November 12, 2008

Election Results and What They Could Mean for Health Care

With SCHIP and health care reform bills on the near horizon, president-elect Barack Obama captured the White House by a controversy-proof margin, and in Congress, the Democrats widened their margins. In Florida, the legislature's partisan balance will barely change, and Amendment 2's passage portends confusion on whether health coverage benefits can be extended to partners. (Greg Mellowe, Florida CHAIN)  Read more

Recession + Budget Cuts = Massive 1-2 Punch

 

State economists recently echoed financial experts across the country, agreeing that we’re sinking deeper into a recession. Florida’s economy in particular may not begin to rebound until mid-2010. One dire consequence is that the State’s sales tax-dependent budget is being even further squeezed.  (Greg Mellowe, Florida CHAIN) Read more
Proposed Constitutional Budget Caps = Draconian Problems, Not Solutions

 

Budget cuts for Florida’s state and local governments already have hit vital public services and programs for elders and other vulnerable residents hard. Now an even more draconian menace looms — proposals to constitutionally cap state and local revenue and spending. Already one signature drive has commenced. (Jack McRay, AARP Florida) Read more

ALERT!  NEW POLICY TO PREVENT KIDS FROM LOSING (OR NOT GETTING) KIDCARE COVERAGE

Over the past few months, thousands of Florida children have been disenrolled from their KidCare coverage by mistake, because the change to a new company that handles KidCare paperwork has been difficult. On October 23rd, advocates sent a letter to the Healthy Kids Corp. board, requesting a stop in disenrolling kids until the problems are fixed. The request was unanimously approved the next day. Read more and help

Finding Solutions for Pregnant Women through Grassroots Advocacy

 

The health of pregnant women and babies is a sentinel indicator of the health of a community. In Volusia and Flagler Counties as in the rest of the State of Florida, over 50% of pregnant women are on Medicaid.  Policy decisions regarding the State’s Medicaid system has had an unfortunate impact on access to health care and health outcomes for Florida’s most vulnerable citizens. (Dixie L. Morgese, Healthy Start Coalition of Flagler & Volusia Counties)  Read more

Looking Back, Looking Ahead: Medicaid Reform in Florida

On October 15, 2008 in Tampa, over 200 participants in an all-day meeting examined the Medicaid reform pilots operating in several Florida counties since September 2006.  Sponsored by the Jesse Ball duPont Fund, the Florida Health Policy Center and the Florida Philanthropic Network, the conference featured the release of a final report by Georgetown University researchers in their series on Medicaid reform. (Jack Hoadley and Joan Alker, Georgetown University Health Policy Institute) Read more
Add Inequity to Long List of Reform’s “Enhanced Benefits” Flaws

By reviewing recently released data for the Enhanced Benefits program, we have yet another troubling example of how the “real life” experiences in the Medicaid Reform experiment continue to fall short of the goals. EBR provides credits to consumers who are theoretically encouraged to perform any of a variety of approved “healthy behaviors”.  (Greg Mellowe, Florida CHAIN) Read more

As Pilot Ends, Praise JaxCare for Pioneer Effort to Cover Uninsured

 

JaxCare was a pilot program. Its purpose was to extend Jacksonville’s health care safety net, while learning through experience how to responsibly manage the health care needs of a community’s uninsured population. JaxCare succeeded in this mission. (Rhonda Davis Poirier, DrPH, JaxCare) Read more

Orlando and Miami Town Halls Explore Health Care Access Solutions  

 

On Thursday, October 16th, residents, legislators and candidates gathered - more than 70 in Orlando and mroe than 45 in Miami - for two town hall meetings to discuss solutions to the health care crisis.  Read more

Time Again For Critical Medicare Part D Decisions

Open enrollment for the Medicare Part D prescription drug benefit runs from November 15th through December 31st. “This is the one chance this year most people with Medicare have to make a change in their health and prescription drug plans." And Floridians will choose from 54 plans, amid stronger marketing regulations to prevent previous abuses. (Greg Mellowe, Florida CHAIN) Read more

Providers and Advocates Unite to Address Admin Overload with Florida Healthy Kids

A month after launching their back to school kick-off events to inform families about KidCare, Florida's child health insurance program is backlogged with families trying to enroll. In Ft. Lauderdale and Miami, providers and advocates met with Florida Healthy Kids staff to discuss the problems overwhelming the program. (Laura Goodhue, Florida CHAIN) Read more

Pain Meds Do Not = Health Care, as Lack of Insurance Poses Dire Obstacles, Extends Young Adult’s Disabilities

A year ago, Christina, 24, found herself disabled with kidney and liver damage, and unable to function independently. After surgery resulted in a spine infection, and having twice been denied Medicaid, she wonders when she'll get coverage for the operation she now needs to begin to get better. Meanwhile, her prescribed treatment has moved from pain pills to methadone. Read more

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

Florida CHAIN: 3167-B Gardens East Drive, Palm Beach Gardens, FL 33410 info@floridachain.org     www.floridachain.org  

 

Election Results and What They Could Mean for Health Care

 

President-elect Barack Obama captured the White House by a controversy-proof margin, with a projected 52% (vs. 46%) of the record 133 million popular votes cast and at least 349 of the 538 electoral votes available (as of Friday). In Congress, Democrats widened their majority to 254-173 in the House (8 races still undecided as of this writing) and to 57-40 in the Senate (3 races remain undecided).

 

In Florida, Democrats picked up 2 additional Central Florida Congressional seats, while Republicans recaptured a seat in the Treasure Coast. Thirteen other Republicans and 8 Democrats retained their seats.

 

In the Florida Legislature, although a number of seats were contested, Republicans’ margin of control in the House decreased by only one (to 76-44) and remained constant in the Senate at 26-14.

 

Amendment 2 to the Florida Constitution passed 62% to 38%, with a minimum of 60% needed for passage. Amendment 2 defines marriage as the “legal union of only one man and one woman as husband and wife”, adding that “no other legal union that is treated as marriage or the substantial equivalent... shall be valid or recognized.” Confusion about the interpretation of the latter phrase will likely mean that critical questions - such as whether health coverage benefits can be extended to partners - will have to be answered by the courts over the next few years.

 

With respect to long-anticipated action at the federal level, we excerpt summaries of several Kaiser Family Foundation Health Policy Reports. Those reports quote CongressDaily, CQ Today, CQ HealthBeat, Bloomberg.com and the San Francisco Chronicle, among other sources. Those citations are removed to simplify reading. Please read the original reports in full here.

 

SCHIP:         

“...[T]he ‘first dilemma’ the new Congress will face on health care is whether to move legislation that would renew and expand SCHIP [Children’s Health Insurance] as its own bill or as part of ‘a larger overhaul effort.’ ...An SCHIP expansion likely would be funded by an increase in the tobacco tax, but other reforms -- such as expanding coverage to uninsured adults – ‘will vie with other priorities for dollars.’”

 

“Child advocates said they think the legislation will be similar to $35 billion expansion that President Bush vetoed in 2007, except with more funding -- potentially as much as $50 billion over five years -- to reflect inflation. The bill could include one ‘controversial tweak’ that would lift a prohibition on legal immigrant women and children enrolling in Medicaid or SCHIP for their first five years in the U.S.”

Health Care Reform:

“Efforts to draft comprehensive health reform legislation are advancing in the Senate.... Edward Kennedy (D-Mass.) plans to lead a unified Democratic effort to develop and pass legislation based on President-elect ... Obama's health care proposal ...His] committee has not yet begun to draft legislative language and has not settled on the final aspects of an overhaul... Kennedy would act on ‘cues from the Obama White House’ on health care and expects that Congress will act on an overhaul measure during Obama's first term....”

 

“[However, other] analysts ‘played down the likelihood’ that the Obama administration and Congress would even attempt to pass a unified overhaul bill, ...[as] crafting an all-encompassing bill would be contentious....”

“Health reform efforts could be limited [further] by declining tax revenues and an increasing federal deficit related to the recent economic downturn...[S]tabilizing the economy and withdrawing from Iraq -- two priorities of Obama's -- could pull resources and attention away from other Democratic goals, including expanding health coverage.”

Greg Mellowe, Florida CHAIN

 

 

Recession + Budget Cuts = Massive 1-2 Punch

 

State economists recently echoed the sentiments of financial experts across the country, agreeing that we’re sinking deeper into a recession, and that the situation may not turn around as quickly as we’d originally hoped. Florida’s economy in particular may not begin to rebound until perhaps mid-2010.

 

One dire consequence of this setback is that the State’s sales tax-dependent budget will be even further squeezed. In August, the revenue forecast for the current fiscal year (through June 2009) was reduced by another $1.8 billion. Even after tapping reserves, the State is still short $800 million short. That figure will likely be higher still after the next forecast is released this month. Governor Crist had already instructed agencies to hold back 4% of their budgets (from which Medicaid had been spared), but that may not be enough.

 

Given the bleak picture, state agencies were asked to prioritize 10% in additional cuts for next year. In that situation, the Agency for Health Care Administration (AHCA) would have no choice but to make the painful cuts that had been averted last legislative session...and many more. AHCA’s list of 27 possibilities includes eliminating many Medicaid-funded  such as adult vision, hearing and dental services; slashing payments to hospitals, nursing homes, HMOs and health departments; ending Medicaid coverage for 19-20 year olds; lowering Medicaid eligibility for pregnant women from 185% to 150% of the poverty level; and eliminating the Medically Needy program for pregnant women and children. On top of this, the Department of Health’s separate cut list would devastate efforts to combat poor birth outcomes, HIV & AIDS and diabetes.

 

NOTE: These cuts exclude the remainder of the Medically Needy program, as well as the MEDS-AD (Aged and Disabled) Waiver program, because the Legislature and Governor already agreed to end these programs as of June 30, 2009, so they can’t technically be cut.

 

AHCA also submitted its full 2009-10 Legislative Budget Request to the Governor. These recommendations assume those severe cuts won’t be necessary and serve as the basis for the Governor’s own formulation of budget recommendations. AHCA proposes taking some small but positive steps, including restoring funding for Medically Needy and MEDS-AD (again on a one-time rescue basis), as well as increasing Medicaid funding in areas of desperate need such as patient transportation and specialist and dentist reimbursement rates. The Agency also proposes launching a campaign to increase the efficiency of specialty care in Medicaid.

 

Unfortunately, AHCA also recommends spending $6.7 million and creating 23 new positions to expand the Medicaid Reform Pilot to capture another 290,000 consumers in 20 additional counties (Miami-Dade, the Keys, the Panhandle and the Big Bend). 

 

Ironically, the worse things get for Florida in the coming year, the less equipped our health care safety net will be to keep the most vulnerable Floridians from falling through the cracks.

Greg Mellowe, Florida CHAIN


 

Proposed Constitutional Budget Caps = Draconian Problems, Not Solutions

 

Budget cuts for Florida’s state and local governments already have hit vital public services and programs for elders and other vulnerable residents hard. 

 

Now an even more draconian menace looms — proposals to constitutionally cap state and local revenue and spending.

 

Already one signature drive has commenced to amend the state constitution to cap local-government revenue and spending.  Another drive has started to limit local property tax assessments on all residential and commercial property to 1.35 percent of taxable value.  Further, proponents are seeking to have the Legislature put an amendment on the ballot for state and local constitutional revenue and spending caps.

 

If nothing else, proponents of these constitutional caps are opportunists.  They seek to capitalize on the recession, on perceived inequities in local property taxation (think “Save Our Homes Amendment”) and on increases in property insurance premiums to pull the wool over the voting public’s eyes. 

 

Consider what has happened in Colorado, the only state to place a similar spending and revenue cap in its constitution. 

 

During the 13 years Colorado’s cap was in effect, the plan devastated public services.    Slow at first, erosion of Colorado’s quality of life for its residents and its business environment came faster and faster until the structural flaws of Colorado’s caps became all too evident.  Public education, public health, services for elders and infrastructure all suffered severely.  Imagine what would happen to Florida’s already fragile public health care system if such caps were enacted - vital healthcare services for children, seniors, and the disabled could be reduced or cut entirely.  Ultimately, in 2005, Colorado suspended its constitutional cap in order to assess how it can undo the damage.

 

A constitutional cap on state and local government revenues would be wildly unsuited to Florida.  As a percentage of individual income, Florida’s tax burden ranks in the bottom 10 states. Florida has no personal income tax and no annual state personal property tax.  More than half of all transactions in Florida are exempt from the general sales tax. 

 

Further, Florida has a constitutional requirement for a balanced budget.  Florida has cut its state budget from a high of $72 billion two years ago to $66 billion this year.  Lawmakers are likely to make equally or greater cuts to this and next fiscal years’ budgets. 

 

Florida’s budget is so constricted that government is challenged to help the state snap out of the economic slump. 

 

Imagine circumstances if Florida and its local governments (including special districts) were to have revenue and spending caps and Florida were to suffer another Hurricane Katrina.  Even proposing constitutional caps on revenue and expenditures dampens enthusiasm for state and local government bond markets.  Taxpayers would wind up paying more due to higher interest costs for bond issuances or due to erosion of unfunded or underfunded infrastructure and service programs that keep and entice residents to and business investment in Florida.

 

The real battle begins now— to stop the proposed constitutional caps from being placed on the ballot, either by the initiative process or by legislative origination.  This will require intensive commitment of advocacy resources by advocates, stakeholders, and citizens of Florida. 

 

Constitutional caps are not a solution. They are the geneses of extraordinary problems. 

 

Jack McRay, Advocacy Manager

AARP Florida

  

 

ALERT!

NEW POLICY TO PREVENT KIDS FROM LOSING
(OR NOT GETTING) KIDCARE COVERAGE

Over the past few months, thousands of Florida children have been disenrolled from their KidCare coverage by mistake. The reason for this is that the change to a new company that handles KidCare paperwork has been difficult.

 

On October 23rd, children’s health advocates sent a letter to the Board of Directors of the Healthy Kids Corporation, which runs the parts of KidCare (Healthy Kids, MediKids and Children's Medical Services-CMS) where the problems are happening.  The letter asked the Board to stop disenrolling kids from KidCare coverage until the problems are fixed. At their meeting the next day, the Board unanimously approved the advocates’ request.  

 

More specifically, here is the plan to fix the problems:

 

In October, any child that was disenrolled from KidCare coverage by mistake will be covered again, once they figure out that the child shouldn’t have been disenrolled.  (Also, if a child who was wrongly kicked off (or had an application denied by mistake) had medical expenses during the time that they should have been covered through KidCare, their family should save and submit the bills. The family will be paid back if they provide proof of any medical expenses that KidCare should have paid for.)

 

Throughout November, no child will lose Healthy Kids, MediKids, or CMS coverage because of an unpaid premium or other problems with their paperwork.   Families with children who have lost their coverage over the past few months by mistake should receive a postcard in the mail asking them to contact the Healthy Kids Corporation to get back into KidCare. 

  

NOTE:   None of this means that families can stop paying their Healthy Kids, MediKids, or CMS premiums.  It just means that no child will lose coverage until their case is reviewed and it is determined that he or she is being disenrolled for good reason.

 

At the beginning of December, the Director of the Healthy Kids Corporation will report back to the Board on the steps taken to fix the problems.  If the Board is satisfied that everything is OK, the normal process wil start again. If not, the ban on disenrolling kids from coverage will continue until the problems are fixed.

 

TAKE ACTION:

  • If you believe your child has lost coverage by mistake, watch for a postcard in the mail from Healthy Kids and respond when you get it.
  • Spread the word. 


 

Finding Solutions for Pregnant Women through Grassroots Advocacy

 

The health of pregnant women and babies is a sentinel indicator of the health of a community. In Volusia and Flagler Counties as with the rest of the State of Florida, over 50% of pregnant women are on Medicaid.  Policy decisions regarding the State’s Medicaid system has had an unfortunate impact on access to health care and health outcomes for Florida’s most vulnerable citizens. 

 

The difficult economic times we are facing will no doubt result in further cuts by our legislators with less emphasis on access and more on cutting costs.  Therefore, it is incumbent upon those of us in leadership roles to mobilize our constituents and present our policy makers with creative, innovative, and cost-saving solutions wherever possible.

 

The chart below illustrates the impact policy changes to Medicaid for pregnant women in 2002 had on access to care, particularly in the first trimester of pregnancy.  First trimester entry into prenatal care began to decline in 2002 and despite many efforts at better health navigation support and provider outreach, the numbers continue to decline.  

 

In the case of pregnant women, poor health outcomes result in babies dying before they reach their first birthday or having lifelong developmental challenges that could have been avoided and cost the taxpayer a hundred times what early and consistent prenatal care would have.

 

 

In response to these declining numbers, our community physicians, hospitals, policy makers and health experts have continued to meet over the last year to develop a local alternative to the current system.  The most challenging task is to follow through with ideas and come up with win-win solutions that will help patients and result in improved health outcomes

 

We are working on a creative and simple model alternative for pregnant women which involves implementation of local changes in Medicaid application and billing processes.  We are hopeful that our grass roots efforts will result in a more cost effective means of providing care to pregnant women.  For more information, feel free to review our Medicaid Study and see our model by visiting our website at www.healthystartfv.org.

 

Dixie L. Morgese, Executive Director

Healthy Start Coalition of Flagler & Volusia Counties

  


 

Looking Back, Looking Ahead: Medicaid Reform in Florida

 

On October 15, 2008 in Tampa,over 200  participants in an all-day meeting, “Medicaid Reform: Looking Back, Looking Forward,” examined the Medicaid reform pilots that have been operating in several Florida counties since September 2006.  Sponsored by the Jesse Ball duPont Fund, the Florida Health Policy Center and the Florida Philanthropic Network, the conference featured the release of a final report by Georgetown University researchers in their series on Medicaid reform. 

 

 

Key findings from the report included:

 

  • Beneficiaries and providers think the Medicaid program has become more complex with more paperwork as a result of reform, and there are signs that access to services is worsening.
  • The state has not yet provided data on whether the reform has saved money.  If savings are achieved, it is imperative to assess whether access to services is being compromised.
  • Some key aspects of reform have not yet been implemented or assessed so it is too early to say if it is a success or failure.  However, available data suggest that the reform has not achieved many of its objectives.

The full Georgetown report is available at hpi.georgetown.edu/floridamedicaid.  A video webcast of the full conference is available at http://www.floridahealthpolicycenter.org/.

The morning session of the conference featured a presentation of results from the new report by Joan Alker and Jack Hoadley from Georgetown University, followed by a roundtable with other evaluators of Medicaid reform.  Joining the Georgetown researchers for the roundtable were:

 

     Samantha Artiga of the Kaiser Commission on Medicaid and the Uninsured, which released a report the day before the meeting on consumer choice in the waiver

     Paul Duncan, director of the University of Florida’s state-mandated evaluation of Florida’s reform pilots 

     Yvonne Bigos, director of OPPAGA’s evaluation reports on Florida’s Medicaid reform

 

The roundtable discussion provided an overview of key findings of the evaluations and covered a variety of topics, including provider participation, consumer empowerment, and beneficiaries’ access to care.  Although there was not always complete consensus on the impact of the reforms in these areas, there was a general sense that it may be premature to expand the reforms beyond the five counties currently participating.

 

The keynote address for the conference was presented by Alan Weil, executive director of the National Academy for State Health Policy, an independent group of state health policymakers that seeks to identify emerging issues, develop policy solutions, and improve state health policy and practices.  Weil’s talk, “Medicaid: Health Reform Leader or Laggard?” placed Florida’s reforms in the larger context of relatively high level of overall health spending in Florida, despite lower-than-average funding for its Medicaid program.  He focused on what drives demand and what policy levers are available in trying to control costs, and he challenged the audience to think about how to confront these issues. 

 

Under the oft-cited rubric of consumer engagement, Weil laid out the conundrum that the more you empower people to exert market forces, the more you expose the sick, the poor, and the less sophisticated to risks that directly affect their health.  He also talked about the options available to a public purchaser like Florida Medicaid for containing costs for a program that both tries to serve some of the state’s most vulnerable citizens and to support those providers that most heavily serve this population.  Weil observed that the degree of reform in Florida's Medicaid reform is "not very significant," in that many elements represent less drastic changes than the rhetoric surrounding them. He concluded that some combination of leadership and local action is needed to bring more substantial changes to Florida Medicaid.

 

The conference’s final session was a roundtable of Florida stakeholders, including Tad Fisher of the Florida Academy of Family Physicians, Greg Mellowe of Florida CHAIN, Joseph Rogers of Broward Health and the South Florida Community Care Network, and Anne Swerlick of Florida Legal Services.  From the differing perspectives of providers, plans, and Medicaid beneficiaries, roundtable participants aired differing perspectives on what is and is not working. 

 

Among the themes discussed was whether some of the evident problems in Medicaid reform were a result of reform itself or issues being confronted by Medicaid and the health care system more broadly.  Some identified specific adjustments that might be made to the pilots (e.g., implementing an encounter data system and improving quality monitoring), while some expressed interest in other ways to change Medicaid, such as broader adoption of patient-centered medical homes. 

Jack Hoadley and Joan Alker,
Georgetown University Health Policy Institute

 


 

Add Inequity to Long List of Reform’s “Enhanced Benefits” Flaws

 

By reviewing recently released data for the Enhanced Benefits program, we have yet another troubling example of how the “real life” experiences in the Medicaid Reform experiment continue to fall short of the goals.

 

Recently renamed “Enhanced Benefits Reward$”, the EBR program is perhaps the most talked-about component of Reform, although it’s not the one that brings the most significant changes to Medicaid. EBR provides credits to consumers who are theoretically encouraged to perform any of a variety of approved “healthy behaviors”. Consumers can earn up to $125 in credits per year for use in purchasing over-the-counter items such as vitamins or antacids at participating pharmacies. However, little about the program’s performance so far suggests that it’s either motivating or rewarding healthy behaviors. See the OPPAGA report on that subject, for example.

 

The EBR data, when used together with Reform enrollment data, gives the average amount earned by each plan’s enrollees per month[1].  That doesn’t provide a wealth of information, but it’s sufficient to show that:

 

·        Collectively, plans have awarded their enrollees a (weighted) average of $4.05 in EBR credits per month. PSNs awarded only about 35 cents’ worth more per month than HMOs.

 

·        Interestingly, the HMOs that awarded EBR credits at the highest rates were the 3 which fully or partially pulled out of Reform this fall. Of these, Vista was the highest at $5.77 per enrollee per month. Children’s Medical Services was highest among PSNs at $ 5.27 per month.

 

·        At the other end of the spectrum, the 2 Wellcare HMOs - Wellcare and Healthease - awarded an average of only $3.66 and $3.54 in EBR per enrollee per month, respectively. Together, they awarded 38% fewer credits on average than Vista, and a full third less than United.

 

And that’s of course not the whole story. As has been widely reported, the amount of credits awarded tells us nothing about the extent to which enrollees actually benefitted. Another report shows that only 24% of ALL credits EVER awarded prior to June 30, 2008 were spent by September 8.  That translates into only $1 of actual benefit per enrollee per month.

 

What should we make of this? Inequity and poor quality control are two obvious concerns. It seems clear that, even if all of the other problems with the EBR program were resolved, enrollees of some plans would still have a significantly greater chance of benefitting than those of other plans. That’s backed up by the fact that the vast majority of credits to date were awarded simply for making office visits.  Why would Wellcare plan enrollees make 1/3 fewer office visits, etc., than United enrollees? (This question of course can’t be answered definitively due to the lack of encounter data, but attributing the disparity to differences in the plans’ enrollees or provider networks seems misplaced.)

 

On the other hand, there is an identifiable potential motivation for Wellcare to under-report credits earned by enrollees. If Wellcare matched even United’s reporting rate, its plans’ enrollees would have earned millions more in credits by now. AHCA holds back 2% of premiums paid to plans to fund the Enhanced Benefits program. Wellcare has complained publicly about the retained funds and has requested reallocation of the unused/unearned credits to the plans.

 

Significant funds are being diverted to the EBR program that would be used for patient care in traditional Medicaid. That consumers continue to derive so little from it is bad enough. Hopefully, we won’t learn later that even that that was further suppressed in some cases.

[1] For each plan, the calculation only includes those months in which the plan was operational.

Greg Mellowe, Florida CHAIN

 

 

As Pilot Ends, Praise JaxCare for Pioneer Effort to Cover Uninsured

 

Letter to the Editor

Jacksonville Business Journal

 

Your article, “JaxCare Closes, Stops Coverage Due to Lack of Funds” (October 3-9, 2008), reported some questioning “what the point was” of JaxCare. Permit me to respond.

 

JaxCare was a pilot program. Its purpose was to extend Jacksonville’s health care safety net, while learning through experience how to responsibly manage the health care needs of a community’s uninsured population. JaxCare succeeded in this mission.     

 

In creating JaxCare, Jacksonville community leaders gave the independent non-profit organization two assignments:

 

     One: Test a comprehensive coverage and care coordination model developed for small businesses with low-wage employees. The program provided access to the full range of health care services from primary care to hospitalization as well as assistance in navigating the health care system. While primary care is an important segment of the health care delivery system, and one that JaxCare continually emphasized in its wellness approach, primary care alone cannot fully meet the health care needs of any population.

 

     Two: Use information technology to support the efforts of all safety-net providers in Jacksonville for broader community benefit.  In response, JaxCare constructed two internet-based information exchange networks: one for health care providers and one for social service providers.

 

The financial information referenced in your article covers both of these assignments. The substantial costs for new electronic infrastructure resources for the community have frequently been inappropriately co-mingled with JaxCare’s health plan costs, leading to an overstatement of health plan costs and a misperception of JaxCare’s scope of work.     

 

While in operation, JaxCare provided low-income uninsured workers in 346 businesses with 24,162 member months of access to comprehensive health care services. These workers were individuals who earned too much money to qualify for Medicaid but did not earn enough money to purchase their own insurance.

 

JaxCare was financed as a private/public partnership; that is, for every $1 of public funds invested at least $1 in private money also was invested.  JaxCare used these funds prudently: The average annual medical cost per JaxCare health plan member was $1,339. Consider that one day in a Jacksonville hospital costs $1,672, on average.  

 

Moreover, an independent study by ROI metrix in Atlanta, Ga. reported a 548% return on community investment was realized by the JaxCare health plan.

 

JaxCare achieved customer and employer satisfaction ratings of 90%. Group retention was 87%, compared with 80% in the standard small group insurance market. The Florida Agency for Health Care Administration identified JaxCare as the “best Health Flex plan in the state.”

 

Though the JaxCare pilot was successful, onerous state-mandated restrictions and fundamental shifts in local government finances created significant barriers, prohibiting the program from moving beyond the pilot stage. But the pilot was successful.

 

Moreover, JaxCare provided the community with two lasting resources:

 

     The Jacksonville Health Information Network (“JHIN”),  an internet-based resource that  provides electronic health records for over 230,000 uninsured and/or Medicaid patients in Jacksonville, providing physicians timely access to critical patient information. The JHIN is broadly recognized as one of the early, successful interoperable electronic health information exchanges in America. 

 

     The Northeast Florida Information Network (NEFIN), which provides the software system supporting Jacksonville’s United Way 2-1-1 call in line, as well as shared electronic client records for social service agencies. JaxCare was a primary funder and development partner with United Way of Northeast Florida in creating and deploying this network.

 

The unselfish and caring service of hundreds of physicians, community leaders, and other committed individuals, and the support and participation of all the hospitals and many other provider organizations involved in JaxCare’s pioneering work was exemplary and deserves extraordinary praise from our community.  We hope that the lessons learned through the pilot will not be lost as our community continues to wrestle with the challenges of a growing population of working uninsured citizens.

 

Rhonda Davis Poirier, DrPH

President & CEO, JaxCare, Inc.

 

 

 

Orlando and Miami Town Halls Explore Health Care Access Solutions  

 

On Thursday, October 16th, residents, legislators and candidates gathered in Orlando and Miami for town hall meetings to discuss solutions to the health care crisis.

 

More than 70 Orlando area residents and legislators from Seminole and Orange Counties convened at the Englewood Neighborhood Center in a meeting  moderated by Magda Yvette Torres, host of “En Agenda," a Central Florida Spanish language program. 

 

Meanwhile, more than 45 Miami-Dade residents and legislators participated in a town hall meeting, moderated by Daniella Levine of the Human Services Coalition, at the Allapattah Neighborhood Center.  

 

Local legislators from both sides of the aisle were invited to these nonpartisan events. However, the Orlando attendance included State Representative Scott Randolph; State Representative Darren Soto; Lonnie Thompson, candidate for State Representative; Darius Davis, candidate for State Senator; and John Harris, candidate for Orange County Commission. And in Miami, only only congressional candidates Representative Joe Garcia and Representative Annette Taddeo participated.

 

Some participants at the meetings voiced their frustration at the system that blocks people from getting the care they need because of financial issues or other reasons. “There is a lot of corruption within the health care system. So many people need insurance but are victims of the system,” expressed a Miami town hall participant.

 

The Orlando meeting was sponsored by AARP, Hispanic Health Initiatives, Florida ACORN, and Florida CHAIN; and the Miami town hall was sponsored by Florida ACORN, Human Services Coalition and Florida CHAIN. 


 

 

Time Again For Critical Medicare Part D Decisions

 

Open enrollment for the Medicare Part D prescription drug benefit runs from November 15th through December 31st. “This is the one chance this year most people with Medicare have to make a change in their health and prescription drug plans[1].”

 

“Medicare Part D drug coverage is provided by a variety of private prescription drug plans, not by the Medicare program itself. This is different from the way Parts A and B work. Also unlike Medicare Parts A and B, people have to take action to enroll in Part D[2].”

 

“The Part D drug benefit covers some of the costs for certain drugs. People have to pay the first $295 as a deductible in 2009 and then Medicare will pay 75% of the next $2,405 worth of [covered] drugs. After that they have a gap in coverage, known as the ‘Donut Hole.’  During this Donut Hole gap, [consumers] have to pay all the costs of drugs until they have paid another $3,454 out-of-pocket. At that point, Medicare will begin paying about 95% of the cost of covered drugs until the end of the calendar year2.” Unfortunately, although Medicare Part B premiums won’t increase in 2009, major plans have increased their premiums by an average of more than 30 percent[3].

 

If you have limited income and resources, you may qualify for “extra help” (the low-income subsidy) to pay your prescription drug costs. Call Social Security at 1-800-772-1213? to find out if you qualify for extra help paying for your prescription drug costs.1”

 

Consumers deciding whether or not they should change prescription drug plans (Floridians will have 54 choices in 2009) should ask questions such as the following [excerpted]3:

“-Will the Medicare drug plan work with my current drug coverage?

-Does the plan cover all the medications I am taking?

-Does the plan cover the most important medications I take?

-Does the plan require that you get special permission before it will cover a medication I need?

-How much will I pay at the pharmacy (copayments or coinsurance) for each drug I need?

-How much will I pay in monthly premiums and annual deductible?

-Can I fill my prescriptions at the pharmacies I use regularly?”

 

Consumers can compare plans at www.medicare.gov and are also encouraged to check all information with the plans directly. Florida’s SHINE program also provides educational materials and free unbiased insurance counseling about Medicare prescription drug plans.

 

Also, due to past abuses, stronger rules regulating marketing of plans are now in place. For example, drug plans and their representatives cannot [excerpted]3:

·        “Call or email you if you did not ask them to do so. Cold calling is no longer allowed.

·        Visit you in your home without an invitation.

·        Provide gifts or prizes worth more than $15 to encourage you to enroll.

·        Include the term ‘Medicare Endorsed’, suggest that it is a preferred Medicare drug plan?or imply that they are calling on behalf of Medicare.

·        Try to sell you life insurance or other non-health related products at the same appointment.

·        Market their plans at educational events, in health care settings or at locations and events where free meals are provided.

·        Tell you that you must sign up for a Medicare private health plan (like an HMO) to get Part D drug coverage.”

 

Greg Mellowe, Florida CHAIN

[1] Medicare (Center for Medicare and Medicaid Services)                     

[2] Center for Medicare Advocacy                                                 

[3] Center for Medicare Rights                                                                       

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Providers and Advocates Unite to Address Admin Overload with Florida Healthy Kids

 

Just one month after the state launched their back to school kick-off events to inform families about KidCare, the state’s child health insurance program,  it’s finding itself backlogged with the number of families trying to enroll.

 

During two meetings in Ft. Lauderdale and Miami, a group of service providers and advocates convened with staff from Florida Healthy Kids to discuss the administrative problems overwhelming the program.  

 

In Ft. Lauderdale, Florida Healthy Kids sponsored one of several informational meetings to explain to advocates that the transition to a new TPA (third party administrator) was the main reason for the problems.  However, they were quick to point out that the systemic problems would improve once the kinks were worked out.  

 

Fred Knapp, assistant director of Florida Healthy Kids, explained that also, the timing for initiating a new fiscal and administrative contract for the program may not have been ideal given that the Medicaid program is also facing high volume and a new third party administrator and given the deluge of new applicants due to heightened outreach around the back to school events.

 

These informational meetings were in response to issues raised by advocates about problems getting through the phone lines to enroll families, families receiving notification letters too late, and families who made paid their monthly premiums but had not yet received information about their childrens’ coverage. Florida CHAIN, Human Services Coalition and the Florida Child Health Care Coalition will continue to work with service providers, case workers and the KidCare agencies to resolve these issues.

 

Submitted by Laura Goodhue, Florida CHAIN

 

 

REAL STORIES FROM FLORIDA HEALTH CARE CONSUMERS

  

Pain Meds Do Not = Health Care, as Lack of Insurance Poses Dire Obstacles, Extends Young Adult’s Disabilities

 

My name is Christina, and I’m 24 years old. About a year ago, I found out that I had kidney and liver damage. I’m basically disabled and can't function independently without my mother’s help. It’s hard to dress or bathe myself, and I can't stand or walk for long periods of time. I spend most of the day in bed just trying to survive.

 

I don’t have health insurance so I don't know how to get the surgery I need to get well again.

 

Last year, when I first started seeking care at the hospital, I kept getting sent home and prescribed over the counter pain pills with a diagnosis of “back pain”.  Even after repeated visits, I pleaded for more comprehensive tests to be administered, but the hospital refused.  After my pain became too unbearable, I demanded that blood work be done. It was only after they finally agreed and the tests came back when I found out I had kidney damage.  Fortunately, I was able to get surgery. 

 

I ended up getting a staph infection in my spine but because I didn’t have insurance to cover my care, it wasn’t treated properly and developed into osteomylitis.  A neurosurgeon told me that if I didn’t get surgery, I would become paraplegic. I asked him what I should do since I didn’t have health insurance. His response was as follows: “There are a million doctors. Go find one that will treat you without insurance.”

 

Because of my lack of coverage, the hospital had admitted and discharged me a total of six times between November 2007 and May 2008.  At one point, I went in twice a day (at 9 AM and 9 PM) to get treatment but the physical demands of leaving my house twice to go to the hospital became too challenging. I therefore stopped treatment and developed a septic infection which has created another illness for which I now need treatment.  

 

My doctor has deemed me completely disabled, but I don’t qualify for medical coverage.  She has an appointment for Medicaid, but I’m not sure I’ll get it. I’ve been denied twice before because I’m not yet on disability and don’t have any children. 

 

I still need surgery to repair my back, and I still need treatment for my liver damage. However, the hospital refuses to provide me with the care I need. The neurosurgeon prescribed pain medication for me, but they were too expensive. He said I need to find out the status of my bones by either having surgery or getting an MRI. The MRI seems the easier option, but I can’t afford the office visit, let alone an MRI. The hospital said they couldn’t do it because I already have a diagnosis so I’m considering visiting another hospital and telling them I don’t know why I have such pain.

 

The only thing I can do now is go to a methodone clinic to control my pain. My mother drives me every week and spends about $100 just in gas.

 

I hope I’ll be approved for Medicaid because I don’t know how else I’ll get the care I need to get better.

 

By Christina Patagas

 

Central Florida ACORN is working with Christina and others to increase access to healthcare for the uninsured. For more info. call 407-423-9832.

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

November 12, 2008

State Events 
     North Florida

     Central Florida     

     East Central Florida    

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

 

National Events 
     Conferences 
     National Audio and Web Events

     National Notices

     National Campaigns


STATE EVENTS & NOTICES

NORTH FLORIDA   

 

Notices

 

CENTRAL FLORIDA

 

EAST CENTRAL FLORIDA

WEST CENTRAL FLORIDA 

Events

 

Breakfast Briefing on Programs to Help Uninsured Get Savings on Prescription Medicines

Nov. 20   8:30-10:30 am  Children's Board of Hillsborough , 1002 E. Palm Ave, Tampa   

This briefing is designed for people who work with Floridians who lack prescription drug coverage. This may include social workers, case managers, hospital discharge planners, nurses, outreach workers and administrative staff from non-profit service agencies. Register by email: Email pfizerhelpfulanswers@grassrootseffort.net and provide Participant’s Name, Organization, Address, Phone Number and Email address. Register by phone: 1-800-276-0855 and provide Participant’s Name, Organization, Address, Phone Number and Email address.

 

The Biggest Challenge Remains: Addressing the Most Intractable Cost Problem Facing American Employers

Feb 3-4  Tampa Waterfront Convention Center
Cutting-Edge Employer Case Studies on the Preeminent Issues of Keeping Employees Healthy and Productive....and at an Affordable Cost. Topics will include: Wellness Programs, Managing Vendors, Control Cost Drivers, Predictive Modeling, Transparency, Demand Management, Power Data / Technology, Educate for Results, Disease Management, Benefit Design, Health Promotion, Consumer Directed. Contact: info@HBCE.com or call 941-484–1430.

 

Notices

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

SOUTHWEST FLORIDA

  

SOUTHEAST FLORIDA

  

Events

 

Elder Law Forum for Professionals: Facing the Challenges of Home, Hospital and Facility-Based Care

Nov. 12   1:00-4:30 pm   Classic Residence by Hyatt in Boca Raton, 22601 Camino Del Mar

Join us for the 1st Annual Elder Law Forum, featuring a unique array of presenters –including Laura Godhue, Florida CHAIN Executive Director - from health care, insurance, government, law and consumer advocacy, who will address critical questions facing seniors and people with disabilities living in Florida. The forum will focus on home and community-based care initiatives to provide a vision of the future that includes rapid changes in health care and responses to budget cuts. 1-800-ELDERLAW (353-3752) or 561-750-3850. Conference updates are available at: www.ElderLawAssociates.com  Click here for an Invitation including all details. Click here for the Registration Form

 

Southeast Florida Cancer Control Collaborative Quarterly Meeting

Nov 13  9:30 am–2:00 pm

Holy Cross Hospital, Sister Innocent Conf Ctr, 4725 N Fed Hwy, Ft. Lauderdale

Health Council of South Florida Annual Board of Directors Retreat
Nov 13   10:30 am - 5:00 pm  Wyndham Miami Airport
For reservations or additional information, contact wsejour@healthcouncil.org or
305-592-1452, ext. 116   

World Diabetes Day Health Fair

Nov. 14   Joseph Caleb Community Center, 5400 NW 22nd Ave, Miami

Please contact Angelique Dawkins at (305) 467-5852 for further information.

 

8th Fiesta Patronales, Family Health Day

Nov 15  10:00 am – 4:00 pm  Pines Recreational Center Park, Pembroke Pines

Health and recreation for the Developmental Disability community. Free admission. Phone : (954) 559-5355

Wellness 101: Developing a Worksite Wellness Program

Feb. 6   8:30 am–4:30 pm   South Miami Hospital, Victor E. Clarke Ed Ctr, U.S. 1 & SW 62 Ave

Almost half of all premature deaths in the United States are caused by lifestyle-related choices. We can prevent many of these deaths and enhance quality of life for millions of people if we can help them exercise regularly, eat nutritious foods, avoid tobacco and excess alcohol, learn to manage stress, improve social networks and achieve a sense of fulfillment. Target Audience: Human resource managers, wellness professionals, registered dietitians, registered nurses, exercise physiologists, health education specialists, health promotion professionals, wellness directors, community health professionals and anyone interested in developing a worksite wellness program. Contact Wellness Advantage, Baptist Health South Florida, at 786-596-2387, or e-mail wellnessadvantage@baptisthealth.net.

 

Notices

 

Miami-Dade Community Health Action Plan to Address Health Disparities

Southeast Florida Cancer Control Collaborative has submitted a draft of their Community Health Action Plan to Address Health Disparities to the Miami-Dade County Health Department on July 30, 2008 as the final product of the first year of the Mobilizing for Action Through Planning and Partnerships (MAPP) project. They will be meeting again sometime in late September 2008 to obtain your feedback on the draft, finalize the plan itself, and begin implementing the activities described (depending on cost and the availability of funding). Contact mjenakovich@healthcouncil.org for more information. SFCCC also refers you to the Florida State Health Disparities Strategic Plan as there may be some ideas in this document they will want to incorporate into local efforts.

FLORIDA AUDIO CONFERENCES AND WEBCAST

STATEWIDE NOTICES  

New Florida Cancer Drug Donation Program

This program was created during the 2006 Legislative Session, to provide access to the drugs and supplies used to treat cancer to patients who are uninsured and do not qualify for Medicare, third-party insurance or any other state or federal programs.  Section 499.029, Florida Statutes, authorizes the donation of cancer drugs and supplies by any person or entity to a participant facility for re-dispensing to an eligible recipient.  Facilities holding an Institutional Class II Hospital permit in Florida may elect to participate in the CDDP by submitting a notice of participation to DOH.  As a participant facility, the hospital pharmacy would accept donated cancer drugs and supplies from eligible donors, inspect the donated cancer drugs and supplies for authenticity, and dispense the drugs and supplies to eligible patients.  Who are uninsured and are not eligible for third-party insurance coverage, Medicaid, or any other state or federal assistance. For more information about the Cancer Drug Donation Program, please visit the program website at www.doh.state.fl.us/mqa/ddc/cancer  or E-mail: cddp_mqa@doh.state.fl.us 

NATIONAL EVENTS & NOTICES

 

CONFERENCES AND EVENTS 

 

NIH Summit: The Science of Eliminating Health Disparities 
Dec. 16-18     National Harbor, MD  

 

Health Action 2009

Early Bird Registration Deadline: Dec. 19

Conference: Jan 29-31   Washington, DC

Registration is officially open for business! Who should come? Progressive health care advocates and anyone interested in health care justice. Why should you come? With a new President and Congress, health care reform promises to be at the top of the national agenda in 2009 with a real opportunity for substantive reform.     

 

Supporting Linkages between State Associations of County and City Health Officials and Primary Care Associations
Application deadline: Nov 20
Meeting: Jan 8   Nashville
The National Association of County and City Health Officials (NACCHO), with the support of the Health Resource and Services Administration's Bureau of Primary Health Care, seeks the participation of representatives from SACCHOs, and their respective state primary care associations (PCAs), to engage in a brainstorming session about ways in which SACCHOs and PCAs have collaborated to increase access to primary, preventive, and specialty care on the state level.  NACCHO will sponsor travel, lodging and per diem costs for teams to attend the meeting.  

The Association for Community Health Improvement National Conference

March 11-13     Los Angeles

This annual conference hosts more than 450 professionals from hospitals, health systems, foundations, public health, and community health organizations for a gathering that stimulates real change and improvement in how community health programs are planned, run, and evaluated. There will be four tracks: Leading Community Health Assessments to Set Priorities, Programs, and Policie; Achieving Community Benefit Excellence; Improving Health by Addressing Our Social and Built Environments; Building the Skills of Community Health Leaders (for Today and the Future)

Creating the Future We Want to Be: Transformation Through Partnerships

Community-Campus Partnerships for Health's 11th Conference

April 29 - May 2   Milwaukee

AUDIO AND WEB EVENTS     

Families USA Conference Call: Not all health insurance is created equal

Nov. 12  3:00 EST

Even though a person may have insurance, whether it actually provides protection against unaffordable health expenses depends on the benefits package. The adequacy of benefits has become increasingly important for consumers as health costs rise and some policy makers push for lower-cost plans with fewer benefits.  This conference call to discuss the importance of state-mandated benefits, the problems with limited-benefit health plans, and how to work with women’s groups on these issues. This conference call will take place on Wednesday, November 12 at 3:00 PM Eastern Standard Time. Click Here to RSVP  Click Here for Background

 

Implementing Routine HIV Screening in Community Health Centers: A Story of Success

Nov. 13   2-3 p.m. EST - free registration here.

As a means of providing technical assistance on implementing routine rapid HIV testing in health care settings, the Health Research & Educational Trust is partnering with the National Association of Community Health Centers, Inc., to offer this free audio conference. Following the conference, the presentation will be available to download for free through the ED HIV Test Guide.

Webinar: High and Rising Costs: Demystifying U.S. Health Care Spending

Nov. 14   1:00-2:30 EST

A new report from the Robert Wood Johnson Foundation's Synthesis Project sheds light on the driving forces behind health care spending and examines the reasons why health care costs continue to rise.  To register, email your name, organization and telephone number to egarland@gymr.com or call 202-745-5119. You will receive confirmation and instructions for joining the call and Web presentation. To review the report in advance, visit http://www.rwjf.org/pr/product.jsp?id=35368.

ACHI Audio-Conference
Designing a Community Benefit Dashboard
Nov. 19  2:00-3:00 (ET)

This session is co-sponsored by VHA, Inc. and the Association for Community Health Improvement.

 

Webinar: Improving Children's Healthy Development Through Federal Policy Change
Nov. 19  3:00-4:00 p.m. ET

This event is being cosponsored by The Commonwealth Fund, Voices for America's Children, First Focus, and the National Academy for State Health Policy (NASHP).  With: Charles Bruner, Ph.D. - Director, Child and Family Policy Center; Alan Weil, J.D. - Executive Director, NASHP; Bruce Lesley - President, First Focus; Ed Schor, M.D. - The Commonwealth Fund's Child Health and Development Program. There will be an approximately 20-minute question-and-answer session; you will be able to submit questions online.

NOTICES

Race/Ethnicity: Multidisciplinary Global Contexts: Race and the Global Politics of Health Inequity, Volume 3, Number 1 (Autumn 2009)
Paper submission deadline: Dec. 31
Health outcomes around the world vary dramatically across lines of race, ethnicity, gender, class, place, and nationality. The first issue of Volume 3 explores the implication of race and ethnicity in health outcomes around the world, with special attention to the social, economic and political foundations of health inequity.

CAMPAIGNS & INITIATIVES

2008                                                                                              

November

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

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

 

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

 

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

 

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

                                                    

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

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

                                            

December       


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

November 12, 2008

New listings, in order of submission deadlines 

 

2009-2011 DHAP/ORISE Post-Doctoral Research Fellowships for HIV Prevention in Communities of Color

Applications accepted: Nov.1–Dec. 31

The Centers for Disease Control and Prevention's (CDC) Division of HIV/AIDS Prevention (DHAP) announces four two-year post-doctoral research fellowships for  recently graduated doctoral-level researchers (with doctorates earned no earlier than May 2004 and no later than May 2009) to conduct research leading to the prevention of HIV infection in communities of color in the United States. 

Community Access to Child Health Implementation Funds
Applications accepted: Nov. 1-Jan. 31

The Community Access to Child Health (CATCH) Program is a national program of the American Academy of Pediatrics designed to improve access to health care by supporting pediatricians and communities that are involved in community-based efforts for children. The CATCH Implementation Funds Program provides grants of up to $12,000 each year to pediatricians who want to initiate a pilot project that addresses the local health needs of children in the community. (Grants are also available for pediatric residents, but limited to a maximum of $3,000.)

 

National Call for Cancer Clinical Trial System to Be More Responsive to Community Needs

Proposal deadline: Dec. 5

Communities as Partners in Cancer Clinical Trials: Changing Research, Practice and Policy, developed by the Education Network to Advance Cancer Clinical Trials (ENACCT) and Community-Campus Partnerships for Health (CCPH), details 58 recommendations for how the cancer clinical trial system can involve communities affected by cancer: from trial design - to implementation - to dissemination of research results. ENACCT and CCPH are now seeking "Implementation Partners" that will receive seed grants of up to $8000 and technical assistance to implement the recommendations.

Healthy Communities Demonstration Sites

Application deadline: Dec. 5

During the week of November 10, 2008, NACCHO's Chronic Disease Prevention Project will announce a Request for Proposals (RFP) for applications to become a Healthy Communities demonstration site. NACCHO plans to award up to $30,000 each to 10 local health departments (LHDs) to: 1) build or strengthen a coalition of community partners and 2) develop a community action plan to address chronic disease risk factors such as physical inactivity, poor nutrition, and tobacco use at the policy, systems, and environmental change levels. Questions to (202) 507-4220 or egreen@naccho.org

2009 Barbara Jordan Health Policy Scholars Program

Application deadline: Dec. 12

College seniors and recent college graduates who have a strong interest in addressing racial and ethnic health disparities, or who are themselves a member of a population that is adversely affected by racial and ethnic health disparities are eligible to apply.

Local Efforts Encouraged to Improve Chronic Disease Care

Proposal deadline: Dec. 12

Many patients do not receive the care and support they need to effectively manage their conditions. While some provider organizations have made great strides in creating systems and improving quality, care is uneven across communities and regions. CHCF seeks to accelerate the spread of high-quality chronic disease care in California by providing opportunities for the sharing of strategies and skills across provider organizations working in the same geographic areas.

 

Harvard Center for Population and Development Studies Bell Fellowships Call for Applications - 2009-2010

Application deadline: Dec. 22

Bell Fellows examine a broad range of critical issues in the field of population and development from multidisciplinary perspectives. Most will have interests that match the HCPDS's focal areas: social and environmental determinants of population health; migration and immigration; causes and consequences of health transitions and aging societies; and gender and labor force participation.

 

Healthy Communities, Tobacco Control, Diabetes Prevention and Control, and Behavioral Risk Factor Surveillance System

Application deadline: Dec. 29

The purpose of the program is to reduce the morbidity and premature mortality associated with chronic diseases and to eliminate associated health disparities by supporting capacity building, program planning, development, implementation, evaluation, and surveillance for chronic disease conditions and chronic disease-related risk factors.

     

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

Next deadline for invited proposals: Jan. 15

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.

 

Families USA Wellstone and Social and Health Care Justice Fellowships

Deadline: Jan. 15

The Wellstone Fellowship for Social Justice is designed to foster the advancement of social justice through participation in health care advocacy work that focuses on the unique challenges facing many communities of color. Through this fellowship, Families USA hopes to expand the pool of talented social justice advocates from underrepresented economic, racial, and ethnic minority groups, including black/African American, Latino, Native American, and Asian and Pacific Islander communities. Candidates seeking consideration for the Wellstone Fellowship must demonstrate an interest in health care policy as a tool for reducing racial and ethnic health disparities. While there is no bias in favor of any specific academic discipline, a college degree is preferred. The Villers Fellowship for Health Care Justice was created to inspire and develop the next generation of healthcare justice leaders. Villers Fellows will be given the opportunity to work on a variety of healthcare justice issues during their year-long tenure and will be exposed to different advocacy strategies, including producing analytic reports, disseminating effective messages through the media, successful coalition building, and e-advocacy techniques. Fellows will also develop an understanding of the federal legislative process. Candidates applying for the Villers Fellowship must demonstrate a commitment to social and healthcare justice advocacy following their year of hands-on experience as a fellow. Each fellowship will last from August 2009 through July 2010, and fellows will receive a compensatory package that includes an annual salary of approximately $35,000 and excellent health care benefits. One Wellstone Fellow and one Villers Fellow are selected each year.  

Continuing listings, in order of submission deadlines     

Robert Wood Johnson Foundation Health Policy Fellows Program
Deadline: Nov 14
The Health Policy Fellows program provides a comprehensive experience at the nexus of health science, policy, and politics in Washington, D.C. The fellowship provides the opportunity for exceptional mid-career health professionals and behavioral and social scientists with an interest in health and health care policy. Fellows experience and participate in the policy process at the federal level and use that leadership experience to improve health, health care, and health policy. 

 

Miami-Dade Community Foundation Community Grants

Deadline: Nov 17

The Community Grants Program formally known as the Discretionary Grant Program is the Foundation's most general grant making program. Funding for this program is made available though the Foundation's unrestricted and field of interest funds. The Community Grants programs is designed to honor both the donors interests and address significant community issues such as: education, health, human services, arts and cultural, environment economic development at-risk youth, abused and neglected children, people living with HIV/AIDS, homelessness, social justice, care of animals, heart disease and more.  

 

Echoing Green Fellowships

Deadline: Dec 1
Echoing Green sparks social change by identifying, funding, and supporting some of the world's most extraordinary emerging social entrepreneurs and the organizations they launch. Each year, Echoing Green awards 20 two-year fellowships to help social entrepreneurs launch new organizations that deliver bold, high-impact solutions. Fellows receive up to $90,000 in seed funding and technical support to turn their innovative ideas into sustainable organizations. Individuals at least 18 years of age, or partnerships (organizations led by two people), are eligible to apply.


Robert Wood Johnson Foundation Health Reform Projects

Deadline: Dec 3

The Coverage Team at the Robert Wood Johnson Foundation (RWJF) is accepting proposals on a broad range of applicant-initiated projects related to national health reform. Up to $2 million will be allocated to support grants of up to $400,000 each, for projects that will increase the likelihood that the nation's health care debate will lead to solutions and build momentum to drive federal policy-makers to act.

 

The Kellogg Health Scholars Program

Deadline: Dec 3

This two-year post-doctoral program is accepting applications for its 2009-2011 cohort. ONLY online applications are accepted. Through the Kellogg Health Scholars Program, scholars develop as leaders with research expertise to add to our knowledge about the nature of social disparities in health and interventions to reduce those disparities, the capacity to partner with communities in carrying out research and building policy advocacy and the skills to inform and support policy makers who seek to reduce and eliminate health disparities.

 

Wal-Mart Foundation State Giving Program
Deadline: Dec 19
The Wal-Mart Foundation's State Giving Program awards grants at the state and regional level to programs that have a strong impact within the communities the company serves. Advisory Councils in all 50 states and the District of Columbia will determine how best to distribute State Giving Program funds. The program's priority funding categories include Health, with a focus on access to healthcare and the promotion of healthy lifestyles. Mminimum grant $5,000.

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. 

 

2009 - 2010 Fellowship in Minority Health Policy

Deadline: Jan 2

Supported by The Commonwealth Fund, administered by the Minority Faculty Development Program at Harvard Medical School, 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.   

 

Enhancing Access to Quality HIV Care for Women of Color  

Deadline: Jan 9

This award will support organizations funded under the Ryan White HIV/AIDS Treatment and Modernization Act of 2006 to implement and evaluate focused interventions designed to improve women of color's timely entry into HIV primary care following diagnosis and retain women of color in quality primary HIV care.

 

Community-Campus Partnerships for Health Annual Award

Deadline: Jan 30

Community-Campus Partnerships for Health (CCPH) promotes health (broadly defined) through partnerships between communities and higher educational institutions, including through service-learning and community-based participatory research. 

  

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. 

 

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

 

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

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

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

 

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

 

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

 

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

 

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

 

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

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

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

Expiration Date: May 8, 2011

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

 

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.

November 12, 2008

Florida CHAIN Website Resources

Organizations and Services

     Florida

     Children's Health Care

     Medicare

     Prescription Medications

     Health Disparities

     Other


Manuals, Guides and Toolkits

     Children's Health Care

     Medicaid

     Medicare

     Uninsured

     Health Disparities

     Other


Technology and Audio Visual Materials

     Media Programming

     Web Sites, Web Features

          Florida

          Children's Health

          Medicaid

          Medicare

          Health Disparities

          Other


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

Periodicals and Books

Reports and Studies

     New Listings

        New Listings: Medicaid

        New Listings: Children's Health Care

        New Listings: Medicare

        New Listings: Federal/State Budget

        New: Health Insurance, Health Care Costs

        New: Health Disparities

        New: Other Health Issues

     Florida Reports

     Children's Health Care

     Medicaid

     Medicare

     Federal/State Budgets

     Health Insurance, Health Care Costs

     Health Disparities

     Other Health Issues

FLORIDA CHAIN WEBSITE RESOURCE UPDATE

Florida CHAIN Website Updated

www.floridachain.org was updated in August 2008. Find comprehensive information about Medicaid Reform including background information, evaluations, media coverage, consumer experiences, correspondence with AHCA, and more. Apply for Florida KidCare, access the KidCare renewal flyer, or view the KidCare Coordinating Council’s annual report. Discover resources for people who are uninsured. Find the contact information of Florida’s health committee members. Use our town hall meeting template to create your own town hall. Access health care resources in Spanish. Learn more about Florida CHAIN’s activities, board of directors, and partners. View Florida CHAIN’s publications. Just visit www.floridachain.org and mark it as one of your favorites.  For feedback or suggestions, contact Lisa Margulis at lisam@floridachain.org or 954-986-6535. 

 

ORGANIZATIONS AND SERVICES

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

 

Florida

 

(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.

 

Children's Health

 

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

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

 

Medicare

 

AARP's Public Policy Institute
This website offers an array of publications addressing health care issues that are now available online, including such titles as Quick Health Facts 2008: A Compilation of Selected State Data and Doors To Extra Help: Boosting Enrollment In The Medicare Part D Low-Income Subsidy.

 

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

 

Access to Benefits Coalition

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

 

A Healthier US Starts Here: CMS Prevention and Wellness Initiative

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

 

Prescription Medications

 

The AZ&Me? Prescription Savings

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

 

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

 

The Prescription Project

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

 

Together Rx Access

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

 

Health Disparities

 

Health Resources in Haitian Creole

Provided by Florida Association of Community Health Centers, Inc.

 

The National Resource Center on Public Health Preparedness Needs of Culturally Diverse Communities is a new online central clearinghouse of resources and an exchange site to facilitate communication, collaboration, and networking among key players working to empower and eliminate disparities for culturally diverse communities in emergencies.

African American Health Coalition (AfAHC)
During a time when our country faces tough economic decisions, many programs are being cut that provide information and health services to diverse communities. One such program, the African American Health Coalition (AfAHC), remains committed to providing services to the African and Hispanic-American population in Houston, Texas. Read more

National Resource Center on Advancing Emergency Preparedness for Culturally Diverse Communities
A joint initiative of the Drexel University School of Public Health's Center for Health Equality and the United States Department of Health and Human Services' Office of Minority Health, the site features hundreds of cross-referenced annotated resources in over 40 languages highlighting research, training and education opportunities, measurement and evaluation tools, effective risk communication strategies, and other successful programs and projects.

 

National Health Law Program (NHeLP) Resources

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

 

Refugee Health Information Network 

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

 

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

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

 

Other

 

Partnership to Fight Chronic Disease Promising Practices
The Partnership to Fight Chronic Disease, a diverse, national coalition of more than 100 partner organizations, is committed to raising awareness of policies and practices that save lives and reduce health costs through more effective prevention and management of chronic disease.

 

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

 

The National Alliance on Mental Illness (NAMI)

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

 

MANUALS, GUIDES, TOOLKITS

 

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

 

Children's Health

 

Monitoring and Assessing the Use of External Quality Review Organizations to Improve Services for Young Children: A Toolkit for State Medicaid Agencies

State Medicaid agencies typically contract with external quality review organizations (EQROs) to assess the quality of health services provided through Medicaid managed care plans. But only a handful of states are using these organizations to improve the quality of preventive and developmental services for young children. This toolkit shows state Medicaid officials how they can work with EQROs to evaluate and improve the quality of preventive and developmental services delivered to children enrolled in Medicaid managed care plans. (July 2008, Mathematica Policy Research, Inc., and George Washington University)

 

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

 

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

 

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

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

 

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

 

Medicaid

 

Return on Investment Calculator for Medicaid Quality Initiatives

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

 

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

 

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

 

Medicare

 

Toolkit: Medicare Private Fee-for-Service Plans

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

 

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

 

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

 

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

 

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

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

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

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

 

Uninsured

 

The Opportunity for National Health Reform in 2009 is a PowerPoint presentation from Community Catalyst that provides a broad overview of the current health care environment, a history of prior reform efforts, and possible scenarios for the future. The presentation focuses on building the capacity of state consumer advocates to influence the national effort, facilitating state advocacy group participation in policy and design and implementation, promoting federal policy that supports state programs, and working to protect vulnerable populations. Click on the orange box labeled “The Opportunity for National Health Reform in 2009” 

 

Community Benefit & Charity Care: State-by-State Maps
ACHI has updated national, state-by-state maps of hospital association and government Web sites and documents on community benefit and charity care.  States are linked to either recent statewide reports on community benefit or charity care, or to state reporting requirements or guidelines.  View the two maps here.  Write to communityhlth@aha.org with suggested updates or additions.

 

Community Benefit Bibliography Updated
ACHI has updated its annotated bibliography of published community benefit articles. Among the additions are several new pieces written since mid-2007, some reflecting on upcoming changes in IRS reporting.  Download the bibliography here

 

The Consumer Guide to State Health Reform

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

 

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

The Uninsured and Their Access to Care

Covering the Uninsured: Growing Need, Strained Resources

Massachusetts’ New Law to Cover the Uninsured

Women's Health Insurance Coverage

The Uninsured: A Primer

 

Health Disparities

 

Fact Sheet: HIV/AIDS among African Americans, contains the latest statistics on how HIV/AIDS has affected the African American community. (Updated August 2008, CDC)

 

Critical MASS Toolkit: Taking Community ACTION on Health Disparities
Designed to help communities and grassroots coalitions take charge in the fight against disparities, this toolkit was developed by Critical MASS to support individuals and communities like yours in efforts to: Understand the different causes and impacts of disparities in health; Learn where and how to look for data and patterns regarding health; Use group action as a strategy to address health disparities and related issues in communities

 

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

 

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

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

 

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

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

 

Race Matters 

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

 

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

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

 

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

 

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

 

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

 

Other

The Community Health Promotion Handbook: Action Guides to Improve Community Health
Partnership for Prevention and the Centers for Disease Control and Prevention have worked together to bridge the gap between research and practice by developing these Action Guides. 

 

Updated! State-by-State Community Benefit Requirements and Reports
ACHI has updated its interactive maps with state-by-state requirements and voluntary reports on hospital community benefit.  Located on the Community Benefit Resources page, these maps are based on research by ACHI and by the Catholic Health Association.  Visit the interactive maps to learn how each state is working to tell its community benefit story.

 

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

 

Environmental Health Disparities Fact Sheets

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

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

 

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

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

 

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

  

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

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

TECHNOLOGY AND AUDIO/VIDEO RESOURCES 

Media Programming

Unnatural Causes: Is Inequality Making Us Sick?

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

  

Web Sites, Web Features & Databases

 

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

 

Florida

 

Florida Medicaid Reform Evaluation Project 

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

 

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

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

 

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

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

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

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

 

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

 

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

 

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

 

Florida Association of Community Health Centers (FACHC)

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

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

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

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

 

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

  

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

 

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

 

Florida KidCare Applications can be completed online

 

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

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

 

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

 

Florida Progressive Information Network (FLPIN)

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

 

Children's Health

Healthy Counties Database on Youth Obesity

A new resource containing more than 100 profiles of model policies, programs and initiatives that counties nationwide enacted to prevent childhood obesity. (June 2008, National Association of Counties)

 

Children’s Health Coverage Conversation Guide

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

 

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

 

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


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

 

Medicaid

 

Medicaid Calculator

You can show your state officials that cutting Medicaid is a big mistake with this revised and updated Medicaid Calculator from Families USA. Simply click on your state and use the worksheet to find out how much your state stands to lose in jobs, wages, and business activity.

 

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

 

Medicaid Fact Sheets Tool

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

 

Interactive Tools on Medicaid

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

 

Medicare

 

2009 Medicare Prescription Drug Plan Finder and Medicare Options Compare

CMS has announced that beneficiaries, their caregivers, and family members can begin to review 2009 Medicare prescription drug plan and health plan information online. The 2009 Plan Finder allows beneficiaries to compare prescription drug coverage from both stand-alone Prescription Drug Plans (PDPs) and Medicare Advantage (MA) plans that provide prescription drug coverage (MA-PD plans) and to view premiums, formularies, and availability of coverage in the gap. Additionally, the 2009 Medicare Options Compare tool allows beneficiaries to compare Medicare health plan options, such as HMOs and PPOs. For more information and to view the plan finder tool please click here. The LIS Outreach Toolkit can be accessed here. People without Web access can get the same information provided by the online plan comparison tools by calling 1-800 MEDICARE (1-800-633-4227), by visiting their local State Health Insurance Assistance Program (SHIP) office for free personalized counseling.

 

Understanding Advance Beneficiary Notices

Usually, health suppliers and providers have an idea of whether or not Original Medicare will pay for your health services. However, there are some services that are only covered in specific circumstances and a supplier or provider might not know if Medicare will cover it for you. An Advance Beneficiary Notice (ABN) is a notice that suppliers and other medical providers are required to give you when they offer you services or items that they know or have reason to believe Medicare will not pay for in this individual case, even though Medicare may cover it at other times. Read the full article from Medicare Rights.

 

Finding out What Has Been Covered: Understanding Medicare Summary Notices (MSNs) and Explanations of Benefits (EOBs)

The MSN is a summary of all claims Medicare has processed for you during the previous three months. The MSN is not a bill. It will contain information about submitted charges, the amount that Medicare paid, and the amount you may be responsible for. If you have a Medicare private health plan, your plan may also send you this information in an Explanation of Benefits (EOB) notice. The EOB will contain similar information fields to the MSN but these fields’ titles may vary among plans. Read the full article from Medicare Rights.

 

Know What You Should Pay for Outpatient Services with Original Medicare

Much of the time, payment for Original Medicare-covered services is a smooth and easy process. If you have Original Medicare and you see a provider who agrees to accept the Medicare-approved cost of services, you simply pay the provider a coinsurance. However, there are several factors that can complicate the situation. Avoid problems by knowing when you can be asked to pay for Medicare-covered services, how much you should be charged, and what your providers’ responsibilities are to submit claims to Medicare. Read the full article from Medicare Rights.

 

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

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

 

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

 

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

 

Uninsured

Ask the Experts: High-Risk Pools

In this webcast, panelists discuss how high-risk pools work, including their funding, the benefits they provide, and the premiums that are charged to enrollees. Panelists also discussed how high-risk pools are a factor in helping stabilize the individual insurance market, as well as what role they might play in a reformed health care system. (7/15/08, KFF)

 

Election Year Health Reform Messaging (ppt presentation)

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

 

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

 

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

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

  

Families USA’s State Coverage Expansions Resource Center

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

 

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

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

 

Uninsured Tutorial, Module, and Reference Library

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

  

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

 

Healthcare Coverage Options Database: Assistance for Obtaining Health Coverage

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

 

Health Disparities

 

Health Literacy Website

The average American adult reads at a middle school level; but, most medical information printed and spoken by doctors is at a college level or more. This disconnect can cause major problems. To combat this, the Jefferson County Health Department has begun to work toward improving health literacy. They have partnered with East Central Missouri Area Health Education Center (ECMO-AHEC) in creating a health literacy internship for a recent pre-med high school graduate. Through this internship, the Department has begun to change their written materials to a reading level all people can understand. Also, they have been working toward staff education so they can ensure that their patients understand the medical information told them. Finally, they have created a health literacy website. This website includes information for patients, providers, and public health professionals, as well as a page linking to even more health literacy resources.

 

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

 

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

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

 

Guide to Health Programs (Guia de Programas de Salud)

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

 

“Race, Ethnicity and Health Care” tutorial

Online from Kaiser Family Foundation.

 

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

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

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

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

 

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

 

National Cancer Institute Spanish Web Site

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

 

Facing Race 2007

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

US Racial Disparities Update

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

 

Faith Based Efforts and Resources 

Families USA has posted a new page on the Minority Health Initiatives section of the Web site with links to various to encourage faith leaders to become involved in health care advocacy.

 

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

 

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

 

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

 

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

 

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

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

 

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

 

Other

 

CDC Launches CDC-TV On-Line Video Resource

The Centers for Disease Control and Prevention has launched CDC-TV, a new online video resource that  will cover a variety of health, safety and preparedness topics. The premiere series on CDC-TV is "Health Matters."

 

Health, United States, 2007

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

 

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

 

Latest Health Policy Facts and Data

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

 

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

 

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

 

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

 

New Online Medical Dictionary Reference Tool

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

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

     

State Level Data on Health Coverage & the Uninsured

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

 

The Johns Hopkins INFO Project's OneSource Database

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

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

Investigating an Urgent Healthcare Problem

By the year 2020, a nationwide shortage of up to one million trained nurses could mean that hundreds of thousands of patients will receive less attention and substandard treatment. [NOW on PBS]

 

Mobilizing for National Health Care Reform

The forum held on October 22, is now online as a podcast, with additional documents.  Renowned public health leaders, and advocates for single payer and transitional plans, compared the presidential candidates' plans for national health care reform, and examined how these plans address the concerns of public health, women, low-income residents and health care providers. (Center for Policy Analysis)

 

A podcast from The Commonwealth Fund highlights the success of remote simultaneous medical interpreting (RSMI), a new translation method being used at New York City’s Bellevue Hospital. Like the translation service used at the United Nations, RSMI allows the doctor and patient to speak into enhanced telephones while an off-site interpreter translates.

 

The Deadliest Disease in America, is a documentary produced by URU The Right To Be, Inc, which chronicles the stories of four individuals who experienced racism while seeking medical care. The film serves as a vehicle to foster discussion about the U.S. health care system and what strides are being made to eliminate racial and ethnic health disparities. For more information, to view the trailer, and to see a list of conference tour locations, click here.

 

Viewpoints: The Health Care Debate

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

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

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

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

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

 

Sick People or Sick Societies?

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

 

Unnatural Causes: Is Inequality Making Us Sick?

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

Unnatural Causes: Is Inequality Making Us Sick? 

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

 

Partnerships to Achieve Health Equity 

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

 

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

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

 

PERIODICALS AND BOOKS

 

Social Epidemiology: Strategies for Public Health Activism
By tracking the distribution of disease and pinpointing relevant risk factors, social epidemiology reveals how social problems are intrinsically linked to the health of populations.  The practice also takes into account the psychosocial, biological, and medial determinants of disease and health.

 

Health Disparities in the United States: Social Class, Race, Ethnicity, and Health
"Clearly articulates the problem of health disparities and how socioeconomic status and race and ethnicity are interwoven. Barr has brought together a vast amount of material in a conceptually meaningful way that hopefully will be digested by those in training to be medical professionals."

 

The Public Health Observatory Handbook of Health Inequalities Measurement

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

 

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

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

Florida Dept of Health Women’s Health Newsletter

The FL Dept of Health website has a Women’s Health page with a new quarterly Women’s Health Newsletter. The April-June 2008 will be online.

REPORTS AND STUDIES

New Listings

New Listings: Medicaid

Florida's Medicaid Reform: Informed Consumer Choice?

Florida's Medicaid reform program aims to encourage consumer choice and market competition by giving health plans new authority to vary benefits and having enrollees choose among the different plans. However, about three in 10 enrollees were not aware that they needed to make this health plan choice and over half of those who were aware reported difficulty making a plan choice, according to a Health Affairs article based on the Kaiser Family Foundation's 2006-2007 Survey of Florida Medicaid Beneficiaries conducted during the first year of the state's reform effort. The study found that three-quarters of the enrollees who were unaware of their need to choose a plan said that they had not been told so by the state, suggesting that they either did not receive, did not read or did not understand the state's letter and other communications about their transition. (10/14/08, KFF, Urban Institute, University of Florida)

 

Medicaid Re-Enrollment Policies and Children's Risk of Hospitalizations for Ambulatory Care Sensitive Conditions

A study examined children in California who received Medicaid coverage to ascertain the health and cost consequences of a policy change that extended the process of redetermining program eligibility from every three months to 12 months. Reducing the frequency of eligibility redeterminations was associated with higher costs, but fewer hospitalizations for ambulatory care–sensitive conditions. (10/16/08, Commonwealth Fund)

 

Assessing the Effects of Medicaid Documentation Requirements on Health Centers and Their Patients: Results of a 'Second Wave' Survey

The second in a two-part study that examines the effects of Medicaid citizenship documentation requirements found that 75% of community health centers continue to experience significant problems with the requirements for one or more eligible patient groups because of the requirements and nearly one-half of health centers continue to report Medicaid application and enrollment delays and disruptions. The report also found that changes implemented to address these issues have done little to alleviate the problems. (10/21/08, George Washington University Medical Center)

 

Children Enrolled In Medicaid Have More Untreated Tooth Decay

Children covered under Medicaid receive considerably less dental care and have more untreated tooth decay than those who are privately insured, expert witnesses testified during a recent hearing held by the House Oversight and Government Reform Domestic Policy Subcommittee. A GAO report found that an estimated 6.5 million children covered by Medicaid had untreated tooth decay in 2005. Children covered by Medicaid between 1999 and 2004 were almost twice as likely to have untreated tooth decay, and 15% difficulty receiving dental care because the provider did not accept their insurance plan, compared with 2% of privately insured children. Low reimbursements were cited as a critical part of the problem. (October 2008, GAO in HealthBeat)

 

Report: Many Enrollees Don't Understand Florida's Revamped Medicaid Program

A substantial number of Medicaid enrollees in Florida's new consumer choice program have struggled to navigate it, leaving some of Florida's most vulnerable citizens, as well as the new program, in an increasingly precarious state. (10/14/08, Health Affairs)

 

Medicaid Re-Enrollment Policies and Children's Risk of Hospitalizations

A study examined children in California who received Medicaid coverage to ascertain the health and cost consequences of a policy change that extended the process of redetermining program eligibility from every three months to 12 months. Reducing the frequency of eligibility redeterminations was associated with higher costs, but fewer hospitalizations for ambulatory care-sensitive conditions. (10-16-08, Commonwealth Fund)

2008 Actuarial Report on the Financial Outlook for Medicaid

From its inception, the cost of the Medicaid program has generally increased at a significantly faster pace than the US economy...As illustrated by the actuarial projection in this report, Medicaid costs will likely continue to increase as share of DGP in the future under current law. (10/17/08, US DHHS)

 

States Make Cuts To Medicaid, Other Health Coverage Programs To Address Budget Gaps
The economic downturn is leading many states to cut back on health coverage programs such as Medicaid. Medicaid "is a target" for cuts because in most states it represents the second-largest portion of their budget. On average, Medicaid accounts for 17% of state budgets. (10/29/08, CBPP in USA Today)

Medicaid Costs Expected to Increase 7.9 Percent Annually
Medicaid's growing strain on federal and state budgets is unlikely to abate over the coming decade as the cost of providing health care to the poor is expected to increase 7.9 percent annually. (10/17/08, AP)

New Listings: Children's Health Care

Improving Child Health Care Through Federal Policy: An Emerging Opportunity

The issue brief reviews recent legislative proposals focusing on child health care coverage and quality. The brief also proposes a set of provisions that would strengthen primary, preventive and developmental health care services. (10/21/08, Commonwealth Fund)

 

Evidence-Based Maternity Care: What It Is and What It Can Achieve
The report argues that while U.S. women pay more than those in any other country for maternity care, they do not receive the highest quality care. The report looks at how maternity care is delivered and financed, and how it is received from the perspective of mothers' families and health care payers. The report concludes that maternity care can be greatly improved by using evidence-based care. The report also notes that caesarean sections are overused, a trend caused by physicians' preference for the procedure, rather than by the health needs of pregnant women and infants. (10/8/08, Childbirth Connection release)

New Listings: Medicare

Potential Cost Impacts Resulting from CMS Guidance
A report of survey results indicates that current government regulations requiring Medicare's Part D prescription drug plans to include all drugs in certain designated classes could be costing US taxpayers an additional $511 million per year. A new law, which could lead to an expansion of the number of drug classes, could increase that cost substantially. (10/16/08, Academy of Managed Care Pharmacy)

 

CMS: Medicaid Spending to Hit $674 Billion by 2017

The first of what it said will be an annual report projecting Medicaid outlays said that combined federal and state spending on the health care program for the poor and disabled will reach $339 billion in 2008. Spending on the program will grow at a 7.9 percent yearly clip over the next decade, reaching $674 billion by 2017. (10/13/08, Office of the Actuary at the Centers for Medicare and Medicaid Services/CMS)

 

As Home IVs Grow, Medicare Patients Miss Out

A Wall Street Journal study found a growing number of people needing IV medications are getting their treatment at home. But a gap in Medicare coverage is making it harder for older and sicker patients to swap hospital stays for home care." Many private insurers provide full coverage for home-infusion therapy. Administering the medications at home typically costs $150 to $200 daily, compared with $1,500 to $2,500 per day for a typical inpatient hospital stay. Home-infusion therapy also reduces patients' risks for contracting an infection through IV lines and catheters at hospitals. Medicare covers the cost of medications administered intravenously through its prescription drug benefit plan -- "not the pharmacy and nursing services, supplies and equipment that make up roughly half the cost of home-infusion therapy." supplemental Most Medicare coverage can receive infusions at outpatient facilities, but have to be admitted to a hospital or nursing home, where services are covered under Medicare Part A. (10/17/08, Wall Street Journal)

 

Medicare Now and In the Future

The second in a series of election briefs on health policy issues presents an overview of Medicare, detailing whom the program covers, what services are provided, how care is supplied to the elderly and disabled and what future challenges the program faces. The brief highlights Medicare's long-term financing challenges, the role of private plans, the prescription drug benefit and the efficacy of current benefits. (10/2/08, Kaiser Family Foundation)

 

Medicare Advantage's Private Fee-for-Service Plans: Paying for Coordinated Care Without the Coordination

Like the private managed care plans offered under Medicare Advantage, private fee-for-service (PFFS) plans are paid more per beneficiary than those individuals would be expected to cost if they were enrolled in traditional fee-for-service Medicare. However, PFFS plans are not required to provide the same type of coordinated care required of Medicare Advantage plans. Payments to PFFS plans in 2008 average 16.6 percent more than costs in traditional Medicare, or $1,248 for each of the 2 million enrollees in PFFS plans—a total of nearly $2.5 billion in extra payments. Recently, Congress has made significant revisions to policies that will affect how PFFS plans will operate in 2011 and thereafter, as well as their prospects for continued growth. This issue brief examines the development of PFFS plans, the policies underlying the rapid increase in the plans and their enrollment, the payments they receive, and the potential impact of the new legislation. (10/21/08, Commonwealth Fund)

 

Fewer Medicare Prescription Drug Plan Options Available Next Year For Low-Income Residents

Low-income residents in all states but Wisconsin who are enrolled in Medicare prescription drug benefit plans will have fewer plans to choose from in 2009, according to an analysis released this week. According to the analysis, the number of free-standing plans eligible to serve low-income beneficiaries, who qualify for lower deductibles and monthly premiums or no premiums at all, will decrease from about 500 this year to 308 in 2009. (10/10/08, Avalere Health, in USA Today)

New Listings: Federal/State Budgets

State Revenues Plummet: July-September Numbers Worst in Years

Cuts in state spending "will take demand out of the overall economy and worsen the economic downturn." He added that moves such as slashing reimbursements to Medicaid providers or reducing grants to not-for-profit social-service providers "are all things that take dollars out of families' pockets, and that's money they can't spend in their local economies.” (10/31/08, CBPP)

 

Overview of States and the Weak Economy
This snapshot of state budget problems has been updated to reflect new data on 2009 mid-year shortfalls, 2010 projected shortfalls, and state revenues. (10/20/08, CBPP)

 

State Budget Troubles Worsen
Mid-year shortfalls totaling $12.3 billion have opened up in the 2009 budgets of at least 27 states and the District of Columbia.  This new round of shortfalls is in addition to the budget gaps of $48 billion that 29 states closed as they adopted their budgets for this fiscal year. Seventeen states now project deficits for 2010, including Florida. (10/24/08, CBPP)

 

States Forced to Cut Health Coverage for Poor

Economic troubles are forcing states to scale back safety-net health-coverage programs - even as they brace for more residents who will need help paying for care. (10/29/08, USA Today)

 New Listings: Health Insurance, Health Care Costs   

Uninsured Children and Adolescents with Insured Parents

Among all US children, more than 3% were uninsured with at least 1 insured parent. Predictors of such uninsurance included having low and middle income. About 28 percent of uninsured U.S. children have at least one parent with health insurance; children most likely to be in this situation, the study found, were those from single-parent or Hispanic families. Having a parent covered by only public insurance was associated with better children's coverage rates. (10/22/08, JAMA)

 

Health Care Opinion Leaders' Views on Payment System Reform

The 16th Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey asked a diverse group of experts about health care payment system reform. Survey participants are fundamentally dissatisfied with the way health care is paid for in the United States, with more than two-thirds reporting the fee-for-service system is not effective at encouraging high quality and efficient care and more than three-quarters preferring a move toward bundled per patient payment. Shared accountability for resource use was favored as a means for improving efficiency, and at least two-thirds supported realigning provider payment incentives to improve efficiency and effectiveness, using strategies including increasing payments for primary care under Medicare and paying for transitional care services. Opinion leaders also supported Medicare negotiation of pharmaceutical prices and competitive bidding for durable medical equipment. A majority expressed support for creation of a Medicare Health Board to make Medicare payment and benefit decisions, subject to congressional guidelines. (11/3/08, Commonwealth Fund)

 

The American Public on Health Care: The Missing Perspective

This report is the culmination of an eight-month initiative that explored the challenges facing health care in America - the problems and trade-offs - through the public's perspective. The report releases new national poll results and includes messages for the presidential candidates, government leaders, health care providers, insurers, employers, and the public. Among the key findings of the project: There is a palpable anxiety about costs; American's believe in the power of information and want accountability for results; they want portability in their health care; public performance ratings of doctors and hospitals; coverage for pre-existing conditions, employer-based care required; assistance for the low-income; medical record-sharing; evidence-based medicine; and a public menu of costs. (October 2008, Accenture Institute for Public Service, with guidance from the Institute of Medicine)

 

An Eroding Model for Health Insurance

Ineligible for group insurance, millions of Americans are paying more for individual policies that offer less coverage and expose them to seemingly arbitrary exclusions and denials. The health insurance system has become increasingly expensive and inaccessible. It leaves patients responsible for bills they understood would be covered, squeezes doctors and hospitals, and tries to avoid even minuscule risks. (10/21/08, Los Angeles Times)

 

What Price Universal Health Coverage? For Many Small Employers, Any Price Is Too High

Over a third of US employers (almost exclusively small employers, with fewer than 500 workers) do not sponsor an employee health plan and one of the central questions of the reform debate is how they might be induced to do so. According to a major new employer survey...the majority of these employers believe that, at its current price, employee medical coverage is far beyond their means. (10/21/08, New York City)

Who Gained the Most Under Health Reform in Massachusetts?

We know that health insurance coverage rose dramatically in the past year in Massachusetts.  This study examines what the effect has been on specific populations, finding that the greatest gains in insurance coverage were reported by lower-income adults, younger adults and those in minority groups. (10/15/08, Urban Institute)

Some Cut Back on Prescription Drugs in Sour Economy

For the first time in at least a decade, the nation's consumers are trying to get by on fewer prescription drugs. As people around the country respond to financial and economic hard times by juggling the cost of necessities like groceries and housing, drugs are sometimes having to wait. (10/22/08, New York Times)

Troubled Economy Leads More Americans to Use Drug Assistance Programs
Struggling with unemployment, lack of health insurance and high medical costs amidst the recent economic crisis, more Americans are utilizing prescription drug assistance programs, which are "normally aimed at providing medications to the poorest Americans." (10/21/08, Wall Street Journal)

 

Premiums Versus Paychecks

Throughout the first eight years of the new millennium, health care costs have skyrocketed, while working families' wages have stood still. Other factors have also threatened families' economic well-being, including rising gasoline prices and the downturn in the housing market, but the confluence of stagnant wages and rising health care costs has become a significant strain on family budgets. (September 2008, Families USA) 

U.S. Health Care System Wastes $700 Billion on Unneeded Tests

At a time of financial crisis and a soaring deficit, the amount of reckless spending in the health care system is astounding: $700 billion is wasted each year on unnecessary tests and procedures that do not improve patient outcome. That wasted money is enough to give over $15,000 towards care for every one of America's 45.7 million uninsured.  (10/29/08, Medical News Today)

Variation in Standards and Guidance Limits Comparison of How Hospitals Meet Community Benefit Requirements
The report examined differences in the way charity hospitals, which receive tax-exempt status for performing services that benefit the community, define community benefits. GAO found that variations in activities not-for-profit hospitals define as community benefits lead to substantial differences in the amount of community benefits they report. Even if hospitals define the same activities as community benefits, the facilities may measure their cost differently. (September 2008, GAO) 

Blueprint for a Healthier America

Trust for America's Health (TFAH), a nonprofit and nonpartisan health advocacy group, hasissued a new report stating that prevention should play a significant role in any major effort to overhaul health care in America. Preventative measures will reduce the cost of health care, according to report, which is meant as a guide to the new administration and Congress. (October 2008, Trust for American Health)

Solving the Riddle of Patchwork Family Coverage

When Americans are uninsured, it may not be a family affair. Because of the nation's patchwork coverage system, kids who have health benefits may have uninsured parents, and parents with health coverage may have uninsured kids. If only some members of a family have insurance, a new study notes, the most typical pattern is that parents go without while their children are insured—particularly since the 1997 creation of the State Children's Health Insurance Program (SCHIP). Still, for policy makers trying to figure out how to widen coverage, covering uninsured kids whose parents have health insurance benefits is a big part of the puzzle, the study suggests. some 2.3 million children a year are uninsured even though at least one of their parents has health insurance. That means that slightly under one-third of the nation's 9 million uninsured children have one or more parents with coverage. (10/21/08, CQ)

Compensation for Workers With and Without Access to Health Benefits at Work; Health Benefit Offer Rates and Employee Earnings

The two analyses in the Kaiser Family Foundation's Snapshots: Health Care Costs series examine the relationships between employer-sponsored health benefits and employee earnings. The snapshots find that workers who do not have access to employer-sponsored coverage on average receive lower wages and other compensation compared with workers who are offered health benefits. The analyses also suggest that businesses with higher-wage workers are more likely to offer health insurance and other benefits to employees. (10/2/08, KFF)

 

Feeling the Health Care Pinch
This new survey shows that nearly 70 percent of adults aged 25-34 claim the economic downturn of the last 12 months has made it somewhat or significantly more difficult to pay for health care expenses. Ironically, among people over 55--pre-retiree and retiree aged consumers whom many often think of as struggling to pay for health care -- more than half said the downturn in the economy has not impacted their ability to pay for health care at all. Overall, three out of four people are concerned about the cost of health care. (October 2008, MedCo Health Solutions)

Employers Ambivalent About Health Overhaul Plans

One of the truisms among those who predict a possible overhaul of the U.S. health care system in the next few years is that employers want big changes in the system this time—unlike in the early 1990s, when they played a major role in blocking the Clinton universal coverage proposal. But a new survey by the Mercer consulting firm finds no strong momentum building behind any major proposal now on the table. (10/22/08, CQ HealthBeat)

Subsidies for Low-Income Individuals Better Way to Cover Uninsured

Providing subsidies to individuals rather than to businesses is a fairer and more efficient way to extend health coverage to the uninsured, according to a new report. Subsidies for individuals and family members are better at targeting low-income people—those who are least likely to be insured. Such a system is more equitable since individuals with similar economic circumstances would receive similar treatment. Furthermore, employer subsidies are of little use to workers who cannot afford health insurance even if their employers offer it or to those who are unemployed. (1022/08, Urban Institute)

Myths and Misconceptions about U.S. Health Insurance
Examined five myths about the U.S. health insurance system: uninsured people with pre-existing conditions cannot find affordable coverage; the cost of covering the uninsured is offset by savings from expensive and inefficient care received by the uninsured in emergency departments; lack of coverage is the major access barrier to high-quality care; employers can afford to shoulder more of the cost of providing their employees with coverage; and inaction is the answer until a solution can be found (10/21/08, Health Affairs)

 

The Politics of Paying for Health Reform: Zombies, Payroll Taxes and the Holy Grail Examines the political strengths and weaknesses of major proposals to fund universal health coverage. Oberlander also examines barriers to changing the way the U.S. pays for health care (10/22/08, Health Affairs)

The Decline in the Uninsured in 2007: Why Did It Happen and Can It Last?

This policy brief examines the underlying shifts in health insurance coverage in 2007, which resulted in a 1.5 million decrease in the number of uninsured people under age 65, due to increased public coverage. This includes about 300,000 in Massachusetts, which implemented its comprehensive health reform that year. The brief also projects that the current economic downturn and rising unemployment rate likely will cause the number of uninsured to grow by at least 2 million in 2008.  (10/15/08, KFF)

 

Equal Treatment for the Uninsured? Don't Count on It

It's not uncommon for patients with no insurance or poor insurance to receive different treatment. A 2006 study of 25 primary care private practices in the Washington area showed that in nearly one in four encounters, physicians reported adjusting their clinical management based on a patient's insurance status; nearly 90 percent of physicians admitted to making such adjustments. (10/14/08, Washington Post)

 

Healthcare's Wasted Billions: Why We Lose $700 Billion - And How to Get It Back
Seven hundred billion - sound familiar? Yes, that's the cost of the financial-services industry bailout, but it's also about the amount of money America is wasting every year on unnecessary healthcare expenses.  If we could take the steps needed to save that $700 billion, we could take "just" $100 billion to cover the uninsured and have $600 billion left over for Wall Street.  (10/8/08, The Christian Science Monitor)  

 

Improving Health Care - by 'Spreading the Mayo'

At a time of financial crisis and a soaring deficit, the amount of reckless spending in the health care system is astounding: $700 billion is wasted each year on unnecessary tests and procedures that do not improve patient outcome. That wasted money is enough to give over $15,000 towards care for every one of America's 45.7 million uninsured. Hospitals spend almost half their budgets on unnecessary treatments, and the government programs which cap the costs for medical services have created an incentive for doctors to test more - regardless of necessity. The current system offers little hope or incentive for care that is both high quality and cost-effective; this reportcalls on the next president to lead a shift from the current system of managed healthcare to an integrated system, which would cost less and deliver better care, to strive for patient care standards as good and economical as those of the world-renowned Mayo Clinic, a successful example of the integrated health care model. (October 2008, Progressive Policy Institute)

Retail Medical Clinic Patients

Retail medical clinics located in pharmacies and other stores typically attract insured and uninsured patients who are seeking help for a small group of easy-to-treat illnesses or preventive care and do not otherwise have a regular health care provider, according to a new RAND Corporation study. (9/10/08, RAND)

New Listings: Health Disparities 

 

Prescription drugs, like groceries, cost more in poor areas
A study of retail pharmacy prices in Florida found that commonly prescribed drugs such as Nexium and Plavix cost 15 percent more on average in poor neighborhoods than in prosperous ones. (10/27/08, Newswise)

More Americans Forgo Care as Economy Worsens
From Park Avenue dental offices to the Arlington Free Clinic, the global economic crunch is forcing a growing number of Americans to scale back on medical care, but some physicians worry that the short-term savings may translate into more severe long-term health implications. (10/16/08, Washington Post)

Some Doctors Treat Uninsured Patients Differently
A doctor practicing in Memphis describes the ways in which some physicians treat their uninsured patients differently, which can lead to inadequate treatment and serious health problems. (10/14/08, Washington Post)

APA Poll Finds Economic Stress Taking Toll On Women, Hispanics

The declining state of the Nation's economy is taking a physical and emotional toll on all people nationwide, yet financial stress is impacting women and Hispanics in particular, according to data from the American Psychological Association's newly released 2008 Stress in America survey. When asked about the recent financial crisis, almost half of all adults say that they are increasingly stressed about their ability to provide for their family's basic needs. At the same time, eight out of 10 adults said that the economy is a significant cause of stress, up from 66 percent in April(1). Compared to men, women are most likely to report unhealthy behaviors to manage stress like eating poorly (56 versus 40 percent), shopping (25 versus 11 percent), or napping (43 versus 32 percent) as well as to report physical symptoms of stress like fatigue (57 percent compared to 49 percent), irritability (65 percent compared to 55 percent), headaches (56 percent compared to 36 percent) and feeling depressed or sad (56 percent compared to 39 percent). (October 2008, APA)

 

Disparity in Depression Treatment Among Racial and Ethnic Minority Populations in the United States

The study shows that while 33 percent of non-Latino whites received adequate treatment if they experienced depression in the previous year, only 22 percent of Latinos, 13 percent of Asians and 12 percent of African Americans who had experienced depression in the same period received adequate treatment. People from racial minorities in the United States are less likely to have access to care for depression and less likely to receive adequate care when treatment is available, according to a new study. (November 2008, Psychiatric Services/APA)

 

Many Cancer Patients Forgoing Care Because of Cost

One in eight people with advanced cancer turned down recommended care because of the cost, according to a new analysis from Thomson Reuters.  Among patients with incomes under $40,000, one in four in advanced stages of the disease refused treatment. (10/13/08, in USA Today)

 

Patient Ethnicity and the Identification of Anxiety in Elderly Primary Care Patients

Physicians are less likely to diagnose anxiety in elderly black patients than in white patients, according to a recent study. An understanding of the role of ethnicity in the identification of anxiety is important for the screening and management of anxiety in elderly people. (September 20008, Journal of the American Geriatrics Society)

 

Women Buying Health Policies Pay a Penalty

Striking new evidence has emerged of a widespread gap in the cost of health insurance, as women pay much more than men of the same age for individual policies providing identical coverage, according to new data from insurance companies and online brokers. Women's health insurance premiums can cost hundreds of dollars a year more than a man's, even for policies that leave out maternity coverage, new national data show. Florida Health News found it's true in Florida: Rates in West Palm Beach and Tampa on eHealthInsurance for Aetna Open Access run 25 percent more for women than men age 40. (10/29/08, New York Times)

 

Potentially Preventable Hospitalizations among Hispanic Adults, 2006

Hispanic adults from both poor and wealthy communities are much more likely than whites to be hospitalized for health problems that good quality outpatient care can prevent or control, such as uncontrolled diabetes and heart ailments, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. Wealthy communities in this report have average annual household incomes of $62,000 or greater. (October 2008, AHRQ)

 

Ethnic Differences in the Treatment of Depression in Patients With Ischemic Heart Disease

The study examines the differences in depressive symptoms and antidepressant treatment among blacks and whites undergoing a coronary angiography to diagnose heart disease. Blacks have an increased risk of mortality from coronary heart disease and traditional risk factors do not fully account for the disparity. (October 2008, American Heart Journal)

 

Attempted Suicide 4 Times More Likely In Youth From Poor Neighborhoods
Youth in their late teens who live in poor neighborhoods are four times more likely to attempt suicide than peers who live in more affluent neighborhoods, according to a new study from Canada's Université de Montréal and Sainte-Justine Hospital Research Center, as well as Tufts University in the U.S. The researchers also found youth from poor neighborhoods are twice as likely to report suicidal thoughts. (October 2008, Psychological Medicine)

Doctors Implicitly Favor Whites Over Blacks, Like Rest Of Society
In the first large study to explore possible unconscious bias among physicians, researchers have found that doctors mirror the attitudes of the majority in society and implicitly favor whites over blacks. Data from the study were drawn from a sample of more than 400,000 anonymous people who took the race attitude Implicit Association Test online during a 28-month period between 2004 and 2006. More than 2,500 of those test-takers identified themselves as doctors. (October 2008, Project Implicit, operated by the University of Washington, University of Virginia and Harvard University.

 

Racial/Ethnic Disparities in Self-Rated Health Status Among Adults With and Without Disabilities

The report examines differences in self-rated health status by race/ethnicity and disability. The findings are based on an analysis of data from the 2004 through 2006 Behavioral Risk Factor Surveillance System surveys. The analysis found that the disability prevalence was highest among American Indian/Alaska Natives, at 29.9%, and lowest among Asian-Americans, at 11.6%. The report found that 66.9% of whites without a disability rated their health as very good or excellent, compared with 49.9% of blacks without a disability. Among adults with a disability, reports of fair or poor health ranged from 24.9% among Asians to 50.5% among American Indian/Alaska Natives and 55.2% among Hispanics. The report recommends that efforts to reduce racial/ethnic health disparities should include strategies to improve the health and well-being of those with disabilities for each racial/ethnic group. (10/3/08, Morbidity and Mortality Weekly Report, 10/3).

 

Study finds gender, weekend gap in heart-attack care
Florida hospitals are much less likely to provide timely treatment for serious heart attacks if they occur on the weekend, according to a University of South Florida study. And while racial disparity appears to have disappeared, the USF study found, the gender gap persists: Women are far less likely than men to receive the right care. (10/15/2008, Florida Health News)

 

Race and Insurance Status as Risk Factors for Trauma Mortality

Race and insurance status each independently predicts outcome disparities after trauma. African American, Hispanic, and uninsured patients have worse outcomes, but insurance status appears to have the stronger association with mortality after trauma. (October 2008, Archives of Surgery)

 

The Color of Opportunity: Narrowing Racial Divides and Expanding Prosperity for All

A special report on economic determinants of racial disparity, this is an anthology of nine articles that connect evidence to policy on a range of economic issues.  (October 2008, The American Prospect)

 

Screening and Early Intervention Program in Diverse Health Care Settings Reduces Illicit Drug Use

The Screening, Brief Intervention, and Referral to Treatment (SBIRT) program can reduce illicit drug use among patients seeking medical care in a wide variety of health care settings such as hospitals, physician offices, and community clinics, a study finds. (10/31/08, SAMHSA) 

 

 Most in U.S. Agree: Overhaul Health Care System

Dissatisfaction with the U.S. health care system is running high-really high. According to recent survey findings...82 percent of Americans think it should be fundamentally changed or completely rebuilt. (September/October 2008, Commonwealth Fund)

 

Panel: Medical Technology Behind High Health Care Costs

Medical technology is the main culprit behind soaring health care costs and physicians should take a closer look at how it is used, said health care experts during a discussion on a new report examining how to curb rising costs and expand health coverage for the uninsured. (October 2008, Commonwealth Fund)


Americans Dissatisfied With Healthcare, Want Lower Costs Even If It Means Sacrificing Quality
With the election just days away, a new survey by leading health Web site shows a vast majority of Americans are not satisfied with the current state of the U.S. healthcare system and are willing to put cost of care above quality of care. (10/31/08, QualityHealth.com)


Study: Small Business Owners Dissatisfied with Insurer Services

A new report by the PricewaterhouseCoopers Health Research Institute shows that small business owners are not nearly as satisfied with insurer-provided services as large employers and have needs distinct from large companies that are not being met. (10/16/08, Commonwealth Fund)

 

Kaiser Health Tracking Poll: Election 2008 -- October 2008

The final Kaiser Health Tracking Poll: Election 2008 finds more people are reporting problems with health care bills, and paying for health care retains a solid hold on the public’s list of their top economic concerns. About one in three Americans now report their family has had problems paying medical bills in the past year, up from about a quarter saying the same two years ago.  Almost one in five (18%) of Americans report household problems with medical bills amounting to more than $1,000 in the past year.  Nearly half (47%) of the public reports someone in their family skipping pills, postponing  or cutting back on medical care they said they needed in the past year due to the cost of care.  For example, just over one-third say they or a family member put off or postponed needed care and three in ten say they skipped a recommended test or treatment – increases of seven percentage points from last April’s tracking poll which asks the same question.  (10/21/08, KFF) 

New Listings: Other Health Issues   

 

Climate Change Will Affect Public Health: A Call to Action

Extreme heat events (EHE), or heat waves, are the most prominent cause of weather-related human mortality in the United States, responsible for more deaths annually than hurricanes, lightning, tornadoes, floods and earthquakes combined. These events, and other climate-related changes in the worldwide environment that directly affect public health, are examined. (November 2008, American Journal of Preventive Medicine) 

 

Not-for-Profit Hospitals Increasingly Moving From Cities To Suburbs

Not-for-profit hospitals moving from low-income areas of cities where the majority of patients are uninsured to more affluent areas, often in the suburbs, where a larger portion of patients have private coverage has become an "increasingly common strategy." (10/14/08, Wall Street Journal)

 

Study Shows Uninsured Not to Blame for Overcrowded ERs
A study published in the Journal of the American Medical Association shows that most of the responsibility for the increasingly overcrowded emergency rooms during the past decade can be attributed to insured patients and not the uninsured. (10/21/08, USA Today)

 

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)

 

Patients' Perception of Hospital Care in the United States

Using data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), researchers examined patients' experiences in U.S. hospitals—in the first study of its kind—and found that patients have moderately high levels of satisfaction with their care. The quality of clinical care and certain hospital characteristics, such as a higher ratio of nurses to patient-days, were associated with greater patient satisfaction. (10/30/08, Commonwealth Fund)

Florida Reports

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.

Medicaid

Heart Attack Victims on Medicaid from Poor Areas Face Delays

People with Medicaid insurance and living in neighborhoods with lower household incomes appear less likely to reach the hospital within two hours of having a heart attack, according to a new study by researchers at the University of North Carolina at Chapel Hill Gillings School of Global Public Health.  (10/3/08, ASPH Friday Letter)

 

Headed for a Crunch: An Update on Medicaid Spending, Coverage and Policy Heading into an Economic Downturn

According to a new 50-state survey from July 1, 2007 to June 30, 2008, the weakened economy has led to a significant growth in Medicaid enrollment and spending, and this spending likely to grow another 5.8 percent in 2009 if the economy’s downturn continues. The rapid increases in enrollment and spending are raising concerns about program cutbacks as states confront the impact of fewer available resources. The study warns that the resulting state budget shortfalls may lead to a new round of cuts in payments to doctors and hospitals. (9/29/08, Kaiser Commission on Medicaid and the Uninsured)

 Children's Health Care

Database Project to Track Health of 100,000 U.S. Children

An ambitious new government study to follow the health of 100,000 U.S. children from before birth to age 21 is launching in January, and information technology for data collection and analysis is playing a central role. The National Institutes of Health National Children's Study...will examine the effects of genes and environmental factors on the health of American children based on volunteer participants in 105 locations, representing a composite of the U.S. population. (10/7/08, InformationWeek)

 

Family Income Impacts Children's Health

For American children, the state they live in and their family's income and education may help determine how healthy they are, a new survey shows. Among children aged 17 and younger, 16 percent are in less than optimal health, according to this state-by-state survey. Some 16% of U.S. children and teens under the age of 17 are in less than optimal health, according to a new report. "This report shows how much healthier kids in each state could be if we narrow the gap between the children of the wealthiest, most educated families and everyone else." (10/8/08, Robert Wood Johnson Foundation)

Medicare 

MedPAC Mulls Meaning of Rapid Rise in Health Spending

Wrestling with what to say that might help Congress address fast-growing health care outlays, the Medicare Payment Advisory Commission (MedPAC) took a look at some of the factors driving that growth: construction outlays growing at a faster clip than in other sectors of the economy; more rapid wage growth; and bigger gains in employment, for example. (10/6/08, Medicare Payment Advisory Commission)

Study: Poorest, Sickest Medicare Enrollees Face Smaller Drug Plan Menu

A segment of the Medicare population that includes many of its sickest enrollees has a declining number of prescription drug plans from which to choose, according to a consulting firm's analysis. The concern is that "they have a skinnier set of options to match up to their needs." (10/14/08, Avalere Health)

 

Seniors Not Quite Embracing Generic Drugs

Medicare beneficiaries enrolled in the prescription drug benefit are more likely to ask pharmacists for generic medications when they pay for them and for more expensive brand-name treatments when the program provides coverage, according to a study (September 2008, Medco Health Solutions)

 

Review 2009 Medicare Health and Drug Plan Options, Consumer Group Advises “Considering alternative coverage options can be overwhelming, but there are some basic rules to help people make decisions and guard against aggressive or deceptive marketing employed by companies offering these plans.” (October 2008, Medicare Rights Center)

How Does the Benefit Value of Medicare Compare to the Benefit Value of Typical Large Employer Plans?

Compares the traditional fee-for-service Medicare program, including the drug benefit, with a typical large employer PPO plan and with the standard BCBS national PPO plan available under the Federal Employees Health Benefits Plan. According to the analysis, Medicare's benefit package is less generous than other plans because of high inpatient deductibles for hospital stays; the lack of a limit on beneficiaries' out-of-pocket spending; the Medicare prescription drug benefit's so-called "doughnut hole" coverage gap; and a general lack of dental coverage (9/22/08, Kaiser Family Foundation)

The Continuing Cost of Privatization: Extra Payments to Medicare Advantage Plans in 2008 considers the policies of the Medicare Modernization Act (MMA) that have spurred greater enrollment in private plans and that have substantially increased Medicare costs. Private health plans serving Medicare beneficiaries will be paid an average of 12.4 percent more per enrollee in 2008 compared to what the same enrollee would have cost in the traditional Medicare fee-for-service program. (September 2008, Commonwealth Fund)

 

Medicare Part D Low-Income Subsidy: Assets and Income Are Both Important in Subsidy Denials, and Access to State and Manufacturer Drug Programs Is Uneven examines the importance of assets and income in low-income subsidy (LIS) denials in 2006 and 2007, as well as state and manufacturer programs that provide prescription drugs for Medicare beneficiaries. The study found that state pharmaceutical assistance programs (SPAPs) differ in the type and extent of assistance they offer, and not all drug company patient assistance programs (PAP) are open to Part D beneficiaries. (September 2008, GAO)

 

Medicare Spending Billions Of Dollars On Questionable Claims For Medical Equipment, Report Finds

CMS in recent years has paid more than $1 billion in questionable Medicare claims for medical equipment with minimal or no relation to the conditions of beneficiaries, according to a report released by the Senate Permanent Subcommittee on Investigations. The report marked the third in a series released by the subcommittee on questionable Medicare claims. For the report, investigators reviewed Medicare claims submitted by medical equipment suppliers from January 2001 to December 2006 for 18 items.  The practice leaves "billions of taxpayers' money susceptible to fraud, waste and abuse," the report said. (9/24/08, USA Today)

 

Low-Income Medicare Beneficiaries Will Have Fewer Part D Options in 2009

The analysis revealed that, nationwide, there will be a total of 308 [prescription drug plans] qualified to serve low-income Medicare beneficiaries in 2009, almost 200 fewer than in 2008. These almost-200 plans covered approximately 1.3 million individuals who will now need to be reassigned. That number is up from 1.2 million individuals who CMS reassigned in 2008 and 250,000 individuals in 2007.” (October 2008, Avalere)

 

Medicare Now and In the Future

The second in a series of election briefs on health policy issues presents an overview of Medicare, detailing whom the program covers, what services are provided, how care is supplied to the elderly and disabled and what future challenges the program faces. The brief highlights Medicare's long-term financing challenges, the role of private plans, the prescription drug benefit and the efficacy of current benefits. The brief also underscores how the presidential candidates might address key Medicare issues, if elected (10/2/08, Kaiser Family Foundation)

Federal & State Budgets/Health Care

State Budget Troubles Worsen: 21 Face Shortfalls
Mid-year shortfalls have opened up in the 2009 budgets of at least 21 states including Florida.  (10/10/08, CBPP)

 

Many States Imposing Cuts that Hurt Vulnerable Residents

As a new fiscal year begins in most states, at least 22 states including Florida have made or proposed budget cuts that threaten vital services for many residents. Targeted areas include Public health and Elderly and disabled services. (10/1/08, CBPP)

Health Insurance, Health Care

Premiums versus Paychecks: A Growing Burden for Florida’s Workers

Over the past eight years (2000 through 2007), family health insurance premiums for Florida’s workers rose 3.6 times more quickly than median earnings. On average, health care premiums for families rose by 72.0 percent, while median earnings rose by only 20.2 percent. In addition to higher premiums, working families faced higher out-of-pocket health care costs, such as deductibles, copayments, and costs for services that were not covered by their insurance plans. As a result, health care costs are absorbing an ever-larger portion of family budgets, and it is clear why many Florida families feel worse off economically than they did eight years ago. (September 2008, Families USA)

 

Get Sick, Get Out: The Medical Causes of Home Mortgage Foreclosures

We studied homeowners going through foreclosure in four states and found that medical crises contribute to half of all home foreclosure filings. If these patterns hold nationwide, medical causes may put as many as 1.5 million Americans in jeopardy of losing their homes each year. (10/6/08, Health Matrix)

 

Study: Many Primary Care Docs Don't Understand Consumer-Directed Health Plans

A new study on primary care physicians' knowledge of consumer-directed health plans found that many doctors do not understand the financial implications of these plans for their patients.  October 2008, American Journal of Managed Care)

Faced with Increased Health Costs, Americans Favor Major Overhaul

With increased medical costs putting a strain on household finances, Americans say they are unhappy with their health care system and want to see major changes (10/7/08, Employee Benefit Research Institute's 11th annual Health Confidence Survey)  

 

More than 57 Million Americans Had Medical Debt in 2007

More than 57 million Americans experienced problems paying their medical bills in 2007, and 42.5 million of them had insurance coverage. (September, 2008, Center for Studying Health System Change)

Survey Finds Health Plan Premiums, Deductibles Rising

The cost of employer-sponsored health insurance averaged $12,680 this year for family coverage and $4,704 for individuals, reflecting a 5 percent increase in premiums, according to an analysis. Although the premium hike was relatively modest, many workers faced rising deductibles, with 18 percent of all covered workers paying annual deductibles of at least $1,000. (September 2008, Kaiser Family Foundation and the Health Research and Education Trust)

 

Premium, Out-Of-Pocket Costs For U.S. Workers To Increase By 9% In 2009

The combined average premium and out-of-pocket costs for health coverage for a U.S. worker are projected to increase by nearly 9% in 2009, to $3,826 per year. The study evaluated data on employer-sponsored health plans from more than 300 major businesses with an average of 16,000 employees, encompassing more than 13 million health plan members. (September 2008, Hewitt's Annual Health Care Survey 2008)

Two-Thirds Of Adult Americans Willing To Pay Higher Taxes To Fund Chronic Disease Prevention Programs

More than two-thirds of adult Americans agree that the U.S. healthcare system needs to put more emphasis on chronic disease preventive care than on treatment, and they're willing to pay higher taxes to fund those programs, according to a new survey. (September 2008, National Association of Chronic Disease Directors)

 

Drugs Expected to Drive Increase in Mental Health Spending

Annual spending for mental health and substance abuse treatment is projected to nearly double between 2003 and 2014, to $238.7 billion, according to a study published online today by. (10/7/08, Health Affairs)

 

Getting Your Money's Worth: Never Easy, Especially in Health Care
The Congressional Budget Office (CBO), whose number crunchers assess the cost of specific legislation moving through Congress, routinely churns out reports on health care policy proposals. But sometime later this year, the CBO will produce a document unusual in both its scope and aim. Its purpose: to cost out various options for slowing the growth of health care spending in the United States. (9/29/08, CBO)

 

Trade-Offs Getting Tougher: Problems Paying Medical Bills Increase for U.S. Families, 2003-2007

This report estimates that 14 million more people had problems paying medical bills in 2007 compared to 2003. Among the non-elderly insured and uninsured, 2.2 million were in families that filed for bankruptcy as a result of medical debt, while a much larger number reported other financial consequences, such as difficulties paying for necessities or having to borrow money. (September 2008, Center for Studying Health System Change)

 

Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 2008 Current Population Survey

This report examines the factors that affect whether an individual has health insurance and the sources of that coverage. According to the report, the percentage of U.S. residents younger than age 65 who had health coverage through their employer remained at 62.2 percent between 2006 and 2007, but this year’s rise in unemployment and food and gasoline prices suggest a future decline in the number of workers who have or are able to afford employer-based health insurance. (September 2008, Employment Benefit Research Institute)

 

Employer Health Benefits: 2008 Annual Survey

This provides a detailed look at trends in employer-based health coverage, including changes in premiums, employee contributions, and cost-sharing. The survey also documents the prevalence of high-deductible health plans and includes new questions on the wellness programs and retiree health benefits that are offered by employers. (September 2008, KFF)

 

Prescription Drug Trends Fact Sheet

This resource provides information about prescription drug expenditures and coverage, key factors that contribute to rising prescription spending, and efforts to contain certain rising drug costs. Prescription drug spending has become one of the fastest growing components of national health care spending as a result of increased use of prescription drugs, lower rebates from drug manufacturers, and changes in the therapeutic mix of drugs. (September 2008, KFF)

Health Disparities

 

Unequal Burden: The True Cost of High-Deductible Health Plans for Communities of Color

Some policymakers are touting high-deductible health plans (HDHPs) as a strategy for reducing the number of uninsured. But little is known about how these plans will affect pervasive racial and ethnic health disparities. This brief discusses the full costs associated with HDHPs plans and why these expenses are disproportionately unaffordable for many communities of color. It also examines several myths about health savings accounts (HSAs), which are often coupled with such health plans. It discusses three serious concerns: High out-of-pocket costs; Incentives to delay or avoid necessary care; andBarriers that will widen the health disparities gap. (September 2008, Families USA)

 

State of Health Care Quality 2008 

The quality of health care for millions of Americans improved in 2007 but with significant variations in performance that continue to leave many people receiving substandard care  - amid rising health costs and a sluggish economy. While quality improved for most people in private health insurance plans, there was little improvement in the care delivered to those enrolled in Medicare and Medicaid, the nation's two largest public health care programs. There were great geographic differences in quality of care received. (10/7/08, National Committee for Quality Assurance)

 

Racial/Ethnic Disparities in Self-Rated Health Status Among Adults With and Without Disabilities

This report examines differences in self-rated health status by race/ethnicity and disability. The analysis found that the disability prevalence was highest among American Indian/Alaska Natives, at 29.9%, and lowest among Asian-Americans, at 11.6%. 66.9% of whites without a disability rated their health as very good or excellent, compared with 49.9% of blacks without a disability. Among adults with a disability, reports of fair or poor health ranged from 24.9% among Asians to 50.5% among American Indian/Alaska Natives and 55.2% among Hispanics. The report recommends that efforts to reduce racial/ethnic health disparities should include strategies to improve the health and well-being of those with disabilities for each racial/ethnic group. (10/3/08, Morbidity and Mortality Weekly Report)

 

National Healthcare Disparities Report

 A major aim of US health care policy is to improve the quality of care in the nation.  To accomplish this, the socioeconomic, racial, ethnic and gender inequalities...must be addressed.  This report found most recent found that Hispanics had lower quality of care than non-Hispanic whites on two-thirds of its 32 core quality measures. (October 2008, H-CUP Statistical Brief)

 

Nowhere to Turn: How the Individual Health Insurance Market Fails Women

This report looks at the experiences of women seeking coverage in the individual insurance market and finds that many women face obstacles obtaining comprehensive, affordable health coverage. These challenges include being charged higher premiums than men, a practice known as “gender rating,” and being unable to find affordable maternity coverage. (October 2008, National Women’s Law Center) 

Other Health Issues 

 

The 2008 Presidential Candidates' Health Reform Proposals: Choices for America

This report describes how each candidate would seek to expand health insurance coverage, improve the quality and efficiency of the health system, and control costs. As shown in the report, both plans seek to expand health insurance coverage. But while Senator McCain would encourage individuals to select their own coverage through the individual insurance market, Senator Obama would strengthen employer coverage and public programs and create a new group insurance exchange. Includes an interactive Web feature  comparing the Obama and McCain plans side-by-side in 24 different areas. (10/2/08, Commonwealth Fund)

 

A Princeton Economist Reviews Candidates' Health Plans

If all doctors practiced medicine as they do at the Mayo Clinic - which is renowned for effective, efficient care - the health care system could save as much as $200 billion to $300 billion a year. But the government has, as yet, refused to penalize doctors who practice far less efficient, less effective care. (10/6/08, Chicago Tribune)

 

Health Care Proposals of the 2008 Democratic and Republican Presidential Nominees: Implications for Improving Access, Affordability and Quality for America's Minorities

Examines how the health plans of Sen. Barack Obama and Sen. John McCain would address racial health disparities. The report also includes a side-by-side comparison table of each candidate's health plan as it relates to reducing racial health care disparities. (8/29/08, Joint Center for Political and Economic Studies)

 

Are Bad Times Healthy?

Most people are worried about the health of the economy. But does the economy also affect your health?  It does, but not always in ways you might expect. The data on how an economic downturn influences an individual's health are surprisingly mixed. (10-7-08, New York Times)

 

On Busier Days Hospital Patients Are Discharged Earlier

When a hospital is capacity constrained, the constraint can affect admission and discharge decisions. A new study in the RAND Journal of Economics examined how hospitals' admission and discharge behavior is affected by fluctuations in demand. Results show that on days when hospitals face high demand, patients are discharged earlier than expected when compared to those discharged on days when demand is low. (Summer 2008, RAND Journal of Economics)
 
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