain full support for the “Cigarette User Fee”. This legislation aims to reduce smoking and provide access to health care. Including expanded health care for pregnant women is an HFA priority.” Martin Luther King, Jr. reminded us that: “The ultimate measure of a man is not where he stands in movements of comfort and convenience, but where he stands at times of challenge and controversy.” Please join us in congratulating Senator Deutch and thanking him for standing with us during “times of challenge and controversy”.
Photo caption: HFA partners participating in the June 18 presentation were (L-R) Patty Kodish, March of Dimes; Laura Goodhue, Florida CHAIN; Terry Elder and Phillip Mrozinski, AARP (For more information about HFA and their health care priorities for allocating the revenue from the $1 increase, please visit www.healthyfloridaalliance.org).
Submitted by Linda Vaughn, Florida CHAIN
As newspapers across the state have already reported, Florida was ranked 50th overall among the states and D.C., with only Oklahoma receiving a lower overall rating. Mississippi and Louisiana were ranked just above Florida. With respect to the specific dimensions, Florida was rated 51st in access, 37th in quality, 34th in cost, 43rd in equity and 38th in the “potential to lead healthy lives”. The specific factors underlying Florida’s painfully low overall ranking bear even closer examination. First, given the two indicators used to assess health care access, the fact that Florida is near the bottom of the heap is no surprise to anyone familiar with the extent of uninsurance in our state. But the Scorecard was even more emphatic, ranking us dead last in overall access. In terms of the specific measures, Florida’s 18.1% uninsurance rate among all children, more than twice the national average, was the 3rd highest in the nation. Those results may have been mildly surprising to child health advocates. Indeed, as of last month, more than 1.4 million Florida kids were enrolled in coverage through KidCare, and May was the 7th straight month in which KidCare enrollment increased. However, this is about the same number that was enrolled two years earlier, when uninsurance was measured for the Scorecard (using the 2005 and 2006 U.S. Census Bureau Current Population Surveys). Understatement of the problem may partially account for the differing perceptions. For example, when Governor Crist unveiled his legislative priorities last February, including increasing KidCare enrollment, he noted that 548,000 Florida children were uninsured. That estimate tracks with the most recent Florida Health Insurance Study and other State reports. By contrast, the Census figures cited in the Scorecard indicate that Florida is home to 817,000 uninsured children. If the lower number cited by the Governor had been used in the Scorecard, Florida would rank 41st which, although still very low, would not have led to a ranking of worst access nationwide. In contrast to the 2 measures that define the Scorecard’s assessment of child health access, the authors use 7 measures to assess health quality. Lower ratings were the norm, such as a ranking of 47th in the percentage of children with special health care needs who experienced problems getting referrals to specialty care (27.7%). Here again, the State is well aware of these specialty care concerns, and that they are particularly pronounced in the Medicaid program due to low provider reimbursement rates. As a final example, Florida’s overall ranking in the equity dimension was driven downward significantly by its poor showing with respect to income equity (i.e., the extent to which child health access and quality are equal for children of all income levels). The Scorecard measured income equity by examining how two other indicators varied by income level: 1) the percentage of kids who had both a preventative medical and dental visit during the past year, and 2) the percentage with a “medical home”. Florida was ranked 49th on the first measure according to Commonwealth’s analysis of National Children’s Health Survey data. The more in-depth Florida Chartbook, which is developed using the same data, elaborates: children below the poverty line are half as likely to get preventative dental care as their higher income counterparts. Lack of adequate oral health services for low-income children, particularly in Medicaid, is a persistent struggle in Florida. This is another long-recognized crisis, and was the focus of a largely unsuccessful Governor’s legislative initiative this past Session. In short, we’ve long been aware of the factors underlying Florida’s failing grade on the Child Health Scorecard, but awareness has not been enough to prompt legislators to meaningfully change these dynamics. The Scorecard did provide some encouragement to low-performing states like Florida, however, noting a strong relationship between access and quality, particularly noting that increasing access does not necessarily reduce quality. In fact, higher access was generally correlated with higher quality. None of the 15 states with the lowest health quality were even in the upper half in terms of access. Seven states (Massachusetts, Iowa, Rhode Island, Ohio, Vermont, Alabama, and Wisconsin) are national leaders in both areas, however. Florida certainly need not remain mired at the bottom of the list. Submitted by Greg Mellowe, Florida CHAIN
Boots on the Ground: Florida Healthy Kids Joins Forces with Covering Kids and Families to Expand Florida KidCare Outreach
The Florida Healthy Kids Corporation is working with Florida Covering Kids and Families, based at the Lawton and Rhea Chiles Center for Healthy Mothers and Babies at the University of South Florida, to implement an outreach campaign targeting organizations and associations whose members and clientele interact with families likely to be eligible for Florida KidCare, the state children’s health insurance program. The new outreach effort is entitled “Boots on the Ground.” Florida Healthy Kids is providing funding for the program, financial incentives, outreach materials, applications and promotional items. In addition to applicant screening, Covering Kids and Families will provide technical assistance and performance evaluation. Boots on the Ground has enlisted participation from over 30 community-based partners to complement the state’s existing marketing and outreach efforts. These partners will encourage participation in areas of the state where no formalized marketing or outreach activities currently take place. Participants in the new program are non-profits or governmental entities, many of whom target groups or areas identified as under-represented by Florida Healthy Kids and the 2007 Florida Children’s Health Insurance Study. Ensuring geographic diversity has also been a key in selecting from the over 100 applicants. Calls to participate in Boots on the Ground were made in April. Since then, over 100 applications were received. Florida Healthy Kids’ Director of External Affairs, Jennifer Lloyd, was very pleased with the high level of interest: “The response and positive feedback has been overwhelming. We received applications from a diverse group of community partners under the Community Partnerships component of Healthy Kids’ Boots on the Ground initiative and while no additional applications are being accepted at this time, we are always looking for new opportunities and additional ways to enhance existing partnerships.” Florida Covering Kids and Families Project Director A broad range of audiences will be targeted by Boots on the Ground: pregnant women, infants and youth, underserved African-American, Asian-American, Caribbean, and Latino populations, migrant and seasonal farm workers and rural residents, low income church members, abused, abandoned and neglected children, high-risk children, the homeless, foster families, adoptive families, and teens involved in foster care, among others. Boots on the Ground participants will partake in an array of activities, such as: conducting media outreach at hospitals; participating in Back-to-School activities; partnering with Voluntary Pre-Kindergarten agencies, libraries, schools, and churches; utilizing case managers, outreach workers, facilitators, and program supervisors for KidCare outreach through parenting and after school programs; and working with local businesses to raise KidCare visibility. Boots on the Ground is composed of three participation levels. Level One participants will display KidCare signage, add a KidCare web banner to their organization’s website, provide KidCare advertising in newsletters, distribution lists and other communications to their members. Level One participants include: Bay, Franklin, and Gulf Healthy Start Coalition, Coordinated Child Care of Pinellas, Florida Community Health Centers (West Palm Beach), Healthy Start Coalition of Hardee, Highlands, and Polk Counties, Jewish Community Center of the Greater Palm Beaches, Inc., Lowry Park Zoological Society of Tampa, Inc., Mid-Florida Community Services, Inc. Head Start (Brooksville), Rural Social Services Partnership (Tampa), South Brevard Area Inter-Faith Sponsoring Committee, St. Francis Foundation, Inc. (Thonotosassa), and United Way of Central Florida—Success By 6 (Highland City). In addition to all Level One activities, Level Two participants will be trained in particulars about Florida KidCare, provide public access to the Florida KidCare Online application, and advertise Florida KidCare availability to their members. The following organizations are participating at Level Two: 2-1-1 Brevard, Early Learning Coalition of Brevard County, Chipola Healthy Start (Marianna), Okaloosa County Comprehensive Head Start Child Development Center, Project Patchwork, Inc. (St. Petersburg), and Volunteer Services of Manatee County.
Level Three participants perform Levels One and Two tasks plus have trained staff available to help families complete the Florida KidCare application process, participate and disseminate outreach materials at local activities and identify and develop other community partnerships. Level Three participants include: Brevard Health Alliance, Charlotte County Family Services Center, Childhood Development Services (Ocala), Communities in Schools of Bradford County, Girls Inc. of Pinellas, Harvest Time International (Sanford), Kid Finders Network, Inc. (West Palm Beach), Minority Development & Empowerment, Inc. (Oakland Park), Panhandle Area Educational Consortium Migrant Educational Program (Quincy), Panhandle Area Health Network (Marianna), Premier Community Health Care Group (Dade City), Jobs for Miami, Seagull Industries for the Disabled (Riviera Beach), The Volunteer Way (New Port Richey).
Florida has one of the highest uninsured rates for children in the country. With the help of Boots on the Ground, Florida can help close the gap by providing children the health insurance they need. Submitted by Patrick Cannon, Ph.D., Florida Covering Kids & Families
Jacksonville Launches Effort to Address Disparate Infant Mortality Jacksonville will launch a two-year implementation effort on June 25, responding to recommendations from a community-led study targeting the city’s high rate of infant deaths. The recommendations, the culmination of a nine-month study by the Jacksonville Community Council, Inc., cite the city’s failure to address racism, poverty and socioeconomic disparities as factors contributing to Jacksonville’s poor birth outcomes. Action recommended by the study include the establishment of a Children’s Ombudsman for the city to represent and advocate for public policy changes; expanded sex education through the school system; improved availability of healthy foods in at-risk neighborhoods; increased collaboration among agencies serving women, infants and families; and intensified efforts to address racism and disparities. Rev. Tom Rodgers, chair of the Northeast Florida Healthy Start Coalition, will lead the implementation phase of the study which brought together more than 130 experts, community residents and service providers. Jacksonville consistently exceeds national and state rates for babies who die before their first birthday. Overall, 9.5 infants out of every 1,000 live births die in the first year of life in the city. Significant disparities exist for Black babies who die at a rate of 12.7 per 1,000 live births compared to 7.2 deaths per 1,000 for their white counterparts. Copies of the study report are available at www.jcci.org. For more information contact Steve Rankin, Submitted by Carol Brady, Executive Director, NE Florida Healthy Start Coalition
Organizations: TAKE ACTION to Make Health Care High Priority on McCain’s and Obama’s Agendas Your organization's help is needed in signing on to a letter to the Florida Presidential Campaign Directors urging them to tell Senator Obama/McCain to make comprehensive health reform the earliest and top domestic priority in his Administration, if elected President. Please sign your organization on by emailing lisam@floridachain.org by Monday, June 30th. Letter to be sent to State Campaign Directors for Senators Obama and McCain: Dear [Florida Campaign Director]: Families across Florida are increasingly anxious about their access to high-quality, affordable health care, as you no doubt heard directly from voters during the primary season. Health care premiums are rising much faster than wages, and everyone is feeling the effects: Businesses that offer health insurance see it in their bottom lines, and family budgets are strained by rising out-of-pocket costs. For the small businesses and individuals who do not have coverage, the possibilities of obtaining coverage grow ever dimmer. The recent downturn in the economy has compounded these problems. Chief among the worries that people express about their family’s economic security is the fear of not being able to take their child to the doctor or get the medications they need to stay healthy and take care of their loved ones. We, therefore, urge you to tell Senator [Obama/McCain] to make comprehensive health reform the earliest and top domestic priority in his Administration, if elected President. We ask you this on behalf of Florida’s children, seniors, people with disabilities, and families. And we ask that Senator [Obama/McCain] make this commitment clear to Florida voters during the general election season. We are sending an identical letter to the state campaign director(s) for Senator(s) Obama/McCain. Sincerely,
(Your organization will be listed) Compilation of Leaders’ Views on Health Care Reform Set Stage for 2009 The Kaiser Family Foundation has compiled a series of interviews with leaders of organizations representing "health care providers, insurers, policymakers, employers, labor unions and consumers" who discuss their perspectives on what needs fixing in America's health care system and how they believe it should be fixed. In Viewpoints: The Health Care Debate, these leaders address issues of health care coverage, access, quality and cost, and financing. Currently, a total of 19 interviews are posted, a few of which are excerpted below. A diverse array of perspectives is recorded here, including both optimism and cynicism and calls for both incremental and sweeping change. But all agree that we can and must reform our health care system at some level, while reducing the ranks of the 47 million uninsured Americans, particularly in light of the arrival of a new President and Congress: Ron Pollack, Executive Director, Families USA: "...every time healthcare reform has been on the agenda, one or more major interest groups spent a fortune in opposition? and I think that we need to try to get those key stakeholders together and see whether, for the first time, we actually can reach an agreement so that if a president comes into office in 2009, with a congress, and they are both eager to try to do something significant with health care reform, that this time we succeed rather than fail, and that has to start by dealing with the key interest groups, the key stakeholders, so that hopefully we have a consensus about a direction of where to go, and that is not an easy thing to achieve." "...we have already had plenty of preliminary conversations, and I would say every major interest group that has been a key stakeholder in the health care system is prepared to sit at the table... So, the various groups, many of whom were blockers at different iterations of health care reform, are each determined to come together to try and create a dialogue. And this is not easy?" Karen Ignagni , President, America's Health Insurance Plans: "...I think we are on the cusp of a tipping point for the nation actually to get very serious about finally solving this problem. But it has been 100 years in which we have tried to solve the problem in this country?and one of the single most important barriers to solving it is whether or not the nation will commit the resources necessary to actually solve the problem once and for all? "...the people who say they are committed to healthcare reform and getting everybody covered is a very, very high number. That number drops off considerably when people are asked: Will you support an individual mandate? Would you support employer mandate? Would you support higher taxes? The rein is the policy conundrum." "So it's important for organizations that support reform to work together, to try to help the next president, to prepare the way for the nation to understand?" Scott Serrata, CEO, Blue Cross and Blue Shield Association: "It is almost this self-fulfilling engine that is driving here. As cost goes up, fewer people have coverage. As fewer people have coverage, they use the system inappropriately so costs go up even faster. So we continue to run that cycle. We have to break that cycle. We have to get the actual cost of delivering medical care under control so that we can address these other issues that face us." Ray Scheppach, Executive Director, National Governors' Association: "...I would say from the state perspective there is not a lot of people who believe that Washington D.C. is going to really get it done this time. And I think our view is that they probably should do it incrementally rather than try and do one big domestic sweeping program?And really what the federal government needs to do is to set the foundation so that the states can move?" Rev. Heyward Wiggins, National Network Steering Committee Member, PICO: "...we have this moral fiber, this thing that drives us, it doesn't ask those [immigration] questions. If you see somebody who is laying on the street and needs help, you just want to help them. So if there is no documentation there, we need to find a way to make that happen, so that they can be covered as well. The human element cannot be taken out." Andy Stern, President, Service Employees International Union: "I think, as we all know, that when you [start with] nice 30,000-foot [i.e., very general] principles, there is a lot of unity around this town and as you begin to dig down, we have not gotten there and that was never our intention to start with - to just dig down to the perfect health care plan. In the end, we are not legislators? "...when you have a kid like my son, 21, [who] is going to have 9 to 12 jobs by the time he is 35? Only one out of three employers today will be economically relevant in 25 years. How in the world in a self-managed work life do you have employer-sponsored benefits? It is not going to work in the 21st century economy? "I think this president has to turn this health care system upside down in the sense that he needs to say, 'It is not going to be incremental. I am ready to solve this problem and it is not going to be perfect and I have listened to all the Ideas and if you want to get on our team, lets go play.'" (Some punctuation added for readability.) Submitted by Greg Mellowe, Florida CHAIN
Last week, the Senate was blocked from moving forward with the bipartisan bill Baucus-Snowe-Smith-Rockefeller bill that would have improved Medicare and protected Medicare recipients from skyrocketing premiums. We are disappointed but let’s be clear – this fight is not over. With a looming deadline for Congress to act on Medicare, the next few weeks are going to be critical in AARP’s campaign to Keep Medicare Fair. But before we look ahead, we need your help. The vote was close – too close – and NOT ENOUGH Senators voted to improve Medicare. Already AARP has issued a press release on behalf of its 40 million members stating its frustration with the actions of a minority of the Senate who blocked action. But nothing is more meaningful than when activists send in their own letters. Nearly 350,000 advocates have signed the Keep Medicare Fair petition. You’ve sent over 270,000 emails to Senators. You’ve made over 65,000 phone calls. They know where you stand. But for all of that effort, a minority of the U.S. Senate chose to block action on legislation that would have helped to Keep Medicare Fair. AARP supported this bipartisan piece of legislation because it offered a substantial number of items that would have improved Medicare and helped to keep premium increases under control. Last, a sincere thank you to all of you. Your action has inspired me, Members of Congress, and everyone here at AARP. I know that together we can win in this fight. I will be in touch soon with the next steps in our campaign to Keep Medicare Fair. (Submitted by Barry Jackson, AARP) P.S. – Want to hear from the Senators themselves? Read Senator Baucus’ and Senator Grassley’s takes on the Medicare bill exclusively on AARP’s blog, shAARPsession.
Finally, Harmful New Medicaid Rules on Track to Be Blocked This article blends the content of updates provided by the Center for Budget and Policy Priorities and the Local Education Agencies Network. We appreciate all of their efforts. As you may have read previously, efforts undertaken by advocates to prevent 7 new Bush Administration-pushed Medicaid regulations from going into effect have been fairly intense and continuous over the last several months. That chapter may finally be drawing to a close, however, and with a largely hoped-for ending. Each of the proposed rules targeted a long-funded and important service for which federal Medicaid matching funds would be significantly reduced or made available altogether. It is now clear that Florida stood to lose well over a billion dollars in federal funding for important health and directly health-related services over the next 5 years, if the rules went into effect. First, proposed legislation imposing moratoria on (i.e., completely blocking) the implementation of the new Medicaid rules until at least April 2009 was introduced in Congress. The House passed H.R. 5613 on April 23 by a huge (veto-proof) margin. The Senate did not consider the bill, however, out of concern that a likely Presidential veto would trigger a bitter fight with the Administration that some Senate Republicans might seek to avoid. So instead, the moratoria were incorporated into a huge budget bill related to supplemental funding for the war that will pass in some form. A broad coalition of groups - including children’s advocates, school administrators, hospitals, pediatricians, mental health advocates, labor unions and many others - recognized that the seven rules would together devastate the Medicaid safety net and hurt the vulnerable consumers who rely on it. Refusing to concede, the Administration attempted at least 3 times to break up the coalition by offering to accept a moratorium on a few of the rules. Yet the coalition persisted in supporting all seven. In the end, the Administration relented in its opposition to including moratoria on more than 4 rules in the bill, and signaled that it would accept a bill with 6 moratoria. Consequently, on June 19th, the House passed a new version of the supplemental spending bill that blocks implementation of 6 of the 7 Medicaid rules. The domestic portion of the bill, which included the moratoria (and an extension of unemployment compensation benefits) passed by an overwhelming majority (416-12). From Florida’s delegation, only Rep. Dave Weldon (R-Indialantic) voted against the measure. Advocates hope that the 7th rule, which significantly narrows the types of services that Medicaid will fund in terms of outpatient hospital services, will be dealt with separately. And although this is by no means justification to ignore the remaining rule, Florida is not expected to lose any Medicaid funding as a result of its implementation. The spending bill will be taken up by the Senate this week and is expected to pass by another wide margin. It is expected that the President will then sign the bill. Thank you again for all of your efforts to explain the impact of and your concerns about these harmful regulations. Our federal partners have indicated that our efforts, in unison with those of many other partners, made the difference. Submitted by Greg Mellowe, Policy Director, Florida CHAIN
Throughout the course of the Medicaid Reform experiment, one useful source of information about its progress have been the policy briefs released periodically by the Health Policy Institute at Georgetown University, as commissioned by the Jessie Ball duPont Fund. The fifth brief in that series, Challenges with Mental Health Services, elaborates on concerns that have persisted throughout the Pilot period, in this case with an emphasis on a particularly vulnerable subgroup of Reform participants: individuals with severe mental illnesses. The backdrop for the authors’ review is the reality that evidence-based advances in treatment, along with reliance on a recovery-based approach, have significantly improved outcomes for consumers. As they note, effective care is individualized and usually involves a long-term plan that incorporates medication, therapy and a range of support services, and which is integrated and coordinated through case management. The Florida Department of Children and Families (DCF), which houses the State’s mental health policy and program arm, aims to ensure the “provi[sion of] a wide array of services to address both the treatment needs of the individual and the rehabilitative and support services necessary for safe and productive community living.” Challenges points out that this approach is generally incompatible with the managed care model to begin with, and it seems particularly ill-suited for Medicaid consumers, who often have fewer resources and more physical health problems than their non-Medicaid counterparts. The authors’ research suggests this incompatibility is even more pronounced under Medicaid Reform, amplifying a similar observation made by the AHCA Inspector General last fall. In particular, mental health providers noted that the Reform plans, which have the authority to vary the amount and duration of services that consumers receive, have significantly tightened access to case management services: “Providers perceived health plans as having a narrow, clinical orientation and not understanding the benefits of paying for case management services.” And in keeping with a recurring theme, they infer that the open door for plans to opt out of providing such essential services, regardless of the consequences, is the hands-off approach to regulation taken by the State. There are no administrative rules under Reform, and so the only restrictions on the plans are the conditions of the federal Medicaid waiver and the contracts between the plans and the Agency for Health Care Administration (AHCA). When the authors compared those contracts with “model purchasing specifications” developed at the federal level, they found that the Reform contracts “[contain] insufficient requirements to ensure that they cover the full scope of services, or to ensure that they cover these services in adequate amounts”. In addition, “the variability of contracting details raises questions about accountability.” The contracts have been amended several times already to deal with vulnerability or liability arising from these loose contracts. The brief also addressed a bigger-picture accountability issue: the so-called “80-20” rule, which dictates that at least 80% of a health plan’s mental health funding be spent on direct mental health services (vs. administration, marketing or profit). The 80-20 rule was originally understood to be applicable to Reform plans. This was of such concern to the plans that they mounted a successful legislative campaign to eliminate it in 2007, but Governor Crist’s veto negated it. Ultimately, AHCA trumped the veto by continuing to stand by its opinion that 80-20 doesn’t apply to Reform anyway. (Notably, this requirement is completely unrelated to the question of total spending on health care by Reform plans; reports filed by HMOs with the Office of Insurance Regulation do not separate out Reform from non-Reform spending.) Finally, the brief addressed another common theme in Reform: the extent to which increased flexibility for health plans has dramatically increased the administrative burden on providers. The reporting closely matches comments made at AHCA feedback workshops, where providers lamented the complexity of using a dozen different authorization forms and procedures, with AHCA explaining that it let these problems go unchecked in order to allow the experiment to work unhindered. (Discussions between AHCA, health plans and community mental health providers have reportedly produced some streamlining, at least in behavioral health.) Georgetown’s 5th Medicaid Reform brief accentuates several themes familiar to observers of the experiment, concluding that AHCA “may need to take a more active role in ensuring that Medicaid beneficiaries receive the types and level of mental health services they need.” More specific recommendations include strengthening coordination between AHCA and DCF, as well as establishing specialized plans for consumers with severe mental illnesses (which is in line with legislation that did not pass last Session). Submitted by Greg Mellowe,
Mental Health Parity: Legislative Update Below is the text of an email message received from MHA’s national President David Shern about the Federal Parity*Legislation. Unfortunately, this good news at the Federal level is not matched by action of the Florida legislature. Parity did not make if past our Legislature in the 2008 Session. We will be approaching candidates in this November's Legislative Elections about their stand on this issue. Please stay on the look out for our announcements about the "CONTRACT FOR FLORIDA's MENTAL HEALTH/SUBSTANCE ABUSE REFORM".
House, Senate Negotiators Reach Agreement on Key Provisions in Parity Bill I am pleased to announce that Senate and House negotiators have bridged their differences on the requirements for health plans under a mental health parity bill. This compromise is a major step forward. We anticipate further deliberations before any legislation would move to a vote. Nevertheless, we are excited about this breakthrough and cautiously optimistic about passage of a final bill. Mental Health America has been involved from the beginning in this historic effort and will continue our efforts to push the legislation over the finish line. The agreement provides that whatever mental health conditions are covered under a health plan must be at parity with medical coverage (except to the extent that a state parity law requires broader coverage). If a plan offers out-of-network benefits for medical or surgical care, it must also offer out-of-network coverage for mental health and addiction treatment and provide services at parity. And, it preserves strong state parity and consumer protection laws. Your strong support and commitment to the cause of parity are the reasons we have reached this milestone. We need your continued involvement to ensure we achieve victory in our fight. For more information about the Parity issue go to our online Tampa Bay Mental Health Town Square. CLICK HERE for the page with information about this topic. Submitted by Scott F. Barnett, Executive Director of Mental Health America of Greater Tampa Bay
In a study reviewed in an article published on-line this month by Health Affairs, researchers for the Commonwealth Fund estimated that the number of under-insured adults in America increased by an astounding 60 percent between 2003 and 2007 - to 25 million. And a staggering 75 million of non-elderly adults (42% of the total) were either uninsured or under-insured at some point in 2007. In How Many Are Underinsured? Trends Among U.S. Adults, 2003 and 2007, the authors defined an individual as underinsured if he or she either: 1) spent at least 10 percent of their household income on out-of-pocket medical expenses, or 2) spent 5 percent of their household income on deductibles. For low-income individuals (less than 200% of the poverty level), the threshold for out-of-pocket expenses was reduced to 5%. Adults in households with incomes below the poverty level have the highest rate of under-insurance (as well as uninsurance), but most of the growth in the under-insured population was among households with incomes above 200% of the poverty level. The size of that group nearly tripled in 4 years. Perhaps most importantly, the report also explored the very real consequences of being under-insured. For example, more than half of the under-insured (53%) reported that they refrained from seeking needed medical care, which is less than the corresponding rate for the uninsured respondents (68%), but significantly more than the 31% of those with solid coverage who refrained. Also, the percentages of under-insured and uninsured people experiencing financial distress due to high medical bills were similar, but the percentage of people with solid coverage experiencing such stress was less than half that of the under-insured. Most readers of an article like this would agree that the fact that the 47 million Americans without health insurance coverage is a crisis in need of a powerful solution. But if that 47 million were significantly reduced, would that signal great progress in solving uninsurance? Not necessarily. Health insurance coverage is not a “light switch”. Leaving the ranks of the uninsured to join the ranks of the seriously under-insured may not constitute much progress. These considerations are particularly relevant as Florida embarks upon its experiments with very limited coverage, namely the Governor’s Cover Florida and the Florida Health Choices initiatives. The coverage available through these new State-sponsored programs will by definition be designed to leave the consumers who purchase it under-insured. The study raises questions about the extent to which these formerly uninsured Floridians will be better off once under-insured. Given the continuously increasing cost of health care and health insurance coverage, however, more of the under-insured seem likely to have dropped or lost access to solid coverage. The authors found that the sharp increase in the under-insured population is a function of changes in “benefit design”. In other words, insurers are reducing their costs or increasing the cost-sharing by policyholders by limiting services, increasing deductibles, etc. The study concludes that “both private insurance and public policies [must] take benefits as well as premiums into account....Discussion of insurance expansions require decisions regarding the scope of benefits and cost-sharing provisions, and they raise the question of how designs should vary depending on household incomes”, if the true goal is delivering “effective...care and improved outcomes—not just coverage.” Submitted by Greg Mellowe, Policy Director, Florida CHAIN
Why Covering the Uninsured is Everyone’s Sign the pledge. Join the Divided We Fail movement. Learn more at www.dividedwefail.org During this long campaign year, you’ve likely heard from both governmental and private studies that nearly 47 million Americans don’t have health insurance. And, you might be thankful that you have health insurance and that’s not your problem. The truth is that the uninsured are your problem, my problem and America’s problem. The United States spends $126 billion annually caring for the uninsured. According to a 2004 report by the Kaiser Family Foundation, $40.7 billion will not be covered by any private or public insurer or paid for by patients. Hospitals bear the brunt of the costs, accounting for 60 percent of the money needed for uncompensated care. Some hospitals across the country are forced to shut their doors, put off needed improvements and updates on technology, facilities and equipment or cut high-level emergency room services. In the end, our communities bear the brunt of the costs. Lack of health coverage is a big and growing problem for hardworking Americans – particularly young workers. The increase in the number of uninsured is mostly working adults, ages 18-24. Nearly one million full-time workers lost their health insurance in 2005. It also is a big problem for small businesses. Almost one-third of the uninsured people in America are small business owners and their families according to a National Federation of Independent Business (NFIB) survey. Businesses cite the extraordinary jump in health insurance premiums as a major hurdle to doing business. Costs for health insurance for employees escalated more than 9 percent this year and is expected to jump another 9 percent in 2009, according to a recent report by PriceWaterhouseCoopers. Simply put, many businesses, particularly smaller ones, cannot afford to provide health coverage to employees. Divided We Fail, a national initiative led by AARP, the Business Roundtable, Service Employees International Union and the National Federation of Independent Business, is focused on engaging government, business and voters in finding bipartisan solutions to the health care and lifetime financial security issues. These organizations are not always on the same side, but all agree that in order for America to move forward, it must be united in finding solutions to these two critical domestic issues. The uninsured are not a small segment of our society. Nearly 40 percent of the uninsured population resides in households that earn $50,000 or more. A growing number of middle-income families cannot afford health insurance payments even when coverage is offered by their employers. The 47 million uninsured people in America are your family, your friends and your neighbors. The number of uninsured will likely continue to rise during these tough economic times. Everyone in this country should have access to quality affordable health care. It’s time to join together to find broad-based, bipartisan solutions that address this issue in a real and lasting way. To find out how you can let your voice be heard, visit www.dividedwefail.org. Submitted by Lori K. Parham, AARP Florida State Director
Florida Healthcare Advocates Convene to “Re-Frame” the Health Care Debate The Herndon Alliance Messaging Workshop, Talking About Health Reform, brought into focus how the right words can motivate people to advocate for progressive healthcare reform.
L-R:David Pizzi, Blue Cross Blue Shield-Florida; Sherry Prowda, Herndon Alliance; Annette DeSoto, Beyond the Divide; Persephone Taylor Gary, The Children’s Trust; Penelope Tiam Fook, March of Dimes; Michael Citro, Florida College of Emergency Physicians; Elizabeth Buckley, FOCUS; Linda Vaughn, Florida CHAIN
Nearly thirty health care advocates from around the state representing a diverse cross section of interests and populations gathered in Orlando on June 11th to take advantage of this exceptional workshop. They learned how to use language to talk about healthcare reform and get results by inspiring and not turning off the very people they are trying to motivate. They learned how to influence registered voters, 96% of whom were covered by some type of healthcare insurance in 2006, to advocate for the 45 million Americans who remain uninsured.
Herndon’s research based message framing is based on group value belief systems. Long used in business, this approach has just recently been applied to social issues. The emphasis is on the importance of connecting with people rather than winning an argument and how and when to adjust your information and language accordingly.
Penelope Tiam-Fook, State Public Affairs Director for the March of Dimes was glad she drove from Tallahassee to be there: “The workshop helped me rethink my approach in communicating advocacy messages to various audiences to educate and urge support for our policy issues. The trip to Orlando was definitely worth my time, and I plan to put the things I learned to work right away.” FOCUS Development Director Liz Buckley was delighted by the insightful research that reaffirmed the importance of really connecting with people. "The Herndon workshop was a profound eye-opener! We were intrigued by the powerful difference one word can make - and they aren't the words you think they will be. I especially appreciated their integrating into the training the organizational priorities of the attendees - making it easier to apply these valuable lessons to our individual organizations. And, it was a rich opportunity for networking among diverse groups. I'd recommend it to anyone committed to meaningful health care reform." The number of organizations participating and the encouraging responses illustrate the need for more of these excellent messaging workshops throughout the state. Since 2005 Herndon Alliance, a neutral nonpartisan coalition of more than 150 national, state and local partners has been providing a unified approach to talking about health care reform. United by their visions and goals to build a system that provides quality, affordable health care for all, Herndon does not advocate for specific policy initiatives. Instead, they focus on issues of interest to the public and explore ways to avoid barriers and create a wide cross section of support. Sherry Prowda, Communications Manager for Herndon explains, “For too long others have divided us through fear, instead of uniting us through shared beliefs and common purpose. Americans have said very clearly in poll after poll that what we want is guaranteed quality affordable health care for all. It's time we joined together to get the job done!” Herndon’s analytic research reveals the values, attitudes and beliefs of voters about health care reform and represents the most in-depth and current inquiry into America’s attitudes on health care. Herndon delivers the strategies and resources to achieve more powerful and accurate messaging – to show what ideas, stories, and messages best resonate with likely voters and motivate them to push for real and substantial reform. The research has also tackled obstruction messages, frequently and successfully used by opponents to real reform. By identifying voter’s values and beliefs about health care reform, they can pin point what language engages or alienates people.
If Herndon had to choose one word that’s worth more than a thousand pictures, most likely it would be this one: Unified.
Florida CHAIN wishes to express our deep appreciation to the organizations that joined us in sponsoring the Talking About Reform Workshop: AARP, Hispanic Health Initiative and the Human Services Coalition. You can learn more about Herndon Alliance’s mission to help you take values-based research and effective health care communications to the people of America at www.herndonalliance.org Submitted by Linda Vaughn, Florida CHAIN
REAL STORIES FROM Even with Attorney, Medicaid Reform Falls Short for SSI Client in Plan Selection, Appointments, Transportation From Cora W.:
"Medicaid Reform has been a terribly frustrating experience for me. When I signed up for Medicaid, I wasn’t told that I would have to go into an HMO (previously I had non-medicaid coverage). I was automatically put into a plan which I didn’t know about.
I showed up at the doctor for my appointment with serious infection problems. I was sent away and told that I was in HealthEase and that my doctor was not in the plan. My caseworker at Children’s Diagnostic Treatment Center then moved me into Amerigroup. But the switch wouldn’t take effect for two weeks. I called an attorney from Coast to Coast Legal Aid and told her I wanted to go to Cleveland Clinic. We called Cleveland Clinic and found out that they only take Netpass PSN.
We then called the Medicaid Reform Choice Counselor but were disconnected. So my attorney and I called again. The Choice Counselor insisted on speaking to me directly, and asked me repeatedly whether I was being coerced and whether I was acting on her own. When they started to get into substantive issues, my attorney put the phone on speaker and announced her presence. She again asked me if it was okay and if my attorney had authority to speak for me. I told her it was fine and that we wanted to switch into the PSN. The Choice Counselor asked me if I wanted to switch from HealthEase. Then she asked if I had a developmental disability because if I did, I would not need to be on an HMO. I told her I did. The Choice Counselor named the 5 criteria to be considered developmentally disabled, and I told her I had a physical problem.
The Choice Counselor then asked me if I had private insurance. I answered that I didn’t. She then continued with a series of questions: “Do you have other special medical needs?” “No,” I replied. “Are you pregnant?” “No,” I replied. “Do you take prescription medications?” “Yes,” I replied. “Did you check your chosen health plan to see if the medicines are on it?” “Yes,” I replied. “Do you have a list of your medicines with you?” “No.” “Do you want to go over other plans?” ”No.” “Do you want a doctor list?” “No.” “Have you picked a primary care doctor?” ”No”. She then told me to call within a week to name a primary care doctor and then the change would occur a week following that. We called Cleveland Clinic and made an appointment for June 2, the day after I was to have been able to be switched into the new plan.
We asked how to arrange our transportation and were told to call Netpass. We called Netpass and were asked to name a primary care provider. I explained that we couldn’t until two weeks following. We tried to get the information we needed about transportation, but they told us to call Medicaid and gave us the number. We called Medicaid and it was not possible to speak to anyone; we could only leave a message. We called the Choice Counselor back to try to name our primary care provider and to find out about transportation. By this time, I was sick and doubled over in my chair. I begged the Choice Counselor to talk to my attorney. The Choice Counselor took the primary care provider’s name and told us that we should call Netpass the next week to discuss transportation." Adapted by Coast to Coast Legal Aid client experience
West Central Florida
National Events 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
2008 Florida Conference on Aging Aug 11 -14 Orlando Resort at SeaWorld Call Events
Florida Mental Health Summit 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: 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
Looking Back, Looking Ahead: Medicaid Reform in Florida - Year 2 Oct 15 9:00 am-4:00 pm Marriott Tampa Airport Researchers at Georgetown University's Health Policy Institute, with support from the Jessie Ball duPont Fund, the Florida Health Policy Center, and the Florida Philanthropic Network, will host this event to examine Florida's experience with Medicaid reform. Contact jwt24@georgetown.edu or
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. Events
Breast Cancer Awareness for the Hispanic Community June 25 6:00–7:30 pm PBCC Lake Worth Campus, Rm CE -119 Palm Beach Cancer Institute Foundation and PBCC present speaker Dr. Rogelio Brito. Learn about early detection and treatment of breast cancer at this free special community event. Light refreshments. To register:
Dialogue on Health Across Cultures: A Workshop on Cultural Competency in Cancer Care for South Florida Case Study Submission Deadline: July 11 Sept 20 Nova Southeastern University, Ft. Lauderdale/Davie The Southeast Florida Cancer Control Collaborative invites you to attend its cultural competency workshop. The program is designed for participants to: gain a better understanding of the diversity of cultural values, attitudes and beliefs that impact health behaviors and the use of health care services in South Florida; educate health care providers about the importance of a culturally sensitive environment, materials and resources; and increase awareness of race, ethnic and gender disparities, as well as language and cultural barriers in accessing cancer care. More info: MGonzalez16@med.miami.edu or 305?]243?]4821.
HSC’s Advocacy Corps Trainings May 17 – July 26, 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: 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 Notices
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
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
Making an Impact: Evidence-Based Community Benefit 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.
The Association for Community Health Improvement National Conference Proposal Deadline for Breakout Sessions: Aug 8 March 11-13 Los Angeles This annual conference hosts more than 450 professionals from hospitals, health systems, foundations, public health, and community health organizations for a gathering that stimulates real change and improvement in how community health programs are planned, run, and evaluated. There will be four tracks: Leading Community Health Assessments to Set Priorities, Programs, and Policie; Achieving Community Benefit Excellence; Improving Health by Addressing Our Social and Built Environments; Building the Skills of Community Health Leaders (for Today and the Future)
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." ACHI audio conferences
Cutting through the Clutter: Building Awareness of and Identity for Community Benefit Conducting High Quality Community Health Assessments: Two Communities Illustrate Contrasting Approaches $40 (members) and $80 (non-members)
Social Determinants of Health: A Call For Papers On Nov 8, 2008, The Lancet will publish a theme issue devoted to the social determinants of health. We invite submission of research papers, reviews, viewpoints, and comments with an emphasis on action-what the doctor, public-health worker, policy maker, and politician can do to reduce inequalities and tackle the broad interplay of economic and social forces affecting health.
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/
Two New PAL Lawsuits challenge illegal deceptive drug marketing! PAL has two new opportunities for our coalition members and consumers to join lawsuits challenging illegal pharmaceutical marketing tactics, concerning: 1) Vytorin and Zetia, two cholesterol drugs for which Merck and Schering-Plough suppressed results of their own study. Any consumer, health plan or union benefits fund that purchased or paid for any of the cost of these two drugs from April 1, 2006 to the present can join the case. Click here for a flyer, email wwilkinson@communitycatalyst.org or call 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
UV Safety Month
National Immunization Awareness Month
National Cholesterol Education Month
Let's Talk Month National Domestic Violence Awareness Month American Cancer Society
National Alzheimer's Disease Awareness Month National Hospice Palliative Care Month Pancreatic Cancer Awareness Month
Great American Smokeout – November 20 Gastroesophageal Reflux Disease Awareness Week – Nov 25-Dec 1
New listings, in order of submission deadlines National Breast Cancer Coalition Fund: Best Practices in Breast Cancer Advocacy Awards The National Breast Cancer Coalition Fund (NBCCF) is the nation's leading grassroots advocacy organization dedicated to ending breast cancer through the power of action and advocacy. NBCCF's Best Practices in Breast Cancer Advocacy Awards recognize consumer-led grassroots advocacy organizations whose programs are addressing critical issues in systems of research, access to quality care, and public policy. NBCCF will consider applications from a wide range of organizations, including those that serve diverse populations and the medically underserved. Up to seven awards will be given, ranging from $25,000 to $50,000 each. Nominees must be current, dues-paying members of NBCCF. (Organizations may join at time of nomination.)
ADA Foundation: Samuel Harris Fund for Children's Dental Health Deadline: July 17 The grant program's main objective is to help children whose socioeconomic status impacts their access to professional oral care and adversely affects their oral health habits at home. Faith-based Advocacy: Galvanizing Communities to End Childhood Obesity Deadline: July 25 The Robert Wood Johnson Foundation's goal is to reverse the epidemic of childhood obesity by 2015 by promoting healthy eating and physical activity in schools and communities throughout the United States. Developing and Disseminating Targeted Immunization Materials Deadline: July 29 The purpose of the program is to provide support for the dissemination of immunization information using electronic and/or digital formats to enhance the effectiveness of disease prevention programs that reduce the annual burden of vaccine preventable diseases. This program addresses the “Healthy People 2010" focus areas of Health Communications and Immunization and Infectious Diseases. Grants for Organizations that Serve Disadvantaged Communities Maximizing Enrollment for Kids: Making Medicaid and SCHIP Work Deadline: Aug 6 Although states have made progress in finding, enrolling and retaining eligible children in public health coverage programs like Medicaid and the State Children's Health Insurance Program (SCHIP), the number of uninsured children who are eligible but unenrolled still remains high.
Johnson & Johnson/Society for the Arts in Healthcare Partnership to Promote Arts and Healing The Society for the Arts in Healthcare (SAH) promotes the use of the arts to enhance the healthcare experience for patients, their families, and caregivers. The Johnson & Johnson/SAH Partnership to Promote Arts and Healing provides grants averaging $75,000 over three years to collaborations of healthcare organizations and arts agencies in the U.S. and Canada that have established models of high quality healthcare through the use of arts. Funded programs must have been in existence for a minimum of three years and have demonstrated a high potential for replication. Programs may be located in a variety of settings, including clinics, hospitals, hospices, medical schools, and public health services. At least one member of the partnership must be a current member of SAH. The deadline for letters of inquiry is August 8, 2008. Visit the SAH website for program details and application guidelines.
Cancer Prevention and Control Activities Physician Advocacy Merit Award Deadline: Sept 2 The Institute on Medicine as a Profession offers three $10,000 Merit Awards each year to recognize physician advocates for their commitments and accomplishments.
Ladder to Leadership: Developing the Next Generation of Community Health Leaders Continuing listings, in order of submission deadlines 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. 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. American Academy of Pediatrics: Community Access to Child Health Program Planning Funds 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.
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
GE Healthcare Charitable Giving Program Deadlines: Aug 1, Nov 1
2009-10 Packer Policy Fellowships Deadline: Aug 15
Department of Health and Human Services Understanding and Promoting Health Literacy (R21)
2009-10 Harkness Fellowships in Health Care Policy and Practice
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 Community-Campus Partnerships for Health Annual Award Innovating Worthy Projects Foundation Advancing technology to improve healthcare sevices: Verizon Foundation Applications accepted: Jan 1 through Nov 30 The Humana Foundation 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) Community Participation Research Targeting the Medically Underserved (R01) Community Participation Research Targeting the Medically Underserved (R21)
Community Participation in Research (R01) 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
Johnson Foundation: Wingspread Conferences Multiple deadlines Medical Care Enhancement Funded by United Health Foundation Donors Forum of South Florida on-line database 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 Technology and Audio Visual Materials Audio, Videos and Films: Web, Rent/Purchase. Theater New Listings: Children's Health New Listings: Federal/State Budget New: Health Insurance, Health Care Costs Health Insurance, Health Care Costs
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.
Newly posted resources are at the top of each Topics List.
The Florida Discount Drug Card 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:
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.
IPUT, Informed Parents United Together: Advocating for Universal Education and More! This nonprofit agency works at an individual local network level to educate parents
AARP's Public Policy Institute
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 (
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.
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:
The Partnership for Prescription Assistance
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.
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
The National Resource Center on Public Health Preparedness Needs of Culturally Diverse Communities is a new online central clearinghouse of resources and an exchange site to facilitate communication, collaboration, and networking among key players working to empower and eliminate disparities for culturally diverse communities in emergencies. African American Health Coalition (AfAHC) National Resource Center on Advancing Emergency Preparedness for Culturally Diverse Communities 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
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
Community Clinical Oncology Program
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
Newly posted resources are at the top of each Topics List.
First Focus Children's Budget 2008
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
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
Helping Pediatric Practices Implement Parental Depression Screening
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 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.
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
Medicare Rights Center Part D appeals manual
New/Updated Resources Medicare Drug Plan Resources 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.
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 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
Critical MASS Toolkit: Taking Community ACTION on 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)
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
Reducing Racial and Ethnic Disparities: A Quality Improvement Initiative in Medicaid Managed Care ToolkitCenter for Health Care Strategies
Families
2008 Federal Poverty Guidelines 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
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
Five Guidelines for Developing Customer-Friendly Websites better job of helping people find information on the Web about Medicaid, SCHIP and other government services by producing a customer-friendly sites
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 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 A low literacy brochure describing services offered at
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
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
Florida Health Insurance Coverage of Children 0-18 (2004-2005)
Statehealthfacts.org Updates Data on Medicaid & SCHIP Coverage for Children
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
State of Florida Health Care Consumer Websites
Medicaid Applications Online 24/7 and in Neighborhoods
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
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 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
Online Parent SCHIP Information
Fact Sheets on Medicare, Long-Term Care Spending; Medicaid; Long-Term Spending Data
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.
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
Fact Sheets on Medicare, Long-Term Care Spending; Medicaid; Long-Term Spending Data
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
Using this tool, Medicaid benefits can be compared across the 50 states, the Using this tool, Medicaid benefits can be compared across the 50 states, the Families 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
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.
Health Care Coverage in America: Understanding the Issues and Proposed Solutions includes a corresponding PowerPoint presentation. (Cover the Uninsured)
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.
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. ( Complete body of reviewed research available through new interactive tool. (10/11/07, Robert Wood Johnson Foundation)
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.
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 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
Factline: Tracking Health in Underserved Communities
New Database for Medical Language Access
2007 Federal Poverty Guidelines Now Available
Women's Health Insurance Coverage Fact Sheet
Comprehensive source of Hispanic data Rural Communities Statistics and Information
Immigrant Health Policy Reference Library
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
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
Consumer Health Information for You and Your Family
Metropolitan Quality of Life Data
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 State Level Data on Health Coverage & the 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 The Deadliest Disease in America, is a documentary produced by URU The Right To Be, Inc, which chronicles the stories of four individuals who experienced racism while seeking medical care. The film serves as a vehicle to foster discussion about the U.S. health care system and what strides are being made to eliminate racial and ethnic health disparities. For more information, to view the trailer, and to see a list of conference tour locations, click here.
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 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)
Social Epidemiology: Strategies for Public Health Activism Health Disparities in the United States: Social Class, Race, Ethnicity, and Health
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.
The Three E’s: Enrollment, Employment, and Earnings in the Medicaid Buy-In Program, 2006 presents a national profile of the enrollment, employment, and earnings of buy-in participants and investigates the association between participant characteristics, state program features, and employment outcomes. The report notes that the buy-in program continues to be a popular coverage option for states and that enrollment grew nationwide between 2001 and 2006 from 29,398 to 97,491. (4/11/08, Mathematica) Medicaid, SCHIP, and Economic Downturn: Policy Challenges and Policy Responses examines the implications of a recession for health coverage and state programs. It also projects the impact of a one percentage point rise in the national unemployment rate on Medicaid and CHIP and the number of uninsured individuals. The analysis also documents how federal fiscal relief during the last economic downturn of 2003-2004 helped to stabilize Medicaid and helped states avoid deeper budget cuts. (4/28/08, KFF) New Listings: Children's Health
Determining Income Eligibility in Children’s Health Coverage Programs: How States Use Disregards in Children’s Medicaid and SCHIP Medicaid Managed Care for Children in Child Welfare U.S. Variations in Child Health System Performance: A State Scorecard High Body Mass Index for Age Among US Children and Adolescents, 2003-2006 A recent study shows the growing rate of childhood obesity has started to level off. However, this is not true for children of color. Researchers from the Centers for Disease Control and Prevention (CDC) analyzed data on more than 8,000 children. CDC found that among girls aged 12 to 19, about 28 percent of blacks and 20 percent of Mexican-Americans were obese, compared to 14 percent of whites. For boys aged six to 11, about 28 percent of Mexican-Americans and 19 percent of blacks were considered extremely obese, compared to 16 percent of whites. (5/28/08, JAMA)
Multiple Health Disparities in Non-English-Speaking Households
Medicare Advantage in 2008
The issue brief prepared for the Kaiser Family Foundation by Mathematica Policy Research analyzes recent developments in the Medicare Advantage marketplace, including plan choices available to beneficiaries and enrollment trends by plan type and geography. It also examines market share for the insurers offering MA plans and the role MA plans play in providing employer-sponsored retiree health benefits (6/5/08, KFF)
Nearly Three-Fourths Of Medicare Drug Plan Beneficiaries Will Pay 16% More For Coverage This Year Monthly premiums for Medicare beneficiaries enrolled in the 10 largest prescription drug plans this year increased by an average of 16% to $26.39. (6/4/08, Avalere Health) Wide Racial, Geographic Health Care Disparities Among Medicare Beneficiaries Race and place of residence can have a significant effect on the quality of care a Medicare beneficiary receives, according to a new report. The study examined Medicare claims over the past two decades for evidence of racial and geographic disparities in several indicators of health care quality. Blacks were found to be less likely than whites to receive recommended care within a given region, but greater disparities in care were found among different geographic regions, according to the study (6/5/08, RWJF). Variations in regional Medicare spending do not affect beneficiaries' perceptions of the care they receive, according to a new study. (5/28/08, JAMA) Medicare Part D: Simplifying the Program and Improving the Value of Information for Beneficiaries Exploding Enrollment in Fee-For-Service Plans Causes Concerns The escalating enrollment in private Medicare fee-for-service plans reflects their popularity, but their cost is becoming a concern for Democratic lawmakers. (6/6/08, Commonwealth Fund) Proposal: "Early Medicare" Program Would Provide Federal Health Care to Uninsured Using Medicare as a model to cover all uninsured adults is not the way to address the health care gap in the United States, said Rep. Tom Price, R-Ga., during a panel discussion of a new proposal that would mirror the federal program to cover those without health insurance. The proposal, authored by the Commonwealth Fund, would establish a new program modeled after Medicare called Medicare Extra. Advocates say the federally administered program would improve coverage and access to care while lowering costs, and could yield a health system savings of $1.6 trillion over 10 years. (6/6/08, Commonwealth Fund) Disparities in Health and Health Care among Medicare Beneficiaries Study highlights inequity in health care quality in the U.S. The study also points out that these disparities are particularly striking when comparing different regions of the country. For example, researchers showed amputation rates for blacks in Mississippi and South Carolina are three times greater compared to blacks in Colorado and Nevada. (June 2008, RWJF) Medical Fraud a Growing Problem; Medicare Pays Most Claims Without Review Medicare has a "growing fraud problem and the need to devote more resources to theft prevention." Law enforcement officials estimate that health care fraud costs taxpayers more than $60 billion annually. HHS Inspector General Daniel Levinson has said repeatedly that Medicare is "highly vulnerable" to fraud. Fraud "hot spots" include South Florida -- "where schemes center on expensive, infusion-based HIV medications and on equipment such as wheelchairs, walkers, canes and hospital beds" (6/13/08, Washington Post) Cost-Related Medication Nonadherence and Spending on Basic Needs Following Implementation of Medicare Part D
New Listings: Federal/State Budgets
How Many Are Underinsured? Trends Among U.S. Adults, 2003 and 2007 Viewpoints: The Health Care Debate Failing Grades: State Consumer Protections in the Individual Health Insurance Market
Young and Uninsured: Health Coverage Gaps for Young Adults
Are the Uninsured Responsible for the Rise in Emergency Department Visits in the United States?
Newly Insured Outpace Available Doctors Hospitals Put Patients' Debt Up for Auction On the Road to Universal Coverage: Impacts of Reform in Massachusetts at One Year The Nation's Smallest Businesses Battling High Health Care Costs Behind the Numbers: Medical Cost Trends for 2009 The Healthcare Trap: Why Do Rich Countries Spend So Much on Health, When Evidence Shows It Doesn't Make Much Difference to Life Expectancy? How Private Health Coverage Works: A Primer–2008 Update Health and Wellness Initiatives: The Shift From Managing Illness to Promoting Health
Achieving Affordable Health Insurance Coverage for All Within Seven Years: A Proposal From America's Internists, Updated 2008
Beyond Health Care - Socioeconomic Status and Health US Health Care Still Failing Ethnic Minorities Panel Issues Blueprint for Minority Community Preparedness Doctors Miss Cultural Needs
Toxic Pesticides Threaten Urban Communities of Color
Racial and Ethnic Disparities in Hospital Patient Safety Events, 2005 Socioeconomic Determinants of Psychological Well-Being: The Role of Income, Income Change, and Income Sources during the Course of 29 Years Lifeline to Health Equity: Policies for Real Health Reform Physician Performance and Racial Disparities in Diabetes Mellitus Care Physicians’ lack of attention to cultural differences between populations can adversely affect the quality of care they provide. Researchers analyzed the patient records of 90 primary care physicians who were treated for diabetes between 2005 and 2007. Researchers believe that health disparities occur because physicians are doing the same type of treatment for each individual patient and not considering their diverse needs. (6/9/08, Archives of Internal Medicine)
New Listings: Other Health Issues
Shortage of Doctors in Primary Care May Harm Health of Nation: More U.S. Physicians Educated Overseas
Surf, Turf and the Future of Primary Care Improving Public Health through Prevention Despite Pressing State Deficit, Latest Field Poll Shows Voters Strongly Opposed to Health Care Cuts (6/10/08, The Field Poll) U.S. Mortality Drops Sharply in 2006, Latest Data Show
The Concept of Prevention: A Good Idea Gone Astray? 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
State of Breast Cancer Report Names
Florida Funding For Safety-Net Hospitals Could Be Affected By Proposed Property Tax Cuts Proposed cuts to
Too Great a Burden: Florida Families at Risk A Report on the Impact of Healthcare Costs on 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 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
(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
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
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 SCHIP Enrollees Have Unmet Health Care Needs And Waiting Period Would Negatively Affect Them 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
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 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)
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)
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 Health Insurance, Health Care Costs
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
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? 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)
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 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
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) | ||||||||
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