December 28, 2007 Medicaid Reform: Simmering Concerns Translates Into Major Changes The early part of December saw a number of unprecedented events in the life of the Medicaid Reform experiment, particularly the announcement by the Agency for Health Care Administration’s (AHCA’s) decision to recommend against expanding Reform in 2008 and the decision of Medicaid Director Tom Arnold to step down from his position as the State official responsible for implementing Reform. (by Greg Mellowe, Florida CHAIN) Read more Photo: L to R: former State Rep. Eleanor Sobel, Rep. Schwartz and outgoing Medicaid Director Tom Arnold at Rep. Schwartz's Dec. forum on Medicaid Reform
	More on Medicaid Reform: Reality Yet to Match Stated Intent During the first part of December, several events shed light on the status of the evolution of the Medicaid Reform experiment. Increased consumer choice and market-driven improvements are the stated bases for Reform, but each of these accounts illustrates the extent to which these aims have not been realized:  Increased Service Options Yet to Materialize; Enhanced Benefits Not Yet of Much Benefit; Plans for Drug Finder Software Yet to Include Consumer Access (by Greg Mellowe, Florida CHAIN) Read more
	Children’s Health Insurance: In the End, Extension Wins Out Over Expansion (for Now) Concerted efforts and compelling arguments made by child advocates ultimately could not secure the long sought after expansion of children’s health coverage given the polarized nature of the debate. Instead, an extension of current coverage levels until after the presidential elections was the ultimate outcome, which just ended last week. (by Greg Mellowe, Florida CHAIN) Read more

	Florida Office on Disability and Health Survey The Florida Office on Disability and Health needs to know what disability and health care issues concern you most.  Please help by participating in their very important survey! (Submitted by The Family Cafe) Read more
	1 in 4 Floridians Likely Burdened by Health Care Costs; Most Are Insured Families USA issued a report last week quantifying the extent to which Florida’s families must pay too much of their income for health care: almost 3.9 million Floridians under age 65 are in families that will spend more than 10 percent of their family income (before taxes) on health care costs in 2008. More than a quarter of all Florida residents fall into this group! And four out of five have some form of health insurance coverage! (by Greg Mellowe, Florida CHAIN)  Read more Senior Care: Proceed with Caution on Behalf of Vulnerable Elders   Late last month, AHCA in conjunction with the Dept of Elder Affairs, held a public meeting in Tallahassee to invite input regarding the design of the evaluation of Florida Senior Care. This involves a group of beneficiaries who can least afford to hang in the balance while the kinks are ironed out. If the State is serious about increasing quality of care for dually-eligible seniors and not just achieving unknown cost savings, careful consideration must be given until the kinks are ironed out in one experimental waiver implementation before launching into another. (by Greg Mellowe, Florida CHAIN)Read more
	Florida Tobacco Tax Effort Updates The Healthy Florida Alliance is proud to welcome its newest member, Florida Legal Services (FLS). As part of its mission, FLS works with local programs and other health and human services providers to increase poor people’s access to health care services.  One of the first steps in implementing a state tobacco tax is to find sponsors to file legislation. The HFA is moving forward in finding sponsors for a bill for the 2008 legislative session. (by Lisa Margulis, Florida CHAIN) Read more
	Medicaid Waiver, Pharmaceutical Access, Film: Today's Appealing Medicare Part D Denials: Challenging... But More “Appealing” Than the Alternative Seniors must access their Medicare Part D drug benefits through a Medicare Prescription Drug Plan (PDP), and the push for enrollment has been in full force since Nov 1. Stories of high-pressure tactics exerted by some PDP representatives have made the news, while many low-income seniors learned that they would need to switch plans in 2008 in order to reduce out-of-pocket expenses. So when this whirlwind of activity ends with the new year, some seniors may find themselves enrolled in PDPs that don’t cover their medications.(by Greg Mellowe, Florida CHAIN)  Read more
	Mental Health is Voting "Yes" to Less Spending and Better Services - Education and Support Rally in Tampa Bay on Feb 2   Mental Health America of Greater Tampa Bay, on Feb 2, is hosting the second Tampa Bay Region Mental Health Brainstorming Council. It will be a combination of an educational and support rally for funding and carrying out the Supreme Court Report on Transforming Florida’s Mental Health System. We are all responsible to make sure our legislative leaders know about this Report. (by Scott F. Barnett, Mental Health America of Greater Tampa Bay, Inc.)  Read more
	FOCUS (Federation of Congregations United to Serve) Orlando Focuses On Insuring More Children After the success of an October 1st press conference hosted by FOCUS (Federation of Congregations United to Serve) Orlando, leaders are contacting members of the Orange County legislative delegation to press for KidCare reform in March's Regular Legislative Session.  Read more

	Medicaid Reform: A Physician’s Perspective At the Medicaid Reform forum held December 4th in Broward County (see related article), numerous individuals representing various stakeholders and professions offered their perspectives on Medicaid Reform and its impact. Perhaps most poignant of all of the testimony was that of Aaron Elkin, an obstetrician, Medicaid provider and spokesperson on managed care. (by Greg Mellowe, Florida CHAIN) Read more

	CHAIN Reaction is a bi-weekly publication of Florida CHAIN (Community Health Action Information Network), a statewide consumer advocacy organization that works toward access to quality health care, empowering people to actively shape their world by participating in civic life and caring for each other’s well being.  Florida CHAIN: 6600 Cypress Road #508, Plantation, FL 33317   info@floridachain.org     www.floridachain.org
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Medicaid Reform: Simmering Concerns Translate Into Major Changes The early part of December saw a number of unprecedented events in the life of the Medicaid Reform experiment, particularly the announcement by the Agency for Health Care Administration's (AHCA's) decision to recommend against expanding Reform in 2008 and the decision of Medicaid Director Tom Arnold to step down from his position as the State official responsible for implementing Reform: December 4: State Representative Elaine Schwartz (D-Hollywood) held a forum to review the progress of Medicaid Reform to date, particularly focusing on the report issued by AHCA's Inspector General, to which AHCA had not yet formally responded. The Inspector General raised numerous concerns and recommended against expansion until more data is available. A dozen experts and advocates addressed a panel that included legislators and Medicaid Director Tom Arnold. A number of other AHCA officials were in attendance. Mr. Arnold provided the most complete response to date to concerns raised in the Inspector General's report, indicating that efforts were underway within AHCA to do the following: ·         Establishing a comprehensive grievance reporting system ·         Requiring plans to provide updated and accurate lists of providers in their networks ·         Creating the capacity to identify which plans cover any particular patient's combination of medications. ·         Taking steps to increase access to specialists (in Reform and throughout Medicaid as a whole) in 5 critical areas of specialty care. He also insisted that, as of yet, there were no plans to recommend expansion of Medicaid Reform. To view the testimony provided at the forum, visit the City of Hollywood's website: http://hollywoodfl.org/city_clerks/prev_com.htm. Then select "Workshops" on the right and then choose "December 4th." December 6: During a teleconference for the Medicaid Reform Technical Advisory Panel, Tom Arnold announced that AHCA was formally recommending that the Reform Pilot not be expanded in the 2008 Legislative Session. The press release issued by AHCA shortly thereafter stated that: "[AHCA] will continue to monitor the progress of the pilot and communicate with stakeholders in the program to gather the information necessary to make sound recommendations to Governor Crist and the Legislature." December 7:  Tom Arnold, who not only served as the State's Medicaid Director, but also a key architect of Medicaid Reform, announced that he was stepping down from his position in AHCA. Mr. Arnold will return to the Florida Department of Health, where he will oversee the county health departments. December 11: State Representative Aaron Bean (R-Ferdandina Beach), Chair of the House Healthcare Council, told the Florida Times Union that he "may even overrule the stance by [AHCA] and push for at least limited expansion beyond Northeast Florida next year." Rep. Bean was specifically quoted as following: "We did not know this was coming and I am not happy. I'm shocked that I would not be briefed on a recommendation this big, and I'm disappointed. This was a lack of leadership." In responding, AHCA told the Times Union that "the delay may only be temporary and that the program simply isn't ready to go statewide yet." AHCA spokesperson Doc Kokol elaborated: "This is not a statement about the long-term viability of Medicaid Reform, it's just that this project is very early and very young. We're simply not at a point where we're ready to make a recommendation to go statewide one way or another. It's not to say that the next step isn't a statewide rollout. But we're simply not at that point yet." December 12: AHCA Secretary Andrew Agwunobi announced that assistant Deputy Secretary for Medicaid Finance, Dyke Snipes, will assume the role of acting Medicaid Director January 2, and that AHCA would commence a nationwide search for a new Medicaid Director. The impact of these changes in concrete terms will unfold over the course of the coming months. (Submitted by Greg Mellowe, Florida CHAIN)   More on Medicaid Reform: Reality Yet to Match Stated Intent During the first part of December, several events shed light on the status of the evolution of the Medicaid Reform experiment. Increased consumer choice and market-driven improvements are the stated bases for Reform, but each of these accounts illustrates the extent to which these aims have not been realized:   1. Increased Service Options Yet to Materialize Georgetown University’s Health Policy Institute issued its fourth in a series of policy briefs on Medicaid Reform earlier this month. The brief is titled Medicaid pilots at one year: How is the new Medicaid marketplace faring?, and can be downloaded in full at: http://hpi.georgetown.edu/floridamedicaid/pdfs/briefing4.pdf   First and foremost, researchers concluded that “[o]verall, new offerings by plans are less generous than in the first year – with lower limits on specific benefits, higher copayments, and fewer extra services.” More specifically, “[o]ne quarter (seven) of HMO offerings reduced therapy benefits – both for adults who are disabled and parents. No HMO improved its benefit?Limits on durable medical equipment, an important benefit for people with chronic and disabling conditions, were reduced by six HMOs and improved by just one?eight plans add[ed] at least some services, while 19 reduc[ed] or eliminat[ed] extra services?copayments were increased or added in 58 instances across all services and reduced or eliminated in one case.   The authors also noted that it is too early to assess whether the state is saving money. In announcing that it would recommend against expanding Reform in 2008, the Agency for Health Care Administration at least tacitly acknowledged this finding.   2. Enhanced Benefits Not Yet of Much Benefit AHCA also conducted workshops in December to collect input on the Enhanced Benefits component of Medicaid Reform. Enhanced Benefits have been touted as one of the key innovations of the program. Participants receive credits to purchase over-the-counter items such as vitamins, toothpaste and antacids (since Medicaid does not pay for these basic health items) for each “healthy behavior” they perform. Participants can earn up to a total of $125 per year.   The most encouraging news is that, through 16 months of Reform, approximately $8 million dollars in credits have been awarded, including a record $1.2 million in October. This amounts to more than $40 per consumer earned. Through November, however, only $421,000 in credits have been redeemed, or slightly more than $2 per consumer. In other words, after almost a year and a half, the average Enhanced Benefit received by Reform participants totals less than one over-the-counter item. In fairness, a record $80,000 worth of credits were used in November, but the extent to which these credits served as an incentive for any healthy behavior is in question.   Upon further review, the connection between behavior and incentive seems even more suspect. Plans have up to 90 days to credit consumers’ accounts (though AHCA reports that most plans credit more quickly). Furthermore, almost half (48%) of the credits were awarded for simply making a physician office visit. Less than 500 consumers each received credit for participation in diabetes or asthma disease management programs. For both HIV/AIDS and hypertension disease management programs, the number of credited participants was less than 35. In order to receive credit for many behaviors that require ongoing activity, the physician and consumer must complete a form and send it to the health plan; however, several plans reported having never received a completed form to process.   At the workshops, AHCA sought input on ways to increase and improve participation by consumers, pharmacies and physicians. It seems likely that, at a minimum, additional opportunities to earn credits will be created and outreach materials will be simplified.   3. Plans for Drug Finder Software Yet to Include Consumer Access ACS, AHCA’s longtime IT contractor and provider of Choice Counseling services under Medicaid Reform, unveiled a prototype of its software that has the potential to resolve one critical and complex challenge of Reform. Specifically, the “Navigator” drug finder database software would match a consumer’s drug history with the Preferred Drug Lists of all of the relevant health plans, and show which plans cover which medications. The software will instantly produce what would otherwise require time-draining, complicated and error-prone manual searches of all of the plan websites. Navigator could prove to be invaluable, as AHCA has the capacity, for the first time, to allow meaningfully informed choice among plans with respect to prescription drug options.   Unfortunately, ACS’ current design funnels the significant resources invested into the development of a tool that would ONLY be used by Choice Counselors. In particular, there are no plans to include an on-line version of Navigator that would allow consumers and those assisting them to enter their own list of medications and run their own searches. In other words, instead of seizing the opportunity to ensure transparency among plans and promote the meaningful choice that was the promised foundation of Reform, ACS proposes to intentionally withhold the resource. It is particularly important to note that issues such as confidentiality and liability do not pose legitimate barriers to making this capacity available to consumers; Medicare already has a powerful Prescription Drug Plan search tool available on-line.   (Submitted by Greg Mellowe, Florida CHAIN)  Children’s Health Insurance: In the End, Extension Wins Out Over Expansion (for Now) Concerted efforts and compelling arguments made by child advocates ultimately could not secure the long sought after expansion of children’s health coverage given the polarized nature of the debate. Instead, an extension of current coverage levels until after the presidential elections was the ultimate outcome, which just ended last week. To recap: In October, Congress passed and the President vetoed legislation that would have reauthorized and expanded the State Children’s Health Insurance Program (SCHIP, known as KidCare in Florida) to cover an additional 4 million uninsured children. Shortly thereafter, an attempt to override the President’s veto fell several votes short of the 2/3-majority needed. By early November, the House and Senate had passed a revised version of the bill that addressed many of the concerns raised by opponents. Supporters cited numerous changes to the bill that responded to those concerns, including: ·         requiring states to focus even more on serving poorer households. (Florida already limits eligibility to 200% of the poverty level.) ·         linking financial incentives provided to states for enrolling the lowest-income  children. (Payments are tied to enrollment in Medicaid, not SCHIP. Most Medicaid recipients fall below the poverty level.)  ·         tightening already strict citizenship documentation procedures even further, including a mandatory Social Security database check. ·         providing incentives to use SCHIP funds to help children obtain the private coverage offered by their parents’ employers, if available. On December 12th, President Bush vetoed this version of the legislation as well. In using his veto power for only the 7th time in his 7 years in office, the President focused on his executive status rather than on children’s health status: “Sometimes the legislative branch wants to go on without the president, pass pieces of legislation, and the president can then use the veto to make sure he’s a part of the process. And that’s what I fully intend to do. I’m going to make sure. And that’s why when I tell you I’m going to sprint to the finish, and finish this job strong, that’s one way to ensure that I am relevant. That’s one way to ensure that I’m in the process?” (excerpted) As before, the vetoed bill would have provided coverage to nearly 4 million otherwise uninsured children, the vast majority of them poor enough to already qualify for coverage under states’ current rules. The President nevertheless vetoed the bill in response to critics’ ongoing concerns, most of which were viewed by advocates as already resolved or unfounded. Negotiations continued for more than a month following that vote. By early December though, prospects for expansion looked bleak, and the focus shifted to the possibility of an extension. House Republicans complained that Democrats had not responded to their November proposal, while Democrats said they rejected that proposal outright because, for one, it tightened income eligibility limits for Medicaid. Funding for SCHIP was set to expire December 14th, but Congress passed an emergency extension to keep the program afloat for another week while a longer-term resolution is sought. Congress had been considering a proposal to extend SCHIP at current levels through the end of the fiscal year (September 2008). Advocates expressed serious concerns about year-to-year extensions, however, because states would be subject to sudden changes in funding or rules. Finally, on December 21st, Congress passed and the President has indicated he will sign the Medicare, Medicaid and SCHIP Extension Act. Most prominent among the numerous provisions added to this 11th-hour bill was an extension of SCHIP at current levels and with current requirements (i.e., without some of the tougher rules in versions vetoed by the President) until March 31, 2009. With this compromise, the continuation of existing coverage is assured and the controversial discussion of if and how to expand coverage until after a new president is in office. (Submitted by Greg Mellowe, Florida CHAIN) Sources: Families USA, Center for Policy and Budget Priorities, Congressional Quarterly, Florida Child Health Care Coalition    Florida Office on Disability and Health Survey   The Florida Office on Disability and Health needs to know what disability and health care issues concern you most.  Please help by participating in their very important survey! Visit the website: http://FODH.HealthIssuesSurvey1.sgizmo.com!    FODH was recently established by funding from the National Centers for Disease Control and Prevention (CDC). They are located at the University of Florida in the College of Public Health and Health Professions.   The overall goal of their project is to improve the health, well being and quality of life of Floridians living with disability.  Disability is likely to impact all people at some time.  Thus, it is important to have a sound framework for addressing disability and health issues.   During the first year of this project, through the guidance of an advisory board comprised of various stakeholders, a Florida Strategic Plan will be developed to focus on these issues.  Through your participation in this survey, you will provide important information to assist  in the development of this strategic plan. Your participation in this survey is completely voluntary and not compensation is offered.  You may skip questions and you may withdraw from participation in this survey at any time.  Your identity will not be know and not personal identifying information will be obtained through your participation in this survey.  They need your views, so please help by participating in this very important survey! Visit the website: http://FODH.HealthIssuesSurvey1.sgizmo.com Thanks, The Family Cafe 1 in 4 Floridians Likely Burdened by Health Care Costs; Most Are Insured   Families USA issued a report last week quantifying the extent to which Florida’s families must pay too much of their income for health care.   In Too Great a Burden: Florida's Families at Risk, Families USA reported that almost 3.9 million Floridians under age 65 are in families that will spend more than 10 percent of their family income (before taxes) on health care costs in 2008. More than a quarter of all Florida residents fall into this group! Even more incredibly, four out of five have some form of health insurance coverage!   In addition, a staggering 1.2 million Floridians (8%) reside in families that will spend more than 25 percent of their income before taxes on health care costs. Again, almost three-fourths of people facing this situation also have some form of health coverage. Families that pay more than 10% of their income for health care are recognized as being significantly burdened by these costs, and are likely to have difficulty meeting other expenses such as food and housing.  Low-income families are obviously least able to dedicate significant portions of their income to health care.   Families USA also found that the percentage of “health cost-burdened” families has increased significantly since the 2000 Census.   The primary cause of this increase in health cost burden was the increased cost of health insurance premiums. These higher premiums in turn resulted from increasing health care costs and decreasing competition within the insurance industry.   The report discusses the causes and consequences of health care cost burden more fully, and can be downloaded at: http://www.familiesusa.org/assets/pdfs/too-great-a-burden/florida.pdf   (Submitted by Greg Mellowe, Florida CHAIN)  Senior Care: Proceed with Caution on Behalf of Vulnerable Elders Senior Care - the implementation of an integrated, fixed-payment delivery program for Medicaid beneficiaries who are 60 years of age or older or dually eligible for Medicare and Medicaid - is currently being implemented in Miami Dade and Orange counties. Late last month, the Agency for Health Care Administration, in conjunction with the Department of Elder Affairs, held a public meeting in Tallahassee to invite input regarding the design of the evaluation of Florida Senior Care. Below is Florida CHAIN's commentary:   In theory, the idea of improving coordination of care, especially for seniors with severe resource limitations, is laudable. It is how that theory will play out in practice in Senior Care that is the cause for concern, especially when the primary factor is controlling costs.   Seventeen months into the Medicaid Reform experiment, as has been shown by the Inspector General’s report among other sources, some fundamental concerns have yet to be addressed, serious gaps in communication have yet to be resolved and some basic data needed to evaluate cost-effectiveness has yet to be available.   If the State is in fact serious about increasing the quality of care for dually-eligible seniors and not just achieving some arbitrary level of cost savings, careful consideration must be given until the kinks are ironed out in one experimental waiver implementation before launching into another.   If the Medicaid Reform Pilot is something of a gamble, then a Senior Care pilot could be considered a kind of “doubling down.” Instead of one massive, complex program, efforts will need to be linked across two massive, complex programs administered at two different levels, even as the state prepares to bring on a new fiscal agent for Medicaid this spring.    This involves a group of beneficiaries who can least afford to hang in the balance while the kinks are ironed out. Many vulnerable seniors are less likely to be able to navigate the various levels of the system, especially when contact with a human is at a premium; less likely to bridge any gaps in transportation; less likely to be able to cope with any hiccups in service; less likely to remain at home without assurance of continuity of care.   Better assignment and management of risk is one thing, but when the State as the fiduciary agent is also itself a source of significant additional risk, to seniors’ well-being if not to the economic bottom line.   Building successes is a reasonable plan of action. Ignoring the fact that successes have not yet been achieved and pressing on as if they have is not.   It is encouraging that there are protections and safeguards not in Medicaid Reform to be built into Senior Care in recognition of some of these barriers. These features should be added to Reform. However, protecting beneficiaries from aspects of a plan that you know would otherwise be problematic does not ensure that the plan itself is not. (Submitted by Greg Mellowe, Florida CHAIN) Florida Tobacco Tax Effort Updates The best way to tackle problems is by proposing solutions. For members of the Healthy Florida Alliance, the problem of tobacco related illnesses and deaths along with the inability of Floridians to access the health care they need has a solution. The Healthy Florida Alliance- a partnership of organizations dedicated to improving the well being of Floridians- is fully committed to increasing the tobacco tax by $1 per pack of cigarettes and allocating the generated revenue to health access expansion.      New HFA Member: The Healthy Florida Alliance is proud to welcome its newest member, Florida Legal Services (FLS).  FLS provides civil legal assistance to indigent persons who would not otherwise have the means to obtain a lawyer.  As part of its mission, FLS works with local programs and other health and human services providers to increase poor people’s access to health care services   Legislation: One of the first steps in implementing a state tobacco tax is to find sponsors to file legislation. The HFA is moving forward in finding sponsors for a bill for the 2008 legislative session.  CHAIN Reaction will provide updated information as to the progress of the bill as it is filed and moves through legislative process.   Frequently Asked Questions: As the HFA conducts its outreach to recruit new supporters to the effort, a series of commonly raised objections and concerns have been raised such as the tax having an adverse affect on the economy; the implications of the tax being regressive; and the justification of the allocation to programs like Medicaid and KidCare. In response, the HFA has just released a Frequently Asked Questions document that can be accessed by clicking here.    For more information on the Healthy Florida Alliance, click here. To sign on as a member using the Endorsement Form, click here.   (Submitted by Lisa Margulis, Florida CHAIN) To learn more about the Healthy Florida Alliance, visit www.healthyfloridaalliance.org Appealing Medicare Part D Denials: Challenging... But More “Appealing” Than the Alternative   It’s difficult to watch television or read the newspaper for any length of time without encountering an advertisement for a Medicare Prescription Drug Plan (PDP). Seniors must access their Medicare Part D drug benefits through a PDP, and the push for enrollment has been in full force since November 1. Stories of high-pressure tactics exerted by some PDP representatives have made the news, while many low-income seniors learned that they would need to switch plans in 2008 in order to reduce out-of-pocket expenses. So when this whirlwind of activity ends with the new year, some seniors may find themselves enrolled in PDPs that don’t cover their medications.   An article in the last issue of CHAIN Reaction addressed the difficulty seniors will likely encounter if they attempt to change to a new PDP from one with a formulary that doesn’t cover needed medications. The Center for Medicare Rights emphasizes, however, that seniors will usually be more likely to succeed in an appeal of a drug plan’s decision to deny a medication than in an appeal to change drug plans altogether.  Accordingly, the Center has published a guide informing seniors and those helping coordinate their care about the process for appealing those denials.   As a first step, consumers (or their advocates) need to obtain a letter from their doctor explaining why the medication is necessary and submit it to their plan, which in turn must provide a determination in writing within 72 hours of submission. If not successful, consumers may ask for a re-determination within 60 days, which the plan must again respond to within 7 days of submission. If the plan denies again, the request must be submitted to Maximus (Medicare’s review agency) within 60 days.   There are even additional steps that may be taken, but they become increasingly technical (a hearing before an administrative law judge would be the next step); assistance for low-income seniors may be available through the local legal aid office. In fact, seniors unfamiliar with this arena would benefit from assistance by an advocate from the outset, especially because the physician’s involvement is also required. Even though Medicare states that no specific forms and formats are required in the early phases, the concepts and procedures should first be thoroughly reviewed. The full manual can be downloaded free of charge at http://www.medicarerights.org/appealsmanual.html.   In the PDP appeals process, the burden shifts from the plan to the consumer, who must justify his or her need to have access to certain medications. With persistence and resources, it may be possible to sustain access. Unfortunately, many seniors may not be able to sustain one or both in the amount needed in order to successfully navigate the process.   And the PDP appeals process is not the only example of administrative barriers that narrow Medicare access without eliminating it outright. Physicians trying to provide care to seniors Medicare have had to exhibit similar persistence. Until another in a series of last-minute fixes were approved by Congress through the Medicare, Medicaid and SCHIP Extension Act last week, Medicare reimbursements to doctors were scheduled to drop by 10 percent in 2008, even though the cost of maintaining a practice is expected to increase by almost 2 percent, according to the American Medical Association. Congress instead approved a ½-percent increase for the first half of 2008. Physician reimbursement rates as a result will again remain relatively unchanged from their 2001 levels. In contrast to these consumers and physicians, the wheels continue to be greased for others.  Medicare Advantage (private Medicare health plans) remain on track to receive more than $150 Billion dollars in additional subsidies over the next 10 years, which would speed up the insolvency of the Medicare program by 2 years, according to the Congressional Budget Office. In addition, legislation that would have allowed Medicare to negotiate lower Part D drug prices passed the House, but failed in the Senate. (Submitted by Greg Mellowe, Florida CHAIN)  Mental Health is Voting "Yes" to Less Spending and Better Services - Education and Support Rally in Tampa Bay on Feb 2   Mental Health America of Greater Tampa Bay, on February 2, 2008, is hosting the second Tampa Bay Region Mental Health Brainstorming Council.  The event will take place from 9:00 am to approximately noon, at St. Lawrence Catholic Church 5225 N. Himes Ave, Tampa. It will be a combination of an educational and support rally for funding and carrying out the Supreme Court Report on Transforming Florida’s Mental Health System.   We are all responsible to make sure our legislative leaders know about this Report.  Voting to fund it will result in saving hundreds of millions of dollars for the State.  It will also provide evidenced based services that better serve people afflicted with mental illness and substance abuse challenges.   Almost 40 mental health and substance abuse organizations attended our first Brainstorming Council back in July of 2007.  Even more will be at the February 2, 2008 event.  If your organization would like to attend contact us at execdirector@mhagreatertampabay.org.   The organization bringing the most registered voters that day will win an award for effective advocacy.  As well as providing information about the Supreme Court Report to the mental health and substance abuse community, the Brainstorming Council will vote on and kick off a 2008 Voter Registration Drive.  It is critical we mobilize to make our voices heard.  By voting for our representatives in this election year we can influence the policies that affect our communities.   Mental Health America of Greater Tampa Bay has launched an internet based legislator tracking system.  This will help us know who knows which legislator and what contacts have already occurred.  Grassroots contacts with legislators in their own districts are as important as visits to Tallahassee during legislative sessions.  Knowing the concerns of their neighbors, friends, and supporters back home is what is most important to legislators.    Teaching legislators that implementation of the Supreme Court’s report will lead to saving hundreds of millions of dollars can support our friends in the political system.  With that knowledge they can vote to improve services and save tax dollars at the same time.  We are happy to share this with other advocacy organizations that want to track specific legislators and the legislation they are supporting or not supporting.   Mental Health America of Greater Tampa Bay, Inc. strongly supports funding and implementing the Supreme Court’s Report.  All of us who care about properly dealing with mental health and substance abuse must stand up and let our communities know the value of funding and implementing this Report.    Without broad public and grass roots support, this chance in a lifetime for major transformation in the delivery of behavioral health services will become just another report gathering dust on a shelf.  If that happens, then shame on us.  Standing for funding and carrying out the Supreme Court’s Report will influence setting up a new effective national model that will reduce the unnecessary suffering of thousands while saving hundreds of millions of dollars for all of us.     (Submitted by  Scott F. Barnett, J.D., LL.M., Executive Director, Mental Health America of Greater Tampa Bay, Inc.)  FOCUS (Federation of Congregations United to Serve) Orlando Focuses On Insuring More Children   After the success of an October 1st press conference hosted by FOCUS (Federation of Congregations United to Serve) Orlando, leaders are contacting members of the Orange County legislative delegation to press for KidCare reform in March's Regular Legislative Session.  Even though reforms did not make it into special session, the House and Senate approved $1.1 million to provide an additional 5,000 children with health insurance.     St. Andrew Neighborhood Apostolate leader shared concerns with the Delegation during their public input session on November 29th.  Leaders are setting research meetings with key legislators and legislative committees as well as key staff members and allies to coordinate the efforts to reform KidCare.    FOCUS Orlando continues to work with and reach out to their sister organizations in Florida, particularly Congregations for Community Action in Melbourne, as they move forward.     FOCUS is a faith-based community organization that develops leaders and empowers people to take democratic action in order to improve the quality of life for families in Orange County. Since its founding in 1995, FOCUS has generated more than $30 million in community improvements. Their process of community organization works and creates positive, concrete changes in communities all across Orange County. They have measured outcomes of success as a community organization, and are proud to deliver a powerful return on investment. For more information, visit http://www.focusorlando.org   REAL STORIES FROM FLORIDA HEALTH CARE CONSUMERS   Medicaid Reform: A Physician’s Perspective   At the Medicaid Reform forum held December 4th in Broward County (see related article), numerous individuals representing various stakeholders and professions offered their perspectives on Medicaid Reform and its impact. Perhaps most poignant of all of the testimony was that of Aaron Elkin, an obstetrician, Medicaid provider and spokesperson on managed care. CHAIN Reaction strives to present the experiences of real consumers in order to shed light on the challenges so many Floridians face in gaining access to care. In this case, the experiences of a health care provider striving to provide that access in the face of obstacles are equally compelling: "My name is Aaron Elkin. I am the Chair of the OB/GYN Department at Hollywood Memorial. I am also the chair of the Broward County Medical Association's Managed Care Committee?We have over 1,500 doctors in the?Medical Association. I will tell you that, through my conversations with many of the doctors, I have not heard a positive remark on Medicaid Reform from any physician.  I am an O.B. in full practice, [including] providing care to the medically needy and Medicaid patients. I can tell you that in South Broward, there are probably only about 4 or 5 full-time obstetricians that are providing care to Medicaid patients, and that number is about to go down.  "Yes, we have the hospital system, which receives a great amount of money ? to provide care those who show up ?requiring care. But the whole idea behind us providing care to the medically indigent is to prevent them going to the emergency room or hospital for care. I have seen, through the hospital system, an inordinate increase in the number of patients who do not go for prenatal care. [More generally, we see] an inability of patients to access providers [and for] providers, an inability to access specialists. "[We cannot permit the response to a broken system be:] "Here is the number for the complaint department." Ladies and gentlemen, we cannot wait for another stroke. We cannot wait for another HIV-positive patient? "There are very few providers that are providing services to those medically needy patients. My experience with those patients being placed [in Medicaid Reform has been] very, very difficult. Those patients have inordinate difficulty accessing specialists. Yes, we're all used to that. But I would ask, out of this room, who has managed care insurance. Probably most of us. But almost none of us have Medicaid Managed Care. Medicaid Managed Care is not like our HMOs. I can tell you that I don't know [that I could access care in a Medicaid HMO]. I would dare each of us to be a secret shopper when they are newly diagnosed with HIV or about to have a premature baby and can't get prenatal care. "The cost for that premature baby is about one million dollars, because they show up at 23 or 24 weeks, and we think that we're saving money for the system.  No, we're not. "What I saw earlier today is the legal system helping patients navigate the system. I do not think that the legal system should be helping us navigate the system. I think medicine should. These are the most vulnerable patients. They do not have a voice. Yes, we are their voice. But they cannot access us. "There are 163,000 members and only l50 complaints.  They will not complain even if they have problems. The assumption that they don't complain because everything is hunky dory is false, and I beg to differ about that. "There are no informed choices. I have not had any patients who have had a face-to-face counseling with any Medicaid choice counselors. and the idea behind this was informed choice. I have not seen one patient that has switched to a Managed Care Medicaid HMO with counseling.  "There are no additional benefits that I've seen to any of my patients. There may be additional benefits that are described with medication in Medicaid Reform. The only additional benefit is for the managed care company [which sends] us more forms. "I am a board-certified OB-GYN. And I get a nurse that works for the HMO questioning why I actually need to do an ultrasound on a patient, or questioning where. I send the ultrasound, or how frequent or whether I should admit the patient. "You may say maybe it's our pride. It's not our pride. It's quality care. And what's happening is we have a direct inability to access health care. These patients are sicker than the average patient. "When you look at what is happening with [Provider Service Networks]. In South Broward, the PSN [environment] is very difficult. We looked into that. It's a truly difficult financial market to be in. I received a contract from a PSN. It was 100 pages long. n those 100 pages, there is nothing about reimbursement. It was mostly about how much responsibility I have as a provider to give them information - and I'm not sure that any of that information makes a difference except for their numbers. “To summarize all this, there is decreased access, there are more costs, there is poorer care, there are less services, more forms, less satisfaction and no informed choice.   “I don’t how long we want to hurt those patients. You know, this Reform was called an experiment.  In the U.S., [we can’t] do an experiment on the most vulnerable population. To me, as a medical doctor, [this] needs to be stopped.” (Submitted by Greg Mellowe, Florida CHAIN) Florida CHAIN Seeks Stories   Florida CHAIN welcomes contributions from health care consumers who are interested in sharing their experiences with readers of CHAIN Reaction. If you have a story to share, please contact Andrew Leone at 954/684-9895 or gregm@floridachain.org

State Events & Notices
     North Florida
     Central Florida
     East Central Florida
     West Central Florida
     Southwest Florida
     Southeast Florida
     Florida Audio & Web Events 
     Statewide Notices
National Events & Notices
     Conferences & Events 
     Audio & Web Events 
     National Notices
     Campaigns & Initiatives

FLORIDA AUDIO CONFERENCES AND WEBCAST

STATEWIDE NOTICES  

NATIONAL EVENTS & NOTICES

CONFERENCES AND EVENTS 

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

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

National Academy of Social Insurance: Getting to Universal Health Insurance Coverage
Jan 31–Feb 1  Washington, DC

NASI’s 20th annual policy conference will focus on achieving affordable health coverage for all Americans. Taking place in the midst of the early Presidential primaries, the conference will bring together the major participants in the health coverage debate to frame the problem, compare specific policy proposals, and identify ways of overcoming the obstacles to reform. 

Society for Epidemiologic Research annual meeting

ACHI’s 2008 Spring Training for Health Champions

Conference Dates: March 5-7, 2008  Atlanta

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

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

March 19-21   Miami

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

Active Living Research Conference Seeks Abstracts

April 9-12 Washington DC

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

National Hispanic Medical Association 12th Annual Conference
April 17-20   Washington, DC
Policy, research, medical and clinical presentations focused on improving the health of Hispanics. Conference Goals are to: provide clinical updates on diabetes, cancer, HIV/AIDs, obesity, cardiovascular disease, asthma, Alzheimer’s disease, and renal disease; increase awareness about cultural competence, literacy, language services and medical care delivery to Hispanics; increase knowledge about Federal and State health policies that impact Hispanics; develop skills for health professionals in academic medicine, research, private sector and government; and make recommendations targeted at Hispanics for the national health policy agenda in the U.S. Expected: 100 Exhibitors; 200 Hispanic Medical Students; 700 Physicians; 140 Speakers/panelist/keynote speakers.

AUDIO AND WEB EVENTS    

2008

January

                                                                     
National Birth Defects Prevention Month
March of Dimes
askus@marchofdimes.com
www.marchofdimes.com  

National Glaucoma Awareness Month
Prevent Blindness America
info@preventblindness.org
www.preventblindness.org                                  

February

                                                                     
AMD/Low Vision Awareness Month
Prevent Blindness America
info@preventblindness.org
www.preventblindness.org  

American Heart Month
American Heart Association
inquires@heart.org
www.americanheart.org  

National Children’s Dental Health Month
American Dental Association
publicinfo@ada.org
www.ada.org/goto/ncdhm                                   

National Wise Health Consumer Month
American Institute for Preventive Medicine
dhirsch@healthylife.com
www.healthylife.com  

                                                                     
Give Kids A Smile Day- Feb 1
American Dental Association
gkas@ada.org
www.ada.org/prof/events/featured/gkas               

                                                                     
National Wear Red Day 2008- Feb 3
National Heart, Lung, and Blood Institute Health Information Center
nhlbiinfo@nhlbi.nih.gov
www.nhlbi.nih.gov/health/hearttruth                     

March

National Colorectal Cancer Awareness Month
Cancer Research and Prevention Foundation
jasmine@preventcancer.org
www.preventcancer.org/colorectal                       

National Multiple Sclerosis Education and Awareness Month
Multiple Sclerosis Foundation
annette@msfocus.org
www.msfocus.org                                              

National Nutrition Month®
American Dietetic Association
nnm@eatright.org
www.eatright.org  

                                                                     
Save Your Vision Month
American Optometric Association
jmmahoney@aoa.org
www.aoa.org                                                    

                                                                     
National Patient Safety Awareness Week – March 2-8
National Patient Safety Foundation
info@npsf.org
www.npsf.org         

                                                       
Brain Awareness Week– March 10-16
Dana Alliance for Brain Initiatives
bawinfo@dana.org
www.dana.org/brainweek                                    

                                                                     
American Diabetes Alert Day – March 25
American Diabetes Association
askada@diabetes.org
www.diabetes.org/communityprograms-and-localevents/americandiabetesalert.jsp  

April

                                                                     
Cancer Control Month
American Cancer Society
www.cancer.org                                               

                                                                     
National Autism Awareness Month
Autism Society of America
mcolston@autism-society.org
www.autism-society.org  

                                           
National Public Health Week – April 7-13
American Public Health Association
Kaitlin.Sheedy@apha.org
www.nphw.org  

                                                                     
National Infant Immunization Week – April 19-26
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention
cdcinfo@cdc.gov
www.cdc.gov/vaccines/events/niiw/default.htm

2008 March for Babies – April 26-27
March of Dimes
marchforbabies@marchofdimes.com
www.marchforbabies.org  

May

American Stroke Month
American Heart Association
inquires@heart.org
www.americanheart.org 

                                                                     
Asthma and Allergy Awareness Month
Asthma and Allergy Foundation of America
info@aafa.org
www.aafa.org                                                   

                                                                     
Healthy Vision Month
National Eye Institute, National Institutes of Health
www.healthyvision2010.nei.nih.gov

                                                                     
Hepatitis Awareness Month
Hepatitis Foundation International
hfi@comcast.net
www.hepfi.org  

Melanoma/Skin Cancer Detection and Prevention Month
American Academy of Dermatology
mediarelations@aad.org
www.aad.org  

Mental Health Month
Mental Health America
infoctr@mentalhealthamerica.net
www.mentalhealthamerica.net                             

                                                                     
National High Blood Pressure Education Month
National Heart, Lung, and Blood Institute Health Information Center
nhlbiinfo@nhlbi.nih.gov
hin.nhlbi.nih.gov/nhbpep_kit/                               
www.ctf.org  

         
National Women's Health Week - May 11-17
Office on Women's Health
U.S. Department of Health and Human Services
www.womenshealth.gov/whw                              

National Women's Check-up Day – May 12
Office on Women's Health
U.S. Department of Health and Human Services
www.womenshealth.gov

June

National Headache Awareness Week – June 1-7
National Headache Foundation
info@headaches.org
www.headaches.org  

National Men's Health Week - June 9-15
Men’s Health Network
info@menshealthweek.org
www.menshealthweek.org   

July

                                  
UV Safety Month
American Academy of Ophtalmology
eyemd@aao.org
www.aao.org/eyemd  

August

Children's Eye Health and Safety Month
Prevent Blindness America
info@preventblindness.org
www.preventblindness.org  

National Immunization Awareness Month
Centers for Disease Control
http://www.cdc.gov/vaccines/events/niam/default.htm

September

Healthy Aging® Month
Educational Television Network, Inc.
info@healthyaging.net
www.healthyaging.net/agingevents.htm  

National Cholesterol Education Month
National Heart, Lung, and Blood Institute Health Information Center
nhlbiinfo@nhlbi.nih.gov
hin.nhlbi.nih.gov/cholmonth                                 

National Pediculosis Prevention Month/ Head Lice Prevention Month
National Pediculosis Association, Inc.
npa@headlice.org
www.headlice.org  

                                                                     
Ovarian Cancer Awareness Month
National Ovarian Cancer Coalition
nocc@ovarian.org
www.ovarian.org                                               

Prostate Cancer Awareness Month
National Prostate Cancer Coalition
info@fightprostatecancer.org
www.fightprostatecancer.org  

               
National Suicide Prevention Week – September 7-13
American Association of Suicidology
info@suicidology.org
www.suicidology.org                                          

October

"Talk About Prescriptions" Month
National Council on Patient Information and Education
4915 Saint Elmo Avenue, Suite 505
Bethesda, MD 20814-6082
(301) 656-8565
(301) 656-4464 Fax
ncpie@ncpie.info
www.talkaboutrx.org  

Healthy Lung Month
American Lung Association
info@lungusa.org
www.lungusa.org  

Let's Talk Month
Advocates for Youth
tom@advocatesforyouth.org
www.advocatesforyouth.org        

National Dental Hygiene Month
American Dental Hygienists' Association
media@adha.net
www.adha.org                                                  

National Domestic Violence Awareness Month
Domestic Violence Awareness Project
National Resource Center on Domestic Violence
ck@pcadv.org
dvam.vawnet.org                                              

       
National Mammography Day – October 17

American Cancer Society
www.cancer.org                                               

National Health Education Week – October 20 - 24
National Center for Health Education
ray@nche.org
www.nche.org

November

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

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

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

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

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

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

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

December            

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

New listings, in order of submission deadlines

American Medical Association Foundation Healthy Communities/Healthy America Fund

U.S Conference of Mayors HIV/AIDS Prevention Grants for High Risk Women of Color

Deadline: Feb 25

Provides support for the implementation of HIV/AIDS prevention programs for high-risk women of color. Award Amount: $70,000/6 grants. Eligibility: Health Departments, CBOs, Indian tribes. Contact:  Ms. Lillie Brown, 202-293-7330, lbrown@usmayors org 

Tobacco Prevention and Control
The National Association of County and City Health Officials is working to identify public health-related funding resources. October 2007’s guide features foundations that have listed Tobacco as a focus area. Click above to be directed to Florida's page. 

Continuing listings, in order of submission deadlines 

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. 

Healthy Kids Grant Program
Deadline: Jan 15
The General Mills Foundation, in partnership with the American Dietetic Association Foundation and the President's Council on Physical Fitness, is accepting applications for the Champions for Healthy Kids grant program. This national program will award fifty grants of $10,000 each to  community-based groups across the United States that develop  creative ways to help youth adopt a balanced diet and physically  active lifestyle. 

Seva Foundation: Native American Grants Program
Next deadline: Jan 25

The Seva Foundation serves people around the world who are struggling for health, cultural survival, and sustainable communities. Seva's Native American Grants Program provides support to Native American-led organizations working to devise solutions to the challenges that face their communities, with emphasis on spiritual and cultural renewal, health and wellness, protecting Mother Earth, economic development, education, and indigenous youth. Grants are provided to nonprofit organizations, Indigenous Nations, and public agencies that provide programs in urban and rural Indian communities throughout the United States.

Wellstone Fellowship for Social Justice

Application deadline: Jan 15

This Families USA fellowship aims to advance social justice through health care advocacy by focusing particularly on the unique challenges facing communities of color. Its goal is to expand the pool of talented social justice advocates from underrepresented economic, racial and ethnic minority groups. The ideal candidate must demonstrate an interest in health care policy and racial/ethnic health disparities. Additionally, they are looking for an individual who displays the potential to contribute to social justice work after their year of hands-on experience as a fellow.

Villers Fellowship for Health Care Justice

Application deadline: Jan 15

These fellows work in Families USA’s health policy department and assist efforts to improve access to health coverage for all Americans, especially for low-income and other vulnerable communities. Specifically, they will conduct research on a range of health care policy issues, and write and contribute to publications that are relevant to current health policy debates. The ideal candidate will demonstrate a commitment to health care justice work following their year as a fellow. Additionally, in order to encourage the development of future leaders, Villers Fellows must commit to mentoring at least one person over the course of their careers.

Vision Health: Developing an Integrative Approach for Promotion and Protection

Application deadline: Feb 11

The purpose of the program is to fund research that will develop an effective comprehensive public health approach to address eye health promotion and vision loss prevention.

Community-Campus Partnerships for Health (CCPH) Annual Award
Nominations deadline: Feb 12
The CCPH Annual Award recognizes exemplary partnerships between communities and higher educational institutions that build on each other's strengths to improve higher education, civic engagement, and the overall health of communities.

Allegany Community Outreach Grants
Deadline:  March 1
ACOR is a grant program of Allegany Franciscan Ministries, Inc.  It provides short-term support to local community projects. The grant award range is $1,000-$5,000; limited numbers of grants. Priority to organizations for projects that strive to: improve the health, wellness and quality of life through a holistic approach to education or direct service; bring about systemic change and promote self-sufficiency; benefit a disenfranchised segment of society; Sponsoring organization strives to incorporate the viewpoint and participation of individuals who are direct recipients of its services (e.g. service recipients are represented on the governing board).

Tobacco Policy Change: A Collaborative for Healthier Communities and States

Application deadline for implementation grants: March 14

Tobacco Policy Change: A Collaborative for Healthier Communities and States, a national initiative of the Robert Wood Johnson Foundation, provides resources for local, regional, and state-based organizations and tribal groups to advocate for effective policies that decrease tobacco use and exposure. This initiative is issuing a special solicitation that will build on previous success in attracting new partners whose constituencies are most directly affected by tobacco use and exposure. Grantees are expected to apply their advocacy skills and experience to advance tobacco and other public health policies in their communities. Organizations from Florida are able to apply.

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.

American Foundation for Suicide Prevention

Deadlines: June 15

AFSP will now accept and review applications for all categories of one- or two-year research grants and fellowships two times a year. The grant amounts for Standard Research Grants are now: max. $60,000 to $75,000; Young Investigator Grants max. $70,000 to $85,000); Pilot Grants max. $20,000 to $30,000). Distinguished Investigator Grants and Postdoctoral Research Fellowships remain at $100,000.  AFSP research grants support studies that aim to increase understanding of the causes of suicide and factors related to suicide risk, or to test treatments and other interventions designed to prevent suicide. Investigators from all academic disciplines are eligible to apply, and both basic science and applied research projects will be considered.

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

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. 

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

Directory Of Health Policy Fellowships

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

Florida CHAIN Website Resources

Organizations and Services

     Florida

     Children's Health

     Medicare

     Prescription Medications

     Health Disparities

     Other

Manuals, Guides and Toolkits

     Children's Health

     Medicaid

     Medicare

     Uninsured

     Health Disparities

     Other

Technology and Audio Visual Materials

     Audioconferences and Webcasts

     Media Programming

     Web Sites, Web Features

          Florida

          Children's Health

          Medicaid

          Medicare

          Health Disparities

          Other

     Videos and Films

Periodicals and Books

Reports and Studies

     New Listings

        New Listings: Medicaid

        New Listings: Children's Health

        New Listings: Medicare

        New Listings: Federal Budget

        New: Health Insurance, Health Care Costs

        New: Health Disparities

        New: Other Health Issues

     Florida Reports

     Children's Health

     Medicaid

     Medicare

     Federal Budget/Health Care

     Health Insurance, Health Care Costs

     Health Disparities

     Other Health Issues

FLORIDA CHAIN WEBSITE RESOURCE UPDATE

Any serious policy proposal that aims to improve health care in America and control rising health care expenditures must address chronic disease.  That’s why a broad group of patients, providers, community organizations, business and labor groups, and health policy experts has joined together to form the  – a national, bi-partisan coalition committed to raising awareness of the policies and practices that save lives and reduce health costs through more effective prevention and management of chronic disease.

MANUALS, GUIDES, TOOLKITS

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

Children's Health

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

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

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: A Primer

Health Disparities

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

Built with funding from the American Hospital Association and expert guidance from a 35-member ACHI working group, this will be online in November 2007.  The Toolkit, a member service of the Association for Community Health Improvement, available to members of the American Hospital Association and the Society for Healthcare Strategy and Market Development, is a hands-on guide for both novice and experienced practitioners seeking to design, conduct and use assessments to improve the health of their communities.

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

PERIODICALS AND BOOKS

The Fall 2007 issue isn issue devoted in large part to oral health and the health of people with disabilities. The table of contents appears below. (11/1/07, Johns Hopkins Press)

REPORTS AND STUDIES

New Listings

New Listings: Medicaid

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)

Saving Lives, Saving Money II: Tobacco-free States Spend Less on Medicaid
This study presents estimates of the reduction in state Medicaid expenditures that would result from reducing or eradicating smoking through effective cessation and prevention programs. (Nov 2007, American Legacy Policy Report)

New Listings: Medicare

Health of Previously Uninsured Adults After Acquiring Medicare Coverage
This study finds dramatic improvement in health trends when previously uninsured older individuals--particularly those with cardiovascular disease or diabetes--gain health care coverage through Medicare, presenting the strongest evidence to date that health improves significantly when people gain health insurance. While individuals who had continuous health insurance coverage did not report a significant change in their health trends as they transitioned to Medicare, those who had no or little coverage reported substantial improvements, with uninsured individuals who had heart disease or diabetes reporting the most dramatic improvements. (12/26/07, Commonwealth Fund, JAMA)

New Listings: Federal Budget

New Listings: Health Insurance, Health Care Costs

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)

Overburdened and Overwhelmed: The Struggles of Communities with High Medical Cost Burdens

The number of people with potentially high medical cost burdens varies widely across the nation. Some of these people lack insurance, while others are insured but are paying a high portion of their income to get that coverage. Federal support will be critical to addressing this problem. (Nov 2007, Commonwealth Fund)

New Listings: Health Disparities 

Scientists Will Update NCI Breast Cancer Risk Calculator To Better Reflect Black Women's Risk
The formula used for the National Cancer Institute's Breast Cancer Risk Assessment Tool, commonly known as the Gail model, often underestimates the risk of cancer in older black women, according to research. The original formula was based on data from about 240,000 white women. (11/28/07, Journal of the National Cancer Institute)

Almost Half Of U.S. Residents Support Providing Emergency Care For Immigrants, Poll Finds
Significantly more people are in favor of providing emergency medical treatment and public schooling to undocumented and documented immigrants than offering them access to other services and benefits, according to a poll. The poll also found that 46% of respondents believe immigrants, whether undocumented or documented, should be able to receive treatment in EDs, while one-third support denying social services, including access to EDs and public schooling, to undocumented immigrants.  (Dec 2007, Los Angeles Times/ Bloomberg)

New Listings: Other Health Issues

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.

Health Insurance, Health Care Costs

Health Disparities