February 3, 2006
STATE ACTION
MEDICARE PART D- FEDERAL PROMISES AND STATE RELIEF, BUT NOT FOR ALL
The Medicare Part D transition began with life-threatening circumstances for poor, elderly, disabled, and chronically ill people throughout the state and nation. An Executive Order from Governor Bush has relieved the crisis for many in Florida, but more must be done immediately to save lives. Read more
CLICK HERE to take action NOW! Quickly and easily send or edit a prepared letter to Governor Bush, with copies to your state legislators and others of influence.
FLORIDA MEDICAID REFORM UPDATE: ADJUSTMENTS NEEDED
Many issues not fully addressed prior to passing HB 3 during the December special session must be revisited now. A policy shift of this magnitude must have safe-guards for beneficiaries in the pilot program and comprehensive ongoing evaluation to measure success or failures. Learn more and write key legislators.
KIDCARE & HEALTHY START FUNDING
HEADS UP! GOVERNOR'S BUDGET PROPOSAL CUTS KIDCARE BY $197 MILLION
The $70.8 billion spending plan unveiled by Gov. Bush on February 1 is another major call to action for Florida healthcare advocates. The budget’s proposed healthcare cuts include a $197 million reduction to KidCare, which provides medical insurance for children in working families that cannot afford private health insurance and earn too much to qualify for Medicaid. Read more and write your legislators.
KIDCARE & HEALTHY START ACTION NEEDED!
Senator Rich and Rep. Vana have introduced legislation to cover children from families with incomes above 200% of the federal poverty level. The legislation would also restore and fund measures to reach the Legislature's KidCare enrollment goal and reach more hard to enroll eligible children.
Florida's Healthy Start Coalitions must receive increased funds to serve an additional 28,000 eligible at-risk pregnant women, to reverse the state's new upward trends in infant mortality and low birth weight babies. Read more and write your legislators about these issues.
NATIONAL ACTION
U.S. HOUSE APPROVED BUDGET BILL HARMS MILLIONS THROUGH LOST HEALTH BENEFITS
A blaring call to action was sounded with the February 1 House of Representatives approval of the Budget Reconciliation bill. This draconian legislation includes drastic cuts in Medicaid, causing severe hardship for millions of our most vulnerable low-income seniors, children, and people with disabilities. Medicaid recipients will have significant increases in out-of-pocket expenses they cannot afford, and even fewer benefits. Many will completely lose Medicaid coverage. State advocates must gear up to minimize harm for Floridians who rely on Medicaid. Read more
Check the roll call here to find out how your Congressional representative voted. Reps who voted YES on this draconian bill MUST hear from you. Make sure to let them know their YES vote was unconscionable, and that you will hold them accountable for the harm that will be done. Click here to write your representative.
CONGRESS MUST MOVE QUICKLY ON MEDICARE PART D CRISIS
Two Senate Bills Offer Partial Fixes
The Medicare Informed Choice Act, S.1841, and S. 2203 have been introduced. Among their ameliorating features, these bills offer critical protections during the first year of the program, and would treat residents in Assisted Living Facilities (ALFs) the same as those in nursing homes by dropping new co-payments for prescriptions. Florida's Senator Bill Nelson is a sponsor of both these bills. Read more and write to Senator Martinez and your Congressional Representative about Medicare Part D now!
EXTENDED INFORMATION FEBRUARY 3, 2006
STATE ACTION
NATIONAL ACTION
STATE ACTION
MEDICARE PART D- FEDERAL PROMISES AND STATE RELIEF, BUT NOT FOR ALL
The Medicare Part D transition began with life threatening circumstances for poor, elderly, disabled, and chronically ill people throughout the state and nation. An Executive Order from Governor Bush has relieved the crisis for many in Florida, but more must be done immediately to save lives.
CLICK HERE to take action NOW! Quickly and easily send or edit a prepared letter to Governor Bush, with copies to your state legislators and others of influence
Governor’s Executive Order – Help for Some. . .
The good news is that Governor Bush has issued an Executive Order to cover prescriptions for many caught without coverage during the chaotic Medicare Part D transition. This order followed assurance from the Center for Medicare and Medicaid Services (CMS) that states would receive 100% reimbursement for covering the costs of denied prescriptions or high co-payments.
One piece of bad news is that that this interim coverage extends only until February 15, hardly enough time for patients to get their prescriptions filled and have the complicated new system’s glitches fixed. Efforts are underway to press CMS to extend this period, and to prompt Florida to take the “leap of faith” to provide continued coverage during the transition.
But Not Help for All
More bad news is that the Executive Order fails to cover the 70,000 vulnerable, low-income chronically ill Floridians who were formerly granted Medicaid as “medically needy.” With incomes even just above 73% of the federal poverty level (the federally required level for Medicaid), they had been placed on a “share of cost” plan that requires them to cover a 20% co-payment before Medicaid picks up the balance.
Most of these “medically needy” have cancer, AIDS, or renal failure, or are organ transplant recipients. As a result, they require continual care and very expensive medications. Because they are quite poor, they cannot pay their share of the costs, so they cannot get the care on which their lives depend.
The Governor must act immediately to see that these 70,000 “medically needy” are able to get their life-saving medications, and that February 15 does not end the interim coverage. With this year’s much increased tax revenues and his proposed extensive tax cuts, the state clearly has the resources. Not acting is unconscionable when lives are at stake.
CLICK HERE to take action NOW! Quickly and easily send or edit a prepared letter to Governor Bush, with copies to your state legislators and others of influence.
Additionally, very low-income people in Assisted Living Facilities have new co-payments of $3-$5 for each prescription. Many take multiple drugs for physical and mental illnesses, and these co-pays will use up most or all of the $54 they receive monthly for personal care. This policy does not apply to people with similar conditions who reside in nursing homes in the state. Congress needs to level the playing field for people with similar disabilities who reside in ALFs.
FLORIDA MEDICAID REFORM UPDATE: ADJUSTMENTS NEEDED
Many issues not fully addressed prior to passing HB 3 during the December special session must be revisited now. A policy shift of this magnitude must have safe-guards for beneficiaries in the pilot program and comprehensive ongoing evaluation to measure success or failures.
Florida CHAIN has collaborated with many other organizations and advocates throughout the state to raise these concerns and suggestions. We are watching several shell bills as vehicles for change.
Some of the Issues:
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The state must assure sufficient and comprehensive data collection and subsequent analysis for an objective analysis of the pilot programs that considers the diversity of the population and state.
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Each pilot project must offer continual public access to its evaluations. Legislators and the general public must know what is working or needs modification.
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MediPass enrollees moved into managed care will only have emergency room coverage until they choose a plan. Many are disabled or have severe cognitive disabilities that making it difficult to make choices. Disruption in their Medicaid services may be life threatening.
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Some studies show that fee for service program work well for certain populations. Efforts to improve efficiency in Medicaid fee for service and to expand the successful fraud and abuse program should be considered as a viable reform alternative, along with managed care.
ACTION MESSAGE: Medicaid Reform Issues for 2006
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Legislators must recommend that proposed evaluation include more key elements now missing from the data collection requirement specified in the Florida Medicaid reform legislation, and that this be regularly made available to the public.
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Additional analysis of this ambitious policy change should be through a formal Request for Proposal process that opens bids to both state and national entities with a wide array of expertise.
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Exempt from the pilot program expansion children in the foster care system and individuals with physical and mental disabilities.
Key leaders for these messages:
Senator Burt Saunders, Chair, Senate HHS Appropriations
Senator Durell Peaden, Chair, Senate Health Care
Representative Holly Benson, Chair Health and Families Council
Representative Aaron Bean, Chair. Health Appropriations
Representative Gayle Harrell, Chair. Health Care General
Representative Rene Garcia, Chair. Health Care Regulation
Secretary Alan Levine, AHCA
KIDCARE & HEALTHY START FUNDING
HEADS UP! GOVERNOR'S BUDGET PROPOSAL CUTS KIDCARE BY $197 MILLION
The $70.8 billion spending plan unveiled by Gov. Bush on February 1 is another major call to action for Florida healthcare advocates. The budget’s proposed healthcare cuts include a $197 million reduction to KidCare, which provides medical insurance for children in working families that cannot afford private health insurance and earn too much to qualify for Medicaid. The cut stands out in a budget buoyed by a tax windfall, and that includes $1.5 billion in tax cuts such as tax holidays and property tax reductions and rebates exceeding $1 billion. Florida CHAIN will keep you informed on developments and opportunities for action. Read more from the Daytona Beach News-Journal.
KIDCARE & HEALTHY START ACTION NEEDED!
Contact members of your legislative delegations with these messages:
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Support SB 942 by Sen. Rich and HB 241 by Rep. Vana to allow children under 5 with family incomes above 200% of poverty to buy into the Healthy Kids low cost insurance program.
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Support the Florida KidCare Coordinating Council’s recommendation to restore and fund community coordination, retention, and enrollment for KidCare, to achieve the Legislature’s enrollment goal and reach more hard to enroll eligible children. Despite improvements in enrollment time, enrollment continues to decline.
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To improve birth outcomes and reverse a new upward Florida trend in incidences of infant mortality and low birth weight babies, the state must appropriate funds for Healthy Start Coalitions to serve 28,000 additional at-risk pregnant eligible women. The current appropriation cannot cover the growing number of eligible high risk pregnant women.
NATIONAL ACTION
U.S. HOUSE APPROVED BUDGET BILL HARMS MILLIONS THROUGH LOST HEALTH BENEFITS
A blaring call to action was sounded with the February 1 House of Representatives approval of the Budget Reconciliation bill. This draconian legislation includes drastic cuts in Medicaid, causing severe hardship for millions of our most vulnerable low-income seniors, children, and people with disabilities. Medicaid recipients will have significant increases in out-of-pocket expenses they cannot afford, and even fewer benefits. Many will completely lose Medicaid coverage.
Check the roll call here to find out how your Congressional representative voted. Reps who voted YES on this draconian bill MUST hear from you. Make sure to let them know their YES vote was unconscionable, and that you will hold them accountable for the harm that will be done. Click here to write your representative.
State advocates must gear up to minimize harm for Floridians who rely on Medicaid. Florida CHAIN with many partner organizations will closely monitor developments and keep you apprised of analysis and opportunities for action. One question to be explored is how this will impact the Florida Medicaid Reform pilot programs – though we seem to be on the fast track in the scheme of things. Read more in Families USA's Press Statement on the vote: House Passes Budget Bill; Medicaid Beneficiaries Are the Big Losers
CONGRESS MUST MOVE QUICKLY ON MEDICARE PART D CRISIS
Two Senate Bills Offers Partial Fixes
The Medicare Informed Choice Act, S.1841, filed by Florida Sen. Bill Nelson, is a small, very valuable bill offering three time-limited protections to help ease the pressure of first year enrollment in the the new drug program.
S. 2203, sponsored by Sen. Bill Nelson and Sen. Hilary Clinton, would waive the new co-payment requirements for Medicare/Medicaid dual eligible individuals in assisted living facilities, who lack the financial resources to make even minimal co-payments for their medications.
Contact Florida’s U.S. Senator Mel Martinez TODAY!
CLICK HERE to write to Senator Martinez or call his office at 1/202-224-3041 with these messages:
Ask him to support and co-sponsor these bills to help resolve some of the oversights in the Medicare Part D program. People with very low income and severe chronic illness, transplant survivors, and others need full coverage under Part D for expensive medications and services.
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S.1841:
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Delays late enrollment penalties by expanding the current six month open enrollment period to the entire year. People need time to make the best choices for their situations.
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Ameliorates bad plan choices by giving beneficiaries a one-time chance during 2006 to change a mistake in choosing a plan.
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Provides extra protection for retirees by keeping them from being dropped by a former employer’s plan during the first year so they have time to correct enrollment mistakes.
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S. 2203:
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Helps fix the problem of assisted living facility residents being forced to spend much of their $54 monthly personal care allowances on co-payments for multiple medications required for their developmental, mental, and physical disabilities.
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Many of these very low-income patients have required hospitalization because they were not able to access their drug treatments. Problems caused by these co-pays are well-documented in Florida.
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This policy does not apply to people with similar conditions who reside in nursing homes in the state. Congress needs to level the playing field for people with similar disabilities who reside in assisted living facilities.
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Congress must move quickly to resolve the system failures inherent in Medicare Part D.
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Lives of low-income elderly, chronically ill and disabled are literally at stake when Medicare recipients cannot receive essential medications due to bureaucratic glitches.
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People with very low incomes and severe chronic illnesses, transplant survivors, and others need full coverage under Part D for expensive medications and services.
Contact Your Member of Congress NOW!
CLICK HERE to write your representative or call through the Capitol switchboard at 1/202-224-3121 with these messages:
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Congress must move quickly to resolve the system failures inherent in Medicare Part D.
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Lives of low-income elderly, chronically ill and disabled are literally at stake when Medicare recipients cannot receive essential medications due to bureaucratic glitches.
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People with very low income and severe chronic illness, transplant survivors, and others need full coverage under Part D for expensive medications and services.
FEATURED PARTNER
Miami Dade LINC-
Human Services Coalition of Dade County,Inc.
Medicaid Reform Forum
At the podium: United Way President-CEO Harve Mogul welcomes the audience. Seated left to right: Steve Marcus, CEO (HFSF); Joan Alker, Sr. Researcher (Georgetown Univ.); Deputy Secretary Tom Arnold (AHCA); and Senator Nan Rich (FL Senate)
Over 160 people attended a forum on Florida’s Medicaid Reform waiver in Miami-Dade on November 29, 2005. Taking place just before the Florida Legislature’s December 2005 Special Session, the forum’s focus was to provide timely and balanced information to legislators, policymakers, service providers and business leaders on the proposed changes to Florida’s Medicaid program and the potential impact it will have on the local community.
State and local legislators, business leaders, health industry professionals and service providers came together at Greater Miami Chamber of Commerce for the forum. Florida State Senator Nan Rich and Florida State Representative René García spoke in addition to Thomas Arnold, deputy secretary for Medicaid, Agency for Health Care Administration (AHCA), the state agency responsible for administering Florida’s Medicaid program, and Joan Alker, a nationally recognized Medicaid expert, gave presentations and then participated in a question and answer session.
The co-conveners of this event were United Way of Miami-Dade, Greater Miami Chamber of Commerce, Miami Children’s Hospital, the Health Foundation of South Florida, Jackson Memorial and Baptist hospitals, The Children’s Trust, the Alliance for Human Services, Health Choice Network, Human Services Coalition, South Florida Hospital and Healthcare Association and the Dade County Medical Association.
Founded in 1995, the Human Services Coalition of Dade County (HSC) http://www.hscdade.org/ works to empower individuals and communities to create a more just society by promoting civic engagement, economic fairness and access to health and human services. At the heart of these efforts is a belief that individuals, families and communities will be strengthened through increased public awareness and civic involvement in improving systems of care.
HSC is a membership-based coalition composed of over 6000 members, representing community groups, faith-based organizations, policy makers, businesses and individuals.
REAL STORIES
February 3, 2006
The following was received from Louis Sciutto, Zephyrhills, FL, through Florida Transplant Survivors Coalition, Inc.
I am sending you this letter in the spirit of sharing information first hand on the experiences and hardships I share with many Florida beneficiaries of these programs.
I am a 59 year old diabetic living in Zephyrhills Florida in Pasco County. As a result of diabetes I got a kidney transplant in 1997, I’ve had two heart attacks, two strokes, osteoporosis, two compression fractures in my L1 and L5 vertebra, a herniated disc, and I am legally blind. I have been receiving Social Security Disability since 1995.
Before I became disabled I owned a small air conditioning business in Lake County. I am a father of four children and a grandfather of three. I owned a four bedroom house in Land O’Lakes Florida. I have been a hard working taxpayer and a productive part of society my entire life. Because of the high cost of being disabled I now live in a mobile home park in Zephyrhills as a single parent raising my 17 year old daughter.
My medical coverage is Medicare and Medicaid’s Medically Needy Share of Cost Program. The Share of Cost Program is what I rely on to maintain my health and stay alive. I take 19 medications a day, a total of 25 pills, and two types of insulin. Since my kidney transplant with the help of these wonderful programs I have been able to maintain and survive my many medical concerns. I do have my bad days but not as frequent as others in my position.
Now some of the changes in these programs are good but I’m concerned on what has fallen through the cracks. These items are not just hardships but for many of us they are seriously life threatening. Please pay attention because people are going to die unnecessarily if the government moves too slowly.
For example Medicare Part D Prescription Drug Plan has a serious loophole for the providers. My plan Medicare Rx Rewards Value shows that it covers my anti rejection drugs for my transplant with a $2.00 to $5.00 co-payment. However when I ordered my medications this month my pharmacy informed me that the law states that if Medicare covers a medication I must get it through Medicare. Well Medicare pays 80% I must pay 20%. The co-pay (20%) on Cellcept and Gengraff (2 of my anti rejection drugs) is $178.00. The plan doesn’t pick up the co-pay. Medicaid doesn’t cover me until I meet my share of cost which is $863.00 a month. I always met my share of cost every month with my medications. Medicare Part D took that away from most of us. Since I can’t meet my share of cost I no longer have Medicaid benefits. Which means I must pay 20% of doctors fees, labs, MRIs, Xrays, etc. To get a clear view of this problem, after paying my basic monthly bills I have $165 left to feed my daughter and myself.
When I finally placed my prescription order I paid $47.00 in co-pays. I left out Cellcept, insulin, some heart medications. When I do get my insulin I’ll be forced to use my syringes. I have heard that the elderly sometimes have to choose between food and medications. Now I know what it feels like. I don’t like it!
There are thousands of people in worse shape than I am, we need your help. Please help us. Sometimes we feel like nobody is hearing us. Thank you for your time.
RECENT HEALTH ARTICLES
February 3, 2006
STATE ISSUES
Bush offers $71 billion budget, $197 million in cuts to KidCare
Touting Florida's financial health as he prepares to leave office, Gov. Jeb Bush released a $70.8 billion budget proposal Wednesday that would boost spending on education and environmental programs -- while also making hefty tax cuts. These include a $197 million in cuts to KidCare, which provides medical insurance for children in working families who can't afford private health insurance and make too much money to qualify for Medicaid. (2/2/06, Daytona Beach News-Journal) More
AARP opposes Medicaid test run
AARP Florida warned politicians Monday that support of a plan to force Medicaid recipients into managed care could result in retaliation from voters this election year. (1/24/06, Ocala Star-Banner) More
Florida to help 100,000 Medicaid recipients with prescription drug coverage
Faced with as many as 100,000 anxious patients in Florida, Gov. Jeb Bush on Thursday ordered the state to provide temporary drug coverage for Medicaid recipients who are unable get their medicine because of glitches in a new Medicare drug program. (1/27/06, Florida Sun-Sentinel) More
Florida's income gap among highest in U.S.
Florida ranks among the top five states for the biggest income gaps between the rich, middle-class and poor. Florida for the first time in 20 years has ranked in the top-five worst states for income inequality, according to the new study, which compared census data between the 1980s and early 2000s. (1/27/06, Miami Herald) More
State legislators to debate use of tax money for stem-cell research
For the first time, Florida legislators this month will tackle the ethically charged issue of stem-cell research and whether tax money should pay for it, particularly the use of stem cells from human embryos. (1/23/06, Florida Sun-Sentinel) More
NATIONAL ISSUES
Poll: Medicare plan confusing
Most people, particularly senior citizens, say they are having a hard time understanding the new Medicare prescription drug program, an AP-Ipsos poll found. (1/22/06, Miami Herald) More
Medicare Woes Take High Toll on Mentally Ill
On the seventh day of the new Medicare drug benefit, Stephen Starnes of Hilliard, Florida began hearing voices again, ominous voices, and he started to beg for the medications he had been taking for 10 years. But his pharmacy could not get approval from his Medicare drug plan, so Mr. Starnes was admitted to a hospital here for treatment of paranoid schizophrenia. (1/21/06, New York Times) More
Health Care, Vexing to Clinton, Is Now at Top of Bush's Agenda
More than 12 years after President Bill Clinton unveiled his plan to remake the nation's health care system, President Bush is moving the issue once again to the top of the national agenda. (1/30/06, New York Times) More
Doctors: Primary Care System On Verge Of Collapse
Primary care -- the basic medical care that people get when they visit their doctors for routine physicals and minor problems -- could fall apart in the United States without immediate reforms, the American College of Physicians said today... Dropping incomes coupled with difficulties in juggling patients, soaring bills and policies from insurers that encourage rushed office visits all mean that more primary care doctors are retiring than are graduating from medical school, the ACP said in its report. (1/30/06, Reuters) More
Over 3 Million Enrolled in High-Deductible/HSA Plans
At least three million consumers currently receive health coverage through high-deductible health insurance plans offered in conjunction with health saving accounts (HSAs), according to preliminary results of a new study by America's Health Insurance Plans (AHIP). According to the study, enrollment in the new insurance policies eligible for HSAs has roughly tripled since last March when a similar AHIP survey found that 1,031,000 people were covered by HSA-compatible insurance policies. (1/26/06, America’s Health Insurance Plans) More
Prognosis Is Mixed for Health Savings
President Bush has made "consumer-directed" health savings plans a cornerstone of his policy for addressing runaway medical costs, and he plans to push them again in the State of the Union address next week. But so far there is little evidence that the approach is helping many consumers come to grips with the high price of health care. (1/26/06, New York Times) More
Medicaid kids more likely to be treated for obesity
Children covered by Medicaid were found nearly six times more likely to be treated for severe obesity than children with private insurance. (2/01/06, USA Today) More And more
Still Smoking in New York City, and Venting About the $8 Pack
If the threat of disease has failed to stop smokers, why, some asked, would a 50-cent increase in taxes do the trick? (1/25/06, New York Times) More
Drugmaker's profits triple as sales slide
Bristol-Myers Squibb Co. said Wednesday its fourth-quarter earnings more than tripled from a year ago despite falling sales because the drug maker's year-ago net income was depressed by a one-time charge. (1/26/06, Ocala Star-Banner) More
New York Times Diabetes Series
The New York Times this week published a four-part series that examined diabetes, "a global crisis" that is "emerging as the biggest health problem menacing New York City." After a one-year examination, the Times found "an alarming lack of urgency about the threat among patients, doctors, insurers" and public health officials, in part because the disease "can take years to show symptoms." (1/12/06. Kaiser Network) More
HEALTH ADVOCACY RESOURCES
February 3, 2006
Note: New Resources are posted at the beginning of each section below.
FLORIDA CHAIN WEB SITE RESOURCE UPDATE
The Florida CHAIN web site now includes resource information in Spanish. To access, click here.
A Top Ten Insider's Guide to Legislative Advocacy
Jack Levine, President of Advocacy Resources, offers "how-to" tips on effective strategies for legislative and congressional advocacy by folks who are not at the Capitol every day. He advises us to understand the value of speaking up on public policy matters which concern and interest you, and that responsible advocacy is the heartbeat of a representative democracy. To access the Guide, click here.
Florida Healthy Start Coalition presentation
An excellent educational presentation by Carol Brady, Executive Director of the NE Florida Healthy Start Coalition, received many favorable comments about the program from members and chairman of the House Health Appropriations Committee. The presentation demonstrated the importance of Healthy Start as a successful program to improve birth outcomes which saves state money for expensive hospital care and reduces infant mortality rates in Florida. Healthy Start has not received an increase in state allocations since it began in 1991, and is requesting a first ever appropriation of $9.5 million to serve more than 28,000 additional families. To view the presentation click here.
GRANTS
HIV/AIDS Prevention Grants Program to reduce risk behaviors associated with HIV/AIDS among Native Americans and African American and Hispanic women. Deadline is Feb. 27. Contact Lillie Brown, (202) 293-7330, fax (202) 293-2352.
Finding Answers: Disparities Research for Change
Robert Wood Johnson Foundation is calling for proposals for Finding Answers: Disparities Research for Change, a national program that seeks to improve the quality of health care provided to patients from racial and ethnic backgrounds most likely to experience lower-quality health care.
2006 Regional Community Health Grants Program
The Aetna Foundation will fund philanthropic initiatives focused on the following health care issues: Childhood Health, Obesity (including diabetes)and Oral Health, and Depression.
ORGANZATIONS AND SERVICES
The Long-Term Care Champions Network is seeking to raise public awareness on this important issue, and needs your help. There is no cost to join the Champions Network; they just want to hear your story. If we continue to let Congress ignore this issue, our financial and health security could be jeopardized. For more information, click here.
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. They provide early intervention and resource support for people in times of personal and family crisis through education, referrals, affirmation, advocacy, collaborative planning and problem solving. To become part of their database, click here.
Client-Centered HIV Prevention Counseling, Testing and Referral
Marco Meneses, Planned Parenthood Community Health Educator in West Palm Beach, has completed this course and the course and is available to speak on the topic in Spanish. Call 561/641-0640.
MANUALS, GUIDES, TOOLKITS
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.
Turning the Tide: Why Acting on Inequity Can Help Reduce Chronic Diseases, a tool kit now available from the Public Health Agency of Canada's Atlantic Regional Office, is designed to support the use of the document, The Tides of Change: Addressing Inequity and Chronic Disease in Atlantic Canada; A Discussion Paper. The package was produced for use by community organizations in examining their work and policies and contains a variety of hands-on resources for use in presentations and group discussions.
The US Department of Agriculture (USDA) has launched a Spanish version of their online nutrition guide, MyPyramid: Steps to a Healthier You. MiPirámide: Pasos Hacia Una Mejor Salud to make it easier for Spanish-speaking Americans to access information about healthy lifestyles and to personalize that information for their own benefit.
A Spanish translation of the Resource Guide to Mental Health Services of Palm Beach County is now available. The guide, published by the National Alliance on Mental Illness of Palm Beach County, provides information to mentally ill persons and their families and is being distributed to people in the Hispanic community who need it. For more information, call NAMI at 561/588-3477.
A Top Ten Insider's Guide to Legislative Advocacy
Jack Levine, President of Advocacy Resources, offers "how-to" tips on effective strategies for legislative and congressional advocacy by folks who are not at the Capitol every day. He advises us to understand the value of speaking up on public policy matters which concern and interest you, and that responsible advocacy is the heartbeat of a representative democracy.
APA Help Center Now Offers Psychology Materials in Spanish
Access free Spanish language materials on mental health issues at the American Psychological Association's (APA) online help center.
My Bright Future Physical Activity and Healthy Eating Guide for Adult Women
US Department of Health and Human Services' HRSA guide
Health Literacy Style Manual
The Covering Kids & Families (CKF) National Program Office at the Southern Institute on Children and Families commissioned the MAXIMUS Center for Health Literacy to develop The Health Literacy Style Manual. The report is a resource for developing and improving applications, notices and other print materials related to government programs. It includes examples from real programs and can be used to make materials more client-centered, increasing consumers’ capacity to find and understand health information and services and to make informed health-related decisions.
TECHNOLOGY AND AUDIO/VIDEO RESOURCES
Public Health Foundation Media Resources
Several publications and videos related to minority health are now available through the Public Health Foundation's (PHF) online bookstore. Topics include: breastfeeding promotion in minority communities, epidemiology of diabetes, social determinants of health, neighborhoods and health disparities, as well as introductory Spanish for the healthcare worker. For a full list of resources on minority health, go to PHF's Learning Resource Center, click here.
Free Resource: Community Outreach Home Health and Hospice Videos
Ministry Home Care, a Wisconsin–based home health and hospice provider, has created two highly-acclaimed videos designed for community and professional education, as well as patient/caregiver information. Both productions demonstrate the impact home-based care can have on the lives of individuals. When Home Is Where You Want to Be...Home Health Care, winner of the silver Telly Award, reviews options when anticipating rehabilitation from a surgical or medical procedure, or recovery from illness. Recipient of the esteemed bronze Telly Award, Hospice...Because Every Moment Matters provides a clear, concise overview of today's hospice program—including holistic services, philosophy of care, and capabilities of specially trained professionals and volunteers. To order and learn details, write to info@ministryhomecare.org
Primer on Low-Income Working Families
Many low-income working families live one health crisis or job setback away from catastrophe. Some barely make ends meet despite "playing by the rules," and more than 9 million working families with children lead this precarious existence. Yet, we know little about their dynamics. This Urban Institute web feature provides a foundation for better understanding this at-risk population.
Acts of Charity: Charity Care Strategies for Hospitals in a Changing Landscape
Based on a survey and other analysis by PricewaterhouseCoopers LLP, this April 20, 2006 audio conference will convey up-to-date information about the fast-moving subject of charity care in the context of community benefit. Join us to learn about the current state of practice, and to hear and discuss recommended strategies.
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
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.
Trends and Indicators in the Changing Health Care Marketplace is an online chartbook that presents up-to-date information on key health care marketplace trends. The chartbook highlights national health expenditures, health care spending and costs, employee and retiree health coverage, HMO enrollment, hospital data, and public views on topics such as managed care, medical errors, and quality information.
Ask Me 3
Learn about Health Literacy and its impact on patients. This website also provides the three most important questions that consumers should ask their doctor, nurse, or pharmacist.
PERIODICALS
Kaiser Family Foundation is writing a weekly Medicare Q&A column that is being distributed by Knight Ridder/Tribune News. The column answers questions from readers related to the new Medicare drug benefit.
The National Center for Health Education (NCHE) is happy to share the Nov/Dec '05 issue of the NCHE Growing Healthy Youth, Parents and Communities (YPC) newsletter. This issue features back-to-school information, activities and resources. You’ll also find activities for students, current health research, heath education resources, funding opportunities, upcoming events, and NCHE news. To receive future issues of the YPC newsletter and other updates from NCHE, email karen@nche.org.
REPORTS
Florida KidCare’s web site now has these two reports for pdf download: Florida KidCare Statewide Enrollment Trend, Title XXI Enrollment and Major Program Changes.
State of the States: Finding Their Own Way on Health Coverage, a Robert Wood Johnson Foundation program that works with states to expand health insurance coverage, today issued its latest annual "State of the States" report, summarizing strategies states are implementing or considering to expand health coverage.
Medicare Modernization Act: An Early Look at Medicare Drug Plan Options for Connecticut’s Medicare Beneficiaries states, “For example, four of the ten ‘worst’ plans for the person with schizophrenia did a better-than-average job covering the medications of the prototype senior. As such, the review highlights that the best plan for an individual often is a highly specific function of the particular medication needs” (CT Health Fdn., Dec. 2005)
The Center for American Progress and American Progress Action Fund have a new initiative to help build momentum around health care reform and to support progressive policymakers committed to with SEIU's Americans for Health Care, they fielded a national poll to create and test health care messages with the public. In brief, the public believes the health care system is broken and understands that policymakers have failed to address this issue. With American families feeling increasingly helpless in the face of skyrocketing
costs and stagnant wages, they are hungry for real reform. Click here for the poll results, executive summary and more.
Quality of care in for-profit and not-for-profit health plans enrolling Medicare beneficiaries, a recent Harvard study in the Dec. 2005 American Journal of Medicine, found that enrollees in Medicare + Choice for-profit health plans received significantly lower-quality care than those in not-for-profit Medicare + Choice plans in all four areas examined: breast cancer screenings, diabetic eye exams, beta-blockers administered after heart attack, and follow-up after hospitalization for mental illness, even after adjustment for socio-economic, demographic and health plan variations. (Medicare + Choice was renamed Medicare Advantage in 2004).
Consumer Driven Health Care Initiatives and Medicaid, call toll-free: 877-919-4059; Pass code: 88373800#
Two background documents mentioned on the call are also available:
A fact sheet on the ramifications of Florida’s Medicaid waiver proposal on children.
A paper on the substantial out-of-pocket medical expenses Medicaid beneficiaries incur.
A special report on Medicaid, by the Pew Center on the States, seeks to analyze the real-world experiences of states, highlight examples of what works and what doesn't, and inform a crucial policy debate that will affect the lives of millions of Americans.
Rising Out-of-Pocket Spending for Medical Care: A Growing Strain on Family Budgets
Since the late 1990s, accelerated growth in health care spending has translated into increased burdens on family budgets. In 2001–02, an average of 13 million families per year had direct out-of-pocket (OOP) costs equal to or exceeding 10 percent of family income. When premium costs are added into the equation, even more families are devoting a substantial share of resources to health care expenses. From the Commonwealth Fund.
Health Coverage for Aging Baby Boomers
Rising out-of-pocket health care costs and sluggish wage growth threatens workers' ability to save for retirement. This is particularly true for adults ages 50 to 64, or "baby boomers," whose per capita health care expenditures are more than twice those of younger adults. In this January 2006 published analysis of The Commonwealth Fund Survey of Older Adults, the authors explore the extent and quality of health insurance coverage for baby boomers in the workforce. Among their key findings: older adults have high rates of chronic health conditions; many have unstable insurance coverage; those who have low income, individual coverage, or no insurance spend a substantial share of their income on coverage and health care and have reduced access to care.
Federal policy has encouraged enrollment of Medicare beneficiaries in health plans, the majority of which are for-profit plans. In Quality of care in for-profit and not-for-profit health plans enrolling Medicare beneficiaries, researchers from the Harvard School of Public Health (HSPH) and Harvard Medical School report their findings that not-for-profit health plans provided significantly higher quality of care to enrollees than for-profit plans on four important clinical services; breast cancer screening, diabetic eye examination, beta-blocker medication after heart attack and follow-up after hospitalization for mental illness.
A recent Urban Institute report, Lowering Financial Burdens and Increasing Health Insurance Coverage for Those with High Medical Costs, reviews evidence that the health care system is doing a poor job of ensuring care for those who most need it and offers options for subsidizing health care coverage for high-cost, high-risk populations.
Mathematica gives good marks in its report to Congress on the State Children's Health Insurance Programs (SCHIPs) that offer health care coverage to children in families with incomes up to 200 percent of the federal poverty level and beyond. In almost all areas examined – outreach, enrollment and access to services – the programs are succeeding. In the 10 states studied, programs were put in place quickly, and overall, families were satisfied with the ease of enrolling children, many of whom remained enrolled for 12 months, depending on the state.
Healthy Food, Healthy Communities: Improving Access and Opportunities Through Food Retailing
An often-ignored cause of obesity and poor health is a lack of access to good, healthy food. Residents in low-income communities have limited options for healthy eating and often resort to buying unhealthy foods at corner stores or fast food outlets. This new California Endowment PolicyLink report, Healthy Food, Healthy Communities: Improving Access and Opportunities through Food Retailing, shows how low-income communities are accessing healthy, affordable food in their neighborhoods.
Disparities in Health Analyzed
A group of Pitt researchers and directors traveled to Washington last week to take part in a conference on racial and ethnic disparities in health and healthcare. "This conference represents Pitt coming to the nation's capital to create a partnership with the federal government on an effort we launched in 2001," said Stephen Thomas, director of Pitt's Center for Minority Health. The summit had been held in Pittsburgh for the past five years, where it was only able to hold 300 participants. This year, more than 2,000 clinicians, physician researchers, public health professionals and practitioners attended.
Ethnic and Racial Differences May Affect Lung Cancer Risk
African Americans and Native Hawaiians are more susceptible to lung cancer from cigarette smoking than are whites, Japanese Americans, and Latinos, according to the results of a large cohort study published in the January 26 issue of The New England Journal of Medicine.
These have recently been added to the web site of Fletcher Allen Health Care in Alliance with the University of Vermont (FAHC): Rural Hispanics at a Glance A 2005 report by the USDA's Economic Research Service and Review of Pesticide Education materials for Health Care Providers Providing Care to Agricultural Workers Evaluates the medical resources available to providers
Young adults are one of the largest and fastest-growing segments of the U.S. population without health insurance. They often lose coverage under their parents' policies at age 19 or when they graduate from high school or college. The updated Rite of Passage: Why Young Adults Become Uninsured and How New Policies Can Help suggests several policy changes that could extend coverage to uninsured young adults.
Between 2000 and 2003, the number of Americans without health insurance coverage grew by 5 million, with nearly the entire increase attributed to a decline in employer-sponsored coverage. A Shared Responsibility: U.S. Employers and the Provision of Health Insurance to Employees explores the characteristics of workers who do not receive coverage from their own firms; examines how health care costs are spread across workers, employers, and the government; and recommends policy options to expand and strengthen employer-sponsored coverage.
Most studies of health coverage expansion policies focus on their potential national impact. Variations in the Impact of Health Coverage Expansion Proposals across States finds that federal strategies have greatly varied effects on different states. This report examines the variability among states with regard to economic characteristics, health care markets, and numbers of uninsured.
Some contend that Medicaid has stretched beyond its original purpose of providing a safety net for the poor and has evolved into an asset shelter for the rich. Medicaid’s Coverage of Nursing Home Costs: Asset Shelter for the Wealthy or Essential Safety Net? reviews the empirical evidence and finds that asset transfers are not significant contributors to Medicaid costs now, and implementing policies designed to further limit them is unlikely to significantly reduce Medicaid costs.
In addition to the 45 million uninsured adults in the United States, another 16 million adults were underinsured in 2003, meaning their insurance did not adequately protect them against catastrophic health care expenses. Insured But Not Protected: How Many Adults Are Underinsured? explains that underinsured adults are almost as likely as the uninsured to go without needed medical care and to incur medical debt. (Full article available with subscription.)
Beginning in January 2006, open enrollment period limitations (also known as enrollment lock-in provisions) will restrict the number of times (and the times of the year) that Medicare beneficiaries can change health plans. Estimating Medicare Advantage Lock-In Provisions Impact on Vulnerable Medicare Beneficiaries examines Medicare managed care enrollment and disenrollment of vulnerable beneficiaries from 1999 to 2001 to estimate the impact of these upcoming restrictions.
Beginning in 2006, 42 million elderly and disabled Medicare beneficiaries will have access to prescription drug coverage through Part D of the Medicare program, including an estimated 14.4 million beneficiaries who will be eligible for low-income subsidies. Low-Income Assistance under the Medicare Drug Benefit provides an overview of the drug benefit and the low-income subsidies, including participation and eligibility.
With discussions on restructuring Medicaid occurring in state capitols and Washington, DC, two new reports provide the latest data on how much of Medicaid's spending is used to cover mandatory versus optional populations and services. The issue paper, Medicaid: An Overview of Spending on "Mandatory" vs. "Optional" Populations and Services, offers a brief summary of the data and a discussion of the practical implications of policy changes. The background report, "Medicaid Enrollment and Spending by ‘Mandatory’ and ‘Optional’ Eligibility and Benefit Categories” (same page) offers a more detailed examination of the methodology and results.
Financing for the nation’s health care safety net is fragmented, and providers must knit together resources from many different funding sources to cover the costs of providing a broad range of services. Stresses to the Safety Net: The Public Hospital Perspective describes those sources of revenue, documenting that nearly 40 percent of all safety net revenues come from Medicaid.
Over the past few years, a number of states have implemented new or increased existing out-of-pocket costs for beneficiaries in their Medicaid, SCHIP, or other public programs. Increasing Premiums and Cost Sharing in Medicaid and SCHIP: Recent State Experiences reviews the key findings from this activity, including the impact on enrollment in public coverage programs, on providers, and on access to care.
In January 2006, Medicare will begin providing coverage for outpatient prescription drugs, and many low-income beneficiaries will have to meet both an income and asset test to receive assistance. Low-Income Subsidies for the Medicare Prescription Drug Benefit: The Impact of the Asset Test estimates that in 2006, 2.37 million low-income Medicare beneficiaries will not qualify for subsidized coverage because they will fail the asset test. The report also examines how the low-income asset test works and the characteristics of people likely to be excluded.
STATE HEALTH EVENTS AND NOTICES
February 3, 2006
NORTH FLORIDA
Walk for the Minds of America
Tuesday, April 4 in Tallahassee
NAMI Florida is holding this event to raise awareness about mental illness and to raise funds for NAMI. For more information, call 850/671-4445 or 877/626-4352.
CENTRAL FLORIDA
Faces of Courage Foundation Tampa Planning Committee for African American Cancer Retreat
Tuesday, February 7, 9:30 AM, TransWorld Building, Meeting Room A, 4115 West Spruce Street, Tampa
Volunteers, survivors and sponsors are encouraged to attend. Since the cancer death rate in the African American community is twice that in the Caucasian community, this program specifically addresses African American needs and wants to make a difference in their lives and help them survive survivorship with some new tools and support. Contact Peggie D. Sherry at (813) 877-CAMP (2267)or psherry@facesofcourage.org, or click here.
Forging Connections, Creating Seamless Health Care for Children & Their Families
March 14-16 in Orlando
National Initiative for Children's Healthcare Quality's 5th Annual Forum for Improving Children's Health Care aims to build will for improvement by highlighting successful evidence-based models and interventions and creating a community of dedicated professionals, policymakers, and payers working to transform health care for children. For details, click here.
SOUTHEAST FLORIDA
HSC Launches Advocacy Summits: Take Action, Sign up Now
Feb. 16 and 17
The Human Services Coalition's Advocacy Institute will be hosting its First Quarterly Policy and Call to Action Summits on . The quarterly coalition building events will focus on affordable housing, immigration and health care access as they relate to the future prosperity of the Miami-Dade community. Participating organizations are encouraged to invite clients and constituents. A pre-summit training will be offered on Feb.4 to provide a policy overview and the ABCs of advocacy. Click here for more information.
National Woman’s Heart Day® Health Fair Offers Free Screenings, Advice for Miami Women
Friday, February 17, 2006 James L. Knight Center from 8:00 AM to 2:00 PM
Women can obtain free heart health screenings with on-the-spot results and advice on adopting heart-healthy lifestyles at the National Woman’s Heart Day® Health Fair. Sponsored by Sister to Sister: Everyone Has a Heart Foundation, Inc. and South Miami Heart Center, the event will feature, heart health presentations, risk assessment screenings and counseling, demonstrations, and educational activities. For more information, click here or contact Hilda Mitrani at 305-992-3475 or HeartFairMiami@comcast.net.
Women’s Health, the FDA and Emergency Contraception, An Evening with Dr. Susan Wood
Wednesday, February 15, 2006
5:30-6:30 Reception in Gallery
6:30-8:00 Lecture and Q&A with Dr. Wood
ArtServe, 1350 East Sunrise Blvd., Ft. Lauderdale
$25 includes hors d’oeuvres. Discount with valid student ID.
Contact Amanda Mourant at Planned Parenthood of South Palm Beach and Broward Counties, amourant@lovecarefully.org or 561/394-3540 ext. 220.
Community Health Fair Celebrates Black History Month
Saturday, February 18, Miami Dade College Medical Center Campus
In collaboration with several community-based organizations, the College is hosting its first ever Community Health Fair as part of the Black History Month celebration. In addition to many free medical screenings and health information, there will be food, Steel Band music and an African Marketplace. Free bus transportation (courtesy of Miami Dade Transit) is available from several locations. For more information, click here or call 305/237-4209.
Exhibitors Needed for Hip Hop 4 Health Fairs in Miami-Dade
Saturday, February 25th 11 AM to 2 PM, Horace Mann Middle School, 8950 NW 2 Avenue
Saturday, April 29th 11 AM to 2 PM, South Miami Middle School, 6750 SW 60 Street
Saturday, May 20th 11 AM to 2 PM, Health Fair at a central location within Miami-Dade County
Hip Hop 4 Health is an outreach effort to help middle school kids get health screenings and information to lead healthier lives. Four health fairs also featuring entertainment will target students, their families and the surrounding communities in underserved areas of Miami-Dade County. Social service and healthcare agencies are invited to participate in these fairs at no cost. Contact Hilda Mitrani at hildamitrani@comcast.net or 305/992-3475.
STATEWIDE
EVENTS
Florida's 4th Annual Supportive Housing Conference: Welcome Home to a Place of Your Own
February 27-28, 2006 in Fort Lauderdale
Topics will include Medicaid Reform and Creating Community Coalitions. For more information call 786/293-2441 or write to mariabaeza@flsupportivehousing.org.
Click here for more information.
Cover the Uninsured Week 2006 will take place May 1-7
Visit covertheuninsuredweek.org to see Florida events.
NOTICES
Florida’s Medicaid Pharmacy Services Instructions Re: Medicare Part D
On January 26, 2006, the State of Florida has issued instructions for Medicaid Pharmacy Providers on newly prescription payments on behalf of certain Medicare/Medicaid dual eligible recipients who are unable to obtain prescriptions or who are being required to pay deductibles, co-insurance or incorrect co-payments with their Part D prescription benefit.
State of Florida Seeks Federal Waivers to Create Senior Care Program
On January 26, 2006, the State of Florida has announced that AHCA will submit waiver applications to the federal Centers for Medicare and Medicaid Services (CMS) to seek approval for the Florida Senior Care Program. Florida Senior Care is an integrated managed care pilot program for Medicaid participants age sixty and older who reside in the Florida Panhandle and Central Florida regions.
NATIONAL EVENTS AND NOTICES
February 3, 2006
CONFERENCES AND EVENTS
National Health Policy Conference 2006
will take place on Feb. 6-7, 2006 at the Renaissance Washington, DC Hotel. For information and registration click here.
Forging Connections, Creating Seamless Health Care for Children & Their Families
will be held March 14-16 in Orlando. National Initiative for Children's Healthcare Quality's 5th Annual Forum for Improving Children's Health Care aims to build will for improvement by highlighting successful evidence-based models and interventions and creating a community of dedicated professionals, policymakers, and payers working to transform health care for children. For details, click here.
Spring Training for Health Champions
ACHI's annual conference, will take place March 14-16, 2006 in Phoenix, AZ. It will focus on challenges in access to care faced by hospitals, health care providers and communities, given the number of uninsured at an all-time high, and recognizing the importance of causes of unequal access and of finding local, state, and national solutions. For more information, click here.
Empowering Communities to Bridge Health Divides
will be held April 1-2, 2006 at Yale University, New Haven, CT, convening more than 600 student leaders and activists, doctors, public health professionals, nurses and others from throughout the world who are interested in international service, global health, public health, and medicine. The conference goal is to inform the public about health divides and empower them to develop solutions to improve access to care for the medically underserved. For details click here.
CAMPAIGNS AND INITIATIVES
National Woman's Heart Day®
will take place February 17, 2006. For more information click here.
New Initiative to Transform the US Public Health Service Commissioned Corps (USPHS)
HHS has announced an initiative to transform the USPHS Commissioned Corps to enable it to address public health challenges more quickly and efficiently in emergencies. For more information, click here.
National Brain Awareness Week
will be held March 13-19, 2006. The Dana Alliance for Brain Initiatives has launched its web site for this week, including an international events calendar. Partner organizations must register to submit activities and order free publications and stickers. Order deadline for free shipping is March 6. Many tools are available on the website. For more information, click here.
National Public Health Week 2006
will be held April 3-9, 2006. The American Public Health Association and hundreds of partner organizations will explore ways that Americans can build healthier communities and healthier kids. Communities across the country will consider how buildings, roads, sidewalks and neighborhood design are affecting the health of children. For more information, click here.
Second Annual Medical Fitness Week
will take place April 24–30, 2006. The Medical Fitness Association sponsoring this international initiative to promote an increase in physical activity levels in all ages and to highlight the medical fitness difference. Medical fitness centers and communities are asked to offer programming to teach families skills to develop healthy lifestyle habits. All participating organizations are also asked to raise money through participation the Walking Challenge for local programs to fight childhood obesity. For details, click here.
National Association for Sport and Physical Education (NASPE) and Walk4Life, Inc. also remind parents that children learn to get more physically active by example, with their new brochure, 101 Tips for Family Fitness Fun. For a free copy and information about bulk rate costs, email jlee-beverly@aahperd.org. To purchase copies, call 1/800-321-0789. Stock number is 304-10322. Spanish brochures, Consejos Divertidos para una Familia en Forma, are also available.
Cover the Uninsured Week 2006
will be held May 1-7, 2006. To download and order resources and materials including posters, stickers, fliers and more, for little or no cost, click here. For large or special orders, call 202/572-2928.
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