October 24, 2007 Following Failure to Override President’s Veto, SCHIP in Uncertain Seas As expected, on October 18, the US House of Representatives fell 13 votes short of overriding President Bush’s veto of the SCHIP funding bill. The bill, funded with $35 billion over five years raised by an increase in the federal tobacco tax, would have provided health insurance for 10 million children from working families who are not eligible for Medicaid but do not earn enough to afford private health care. (by Andrew Leone, Florida CHAIN)  Read more 1. Todd T. relies on Medicaid services threatened by Reform 2. Governor Crist greets CHAIN Days participants in Tallahassee 3. Speaker at Jacksonville town hall meeting on health care access
	TAKE ACTION: Hold our U.S. Reps Accountable, and Keep Up the Advocacy on SCHIP Thank you for urging your Representatives to support overriding the President's children's health veto and for all of your responses to previous alerts on SCHIP. Now it's time for you to take the next step, and hold them accountable. Click here to see and send feedback on your representative's vote and urge next steps. (thanks to Florida Child Health Care Coalition for this alert)  After the Veto: Tax Incentives for Private  Coverage Proposed as Substitute for Direct SCHIP Coverage   In the wake of the failed efforts to override the President’s SCHIP veto, Florida's Senator Mel Martinez and Rep. Tom Feeney released their own less expensive proposal that they claim would nevertheless enable a significant number of uninsured kids to obtain coverage. The tax credit as proposed would neither spark a meaningful expansion of coverage nor leverage the private insurance market. (by Greg Mellowe, Florida CHAIN) Read more
	OIG Report Confirms Advocates' Concerns for Medicaid Patients The Medicaid Reform report by the Agency for Health Care Administration’s Office of the Inspector General (OIG), made public in early October, confirms many of the original concerns of Medicaid consumer advocates and highlights others. As Medicaid Reform was introduced in Broward and Duval Counties, the Medicaid Reform Advocates Coalition expressed alarm at the speed and lack of deliberation, and identified major areas of concern. These included quality and quantity of "choice counselors," real choice, outreach to the disabled, homeless and other hard to reach groups, and how managed care's emphasis on profit would affect beneficiaries' access to care. These and more are affirmed, and caution is urged by the report regarding expansion. (by Andrew Leone, Florida CHAIN) Read more All Invited to AHCA's Medicaid Reform Events for Consumers and Providers   Florida's Agency for Health Care Administration (AHCA) has scheduled for November 2nd through 8th: a summit on access to specialty care for Medicaid beneficiaries, and workshops for consumers and providers to provide input in experiences with the Medicaid Reform pilot projects in Broward and Duval Counties. Florida CHAIN urges participants in Reform to share their experiences at appropriate gatherings below. Please contact Greg Mellowe as soon as possible at gregm@floridachain.org to learn more about the meetings or if you or someone you know has experiences to share. Read more, see the schedule, get involved

	Florida Has Yet to Adopt Program for Disabled Workers to Keep Medicaid   Federal law now allows states to expand Medicaid for persons who work and increase their income without losing their Medicaid by requiring persons to share in the costs of their Medicaid premium. While thirty-nine states have already changed their Medicaid program, Florida still has not taken advantage of this federal program yet.  Advocates want to educate the community about this important change that can help thousands of persons with disabilities from around the state expand their opportunities to re-enter the workforce while keeping the medical care they need. (by Olga Golik, Esq., Citrus Health Network) Read more Rare Decrease in Medicaid Enrollment: Good News, Questions, Missed Opportunities In 2005-06, the number of Americans enrolled in Medicaid declined for the first time since 1998-99, according to a new report, due to: 1) increased citizenship documentation requirements, and 2) the improved economy/lower unemployment. Florida’s experience was similar to the overall trend. This reversed a pattern of increases in enrollment averaging 5 percent per year over the prior 3 years. (by Greg Mellowe, Florida CHAIN) Read more
	U.S. Senate Unanimously Approves Mental Health Parity; House Bill Pending   A longstanding inequity in the health care system is the lack of mental health “parity” in insurance coverage. Specifically, health plans place much stricter limits on access to treatment for mental health and substance abuse needs than they do on access to medical care. Efforts to establish parity at the federal level took a significant step forward this September 18, when the U.S. Senate unanimously passed the Mental Health Parity Act of 2007 (S.558). (by Greg Mellowe, Florida CHAIN) Read more
	SCHIP Vote Affects Florida Tobacco Tax Efforts As efforts to override President Bush’s veto of the SCHIP bill failed, Healthy Florida Alliance advocates and others are refocusing on efforts to increase the state’s tobacco tax to reduce illness and fund access to care. (by Andrew Leone, Florida CHAIN) Read more
	Mental Health Awareness Month Celebrated in Broward Activities related to Mental Health Awareness Month planned by the Mental Health Association of Broward and the Alcohol, Drug and Mental Health (ADM) Planning Council of Broward included an exhibit of works related to the issue at the Broward County Governmental Center. Some of the works in the show Stigma Exposed” were inspired by the experiences of individuals affected by Medicaid Reform. (by Andrew Leone, Florida CHAIN) Read more Health Care Access Rights Town Hall Series Continues   Hispanic Health Initiatives and Florida CHAIN continued their series of Central Florida town hall meetings discussing issues of health care access. Events have already taken place in Orange, Seminole and most recently in Volusia County.  One more town hall will take place in Osceola on November 1. For more information visit Hispanic Health Initiatives at www.hispanichealthinitiatives.org or call 407/339-2001. (by Andrew Leone, Florida CHAIN) Read more

	Elite Care... and Care for the Rest of Us MDVIP is a “new” concept in health care that costs, above and beyond any private insurance or Medicare: $1500 per year, per patient. One of the major problems facing Medicaid consumers in Florida is their ability to find doctors who will see them. Advocates and consumers ought to ask themselves: since when have thorough physicals, personalized care, good advice on how to prevent illness and reasonable wait times for appointments become “premium” services? (by Andrew Leone, Florida CHAIN)  Read more

	CHAIN Reaction is a bi-weekly publication of Florida CHAIN (Community Health Action Information Network), a statewide consumer advocacy organization that works toward access to quality health care, empowering people to actively shape their world by participating in civic life and caring for each other’s well being.  Florida CHAIN: 6600 Cypress Road #508, Plantation, FL 33317   info@floridachain.org     www.floridachain.org
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Following Failure to Override President’s Veto, SCHIP in Uncertain Seas   As expected, on October 18, the US House of Representatives fell short of overriding President Bush’s veto of the SCHIP funding bill.  The bill, funded with $35 billion over five years raised by an increase in the federal tobacco tax, would have provided health insurance for 10 million children from working families who are not eligible for Medicaid but do not earn enough to afford private health care. The vote to override the veto was 273 to 156, or 13 votes short of the necessary two-thirds majority of those present and voting; the House original vote on September 25 was 265 to 159, with the additional support attributable to the tireless efforts of advocates across the socio-political spectrum.   A number of national polls showed overwhelming, non-partisan support for the program, even when characterized as “government run”. President Bush and his supporters had argued that, apart form straying from its original intent to cover only poor children, the measure would have encouraged families with private health insurance to drop it in favor of the more affordable SCHIP (a phenomenon known as “crowd out”).   Supporters countered that the reauthorization bill would merely have brought into the program an additional 4 million children who are currently eligible but not covered for lack of funding.   The Florida SCHIP funded KidCare program, ironically, has just been given a $1 million boost through the next regular session by State legislators meeting to balance a $1.1 billion budget deficit. Even in the midst of the fiscal crisis, they recognized the importance of providing affordable health care to the state’s eligible children.   Meanwhile, SCHIP, originally set to expire in September, was previously extended through November 15. What will happen after that is unclear.   According to the Miami Herald, “House Speaker Nancy Pelosi, D-Calif., said Democrats will begin negotiating immediately with the White House on a compromise to renew and expand the State Children's Health Insurance Program (SCHIP) and will present the president with a new proposal within two weeks.” The only caveat she offered was that “The bottom line is insurance for 10 million children.”   The Orlando Sentinel reported on a counter proposal put forth by Florida Sen. Mel Martinez and Rep Tom Feeney of Oviedo that would cost $11.5 billion and provide incentives for participants to join private plans. According to the report, “The money would be used to enroll as many as 1.5 million lower-income children. The plan also would eliminate tobacco-tax increases that the Democrats included to pay for the program.”   Program supporters who fought hard to override the veto see long -term political advantages, even in defeat. They believe that a vote against the program will be cause for voter retribution in the 2008 election and that a more sympathetic Congress and White House will be able to do much of what was not accomplished this time around.   TAKE ACTION: See how your US Rep voted and send him or her feedback.   Read an another current CHAIN Reaction article on the tax credit proposal following the SCHIP veto.   (Submitted by Andrew Leone, Florida CHAIN)   TAKE ACTION: Tell Congress to Override and Save SCHIP Without fanfare or cameras rolling, President Bush vetoed the State Children Health Insurance Program (SCHIP) bill before him. This bi-partisan legislation would provide $35 billion to fund the reauthorization and expansion of SCHIP. It would cover up to 10 million uninsured American children who are not poor enough to qualify for Medicaid, but whose families cannot afford private health insurance.  In Florida, the long term survival of KidCare, a program that could insure up to 500,000 Floridian children, is at stake. Click here to TAKE ACTION.    Florida's U.S. Senator Bill Nelson voted for SCHIP; Senator Mel Martinez voted against. Some Florida Republican House members voted in support of SCHIP; one Democrat voted against. They ALL need to hear from us.   Click here to tell Senators Martinez and Nelson and your Florida Representative to vote to give children health  coverage by overriding the President's veto - and that Americans of all political stripes overwhelmingly support SCHIP reauthorization and expansion. TAKE ACTION: Hold our U.S. Reps Accountable, and Keep Up the Advocacy on SCHIP Thanks for urging your Representative to support overriding the President's children's health veto, and all your responses to previous alerts on SCHIP. Now it's time for you to take the next step, and hold them accountable. TAKE ACTION Check your U.S. Rep's vote and write or call Although 70 to 80 percent of the public, Republicans and Democrats alike, supports the child health legislation vetoed by the President, a minority in the House were able to just barely prevent the 2/3 vote needed to override. But a diverse powerful and committed movement has galvanized around this bill, and this is a temporary setback. Supporters of children’s health coverage are working in Congress to see that ten million children will not go without care.   Meanwhile, you must continue to do your part by holding your U.S. Representative accountable: Florida U.S. Reps Voting YEA to Override: Republicans Buchanan and Young joined Democrats Boyd, Brown, Hastings, Klein, Mahoney, Meek, Wasserman-Schultz, Wexler, and Castor (Castor had previously voted against the bill) Voting NAY: Republicans Bilirakis, Brown-Waite, Crenshaw, L. Diaz-Balart, M. Diaz-Balart, Feeney, Keller, Mack, Mica, Miller, Putnam, Ros-Lehtinen, Stearns, Weldon If your rep voted to override the veto, please write or call to say thanks.  If your rep voted no, write or call to say how disappointed you are that he or she stood in the way of providing health care for millions children who need it. Remind all reps that: You'll continue to watch how they vote. Hard working families are facing the harsh reality of not having health care for their children.  2,000 children a day join the ranks of the uninsured, according to a recent study. Congress must pass a strong and timely 5-year reauthorization bill this year. A compromise tax credit choice bill will not help the working families most in need. TAKE ACTION:  Click here to write your U.S. Representative or use the toll-free number 1-800-965-4701 Use the talking points listed above. (toll-free number provided by American Friends Service Committee). (thanks to Florida Child Health Care Coalition for this alert)  Read an another current CHAIN Reaction article on the SCHIP veto and override vote.   Read an another current CHAIN Reaction article on the tax credit proposal following the SCHIP veto. After the Veto: Could Offering Tax Incentives to Participate in Private Coverage Substitute for Directly Providing Coverage Through SCHIP?   As mentioned in a related CR article, in the wake of the failed effort to override the President’s veto of SCHIP reauthorization, Florida Senator Mel Martinez (R) and Representative Tom Feeney (R-Oviedo) released their own less expensive proposal that they claim would nevertheless enable a significant number of uninsured kids to obtain coverage.   The Martinez/Feeney alternative calls for only about one third of the additional funding sought in the original SCHIP bill and eliminates reliance on an increased tax on tobacco products as the source of funding for expansion. Most importantly, instead of making coverage directly available for children whose family income is more than 200 percent of the federal poverty level ($40K for a family of 4) the Martinez/Feeney proposal calls for the creation of a tax credit of up to $1,400 per child to assist families in securing coverage from an employer or in the private market.    At the same time, advocates committed to ensuring coverage to 10 million children, including Congressional leadership, will persist in their efforts to expand SCHIP. The question of whether providing tax incentives can accomplish the intended goal may therefore become an aspect of the debate over how to proceed. However, the tax credits are not part of any proposed compromise currently under consideration.   The answer to that question is already well-known, however. The tax credit as proposed by Senator Martinez and Congressman Feeney would neither spark a meaningful expansion of coverage nor leverage the private insurance market.   Studies accepted by the Center for Medicare and Medicaid Services, the entity responsible for administering publicly financed health insurance programs, demonstrate that a family spending more than 5 percent of income on their children’s health coverage is excessively burdened. But families with children targeted by the SCHIP expansion effort would pay far more than that to obtain coverage in the private sector.   Families with incomes between 200-300 percent of the poverty level (~$40-60K for a family of 4) would pay between 20 and 40 percent of their income, for example. A $1,400 tax credit wouldn’t put much of a dent in that cost. In addition, most working families don’t have enough disposable income on hand to pay monthly premiums, and a tax credit at the end of the year won’t solve that problem either. The fact is, most of the families who would benefit from any new tax credit already have coverage.   Hundreds of thousands of Florida’s children would have been covered by the SCHIP expansion proposal that did not survive the President’s veto. An opportunity remains to ensure their coverage, namely the meaningful expansion of SCHIP to cover them. By contrast, the proposed tax credit, no matter how well-intentioned, won’t go far enough and so won’t end up benefiting the hard-working families that proponents of both bills have insisted they want to help.   (Submitted by Greg Mellowe, Florida CHAIN) TAKE ACTION: See how your US Rep voted, send your feedback, and urge the next steps.   Read an another current CHAIN Reaction article on the SCHIP veto and override vote.   OIG Report Confirms Many Advocates’ Long Voiced Concerns for Medicaid Patients   Rushing Medicaid Reform for the Wrong Reasons   The Medicaid Reform report by the Agency for Health Care Administration’s Office of the Inspector General (OIG), made public in early October, confirms many of the original concerns of Medicaid consumer advocates and highlights others.   In 2006, as Medicaid Reform was being introduced in Broward and Duval Counties, the Medicaid Reform Advocates Coalition (MRAC) identified major areas of concern, including: 1. Quality and quantity of "choice counselors" available to consumers; 2. Outreach to hard to reach populations, i.e. the disabled and the homeless; 3. Managed care emphasis on profit and how this affects services; and 4. The re-establishment of the mandated Medical Care Advisory Committee (South Florida Sun-Sentinel Opinion Page, July 31, 2006).   After 18 months, ensuing roundtables, focus groups, town hall meetings and reports by Georgetown University’s Health Policy Institute and the General Accounting Office (GAO) tend to support a general sense that many potential effects of Reform were not adequately addressed prior to implementation. But not until the release of the OIG report has there been so much media attention focused on the problems inherent to Medicaid Reform.   AHCA Secretary Dr. Andrew Agwunobi, who commissioned the report, has praised it as representing “the type of independent, objective and thorough analysis I was seeking.”   The report, in stark contrast to the positive review submitted by Florida Medicaid Director Tom Arnold to the Centers for Medicare and Medicaid Services just a few days before, is generally critical of the program.   For instance, by stating, “The expedited implementation timeframe of the Reform pilot resulted in many of the challenges encountered to date,” the OIG confirms advocates’ contention that Reform was rushed through for political reasons (to ensure it would take place during Gov. Jeb Bush’s term in office), without the appropriate input from consumers, advocates and providers and with more regard for managed care plans than Medicaid recipients.   This sentiment is shared by the Daytona News Journal: “Even as former Gov. Jeb Bush was pushing the state into a massive privatization of Medicaid, advocates were warning: Not so fast. “Bush didn't listen. He wanted sweeping changes, statewide, and he wanted them rapidly. He didn't want to hear that private networks weren't ready to take on a huge influx of patients. He wouldn't listen to those who worried about forcing a medically vulnerable population to choose among health plans to find the one that best meets their needs. He seemed to revel in the attention Florida got from other states for pushing ahead with changes with precious little evidence that they would save the state money.”     No Proof Medicaid Reform Saves the State Money   Debunking the claim that Medicaid Reform is proving to be a fiscal success, the report indicates, “Performance, quality and cost data is not yet available to evaluate cost effectiveness of the Medicaid Reform project.”   This has not stopped proponents of Medicaid privatization at the state and national levels from saying so, anyway. Former Speaker of the House Newt Gingrich, in a recent editorial endorsing a Louisiana candidate for governor, wrote “To deal with the troubled Medicaid program for low-income Louisianans, Jindal suggests four innovative waivers that have demonstrated success in other states. He also appreciates the lessons of Florida's recent Medicaid reforms that now permit people on Medicaid to select from a menu of private plans that include incentive accounts for healthy behaviors. The early evidence out of Florida is that poor people in the new system are getting better health care at lower cost.”   In Florida, State Rep. Aaron Bean also made similar statements on the eve of a special session called to deal with the state’s budget deficit.   No such “evidence” exists, according to the OIG report.   Rather, advocates can point to cases such as Robin Eckman as example of cost inefficiency and less care for “poor people”. Successfully treated for diabetes for years, enrolling in a Reform HMO plan meant either losing her trusted, long-time physician or the prescription medicine that kept her well, because the doctor was a member of a plan that did not cover it.   As a result, Ms. Eckman took the plan approved medicine, almost died of diabetic shock, spent 10 days in a hospital for powerful antibiotic treatments that caused her to acquire severe diarrhea (thus having to take expensive bacteria supplements not covered by the plan and needing to wear diapers). The “cost savings” the HMO sought at the front end cost Florida taxpayers thousands of dollars later instead.     Illusory Choice Not a Substitute for Care   One of the main “selling points” of Medicaid Reform has been the claim that, affording consumers a wide array of plans to choose from would help address the issue of scarcity of providers. The OIG Report confirms what has been evident to advocates throughout: Reform has not improved on the problem: “Characteristics of Medicaid that existed prior to Reform, such as limited access to specialists, continue to be of concern.”   The Sun-Sentinel writes, “Patients have had problems selecting doctors and finding out what medications are covered in their plans. In some cases, drug coverage has run out because patients haven't been able to get that information. Also, there is no formal complaint system. So far, the results are a long way from the agency's goals for Medicaid reform, improving patient care and saving money.”   The role and effectiveness of Choice Counselors in helping consumers navigate through a dozen or so plans so as to pick one that works has also been lacking  According to the OIG, “The accuracy and information available to Choice Counselors has been compromised by high rates of error in the Provider Network Reports.” This in addition to the long-time complaint that Choice Counselors have no access to the plans’ Preferred Drug Lists (PDL’s), so that patients have had to pick plans without the benefit of this information.     Not All Medicaid Consumers Have the Same Needs   Among many shortcomings, and as predicted by MRAC, Medicaid Reform clearly has affected different mandatory populations differently. “Beneficiary subpopulations, such as the severely and persistently mentally ill and those with complex medical conditions face unique and serious challenges in adapting to managed care as do the plans/Provider Service Networks serving them,” according to the OIG.    Not to mention the community based providers, such as Henderson Mental Health who have had to divert resources from case management to administrative to deal with the complexities of plan requirements.     “Rein In Reform”   Although advocates have been able to force some positive changes (Mr. Arnold recently indicated that the Medical Care Advisory Committee was being reinstituted and would begin meeting in November; similarly, Choice Counselors will have access to the plans’ PDL’s beginning in January 2008), there clearly remains much work to be done before Reform can be looked at as a success, let alone a model for the rest of the nation.   “(The OIG) report urges Crist and the Legislature to hold off on any expansion of the program before the serious problems are fixed. But state leaders have a more obvious decision before them: Whether to continue with a reform that has produced no obvious benefits and real problems for a highly vulnerable group of Floridians,” according to the Daytona News-Journal.   Legislators slated to vote on expansion in 2008 ought to heed the urging of the OIG and Medicaid consumer advocates and “Rein in Reform.”   (Submitted by Andrew Leone, Florida CHAIN)   All Invited to AHCA's Medicaid Reform Events for Consumers and Providers   Florida's Agency for Health Care Administration (AHCA) has scheduled for early November: A summit on access to specialty care for Medicaid beneficiaries Workshops for consumers and providers to provide input in experiences with the Medicaid Reform pilot projects in Broward and Duval Counties Florida CHAIN urges participants in Reform to share their experiences at appropriate gatherings below. Please contact Greg Mellowe at gregm@floridachain.org to learn more about the meetings or if you or someone you know has experiences to share. The events take place from November 2nd through 8th, so please get in touch as soon as possible. Agency for Health Care Administration (AHCA) Medicaid Summit Nov 2   12:00 noon - 4:00 pm    Marriott Tampa Westshore, 1001 N Westshore Blvd The purpose of the Summit is to receive input from Florida’s specialty health care providers about ways the Agency should approach the issue of access to specialty health care for Medicaid beneficiaries. All are invited.   Agency for Health Care Administration (AHCA) Medicaid Reform Workshops Nov 7   9:00 am-noon (for Health Care Providers) Nov 7   1:00-4:00 pm (for Medicaid beneficiaries)   Wyndham, Jacksonville Riverwalk, 1515 Prudential Dr. The intent of this meeting will be to gather feedback from Medicaid beneficiaries related to various aspects of the Medicaid Reform Pilot. The specific topics of discussion will be Health Plans’ Customer Service, the Agency’s Outreach efforts and Health Plans’ benefit packages. All are invited.   Agency for Health Care Administration (AHCA) Medicaid Reform Workshops Nov 8   9:00 am-noon (for Health Care Providers) Nov 8   1:00-4:00 pm (for Medicaid beneficiaries)   Hilton Ft. Lauderdale Airport, 1870 Griffin Rd, Dania Beach The intent of this meeting will be to gather feedback from Medicaid beneficiaries related to various aspects of the Medicaid Reform Pilot. The specific topics of discussion will be Health Plans’ Customer Service, the Agency’s Outreach efforts and Health Plans’ benefit packages. All are invited.      Florida Has Yet to Adopt Program for Disabled Workers to Keep Medicaid   Congress designated October as National Disability Employment Awareness Month. While a growing number of employers are realizing the benefits of hiring someone with a disability, Florida’s policies can sometimes discourage persons with disabilities from returning to work.  1,248,000 Floridians are working with one or more disabilities. Currently in Florida, persons with disabilities often quit their jobs for fear of losing eligibility for Medicaid, a publicly funded medical insurance available for low income persons with disabilities.   In Florida, once a person earns wages over the income limits, they can lose eligibility for this important health care coverage. Keeping Medicaid coverage is often a critical component for persons with disabilities who need the medical care and support services that enable their return to the workforce and to maintain their health so they can continue to work.   Federal law now allows states to expand Medicaid for persons who work and increase their income without losing their Medicaid, by requiring persons to share in the costs of their Medicaid premium. While thirty-nine states have already changed their Medicaid program, Florida still has not taken advantage of this federal program yet.  Advocates want to educate the community about this important change that can help thousands of persons with disabilities from around the state expand their opportunities to re-enter the workforce while keeping the medical care they need.     In June 2006 the Florida Substance Abuse and Mental Health Corporation sponsored a statewide meeting to focus attention on the need for a Work Incentive Medicaid Coverage Initiative to provide health care access under Medicaid to individuals with disabilities who are working competitively. A statewide Work Incentive Medicaid Coverage Task Force was formed and Capstone Consulting Group is providing administrative and technical assistance to the group.  The group is developing a website, proposed legislation and educational materials around this issue. The list of supporting organizations is growing.   If you would like a speaker to come to your site or would like to get more information, contact: olgag@citrushealth.com or CapstoneBarbara@aol.com. This initiative is being financially sponsored by the Substance Abuse and Mental Health Corporation, the Advocacy Center, the Florida Developmental Disabilities Council, the Citrus Health Network, the Health Foundation of South Florida and Eli Lilly and Company.   (Submitted by Olga Golik, Esq., Citrus Health Network, Inc.) Rare Decrease in Medicaid Enrollment: Some Good News, Some Questions, Some Missed Opportunities   In 2005-06, the number of Americans enrolled in Medicaid declined for the first time since 1998-99, according to a new report issued by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured. Two very different factors explained the decrease: 1) increased citizenship documentation requirements, and 2) the improved economy/lower unemployment.   Florida’s experience was similar to the overall trend: Medicaid enrollment declined by seven-tenths of one percent, from 2.201 million to 2.185 million (-16,000) in 2005-06. This reversed a pattern of increases in enrollment averaging 5 percent per year over the prior 3 years.   Enrollment trends do vary from state to state, however. During the first six months of 2006, only 9 states saw a greater percentage decrease in Medicaid enrollment than Florida. In addition, Medicaid “leavers” in Florida were primarily children and families, while the number of elderly and disabled enrollees continued to increase.   A review of State enrollment data shows that this pattern continued and even intensified in 2006-07, during which 91,000 fewer Floridians were enrolled than in 2005-06. Again, the decrease can be attributed to families and children leaving the rolls. Whether they left Medicaid for other coverage is unclear.   As a result of decreased enrollment and other factors, the explosive growth in Medicaid spending also slowed, which allowed 42 states to consider making program improvements or expanding coverage to more uninsured people. Florida was one of these states, although its efforts have been among the most limited. According to the report, most of Florida’s improvements pertain to its Medicaid Reform effort.   By contrast, 28 states have adopted or proposed plans for using Medicaid to expand eligibility, and Florida is not among them. Further initiatives may be hampered by the veto of SCHIP reauthorization at the federal level and reduced tax revenues at the state level. (However, the Legislature DID fund an additional 5,000 KidCare slots during the recent Special Session. See the related article above.)   To read the full report, visit http://www.kff.org/medicaid/kcmu101007pkg.cfm. (Submitted by Greg Mellowe, Florida CHAIN)   U.S. Senate Unanimously Approves Mental Health Parity; House Bill Pending   As millions of Floridians know only too well, a longstanding inequity in the health care system is the lack of mental health “parity” in insurance coverage. Specifically, health plans place much stricter limits on access to treatment for mental health and substance abuse needs than they do on access to medical care.   In 1996, Congress took the limited step of requiring plans to set total (annual and lifetime) dollar limits on coverage for mental health care and medical care at the same levels. Florida adopted its own extremely weak version of partial parity in 1992. Neither law has served to balance the scales and ensure continuity of care for Floridians.   Efforts to establish parity at the federal level took a significant step forward this September 18, when the U.S. Senate unanimously passed the Mental Health Parity Act of 2007 (S.558). Although the bipartisan proposal was approved in committee in February, the bill was only able to finally reach the full Senate for a vote after an agreement by stakeholders, including both advocates and the insurance industry. The biggest obstacle pertained to the question of whether federal legislation would pre-empt existing state laws. Ultimately, it was agreed that the Senate-approved version would serve as the minimum standard for states, at least for those plans covered by the legislation.   On the other hand, approval by the House of its version of the bill is still uncertain. H.R.1424 has successfully passed through 2 of the 3 committee hearings required before the bill can be sent to the full House for a vote. However, that final committee hearing (by the Committee on Energy and Commerce) has not yet been scheduled as of this writing.  In addition, H.R. 1424 is stronger than the version that passed the Senate, and so a compromise between the two versions would be necessary.   Click here to learn more about parity legislation from Mental Health America. (Submitted by Greg Mellowe, Florida CHAIN)   SCHIP Vote Affects Florida Tobacco Tax Efforts   The Healthy Florida Alliance (HFA), comprising national, state and local organizations dedicated to increasing health care access for Floridians by funding it through a $1/pack cigarette tax increase, supported the federal tobacco tax that would have funded SCHIP.    Convincing state legislators to add a Florida tax to the federal one had the SCHIP bill passed, however, would have been next to impossible. As those efforts have been thwarted by the President’s veto, HFA advocates and others are refocusing on efforts to increase the state’s tobacco tax to reduce illness and fund access to care.   “The State of Florida needs to raise the cigarette tax by at least $1/pack.  At 34 cents per pack, Florida ranks 43rd among the 50 states.  This tax hasn't been increased since 1990. Studies have proven that cost is the number one deterrent to smoking, especially among young people,” said Tad Fisher, Executive Vice President, Florida Academy of Family Physicians.  “Income generated from the tax could fund much-needed health care services, including expansion of KidCare and increased access to Medicaid,” he added.   Research by Campaign for Tobacco Free Kids and Community Catalyst show revenues from the tax in Florida estimated at close to $900 million in the first year.   Part of these funds would help bridge the gap between Medicaid and Medicare reimbursements paid to physicians, which would help address a major obstacle to care for patients on Medicaid: finding doctors who are part of the program.   For more information on the HFA, its members and the state tobacco tax efforts, visit www.healthyfloridaalliance.org or contact Greg Mellowe, Florida CHAIN Policy Director, at 407/782-6983 or email gregm@floridachain.org   (Submitted by Andrew Leone, Florida CHAIN) To learn more about the Healthy Florida Alliance, visit www.healthyfloridaalliance.org   Mental Health Awareness Month Celebrated in Broward   Activities related to Mental Health Awareness Month planned by the Mental Health Association of Broward and the Alcohol, Drug and Mental Health (ADM) Planning Council of Broward included an exhibit of works related to the issue at the Broward County Governmental Center.   The exhibit’s curator, Chris Yoculan, worked with artists form a number of drop in centers to address, via a range of media, the theme of the show: “Stigma Exposed”. Some of the works were inspired by the experiences of individuals affected by Medicaid Reform.   As part of the opening event, on Monday October 8, a number of performers read through a list of well know historical and present day figures who have suffered from mental illness of various forms, including Albert Einstein, Princess Diana, Francis Ford Coppola and many others.   The Stigma Exposed works will be shown through October 13 at the Broward County Governmental Center, 115 S. Andrews Ave., Ft. Lauderdale.   (submitted by Andrew Leone, Florida CHAIN)   Works displayed during the "Stigma Exposed" event were created by artists from drop-in centers in Broward               Health Care Access Rights Town Hall Series Continues   Hispanic Health Initiatives and Florida CHAIN continued their series of Central Florida town hall meetings discussing issues of health care access. Events have already taken place in Orange, Seminole and most recently in Volusia County.  One more town hall will take place in Osceola on November 1. For more information visit Hispanic Health Initiatives at www.hispanichealthinitiatives.org or call 407/339-2001.   (submitted by Andrew Leone, Florida CHAIN) Damarys Melendez, of Vitas in Ormond Beach, listens to discussion on health care access at Deltona Town Hall meeting.      John Newstreet, aide to Florida Sen. Mel Martinez, lays out the senator's position in favor of SCHIP veto at Deltona town hall meeting. Josephine Mercado, HHI executive director, is at his left.                REAL STORIES FROM FLORIDA HEALTH CARE CONSUMERS   Elite Care? and Care for the Rest of Us:   A beaming former Health and Human Services Secretary and Republican presidential candidate Tommie Thompson betrayed pent up excitement as he proclaimed on the screen, “Someone finally gets it! This is the way of the future!”   The video was part of a hotel seminar arranged by Dr. Sheldon Warman, a Fort Lauderdale physician promising “exciting changes” in his practice. Thompson’s praise was directed at MDVIP: a “new” concept in health care summed up by the tagline: “Live exceptionally well.”   What MDVIP promises is a same-day or day after appointment with a shorter wait at the doctor’s office (“we call it a ‘non-waiting’ room,” joked the co-presenter); a thorough yearly physical check-up (“a similar exam would cost you $3000 at Mayo or Cleveland Clinic”); the doctor’s personal cell phone number (“he would be available 24-7”); and a CD with the patient’s personal medical record, among other similar frills.   The cost, above and beyond any private insurance or Medicare coverage: $1500 per year, per patient.   This thinly veined process of weeding out low and middle-income patients who may otherwise deem themselves lucky just to have employer-sponsored health insurance, reflects a disturbing trend: the seemingly relentless march towards making quality, caring, preventive-minded health care a luxury only to be afforded by the elites.   It begins with the most vulnerable among us.   One of the major problems facing Medicaid consumers in Florida is their ability to find doctors who will see them. This becomes harder when it comes to specialists or dental providers for adults and children. Medicaid reform in Broward and NE Florida has not addressed this problem. In fact, by saddling providers with additional required administrative burdens on top of ridiculously low reimbursement rates, more and more doctors are refusing to take Medicaid patients.  The problem is worse.   The issue is part of the larger problem of a shrinking pool of doctors relative to the growing state’s population.  So how is the problem being addressed?   One of the “advantages” of MDVIP is that now physicians like Dr. Warman, whose practice currently serves 5000 patients, will limit their number to a maximum of 600. What will happen to the remaining 4,400 who cannot afford the premium cost of “exceptional care”? According to Dr. Warman, “We are making arrangements with other doctors who have agreed to take those patients who choose not to stay in my care. We will transfer their files at no cost to the patients.” Great relief!   Advocates and consumers ought to ask themselves: since when have thorough physicals, personalized care, good advice on how to prevent illness and reasonable wait times for appointments become “premium” services? Mr. Thompson’s assertion notwithstanding, a more consumer friendly “way of the future” ought to be quality, affordable health care provided in a stable medical home.    Not doubting Dr. Warman’s sincerity of how “I want to be able to provide the best possible care to my patients,” and recognizing his right to establish whatever practice he chooses, one might still ask him if providing “elite only” care is really the way of addressing the crisis of overburdened medical practices.   (Submitted by Andrew Leone, Florida CHAIN) 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 Andrew Leone at 954/684-9895 or gregm@floridachain.org

FLORIDA AUDIO CONFERENCES AND WEBCASTS

STATEWIDE NOTICES  

NATIONAL EVENTS & NOTICES

CONFERENCES AND EVENTS 

SOPHE 58th Annual Meeting - Partnerships to Achieve Health Equity  
Oct 31–Nov 3   Alexandria, VA
Abstracts are now being accepted online for workshops, symposia, oral presentations, and posters for Society for Public Health Education's 58th Annual Meeting. SOPHE is pleased to be partnering with CDC's Racial and Ethnic Approaches to Community Health (REACH) program and Eta Sigma Gamma for its 40th Annual Meeting.  Sub-themes include health systems change; social determinants of health and transdisciplinary approaches to health education; health communications, health literacy and technology; cultural competence in bridging differences, and; evaluation and dissemination of evidence-based approaches. For more information, contact lvillejo@mdanderson.org

2007 American Public Health Association Annual Meeting & Exposition

Nov 3-7   Washington, D.C.
The is the oldest and largest gathering of public health professionals in the world, attracting more than 13,000 national and international physicians, administrators, nurses, educators, researchers, epidemiologists, and related health specialists. APHA's meeting program addresses current and emerging health science, policy, and practice issues in an effort to prevent disease and promote health.

Creating a Culture of Wellness

Nov 27-29   Washington, DC

The U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion and the Centers for Disease Control and Prevention (CDC) will host this 2007 National Prevention and Health Promotion Summit. This groundbreaking event will unite health professionals, business entrepreneurs, and government leaders at all levels who are dedicated to health promotion, chronic disease prevention, health preparedness, birth defects, disabilities, genomics, and wellness.

National Congress on the Un- and Underinsured: From Practical Local and Regional Solutions to State and National Health Reform

Dec 9-12   Washington, DC

The challenge of the un- and underinsured in America puts great social and economic stress on the nation's health system. The goals of The National Congress are to: define the issue; identify and assess various federal and state health reform proposals; analyze the roles of Medicare, Medicaid and SCHIP in expansion of coverage; describe and compare various international approaches to the issue; identify voluntary, charitable initiatives across the country to address the issue at the local level and assess current obligations and practices of healthcare providers to render care to uninsured patients.

Health Action 2008 
Jan 24-26   Renaissance Mayflower Hotel, Washington DC

Families USA’s Health Action 2008 kicks off a year in which health care will be at the center of the national conversation. Learn and share strategies with other advocates around the country and to recharge for the year ahead.

ACHI’s 2008 Spring Training for Health Champions

Conference Dates: March 5-7, 2008  Atlanta

Topic Tracks: Minimizing Chronic Disease: Strategies for Social Determinants; Maximizing Coverage: Proven Programs and Innovative Proposals; Harnessing Data: Health Assessments to Health Outcomes; Delivering Community Benefit: Management Tools and Community Strategies (co-sponsored by Catholic Health Association and VHA, Inc.); Breaking Silos: Public Health and Health System Partnerships

National Initiative for Children's Healthcare Quality (NICHQ) Annual Forum for Improving Children's Health Care 

March 19-21   Miami

This event is for people committed to eliminating the gap between what is and what can be in health care for all children.  The Forum will feature breakout sessions and in-depth workshops, in four tracks, focused on NICHQ's Improvement Agenda: Assessing, Preventing and Treating Childhood Obesity; Providing Seamless, Evidence-based, Family-Centered Care for Children with Chronic Conditions; Purging Harm from Children’s Health Care; Profound Knowledge: Methods and Tools for Improvement and Innovation. Improvement processes/programs in all of these areas should address disparities and include parents/families.

Active Living Research Conference Seeks Abstracts

April 9-12 Washington DC

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

AUDIO AND WEB EVENTS    

 
November 
 
American Diabetes Month: November
American Diabetes Association
(800) DIABETES (342-2383)
askada@diabetes.org   www.diabetes.org

Diabetic Eye Disease Month: November
Prevent Blindness America
(800) 331-2020
info@preventblindness.org   www.preventblindness.org

Lung Cancer Awareness Month: November
Lung Cancer Alliance
(800) 298-2436
info@lungcanceralliance.org   www.lungcanceralliance.org

National Alzheimer's Disease Awareness Month: November
Alzheimer's Association
(800) 272-3900
info@alz.org  www.alz.org

National Family Caregivers Month: November
National Family Caregivers Association
(800) 896-3650
info@thefamilycaregiver.org  www.thefamilycaregiver.org

National Healthy Skin Month: November
American Academy of Dermatology
(888) 462-DERM (3376)
mediarealtions@aad.org   www.aad.org

National Hospice Palliative Care Month: November
National Hospice and Palliative Care Organization
(703) 837-1500
jradulovic@nhpco.org   www.nhpco.org

Pancreatic Cancer Awareness Month: November
(877) 272-6226
information@pancan.org  www.pancan.org

Prematurity Awareness Month: November
March of Dimes Birth Defects Foundation
(888) MODIMES (663-4637)
askus@marchofdimes.com  www.marchofdimes.com

Prematurity Awareness Day: November 13
March of Dimes Birth Defects Foundation
(888) MODIMES (663-4637)
askus@marchofdimes.com  www.marchofdimes.com

Great American Smokeout: November 15
American Cancer Society
(800) ACS-2345
www.cancer.org

Gastroesophageal Reflux Disease Awareness Week: November 18-24
(888) 964-2001
iffgd@iffgd.org  www.aboutgerd.org

December

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

New listings, in order of submission deadlines

Echoing Green Fellowships for Social Entrepreneurs

Application deadline: Dec 3
The Echoing Green Fellowship Program helps passionate social entrepreneurs worldwide develop new solutions to some of society’s most difficult problems. Through the program, Echoing Green offers individuals, and partnerships of no more than two individuals, seed funding to launch new organizations that turn their innovative ideas for social change into action. Projects must be the original idea of the applicants, and should not be the extension or expansion of another individual's or organization's mission or idea. Applicants must make a full-time commitment to the development of the project and must agree to lead the project for a minimum of two consecutive years.

Leadership Education in Maternal and Child Health Nutrition

Application deadline: Dec 21

This program provides graduate training for nutritionists to assume leadership roles in improving the nutritional status of women, infants, children, adolescent and families. The training will prepare program participants to become leaders in public health programs, clinical settings and/or academic settings.

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

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

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

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

Continuing listings, in order of submission deadlines 

American Psychiatric Foundation Seeks Applications for Advancing Minority Mental Health Awards

Deadline: Nov 1

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

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

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

US Racial Disparities Update

Faith Based Efforts and Resources 

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

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

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

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

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

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

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

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

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

New Online Medical Dictionary Reference Tool

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

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

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

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

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

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

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

Uninsured Tutorial, Module, and Reference Library

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

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

Healthcare Coverage Options Database: Assistance for Obtaining Health Coverage

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

Videos and Films

Covering Kids & Families Video
Parents' Action for Children, a 2006 national supporter, has created a flash animation video in partnership with Covering Kids & Families that promotes the availability of low-cost and free health care coverage for eligible families. Parents’ Action for Children plans to promote the video to their membership of more than 35,000 parents across the country who are working to improve the lives of children and families in their communities. View the video today! For more information, contact 202/338-7227 or coveringkidsandfamilies@gmmb.com  

PERIODICALS AND BOOKS

Health Inequality: Morality and Measurement

Challenging Health Inequalities: Multi-disciplinary Perspectives

Coastal Cancer Update Releases Issue on Work with Hispanic Community

Eliminating Healthcare Disparities in America
In this book, the very best scholars on healthcare disparities are assembled to raise the public consciousness of this issue. Arranged into discrete categories, this volume contains comprehensive coverage, both historical and current, of the healthcare disparity crisis currently plaguing our country in hopes of leading us all to a brighter future.

This Commonwealth Fund bimonthly newsletter describes innovative state health programs from across the country. It is intended to help policymakers, administrators, and researchers as they work to stretch health care dollars and meet the needs of their residents.

REPORTS AND STUDIES

New Listings

New Listings: Medicaid

New Listings: Medicare

CMS Posts Reams of Data on Private Plan Violations

By posting hundreds of pages of information on rules violations by dozens of plans, the data fulfills a "transparency" pledge...But consumer representatives complain the information posted by CMS requires too much computer power and patience with both downloading and poring through legalese in the massive files to be of practical value to seniors trying to pick a prescription drug or private health plan in Medicare. (10/5/07, CQ HealthBeat)

New Listings: Federal Budget

New Listings: Health Insurance, Health Costs

New Listings: Health Equity Issues 

New Listings: Other Health Issues

Waving Cautionary Flags: Florida’s Experience with Medicaid Reform: Reactions from Doctors and Patients

The latest briefing paper on Florida's Medicaid reform programs shows one out of four physicians are declining to participate and those who remain are seeing fewer patients. View the briefing paper  Or view a presentation of the research.  (May 2007, Georgetown University Health Policy Institute, released by the Jessie Ball duPont Fund, The Community Foundation in Jacksonville and United Way of Northeast Florida)

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. 

Miami-Dade and Monroe County 2006 Health Profiles
Health Council of South Florida has released downloadable Health Profiles that provide answers to 10 commonly asked questions about county demographics, health needs, and resources.

Medicaid Changes: What will they mean for Broward and Duval counties, and beyond?
This document is Briefing #1 by researchers at Georgetown University’s Health Policy Institute engaged in a two-year evaluation of the Medicaid reform pilot counties for both Florida counties. The evaluation is assessing how these changes affect Medicaid beneficiaries’ ability to access needed care as well as the impact on community health providers.(September 2006, Georgetown University Health Policy Institute)

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.

Survey Says Doctors Will Trim Staff If Medicare Payments Are Cut 
Reductions in Medicare physician payment rates would not only restrict beneficiaries' access to physician services but will also cause staffing reductions in doctors' offices, according to a new survey from the Medical Group Management Association (MGMA). Unless Congress acts, Medicare payments to physicians will be cut by about 10 percent January 1. More than 41 percent of respondents said they may have to limit the number of Medicare patients they see if Medicare reimbursements are reduced and more than 19 percent said they would not accept new Medicare patients. In addition, 57 percent of physicians who responded to the survey they would have to reduce staff health care benefits coverage to remain financially viable and 44 percent would cut administrative staffing levels. A third of respondents said they would cut clinical staffing levels and 9 percent would cut the number of physicians in their practice. (Sept 2007, MGMA)

Health Insurance, Health Costs

Health Equity Issues

Study Reveals Disparities in Use of Healthcare Benefits by Race, Class
Minority and lower-income healthcare consumers are less likely to take advantage of mental health and prescription benefits than white and higher-income consumers. (9/10/07, Duke University, 9-10-07) 

Issue Brief: Racial and Ethnic Health Disparities 

Key Facts: Race, Ethnicity and Medical Care, 2007 Update

This updated quick reference source on health disparities presents the best available data and analysis, ncluding data on the uninsured and access to care by race/ethnicity as well as information about the isproportionate effect that specific conditions such as diabetes, HIV/AIDS, and asthma have on racial and thnic minority populations in the U.S. New in the 2007 Key Facts are demographic data on the racial/ethnic minority population in each state and the U.S. territories. This edition of Key Facts also includes data from the National Healthcare Disparities Report, examining changes in health care disparities over time.  (Jan 2007,

Kaiser Family Foundation)