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October 14, 2009

Medicaid Isn't to Blame

As new figures are released on our state’s financial health, all fingers are pointed towards Medicaid as the culprit behind our looming deficits. Cuts to the program that provides health care to more than 2 million of Florida’s lowest-income children, seniors and disabled citizens loom even as Congress moves forward with proposals to greatly expand Medicaid for the future. Medicaid isn't the problem, nor is slashing it the solution. The Legislature has other solutions available. (Laura Goodhue, Executive Director, Florida CHAIN) Read more


	Why the Legislature Owes Medicaid Despite the State's budget woes, Florida's Medicaid program has so far escaped serious cuts thanks to the federal stimulus legislation. Florida will receive a total of $5+ billion in extra Medicaid funding for the 27 months ending December 2010. But while appropriately protecting Medicaid with part of the stimulus money, the Legislature also misused short-term funds as a replacement for long-term State funding. As a result, next year (2010-11), leaders say Florida's Medicaid budget is headed for a “cliff” once the stimulus money stops flowing. The fact is, the Legislature intentionally created that cliff and is now preparing to throw Medicaid recipients over the edge. Click here for an explanation of what happened and how it can still be fixed. (Greg Mellowe, Florida CHAIN)

	Extra Foot on the Scale: Overstating the Burden of Medicaid Expansion on Florida's Budget Critics of the health care reform proposals moving through Congress have been sounding the alarm about one component - the proposed Medicaid expansion – that they say could bankrupt the States. That claim is simply not valid, however. In particular, it isn't valid for Florida. The expansion would help Florida immensely. (Greg Mellowe, Florida CHAIN) Read more


	Affordability Still in Question as Health Reform Heads to House and Senate Floors After a grueling months-long process, Congress has finally completed the committee review process for health care reform legislation. It's looking more and more likely that some version of reform will pass the House and Senate floors. But what will that legislation include? Among the most important unresolved issues: will low- and moderate-income families be able to afford the coverage offered? (Greg Mellowe, Florida CHAIN) Read more

	National Health Care Reform Call-in Day: October 20 The House and Senate have made great progress in drafting a comprehensive bill to fix our health care system. But it’s not over till the President has a real reform bill on his desk - a bill that offers affordable, accessible care with protection from tragic exclusions and lapses. Make Three Calls on October 20: Senator Bill Nelson: 202-224-5274 Senator George LeMieux: 202-224-3041 Call and ask for your Member of Congress: 202-224-3121 Tell them it’s time to deliver on health care. We cannot afford to wait.


	Year 4: Information Still Scarce in Medicaid Reform AHCA's recently overhauled Medicaid managed care contracts now require that Medicaid Reform HMOs not only post their “Preferred Drug Lists” on their websites, but also meaningful provider network directories, member handbooks and other information that enrollees need. The stronger requirement seems to back up AHCA's claims that the new contracts will increase accountability by plans. But even when requirements were weaker, the bigger problem was a lack of enforcement of what was required. So far with the new contracts, it's generally more of the same. (Greg Mellowe, Florida CHAIN) Read more

	Free Market “Solution” Seeks Freedom from Accountability The 2008 bill that created the Governor's Cover Florida initiative also created Florida Health Choices. The private, non-profit Florida Health Choices Corporation will create an Internet “marketplace” where insurers can sell bits and pieces of real health coverage with minimal regulations. Unfortunately, the Corporation's first step towards evading “unnecessary burdens” like consumer protections was to evade accountability for its taxpayer-funded operations. (Greg Mellowe, Florida CHAIN) Read more


	Florida Covering Kids and Families Receives Federal Grant to Reduce State's Uninsured The Florida Covering Kids and Families Initiative, a project of the Lawton and Rhea Chiles Center for Healthy Mothers and Babies has received almost one million dollars in grant funds from the US Department of Health and Human Services’ Centers for Medicare and Medicaid Services. The funds will be used to increase enrollment and retention in Florida KidCare, the state’s child health insurance program. (Patrick Cannon, PhD, Florida Covering Kids & Families) Read more

	Multiple Sclerosis without Health Coverage Leads to Debt and Family Strain I have lived in Miami all my life. At 22, I live with my parents and my two sisters, who are 16 and 21. I also live with Multiple Sclerosis, and need hospital care when I lose my balance and my vision. My father works, my mother is disabled, and I have no health insurance. Although I've accumulated $10,000 in debt from six emergency visits, the hospital would not even let me apply for assistance from them because my father earns more than $24,000 a year. (Sheenika Toussaint) Read more

	Multiple Sclerosis and No Health Coverage Lead to Unemployment, Homelessness I’m 47 years old. I have no income and no insurance. After losing my full time job, I was diagnosed with MS in November 2007, but to date, I have not been on any medication whatsoever because I have no health coverage and no access to doctors who can treat my condition. My doctor stopped seeing me and referred me to the health department where they don't treat MS. I lost my apartment and fortunately someone has taken me in. (Laura Bourne) Read more


	Publicize Your National Health Care Reform Events With Us, and Check Out Our New Resources With National Health Care Reform dominating our agendas, Florida CHAIN is now sending out bulletins to publicize national health care reform efforts all around Florida. So add us to your distribution list or forward the information to lisag@floridachain.org so we can help you spread the word. And check out the frequently updated Health Care Reform Sections on our Events and Resources pages.

	Support Florida CHAIN Florida CHAIN is a non-profit organization supported by foundations, corporations and individual donations. If you are interested in becoming a sponsor of our CHAIN Reaction e-newsletter or value our work and would like to make a donation, please click here or call Lisa Grossman at 954-986-6535 for more information.




	CHAIN Reaction is a bi-weekly publication of Florida CHAIN (Community Health Action Information Network), a statewide consumer advocacy organization that works toward access to quality health care, empowering people to actively shape their world by participating in civic life and caring for each other’s well being.


	October 13, 2009 Medicaid isn’t to blame. As new figures are released on our state’s financial health, all fingers are pointed towards Medicaid as the culprit behind our looming deficits. Cuts to the program that provides health care to more than 2 million of Florida’s lowest-income children, seniors and disabled citizens seem to be looming in the short-term even as Congress moves forward with proposals to greatly expand Medicaid for the future. However, Medicaid isn't the problem, nor is slashing Medicaid the solution. Our reluctance to modernize our tax structure and responsibly set legislative priorities is as much the cause of the current Medicaid shortfall as the recession itself. In this issue of CR, we’ll examine how the Governor and Legislature have chosen to re-direct federal economic stimulus dollars meant to strengthen Medicaid towards other budget needs. We'll contrast that with Congress' recognition that Medicaid is the best way to assure coverage for more than a million very low-income, uninsured Floridians. Bills pending in Congress would fully fund expansion for several years, and from then on require only a small investment to sustain. Expanding Medicaid, despite its imperfections, would yield a great return on that investment for Florida. On the immediate front, however, we must act to prevent the Medicaid we have now from being gutted. The Legislature has other solutions available, from utilizing the $900 million raised by the cigarette tax for Medicaid to closing tax breaks for corporations and other inequitable tax exemptions across the board. The cost of our economic recovery must not be borne by our neediest citizens in the form of reduced coverage and access to health care. Laura Goodhue, Executive Director, Florida CHAIN

October 14, 2009

Extra Foot on the Scale: Overstating the Burden of Medicaid Expansion on Florida's Budget

Critics of the health care reform proposals moving through Congress have been sounding the alarm about one component - the proposed Medicaid expansion – that they say could bankrupt the States. That claim is simply not valid, however. In particular, it isn't valid for Florida.

It's true that Florida normally contributes about 45% of the cost of the current Medicaid program, with the federal government picking up the rest. But that is not the case under the proposals receiving serious consideration at present.

First, Medicaid expansion wouldn't occur until 2013 or 2014, well into our economic recovery. Second, Florida's share would top out at only about a dime of every dollar spent. As a result, Florida would need to use – at worst[i] - about 1.3% of its expected General Revenue to cover the new recipients through 2019. However, for several reasons, and especially because not all low-income people will qualify, the actual impact would be significantly less.

The expansion would help Florida immensely by providing real health coverage to hundreds of thousands of very low-income workers and their families who couldn't otherwise afford it. At the same time, those already covered would pay much less in the form of shifted costs for uncompensated care.

Read or print this report in pdf format.

House or Senate

Committee

Senate

Finance

[i]

House

Energy and Commerce

(H.R. 3200 – Incl.

“Blue Dog” Amndmnts)

House

Education and Labor

(& Ways & Means)

(H.R. 3200)

Senate

HELP[ii]

(Placeholder proposal – Unlikely)

Proposed

Medicaid Expansion

Up to 133%

of poverty

Up to 133%

of poverty

Up to 133%

of poverty

Up to 150%

of poverty

Projected

State Match

Rate for

Expansion

[iii]

2013

2014

2015

2016

2017

2018

2019

2020+

N/A

7.7%

8.7%

9.7%

10.7%

11.7%

12.7%

N/A

10.0%

N/A

7.5%

15.0%

22.5%

30.0%

37.5%

45.0%

MAXIMUM

Annual Cost of Medicaid

Expansion to the State

(Average Through 2019)

[iv]^,

^[v]^{,[vi],[vii],[viii]}

$440 Million [ix]

$430 Million

$1.2 Billion

MAXIMUM

% of State General Revenue

Needed to Fund Expansion

(Average Through 2019)

[x]^,

^[xi]^,[xii]

1.3%

0.0%

3.4%

[i] Under the Senate Finance Committee bill as amended, States with both below-average Medicaid enrollment (as a % of state population) AND less than 12% unemployment in August 2009 would have no match requirement through 2018. Florida meets the first condition, but does not quite meet the second.

[ii] The Senate HELP Committee does not have jurisdiction over issues related to the Medicaid program. The issue of state matching requirements for expansion was not fully scrutinized.

[iii] The projected State match rate for currently Medicaid-eligible groups in Florida is 45.0%, per the Legislature's most recent Social Services Estimating Conference. That rate generally varies somewhat from year to year due to economic factors. Other potential changes to the current FMAP formula are not factored into these estimates.

[iv] The average cost is shown in 2009 dollars. However, calculations of percentages below incorporate annual adjustments for inflation.

[v] The source of per recipient per year cost estimates is the Agency for Health Care Administration.

[vi] Medicaid costs used in this calculation were adjusted for inflation at a rate of 4% per year, which is consistent with both a trendline based on the most recent State Social Services Estimating Conference forecast and the projected nationwide overall Medicaid spending growth rate.

[vii]Each multi-year average includes only the years following the launch of Medicaid expansion under the corresponding proposal.

[viii]The cost should be considered a maximum because: 1) many uninsured Floridians who are income-eligible for Medicaid will nevertheless not qualify (e.g., undocumented workers), 2) a significant portion of the State's share of Medicaid funding is from a source other than General Revenue, and 3) the cost per recipient per year may be lower than the estimate used here, as current Medicaid recipients are in poorer health overall than those gaining access to Medicaid through expansion.

[ix] The National Conference of State Legislatures estimated the number of new Medicaid recipients from 2014-2019 at 991,000 under the Senate Finance Committee proposal. Our estimate is more conservative (i.e., anticipates greater enrollment). Substituting in the NCSL estimate of recipients, the average cost drops from $440 million per year to $385 million. NCSL's own estimate based on Congressional Budget Office analyses and CMs data was similar ($383 million).

[x] General Revenue projections through 2017 are based on the Legislature's Long-Term Revenue Forecast. For 2018 and 2019, a placeholder growth rate of 4% was used.

[xi] The State fiscal year runs from July 1- June 30, while the federal fiscal year runs from October 1 – September 30. Adjustments were made to synchronize the time periods under consideration.

[xii] See Note 10.

Greg Mellowe, Florida CHAIN


	October 14, 2009 Affordability Still in Question as Health Reform Heads to House and Senate Floors After a grueling months-long process, Congress has finally completed the committee review process for health care reform legislation. Next up: the full House and Senate floors. It's looking more and more likely that some version of reform will pass. But what will that legislation include? Among the most important unresolved issues: will low- and moderate-income families be able to afford the coverage offered? In the House, 3 different committee bills must be merged. In the Senate, where securing the necessary votes is expected to be more difficult, there are only 2 bills. There are significant differences between them, however, especially in terms of how far they go in making sure that coverage is affordable. The final committee to complete its work - Senate Finance - considered hundreds of proposed amendments during the almost record-setting 8 day “mark-up” process that just ended. In an (unsuccessful) effort to get more Republican support, the Senate Finance Committee's bill proposes a less expensive version of health care reform. Assuring that coverage is affordable for low- and moderate-income families took a back seat as a result. Individuals and families would still qualify for financial help (subsidies) to pay for coverage through 400% of the poverty level on a sliding scale, but in many cases, that help wouldn't be enough. By contrast, the Senate HELP Committee bill tackled the affordability issue much more thoroughly. For example, a family of 3 earning about $27,000 would pay 4½ times as much for premiums under the Senate Finance Committee's proposal as under the HELP Committee’s. To compare how much your family would have to pay for coverage under each version, use the Health Reform Subsidy Calculator posted by the Kaiser Family Foundation. For detailed information about key differences between the bills and what needs to be in any final version of health care reform legislation to guarantee affordability, see the fact sheet created by national partners Community Catalyst and PICO. The 10-year cost was estimated by the independent Congressional Budget Office to be $829 billion, far lower than the other versions and less than the informal limit of $900 set by the President. As the process and the debate continue, advocates must work to make sure that affordability is not lost in the shuffle. Even if you are guaranteed access to coverage regardless of pre-existing conditions, etc., cancellation of coverage due to inability to pay is not much better than outright denial of coverage. Greg Mellowe, Florida CHAIN

October 14, 2009

Year 4: Information Still Scarce in Medicaid Reform

AHCA's recently overhauled Medicaid managed care contracts now require that Medicaid Reform HMOs not only post their “Preferred Drug Lists” on their websites, but also meaningful provider network directories, member handbooks and other information that enrollees need. The stronger requirement seems to back up AHCA's claims that the new contracts will increase accountability by plans. But even when requirements were weaker, the bigger problem was a lack of enforcement of what was required. So far with the new contracts, it's generally more of the same.

We reviewed the websites of the 10 Reform plans (HMOs and PSNs) for Broward County currently listed on the Reform choice counseling page. (We excluded Children's Medical Services as well as a HMO new to Reform that is not listed on the Choice Counseling site.)

First, there are a few encouraging signs. Although none of the plans were in compliance with all of the standards (even without considering content requirements such as 4^th grade readability), several have clearly tried to move in that direction.

However, only two of the 10 plans had all 3 key documents posted, while two others had posted 2 of them. Member handbooks are particularly critical to understanding how plans work, but only 3 plans had posted them as required. Amazingly, 2 plans still had not posted their drug lists anywhere that we could find.

Furthermore, several plans either did not post provider directories or only offered search tools that couldn’t generate the required lists. By contrast, a number of plans are trying to provide more accurate provider lists. The majority still have not posted them using the required structure, however. In addition, many lists were not dated or not updated, and none of those contained an appendix listing providers who had left the network. Most plans also did not or could not indicate whether their providers were accepting new patients. That information is critical for one because of the difficulty in getting useful information from choice counselors, but also because omitting it could veil the fact that a plan's network is inadequate.

Finally, a chronic problem not even addressed in the contracts threatens to negate the usefulness of even the best information. The plan websites are generally difficult to navigate, contain materials that are difficult to find and identify, and lack any sort of uniformity that help the consumer make sense of all the information. As a result, real comparisons and often even comprehension remain out of reach.

A few examples of these issues that confound and obstruct recipients in their efforts to get information and make comparisons include:

Plans combining information related to all of their various plans – Medicaid, Medicare, commercial, etc. – on the same site. Sometimes the commingling goes several layers deep (e.g., one site requires the user to click “[Medicare] Part D” to find the Medicaid drug list).
Plans never hinting that an item or page is specific to Medicaid Reform, or even to Medicaid, period (e.g., one plan refuses to use the word Medicaid on its primary site).
Plans using completely different sets of terms, web design configurations, and formats for documents such as drug lists and lists of benefits.
Plans creating sites that contain easily removable barriers (e.g., providing only one link on a site to a key pages, setting up a search engine to process “Fort Lauderdale” and “Ft. Lauderdale” differently.)

As with other aspects of Medicaid managed care, some of the problems caused by plan websites can hurt Medicaid recipients in both Reform and non-Reform. But it is only in Reform that plans have the flexibility to make incredibly confusing changes and then hide behind the rampant confusion which results. Regardless of the future of Medicaid HMOs in Florida, the danger created by this complexity and confusion makes it clear that the Reform experiment must end.

Greg Mellowe, Florida CHAIN


	October 14, 2009 Free Market “Solution” Seeks Freedom from Accountability The 2008 bill that created the Governor's Cover Florida initiative also created Florida Health Choices. The private, non-profit Florida Health Choices Corporation will create an Internet “marketplace” where insurers can sell bits and pieces of real health coverage with minimal regulations. Unfortunately, the Corporation's first step towards evading “unnecessary burdens” like consumer protections was to evade accountability for its taxpayer-funded operations. Whenever the State pays any entity more than $25,000 to do something, a written contract or agreement is required by law. That requirement obviously applies even to an organization created by the Legislature and funded by name in the State budget. The law specifically applies in the case of the Florida Health Choices program. Note: State law does allow for the use of a purchase order in place of a written agreement. But even if a purchase order is used, it must incorporate at least a bare-bones agreement and include "all provisions and conditions" related to the work to be performed. State contracting guidelines are clear: “Regardless of whether a purchase order or written agreement is used, the document must contain clear and specific language” about the “tasks the provider is to perform, events that trigger payment, required level of services, and [consequences] for non-performance”. Throughout its start-up phase, however, the Corporation Board has sought to avoid getting bogged down by the contracting process. Corporation staff directly confirmed that indeed, no such agreement or purchase order exists. So what safeguards are placed on this million-dollar experiment to create a deregulated marketplace selling never-before-seen forms of insurance? The Corporation's view is that the original legislation provides the only relevant parameters. This is by no means to suggest that the Corporation has acted or will act inappropriately. But does inconvenience or distaste for regulations justify sidestepping accountability? Ironically, AHCA, the state agency that should have contracted with the Corporation is at the same time tightening its contracting practices as it implements landmark Medicaid fraud and abuse legislation passed last spring. It's not even clear that the Corporation has agreed to meet the basic requirements that protect taxpayers, such as following auditing standards, refraining from using funds to lobby the Legislature, and shunning contracts with vendors barred from doing business with the State. Even the insurance companies selling Cover Florida plans have contracts with the State, and they receive no public money. But the real concern is that the Corporation is charged with performing very complex and important tasks linking employers, insurers and individuals who desperately need coverage. For example, the Corporation is supposed to assist employers by collecting premium payments, managing individual benefit accounts and distributing premiums to insurers. Even if the $1 million is a one-time infusion, it's clear that the Corporation is acting on behalf of the State. AHCA documents state that it is “working to establish Florida Health Choices”. The Corporation members are all state agency heads and political appointees. The Board has also noted that the Corporation may be exempt from significant liability as an agent of the State. But most importantly, if the Insurance Commissioner won't approve a type of product the Corporation wants to offer, the Board becomes the substitute regulator and can allow it to be sold anyway. Florida Health Choices is already a risky proposition for Florida, aiming to give employers access to bits-and-pieces coverage instead of addressing the need for real coverage that is affordable to both employers and employees. Now it seems that risk may be further compounded by inadequate oversight. Greg Mellowe, Florida CHAIN

October 14, 2009

Florida Covering Kids and Families Receives Federal Grant to Reduce State's Uninsured

The Florida Covering Kids and Families Initiative, a project of the Lawton and Rhea Chiles Center for Healthy Mothers and Babies has received almost one million dollars in grant funds from the US Department of Health and Human Services’ Centers for Medicare and Medicaid Services. The funds will be used to increase enrollment and retention in Florida KidCare, the state’s child health insurance program.

On September 30, HHS Secretary Kathleen Sebelius announced that $40 million in grants were awarded to 69 grantees in 41 states and the District of Columbia to help find and enroll children who are uninsured but qualify for either Medicaid or the Children's Health Insurance Program (CHIP). Florida Covering Kids and Families, one of only two Florida recipients, will receive $988,177 over the two-year grant period (September 30, 2009 through September 29, 2011).

The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) set aside $100 million for the next four years to help find and enroll eligible children. Grants were awarded to applicants whose outreach, enrollment and retention efforts will target geographic areas with high rates of eligible but uninsured children, particularly those with racial and ethnic minority groups who are uninsured at higher-than-average rates. The vast majority of grantees will, like Florida Covering Kids and Families (FL-CKF), use multiple, community-based approaches.

Project Director for Florida Covering Kids and Families, Jodi Ray, expressed her excitement about the grant, which is the first federal grant FL-CKF has received: "We are honored to receive this federal award. Florida has 800,000 uninsured children, and most of them could be covered by Florida KidCare if they only knew about the program. This grant will help us reach more of these eligible children."

Ray conveyed her gratitude to those who assisted with the grant application: "Applying for this grant was a collaborative effort, and we couldn't have done it without the support of all of the state entities who administer the Florida KidCare program: the Agency for Health Care Administration, the Department of Health, the Department of Children and Families, and the Florida Healthy Kids Corporation. These folks were instrumental in providing the kind of feedback that produced a winning proposal. They will also be indispensible partners in performing the work involved—providing enrollment data, technical assistance, and support—without which this effort would be impossible."

FL-CKF's aims to increase enrollment in Florida KidCare by 40,000 children. It will do so by working with a network of regional collaborative partners. FL-CKF selected 10 local projects, representing 19 Florida counties: Brevard, Calhoun, Escambia, Holmes, Indian River, Jackson, Lake, Liberty, Martin, Okaloosa, Orange, Palm Beach, Pasco, Pinellas, Polk, Santa Rosa, Seminole, St. Lucie, and Washington. FL-CKF will also work with the Florida Association of Children's Hospitals, the Chiles Center's Refugee and Entrant Project, and human resources departments in businesses around the state.

Ray also thanked the local projects and organizations who will conduct outreach across the state for this project: "Significantly increasing Florida KidCare enrollment requires the hard work of our regional partners, in addition to organizations such as the Florida Association of Children's Hospitals and the Chiles Center's Refugee and Entrant Project. We are gratified these organizations agreed to participate."

Dean of USF’s College of Public Health, Donna J. Petersen, MHS, ScD, acknowledged FL-CKF’s efforts to reduce Florida’s uninsured population: “It is enormously gratifying to have the outstanding work of the Florida Covering Kids and Families Coalition recognized by the Centers for Medicare and Medicaid Services. We have always known that outreach to eligible children is essential to assuring their access to health care, care that is critically important to their optimal growth and development.”

Patrick Cannon, PhD, Florida Covering Kids & Families

REAL STORIES FROM FLORIDA HEALTH CARE CONSUMERS

October 14, 2009

Multiple Sclerosis without Health Coverage Leads to Huge Hospital Debt and Strain on Extended Family

My name is Sheenika Toussaint and I am 22 years-old. I live with my mother who is 45, my father who is 48, my two sisters who are 16 and 21 years old. I have lived in Miami, my entire life. I live with a condition known as Multiple Sclerosis and I need hospital care when I begin to lose my balance and vision.

I have sought emergency hospital care six times since my diagnosis. I knew that I would not be able to pay the medical bills I incurred. I informed the hospital that I was unemployed and did not have any health insurance. I asked if I could apply for financial assistance. The hospital would not even let me apply because my father makes more than $24,000 a year.

My medical debt is close to $10,000. I owe money to Bascom Palmer and Jackson Memorial Hospital North and South. Recently, my medical debt and the inability to resolve it has caused my family a great deal of stress, my mother in particular. My mother is disabled and becoming ill due to the stress she endures as a result of the phone calls we receive daily from collection agencies. My father is the only member in our household who is working which makes it impossible for me to repay my debt at this moment.

Sheenika Toussaint

REAL STORIES FROM FLORIDA HEALTH CARE CONSUMERS

October 14, 2009

Multiple Sclerosis and No Health Coverage Lead to Unemployment, Homelessness

My name is Laura Bourn and I’m 47 years old. I have no income and no insurance. I was diagnosed with MS in November 2007, but to date, I have not been on any medication whatsoever.

In October 2007, I started having a tingling numbness all over the right side of my body from face to foot. Fearing stroke-like symptoms, my daughter insisted I go to the hospital. I was admitted, given tests, and was confirmed with a diagnosis of Multiple Sclerosis.

It was during the holiday season and as I was struggling to come to terms with this frightening diagnosis, I found out that my doctor wouldn’t see me anymore. The reason for this, I was told, was because they didn’t help with pain management. This struck me as strange because I hadn’t even asked for pain management. I was told to try the local health department instead but didn’t have much luck there as they didn’t have any care directed for people with MS.

This time in my life was very challenging. Not only was I diagnosed with MS and didn’t have a doctor nor medical care but I was also dealing with the recent loss of my full time job. I began to fall behind in my rent and had to stay with a woman from my church who voluntarily took me in (but said "no" to my cat}.

There is help available out there, BUT in order to receive it, I would need a prescription from a doctor. For someone in my situation without access to a doctor or a prescription, it is useless.

In June of this year, a neurologist specializing in MS whom I had met at a support group mentioned he could possibly be able to help me. I e-mailed him and set up a meeting so hopefully, help is on the horizon.

Laura Bourn

Florida CHAIN Seeks Stories

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

October 14, 2009

Please confirm date, time and location for events, as they are subject to change after being listed here.

NEW: Health Care Reform Events

Southeast Florida
Southwest Florida

FL Audio and Web Events

National

Other State Events & Notices
North Florida

Central Florida

East Central Florida

     West Central Florida
     Southwest Florida
     Southeast Florida
     Florida Audio and Web Events
     Statewide Notices

Other National Events & Notices
Conferences
National Audio and Web Events

National Notices

National Campaigns

HEALTH CARE REFORM EVENTS & NOTICES

It's Time to Deliver!

Among the many opportunities to work toward meaningful health care reform this month are events on the October 20th “It’s Time to Deliver” National Day of Action. Groups across the state - and the country - are working together to generate 100,000 calls on one single day. Together, we will send resounding message to Congress: It’s time to deliver on health care reform!

NORTH FLORIDA

Let's get the word out in Panama City!

Oct 14 7:00 pm Community Room, People’s First Tower, 1022 W. 23rd St, Panama City

Make an impact in your own community while we fight for health care reform that will reduce costs, guarantee choice, and ensure all Americans have quality, affordable health care. We will be holding a pot luck and meeting in regards to what Organizing For America is doing in your area, and how you can get involved. Staff from Organizing For America will be speaking on volunteer opportunities, laying out our plan, showing where we have been and where we are going. This will be a great opportunity to meet back up with old campaign volunteers, and work on helping President Obama.

Big Insurance: Sick of It Rally

Oct 15 4:00 pm Blue Cross Blue Shield, 4800 Deerwood Campus Pkwy, Jacksonville

Rally from after 4pm til dark over at the Blue Cross Blue Shield Deerwood Campus. We'll start at around 4:00 at Seven Bridges (near entrance), and then move on to the Deerwood campus entrance area. I want this rally/protest to be convenient for all. So, please try to attend as early and as long as you can. If you arrive later and see us, feel free to join in. Parking is all around Seven Bridges and Tinseltown

College Students for Health Reform

Oct 20 12:00 pm UF Turlington Hall - On the Set, Gainesville,

Time to Deliver - Official Event. As congress continues to debate health insurance reform legislation OFA and Partner Organizations are teaming up across the country on October 20th to make sure our Representatives know that it is Time to Deliver on real reform! Please join Students throughout Gainesville as we contact our friends and neighbors to talk with them about how health insurance reform will affect students across the state of Florida and encourage them to contact their representatives to encourage them to support the President’s plan. As President Obama has said, we cannot wait another year for reform, now is the Time to Deliver on real reform!

Time to Deliver: Students Phonebanking for Reform!

Oct 20 5:30 pm FL Democratic Party, 214 S. Bronough, Tallahassee

Time to Deliver: Women Phonebanking for Reform!

Oct 20 5:30 pm TBD, Pensacola

Time to Deliver - Official Event. As congress continues to debate health insurance reform legislation OFA and Partner Organizations are teaming up across the country on October 20th to make sure our Representatives know that it is Time to Deliver on real reform! Please join Women throughout Pensacola as we contact our friends and neighbors to talk with them about how health insurance reform will affect Women across the state of Florida and encourage them to contact their representatives to encourage them to support the President’s plan. As President Obama has said, we cannot wait another year for reform, now is the Time to Deliver on real reform!

Let's get it going in Pensacola!

Oct 22 6:00 pm Main Library, 200 W Gregory St, Pensacola

CENTRAL FLORIDA

Kissimmee Library Letter and Call Drive

Oct 14 12:00 pm Osceola Library, 211 E Dakin Ave, Kissimmee

Join us where many of our fellow residents will be writing and calling Senator Nelson's office to express their strong support for the public option. Bring pens and paper to distribute and for those of you kind enough to bring phones, please bring them as well.

Downtown Orlando House Meeting

Oct 14 7:00 pm Orlando Public Library, 101 E. Central Blvd

Join Organizing for America in Downtown, Orlando as we discuss the current health care debate and create and action plan for our area. We will be discussing the current situation in the fight for health care reform and create a team of volunteers to get involved in the community!

Windermere House Party!

Oct 15 7:00 pm TBD, Private home, Windermere

Join Organizing for America activists in Windermere to discus the current health care debate and band together as a team to come up with an action plan in our area.

Commitment Drive!

Oct 17 Shifts at 9:00 am, 1:00 pm Central Park, 401 Park Ave S, Winter Park

Join Organizing for America activists at the Winter Park Arts Festival as we ask citizens to commit to calling their local representatives and demand a reformed health care system. We are in need of volunteers to help out for a few hours to get signatures of people willing to call Senator Bill Nelson, and and/or their House representative.

Let Your Voice Be Heard

Oct 20 11:00 am Homosassa

Time to Deliver Call Party. We are going to have a get together to join forces and call some of our like minded neighbors and ask them to call their representative about health care reform. The goal is to get 100,000 calls to Washington in one day. I'll provide the call lists and scripts, you bring you cell phone and your enthusiasm. Bring a brown bag lunch, drinks and lite snacks will be provided.

OFA Lake County Kickoff Meeting

Oct 20 6:30 pm TBD, Tavares

Kickoff for Organizing for America in Lake County. Come find out how you can get involved and begin organizing your community for Health Insurance Reform. We look forward to seeing you there!

Time to Deliver: Students Phonebank for Reform!

Oct 20 4:00 pm UCF, 4400 Central Blvd, Orlando

Time to Deliver - Official Event. As congress continues to debate health insurance reform legislation OFA and Partner Organizations are teaming up across the country on October 20th to make sure our Representatives know that it is Time to Deliver on real reform! Please join Students throughout Gainesville as we contact our friends and neighbors to talk with them about how health insurance reform will affect students across the state of Florida and encourage them to contact their representatives to encourage them to support the Presidents plan. As President Obama has said, we cannot wait another year for reform, now is the Time to Deliver on real reform!

Missions Possible

Oct 20 2:00 pm Bahama Breeze, International Drive, Orlando

Time to Deliver Call Party. Dialing and Dining at one of the finest restaurants in Orlando.

EAST CENTRAL FLORIDA

Health Care Call House Party

Oct 20 7:00 pm Private home, Daytona Beach

Time to Deliver Call Party. Please come by to help spread the word to congress. Share your thoughts. Let's meet.

WEST CENTRAL FLORIDA

Potluck & Phone Bank for Health Insurance Reform

Oct 14 6:00 pm Private home, South Tampa

Please join your neighbors for food, chatting and dialing the phone to like-minded neighbors, to ask them to contact Senator Nelson and ask him to support health insurance reform with the public option. We want to make sure Senator Nelson hears from his constituents. He recently reported that he's heard from over 52,000 constituents which is GREAT - his position changed in favor of reform in the last six months! So, what you're doing is working, we just need to do more of it.

Health Reform Outreach at Clearwater Jazz Holiday

Oct 15, 16 12:00 noon Coachman Park, Clearwater

As members of congress head back to D.C. to continue to work on a bill for health insurance reform, join Organizing for America in making sure our voices are heard loud and clear to support the presidents principles for reform. Just grab some friends, come out and help distribute fact sheets about President's plan and ask people to call their members of Congress on the spot and voice their support NOW!

Health Reform Outreach at Clearwater Jazz Holiday

Oct 17, 18 10:00 am, 12:00 noon Coachman Park, Clearwater

Time to Deliver: Women Phonebanking for Reform!

Oct 20 4:00 pm OFA State Headquarters, 1702 14th St, Tampa

As congress continues to debate health insurance reform legislation OFA and Partner Organizations are teaming up across the country on October 20th to make sure our Representatives know that it is Time to Deliver on real reform! Please join Women throughout Tampa as we contact our friends and neighbors to talk with them about how health insurance reform will affect Women across the state of Florida and encourage them to contact their representatives to encourage them to support the President’s plan

SOUTHEAST FLORIDA

“We're counting on you!” Rally at Senator Bill Nelson’s Coral Gables Office

Oct 14 4:00 pm Sen. Nelson’s office, 2925 Salzedo Street, Coral Gables

In October, big votes in the Senate could decide the fate of a real public option. We need to thank our potential champion for supporting the public health insurance option. We're organizing “We're counting on you!” rallies to let Senator Bill Nelson know we're counting on him to take the lead in pushing for health care reform with a public option all the way to the finish. Bring water, hats, signs, sunglasses and your health insurance horror stories!

'We're counting on you!' Rally

Oct 14 4:30 pm Sen. Bill Nelson's Office, 3416 S. University Dr, Davie
Every single senator who supports the public option, including Senator Nelson, will have to stand up and fight like hell throughout these weeks—and we need to show Sen. Nelson we'll be right there, ready to fight with him. Seeing a big crowd of voters out in full support of a strong public option is just what Sen. Nelson needs heading into these final, intense weeks of the health care fight. Rallies like these are a lot of fun—a great way to connect with other progressives in the community. And they're powerful: at the rally, you'll hear from speakers personally impacted by our broken health care system—from people denied care by unaccountable insurance companies to small business owners forced to decide between laying off workers or cutting health benefits.

Health Care Reform Cannot Wait! (Canvass)

Oct 14, 16, 19, 21, 23, 26, 28, 30 11:30 am West Regional Courthouse, intersection of Pine Island and Broward, Plantation

Every Monday, Wednesday and Friday starting at 11:30 am, we will be collecting pledges of support for health care reform. We're asking you to come out for a couple of hours and help in this effort to ensure that Congress enacts real health care reform this year, - real health care reform that includes the choice of a public insurance option! Call 954-472-6211 know if you can join us.

Health Care Reform Phone Bank

Oct 14, 21 6:00 pm SEIU, Ste 900 333 W 41ST St
Miami Beach
Let’s Go Miami! Come out to phone bank and show America, Miami Supports health care reform.

Protest Rally

Oct 15 11:30 am Humana Corporate Offices, 2056 Vista Pkwy, WPB

This is part of the National Mobilization for Health Care Campaign coordinated by HealthCare-NOW and Mobilization for Health Care for All. Dozens of similar events will take place on this day. For more information visit www.healthcare-now.org or www.mobilizeforhealthcare.org. Training for Sit-In volunteers required: Oct 14, 7:00 pm, DEC Offices, 6266 S Congress Ave, Suite L11, Lantana. Contact FloridiansHealth@aol.com or 202-360 4444

Health Care Action meeting- Final Push

Oct 15 7:00 pm American Legion inside Harvey’s By the Bay, 6445 NE 7th Ave, Miami

Catching the energy of the final push. At this meeting we will cover- *Facts of current bills *Organizing Team models the history and now! *How you can take action to make sure health care reform happens NOW!

Support Health Care Reform at Federation Fest

Oct 17 Shifts at 11:00 am, 1:00 pm, 3:00 pm Tradewinds Park, 3600 West Sample Road, Coconut Creek

Please join OFA volunteers at Federation Fest, the annual picnic of the Federation of Public and Private Employees. We will be talking to attendees about the Presidents agenda and asking them to support Health Care Reform. The event is open to the public and food and drinks will be available.

South Beach Health Reform Phone Booth

Oct 17, 18 2:00 pm Starbucks, Marriott South Beach, 161 Ocean Dr, Miami Beach

It's simple: Just join up with other supporters in a public area where people will pass by, distribute fact sheets about the President's plan, and help folks call their members of Congress on the spot to voice their support. It's just like Beach Blanket Bingo for Barack!

Senior Citizens for Health Care Phone Booth

Oct 19 11:00 am New Testament Baptist Church, 812 N 7^th St, Ft Pierce

Retired seniors for Health Care will meet to familiarize themselves with the particulars of the Obama Health Care Plan so they can educate and help address the concerns of the public in this area.

Senior Phonebook

Oct 20 2:00 pm All Broward Realty, 4325 W Sunrise Blvd, Plantation

Time to Deliver - Official Event. As congress continues to debate health insurance reform legislation OFA and Partner Organizations are teaming up across the country on October 20th to make sure our Representatives know that it is Time to Deliver on real reform! Please join Seniors as we contact our friends and neighbors to talk with them about how health insurance reform will affect Seniors across the state of Florida and encourage them to contact their representatives to encourage them to support the President's plan.

Miami calls for Healthcare Reform!

Oct 20 6:00 pm TBD, Miami

Time to Deliver - Official Event. As congress continues to debate health insurance reform legislation OFA and Partner Organizations are teaming up across the country on October 20th to make sure our Representatives know that it is Time to Deliver on real reform! Please join Hispanics throughout Miami as we contact our friends and neighbors to talk with them about how health insurance reform will affect Hispanics across the state of Florida and encourage them to contact their representatives to encourage them to support the Presidents plan.

Call for Action

Oct 20 6:00 pm Private home, Ft Lauderdale

Time to Deliver Call Party. After months of negotiations, the entire House and Senate will soon start debating the final plans for health insurance reform. You've called your representatives, but we can't stop there -- if the American people are going to drown out the D.C. lobbyists, we need everyone who supports reform to weigh in. So, on Tuesday, Oct 20, OFA volunteers will gather at "Time to Deliver" Call Parties. We'll call friendly voters whose voices matter in this debate, talk to them about the President's plan, and ask them to call on their representatives to support reform.

The Final Push for Health Care Reform

Oct 20 6:30 pm Accurso Chiropractic, 6030 Bird Rd, Miami

Time to Deliver Call Party. All of us who have participated at any level to promote health care reform, should gather once again for a final push... the last two miles of the marathon. All of us who did not have time until now, get on board NOW for this push.

Phone Banking

Oct 20 7:00 pm

Private home, NE Miami

Time to Deliver Call Party. Phone banking to encourage support for public option in health care reform bill

For Better HEALTH

Oct 20 8:00 pm Exeter at Kings Point, Tamarac

The US must not remain 37th in the World Health Organization survey! If France is FIRST and they spend less per capita and cover everyone in their country, we must strive to become as good if not betterWhy should France and all of Europe have a life expectancy that is three years greater than ours? Why must so many of our citizens go bankrupt when they face the ill fortune of sickness? We talk that the US is the greatest country on earth. Then let's work toward making it so.

Port St Lucie Healthcare Canvass

Oct 24 9:00 am Port St Lucie City Hall

We will be going door to door asking people what kind of healthcare reform they would like to see. We will have petitions to sign.

A Community Response to Health Care Reform
Nov 6 9:00 am-4:00 pm Lecture series; 5:00-7:00 pm Carmichael memorial service Doral Golf Resort & Spa/Marriott, 4400 NW 87th Ave, Miami
Lynn Carmichael Community & Family Healthcare Lecture Series sponsored by Jessie Trice Community Health Foundation, Inc., Jessie Trice Community Health Center, Inc.University of Miami/Miller School of Medicine. Credits will be offered. For additional information, contact: 305-805-170

SOUTHWEST FLORIDA

Phone Bank for Health Care

Oct 14, 15 Shifts at 10:00 am, 1:00 pm, 5:00 pm OFA office, 292 14th Ave. S, Naples

We are still making calls to our supporters encouraging them to call Sen. Nelson asking him to keep up his efforts to get the BEST Health Care Reform bill passed by the Senate.

Write Letters for Health Care Reform

Oct 16 10:00 am–5:00 pm OFA office, 292 14th Ave. S, Naples

We will be writing letters to the editor, Senator Nelson and the members of the Senate Finance Committee to request that they write and pass the BEST Health Care Reform bill possible, supporting President Obama's Health Care goals.

YWCH.CCFL Faith Outreach to Support the President's Health Reform

Oct 18 11:00 am TBD, Naples

Please join our YWCH.CCFL Faith Outreach on Sunday mornings to enlist petition signatures to support the President's Health Care Reform for the USA (should you speak Spanish, French and/or Creole, that would be most helpful). We will discuss support for the President's health care reform for the USA with congregation members - after and outside - the church services. We have been invited by very supportive Faith leaders and their congregations in Collier County, FL who intend to see the President's health care reform passed by Congress this year. Many of these neighbors have been directly affected by the health care crisis in America and understand the severe personal fallout of it all too well.

Time to Deliver: Seniors Phonebanking for Reform!

Oct 20 12:00 pm DEC/OFA HQ, 10051 McGregor Blvd, Suite 201, Fort Myers

DEC/OFA HQ (Fort Myers, FL)

As congress continues to debate health insurance reform legislation OFA and Partner Organizations are teaming up across the country on October 20th to make sure our Representatives know that it is Time to Deliver on real reform! Please join Seniors throughout Lee County as we contact our friends and neighbors to talk with them about how health insurance reform will affect Seniors across the state of Florida and encourage them to contact their representatives to encourage them to support the President’s plan. As President Obama has said, we cannot wait another year for reform, now is the Time to Deliver on real reform!

FLORIDA AUDIO AND WEB EVENTS ON NATIONAL HEALTH CARE REFORM

NATIONAL HEALTH CARE REFORM EVENTS & NOTICES

Health Action 2010 National Grassroots Meeting

Jan 28-30 Washington, DC

The debate over health reform will wrap up soon—one way or another—and we’ll have our work cut out for us. At this event, you'll learn more about the legislation, share field strategies with advocates from across the country, and gear up for the year ahead. Early-bird registration for Health Action 2010 is $395. After December 31, 2009, registration is $445. For more information, write or call Families USA: 1201 New York Ave., NW, Suite 1100, Washington, DC 20005, 202-628-3030.

OTHER STATE EVENTS & NOTICES

NORTH FLORIDA

Health Planning Council Annual Meeting

Oct 22 12:00 Noon-2:00 pm Jacksonville Marriott

Join with other health industry leaders and human service professionals as we look at the state of health care throughout the Northeast Florida region. Learn about several exciting new developments at the Council and future plans that will positively impact the communities we serve. Keynote Speaker Laura McCrary, Director of the Kansas City Regional Health Initiative share how Kansas City health and behavioral health providers moved beyond traditional barriers and began to approach systemic changes to improving care in their community. 904-723-2162

Including Prevention in Health Reform: Prospects and Impacts

Conference: March 4-5 Jacksonville, FL

Save the date and note the location of ACHI's 2010 annual conference. It'll be more hands-on practical and offer more peer-to-peer networking than ever, so stay tuned this summer as details emerge on 2010's premier community health and community benefit professional meeting.

2010 Children's Week

April 11-16 Tallahassee

A full week of activities has been posted online.

Notices

CENTRAL FLORIDA

Hispanic Health Initiatives presenta Cuidando Mi Salud
Primer Viernes de Cada Mes 9:00 am - 2:00 pm Oficina de HHI, 218 Live Oaks Blvd, Casselberry

Entérese si usted está en riesgo de presentar enfermedades cardiovasculares, diabetes y/o tipos de cáncer. ¡Llame hoy para su cita! Gratis. Registracion previa es requerida. 407-339-2001 ó 866-377-2583

Cancer Does Not Discrminate Support Group (in Spanish)

Oct 24 12:00 Noon-2:00 pm Hope Comm. Ctr, 1016 N Park Ave, Apopka

Presenters include colon cancer surgeon and breast cancer survivors. No charge. RSVP quickly as space is limited. Refreshments and door prizes. Sponsored by Hispanic Health Initiatives. Call 407-339-2001 or 1-866-377-2583.

Diabetes Health Forum: Diabetes and Your Vision (in Spanish)

Nov 7 11:30 am-1:30 pm Asociacion Borquena, 1865 N Econlockhatchee Tr, Orlando

Presenters are low vision specialist physicians. No charge. Foot, vision and diabetes screening. Sponsored by Hispanic Health Initiatives. RSVP: call 407-339-2001 or 1-866-377-2583.

Los Amigos Diabetes Class (in Spanish)

Nov 14 8:00 am-2:00 pm Pierson Community Center, 124 W Washington Ave, Pierson

Presenters are diabetes and fitness experts and nutritionists. They will teach you how to control and prevent this disease with a healthy diet and exercise. No charge. Foot, vision and diabetes screening. Sponsored by Hispanic Health Initiatives in collaboration with Northeast Florida AHEC. RSVP required: call 407-339-2001 or 1-866-377-2583.

EAST CENTRAL FLORIDA

WEST CENTRAL FLORIDA

Events

Notices

SOUTHWEST FLORIDA

SOUTHEAST FLORIDA

Events

Persona A Persona/Peer to Peer Recovery Education Course
Oct 5–Nov 30 (9 consecutive Mondays) 6:30-8:30 pm North Broward Medical Center, 201 E. Sample Rd, Deerfield Beach
National Alliance on Mental Illness of Broward Multicultural Outreach Program (MOP) invites all community agencies and friends to promote and advertise their first Spanish NAMI signature program. The Recovery Course is free to all Spanish speaking participants. It is a unique learning program for people with any mental illness who are interested in establishing and maintaining their health and recovery. Flyers are available in Spanish and English. Contact 954-720-6778 or namimop@hotmail.com.

Common Cents: Workshop on Florida's Tax Structure

Oct 14 1:00-3:00 pm Temple Israel, 137 NE 19^th St, Miami

Workshop sponsored by the Coalition for Fair and Comprehensive Tax Reform, followed by a conversation on how we can better prepare to work together in the future on the county budget process. For additional info or to confirm the location, please contact fcfep@yahoo.com or 850-321-9386.

Public Forum: Disease Prevention—Is Inequality Making Us Sick?

Oct 20 6:30-8:30 pm West Dade Regional Library ,9445 Coral Way, Miami

The evening will begin with a short presentation by Dr. Erin Kobetz from University of Miami followed by the documentary viewing of part one of the series Unnatural Causes of Death. Martha Gonzales from the Cancer Information Service (NCI) will then lead a bilingual discussion. Refreshments will be served. Contact rsherman@med.miami.edu or 305.243.4602 with any questions.

Imagine Miami Changemaker Conference III: Show Us the Money ... for Education, for Healthcare, for Human Needs
Nov 6 8:00 am-1:30 pm Temple Israel, 137 NE 19^th St, Miami
Details coming soon, from Human Services Coalition. Save the date.

Health and Hope charity program

Nov 21-22 South Florida Fairgrounds, west of WPB

This event will be run by the nationally known nonprofit group Remote Area Medical Foundation. Organizers expect to give free medical care to 2,500 people a day from across South Florida, but say the number could be higher or lower depending on how many Florida physicians, nurses, dentists and eye doctors sign up to volunteer their services. The RAM group will send tractor-trailers and an airplane filled with supplies, and 30 local agencies and nonprofit groups have agreed to send staffers, run information booths and donate supplies. Doctors and nurses will give basic check-ups and screening tests; dentists will do cleanings, fill cavities and pull teeth; eye specialists will do exams and make free glasses For more information, see www.unitedcancerfoundation.org or call 866-936-2873, or www.ramusa.org

Southeast Florida Cancer Control Collaborative Meeting

Dec 10 Broward General Medical Center

Heather Miller from Chris Evert Children’s Hospital at Broward General Medical Center will host the next meeting and sponsor the food. Please mark your calendar. This will be our “Annual Meeting” with a celebration of accomplishments this year. If you have any suggestions for the format, please contact Vanessa.Vicente@lls.org or Phil Fusca phil.fusca@HCAhealthcare.com.

7^th Biennial Cancer, Culture & Literacy Conference

May 20-22 Sheraton Sand Key Resort, Clearwater Beach

Advance knowledge and skills for addressing culture and literacy across the continuum of care. Offers extraordinary networking and learning opportunities for individuals wanting to learn more about the roles of culture, language and literacy in cancer health disparities

and in the design, implementation and evaluation of cancer communications, programsand educational interventions. Hosted by the Moffitt Cancer Center, the conference provides a national forum for the exchange and dissemination of information covering current research, innovative communications, novel training programs, and emerging education practices. Particular emphasis on survivorship communications. Professional accreditation and continuing education contact hours offered. Call for abstracts, breakout sessions, workshops and information about our scholarship program can be found on the conference website at: www.moffitt.org/ccl.

Notices

FLORIDA AUDIO CONFERENCES AND WEBCAST

STATEWIDE NOTICES AND CAMPAIGNS

NATIONAL EVENTS & NOTICES

CONFERENCES AND EVENTS

Communities Joined in Health Annual Conference
Oct 22–23 Austin, TX
Integrating Community Health: Success in a New Era. Special conference room rate $98 with free internet.

Diversity Matters: An Ongoing Conversation
Nov 2-3 Vancouver, BC

Proposals are currently being accepted for this conference , which is open to professionals, educators, managers, executives, ethicists and researchers in health care, social services, and community service and development; government leaders and policy-makers; as well as consumers and all those interested,. It focuses on cultural competencies in healthcare, education, research and community services. Among keynote speakers, Dr. Roberto Lewis-Fernandez will present on Reduction of Healthcare Disparities Through Cultural Competence: Barriers and Solutions to Consumer Engagement and The Role of Cultural Idioms of Distress in Psychiatric Diagnosis.

Faces of a Healthy Future: National Conference to End Health Disparities II
Nov 3–6 Winston-Salem, NC
The purpose of Faces of a Healthy Future: National Conference to End Health Disparities II is to again bring together representatives from local, regional, state, and national organizations, along with consumers, in a forum addressing the NCMHD and Healthy People 2010 goals through the conference objectives. The goals of Healthy People 2010 are to improve health and to eliminate health disparities. This conference will give the attendees an opportunity to determine progress toward these goals through viewing and assessing projects related to the NCMHD strategic goals (research, research infrastructures and providing public information and community outreach). Individuals and organizations will be given opportunities through poster presentations, oral paper presentations, and panel discussion to detail the success of their projects based on outcomes evidence. This conference will be a call for further action and will capture momentum and move energy forward in assisting with the national planning and implementation to eliminate health disparities.Sponsored by Center for Excellence in the Elimination of Disparities.

National Children’s Health Insurance Summit: Strategies For Increasing Enrollment and Retention

Nov 4-6 Marriott Downtown Magnificent Mile, Chicago

This CMS event will share best practices and discuss recruitment and retention tactics to increase enrollment in the Children's Health Insurance Program and Medicaid. Registration required. No charge. Agenda and other details to follow.

American Public Health Association: 137th Annual Meeting and Exposition
Nov 7–11 Pennsylvania Convention Center, Philadelphia
Sponsored by American Public Health Association

Overcoming Disparities: Building Successful Diabetes and Obesity Programs
Forum: Nov 18-19 Arlington, VA
Each year, the American Diabetes Association (ADA) convenes its Annual Disparities Partnership Forum. The overall goal of the partnership forum is to explore collaborative methods for decreasing type 2 diabetes and obesity in high-risk populations. To request a submission template and call form, please contact Monique Lindsy at mlindsy@diabetes.org.

AUDIO AND WEB EVENTS

Community Benefit Scorecard: Bridging Community and Health System Goals
Oct 15 2:00-3:00 pm ET

A community benefit scorecard elevates the work of community benefit departments by clearly stating the focus, intent, and accountability of key initiatives. This session will describe the process for selecting elements of the scorecard, including linkages between community collaboratives, health system strategic planning, and operational goals. Registration fee $40 members, $80 non-members

NOTICES

CAMPAIGNS & INITIATIVES

Visit the National Health Information Center for a complete list of the 2009 National Health Observances and contact information for resources

October 14, 2009

New listings, in order of submission deadlines

Cardinal Health Foundation: E3 Grant Program for Healthcare Improvement Projects
Letters of Intent due: Oct 30

Deadline: March 5

The Cardinal Health Foundation provides grants for programs that improve healthcare safety and quality, as well as programs that promote healthy and vibrant communities. The Foundation's E3 – Effectiveness, Efficiency and Excellence in Healthcare Grant Program supports initiatives by nonprofit hospitals, health systems, and clinics throughout the United States that impact the efficiency and quality of healthcare. For 2010, grants of up to $50,000 will be awarded for projects that address one of the following two areas: improving medication systems or operating room safety. Health website to review the grant guidelines and submit an online letter of intent.

Welcome Back Awards Program Seeks Nominations to Recognize Those Dedicated to the Depression Community
Deadline: Nov 16

The Welcome Back Awards, a program established by Eli Lilly and Company to recognize outstanding achievements in the fight against depression and the stigma often associated with the illness, is accepting nominations to honor those who work in the depression community. An independent panel of national mental health experts will select honorees in five categories: Lifetime Achievement, Destigmatization, Community Service, Primary Care and Psychiatry. Winners will share a total of $55,000, to be donated to the not-for-profit organizations of their choice. Each award recipient and one guest will receive complimentary airfare and accommodations to attend the ceremony in New Orleans, Louisiana, in May 2010.

Villers Fellowship for Health Care Justice

Deadline: Jan 15

Villers Fellows will conduct research on a range of health care policy issues, and write and contribute to publications that are relevant to current health policy debates. The ideal candidate will demonstrate a commitment to health care justice work following their year as a fellow. Additionally, in order to encourage the development of future leaders, Villers Fellows must commit to mentoring at least one person over the course of their careers.

Wellstone Fellowship for Social Justice

Deadline: Feb 5

This fellowship aims to advance social justice through health care advocacy by focusing particularly on the unique challenges facing communities of color. The ideal candidate must demonstrate an interest in health care policy and racial/ethnic health disparities. dditionally, we are looking for an individual who displays the potential to contribute to social justice work after their year of hands-on experience as a fellow.

Continuing listings, in order of submission deadlines

Johnson & Johnson/Society for the Arts in Healthcare Grant Funds Available for Arts in Healthcare Programs
Letter of Inquiry Deadline: Oct 15
A total of $60,000 will be awarded to nonprofits and government agencies that are members of the Society for the Arts in Healthcare and whose arts in healthcare programs show evidence of initial impact.

Scholars in Health Policy Research
Deadline: Oct 21

The Robert Wood Johnson Foundation Scholars in Health Policy Research program is designed to help develop a new generation of creative health policy thinkers and researchers within the disciplines of economics, political science, and sociology. The program invites recent graduates of doctoral programs to apply. Preference will be given to applicants who have not previously worked extensively in health or health policy research. Applicants must have received a doctoral degree after January 1, 2005, but no later than July 2010. Applications are encouraged from candidates who come from groups that historically have been underrepresented in the three disciplines. Scholars will receive stipends from their university of $89,000 a year.

CVS Caremark Community Grants Program Accepting Grant Applications for Programs Serving Children With Disabilities and the Uninsured
Deadline: Oct 31

Grants of up to $5,000 will be awarded to nonprofits and schools working to provide disabled children and youth under age 21 with health and rehabilitation programs and active play opportunities alongside their non-disabled peers.

Generations: Strengthening Women and Families Affected by HIV/AIDS
Deadline: Nov 2

The National AIDS Fund and Johnson & Johnson have announced the availability of funds through the Generations: Strengthening Women and Families Affected by HIV/AIDS program. This third grant round will award six to eight grants to community-based organizations to create or adapt evidence-based HIV/AIDS prevention interventions that reduce the spread of HIV among at-risk women and girls. Priority areas include urban epicenters and other highly impacted regions, including Florida. In addition to cash grants, agencies receive support through a number of components, including intensive technical assistance, program evaluation, and community building.

The Humana Foundation
Proposals accepted: Nov 1-June 15

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

Dade Community Foundation

Deadline: Nov 15

Grants will be awarded in broad fields of education, health, human services, arts and culture, environment, economic and community development. Priority will be given to programs or projects that use community relationships as a key strategy for enhancing their reach, effectiveness, and results; build relationships, particularly among diverse ethnic and racial groups; reach and engage those whose needs are not being met adequately by existing community resources; pursue strategies that address new and emerging needs or approach existing ones more effectively; strengthen organizational capacity to improve results for communities and individuals they serve; build on strengths and assets of people and communities and engage them in problem solving; focus on the root causes of a problem; and leverage additional private or public resources, both financial and volunteer. For more information, contact 305-371-2711.

Breast Cancer Screening and Treatment Project Funding for Medically Underserved

Deadline: Nov 30

The South Florida Affiliate of Susan G. Komen for the Cure^® announces the availability of grant funds for fiscal year 04/01/2010 to 03/31/2011. Applications for breast cancer and breast health programs from nonprofit organizations, governmental agencies and educational institutions in Palm Beach, Martin and St. Lucie counties are eligible for funding. In addition to funding research, the Affiliate funds non-duplicative, community-based breast health education and breast cancer screening and treatment projects for the medically underserved in Palm Beach, Martin and St. Lucie counties. Contact 561-514-3020 ext. 14 or email: tina@komensouthflorida.org.

Frueauff Foundation
Deadline: Dec 15
The Frueauff Foundation supports mental health services, organizations serving at-risk youth and other community programs. Since its founding, hospitals and health agencies have been recipients of Foundation awards. Equipment, outreach programs, staff positions, screening and education materials are just a few examples of grants given. Health education programs for at-risk children and their parents, support for the critically ill, AIDS/HIV education programs, and nursing scholarships have all received awards in the past decade. Specific institutions and specific programs, rather than national organizations, are usually given.

Commonwealth Fund/Harvard University Fellowship in Minority Health Policy
Application Deadline: Jan 4
This innovative fellowship is designed to prepare physicians, particularly minority physicians, for leadership roles in formulating and implementing public health policy and practice on a national, state, or community level. Five one-year, degree-granting fellowships will be awarded per year. Fellows will complete academic work leading to a Master of Public Health (MPH) degree at the Harvard School of Public Health, and, through additional program activities, gain experience in and understanding of major health issues facing minority, disadvantaged, and underserved populations. For application materials and more information, contact 617-432-2922 or mfdp_cfhuf@hms.harvard.edu

Nominations Open for 2010 Purpose Prize Honoring Older Social Innovators
Deadline: March 5
Five awards of $100,000 each will be given to people over the age of 60 working in a leadership capacity to address societal challenges in the United States or abroad.

Department of Health and Human Services Understanding and Promoting Health Literacy (R21)
Letters of Intent Receipt Date(s): December 24, 2009
Application Submission/Receipt Date(s): 25, 2010

NIOSH Support for Conferences and Scientific Meetings
Application Deadline: May 8, 2011
The purpose of the program is to support high quality conferences/scientific meetings that are relevant to its scientific mission and to the public health.

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

Advancing technology to improve healthcare sevices: Verizon Foundation

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

Chronic Illness Self-Management in Children and Adolescents
Multiple Closing Dates, Jan 10, 2010
The purpose of this Funding Opportunity Announcement is to solicit research to improve self-management and quality of life in children and adolescents with chronic illnesses. Biobehavioral studies of children in the context of family and family-community dynamics are encouraged. Children diagnosed with a chronic illness and their families have a long-term responsibility for self-management. The child with the chronic illness will have a life-long responsibility to maintain and promote health and prevent complications. Research related to biological/ technological factors, as well as, sociocultural, environmental, and behavioral mechanisms that contribute to successful and ongoing self-management of chronic illnesses in children is also encouraged.

Occupational Safety and Health Research
Application Deadline: March 6, 2010
The purpose of this grants program is to develop an understanding of the risks and conditions that are associated with occupational diseases and injuries, to explore methods for reducing risks and for preventing or minimizing exposure to hazardous conditions in the workplace, and to translate significant scientific findings into prevention practices and products that will effectively reduce work-related illnesses and injuries.

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

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

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

NIOSH Support for Conferences and Scientific Meetings
Deadline: May 8, 2011
The purpose of the program is to support high quality conferences/scientific meetings that are relevant to its scientific mission and to the public health.

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

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

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

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

Expiration Date: May 8, 2011

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

Exploratory/Developmental Grants Program for Basic Cancer Research in Cancer Health Disparities
Deadline: Nov 23, 2011
Through this Funding Opportunity Announcement (FOA), the Center to Reduce Cancer Health Disparities (CRCHD) and the Division of Cancer Biology (DCB), at the National Cancer Institute (NCI), invite grant applications from investigators interested in conducting basic research studies into the causes and mechanisms of cancer health disparities.

Translational Research for the Prevention and Control of Diabetes and Obesity
Deadline: March 1, 2012
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the Office of Behavioral and Social Sciences Research (OBSSR) encourage NIH Research Demonstration and Dissemination Project grant (R18) applications from institutions/ organizations to test the effectiveness of interventions for the prevention and control of diabetes and obesity that have a high potential to be adopted, and sustained in applied health care settings.

Research on Clinical Decision-Making in People with or at-Risk for Life-Threatening Illnesses
Application Deadline: May 7, 2012
This funding opportunity seeks to stimulate research on the decision-making processes made by persons at risk for and those faced with life-threatening illness. These illnesses are ones that almost always lead to death in a fairly short period of time if left untreated, but may be chronic or even cured if dealt with early in the disease process. Decision-making can occur from the point of adopting preventive behaviors through the end of life.

Community-Based Partnerships for Childhood Obesity Prevention and Control: Research to Inform Policy
Deadline: May 7, 2012
The purpose of this FOA, issued by the NICHD, is to enhance childhood obesity research by fostering the formation of local, state, or regional teams consisting of researchers, policymakers, and other relevant stakeholders (e.g., community representatives, public health practitioners or officials, educators) in order to identify research questions and hypotheses, design and implement the relevant research, and translate the research into evidence relevant to potential policy efforts in this area.

Cancer Surveillance Using Health Claims-based Data System
Deadline: May 7, 2012
This Funding Opportunity Announcement (FOA), issued by the National Cancer Institute (NCI), encourages grant applications for research entailing the use of health claims data for cancer surveillance. Cancer surveillance may include assessment of patterns of care, quality, and outcomes of care, and health disparities across the continuum of treatment.

2009 Aetna Foundation Regional Community Investment Programs
Various Deadlines
Information regarding the Regional Community Grants Program and Healthy Community Outreach Program including funding categories, schedule, target markets, and the online application process is now available on the Aetna Foundation website.

Ben & Jerry’s Foundation
Ongoing deadline for Letters of Interest
The Ben & Jerry's Foundation offers competitive grants to not-for-profit, grassroots organizations throughout the United States which facilitate progressive social change by addressing the underlying conditions of societal and environmental problems. Grant applicants need to demonstrate that their projects will lead to societal, institutional and/or environmental change; address the root causes of social or environmental problems; and lead to new ways of thinking and acting. Awards are granted ranging from $1,001 - $15,000.

Nathan Cummings Foundation
Letters of inquiry may be submitted at any time

The Nathan Cummings Foundation is rooted in the Jewish tradition and committed to democratic values and social justice, including fairness, diversity, and community. The Foundation seeks to build a socially and economically just society that values nature and protects the ecological balance for future generations, promotes humane health care, and fosters arts and culture that enrich communities. An additional goal is to strengthen the capacity of the Jewish community to work for social and economic justice, both in the United States and Israel. Funding priority is given to projects that have an impact at the state, multi-state, or national level.

Kresge Foundation Grantmaking Programs in Health and Environment

Deadline: Open

Both the Health and Environment Programs address health and environment-related social issues, particularly those affecting minority, low-income, and other underserved communities.

United Health Foundation - Health Services Programs Supported Nationwide
Deadline: Open

United Health Foundation works to improve health outcomes for all Americans. Support is provided to nonprofit organizations that serve the health needs of people and communities throughout the US. The Foundation's priorities are: to enhance the quality of health and medical care services by providing reliable, scientifically-based information to support decisions made by health professionals, communities, and individuals; and to expand access to medical care and health-related services for individuals and families who live in challenging circumstances. Grants generally range from $1,000 to $50,000.

Educational Foundation of America

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

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

Fulbright Scholar Award

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

Ladder to Leadership: Developing the Next Generation of Community Health Leaders
Application deadline: Varies
Ladder to Leadership: Developing the Next Generation of Community Health Leaders is a collaborative initiative of the Robert Wood Johnson Foundation and the Center for Creative Leadership. The initiative aims to enhance the leadership capacity of community-based nonprofit health organizations serving vulnerable populations. It will develop critical leadership competencies for 270 early- to mid-career professionals through an innovative, sixteen-month leadership development curriculum

Build-A-Bear Workshop Foundation Community Improvement Programs
Applications accepted throughout the year.

Provides support to nonprofit organizations that improve communities and positively impact lives. The grantmaking emphasis is on programs that help children and families, animals, or the environment. Average grant $2,500.

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

Directory Of Health Policy Fellowships

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

October 14, 2009

Note: Items in brown are related to health care reform.

NEW SECTION: Health Care Reform Resources

Florida

National

Organizations and Services

New: Florida

New: National

Continued Listings: Florida

Manuals, Guides and Toolkits

New: Florida

New: National

Continued Listings: Florida

Technology and Audio Visual Materials

Media Programming

Web Sites, Web Features

New: Florida

New: National

Continued Listings: Florida

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

Periodicals and Books

Reports and Studies

NEW SECTION: New Health Care Reform Reports

New: Florida Reports

New: National

NEW SECTION: Continued Listings: Health Care Reform Reports

Continued Listings: Florida Reports

HEALTH CARE REFORM RESOURCES

Florida Health Care Reform Resources

Health Action Now Florida Group

AARP’s Florida Health Action Now group is up and running. Please visit and join. Site goers will discover first-hand information about Site goers will discover first-hand information about health care reform, Medicare, myths and facts and other pertinent AARP information.

Florida SEIU Health Care Reform Database

Florida SEIU invites organizations and individuals to enter their information in a Community Partners database for health care reform efforts.

National Health Care Reform Resources

Critical Condition: What’s at Stake in Health Care Reform
BET hosted this news special, which discussed how current health reform proposals will specifically affect the African American community. The panelists on the show included White House Director of Domestic Policy Melody Barnes; U.S. Congress members James Clyburn (D-S.C.) and Maxine Waters (D-CA); BET News’ Pamela Gentry; Conservative Policy Expert Bob Parks; Dr. Brian Smedley; Dr. Majorie Innocent; and Dr. Sampson Davis.

Stand Up for Health Care: Send a different kind of message to Congress.
Families USA will compile voice recordings to create a message to send to Congress. Encourage consumers, providers and advocates to lend their voices to this campaign and send a new message to Congress.

What Do You Really Know about Health Reform?

What do you really know about health reform? This Families USA game is a fun and interesting way to learn the basics about health reform. Please forward it to family and friends!

Paying for Better Care: A Consumer Advocate’s Reference Guide to Payment Reform

provides clear information about some of the most complex concepts of how we pay for health care. It also provides guidance on evaluating payment reform proposals to ensure that they promote: Improved health outcomes, Increased reliance on primary care, Improved care coordination, Greater provider accountability to patients and communities, Patient-centered care that adjusts for unique needs and circumstances, Increased education and empowerment for patients and their families, Greater transparency on how providers are paid and the quality of care they offer. This report helps consumer advocates understand how the current fee-for-service payment model has contributed to escalating costs and lower quality care, what the alternative payment models are and how to evaluate them, and what roles advocates might play in crafting consumer-friendly payment reform nationally or in their states. Read this report and others in the series here. (August 2009, Community Catalyst)

HealthReform.org

The Robert Wood Johnson Foundation has launched to provide timely, nonpartisan information and tools to inform policymakers about the need to reform our ailing health care system. Add the HealthReform.org widget to your social networking page or Web site. This widget feeds the day’s top health reform news clips and The Users’ Guide to the Health Reform Galaxy blog entries. Sign up to have the Daily Health Reform News Digest sent directly to your inbox. Check out The Users’ Guide to the Health Reform Galaxy blog. Learn about new and noteworthy research, data and expert commentary.Access real-time policy analysis. (RWJF)

www.WhiteHouse.gov/realitycheck

has been launched to knock down the rumors and lies that are floating around the internet. You can find the information below, and much more, there. Recent additions include a video of Nancy-Ann DeParle from the Health Reform Office tackling a viral email head on.

Pretty Short Summary of the 3 House Committees Health Care Reform Bills
One-pager about how ealth insurance would be provided through (1) employers; (2) a national insurance exchange; or (3) an expanded Medicaid program. Most aspects of the legislation will take effect starting in 2013.

(August 2009, Coalition on Human Needs)

10 Reasons to Support Health Care Reform

Even though key decisions are still being made, it is clear we have gained significant ground. There is much to be excited about in these proposals: Millions more people will gain health insurance, coverage will be more affordable, and people will have access to the health services they need. These provisions will improve the lives of millions of Americans and give us the peace of mind that comes with knowing that we have coverage no matter what. But the road ahead will not be easy. We must continue to work for improvements and we must ensure that we do not lose the gains we have made so far—they are worth fighting for. Below are some highlights in the health care reform proposals. (Families USA)

The Truth About Immigrants in Health Care Reform

One-page handout. Opponents of health reform are using immigration as one of their wedge issues to take down health reform for partisan political gain by making false claims regarding immigrants. They provide only empty criticism and offer no solutions to the real problem of working families not having access to quality, affordable health care. The Truth is that the current health reform proposals are not comprehensive enough to appropriately address the health needs of America’s diverse population. For instance, numerous barriers remain to affordable health care for immigrants of all statuses. (National Immigration Law Center)

Families USA Advocate Tip: Respond to Attacks on Reform
Use these useful tips and tactics to make sure your local town hall stays civil and under control.

Cover the Uninsured Weekly News Digest

is currently in its seventh year of providing health coverage advocates and activists from across the United States with leading newspaper editorials, articles and columnist op-eds. This year, as America continues a once-in-a-generation national conversation on health reform, RWJF has expanded its health and health care e-mail products to give you more flexibility than ever to customize the topics, frequency of updates and delivery format that work best for you. We'll also be making a few slight changes to some existing products. You can automatically import stories to your blog, Web page or social networking site either through the Cover the Uninsured Widget or by signing up for the RSS Feed. And, for those who prefer daily e-mail clips or updates on other aspects of health care, RWJF offers the Health Reform Daily Clips as well as subject-specific Content Alerts to inform you of interesting research and studies. Register for these and other e-mails (or update your existing selections) by visiting RWJF.org’s E-mail Subscription page.

Kaiser Updates Interactive Health Reform Comparison Tool To Reflect Latest Congressional Action
KFF has updated its interactive side-by-side health reform comparison tool. The online tool allows users to compare any of 12 different major health reform plans, including the House Tri-Committee legislation and the Senate HELP Committee legislation. The comparison tool and many other resources are available on the Foundation’s health reform gateway page, available at, which serves as a clearinghouse of key information, news and analysis about national health reform efforts. Among the resources found there are briefs on key reform concepts and the Foundation’s research and analysis on key issues in health reform, webcasts of reporters-only briefings with key congressional leaders, Kaiser’s polling data, analysis, and news summaries, an editorially independent health policy news service established by the Foundation.

HHS Releases State-Specific Online Reports Highlighting Need for Reform
HHS has released a series of state-specific reports on the “health care status quo,” which she said highlight the urgent need for health reform. The reports include data such as the rising cost of health coverage and the uninsured, and the impact of failing to adequately invest in disease prevention. (6/26/09, DHHS)

Webcast: Will Health Reform Limit Patients' Choices?

How might health reform affect our choices? How could health information technology help us make more intelligent choices? How much choice do we really have now? How much choice do we need? These questions were recently addressed by health policy experts at a National Press Club briefing sponsored by the Alliance for Health Reform and the Robert Wood Johnson Foundation. The briefing provided reporters with access to experts and non-partisan research that will continue to inform the reform debate. Panelists included:Uwe Reinhardt, Ph.D., a health economist at Princeton University;Joe Antos, Ph.D., a health economist at the American Enterprise Institute for Public Policy Research in Washington;Daniel Callahan, Ph.D., a medical ethicist and co-founder of The Hastings Center in New York State; andFormer Congressman Tony Coelho, chair of the Partnership to Improve Patient Care.

Universal Coverage and Access: Critical to Achieving Health Equity

Congressional briefing powerpoint presentation by Ron Pollack. (5/27/09, Families USA)

RAND COMPARE

Rand Corporation’s COMPARE Initiative provides information and tools to help policymakers, the media, and other interested parties understand, design and evaluate health policies. Site includes policy options and analysis, and “HOT” legislation page.

Access Denied video

Accidents Happen video

Children’s Defense Fund encourages all to view and share these videos depicting the importance of health coverage for all children.

I'm fighting for health care reform because... (finish the sentence)
Health care reform isn’t about numbers and statistics – it’s about real problems that people face each day. Sharing your experience can help make complex policy issues understandable for leaders in Washington. Every single one of us -- especially in this tumbling economy -- has either been personally affected by the health care crisis or has a loved one, coworker, friend, or neighbor who has suffered. Families USA wants to hear your story. Sharing is simple -- we've created an easy-to-use tool, so all you have to do is finish the sentence below. Once you’ve given your reason, check back often. Your comments may appear on our site, and we may contact you to ask if we can share your story with members of Congress.

RWJF Health Care Consumer Confidence Index

The inaugural report (June 2009) of the new monthly RWJF Index has been released online. The Robert Wood Johnson Foundation launched a new research tool: the RWJF Health Care Consumer Confidence Index (RWJF Index). The first of its kind, the RWJF Index will provide a monthly snapshot of Americans’ attitudes about health care. Analysis of the data is being provided by the University of Minnesota’s State Health Access Data Assistance Center (SHADAC). The RWJF Index has begun during this critical moment in the health reform debate to serve as a valuable measurement in the months to come, helping with understanding of how changes in the health care system affect the average health care consumer. These monthly data points can be used to make the case for health reform and position the issue in a broader context.

Health Affairs and RWJF Health Policy Briefs

Health Affairs and Robert Wood Johnson Foundation are pleased to announce a new series of Health Policy Briefs aimed at providing clear, accessible overviews of timely and important health policy topics. The first brief explores the current debate over cutting payments to Medicare Advantage plans - the privately run health plans that now serve almost a quarter of Medicare enrollees. Health Policy Briefs will be available at no cost on the Health Affairs Web site, and you may sign up to be alerted to new briefs by email or RSS feed. The briefs will also be available via a direct website link.

Community Catalyst Timeline for State Advocacy Work
Community Catalyst is looking ahead to some of the major opportunities for state advocacy on national health reform in the coming months. The timeline some of the major Congressional activities in the health reform debate and suggested ways for state advocates to be involved and engaged. During these months and beyond, Community Catalyst will continue to provide our partners with alerts, updates, message points, and analyses.

The Healthcare Equality Project
The Healthcare Equality Project (HEP) is a national partnership between community-based and nationwide organizations, faith networks, labor groups, and advocates working together to achieve comprehensive health care reform and health care equality. Its goal is to ensure that health care reform efforts go beyond simply expanding coverage and become an engine for reducing disparities that plague women and racial, ethnic, and other minorities. Its mission is to ensure that the health care reform that is enacted works for everyone. HEP has four specific goals that are designed to build a grassroots and advocacy campaign around health care reform: 1) to develop a public education and advocacy campaign to build awareness of health care disparities among racial and ethnic minorities across the nation; 2) to work with key congressional members to achieve necessary health care reform; 3) to develop and promote policies that address health care disparities; and 4) to strengthen the national network of health care equality advocates, including national organizations, faith-based groups, and student groups.

RWJF Daily News Digest on Health Reform!

Having the right information at the right time is an essential step in changing health care policy and practice for the better. To further this goal, the Robert Wood Johnson Foundation has launched its first ever Daily News Digest. This new service, focused on health reform, is a comprehensive daily look at what’s happening in the mainstream media, policy press and the blogosphere. Sign up to have this useful resource delivered to your inbox.

Webcast: Health Insurance Exchanges: See How They Run

looks at insurance exchanges and examines the following questions: What is meant by a health insurance exchange, and how might it work? Who would be allowed to seek coverage through the exchange? What rules would govern the conduct of plans offering coverage? What’s in it for the consumer?

Senate Finance Committee Hosts Three Roundtables to Discuss Key Elements of Health Care Reform: Delivery System, Coverage, and Financing

Between April and May, Senate Finance Committee (SFC) Chairman Max Baucus (D-MT) and Ranking Member Chuck Grassley (R-IA) hosted a series of three roundtable discussions on health care reform. The roundtable topics covered the health care delivery system, coverage, and financing. These roundtables were intended to encourage discussion between SFC members and health care policy and industry experts. They were also intended to inform the development of a comprehensive health care reform bill later this summer. Soon after each roundtable, the SFC released a policy paper detailing options for addressing each issue. The three roundtables were open to the public, and webcasts and the three policy papers are available on the Finance Committee Web site at www.finance.senate.gov.

ORGANIZATIONS AND SERVICES

New: Florida Organizations and Services

New: National

Continued Listings: Florida

Health Insurance Resource Center has been providing consumers with health insurance information and navigation advice since 1984. They include special resources for Florida at http://www.healthinsurance.org/florida

Insurance claim denied? Here's where to get help
Florida Office of Insurance Regulation: Investigates complaints against insurers, including denials of claims. Online: floir.com Phone: 1-877-693-5236
Subscriber Assistance Program: Reviews disputes between individuals and their managed-care plans. Online: fdhc.state.fl.us/MCHQ/Consumer/SPSAP/ Phone: 1-888-419-3456
Serving Health Insurance Needs of Elders, SHINE: Helps consumers navigate the Medicare appeals process. Online: floridashine.org Phone: 1-800-963-5337
Medicare Rights Center: National group helps Medicare clients understand their rights and benefits. Online: medicarerights.org Phone: 1-800-333-4114
Florida Legal Services: Free help for low-income adults denied prescription-drug coverage from Medicaid or Medicare Part D. Online: floridalegal.org Phone: 1-800-436-6001

Medicare Access Network of Florida
Do you know of any Medicare Part D beneficiaries who have questions about their plan? If so, feel free to direct them to one of the SHINE (Serving Health Insurance Needs of Elders) free counseling sites for help that are located throughout Broward and Miami-Dade. To make an appointment, or for questions, call the Elder Helpline at 1-800-96-ELDER (1- 800-963-5337).

South Florida Smoking Cessation Programs
South Florida Cancer Control Collaborative has also started a list of smoking cessation links. Click here to view the list.

(Florida) Hispanic Health Initiatives
In Florida, almost half of the 3 million uninsured adults are Hispanic. Central Florida has continued to see the rates of the uninsured increase and the availability of culturally competent services decrease. One agency, Hispanic Health Initiatives, Inc (HHI), is the only health services facility in Central Florida created to specifically address the needs of the Hispanic community. Since its inception in June of 2000, this volunteer-driven, community-based organization has worked to connect medically underserved families with free or low-cost health care services. Read more.

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

Florida Relay Service 711

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

Southeast Florida Cancer Control Collaborative (SFCCC)

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

MANUALS, GUIDES, TOOLKITS

New: Florida

New: National

Free Back to School KidCare Materials from Cover the Uninsured
While so many local organizations and activists across the country are engaged in the federal health reform debate, many are also continuing to enroll eligible uninsured children into low-cost and free health care coverage programs--and we want to help. Bookmarks, lapel stickers and information cards are available for order and distribution throughout your community and at your Back-to-School events and activities. Place your order today! You can also register events to get the word out and download free planning materials, including: Health and Enrollment Fair Planning Guide, Guide to School Based Outreach, Guide to Working with the Media, templates, toolkits and guides and more.

Continued Listings: Florida

TECHNOLOGY AND AUDIO/VIDEO RESOURCES

Media Programming

Web Sites, Web Features & Databases

New: Florida Listings

Families USA State Information Website Section

Families USA has updated and enhanced this Website section. Now, the 50 individual state pages are easier to access than ever before. Each page contains information including key health contacts, government links, and state-specific fact sheets and reports. These state pages are easy to find using the new state information map.

New: National

Continued Listings: Florida

Florida CHARTS New Interactive Community Maps Application

This application displays maps for births, deaths, fetal and infant deaths and U.S. Census data. All data is displayed at the census tract level. Users may choose to display quartiles based on all Florida census tracts or calculate results for only one county’s data. The maps also have the tables for the indicator data and census tract reports. There’s a users’ guide on the web page. You can view maps that show the distribution of deaths (numbers, not rates) from cancer and for selected cancer sites – for the state or by county. Under the “births” section, it has the percentage of births to women who smoke. The census data is still from the 2000 census or before (ok for areas that haven’t experienced much change).

Tobacco-Free Business Florida

Tobacco-Free Florida has created a new satellite website for businesses. The site has posters that can be downloaded to display at workplaces, as well as a pledge to be tobacco free. If the business takes the pledge, they are automatically entered to win a $500 giftcard for an employee lunch! The phone number for the state's toll free tobacco cessation quitline, Florida Quit-for-Life Line, is 1- 877-U-CAN-NOW.

Updated Hospital & Health Plan Data on Florida Health Finder

The Agency for Health Care Administration announced the release of updated health plan quality and hospital inpatient data on Florida Health FinderConsumers can access and compare the most recent quality of care and patient satisfaction measures for Florida HMOs and PPOs. In addition, the website now contains hospital inpatient data for July 2007 through July 2008. The most current Hospital Financial Data Book is also available, showing an analysis of hospital financial results for fiscal years ending in 2007.

Kids Count

Annie E. Casey Foundation recently updated its online database, , which contains state-, city-, and now community-level data for more than 100 measures of child well-being. This database can generate custom reports for specific geographic areas and compare them based on a particular topic (for example, poverty, education, and health/health insurance).

Florida Census Data
Here is a very helpful link to a map of Florida that has each county hyperlinked to its US Census data, including: racial/ethnic populations, education level, income, federal dollars they receive, etc.

Updates to www.FloridaHealthFinder.gov Website

AHCA has announced a major redesign of this site and the addition of a new hospice comparison tool. The site contains interactive tools that give Floridians the opportunity to compare pricing and performance for hospitals, ambulatory surgery centers, emergency rooms, health plans, nursing homes, and pricing on prescription drugs. The easy to use website provides health outcome information for over 150 conditions and procedures in Florida’s health care facilities and is linked to an extensive health care encyclopedia.

statehealthfacts.org

This web site recently added new data on Medicaid, CHIP and Medicare. New data from the Congressional Research Service on CHIP enrollment and projected federal allocations have been added for all states and the nation. In addition, data on the distribution of enrollment in CHIP by family income level for fiscal year 2008 and the projected federal CHIP allotments under the CHIP Reauthorization Act for FY 2009 are available for all states and the nation. Statehealthfacts.org also added new data from HHS and the Government Accountability Office about temporary federal Medicaid relief provided by the federal economic stimulus plan to states from October 2008 through March 2009, along with the total estimated federal stimulus allocations to each state through December 2010. The Web site also added new data from an analysis by the Urban Institute and the Foundation's Commission on Medicaid and the Uninsured of 2005 CMS data on dual eligibles. The new data include Medicaid spending for dual eligibles by service, Medicaid spending per dual eligible, dual eligibles as a percent of total Medicare and Medicaid beneficiaries and the distribution of dual eligible enrollment.

SHADAC Launches Redesigned State Health Access Assistance Web Site
The new RWJF Web site gives users easy access to research and resources related to issues of health insurance coverage, data collection methods and state health policy.

Florida Medicaid Reform Evaluation Project

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

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

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

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

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

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

Florida Association of Community Health Centers (FACHC)

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

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

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

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

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

State of Florida Health Care Consumer Websites
The recently expanded FloridaCompareCare.gov aims to improve care and reduce costs by giving citizens the tools to compare outcomes and prices between health care providers and medical services. Through this website one can see data on certain conditions and procedures related to quality of care, pricing and performance at the state’s hospitals and ambulatory (outpatient) surgery centers. In 2005, Florida became the first state to publicly report infection and mortality rates in each hospital. In July 2006, Florida became the first state to publicly report separate pediatric quality of care data. In addition, adult data can now be broken out specific to ages 65 and over. Additional new breakdowns include types of facilities.

FloridaHealthStat.com provides health care information to assist consumers, health care professionals, and researchers in making well-informed health care decisions and in researching the status of health care in Florida. MyFloridaRx.com provides consumers with the retail prices of the most commonly used prescribed drugs by pharmacy across Florida. For questions or comments regarding any of Florida’s consumer websites, contact 850/922-7036.

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

Florida KidCare Applications can be completed online

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

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

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

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

Moving Science to Practice and Policy: Addressing Inequities through a Focus on Place
National Center on Minority Health and Health Disparities (NCMHD) has recently released this first videocast as part of the NIH’s monthly Health Disparities Seminar Series. In the videocast, Dr. Brian Smedley speaks about the negative effects of racial and socioeconomic segregation on health. He also highlights some of the challenges and opportunities in applying research to policies and practices that address health inequities and improve health opportunities.

PBS Re-Broadcasting "Unnatural Causes" Series in October
PBS will be re-broadcasting this series in October. It is about health; about why some of us get sicker more often and die sooner and what causes us to fall ill in the first place. PBS has criss-crossed the country investigating the stories and findings that are shaking up conventional notions about what makes us healthy or sick. These compelling personal stories illustrate obstacles and inequities in society but they also point the way to new possibilities as individuals and communities organize to give control over their destiny and their health. See local listings for dates and times.

Treatments on Different Races

CNN recently launched a video discussion on race and healthcare, Treatments on Different Races, as part of a week-long focus on health care issues. CNN anchors discussed disparities in disease outcomes between minorities and whites. According to the anchors, one of the most striking disparities is differences in survival rates—for example, the survival rate for black men that have strokes is 25 percent compared to 52 percent for a white men.

PERIODICALS AND BOOKS

Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement

In The Institute of Medicine’s (IOM) 2009 report, Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement, the Subcommittee on Standardized Collection of Race/Ethnicity Data for Healthcare Quality Improvement identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data; and makes recommendations for a nationally standardized approach for use in health care quality improvement. May be read online free of charge. (2009, Institute of Medicine)

Focusing on Children's Health: Community Approaches to Addressing Health Disparities

The Institute of Medicine’s recent report, Focusing on Children’s Health: Community Approaches to Addressing Health Disparities, describes the evidence linking early childhood life conditions and adult health; discusses the contribution of the early structural and social aspects in children’s lives to observed racial and ethnic disparities in health; and highlights successful models that engage both community factors and health care to affect the child’s development over life. May be read online free of charge. (2009, Institute of Medicine)

Medical Manual for Religio-Cultural Competency

To meet the needs of its diverse clinician and patient constituency, EmblemHealth announced on Friday publication of what is believed to be the first comprehensive guide to help physicians and medical professionals address the needs of patients whose health care decisions are influenced by their religious and cultural beliefs. The manual is sponsored by EmblemHealth and created by the Tanenbaum Center For Interreligious Understanding, a global leader in training health care providers to offer religiously and culturally competent care for patients of all ages and backgrounds.

REPORTS AND STUDIES

New Listings

New Health Care Reform Reports

Statement: Robert Greenstein, CBPP Executive Director, on the Senate Finance Committee’s Health Reform Bill
The Senate Finance Committee’s approval of an ambitious health reform plan marks a major step toward enactment of legislation to extend health care to tens of millions of people who lack it, strengthen insurance protections for millions more who are underinsured or face exorbitant charges, and begin to address the nation’s most serious fiscal threat — the relentless rise in health care costs. The CBO has reported that the bill would modestly reduce the budget deficit both over the next ten years and beyond. This is a fiscally responsible bill that would redirect federal spending and tax subsidies from less productive uses elsewhere in the health care sector. While the committee package represents a vast improvement over the current health insurance system, it has some serious shortcomings that likely would limit its effectiveness in certain areas. Because the health reform bills approved by the Senate Health, Education, Labor, and Pensions (HELP) Committee and three House committees are stronger in those areas, policymakers should blend the best provisions from these bills as they move forward. (10/13/09, CBPP)

Medicare Spending for Previously Uninsured Adults

Closing the healthcare coverage gap for older working-age adults could lead to substantial health gains and reduce Medicare spending, in turn offsetting almost half the costs of expanding coverage, a new study by researchers at Harvard Medical School finds. According to the report, people between the ages of 51 and 64 who had continuous coverage cost the Medicare system significantly less than those who did not. The authors estimate that while expanding coverage for uninsured adults between the ages of 51 and 64 would cost $197 billion due to greater healthcare utilization, the improved health of that population could lower future Medicare spending by $98 billion. (October 2009, Commonwealth Funded, in Annals of Internal Medicine)

Report: Health Bills Show Some Price Gaps
Older Americans who buy health insurance on their own could pay nearly 50% more in premiums under the Senate Finance Committee bill compared with other versions pending in Congress, an independent study says. (10/9/09, USA Today)

Medicaid and Children's Health Insurance Program Provisions: America's Affordable Health Choices Act & America's Healthy Future Act
This brief examines provisions related to Medicaid and the Children's Health Insurance Program (CHIP) in the House Tri-Committee bill and Senate Finance Committee bill compared to current law. (9/22/09, KFF)

AP Poll: Health Care Overhaul Has a Pulse
The fever has broken. The latest Associated Press-GfK poll has found that opposition to Obama's health care remake dropped dramatically in just a matter of weeks. Still, Americans remain divided over complex legislation that Democrats are advancing in Congress. (10/7/09, Washington Post)

Americans Willing to Fund Healthcare Reform - Poll
Most Americans would pay higher taxes to fund healthcare reforms that provide the best quality of care, but only a minority expects Washington to deliver it, according to a survey. (9/30/09, Reuters)

Should Congress Require that Most Americans Have Health Insurance?
The leading health reform bills in Congress would impose a national individual mandate requiring most Americans to have health insurance. This Health Policy Brief explores the background of individual mandates; the technical aspects that still need to be agreed upon such as coverage standards, out-of-pocket-costs, purchasing exchanges, government subsidies and penalties; and the arguments on both sides of the issue. (9/29/09, Health Affairs/RWJF Health Policy Brief Series)

In Debate on Health, It's Coverage vs. Cost
As Democrats prepare to take up health care legislation on the floor of the Senate and the House, they are facing tough choices about two competing priorities. (10/6/09, NY Times)

Mandate Minus Price Controls May Increase Healthcare Costs
In the drive to bring health coverage to almost every American, lawmakers have largely rejected restrictions on how much insurers can charge, sparking fears that consumers will continue to face the skyrocketing premium increases of recent years. (9/24/09, LA Times)

Without US Healthcare Plan, States Could Pay More
If the US Congress fails to reform health care, states will spend more on their programs for the poor than they currently pay out, according to a new report on Wednesday. (9/30/09, Reuters)

In Delivering Care, More Isn't Always Better
A dirty word in health-care reform is "rationing," a term that conjures up the image of faceless government bureaucrats denying lifesaving therapies in the name of cutting costs. But what if the real issue is not the specter of future rationing, but the haphazard, even illogical, way in which care is delivered today? (9/29/09, Washington Post)

Many People Are Confused or Misinformed on What Is, and Is Not, in Health Reform Proposals
Large numbers of people either believe damaging misinformation about the health care proposals being discussed in Washington or are not sure what to believe. The polls also shows that almost half of all adults continue to support what they see as President Obama's health care reform proposals, significantly but not substantially more than oppose them. And, more people like the president's proposals than like what they think the Democrats in Congress are proposing, and much more than what they think Republicans in Congress want. (9/24/09, Harris Poll)

"Health Coverage in Florida: How Will Health Reform Help?"

Everyone—businesses large and small, seniors, children, those who currently have insurance, and those who don’t—will be guaranteed access to coverage they can afford if America’s Affordable Health Choices Act of 2009 (H.R. 3200) becomes law. Many of the problems in Florida’s health care system will be fixed, so Floridians will be able to obtain and keep high-quality, affordable coverage that meets their needs. The major gaps in Florida’s current health coverage system are described below, along with the significant ways in which H.R. 3200 will address them. (Oct 2009, Families USA)

Americans Want Obama Administration to Focus on Economic Recovery Before Health Care Reform
When one thinks of the economy, there are different permutations of it. Are Americans thinking of the U.S. economy? Probably, but there is also the European economy and the Asian economy to consider as well and how confident are Americans in the overall strength of each of these. When it comes to the U.S. and global economy, Americans are split and there is uncertainty regarding the European and Asian economies. (9/29/09, Harris Poll)

Current Health Reform Proposals: No Government Takeover of American Health Care

found that health reform proposals would create consumer protections to improve the quality of coverage, use subsidies to help make insurance more affordable, and build on existing public programs so that they are better able to serve those who qualify. Health reform would retain a strong private sector, increase consumer choices, and help the uninsured purchase insurance. (Sept 2009, Urban Institute)

Out of Options: Why So Many Workers in Small Businesses Lack Affordable Health Insurance, and How Health Care Reform Can Help

examines why small businesses often have more difficulty offering their employees health insurance, as well as how the economic downturn has intensified the problem. The brief also outlines how measures in the health reform proposals, such as the creation of an exchange and tax credits for small businesses, could help small businesses and their employees gain access to affordable, comprehensive coverage. (Sept 2009, Commonwealth Fund)

Individuals with Special Needs and Health Reform: Adequacy of Health Insurance Coverage

examines the health care needs and medical expenses of three individuals who require extensive acute and long-term care to discover how reform proposals can best serve those with special health needs. It concludes that a comprehensive benefits package, limits on out-of-pocket expenses, subsidies, and strong Medicaid programs are essential to ensuring that people with special needs are fully supported under health reform. (Sept 2009, KFF)

Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2009 Update

explains why young people ages 19-29 continue to be one of the largest and fastest-growing groups without health insurance and the possible repercussions of this trend. The brief also suggests policy reforms that could help young adults stay insured as they become more independent. (Aug 2009, Commonwealth Fund)

In Pursuit of Affordable Health Care: On the Ground Lessons from Families in Massachusetts

details how the state’s health reform legislation has achieved near-universal coverage (94.7 percent) by combining a foundation of public coverage with greater access to private insurance through employers. While some budgetary challenges remain, the program has been largely successful, including a marked increase in job-based coverage. (Sept 2009, KFF)

Health Reform in Massachusetts: An Update on Insurance Coverage and Support for Reform as of Fall 2008

provides an update of the impact on working-age adults, the primary target of reform policies, as well as an update on public support for health reform. The state has achieved its goal of near universal health coverage, and residents continue to show strong support for health reform, despite the rising costs of the program. (Sept 2009, Urban Institute)

Explaining Health Reform: What Are Health Insurance Subsidies?

explains what insurance subsidies are and how they can help lower-income families and individuals afford health coverage. The brief also examines different ways of structuring subsidies and describes how each would affect the reform proposals that are currently under discussion in Congress. (Aug 2009, KFF)

Health Coverage and Expenses: Impact on Older Women’s Economic Well-Being

explores gender-based differences in health and long-term care use, spending patterns, and the financial burden of out-of-pocket expenses among Medicare beneficiaries. The study reveals that women’s health care expenses were higher than men’s, and older women had an even greater overall financial burden with less income at their disposal. It concludes that controlling health spending and developing options to help finance long-term care for Medicare enrollees are key to improving the economic security of older women. (Aug 2009, KFF)

The Risk of Losing Health Insurance over a Decade: New Findings from Longitudinal Data

reveals that nearly half of all Americans under the age of 65 go without health insurance in a 10-year period. In fact, 36 percent will go without coverage for at least one full year during that period. Given the frequency of gaps in coverage among Americans under 65, the study concludes that, without health reform that expands coverage, these trends are likely to worsen in the years to come. (US Dept of Treasury)

Community Health and Senator Baucus's Reform Bill
This 7-page excerpt of a 30+ page summary produced by the American Hospital Association focuses on: coverage and insurance, reducing health disparities, wellness and prevention, and provisions relating to community benefit and tax-exempt hospitals. For instance, did you know that Senator Baucus's bill would require hospitals to conduct community health needs assessments at least every three years and have a strategy to address those needs? (Sept 2009, AHA/ACHI)

Improving Care and Reducing Costs by Expanding Coverage
A major focus of the health reform debate in Congress is the cost of covering uninsured Americans—and how to pay for it. However, a new Commonwealth Fund study released online demonstrates that expanding health coverage might not cost as much as policymakers assume. (10/5/09, Annals of Medicine)

New: Florida Reports

Costly Coverage: Premiums Outpace Florida Paychecks
Over the past decade, the cost of health insurance has skyrocketed, while working families’ wages have merely inched upward. As the recession lingers on, this situation continues to worsen. Reduced hours and job losses have left millions of families struggling to afford their share of premiums and millions more with no coverage at all. The combination of stagnant wages and rising health care costs is placing a growing strain on family budgets, and many families have reached a breaking point. Quite simply, America's families are being priced out of health coverage. In addition to higher premiums, working families now face higher out-of-pocket health care costs, such as higher deductibles, copayments, and costs for services that are not covered by their insurance plans. As a result, health care costs are consuming an ever-larger portion of family budgets. It is clear why many families feel worse off economically than they did a decade ago. These state reports, which are based on data from the U.S. Census Bureau and the U.S. Department of Health and Human Services, examine what these trends mean for America’s working families. (Aug/Sept 2009, Families USA)

FL ranks low in kids' health spending
Florida, among the top 3 states in health spending on the elderly, falls near the bottom when it comes to children. Florida ranked 50th among states and the District of Columbia for the percentage of its children covered by health insurance, according to a scorecard. Overall, Florida ranked 44th among all 50 states and the District of Columbia for the performance of its health system, based on measurements that included access to care, prevention and treatment of disease, costs, avoidable hospital use and equity. (10/7/09, Commonwealth Fund in Palm Beach Post)

New Listings: Medicaid

The Crunch Continues: Medicaid Spending, Coverage and Policy in the Midst of a Recession

"The recession is driving up enrollment in Medicaid at higher than expected rates, threatening gargantuan state budget gaps even as Congress and the White House seek to expand the government health insurance program for the poor and disabled," The New York Times reports. "The annual survey of state Medicaid directors found that the program had been spared the worst effects of massive state budget shortfalls because of federal aid in the stimulus package. But it also revealed grave concerns about what will happen when that relief dries up at the close of 2010." (9/30/2009, KFF)

Advancing Access to Medicaid Home and Community-Based Services: Key Issues Based on a Working Group Discussion with Medicaid Experts
This brief highlights key strategies to address financing, program administration and community workforce challenges that key experts, federal and state officials and advocates believe must be overcome to expand access to home and community-based services (HCBS). (Sept 2009, KFF)

New Listings: Children's Health Care

Containing Costs And Improving Care For Children In Medicaid and CHIP
This study examines the overall distribution of spending for children in Medicaid/CHIP as measured by the Medical Expenditure Panel Survey. The study found: "Ten percent of enrollees (two-thirds of whom have a chronic condition) account for 72 percent of the spending" whereas "30 percent of enrolled children," who are disproportionately African American, "receive little or no care" over a twelve-month period. "These results highlight the importance of cost containment strategies that reduce avoidable hospitalizations among children with chronic problems and policies that increase preventive care, particularly among African American children," the authors write. (9/17/09, Health Affairs)

Kids need specialized care in hospital emergency departments
In a policy statement, a team of pediatric emergency medicine specialists and other health experts point to a IOM report that found only 6 percent of U.S. hospital emergency departments are fully equipped to properly care for children even though children account for more than 20 percent of all emergency room visits. The authors make "recommendations for appropriate equipment, training, medications, and policies for pediatric emergency care." (9/21/09, Children’s National Medical Center in Pediatrics)

New Listings: Medicare

Medicare Governance and Provider Payment Policy

examines the decision-making processes governing Medicare and how they tend to become overly politicized by both Congress and the White House. The report makes several recommendations for protecting Medicare payment decisions from political interference, including establishing a new, independent Medicare policy board. (Sept/Oct 2009, Health Affairs)

How Medicare Could Get Better Prices on Prescription Drugs

examines federal spending for Medicare Part D plans under the current “noninterference” provision that prevents the government from negotiating prescription drug prices on behalf of enrollees. The report compares and assesses several options for reforming this system, including adopting a system of rebates similar to those used by state Medicaid programs, expanding the use of generic drugs, and other options that may reduce federal spending without requiring price negotiations. (Aug 2009, Commonwealth Fund)

Better Use Of Medicare Data Could Help Cut Costs

Economists say better use of Medicare data could help make health care less expensive while the federal program faces some cuts under current legislation. "Economists say one reason the health care system wastes so much money is a simple lack of information." Arnold Milstein, who advises the White House on health care economics, "diagnosed the problem as one of relative ignorance: Physicians don't have a clue how they compare with their colleagues. They don't know if they're spending more than another doctor to treat the same condition. There just wasn't any place for them to see comparative statistics." (9/29/09, NPR)

Medicare Advantage Plans To Increase Premiums For Some - But Not All - In 2010

A report on the future prospects for seniors who are enrolled in Medicare Advantage. "In Miami next year, seniors once again won't have to pay any monthly premiums for a Medicare health plan sold by HMO giant Humana Inc. Meanwhile, in Philadelphia, seniors will pay premiums of $52 - up from zero - for the least expensive HMO plan from Independence Blue Cross. The new information underscores the drastic differences in how seniors will be affected - depending on where they live -- by federal funding cuts next year to private Medicare health plans known as Medicare Advantage (10/1/09, Kaiser Health News)

New Listings: Federal/State Budgets

Out-of-Pocket Health Care Costs Could Increase More Than 35 Percent in Every State by 2019

Even as state government officials worry that a health overhaul will compel them to spend more on Medicaid, a new report finds that states face rapid cost increases if the health care system is not reformed. (9/30/09, RWJF)

New Listings: Health Insurance, Health Care Costs

Cost Savings and Cost-Effectiveness of Clinical Preventive Care
This report evaluates the economic evidence for investing in preventative care as indicated in cost-effectiveness literature. The authors conclude: "Based on the literature synthesized in this report, there are relatively few clinical preventive interventions for which there is strong evidence of cost savings. Moreover, many preventive interventions that do save money are already in widespread use (e.g., childhood immunizations), thus limiting the potential for additional savings. For these reasons, it is unlikely that substantial cost savings can be achieved by increasing the level of investment in clinical preventive measures. On the other hand, this review has shown that many preventive measures deliver substantial health benefits given their costs" (Sept 2009, RWJF)

Cost Savings and Cost-Effectiveness of Clinical Care Prevention Care
A new Synthesis Project report from the Robert Wood Johnson Foundation provides policy-makers with a framework for evaluating the cost-effectiveness literature and investigates the economic evidence for investing in preventive care. (Sept 2009, RWJF)

Federal Government Surveys that Count Uninsured People in America
A new estimate of the number of uninsured Americans at the county, state, and national level was released as part of the U.S. Census Bureau’s first-ever release of data collected through the American Community Survey (ACS). By polling about 30 times more Americans than the Census Bureau’s Current Population Survey (CPS), the ACS is able to estimate the number of uninsured Americans at the county level—data which will be useful for state and federal health policy-makers alike. (9/22/09, RWJF)

Survey of Local Health Department Job Losses and Program Cuts
The National Association of County and City Health Officials today released a report that found local health departments sustained the elimination of 8,000 staff positions, over and above 7,000 lost in 2008. NACCHO points out that, “These data demonstrate that the economic strains on local and state government budgets are reducing public health resources at a time when a stable public health system is greatly needed.” (9/21/09, National Association of County and City Health Officials)

Ambulatory Care Among Young Adults in the United States
Using cross-sectional data, researchers examined ambulatory care utilization among adults, ages 20 to 29 years. Despite young adults being "the most likely age group to be uninsured and have the highest prevalence of substance abuse, motor vehicle accidents, and sexually transmitted diseases," the researchers conclude, "Young adults use less ambulatory medical care relative to other groups and infrequently receive preventive care directed at the greatest threats to their health." (9/15/09, Annals of Internal Medicine)

Effective Prevention Extends Lives And Increases Medical Cost Savings

Prevention measures against chronic diseases such as obesity, hypertension and diabetes will lead to both health benefits as well as medical cost savings in older Americans, a new study indicates. (Sept 2009, American Journal of Public Health)

Young Adults Visit Doctors Least At An Age When Risky Behavior Peaks

When adolescents graduate to young adulthood, their preventive care tends to fall by the wayside. A recent study has found that young adults are much less likely to use ambulatory or preventive care, even though their mortality rate is more than twice that of adolescents. (9/15/09, Annals of Internal Medicine)

The Burden of Health Insurance Premium Increases on American Families
The White House has issued a report calling for health insurance reforms to control the rising cost of premiums. According to the report, “Health insurance premiums are highly variable across the country, with states experiencing premium growth of between 90% to nearly 150% over the past decade. These differences lead to inequities for families and businesses as well as underlying differences in the uninsured across states. In every state, premiums have increased faster than wages and in every state, family budgets are consumed by an increasing share of health care premiums.” (9/22/09, US Exec Ofc of the President)

Poll: Americans' Satisfaction With Insurance Coverage
Overall, this tracking poll found that most Americans with insurance give their plan a favorable rating, and most are satisfied with various aspects of their coverage and care. However, on closer examination, the data finds that younger Americans, those with lower incomes and those who report being in poor personal health are significantly less likely to say they are satisfied with their insurance than their counterparts. (Sept 2009, KFF)

Study: Uninsured Have Higher Risk of Death
Lack of health insurance is associated with as many as 45,000 deaths annually, according to new study. The study found a 40% increased risk of death among the uninsured based on data from the Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey. Previous studies by the Institute of Medicine and others have shown that people with health insurance are more likely to get the health care they need and to have a regular source of care, the authors note. (9/17/09, American Journal of Public Health)

New Listings: Health Disparities

Health Coverage in Communities of Color: Talking about the New Census Numbers

In 2008, people of color made up 35 percent of the U.S. population but 54 percent of the uninsured. In fact, as in years past, every racial and ethnic group had uninsured rates that were higher than the rate for non-Hispanic whites and higher than the national average. As the recession has deepened, the share of people with job-based health insurance in particular has declined, falling from 59.3 percent in 2007 to 58.5 percent in 2008. Every racial and ethnic group was more likely not to have job-based health coverage than non-Hispanic whites. (Sept 2009, Families USA)

Health Equity Policies: A Review of the Recommendations

The Disparity Reducing Advances Project released Equity Policies: A Review of the Recommendations, a compilation of 27 reports, memos, and briefs that identify action steps for creating health equity. Each piece highlights recommendations, strategies, and/or priorities for health equity. (10/5/09, The Disparity Reducing Advances Project)

Limited Health Literacy Presents Hurdles To Decent Care

People who struggle with poor reading and math skills experience problems understanding instructions from health care providers and adhering to treatment, according to a new research review. (Sept 2009, Health literacy and health actions: A review and a framework from health psychology, Health Education & Behavior in Medical News Today)

Study Finds Stark Differences in Health Insurance Coverage across Congressional Districts
A new analysis using recently released 2008 data from the federal American Community Survey – reveals substantial variation across congressional districts in rates of private and public coverage and uninsurance. The share of nonelderly residents with private coverage ranged from 30.2 to 89.7 percent. This translates into more than 10-fold differences in public coverage rates (4.3 to 52.3 percent) and uninsurance rates (3.7 to 43.0 percent). (10/5/09, Urban Institute)

The Uninsured: Rates By State And Congressional District (interactive map)
The Census Bureau reports that 17 percent of the U.S. population under age 65 was without health insurance last year. Texas had the highest rate at 26.5 percent, and Florida was second at 24.8 percent. Massachusetts had the lowest uninsurance rate of those under 65 — 4.6 percent. (9/23/09, NPR)

HHS Officials Suggests Health IT Could Reduce Care Disparities
Speaking at a recent conference as part of National Health IT week, Garth Graham, M.D., deputy assistant for the U.S. Department of Health and Human Services' Office of Minority Health, suggested that telemedicine and other health information technology (IT) tools could be leveraged to reduce racial and ethnic care disparities, Government Health IT reports. (9/24/09, RWJF)

Aiming Higher: Results from a State Scorecard on Health System Performance, 2009

The cost and quality of health care, as well as access to care and health outcomes, continue to vary widely among states, according to the Commonwealth Fund Commission on a High Performance Health System's second state scorecard report. See an interactive map to view state-specific rankings and results and estimates of lives and dollars saved if a state's performance were brought up to benchmark levels. You can create custom bar charts and tables comparing states that you choose on performance indicators you select. (10/8/09, Commonwealth Fund)

Education Matters for Health
An issue brief examines three major interrelated pathways through which education attainment is linked with health - health knowledge and behaviours; employment and income; and social and psychological factors, including sense of control, social standing and social support. This brief also explores how educational attainment affects health across generations. (9/9/09, RWJF)

The Economic Burden of Health Inequalities in the United States

This new report that found that between 2003 and 2006, more than 30 percent of medical expenditures for African Americans, Asians, and Hispanics were excess costs as resulting from inequities in the health of these groups. The Health Policy Institute also held a health briefing to discuss the analysis and preliminary results of this study, which is available as a webcast. (Sept 2009, Health Policy Institute at the Joint Center for Political and Economic Studies)

Estimating the Cost of Racial and Ethnic Health Disparities

This report examines the cost burdens of racial and ethnic disparities for a select set of preventable diseases and the excess rates of these diseases among African Americans and Latinos relative to whites. It estimates that, over the next decade, health disparities will cost the health care system approximately $337 billion. (Sept 2009, Urban Institute)

A Profile of American Indians and Alaska Natives and Their Health Coverage

provides an overview of the some of the demographic factors that influence the health and insurance coverage of American Indians and Alaska Natives and examines their relatively high rates of chronic conditions compared to other racial and ethnic groups. (Sept 2009, KFF)

Immigrants’ Health Coverage and Health Reform: Key Questions and Answers

looks at key questions related to immigrant health care and health reform. The brief addresses topics such as how immigrants receive health coverage, how many of the uninsured are non-citizen immigrants, and what would happen to coverage for non-citizen immigrants under current health reform proposals. (Sept 2009, KFF)

Black Americans and HIV/AIDS and Latino Americans and HIV/AIDS

provide statistical evidence on the affect of HIV and AIDS on Black and Latino Americans. Both Black Americans and Latino Americans continue to be heavily affected by the HIV/AIDS epidemic. (Sept 2009, KFF)

Cultural Competency in Health Care: Evaluating the Outcomes of a Cultural Competency Training among Health Care Professionals

analyzes whether cultural competency training produces a change in the knowledge and skills of providers and administrators. The study finds that as a result of cultural competency training, participants self-reported not only an enhanced understanding of the health care experiences of patients from diverse backgrounds but also an improvement in the skills necessary to effectively work in cross-cultural situations. (Sept 2009, National Medical Association)

Healthy, Equitable Transportation Policy: Recommendations and Research

examines how transportation directly affects health. The report shows that low-income communities and communities of color often do not have access to the benefits of transportation systems, but rather bear the burdens of that system. For example, these communities are often situated near bus depots, highways, and truck routes, where pollution levels and asthma rates are high. (Prevention Institute, Policy Link, and Convergence Partnership)

Hispanics, Health Insurance, and Health Care Access

looks at health insurance coverage and access to health care among Hispanics by immigration status. The study finds that about 60 percent of Hispanic adults in the United States who are neither citizens nor legal permanent residents lack health insurance. In contrast, 28 percent of Hispanic adults who are citizens or legal permanent residents and 17percent of the overall U.S. adult population lack health insurance. (9/25/09, Pew Hispanic Center)

New Listings: Other Health Issues

Hospital Mortality: Complications Are Not Best Predictor

A compelling University of Michigan Health System study debunks assumptions about the role of complications in distinguishing good and bad hospitals. The report that serious complications are common after major surgery - about 1 in 6 patients - but the study shows what drives hospital mortality is failure to rescue. (10/1/09, NEJM)

Health Care Viewed for First Time as Most Important Issue
The latest Harris Poll brings more bad news for the White House. For the first time in his presidency, President Obama's negative rating exceeds his positive score. And those who think that the country is on the wrong track have risen while those who think it is moving in the right direction have fallen. Another finding is that health care is now viewed for the first time as the most important issue, more important than even the economy. Review the entire poll results. (9/17/09, Harris Poll)

National Profile of Local Health Departments, 2008
A reliable and comprehensive description of LHDs’ infrastructure and practice. Get the latest facts and figures about LHDs’ services, financing, workforce, organization, and much more. (Sept 2009, NACCHO)

Continued Listings: Health Care Reform Reports

Comparative Effectiveness May Not Produce Hoped-For Savings

One component of Democrats' health reform plan, comparative effectiveness research, would seek to improve quality and lower medical costs by identifying the most clinically and cost-effective treatments available, but a new study by the Rand Corp. finds the impact of the research may be slow to arrive, BusinessWeek reports. "In the US, where the doctor-patient relationship is sacrosanct, just because a study says a particular treatment is superior for most patients, or the most cost-effective, doesn't mean practitioners will embrace it," according to BusinessWeek. The economic stimulus bill, passed in February, directed $1.1 billion toward this type of research, but researchers say the program may be shortchanged by restrictions on how its findings can be used. The Rand report says, according to Business Week, "Past efforts have shown that incentives or other mechanisms may be needed to change behavior. Because the stimulus bill specifically prohibits using the results of federally funded comparative effectiveness research ... to guide payment policy or benefit design, developing strong incentives that will drive down spending is considerably less likely (9/8/09, Rand)

New Poll Shows Concerns With Current Health Care System Remain High
New polling released today shows that Americans 50-plus remain concerned with the current health care system, underscoring the need for reform. Data released jointly today by AARP, the American Medical Association (AMA) and the American Nurses Association (ANA), show that about half of people over 50-years old are concerned that there won't be enough nurses or doctors to provide care in the future, and two-thirds of those polled are either very or somewhat concerned that the current system limits their ability to see the doctor of their choice. (9/10/09, AMA and ANA)

Medicare Changes Could Save Money For Taxpayers, Enrollees But Seniors Fret
Health reform legislation could change key aspects of Medicare policy, such as the amount seniors pay for drug coverage, a prospect that leaves many beneficiaries wary of the overhaul amid reassurance from the administration and harsh warnings from critics. For instance, "Medicare beneficiaries would often have to pay higher premiums for prescription drug coverage, but many would see their total drug spending decline, so they would save money as a result of health legislation moving through the House, the Congressional Budget Office said in a recent report." (8/31/09, New York Times)

Hospital Executives Worry About Reform Uncertainties
Hospital executives worry about uncertainties in reform. "Anxiety is running high among hospital executives as they ponder the ever-changing proposals on Capitol Hill. Wary of changes to payment formulas and fiercely protective of their franchise, industry groups are spending millions to lobby Congress. They also pledged $155 billion in Medicare and Medicaid savings in a deal with the White House in hopes of avoiding a deeper restructuring that could cost them more." (8/29/09, Washington Post)

Health Bill Would Cut Drug Spending for Many on Medicare, Budget Office Says
"Medicare beneficiaries would often have to pay higher premiums for prescription drug coverage, but many would see their total drug spending decline, so they would save money as a result of health legislation moving through the House, the Congressional Budget Office said in a recent report. (8/30/09, New York Times)

Young Adults Likely to Pay Big Share of Reform's Cost
As health-care legislation advances through Congress, the young adults who were so vital to President Obama's election are emerging as a significant beneficiary of his top domestic priority, but they are also likely to play a major role in funding any reform. (9/16/09, Washington Post)

Poll: More Erosion in Health Care Confidence
August's contentious disputes over health care appeared to take a toll, further eroding consumers' confidence about their health care future and access to care, a new report has found. (9/15/09, AP)

Poll Finds Most Doctors Support Public Option
Among all the players in the health care debate, doctors may be the least understood about where they stand on some of the key issues around changing the health care system. (9/15/09, NPR)

Reform Opposition Is High But Easing
President Obama continues to face significant public resistance to his drive to initiate far-reaching changes to the country's health-care system, with widespread skepticism about central tenets of his plan, according to a new Washington Post-ABC News poll. (9/14/09, Washington Post)

Current Health Reform Proposals: No Government Takeover of American Health Care
Current national health reform proposals would not cause "a government takeover of health care." Pending legislation would leave in place the country's largely private medical care system, in which more than 90 percent of doctors are in private practice and 84 percent of all hospital admissions are to private facilities. (9/8/09, Urban Institute)

US Health Reform Estimates Need Long View
Complications from chronic illnesses often do not emerge for many years. Current federal cost projection methods are constrained by ten-year cost estimates, which capture increases in near-term intervention costs but not changes in long-term costs. An article presents results from an epidemiologically based model that projects federal costs for diabetes under alternative policies, and we discuss the potential changes in the federal budget process needed to capture the full impact of these interventions. (9/1/09, Health Affairs)

A Medical Mystery: Why Health Care Is So Expensive
For all the attempts to lower the cost of health care in the United States, it remains expensive. Overall medical spending accounts for more than 17 percent of America's entire economy. (9/4/09, NPR)

Bending the Curve: Slowing Health Care Costs Requires Comprehensive Approach
Much of the rhetoric around health reform has centered on the overriding need to reduce the growth of health care costs, but agreeing on approaches that accomplish this goal has proven elusive. In order to slow the rise in health care costs, steps must be taken to address significant problems that exist with payment, benefits, regulations, and organizations in the current health care system. (9/1/09, RWJF)

Report Estimates Impact of Various Health Coverage Proposals
An estimated 17 million uninsured Americans would gain health coverage if Medicaid were expanded to cover people with incomes up to 133% of the federal poverty level, according to a new study. Providing subsidies to purchase health coverage to individuals with incomes between 133% and 399% of the poverty level would benefit 16.3 million uninsured adults, the study estimates. The groups also released studies estimating how many uninsured parents, childless adults and children would be covered under these and other scenarios being considered by Congress as part of health care reform. (8/28/09, Robert Wood Johnson Foundation and Kaiser Commission on Medicaid and the Uninsured)

Aspects of Health Reform: Economic Principles
As health reform again grabs headlines, it is important for policy-makers to understand four economic principles—efficiency, equity, adverse selection, and moral hazard—as they think about how best to expand coverage to millions of uninsured Americans. A new set of research papers published in the latest edition of Inquiry brings together health care economists from the Robert Wood Johnson Foundation-sponsored Economic Research Initiative on the Uninsured (ERIU) at the University of Michigan to examine these principles and how they relate to health reform. Articles include: Employer-Sponsored Health Insurance and the Promise of Health Insurance Reform; Mandates and the Affordability of Health Care; Risk Selection and Risk Adjustment: Improving Insurance in the Individual and Small Group Markets; Beneficial Moral Hazard and the Theory of the Second Best (8/31/09, RWJF)

Children's Advocates Fear Health Reform Could Undermine CHIP
As Democratic leaders pursue their quest to provide millions of Americans with health care insurance, some advocates see an unlikely casualty of reform: youngsters now covered by the Children’s Health Insurance Program whom they fear could end up with reduced benefits. (8/25/09, KFF)

Why So Many Workers in Small Businesses Lack Affordable Health Insurance
Small-business owners and employees are among those who stand to benefit the most from provisions in some of the current health reform proposals under consideration by Congress, according to a new study. (9/9/09, Commonwealth Fund)

Employer-Sponsored Coverage More Costly
The average premium for employer-based family health coverage rose 5% in 2009 to $13,375, according to a new survey. Sixty percent of firms offered health benefits to at least some of their workers, with the average employee paying about one-third of the premium. Four in 10 workers at firms with fewer than 200 people had deductibles of $1,000 or more. Between 1999 and 2009, the average family premium for employer-based coverage rose 131%, three times more than worker wages and four times the general rate of inflation. “Today’s survey results demonstrate the need for comprehensive, meaningful reform,” said Maulik Joshi, HRET president and AHA senior vice president for research. “Our nation faces a unique opportunity to achieve reform and build a better health care system that improves care for patients and provides coverage for all at an affordable cost.” (9/15/09, KFF and AHA Health Research & Educational Trust)

Free Report - Better Health, Not Just Better Health Care
This report was produced in partnership with the Big Cities Health Coalition, a group of eighteen city and county health departments from major American urban centers representing 14 percent of the country's total population. It focuses on how the federal government can play a vital role in improving public health by working with state and local health departments. The report includes examples of some innovative programs that these health departments have developed to prevent or address chronic diseases. The report is available for free, both online and in print. (September 2009, Milbank Memorial Fund)

Tax Offsets in Baucus Health Plan Are Sound But Can Be Improved

The excise tax is a sound way to help pay for health reform, but it has some shortcomings that can and should be addressed. Policymakers should modify the proposal to avoid unfairly affecting firms with older — and hence less healthy — workforces and to keep the “reach” of the tax from expanding too much. (9/18/09, CBPP)

Statement of Robert Greenstein on Chairman Baucus’ Health Reform Plan

"Senator Baucus’ plan is a major contribution to the health care debate, as it would extend coverage to tens of millions of uninsured Americans and improve insurance for millions of Americans who already have coverage — through reforms that deal with matters such as pre-existing conditions — and do so while fully offsetting the costs, and beginning to slow the growth of health care spending. The plan does suffer, however, from two key problems that need Congress’ attention: insufficient subsidies to help low- and moderate-income people afford health coverage and out-of-pocket costs, and a “free rider” provision that would give employers disincentives to hire prospective workers from low-income families, especially parents with children. (9/16/09, CBPP)

Poverty Rose, Median Income Declined, and Job-Based Health Insurance Continued to Weaken in 2008: Recession Likely to Expand Ranks of Poor and Uninsured in 2009 and 2010

Median household income declined 3.6 percent in 2008 after adjusting for inflation, the largest single-year decline on record, and reached its lowest point since 1997. The poverty rate rose to 13.2 percent, its highest level since 1997. The number of people in poverty hit 39.8 million, the highest level since 1960. The number of people who are uninsured jumped by 682,000...and reached 46.3 million. The figures for 2009, a year in which the economy has weakened further and unemployment has climbed substantially, will look considerably worse, and the figures will likely worsen again in 2010 if, as many economic forecasters expect, unemployment continues to rise in that year. (9/10/09, CBPP)

Private Health Coverage Declined, Became Less Secure In 2008: New Census Data Underscore Importance of Comprehensive Health Reform

“The Census Bureau reported today that 46.3 million U.S. residents lacked health insurance in 2008, an increase of 632,000 over the previous year. Nearly 6.6 million more people were uninsured in 2008 than in 2001, when the previous recession hit bottom. “The number and share of people without health insurance are doubtless higher now (in September 2009) than these figures show, since the unemployment rate has grown substantially over the past year and many people have lost their health insurance along with their job.” (9/10/09, CBPP)

Employer Requirement in Baucus Health Package Would Have Unintended Effect Of Discouraging Hiring Of Low-Income And Minority Workers

“[A] proposal included in the new health reform package that Senator Max Baucus unveiled this weekend would have serious consequences, particularly for low-income and minority workers and women?. [It] would discourage the hiring of lower-income people. And since minorities are more likely to have low family incomes than non-minorities, a larger share of prospective minority workers would likely be harmed.” (9/7/09, CBPP)

Paying the Price: How Health Insurance Premiums Are Eating Up Middle-Class Incomes--State Health Insurance Premium Trends and the Potential of National Reform

The rapid rise in health insurance premiums has severely strained U.S. families and employers in recent years. This analysis of federal data finds that if premiums for employer-sponsored insurance grow in each state at the projected national rate of increase, then the average premium for family coverage would rise from $12,298 (the 2008 average) to $23,842 by 2020—a 94 percent increase. However, if health system reforms were able to slow premium growth by 1 percentage point in all states, by 2020 employers and families together would save $2,571 per premium for family coverage, compared with projected trends. If growth could be slowed by 1.5 percentage points—a target recently agreed to by a major industry coalition—yearly savings would equal $3,759. The analysis presents state-by-state data on premium costs for 2003 and 2008, as well as projections, using various assumptions, for costs in 2015 and 2020. (8/20/09, Commonwealth Fund)

HR 3200 Health Reform Analysis and Overview
A new document provides a detailed comparison of the key child and family provisions in the House Tri-Committee and Senate HELP Committee proposals. On the "Say Ahhh!" blog, Dawn Horner provides an overview of the most notable amendments and changes in the House bill for children and families. (August 2009, Georgetown University Health Policy Institute, Center for Children and Families)

Coverage Denied: How the Current Health Insurance System Leaves MILLIONS Behind
A large proportion of Americans have health conditions that insurance companies can qualify as "pre-existing conditions," that preclude affordable, accessible coverage. (US Dept of HHS)

Last Chance for the Public Option? Reports of Its Demise Could Be Premature
Administration officials should have been able to predict that the public option -- a Medicare-like program from which Americans could chose to get their health insurance -- would eventually become the ideological flashpoint of the entire debate. Congress reconvenes soon, and the ugliest parts of this debate -- the lies about death panels and covering undocumented immigrants, the accusations of Nazism, the assault-weapon-toting nutballs -- will fade into the background. The next phase is the actual process of legislation (just as ugly, perhaps, in its own way). There are a number of different scenarios, so it's worth going through step by step to see where this whole mess might actually end up. (8/25/09, American Prospect)

Key Issues in Health Reform

Covers: The federal government’s role in financing and delivering health care; Lowering the rate of growth of Medicare spending; Advance care planning for serious illness (8/20/09, Health Affairs)

Who's Paying to Kill Health Reform?
In watching town hall after town hall, many of us have looked at attendees frantically spouting nonsense about "death panels" and comparing the public health insurance option to Hitler and wondered, "where do they get these people?" Click to see graphic that attempts to explain this (8/24/09, Campaign for America's Future)

Does Medicare Under-Pay Hospitals?
An overview of the Medicare reimbursement issue--particularly as it pertains to hospitals. Medicare is the second largest health care payer in America, trailing only Medicaid. The program is very popular with its enrollees, with polls showing a higher level of satisfaction than with private insurance. Medicare is less popular with hospitals. Opponents of health care reform in general and of a strong public option in particular often cite hospital dissatisfaction with Medicare as a reason why the reform programs won't work. They report that evidence suggests that overall Medicare pays hospitals less than what it costs them to provide care. Private insurers pay more, and by "cost-shifting," hospitals use these payments to make up the losses on Medicare. Opponents worry that if a public option linked to or modeled on Medicare becomes the dominant payer for people under 65, hospitals will go broke without the "subsidy" from private insurers, and the health system will be destroyed. Data collected by hospital groups and the insurance industry suggests that this is unlikely to happen. (8/24/09, Health Beat)

Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2009 Update

Young adults ages 19 to 29 are one of the largest segments of the U.S. population without health insurance: 13.2 million, or 29 percent, lacked coverage in 2007. They often lose coverage at age 19 or upon high school or college graduation: nearly two of five (38%) high school graduates who do not enroll in college and one-third of college graduates are uninsured for a time during the first year after graduation. Twenty-six states have passed laws to expand coverage of dependents to young adults under parents' insurance policies. Congressional proposals to reform the health system could help uninsured young adults gain coverage and prevent others from losing it. (8/6/09, Commonwealth Fund)

Many Seniors Worry Health Reform Could Hurt Instead Of Help

Polls, events and Congressional offices report that far lower proportions of seniors than other groups support health reform, and they are genuinely worried about losing current benefits. (8/13/09, Medical News Today)

82% majority of Canadians believed their country's health care system was superior to the U.S. system

A recent Harris/Decima poll in Canada that found a 10-to-1 majority of Canadians believed their system was "superior" to the U.S. system. They might also note that a 70% majority of Canadians thought their system was "performing well"; and that a majority favored an expansion of public sector health care (i.e., "government-run" health care in the current debate) over private sector health care. (8/1/8/09, Harris Poll Weekly)

"34% of adults now think that Obama's proposed (health care) reform would be bad for 'people like you,' compared to only 18% in January..."

The More People Think They Know about Obama's Health Care Reform Proposals The More They Oppose Them. In late January only 17% of the public claimed to know much about President Obama's health care reform proposals. By late July, just before the president's press conference on July 22nd, that number had more than doubled, to 36%, while fully 72% felt they knew "a lot" or "some." The full importance of this question is that how much people feel they know about the president's proposals are strongly correlated with opposition to them. (8/11/09, Harris Poll Weekly)

Recent Harris Polls Show Increased Opposition to Obama's Health Care Reform Proposals But Majority Support the 'Public Option'
Two recent Harris Polls provide new information on public attitudes to President Obama's health care reform proposals. However, both of these were conducted before President Obama's press conference on July 22nd in which he made an eloquent plea for public support and which may have influenced public opinion after these two surveys were conducted. (8/10/09, Healthcare News)

How Health Care Reform Can Lower the Costs of Insurance Administration
A national health exchange that includes both public and private plan options as part of comprehensive health reform may save up to $265 billion over 10 years in insurance administrative costs, in part by reducing insurance companies’ spending on brokers’ commissions and marketing. (July 2009, Commonwealth Fund)

Health Care Premiums Run Amok: The Cost of Doing Nothing about the Health Care Crisis

shows that, without health reform, average family premiums will grow to more than $22,000 by 2019, up from $13,000 today. And once copayments and other out-of-pocket expenses are factored into the total, overall family health care costs will be even higher. This memo includes the forecasted premium increases for each state. (7/24/09, Center for American Progress)

State Variation and Health Reform
discusses how the impact of reform on individual states will vary based on their economic situation, current health coverage, and health care expenditures. This analysis pulls together key information related to state variation, including their economic profiles, Medicaid and CHIP eligibility and enrollment levels, coverage of the non-elderly population, and their individual and small-group markets. (8/6/09, KFF)

Coverage for Low-Income People: Should the Medicaid Program Be Expanded to Cover More of the Uninsured? Should There Be Changes in the Children’s Health Insurance Program?

examines the options being debated by key congressional committees and summarizes arguments for and against expansion of these public programs. The proposed changes could raise income eligibility levels, allow low-income individuals to buy private insurance with help from subsidies, or even enroll in a public option. (7/23/09, Health Affairs)

Too Sick for Health Care: How Insurers Limit and Deny Care in the Individual Insurance Market

reveals the practices insurers use against the roughly one in four Americans who either purchase their insurance in the individual market or have considered doing so. This memo, and the accompanying 50 state fact sheets, examine how insurers in this market offer weak benefits, exclude benefits, cancel coverage, and limit coverage. (7/20/09, Center for American Progress)

Failure to Protect: Why the Individual Insurance Market Is Not a Viable Option for Most U.S. Families

finds that, over the last three years, nearly three-quarters of people who tried to buy coverage in this market never purchased a plan, primarily due to high premiums. More than two out of five adults with coverage through the individual market reported not getting needed health care because of cost. People with such coverage also spend far more out of pocket than those with job-based coverage and are more vulnerable to catastrophic health care costs. (7/21/09, Commonwealth Fund)

The Clock Is Ticking: More Americans Losing Health Coverage
Each week, another 44,230 Americans lose health coverage. That adds up to a staggering 2.3 million people losing coverage per year, which further makes the case for the urgency of action on health reform. This new report provides the first ever state-by-state data on the number of people who are expected to lose health coverage between the beginning of 2008 and the end of 2010. Numbers are broken down per week, per month, and per year. (7/16/09, Families USA)

Should Health Benefits Be Taxed So More Can Be Insured?
Health Affairs and the Robert Wood Johnson Foundation (RWJF) released the latest in a series of Health Policy Briefs, which provide objective, non-partisan analysis of policy proposals related to health reform. (7/9/09, Health Affairs)

Private and Public Insurance Choices Would Help Reduce Administrative Health Care Costs by $265 Billion Over 10 Years

As lawmakers debate how to pay for an overhaul of the nation's health care system, a new report from The Commonwealth Fund projects that including both private and public insurance choices in a new insurance exchange would save the United States as much as $265 billion in administrative costs from 2010 to 2020. Congressional leaders are attempting to keep 10-year federal budget costs of health care reform legislation under $1 trillion. (7/16/09, Commonwealth Fund)

Fork in the Road: Alternative Paths to a High Performance U.S. Health System

Expanding health coverage to nearly all Americans through a national insurance exchange could reduce national health expenditures by between $1.2 trillion and $3 trillion over 11 years, estimates a new study. The study estimates that an insurance exchange offering a choice of private health plans could save an estimated $1.2 trillion over 11 years, when combined with certain other reforms proposed by a Commonwealth Fund commission. Including in the exchange a public plan that reimburses health care providers at rates midway between current Medicare and private plan rates could save $2 trillion over 11 years, while a public plan that reimburses providers at current Medicare rates could save $3 trillion, the study adds. (6/24/09, Commonwealth Fund)

Cost Implications of Three Health Reform Scenarios, with Alternative Public Plan Options

A comprehensive approach to health insurance, provider payment, and care delivery system reforms has the potential to slow health care cost increases while achieving near-universal coverage. The potential savings for families, businesses, and the federal government vary markedly, however, depending on whether or not a public insurance plan option is included and how such a plan is structured, according to a new analysis from The Commonwealth Fund. (6/24/09, Commonwealth Fund)

AFL-CIO 2009 Health Care for America Survey

The results of the online 2009 Health Care for America Survey, sponsored by the AFL-CIO and Working America, reveal deep problems that must be fixed. A total of 23,460 people responded to the survey, which was conducted between April 1 and May 31, 2009. And more than 6,000 people took the time to tell heart-wrenching stories about the toll of health care costs, lack of insurance, systemic flaws in our health care system and the economic downturn. (July 2009, AFL-CIO)

Health benefit tax could single out Florida
Employer-based health insurance in South Florida costs 21% more than the national average, so the region would be in the cross-hairs if a Senate proposal to tax the most expensive plans goes anywhere. (7/11/09, Miami Herald)

Three Proposals to Pay for Health Care Reform: Impacts on People in Your State
State Fact Sheets and Analysis

Congress will likely pay for health care reform partly by finding savings in the existing health care system and partly by raising revenue in other ways. There are several ways that Congress can raise this additional revenue without hurting families who are already struggling to pay for health care and other necessities. CTJ has analyzed three of these progressive revenue options -- the House Ways and Means Committee surcharge proposal, the President's proposal to limit itemized deductions for high-income taxpayers, and a proposal formulated by CTJ to make the Medicare tax fairer and more progressive. (July 2009, Citizens for Tax Justice)

Some States May Have to Foot More of the Health Care Overhaul Bill
Thus far, battle lines in the health care debate "have been drawn largely in partisan terms," but due to the fact that certain states will have to bear more of the costs of reform, "lurking regional divisions could fracture Congress even further" and make it more difficult to find a compromise. (7/6/09, Los Angeles Times)

Changes to the Tax Exclusion of Employer-Sponsored Health Insurance Premiums: A Potential Source of Financing for Health Reform

"Many have suggested that reducing or eliminating the tax exclusion of employer-sponsored health insurance (ESI) could generate significant additional tax revenue to fund expansions in health insurance coverage," write the authors of a recent paper that explores "revenue and distributional consequences of several policy options that would alter the ESI tax exclusion. The paper examines the "a cap, or dollar limit, on the amount of employer-sponsored health insurance premiums excluded from taxable income" as well as "an index that determines how this cap might grow over time." The authors conclude, "in addition to providing a source of funding for health reform and incentives for seeking less expensive coverage, limiting the tax exclusion would mitigate the huge inequities built into the current treatment of employer contributions to premiums." (6/1/09, Urban Institute)

Medicare Offers Mixed Lessons For Possible 'Public Plan'

Of Medicare, which provides coverage to more than 45 million elderly and disabled, NYT says: "How closely a new public plan would resemble Medicare is unclear. Still, Medicare's record offers insights into the benefits and pitfalls of public health care. While it has driven down costs though its sheer market dominance, Medicare has also been extremely slow in using its power to encourage or compel more effective health care. And, of course, providing health care for older Americans has been expensive. Medicare is expected to represent an estimated 13 percent of next year's federal budget. (7/4/09, New York Times)

Most Americans Want Health Reform But Fear Its Side Effects
A majority of Americans see government action as critical to controlling runaway health-care costs, but there is broad public anxiety about the potential impact of reform legislation and conflicting views about the types of fixes being proposed on Capitol Hill, according to a new poll. Sixty-two percent of Americans support the public plan option under health reform, but when respondents were told having a public plan meant some health insurers would go out of business, support dropped to 37 percent. (6/24/09, Washington Post/ABC News)

Health Affairs/RWJF Policy Brief: A Public Health Insurance Plan
Strong divisions among lawmakers and interest groups have developed over whether or not a public plan should be included in health reform legislation. Supporters argue that a plan could lower administrative costs and leverage greater bargaining power to reduce health care costs for enrollees. Those opposed to a public plan say that a public plan would not be fiscally responsible or sustainable. Opponents also argue that a new government-run plan would crowd private insurance companies out of the market and eventually lead to a universal system of government-run health care. (6/19/09, RWJF)

Primary-Care Doctor Shortage May Undermine Reform Efforts
As the debate on overhauling the nation's health-care system exploded into partisan squabbling this week, virtually everyone still agreed on one point: There are not enough primary-care doctors to meet current needs, and providing health insurance to 46 million more people would threaten to overwhelm the system. (6/20/09, Washington Post)

Health Reform & Adolescents

A new report finds that many American adolescents are suffering from unmet physical, reproductive and behavioral health needs. The report finds that many adolescents are uninsured and have limited options for purchasing insurance that meets their unique health needs. also explores the issues of patient confidentiality, finding that the vast majority of health insurance agencies violate adolescents’ privacy by mailing home an explanation of benefits statement for services billed by providers. This often discloses sensitive and confidential services such as STD screenings and treatment. (6/26/09, First Focus)

New Report: Private and Public Insurance Choices Would Help Reduce Administrative Health Care Costs by $265 Billion Over 10 Years
As lawmakers debate how to pay for an overhaul of the nation's health care system, a new report from The Commonwealth Fund projects that including both private and public insurance choices in a new insurance exchange would save the United States as much as $265 billion in administrative costs from 2010 to 2020. (7/16/09, Commonwealth Fund)

House Health Bill’s High-Income Surcharge: A Reasonable Approach

“The House surcharge proposal is reasonable and well-targeted. In recent decades, incomes have grown disproportionately for households at the top of the income scale, while their taxes have fallen substantially. Moreover, despite charges to the contrary, the proposal would have only a small impact on small businesses.” (7/17/09, CBPP)

Legislating Under the Influence Health Care Report
A recent poll found that 60 percent of voters believe Congress puts the interests of campaign contributors over constituents, and 79 percent are worried that dependence on large campaign contributions will prevent Congress from tackling the important issues facing America today. A look at the numbers shows that citizens are right to worry. Major health care interests have spent $1.4 million per day this year lobbying Congress, so you can bet the legislative battle will not simply rest on the merits of each side’s argument. Health care-related industries wield tremendous influence in Washington and have sustained an expensive, high-intensity campaign to protect their own interests. (6/24/09, Common Cause)

Avalere Analysis of Proposed Elimination of Coverage Gap

Proposed health reform legislation from the House of Representatives will completely eliminate the Part D doughnut hole in 14 years, but would provide more immediate assistance to people using high-cost specialty drugs by progressively narrowing the coverage gap. (June 2009, Avalere Health)

Senate Finance Committee Faces Difficult Choices In Lowering Cost of Health Bill
Subsidy Changes Could Leave Some Without Affordable Coverage

The Senate Finance Committee is seeking to reduce the cost of its health reform bill to approximately $1 trillion over ten years, but faces difficult choices in doing so. Among the modifications it is considering are changes in subsidies intended to help low- and moderate-income families and individuals afford insurance. Some of these changes which would make it more difficult for moderate-income households (those between 300 percent and 400 percent of the poverty line) to afford insurance, which would likely result in a number moderate-income people remaining uninsured. At the same time, these changes would be preferable to changes that would adversely affect people with incomes below 300 percent of the poverty line, where the consequences of rolling back subsidies or benefit packages would be still more severe. (7/1/09, CBPP)

Health Disparities: A Case for Closing the Gap
The United States spends more than any other nation in the world on health care. Despite consistent increases in spending, disparities among demographic groups persist. Low-income Americans and racial and ethnic minorities experience disproportionately higher rates of disease, fewer treatment options, and reduced access to care. With unemployment on the rise, the disparities already apparent among these groups will continue to increase. This new report demonstrates the need for reform that reduces costs to make health care affordable; protects a patient's choice of doctors, hospitals, and insurance plans; invests in prevention and wellness; and assures quality, affordable health care for all Americans. (June 2009, US DHHS)

Reducing Medicaid and Medicare Drug Costs Could Help Pay For Health Reform

By lowering the costs that Medicaid and Medicare pay for prescription drugs, Congress could generate substantial savings to help pay for comprehensive health reform that achieves universal coverage. (6/11/09, CBPP)

Maintaining Current Value of Itemized Deductions For High - Income Taxpayers Could Help Pay For Health Care Reform

If Congress rejects the President’s proposal to help pay for health care reform by limiting the value of itemized deductions for high-income filers, it should at least prevent those subsidies from expanding in 2011, as they would under current law. Simply keeping the value of itemized deductions for filers in the top two brackets at their current levels would raise $68 billion over ten years according to the Urban-Brookings Tax Policy Center. (6/10/09, CBPP)

Some Media Reports Mischaracterize CBO Estimate of Senate “HELP” Health Reform Bill; Final “HELP” Bill Likely To Cover Many More People Than Partial Draft CBO Analyzed

The news media are widely reporting that, according to a partial and preliminary Congressional Budget Office (CBO) analysis, health reform legislation that the Senate Committee on Health, Education, Labor, and Pensions (HELP) is developing would cut the number of uninsured by only 16 million people while costing $1 trillion over ten years. That conclusion, however, is incorrect. The CBO analysis covers only a part of the HELP plan (the parts for which the Committee gave CBO detailed specifications) and does not include major elements of the plan that would further substantially reduce the number of uninsured. (6/16/09, CBPP)

Crossing Our Lines: Working Together to Reform the U.S. Health System

This report aims to provide quality, affordable health coverage for all Americans and includes recommendations to improve quality and control costs. Authors Howard Baker, Tom Daschle and Bob Dole address key issues, including the need for strong insurance reforms that require guaranteed issue; the elimination of medical underwriting for pre-existing conditions and rating limitations; new state and regional coverage options through exchanges; reforms that constrain cost growth; and financial assistance through Medicaid and tax credits. The two-year consensus-building process has been supported by the Robert Wood Johnson Foundation. (6/17/09, The Leaders' Project on the State of American Health Care)

New Polls Find Support For Health Reform, Fear Of Costs
A series of new polls show support for major health care reform, but trepidation about certain policy proposals, and anxiety about quickly growing health care costs, the possibility of losing coverage, and the federal budget deficit in general. (6/19/09; AP, WSJ, NYT, SF Chronicle in MedNews Today)

Insurers Support Coverage Mandate Because It's Good for Business
Having previously fought the health care reform efforts of President Bill Clinton, the health insurance industry is now supporting a major overhaul of the system, particularly a requirement that everyone purchase coverage, mostly because it "faces a bleak future" if such a mandate is not adopted. (6/7/09, LA Times)

Employer Requirement Under Consideration For Senate Finance Committee Health Bill Could Discourage Hiring of Low-Income, Minority, Disabled Workers

"While an employer responsibility requirement is an essential component of health care reform, a proposal that the Senate Finance Committee and the Senate Health, Education, Labor, and Pensions Committee are considering for the forthcoming health legislation is flawed and would have serious unintended consequences, particularly for low-income and minority workers and workers with disabilities." (6/24/09, CBPP)

The Last Piece of the Puzzle: Providing High-Quality, Affordable Health Coverage to All Children through National Health Reform
This report provides a blueprint of how to fill in the health coverage gaps for children and build a family-friendly health care system that addresses children's unique needs. (May 2009, Georgetown University Center for Children and Families)

Explaining Health Care Reform: What are Health Insurance Exchanges?
Various health reform proposals being discussed suggest developing an 'exchange' or a market-place where uninsured individuals will be able to purchase coverage. This brief explains the purpose and function of exchanges, how they would relate to greater regulation of the insurance market, and some of the key questions likely to be addressed by any health reform proposal that calls for the creation of exchanges. (May 2009, KFF)

Rules of the Road: How an Insurance Exchange Can Pool Risk and Protect Enrollees
Several leading proposals for major health reform include a new entity — sometimes called an “exchange” — that would offer a choice of health insurance plans to individuals and, if designed well, provide insurance options that are affordable, comprehensive, and easy for consumers to compare. This report discusses features that should be included in a health insurance exchange so that it provides individuals with coverage options that are affordable, comprehensive and easy to compare. (5/31/09, CBO)

HHS Report, Forum Call for Health Reform to Reduce Disparities
Low-income Americans and racial and ethnic minorities experience disproportionately higher rates of disease, fewer treatment options and reduced access to care, according to a report released today by Health and Human Services that calls for reducing disparities as part of health reform. The report was released in conjunction with a White House forum on health reform and disparities. At a news briefing this morning, members of the Congressional Black Caucus, Congressional Hispanic Caucus and Congressional Asian Pacific American Caucus announced their reform priorities for reducing racial and ethnic health disparities. The groups called for elevating the National Institutes of Health’s National Center on Minority Health and Health Disparities and strengthening HHS’ Office of Minority Health. They also called for a public health insurance plan option and adequate reimbursement for language and translation services. (6/9/09, DHHS)

Health Reform: Cost of Failure
Examines three different scenarios that could occur if the U.S. does not reform its health care system. It concludes that in the best case scenario, inaction could increase family and individual spending by at least 46 percent and nearly double government expenditures as more U.S. residents become eligible for programs such as Medicaid and CHIP. (5/21/09, RWJF)

White House: The Economic Case for Health Care Reform
Slowing the annual growth rate of health care spending by 1.5 percentage points would improve Americans’ standard of living, and reduce the federal budget deficit and the unemployment rate, concludes a new report by the White House Council of Economic Advisors. In addition, expanding coverage would increase the economic well-being of the uninsured, likely increase labor supply and improve the functioning of the labor market. The three-member council advises the president on the formulation of both domestic and international economic policy. (6/2/09, The White House)

Report Recommends Ways to Increase Coverage Among Children
This report recommends expanding Medicaid and Children’s Health Insurance Program eligibility to help cover the nearly 9 million remaining uninsured children in the U.S. It suggests allowing families with incomes up to 150% of the federal poverty level to enroll in Medicaid and children in families with incomes up to 300% of the FPL to enroll in CHIP, while providing flexibility for states wishing to expand eligibility further. For ineligible families, it recommends establishing an insurance exchange and providing subsidies to help them afford coverage. Ensuring access to care will require major new federal resources, it said, suggesting that the federal government require Medicaid and CHIP reimbursement rates to be comparable to Medicare. (5/29/09, Georgetown University Health Policy Institute Center for Children and Families)

Designing Benefit Standards for a Health Insurance Exchange

explains that, in any exchange that is created as part of health reform, it is crucial to establish benefit standards so that all plans cover a comprehensive range of services, thereby ensuring that individuals and small businesses have a choice of affordable, comprehensive plans. These benefit standards would protect people with particular medical conditions from facing excessive costs, and they would better enable consumers to compare plans based on price and quality. (5/21/09, CBPP)

Ensuring Affordable Health Coverage and Health Care Services in an Insurance Exchange

finds that any health reform proposal that requires everyone to obtain health insurance must establish mechanisms to make health coverage and health care affordable. It also identifies four key components that any successful exchange should have: minimum standards for benefit packages, limits on the degree of variation in different benefit packages, limits on the number of different plan choices, and a requirement that insurers in the exchange offer the full range of benefit packages. (5/21/09, CBPP)

Medicaid as a Platform for Broader Health Reform: Supporting High-Need and Low-Income Populations

summarizes the problems that low-income individuals face in today's health care system and explores policy options for expanding Medicaid to cover more of this population as a base for broader health reform efforts. The report finds that Medicaid can provide a strong foundation that can help ensure the success of broader reform efforts by maintaining coverage for the poor and sick while providing a vehicle to reach low-income adults. (5/12/09, KFF)

Meeting Enrollees’ Needs: How Do Medicare and Employer Coverage Stack Up?

finds that elderly Medicare beneficiaries reported greater overall satisfaction with their health coverage, better access to care, and fewer problems paying medical bills than those under age 65 who are covered by job-based plans. This study was designed to examine whether a public plan could potentially improve access to necessary services and reduce the burden of medical bills for individuals under age 65. (5/12/09, Commonwealth Fund)

Building Momentum as Democrats Forge Health Care Reform
This review of recent action on health reform discusses industry and provider groups' pledge to reduce spending by $2 trillion over the next 10 years, noting that the groups' pledge was a "recognition that the pace of reform is quickening and they wanted to be a full participant in negotiations." It also addresses congressional action, including discussions of a public insurance option and how lawmakers are attempting to address the cost of reform. (5/14/09, NEJM)

Forging a New Plan For Health Care: Principles and Priorities for Sustainable Reform

The U.S. stands poised to enact dramatic and far-reaching changes to health-insurance markets in the name of expanding insurance coverage to the more than 45 million uninsured and controlling rapidly rising health-care costs in both the public and private sectors. Early signals from Congress and the administration indicate that many of these changes will involve expansions of existing government programs like Medicare and Medicaid, massive new regulation of private insurance providers, and trillions of dollars in new federal spending that will have to be financed through new taxes or substantial rationing of patient access to health-care goods and services. This paper makes the fiscal and political case for bipartisan health-care reform that: addresses dysfunctions in the existing health-care-delivery system; expands access to affordable private health insurance in an incremental and fiscally responsible manner; and improves market-based options for consumer access to information on health-care quality. (May 2009, Manhattan Institute for Policy Research)

Tax on Employer Health Benefits Could Be Used to Pay for System Overhaul
"A new tax on employer-provided health insurance is emerging as a likely option to finance an overhaul of the nation's health-care system," but opposition to the plan is coming from many directions. (5/22/09, Washington Post)

Study Lends Urgency to Passage of Health Care Legislation
A study by the Robert Wood Johnson Foundation found that in 10 years the number of uninsured Americans could reach beyond 65.7 million and health care costs could more than double, a situation that is motivating lawmakers to pass a bill to revamp the health care system by the end of the year. (5/21/09, Reuters)

Too Great a Burden: Americans Face Rising Health Costs

Nearly one in four Americans under the age of 65—some 64.4 million people—will spend more than 10 percent of their pre-tax family income on health care in 2009.... And 18.7 million non-elderly Americans.... are in families that will spend more than 25 percent of their income on health care in 2009. What’s even more troubling is that most of these Americans are in families who already have health insurance. 82.6% of Americans in families that spend more than 10% of income on health care are insured, and 76.4% of Americans in families that spend more than 25% of income on health care are insured.With the economy in decline and unemployment at its highest rate in decades, more people are out of work and losing their health coverage as a result. Yet even those with insurance are exposed to thinner coverage and higher out of pocket costs. The need to secure true health reform has never been more urgent: The economic security of American families lies in the balance. (May 2009, Families USA)

Limiting the Tax Exclusion For Employer-Sponsored Insurance Can Help Pay For Health Reform; Universal Coverage May Be Out of Reach Otherwise

Congress is unlikely to be able to finance health reform legislation that includes universal coverage unless it limits the exclusion of employers’ health insurance payments from workers’ income and payroll taxes. Limiting the exclusion could provide significant revenues for health reform without eroding employer-sponsored insurance or causing other undesirable side effects - if the cap and the rest of the health reform legislation are well designed. (6/2/09, CBPP)

Paying for Health Reform

The next in a series of reports about how policymakers could pay for health reform that extends insurance to all Americans and slows the growth of health care costs:
Curbing Flexible Spending Accounts Could Help Pay For Health Care Reform

Reversing the Erosion in Alcohol Taxes Could Help Pay For Health Care Reform

Taxing High-Sugar Soft Drinks Could Help Pay For Health Care Reform (5/27/09, CBPP)

Report Highlights National Cost of Chronic Disease
The U.S. spent an estimated $1.7 trillion treating patients with one or more chronic diseases in 2007, about three-quarters of total health care spending. “The health of our nation and our economy will only improve when we move from a ‘sick-care’ system focused on treating chronic diseases to a true health care system devoted to prevention and wellness,” said former Surgeon General Richard Carmona, M.D., PFCD chairperson and president of the Canyon Ranch Institute. Reducing the prevalence of chronic disease through an increased focus on wellness is one pillar of the AHA’s framework for reform, Health for Life: Better Health. Better Health Care. The AHA is a national PFCD partner. (5/14/09, second annual Almanac of Chronic Disease by the Partnership to Fight Chronic Disease)

Key Priorities to Help Low-Income Medicare Beneficiaries

discusses three actions Congress should take to improve the Medicare Savings Programs (MSPs) and the Part D Low-Income Subsidy (LIS) as part of health reform. (May 2009, Families USA)

Medicare: Helping Low-Income Seniors and People with Disabilities

examines the high out-of-pocket costs Medicare beneficiaries face and how health reform should improve existing programs that help them afford these costs. (May 2009, Families USA)

Continued Listings: Florida Reports

State, U.S. Hospital Rankings Differ

Judging by Florida’s online healthcare guide, Jackson Health System in Miami is among an elite group of 14 best hospitals for treating heart attacks. But a federal site shows Jackson as among the country’s worst. Which are we supposed to believe? (7/22/09, Health News Florida)

43.8 Million Americans Uninsured in 2008 include almost half of Floridians
An estimated 43.8 million Americans had no health insurance in 2008, according to a new CDC report. That’s 700,000 more people than in 2007 and 2.8 million more than in 1997. Only 56 percent of Floridians under age 65 had private health coverage last year, according to a new federal survey. One-fourth of the others were uninsured and the rest were covered by a government program.Massachusetts had the lowest percentage of uninsured residents under age 65 (3.4%), and Texas had the highest (22.9%). An estimated 8.9% of children had no health insurance, the same as in 2007 but down from 13.9% in 1997. (7/01/09, CDC)

Miami's patient co-pays highest
In a list of the 10 U.S. hospitals with the highest out-of-pocket costs for Medicare patients, six are in Miami-Dade. Note: The highest-cost hospital, Cedars Medical Center, is now University of Miami. (7/8/09, US News & World Report)

Florida Medicaid grew 13% in past year
Spurred by high unemployment, Florida Medicaid enrollment grew by more than 13 percent in the past year to 1.6 million, according to new state data. Still, only two of three Floridians who qualify for Medicaid are enrolled. (7/1/09, Health News Florida)

Florida Medicaid, KidCare enrollment up

The number of women and children enrolling in Medicaid, the safety net health care program for the poor, and KidCare is expected to rise as the state economy continues to lag, a reports says. The News Service of Florida reports that state economists spent Monday going over new forecasts for both the Medicaid program – which is funded with a combination of state and federal money – and KidCare, the state-subsidized children’s health insurance program.Those latest forecasts show an 8 percent growth in the number of pregnant women who are below the poverty line and enrolled in Medicaid during the fiscal year that ended on June 30. But that growth is expected to surge to nearly 15 percent in the coming year.The numbers are even more dramatic for children. (7/21/09, Health News Florida)

FL quality rated below average in new federal report
Quality of health care in Florida is rated “weak” or “very weak” on five of a dozen measures, with the worst scores going to diabetes and respiratory care. Florida’s strengths are in home-health care and cancer treatment, the report by the Agency for Healthcare Research and Quality. The state received an average score in five categories. (6/30/09, AHRQ)

Medicaid Reform: Legislature Should Delay Expansion Until More Information Is Available to Evaluate Success

Nearly three years into a Medicaid privatization program former [Florida] Gov. Jeb Bush said could be a national model, state officials say they do not have crucial data to measure the program's effectiveness, including how many patients' treatments and prescriptions have been approved or denied. There is "little evidence" that the program "has improved health care or saved the state money." Florida's Agency for Health Care Administration, which "oversees the pilot" told the AP in an email that due to an overhaul of their computer system, they "do not have usable data at this time." (6/2/09, OPPGA)

Malpractice Suits, Other Factors Contribute to Rise in Caesarean Births
In hospitals across the country but particularly in Florida, surgical births are becoming a given. Nearly 40 percent of Florida babies were born by C-section in 2008; in the Tampa Bay area, the rate is 38 percent. The U.S. rate in 2007 (the most recent year available) was 31.8 percent. A decade ago, the national rate was 21 percent and Florida's was 23 percent. Many doctors believe that the increase in caesarean section births in the U.S. over the last decade has been fueled by three main factors -- fear of malpractice lawsuits, a decrease in vaginal births after c-sections and rising rates of obesity. (6/17/09, St. Petersburg Times)

Nonprofits & The Economy Survey
The Community Foundation for Palm Beach and Martin Counties and Allegany Franciscan Ministries recently released the full results of the Nonprofits and the Economy Survey. Over 300 nonprofit organizations responded to the survey, which asked them about their current challenges, the impact the economic downturn is having on the services they offer and their most pressing funding needs. To schedule a presentation for your organization, please contact the Community Foundation at 561-659-6800 ext. 121 or kparmelee@cfpbmc.org. (May 2009, Community Foundation for Palm Beach and Martin Counties and Allegany Franciscan Ministries)

Floridians 50-to-65 Losing Coverage

In Florida, the ratio of workers ages 50 to 65 who lacked health coverage in a study two years ago had tripled in this decade to 18 percent, an AARP study found. A spokesman said the numbers have doubtless grown since then because of the recession in a trend AARP views as alarming. (5/8/09, AARP in Tampa Tribune)

Medicare Fraud Prevalent In South Florida

Just 2% of Medicare beneficiaries in the U.S. live in South Florida, but the area accounted for 17% of Medicare's total spending on inhalation drugs in 2007 because of potential fraud, according to a new fraud report. (April 2009, HHS Office of Inspector General)

Reports Criticize Health Care At U.S., Florida Immigration Detention Centers
The Immigration and Customs Enforcement agency routinely delays, denies or provides low-quality medical care for detained immigrants in ill-equipped facilities nationwide, according to two new reports (March 2009, Human Rights Watch and the Florida Immigrant Advocacy Center)

A Closer Look at Tobacco Taxes: “Florida’s Fiscal Crisis: The Prescription”
This report recommends: Raise the cigarette tax by $1.00 per pack and increase the tax on "other tobacco products" to 100% of the wholesale price. It is estimated that this change in tax rate will add an additional $1,000.8 million to the state's recurring general revenues. (March 2009, Florida Center for Fiscal & Economic Reform)

ASTHO 2008 Florida Snapshot: Activities to Promote Health Equity
The Association of State and Territorial Health Officials (ASTHO) has published online snapshots highlighting state activities that promote health equity. Nearly every state is represented. This online tool features an overview of each state’s health priorities, a flowchart outlining the organization and infrastructure of state departments of health, each state’s activities and/or organizations that address the social determinants of health.

Florida among 10 worst states for adult diabetes
In just one decade, Florida has gone from having one of lowest rates of adult diabetes in the country to cracking the top 10 worst, federal health officials reported Thursday. Diabetes more than tripled in Florida in the past decade while it was doubling at the national level, according to CDC. (10/31/08, South Florida Sun-Sentinel)

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

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

Dying for Coverage in Florida

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

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

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

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

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

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

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

Miami-Dade Health Profiles 2007

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

(Florida) AHCA's Annual Report on Medicaid Reform

(delivered 10/1/07)

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

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

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

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

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

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