FL Health Care Consumer Voice Needs Vehicle

 

Every other day, there seems to be a new version of legislation that would fix KidCare, the state’s health insurance program for children. However, pressure is still needed in the House Health Policy Committee to adopt SB 930 sponsored by Sen. Mandy Dawson (D-Fort Lauderdale).

 

As child advocates, we like the provisions in this bill because it would: 

The House Healthcare Council is not expected to take up KidCare legislation until at least the week of April 9.

 

Florida KidCare is made up of four programs with different eligibility requirements and funding streams by the state and federal governments. One of the key components is traditional Medicaid. Children whose families make too much money to qualify for Medicaid may be eligible for other health coverage offered through KidCare.

 

However, benefits differ greatly between these health plans.

For example, children enrolled in Medicaid qualify for Early Periodic Diagnostic Screening and Treatment (EPSDT), and services must be provided when they are medically necessary. Children who don’t qualify for Medicaid – but are eligible for other subsidized insurance programs through KidCare – are not entitled to these services. It is equally important that all children receive the same basic benefit package that includes the EPSDT standards required under Medicaid. 

In addition, all providers who treat KidCare enrollees should receive the same reimbursement rates unless they are providing services to children with special health care needs.

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It’s been almost two years since a group of lawmakers backed by former Gov. Jeb Bush convinced the Florida Legislature to approve a Medicaid pilot project called Florida Senior Care. 

 

The Medicaid experiment in two test sites would provide health care, long-term care services and care coordination with the overall goal of reducing costs. While the federal government approved the concept seven months ago, some members of the Florida Legislature have been reluctant to do the same.

 

But now, the legislators behind the plan are proposing changes that would make Florida Senior Care more palatable to their colleagues. Consumers should be aware of the following changes under HB 7065 sponsored by Healthcare Council and Rep. Hugh Gibson:

 

• The first pilot site would change from the Panhandle to Miami-Dade County; the second test site would remain in Central Florida.
• Enrollment at both pilot sites would be voluntary.
• Individuals must make an affirmative choice of whether to participate in the pilot program. In the original plan approved by the federal government, individuals were required to opt out (affirmatively say “no”) to the offer for Florida Senior Care within 30 days or they would be automatically enrolled into one of the Florida Senior Care Plans.
• Individuals may elect to change their plan within 90 days. After this time period they must remain in the plan for one year.  
• Individuals who participate in Florida Senior Care can choose to remain in their current residence regardless of when they enter the program. However, the individual’s current residential facility would have to accept the Medicaid rate or the contracted rate from the managed care organization.
• The bill removes the requirement for the Agency for Health Care Administration to competitively bid out managed care entities to run the pilot program. The Agency may select entities to operate the pilots who meet or exceed the minimum standards of the Agency. 

The House Policy and Budget Council approved the bill Friday in a 22-7 vote. It is expected to be scheduled for a House floor vote. The Senate companion bill is SB 2450 sponsored by Sen. Durell Peaden and has not yet been heard in any Senate committee. 

 

If the bill is approved by the full Legislature and signed by the governor, the state Agency for Health Care Administration will have to seek federal permission for the changes listed above.

     www.floridachain.org  Florida CHAIN  chainreaction@floridachain.org 

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 Florida CHAIN Awarded Robert Wood Johnson Foundation Grant to Support Efforts To Improve Health Access Programs Through An Increased Tobacco Tax 

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April 2, 2007

Last January, Staywell, one of the Medicaid Reform HMO’s denied Robin Eckman, of Fort Lauderdale, the insulin medication prescribed by her long time physician. As reported on the February 20, 2007 South Florida Sun-Sentinel article, Staywell approved only a generic brand opposed by her doctor that caused Ms. Eckman’s blood sugar to spike, almost killing her and sending her to the hospital for 12 days. It was only after strong advocacy efforts by her doctor and community based organizations asking the local office of the Agency for Health Care Administration (AHCA) to intervene, that Ms. Eckman was able to get the insulin that works for her.
 
But some damage had been done. While in the hospital, Ms. Eckman was administered large dosages of powerful antibiotics to treat the diabetic shock and resulting infections. As a result, she began suffering from severe diarrhea.  To combat the condition, her doctor prescribed a regimen of 3 pills for a month, a total of 90. Staywell only approved 42.  A few days ago, when Ms. Eckman ran out, she tried to have the prescription refilled but was told by her pharmacist that the HMO would not cover the cost. Her incontinence resumed.
 
To deal with the discomfort and try to undo the damage caused by the plan’s original refusal to dispense the recommended medication, Ms. Eckman has incurred additional expenses. She has been taking “good bacteria,” at a cost of $12.99 for a 3 day dosage, which she can no longer afford on her fixed income. Furthermore, she had been using adult diapers, the cost of which Staywell also doesn’t cover.
 
Medicaid Reform proponents claim that the new model promotes preventive care and rewards responsible behavior. But in Ms. Eckman’s case, her plan would not cover the cost of the reagent strip she needs to monitor her disease, much less the medication on which her life depends. Unfortunately, as we predicted, this is how Medicaid Reform fails too many consumers.
 
In June 2006, one month before the implementation of Medicaid Reform in Broward and Duval, the South Florida Sun-Sentinel published an opinion piece by Florida CHAIN and the Medicaid Reform Advocates Coalition. It outlined 4 major areas of concern with regards to reform. The 3rd area of concern had to do with how HMO’s are structured to cover people who are typically well. This is how they make a profit, and this is why they can charge different rates based on health histories. Under Medicaid Reform, in which they get a set reimbursement from the State, to make the program profitable to them, HMOs are allowed to limit the type, scope and duration of treatment, and are allowed Preferred Drug Lists through which they can substitute generics for brand name drugs.
 
When a Medicaid consumer is enrolled from Medicaid to a Reform Managed Care plan, brand name medications that are or have been prescribed by their physicians are not “grandfathered”. The plans are allowed to require consumers to start from the generic brands eve, as in Ms, Eckman’s case, above the objections of their physician.
 
Medicaid consumers typically don’t comprise the healthier consumer category. If under 65, by definition, to qualify for Medicaid they suffer from chronic ailments and disabilities: not good prospects for HMO’s. They should not be treated callously by managed care plans more concerned with a bottom line.

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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 andrewl@floridachain.org

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RECENT HEALTH ARTICLES

April 2, 2007 

 

Florida News & Opinions

    KidCare, SCHIP, Healthy Start

    Medicare and Medicaid

        Medicare Drug Coverage, Drug Costs

        Other Medicare, Medicaid

    Health Insurance and Costs

   Other Health Issues

National News & Opinions 

     Medicare, Medicaid, SCHIP

        Medicare Drug Coverage, Drug Costs

        Other Medicare, Medicaid, SCHIP

     Health Insurance and Costs

     Other National Health Issues

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FLORIDA NEWS & OPINIONS

 

KidCare, SCHIP, Healthy Start

 

Advocates fear KidCare will be underfunded
Children's advocates said policy changes in the state's KidCare program will likely happen this session, but they fear lawmakers won't provide the necessary funds to include the 500,000 income-eligible children who aren't insured. ''If dollars don't follow that, we really don't go anywhere,'' said Karen Woodall, a social-services lobbyist.  (3/30/07, Tallahassee Democrat)    

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Medicare and Medicaid

 

Medicare Drug Coverage, Drug Cost

 

'Medically Needy' Program Requires Overhaul, Patients Say
Chronically ill patients asked lawmakers Thursday to repair a Medicaid program they say is broken, now that changes to the federal Medicare program make it harder for them to qualify for state assistance. But with the budget process barreling along and most committee work nearing an end, their crusade faces tough odds. The Medicaid Medically Needy program serves chronically ill people with low incomes that aren't quite low enough to qualify them for full Medicaid benefits. The program subsidizes such patients only when their monthly medical bills climb high enough. For many such patients who also qualify for the federal Medicare program, Medicare Part D has made it almost impossible to qualify as Medically Needy. The state requires such patients to get their drugs through the Medicare Part D drug program now, and no longer factors drugs bills into those patients' total monthly medical cost. Some such patients still need help paying other medical bills, but cannot qualify as Medically Needy because their monthly costs are no longer high enough. (03/23/07, Tampa Tribune)

 

Florida to Receive $1 Million in Rebates for Prescription Overpayment
Nearly 4,700 Floridians will be receiving a refund for amounts they overpaid for Remeron, a common antidepressant prescription drug, Attorney General Bill McCollum announced today. Rebates totaling nearly $1 million have been sent to Florida consumers and public agencies as the result of a settlement regarding the drug.  Florida’s settlement was part of a multi-state agreement reached by the drug’s manufacturers and all 50 states in February. (3/28/07, Florida Health News)

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Other Medicare, Medicaid

Medicaid for kids under fire: State lawsuit clears roadblock in bid to create improved care
Imagine being the parent of a child no doctor or dentist wants to see. All because you don't have your own insurance, you're too poor to pay the bill yourself, and the government insurance that's supposed to cover your child has irked doctors so badly they won't take your child or any others on the plan. Roughly half of the 1.2 million Medicaid-eligible children in Florida are going with limited or no medical and dental care, according to a lawsuit filed by the state's pediatric and dental associations.  (3/25/07, Southwest Florida News-Press)

 

Budget plan favors infrastructure over needy
Florida lawmakers assembling a $70 billion-plus state budget planned to spend a larger chunk of it on roads and other needs, but not on boosting services for disabled people.  The Senate would save about $60 million in state tax dollars by cutting a portion of the developmental disabilities program -- which has multimillion deficits now -- but it would cause the state to lose out on about $78 million more in federal money. (3/30/07, Miami Herald)

It's Morgan's Turn: Family Celebrates A Small Victory Over Bureaucracy
It was Morgan's turn Thursday to celebrate the end of a frustrating two-year wait for the wheelchair at the Morgan Kelly Medicaid Progress Conference, a gathering of parents and advocates for disabled children that drew attention to bureaucratic ordeals like the one faced by Morgan's mother, Angela Floyd. Though doctors prescribed a power wheelchair in early 2005, Floyd said Florida's Medicaid program repeatedly denied the recommendation until this month. Floyd said it was only after she enlisted help from elected officials that the Agency for Health Care Administration, also known as AHCA, Florida's Medicaid authority, approved the wheelchair for Morgan, who has spinal muscular atrophy, a progressive motor neuron disease. (3/23/07, Lakeland Ledger)

 

States Medicaid list of doctors full of errors
Its nearly impossible to know how many doctors take Medicaid in Lee and whether they are accepting new patients. The News-Press asked the states Agency for Health Care Administration for a list of providers that actively see Medicaid children. First, the agency wanted to charge $775 for the data. (3/25/07, Ft. Myers News-Press)

 

A few specialists thrive serving Medicaid clients
Medicaid may challenge doctors finances, but some of them have managed to run successful practices without turning away Medicaid patients. Dr. Emilio Del Valle runs a thriving pediatric practice in south Fort Myers. He won’t limit the number of Medicaid children he takes. He already had to see lots of children to stay viable. (3/25/07, Ft. Myers News-Press)

 

Proposed Medicaid cuts could hurt pharmacies
If the pharmacist behind the counter at your independent pharmacy is on edge, there’s good reason. Federal health-care regulators have proposed big cuts to Medicaid that would mean pharmacies, both chain stores and the independents, would get paid less than their costs for filling generic prescriptions for the poor and disabled on Medicaid. Many pharmacies, especially the independent operators with more Medicaid clients than their corporate-owned competitors, couldn’t survive much beyond the effective July 1 date of the reimbursement change on generics. (3/17/07, Naples News)

 

Medicare headache: Health care providers refuse to accept Advantage
Irv Boxerbaum's primary-care physician refused to see him when he found out about his new health insurance. In order to cut costs, Boxerbaum's former employer recently changed its retirees' health insurance to a Medicare Advantage private fee-for-service plan, called Advantra Freedom. In a letter, the company told Boxerbaum that he can seek care from any licensed physician or hospital in the U.S. who accepts Medicare and the PFFS plan's terms and conditions - with no need for a referral. But Boxerbaum is yet to find a provider here who accepts the plan. (3/29/07, Ocala Star-Banner)

Universal Health Is Still Short of Cash
Universal Health Care Insurance Co. raised about $3.5 million in four days, but state regulators say that leaves the St. Petersburg Medicare insurer still more than $118 million short of the funds it needs to remain solvent. Regulators on Friday had recommended liquidating the company after it failed to meet a state-imposed deadline for shoring up its financial reserves by as much as $122 million. The state temporarily backed off Tuesday after a review of the company's most recent financial statement showed Universal has a surplus of $3.5 million and is no longer insolvent. Instead, regulators said, Universal is classified as "impaired." That means it's in the black, but still doesn't meet state requirements. (3/30/07, St. Petersburg Times)

 

State Takeover Delayed For Any, Any, Any Health Insurer
At the request of a Tallahassee judge, Florida officials agreed Thursday to postpone their requested takeover of the company that sponsors the Any, Any, Any Medicare plan. (3/30/07, Tampa Tribune)

 

Medicare OKs Payment To Any, Any, Any Insurer
On Wednesday, even as state officials asked a court to let them liquidate Universal Health Care Insurance Co. in three days, the federal Medicare agency authorized payment of an estimated $90 million in premiums to the company Sunday. (3/29/07, Tampa Tribune)

 

State Declares Insurer Insolvent
At the stroke of 5:01 p.m. Friday, Florida Insurance Commissioner Kevin McCarty declared that Universal Health Care Insurance Co., sponsor of the Any, Any, Any plan, was insolvent. In an e-mail to Alex Sink, the state's chief financial officer, McCarty recommended that the Department of Financial Services begin proceedings to place.the insurer in receivership. (3/24/07, Tampa Tribune)

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Health Insurance and Costs

OUR OPINION: Children's Cabinet a good idea
It's not hard to find reasons to support the creation of a Florida Children's Cabinet, a proposed 15-member panel of agency heads, lawmakers and child advocates who would recommend ways to streamline services, improve efficiency and advise the Legislature on budgetary matters regarding children's programs. We can think of 700,000 reasons right off the bat. That's the number of youngsters in our state without health insurance. (3/23/07, Ocala Star Banner)

 

Sebastian patients won't have to switch doctors or pay more
A contract dispute between Sebastian River Medical Center and UnitedHealthcare that threatened to prompt several hundred or more area residents to search for new doctors who accept their insurance has been resolved.  (3/29/07, Stuart News)

More kids in lower-income families lack health insurance: Texas has the highest uninsured rate at 20.3%, followed by Florida with 16.9%
About 47 percent of parents in families earning less than $40,000 a year are offered health insurance through their employers -- a 9 percent drop during the past decade. The figure underscores concern that low-income parents are experiencing a dramatic erosion in employee benefits, according to the Robert Wood Johnson Foundation, which funded the research. The foundation said the research also shows the importance of the State Children's Health Insurance Program, which has been in effect for a decade. (3/14/07, Orlando Sentinel)

Blue Cross of Florida scores well in survey
Blue Cross and Blue Shield of Florida ranked first for customer satisfaction among major health plans in the South -- and second overall nationally -- in a J.D. Power and Associates survey released Thursday. Of the 13 major health plans available in the South, Blue Cross was the only major health plan in Florida to score above the regional average in the research company's National Health Insurance Plan Satisfaction Study. The state's other four major health plans, in order of ranking, were United Healthcare, Aetna, Cigna Healthcare and Humana. (3/16/07, Orlando Sentinel)
 

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Other Health Issues 

 

Official cites doctor 'crisis' in death
Donna Casasnovas understood the consequences of a shortage of emergency room specialists months before the Palm Beach County Medical Society released the results of its study earlier this week. She might not have known that the 14 area hospitals have struggled for years to find enough surgeons for their ERs. (3/28/07, Palm Beach Post)

 

Oversight Board Approves Clinic: Central Florida Health Care now moves on to the County Commission

Central Florida Health Care's Lakeland clinic - the first of several primary care clinics to be opened with help from indigent-care sales-tax funds - would operate seven days a week, a total of 76 hours, under plans approved Friday by the Citizens Oversight Committee. Because the arrangement involves a contract between Polk County and Central Florida, plans for the clinic now go to the Polk County Commission at its April 18 meeting. (3/17/07, Lakeland Ledger)

 

Nonprofit offers Hispanics prenatal care
Studies have shown that women who receive prenatal care generally have a better chance of delivering a healthier baby. But for 44 percent of Hispanics in Palm Beach County, numerous factors such as cultural and language differences, inaccessibility, cost and lack of education combine to create impediments to care. For five years, Healthy Mothers/Healthy Babies of Palm Beach County looked for ways to change that. Now, armed with a $350,000 one-year grant from the Children's Services Council, the nonprofit is preparing to launch a program designed to create a positive prenatal experience for Hispanic women in Lantana and Lake Worth. (3/23/07, Palm Beach Post)

 

Free Primary Health Clinic Set To Open
A group of good Samaritans is working hard behind the scenes to bring free primary health care to for the needy of Highlands County. Samaritan’s Touch Care Center will provide free medical exams and testing, free medications, health education, eye care and emotional and spiritual support to those who qualify. A primary doctor was enlisted, an equipped facility has been secured, staff is hard at work raising money while applying for grants and existing staff is busy soliciting volunteer health care professionals. (3/23/07, Tampa Tribune)

 

Lee nonprofit helps uninsured, Medicaid patients
Veronica Ramirez held her 1-year-old son Eduardo tight as a nurse practitioner peered into his ears. The infection was gone. The infection was gone. Eduardo was healthy, and his mother could take him home. Eduardo is one of Florida’s 1.2 million Medicaid children, and he gets all of his medical care at the Family Health Centers, a nonprofit Fort Myers-based organization dedicated to serving the community’s health needs, regardless of patients’ ability to pay. The organization has 11 offices in Lee County and offers pediatric and primary care, women’s health (including obstetrics), dental care and some lab work.  (3/25/07, Ft. Myers News-Press)

 

South Miami clinic will treat children for free
When Wayne Brackin's sons played in South Miami's sports leagues, he often heard stories from coaches about chronically ill children in the neighborhood who didn't have healthcare. ''It became obvious to me that there was a group of children who tended to wait until they were so sick that they went to the emergency room,'' said Brackin, CEO of South Miami Hospital and recently named chief operating officer of Baptist Health South Florida. Brackin came up with the idea of creating a neighborhood clinic, and on Thursday, community leaders gathered to celebrate its upcoming opening at 6701 SW 58th Pl. The medical facility in a former recreational space is a $200,000 outfit complete with three exam rooms, a waiting area, receptionist and medical office. (3/25/07, Miami Herald)

 

Grant Aims to Improve Health of Area's Likely Future Mothers
When the CDC came out with a list of recommendations for women to take before they ever conceive, the people behind Jacksonville's Magnolia Project weren't surprised. Faced with a fight against the region's higher than average infant mortality rates, the group suspected years ago that the general health of the mother might have something to do with how well the baby fares and set out to help women without health insurance or with other risks that could impact a future pregnancy. Now, as interest in what's known as "preconception care" grows, the Northeast Florida Healthy Start Coalition is taking its show on the road. A $148,000 grant from the state aimed at improving the health of women likely to become future mothers will be split between the five-county area but spent largely in Clay and St. Johns counties on spinoffs of the Magnolia Project called Camellia and Wildflower. (3/20/07, Florida Times-Union)

 

Doctors' clinic helps the Indian River County's needy
Ask Dr. Richard Haight why physicians should volunteer to treat people without medical insurance, and he might mention the case of a local woman who waited until a tumor had grown through the outside of her breast before pain drove her into a hospital emergency room. "It was something that you'd see in the Third World," said Haight, one of several doctors who volunteer. (3/25/07, Stuart News)

 
Aging doctors cited in Palm Beach County physician shortage
Dramatic shortages in general surgeons, family doctors and some specialists will make finding a doctor increasingly difficult in Palm Beach County as the population grows and the number of practicing physicians shrinks, according to a survey. (3/27/07, South Florida Sun-Sentinel)

 

Nelson pushes for more medical residents: Senator stumps for proposed legislation during stop at Shands Jacksonville
Sen. Bill Nelson, D-Fla., and  Sen. Harry Reid, D-Nev., introduced legislation last month to increase the number of residency slots in 24 states, with the Sunshine State topping the list. Doctors must go through a residency where they train with physicians, develop expertise in medical procedures and then specialize in a medical field before becoming board certified and able to practice medicine. Florida does not have enough residency slots relative to its population, Nelson said at a news conference at Shands Jacksonville.  (3/20/07, Florida Times-Union)

 

County Commission authorizes tax referendum on new hospital
Jackson County Commissioners agreed unanimously Tuesday evening to send the question of a half-cent sales tax for a new hospital to the voters. The action came after they had heard from 13 residents in a 6:15 p.m. standing-room only public hearing, where only one person who spoke was completely against the idea. Donna Casasnovas understood the consequences of a shortage of emergency room specialists months before the Palm Beach County Medical Society released the results of its study earlier this week. She might not have known that the 14 area hospitals have struggled for years to find enough surgeons for their ERs. (3/28/07, Jackson County Floridan)

Mental health: Lawmakers, invest wisely
Florida ranks 48th in the country in per-capita spending for mental-health services, 47th in Medicaid spending for child beneficiaries and 43rd in Medicaid spending for adult beneficiaries. A significant portion of these problems can be traced to the lack of mental-health care. It is an embarrassing and unfortunate statement about our lack of commitment to care for those with mental illness. We aren't adequately funding proven and cost-effective local mental-health programs, though their success proves time after time that treatment and community supports work. We know that access to local mental-health care is the key to providing patients with much-needed help at a reasonable cost to taxpayers.(3/27/07, Tallahassee Democrat)

 

EDITORIAL: Lawmakers Should Not Forsake Florida's Mental Health Needs
Last year, the issue of underfunded mental health concerns received considerable media attention as many Floridians heard the term "forensic beds" for the first time in reference to the system's inability to move jailed inmates with mental illness to a state hospital setting until they were deemed capable of facing charges against them. The law requires that these vulnerable inmates be moved within 15 days of incarceration, but a waiting list that topped 300 created a logjam and one that will require nearly $50 million annually to fix. While that single issue received a great deal of attention, it is merely the tip of the iceberg due to a long history of ignoring funding needs. Florida currently ranks 48th in the country in per-capita spending for mental health services, 47th in Medicaid spending for child beneficiaries and 43rd in Medicaid spending for adult beneficiaries. (3/26/07, Tampa Tribune)

EDITORIAL: Jailing the mentally ill
Gov. Charlie Crist has proposed spending $79 million in the upcoming state budget to serve the mentally ill who run afoul of the law. While mental health and corrections officials praise the governor for addressing a problem that has been too long overlooked, they say his proposal falls far short of meeting the actual needs. (3/30/07, Stuart News)

 

Crist rethinks suicide program, says he'll keep it
As lawmakers start finalizing a new, $71 billion state budget, a $150,000 suicide prevention program is hanging in the balance that Duval County suicide advocates consider key to helping the county lower its high number of suicides. (3/29/07. Florida Times-Union)
 

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NATIONAL NEWS & OPINIONS

 

Medicare, Medicaid, SCHIP

  

Medicare Drug Coverage, Drug Cost

 

Legislation Would Revise Asset Test For Medicare Prescription Drug Benefit, Enroll More Low-Income Beneficiaries In Drug Plans
HR 1536 seeks to help the estimated 3.27 million low-income beneficiaries who qualify for, but do not receive, federal subsidies under the Medicare prescription drug benefit and expand the eligibility for the subsidies to more beneficiaries. It would provide CMS with "limited access" to Internal Revenue Service data to identify Medicare beneficiaries eligible for the subsidies and would require multiple, "clearly worded" notices to beneficiaries and other outreach efforts. In addition, the bill would end a practice in which financial assistance provided by adult children to cover the cost of utility bills or groceries are considered income in calculations to determine whether Medicare beneficiaries qualify for the subsidies. The legislation also "would not punish low-income seniors for accumulating modest retirement savings" in calculations to determine whether they qualify for the subsidies. Sponsor Rep. Doggett said, "These changes will extend coverage to more than half of the low-income individuals and about two-thirds of couples who have previously been denied solely because of their very modest savings." (3/20/07, CQ Health Beat)

 

Opinion: Mandatory Vaccines Help Drug Firms, Not Necessarily Consumers
There's nothing wrong with a drug maker publicizing its products and their benefits, but the lure of lucrative government contracts can prompt them to play fast and loose. In lobbying state lawmakers to make its latest vaccine mandatory, Merck has greatly exaggerated both the threat of a disease and the ability of a drug to prevent it. The drug in question is Gardasil. (3/21/07,Tampa Bay Online)

 

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Other Medicare, Medicaid, SCHIP News  

Expanded Health Program for Children Causes Clash
The Bush administration says it will strenuously resist Democratic plans for a threefold expansion of the Children's Health Insurance Program, ensuring a clash with Congress over the most important health care legislation being considered this year. Administration officials said that much of the new government coverage proposed by Democrats would simply replace private insurance, and they expressed concern about a sharp increase in the proportion of children covered by public programs in the last decade. (4/1/07, New York Times)

U.S. to Offer Care to Infants of Illegal Immigrants
CMS on Tuesday announced that infants born to undocumented immigrants whose deliveries are covered by Medicaid could automatically receive coverage under the program for one year, a reversal of current policy. Under an interim final rule issued in July 2006, CMS said that infants born to undocumented immigrants and others whose deliveries are covered by an emergency Medicaid provision would not automatically receive coverage under the program. (3/21/07, New York Times)

Top Democrats Propose Broad SCHIP Expansion to Cover All Children
Representative Dingell and Senator Hillary Rodham Clinton teamed up on a bill to expand the State Children's Health Insurance Program (SCHIP) that "will be the basis for House efforts to reshape the program" as well as a "building block" for Clinton's presidential campaign platform. (3/14/07, New York Times)

 

Bipartisan Rally in Washington Calls for Expansion of SCHIP

Democrats and Republicans rallied in Washington to support increased funding of the State Children's Health Insurance Program and to protest the spending levels proposed by President Bush, which they contend would cause more than 1 million children to lose coverage. (3/14/07, Philadelphia Inquirer)

 

OPINION: SCHIP Should Only Cover Poor Children
The State Children's Health Insurance Program is imperiled because it is "structurally flawed," and many of the nation's governors "have led the program astray" by using it to "provide taxpayer-subsidized health care for adults and middle-income families, even when poor children go without coverage," writes Grace-Marie Turner, president of the conservative Galen Institute, in a Wall Street Journal commentary. (3/17/07, Wall Street Journal)

 

President Bush Threatens Veto Of Supplemental Appropriations Bill
President Bush on Monday issued a formal veto threat to a $124 billion House supplemental appropriations bill for military operations in Iraq and Afghanistan that includes funds for a number of health care programs.  The bill includes $3.5 billion more than Bush requested for Department of Defense and Department of Veterans Affairs health care programs, as well as $1 billion for avian flu preparedness. The bill also would provide $750 million for SCHIP. (3/20, Washington Post)

 

The Immigrant Children’s Health Improvement Act (ICHIA)
On March 5, 2007, bipartisan legislation was introduced in both the House and the Senate that would allow lawfully present immigrant children and pregnant women to enroll in Medicaid and the State Children’s Health Insurance Program (SCHIP). The Immigrant Children’s Health Improvement Act (ICHIA) would completely eliminate the five-year bar for legal immigrant children and pregnant women to access publicly funded health care. SCHIP reauthorization provides an important opportunity to focus attention on the health care needs of immigrant children and to make sure that our health care safety net provides quality health coverage to all children. More than 20 states already spend their own money to provide safety net programs for low-income immigrants. Enacting ICHIA would bring significant fiscal relief to the states that are already doing the right thing. (March 2007, National Immigration Law Center)

 

Varying Medicaid Eligibility Rules Leave Many Without Coverage
About 50 million low-income people qualify for Medicaid assistance, but "despite its wide reach, the program is not an all-encompassing safety net," according to USA Today, in an article profiling a family that fell between the cracks. (3/14/07, USA Today)

 

Hospital Groups Push Back on Proposed Medicaid Rule
Hospital groups, lawmakers, and governors are continuing to fight the Bush administration on proposed regulatory changes to Medicaid they say would cut nearly $4 billion from the nation's health care safety net over the next five years. (3/26/07, CQ HealthBeat)

 

Medicare Advantage Cuts May Be Tough Row to Hoe

In a move that portends resistance from rural-state senators to possible Medicare payment cuts to private health plans, Sen. Orrin G. Hatch fell one vote short in an attempt to require a reserve fund to pay for wider coverage of uninsured children and other Medicaid and Medicare changes. (3/26/07, CQ HealthBeat)

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 Health Insurance and Costs

 

Candidates Outline Ideas for Universal Health Care

Democratic candidates for president promised to guarantee health insurance for all, but disagreed over how to pay for it and how fast it could be achieved. (3/25/07, New York Times)

 

USA Today Profiles the Uninsured as the Issue Re-Emerges as a Leading Domestic Topic
"The debate over how to provide health care for the uninsured is moving back to center stage in Washington and many state capitols," reports USA Today, in an article profiling six individuals or families who, "through choices, circumstance, bad luck -- or a combination of all" -- found themselves among the nation's 46 million uninsured. (3/14/07, USA Today)

 

Study Finds Drop in Employer-Based Coverage for Low-Income Families
Research funded by the Robert Wood Johnson Foundation found that fewer than 47 percent of parents in families earning less than $40,000 a year are offered employer-based health insurance -- a drop of 9 percent over the past decade. (3/14/07, Associated Press)

 

Bush Rejects Health Care Recommendations from Congressionally Appointed Citizens Task Force
President George Bush rejected the recommendations of a citizens' task force appointed by bipartisan Congressional members, contending that while he agrees with many of the goals of the task force, he does not agree on how to achieve them.  (3/14/07, Associated Press)

 

Health Reform Plans in Congress Would Cover More Uninsured and Cut Health Costs More Than Bush's Plan
An analysis of 10 Congressional health care reform proposals introduced in 2006 and 2007 found that two would cover almost all of the uninsured and many would lower spending, while President Bush's proposal would cover only 9 million of the uninsured and would increase administrative costs. (3/20/07, Reuters)

 

Computing Error Leads Government to Lower Estimate of Uninsured Slightly
The Census Bureau reported that it has overstated the number of uninsured by almost 2 million since 1995 due to a computer programming error, according to the Associated Press, though it said the impact of the revision is small. (3/23/07, Associated Press)

 

Polls Show Uninsured and Health Care Reform as Top Election Issues
Health care reform is one of the nation's leading concerns and a presidential election issue, according to a poll by America's Health Insurance Plans (AHIP), while a poll by the American Society for Quality found that soaring health care costs were more worrisome to Americans than the war in Iraq. (3/24/07, Milwaukee Journal Sentinel) 

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Other Health Issues

 

Four physician membership organizations release "Joint Principles of the Patient-Centered Medical Home (PC-MH)"
The four groups - the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics AAP), the American College of Physicians (ACP) and the American Osteopathic Association (AOA) - represent some 333,000 physicians. The pediatricians, family physicians, internists and osteopathic physicians represented by the four organizations provide the vast majority of primary care services to children, adolescents, and adult patients in the United States. The set of seven principles describes the characteristics of a practice-based care model for providing comprehensive primary care for children, youth and adults in a health care setting. The PC-MH facilitates partnerships between individual patients and their personal physicians and - when appropriate - the patient's family. The Joint Principles define the following key characteristics of the PC-MH: Personal physician - each patient has an ongoing relationship with a personal physician trained to provide first contact, continuous and comprehensive care. Physician directed medical practice - the personal physician leads a team of individuals at the practice level who collectively take responsibility for the ongoing care of patients. Whole person orientation - the personal physician is responsible for providing for all the patient's health care needs or taking responsibility for appropriately arranging care with other qualified professionals. This includes care for all stages of life; acute care; chronic care; preventive services; and end of life care. Care is coordinated and/or integrated - across all elements of the complex health care system. (3/13/07, Medical News Today) 

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HEALTH ADVOCACY RESOURCES

April 2, 2007

Florida CHAIN Website Resources

Grants and Fellowships

Organizations and Services

Manuals, Guides and Toolkits

Technology and Audio Visual Materials

     Audioconferences and Webcasts

     Media Programming

     Web Sites, Web Features

     Videos

Periodicals and Books

Reports and Studies

     New Listings

        New Listings: Medicare, Medicaid, SCHIP   

        New Listings: Federal Budget

        New: Health Insurance, Health Care Costs

        New: Health Equity Issues

        New: Other Health Issues

     Florida Reports

     Medicare, Medicaid and SCHIPS

     Federal Budget/Health Care

     Health Insurance, Health Costs, Health Care Reform

     Health Equity Issues

     Other Health Issues

 

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FLORIDA CHAIN WEB SITE RESOURCE UPDATE

Florida CHAIN has advocacy tools available online.

 

Expanding Medicaid Eligibility for Pregnant Women

(By Carol Brady of Florida Association of Healthy Start Coalitions)
This one-page report responds to these questions: Why is health care coverage important during pregnancy?How does Medicaid impact health care coverage for pregnant women? Why do we need to expand Medicaid eligibility for pregnant women? How can Florida expand coverage for pregnant women? Expanded eligibility would leverage federal funding for the uninsured, increasing access to prenatal care for at-risk women and matching SCHIP Medicaid eligibility for infants through age one. Expanding Medicaid coverage for uninsured women up to 200% of the federal poverty level would provide needed support to the working, uninsured families for whom pregnancy-related health care is a significant burden.

 

Florida Medicaid Reform PowerPoint Presentation

Educate your colleagues and/or employees on Florida Medicaid Reform basics. with Florida CHAIN's PowerPoint presentation for public use. Feel free to call Florida CHAIN for more information about Medicaid reform or about the PowerPoint: 954/791-7314.

 

The Florida CHAIN web site now includes resource information in Spanish.

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GRANTS AND FELLOWSHIPS

 

New listings

 

New Routes to Community Health
Informational conference call: April 4 Read More

Video webcast: April 17 Read More

Deadline for brief online proposals: May 17
The mission of Robert Wood Johnson's New Routes to Community Health, anchored in community partnerships, is to increase the health of new immigrants to the United States using local media. Our definition of health is broad and includes the building or shoring-up of the infrastructures that support good health. Register now to learn more about this new grant program.

 

Compassion Capital Fund mini-grants
Deadline: April 10
These federal mini-grants are awarded to grassroots faith-based and community organizations serving distressed communities. These grassroots organizations use the funds toward building their organization's capacity in one of four social service priority areas of need: at-risk youth, homelessness, healthy marriage, or rural communities. Total awards $10 million in grants of up to $50,000 to approximately 200 organizations are anticipated. For information on other CCF grant programs, visit the CCF Web site or the Administration for Children and Families Open Funding Opportunities page.  

Finding Answers: Disparities Research for Change
Deadline: May 17
This Robert Wood Johnson Foundation initiative provides funds to healthcare organizations implementing interventions aimed at reducing disparities. The funds are used to evaluate the interventions and their potential for broad dissemination. With this pool of funds, project leaders hope that health plans, hospitals, and community clinics will be encouraged to focus on racial and ethnic disparities as a priority in their quality improvement agendas.  

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Continuing listings, in order of submission deadlines

 

Fresh Ideas: Improving the Health of Immigrant and Refugee Communities
Application Deadline: Apr 13
This initiative aims to give immigrants and refugees the tools and support they need to improve and maintain their own health. Today, more than 30 million immigrants and refugees live in the United States. They often have high rates of chronic health problems, due at least in part to difficulties they have getting appropriate social and health services. Language barriers, lack of education and cultural differences sometimes make it harder for immigrants and refugees to obtain culturally appropriate services, outreach or other information that could help them live healthier lives. 

 

Community Program/Community-Based Participatory Research
Letter of Intent Due: April 13

Invited Full Proposal Due:  June 22

The Lance Armstrong  Foundation seeks to create a  community of individuals and organizations across the United  States that both understands the challenges and opportunities  that a cancer experience presents and is committed to collaborating to address and resolve the physical, emotional, and  practical issues faced by cancer survivors. Interventions must be cancer survivorship-related and may be designed to directly impact health or behavior, or be targeted at providers, systems, and/or policies.  CBPR is defined as a collaborative, equitable research partnership that has the following characteristics:  It is participatory; It is cooperative, engaging community members and researchers in a joint process in which both contribute equally; It is a co-learning process; It involves system development and local community capacity building; It is an empowering process through which participants can increase control over their lives; It achieves a balance between research and action. Funding maximum: $25,000; Period of Support: 1 to 2 years.

Community Program – Evolution Grant

Letter of Intent Due: April 13

Invited Full Proposal Due:  June 22

The Lance Armstrong Foundation endeavors to positively impact survivors by partnering with community organizations to develop and expand direct service and support programs that address quality-of-life issues. The LAF Community Program provides financial support and capacity-building to community non-profit organizations enhancing the quality of life today for those living with, through and beyond cancer. Evolution Grant priority is given to projects that employ innovative, collaborative approaches to addressing long-term survivorship issues and the needs of underserved communities including, but not limited to adolescent/young adult survivors, ethnic and racial minorities, and rural populations.  Grant applications will be considered in four subject areas: 1. Physical Activity and Nutrition; 2. Survivorship Education; 3. Emotional Support; 4. Practical Issues of Survivorship.  Organizations should have a well-developed design for the program and a complete plan for its implementation and evaluation. Funding up to $100,000 over two years OR up to $150,000 over three years.

Community Program – Implementation Grant

Letter of Intent Due: April 13

Invited Full Proposal Due:  June 22

The LAF Community Program provides financial support and capacity-building to community non-profit organizations enhancing the quality of life today for those living with, through and beyond cancer. The LAF also offers its Community Program partners regular training, technical assistance and the opportunity to discuss challenges and exchange best practices at an annual Community Program conference.  Priority is given to projects that employ innovative, collaborative approaches to addressing long-term survivorship issues and the needs of underserved communities including, but not limited to adolescent/young adult survivors, ethnic and racial minorities, and rural populations.  Grant applications will be considered in 1. Physical Activity and Nutrition; 2. Survivorship Education; 3. Emotional Support; 4. Practical Issues of Survivorship. Funding maximum $25,000 per year. Period of Support 1 to 2 years

 

Racial and Ethnic Approaches to Community Health Across the US (REACH US)
Deadline: May 7
The National Center for Chronic Disease Prevention and Health Promotion, at the Centers for Disease Control and Prevention, announces the availability of fiscal year 2007 funds for cooperative agreements to advance evidence- and practice-based programs and culturally based community practices to eliminate racial and ethnic health disparities through implementation, evaluation, and dissemination of state of the art knowledge. 

 

CDC Foundation Hero Award Call for Nominations
Deadline: May 15
The Centers for Disease Control and Prevention (CDC) Foundation Hero Award was established in 2005 to coincide with the foundation's tenth anniversary celebrating "A Decade of Heroes." The award recognizes an individual or organization that has made a significant contribution to improving the public's health through exemplary work in advancing CDC's mission of promoting health and quality of life by preventing and controlling disease, injury and disability.

 

NIH: Community Participation in Research
Deadline:  May 18

The goal of this funding opportunity announcement is to support research on health promotion, disease prevention and health disparities that is jointly conducted by communities and researchers. This funding opportunity announcement will utilize the National Institutes of Health research project grant (R01) award mechanism and runs in parallel with an announcement of identical scientific scope, PAR-06-247, that solicits applications under the exploratory/Developmental Grant (R21) award mechanism. 

 

Supporting Innovation in Health and Health Care
Deadline:  July 10
The Local Initiative Funding Partners Program (LIFP) is a partnership program between the Robert Wood Johnson Foundation (RWJF) and local grant-makers to fund promising, original projects to significantly improve the health of vulnerable people in their communities.

 

$115 Million Commitment to Improve Quality of Health Care in Communities
Robert Wood Johnson Foundation will expand regional quality strategy, and will focus on patients and reducing racial and ethnic health care disparities. The philanthropy, which works to improve the health and health care of all Americans, will expand its strategy to improve the quality of care for patients with chronic illnesses by focusing more intensively at the local level. RWJF will also remain active in national efforts to standardize performance measures and public reporting on quality.  

The Effect of Racial and Ethnic Discrimination/Bias on Healthcare Delivery
Deadline: variable
The purposes of this Funding Opportunity Announcement are: (1) to improve the measurement of  racial/ethnic discrimination in healthcare delivery systems; (2) to enhance understanding of the influence of racial/ethnic discrimination in healthcare delivery and its association with disparities; and (3) to reduce the prevalence of racial/ethnic health disparities.

 

United Healthcare Children's Foundation Helps Underinsured Children
The Foundation offers support for children nationwide with assistance grants for medical services not fully covered by health insurance. Parents and caretakers can apply for up to $5,000.00 for health care services that will help improve their children's health and quality of life.  Eligible children must be 16 or younger. Families must meet economic guidelines, live in the U.S. and be covered by a commercial health insurance plan.  Examples of the types of medical services covered by include speech therapy; physical therapy and psychotherapy; medical equipment such as wheelchairs, braces, hearing aids and eye-glasses, and orthodontic and dental treatments. The Foundation has helped more than 375 families and provided nearly $1 million in financial assistance

 

NIH: Social and Cultural Dimensions of Health
Application deadline: variable
The ultimate goal of this program announcement is to encourage the development of health research that integrates knowledge from the biomedical and social sciences. This announcement invites applications to (a) elucidate basic social and cultural constructs and processes used in health research, (b) clarify social and cultural factors in the etiology and consequences of health and illness, (c) link basic research to practice for improving prevention, treatment, health services, and dissemination, and (d) explore ethical issues in social and cultural research related to health.

 

Changes in Health Care Financing and Organization 
Application Deadline: Open
This Robert Wood Johnson Foundation program supports policy analysis, research, evaluation and demonstration projects that provide policy leaders timely information on health care policy and financing issues. This Call for Proposals is intended to support projects that: 1) examine significant issues and interventions related to health care financing and organization and their effects on health care costs, quality and access; and 2) explore or test major new ways to finance and organize health care that have the potential to improve access to more affordable and higher quality health services.  

 

Funding for Community-Based Approaches to Improve Care for Vulnerable Populations
Deadline: Rolling
The Robert Wood Johnson Foundation is accepting applications for its Fresh Ideas: Community-Based Approaches to Improve Care for Vulnerable Populations grant program. The purpose of this program is to promote community-based approaches to health and health care problems that interact with social problems. Examples include inadequate housing, poor education and poverty. Priority is given to projects that focus on hard-to-reach populations such as new immigrants and refugees and at-risk adolescents.

 

Research Proposals on Disparities Issues

Proposals will be reviewed on a rolling basis. 

Robert Wood Johnson Foundation seeks to reduce racial and ethnic disparities in the care of patients with cardiovascular disease, diabetes mellitus type 2 and/or depression. To that end, RWJF invites research proposals that offer solutions towards reducing health care disparities. RWJF encourages researchers to include data and analyses in their proposals to help us better understand these disparities related to: sub-ethnic and other marginalized groups (e.g., Mexican, Puerto Rican, Vietnamese and American Indian); and  acculturation factors (e.g., generation, years in US, age of migration and language proficiency).  RWJF will consider projects of up to $75,000 with a one-year time frame.    

State Coverage Initiatives
Through funding from Robert Wood Johnson Foundation, State Coverage Initiatives offers both policy planning and demonstration grants. SCI grants are designed to support states in the early stages of planning coverage expansions and those states that have decided on a new coverage expansion mechanism and seek assistance designing and implementing the program. Specific new grant opportunities are announced on the Web site and through the e-newsletter, St@teside; however, states may submit project ideas at any time. For specific info, contact isabel.friedenzohn@academyhealth.org or 202/292-6726  

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.

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ORGANZATIONS AND SERVICES

 

Newly posted resources are at the top of the list.

   

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

 

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

 

Access to Benefits Coalition

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

 

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

 

Southeast Florida Cancer Control Collaborative (SFCCC) 

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

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MANUALS, GUIDES, TOOLKITS

 

Newly posted resources are at the top of the list.

 

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.

 

 

Free Cover the Uninsured Week 2007 Planning Materials Available
Start planning and promoting activities now—with help from newly updated planning guides! This year, Cover the Uninsured Week comes at a critical juncture in the health coverage debate: After 10 years, the State Children's Health Insurance Program (SCHIP) is up for reauthorization in Congress. Our nation's leaders have the opportunity to provide funding to cover the children currently enrolled in SCHIP and expand the program to cover millions more children in need of health coverage. As a result, Cover the Uninsured Week 2007 will focus on the importance of children's health coverage and the success of SCHIP. To help you promote the importance and availability of SCHIP, these guides are now available:   Health and Enrollment Fair Planning; Working with the Media; Editorial Placement; Campus Event Planning. Additional Cover the Uninsured Week 2007 materials will be posted.

 

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 site.

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)

 

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.

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

The Uninsured and Their Access to Care

Covering the Uninsured: Growing Need, Strained Resources

Massachusetts’ New Law to Cover the Uninsured

Women's Health Insurance Coverage

The Uninsured: A Primer

 

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.

 

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.

 

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TECHNOLOGY AND AUDIO/VIDEO RESOURCES

 

Audio Conferences and Webcasts

 

Dated events listed chronologically; standing webcasts listed last 

Today's Topics In Health Disparities - Is the U.S. Making Progress in Reducing Disparities in Health Care Access and Quality?
This discussion provides an overview of key findings in the 2006 National Healthcare Disparities Report. Panelists focus on evidence showing the areas in which racial and ethnic disparities in health care have narrowed and discuss interventions that may explain some of the gains achieved. In Video   Podcast  Transcript (3/2/2007, Kaiser Family Foundation Broadcast Studio)

Archived Webcast of SCHIP Enrollment and Retention Briefing
Nearly three-fourths of America's nine million uninsured children are eligible for either State Children's Health Insurance Program (SCHIP) or Medicaid. As Congress begins debating the reauthorization of the program, policy analysts are examining what keeps these children from enrolling. To address these issues, the Alliance for Health Reform and the Robert Wood Johnson Foundation (RWJF) sponsored a briefing Feb. 26 at the Columbus Club, Union Station. Sens. Edward Kennedy and Orrin Hatch, among others, were featured guests.

Health Action 2007 National Grassroots Meeting
You can view the webcasts of plenary speakers (Sen. Barack Obama, Uwe Reinhardt, Sen. Edward Kennedy, and more); peruse the tool kit; meet the consumer health advocates of the year; check out the materials from many of the plenaries and workshops; and browse the many photos that were taken. The slide presentation Resuming the Path to Health Coverage for Children and Parents consists primarily of charts showing the state of health insurance access for families. States have shown renewed enthusiasm for covering the uninsured, especially children, but the Deficit Reduction Act (DRA) has also caused some setbacks.

Bridging the Divide: Medicare's Role in Reducing Racial and Ethnic Disparities
This Jan. 29, 2007 event examined a growing body of evidence indicating disparities in quality of care among Medicare beneficiaries of different racial and ethnic backgrounds. Panelists also discussed whether and how the Medicare program should use its clout as a health care payer and player to move toward eliminating racial and ethnic disparities. Webcast available through Kaiser Network.

National Town Hall Meeting on Children’s Health Coverage
During Campaign for Children's Health Care's town hall meeting, Senators Max Baucus (D-MT), Orrin Hatch (R-UT), Jay Rockefeller (D-WV), and Gordon Smith (R-OR) expressed their bipartisan support for expanding children’s health coverage. This bodes well for efforts to achieve health coverage for all kids. An archived Web cast of the 35-minute national town hall meeting is available on the campaign’s Web site.

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Media Programming

 

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Web Sites, Web Features & Databases

 

Newest postings are listed at the top of State and National Web Resources sections below

 

State Web Resources

 

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

 

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

 

Florida Association of Community Health Centers (FACHC)

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

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

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

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

 

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

 

"2006 Kids Count” Report

The annual report measures each state in terms of 10 statistics, including infant mortality, teen birth rate and infants born with low birthweights. The report finds no change in U.S. infant mortality since 2000, less than a percentage point increase to 7.9% in 2003 in the percentage of infants born weighing less than 5.5 pounds and a decrease in the teen birth rate from 48 births per 1,000 girls in 2000 to 42 births per 1,000 in 2003. (6/27/06, Annie E. Casey Foundation)

 

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

 

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

 

Florida KidCare Applications can be completed online

 

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

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

 

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

 

Florida Progressive Information Network (FLPIN)

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

 

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National Web Resources

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

 

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

 

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

 

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

 

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

Update on State Pharmacy Programs 
State Pharmaceutical Assistance Programs: A Chartbook--Updated and Revised, presents a wealth of data on state drug assistance programs throughout the country. In addition to eligibility requirements, benefit design, and program administration, the chartbook provides details on the most recent annual enrollment, utilization, and program expenditures for these programs. It also serves as a baseline for comparing and contrasting program offerings with the new Medicare Part D prescription drug benefit. You can also download the charts to create a PowerPoint presentation. (Jan. 2007, Commonwealth Fund)

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

 

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

New HHS Web Site Promoting Long-Term Care Planning
The National Clearinghouse for Long-Term Care Information Web site provides comprehensive information about long-term care planning, services and financing options, along with tools to help people begin the planning process. The clearinghouse Web site is designed to increase public awareness about the risks and costs of long-term care and the potential need for services, and to provide objective information to help people plan for the future. The new Web site also supports the "Own Your Future" education campaign, a joint federal-state initiative designed to increase consumer awareness about planning for long-term care. 

New Online Medical Dictionary Reference Tool

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

 

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

 

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

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

 

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

 

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

 

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

     

State Level Data on Health Coverage & the Uninsured

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

 

The Johns Hopkins INFO Project's New OneSource Database

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

 

Uninsured Tutorial, Module, and Reference Library

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

  

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

 

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

  

Medicaid Fact Sheets Tool

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

 

Interactive Tools on Medicaid

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

 

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.

 

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Videos

 

Collateral Damage: Bad Medicine in Tennessee
In 2005, when Governor Phil Bredesen of Tennessee announced he would reform his state’s Medicaid program,

people took him at his word. Little did they know that Bredesen’s idea of reform meant cutting 190,000 people off the program almost overnight. The size and speed of the cuts were unprecedented; the suffering they caused was immeasurable. The sickest, neediest people were denied medical care while the nation sat by and watched, and the Governor boasted to other heads of states about his success reigning in the rising cost of health care. This intense, moving film exposes the injustice that occurred in Tennessee and its implications for Medicaid cuts nationwide. In the richest nation in the world, where people die every day because they lack access to health care, the disparities revealed in this film are chilling.

 

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

 

Problems with the Medicare Drug Program and How to Fix Them: Video

This 14-minute video produced by Families USA features trusted newsman Walter Cronkite discussing the problems within the new Medicare prescription drug benefit and offering solutions for the Part D program. The video offers an authoritative look at Medicare’s prescription coverage. First-hand experiences come from retirees from across the country, who offer an up-close look at the troubles the new drug benefit has generated, from the headaches of sorting through dozens of plans to the financial tolls the program will take on so-called beneficiaries. A dedicated community pharmacist shares his insights on the roll-out of Part D and knowledgeable consumer advocates analyze the politics at the core of the creation of the Medicare drug program. Watch the Video Online or Request a Copy

  

 

PERIODICALS AND BOOKS

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

New National Child Survey Research Results: Pediatrics special volume highlights NSCH research articles
The Pediatrics special volume issue illustrates national and state findings from the 2003 National Survey of Children's Health (NSCH). In this issue, there are fifteen articles that provide critical information for policy makers and others concerned with ensuring the best care and health outcomes for children. To preview these articles visit the Data Resource Center for the National Survey of Children's Health home page and click on the Pediatrics link under New Publication.The Data  Resource Center features an easy-to-use interactive data query that allows users to search, view and compare NSCH results at state, regional and national levels, stratified by selected demographic characteristics including age, race, household income, insurance type, and special health care needs status.  (February 2007)

Kaiser Health Disparities Report: A Weekly Look at Race, Ethnicity and Health
This free, weekly report from kaisernetwork.org and the Kaiser Family Foundation, synthesizes news coverage from hundreds of print and broadcast news sources related to health and health care issues that effect racial and ethnic communities. The report also highlights new studies and journal articles, initiatives, developments in the field, and upcoming events.

Covering Health Issues - A Sourcebook for Journalists
The newest edition of the Alliance for Health Reform's 300-page guide, "Covering Health Issues," is now available for downloading. The guide is useful for anyone interested in health policy issues. Each chapter contains key facts, an overview, expert sources with telephone numbers, story ideas, helpful websites and a discussion of current policy proposals.

REPORTS AND STUDIES

New Listings

New Listings: Medicare, Medicaid, SCHIP

How Stable Is Medicaid Coverage for Children?
The researchers find that while the program provides a "long-term continuous source of coverage for millions of children," it also creates "a revolving door for others." Many children are covered for reasonably long periods, but many others experience short gaps—from two to four months—in coverage. The authors note that "[e]ven brief gaps are likely to cause disruption in care management and possibly in heath care itself." (March/April 2007, Health Affairs)

 

Transforming the U.S. Child Health System
Researchers look at the current child health system--fragmented, underperforming, and fraught with inefficiencies--and propose an agenda for radical system change. Instead of the current patchwork system of programs and funding streams. They recommend integrated care that takes "a more comprehensive and holistic approach to optimizing health development." (March/April 2007, Health Affairs) 

 

IMPROVING CHILDREN'S HEALTH: A Chartbook about the Roles of Medicaid and SCHIP
This publication provides 30 graphs summarizing current information about health insurance coverage and the health needs of low-income children, as well as the effects of Medicaid and SCHIP coverage on children's health. (2007 Edition, Center on Budget and Policy Priorities)

 

Low Income Uninsured Children with Special Health Care Needs: Why Aren’t They Enrolled in Public Health Insurance Programs?
Many eligible children are not enrolled in public insurance programs. This Urban Institute report concludes that parents’ lack of information about the programs and negative perceptions of the application process are two primary reasons why eligible children are not being enrolled. (Jan. 2007, Pediatrics)

 

The Kaiser Family Foundation has posted several new resources related to children’s coverage and the reauthorization of SCHIP. Selected resources include the following (Feb. 2007):
Interactive Children’s Health Insurance Coverage Timeline
Characteristics of the Uninsured: Who Is Eligible for Public Coverage and Who Needs Help Affording Coverage?

 

Aging out of Early and Periodic Screening, Diagnostic and Treatment (EPSDT): Issues for Young Adults with Disabilities
This report discusses the challenges and implications for young people with disabilities when they become adults and lose their EPSDT benefits. It also examines the effects of recent changes to the Deficit Reduction Act that increase states’ power to aid individuals with disabilities. (1/18/07, Kaiser Family Foundation)

 

Toward Real Medicaid Reform
In this paper the authors describe and develop several options for Medicaid reform that would expand coverage, provide fiscal relief to states, shift responsibility for some or all of the care of dual eligibles to the federal government, and eliminate or restructure disproportionate-share hospital (DSH) payments. (2/23/07, Health Affairs)

 

Next Steps: Strategies to Improve the Medicare Part D Low-Income Subsidy
Dept of HHS has estimated that at least 75 percent of the Medicare beneficiaries who do not have any prescription drug coverage are eligible for the Low-Income Subsidy. This report identifies recommended legislative, administrative, and regulatory reforms that should be made to the Low-Income Subsidy to improve access to the program for seniors and people with disabilities with limited means. (Jan. 2007, Access to Benefits Coalition and National Council on Aging)

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New Listings: Federal Budget

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New Listings: Health Insurance, Health Costs

 

The Illusion of Coverage: How Health Insurance Fails People When They Get Sick
This report tells the personal, emotional, and physical hardships of the millions of hard-working, insured Americans who are struggling with medical debt.With stories of dozens of insured individuals and families from seven states, the report demonstrates how private insurance companies fail to protect health consumers from substantial financial losses. Some of key findings: Shifting more costs of care onto patients -- through high deductibles, co-insurance, and less comprehensive coverage -- has significant consequences for both health and financial well-being; Insurance company policies and procedures leave patients confused, in debt, reluctant to seek health care, and vulnerable to predatory scam products; When it comes to health insurance, you can’t measure "affordability" by looking only at premiums: You also have to consider the costs that people will face when they get sick.  As this report shows, more and more insured people face staggering out-of-pocket medical bills that leave them asking whether it was worth having insurance at all. (Mar. 2007, The Access Project)

 

Uninsured Receive Less Care and Experience Worse Outcome
A new study commissioned by the Kaiser Family Foundation and authored by The Urban Institute documents that people who are uninsured receive less care and have worse outcomes following an accident or the onset of new chronic condition than those with insurance.The study finds that following an accidental injury, the uninsured were less likely than the insured to receive any medical care. Similarly, the uninsured with a new chronic condition were also less likely to receive care. In addition, the uninsured with an injury were about twice s likely not to have received any recommended follow-up care, as was also the case with new chronic conditions. Ultimately, the study indicates that the uninsured were more likely to report not fully recovering and no longer being treated following an accident and roughly seven months after the initial health shock, the uninsured with new chronic conditions reported worse health status than the insured with similar conditions. 3/14/07, JAMA)

 

Access Denied: A Look at America's Medically Disenfranchised
This study  examines access to basic health care among U.S. residents of all races and ethnicities, income levels and insurance statuses. According to the study, 56 million residents, or nearly one in five, do not have a medical home," and a shortage of local primary care physicians is one reason people lack access to basic medical care (March 2007, National Association of Community Health Centers)

 

State of the States: Building Hope and Raising Expectations
State leaders are increasingly willing to address the rising number of uninsured Americans and are investing in efforts to expand coverage. It outlines the specific developments in a few key states, and it identifies trends that many new state plans have in common. (Jan. 2007, Robert Wood Johnson Foundation)

 

Health Insurance Coverage of Women Ages 18 to 64, by State, 2004-2005
provides statistics on insurance for all women, including low-income women. In addition, Women’s Health Insurance Coverage describes the various sources of insurance for women and examines how being uninsured affects women. (Feb. 2007, Kaiser Family Foundation)

 

Insurance Premium Cost-Sharing and Coverage Take-up
One of the many reasons an individual may be uninsured is that she or he decides that an employer’s offer of health insurance is too expensive.This report looks at how the take-up rate for workers within firms varies with the level of premium contributions in those firms. (Feb. 2007, Kaiser Family Foundation)

 

Immigrants and Employer-Sponsored Health Insurance
This report examines why foreign-born workers are less likely to have employer-sponsored health insurance coverage. The authors conclude that immigrants have a higher probability of working in a firm that does not offer insurance.  (Feb. 2007, Health Services Research)

 

Covering the Uninsured: Growing Need, Strained Resources
This report explains the continued increase in the number of uninsured Americans and examines how federal programs have struggled to stem these increases.(Jan. 2007, Kaiser Family Foundation)

 

National Health Spending in 2005: The Slowdown Continues
This report outlines the growth of health care spending in relation to the gross domestic product (GDP). It concludes that prescription drug expenditures drove the increase in spending in 2005 because hospital, physician, and clinical services grew at similar rates as they did in 2004. (Health Affairs, 26, no. 1, 2007)

 

An Analysis of Leading Congressional Health Care Bills, 2005-2007: Part I Insurance Coverage
Many of the health care proposals pending on Capitol Hill could significantly reduce the number of uninsured Americans and decrease health care costs. The report analyzed 10 health plans introduced in the 109th and 110th Congresses as well as President Bush's proposal to give tax deductions of $7,500 to individuals and $15,000 to families for purchasing health insurance, no matter what the cost or type of insurance or whether it is purchased through an employer. (March 2007, The Commonwealth Fund)

Fundamental Reform of Payment for Adult Primary Care: Comprehensive Payment for Comprehensive Care
A team of physicians led by The Commonwealth Fund explain how their proposed system would avoid the problems of previous capitation systems, which merely bundled together inadequate fee-for-service payments. The authors call for a new social contract: substantially increasing payments for primary care in return for greater accessibility, quality, safety, and efficiency. (Mar. 2007, Journal of General Internal Medicine)

 

Paying for Care Episodes and Care Coordination

Commonwealth Fund president Karen Davis explores alternatives to the current fee-for-service payment system, which she says is a barrier to effective, coordinated, and efficient care. Davis examines new approaches that base payment on the total care a patient receives during an episode of illness or a defined period. Creating a global fee for "care episodes," she says, would properly reward providers who provide effective, lower-cost care. She also discusses how physician payments could be tied to care provided within a patient's "medical home," rewarding coordination and efficiency and slowing the escalating costs of health care. (Mar. 2007, New England Journal of Medicine)

 

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 New Listings: Health Equity Issues 

 

Heart Attack Patients With Financial Barriers To Health Care Have Poorer Recovery
About one in five heart attack patients report having financial barriers to health care services, and these patients are more likely to have a lower quality of life and increased rate of rehospitalization, according to a study in the March 14 issue of JAMA, a theme issue on access to care. According to background information in the article more than 16 million Americans avoid health care due to cost or have trouble affording their medications despite having health insurance. Patients who have difficulty affording health care may have an increased risk for poor health outcomes, though few studies have directly investigated this. (3/14/07, JAMA)

 

Black-White Life Expectancy Gap Narrows, But Remains Substantial
Reductions in the death rate from homicide, HIV disease, unintentional injuries and among women, heart disease - have contributed to narrowing the life expectancy gap between blacks and whites in the United States, although substantial inequalities and challenges remain. (3/14/07, JAMA)

 

Key Facts: Race, Ethnicity and Medical Care
This is a quick reference source on the health, health insurance coverage, access, and quality of health care of racial and ethnic groups in the United States. The report highlights data that show whether health care disparities are narrowing, widening, or persisting for specific racial and ethnic groups and presents newly collected data for people who identify with more than one group. (Jan. 2007, Kaiser Family Foundation) 

Florida Reports 

 

Expanding Medicaid Eligibility for Pregnant Women

(By Carol Brady of Florida Association of Healthy Start Coalitions)
This one-page report responds to these questions: Why is health care coverage important during pregnancy?How does Medicaid impact health care coverage for pregnant women? Why do we need to expand Medicaid eligibility for pregnant women? How can Florida expand coverage for pregnant women? Expanded eligibility would leverage federal funding for the uninsured, increasing access to prenatal care for at-risk women and matching SCHIP Medicaid eligibility for infants through age one. Expanding Medicaid coverage for uninsured women up to 200% of the federal poverty level would provide needed support to the working, uninsured families for whom pregnancy-related health care is a significant burden. 

 

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

 

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

 

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

 

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

 

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

 

Medicare, Medicaid and SCHIP

Congress Has a Number of Options to Pay for Extending Health Coverage to More Low-Income Children
There is growing consensus that SCHIP reauthorization should make substantial progress toward covering all uninsured low-income children.  The cost, however, will be substantial.  Immediately enrolling the roughly 6 million children who are eligible for publicly funded coverage but are unenrolled would cost the federal government more than $50 billion over five years. In the House and, most likely, in the Senate as well, SCHIP reauthorization legislation will be subject to “pay-as-you-go” rules, which require that the cost of increases in mandatory programs (such as SCHIP) be fully offset through entitlement reductions and/or revenue increases.  Some have argued that the goal of reaching many of the eligible uninsured children should be shelved because the cost cannot be “paid for.” In fact, however, ample offsets exist on both the spending and revenue sides of the budget to cover the costs several times over — if there is political will to pursue them. (3/8/07, Center on Budget and Policy Priorities) 

CBO Estimates States Will Face Federal SCHIP Shortfalls of $13.4 Billion Over Next 5 Years
On February 23, the Congressional Budget Office issued estimates of the federal funding shortfalls states will face if annual funding for the State Children’s Health Insurance Program (SCHIP) is frozen at the current funding level of $5 billion a year, as is assumed under the budget “baseline.”  Since SCHIP began, the number of children without insurance has fallen, particularly in low-income families. Still, according to the most recent CPS estimates, about 9 million children lack health insurance, a figure that other Urban Institute research indicates may be on the rise. Only 25 percent of SCHIP enrollees live in families with access to employer-sponsored insurance (ESI), far below the 40 percent figure assumed by the Congressional Budget Office in 1997. (2/26/07, Center on Budget and Policy Priorities) 

Medicaid: Health Promotion and Disease Prevention for School Readiness
Medicaid’s child health program, Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), emphasizes health promotion and disease prevention as vehicles to ensure that children are ready for school and able to succeed in life. Required components of preventive care can be mapped to specific health outcomes that are important attributes of school readiness and prerequisites for educational success. The federal government and states can take specific action to assure that children receive all of the health care services, including preventive services, necessary to promote their optimal health and development and, thus, to maximize their future productivity. (March/April 2007, Health Affairs)

Uninsured Children Are Eligible for the State Coverage
The decade-old State Children's Health Insurance Program (SCHIP) has signed up close to 70 percent of its target population, a new Urban Institute report estimated, but 1.8 million eligible children nationwide are yet to be enrolled. Federal funding, about $5 billion this year, will have to increase substantially if these children are to join the approximately 3.9 million children now with SCHIP coverage. (2/9/07, Robert Wood Johnson Foundation)

Coverage Patterns Among SCHIP-Eligible Children and Their Parents
This brief uses the 2005 Current Population Survey to examine national patterns of coverage among families with SCHIP eligible children.  Key findings are that: close to 2 million uninsured children are eligible for SCHIP, the majority of SCHIP enrollees could not be enrolled in an employer plan that covers their parents, and almost 40% of SCHIP enrollees lives with an uninsured parent.  This implies that federal funding will have to be increased substantially to cover the remaining eligible but uninsured children and that many children stand to lose coverage altogether if federal funds are inadequate to meet existing program needs. (2/9/07, Urban Institute)

The State Children's Health Insurance Program: Past, Present, and Future
At the end of the 2007 fiscal year, congressional authorization for the State Children's Health Insurance Program (SCHIP) is set to expire. For SCHIP, the reauthorization process--historically a chance to review, refine, and revamp programs--will take place at a time when the uninsured rate for children is once again on the rise. This new report examines the array of policy options that Congress is likely to consider for SCHIP, a program widely hailed for assisting children whose families have too much income to qualify for Medicaid but too little to afford private insurance. In addition to reviewing the program's history, goals, and performance, it describes how eligibility, benefits, and financing might be modified during reauthorization; it also discusses the policy and political implications of change.

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Federal Budget/Health Care

 

President's Budget Would Cut Deeply into Important Public Services and Adversely Affect States
This new analysis finds that: The President’s budget would reduce funding for most parts of the domestic discretionary budget below the 2007 funding levels, adjusted for inflation. The cuts would start in 2008 and grow deeper in each of the four succeeding years; The proposed reductions would effectively shift billions of dollars in costs on to states, requiring them to scale back key public services or raise taxes to plug the holes left by the federal cuts; The reductions would come from a wide range of areas, including education, environmental protection, community development, and key supports for low-income families; At the same time, the budget would permanently extend virtually all of the 2001 and 2003 tax cuts. Extending the tax cuts would cost much more each year than all of the proposed discretionary program cuts would save. (2/21/07, Center on Budget and Policy Priorities)

President's Budget Would Provide Less than Half the Funds States Need to Maintain SCHIP Enrollment
Under the President's budget, federal SCHIP funds would fall a total of $7 billion short of what will be needed to sustain states’ current programs. The likely result of this shortfall would be fewer individuals covered through SCHIP and more people who are uninsured. While the President’s budget for SCHIP reauthorization acknowledges the need for additional funding above the levels assumed in the budget baseline: it does not provide sufficient funding for states simply to sustain their existing programs; it erects fiscal incentives for states to cease providing SCHIP coverage to children with modest incomes and low-income parents; and it does not encourage states to continue making progress toward covering more uninsured children. (2/22/07, Center for Budget and Policy Priorities)

States' SCHIP Enrollment and Spending Experiences and Considerations for Reauthorization
SCHIP enrollment increased rapidly during the program's early years, but has stabilized over the past several years...Many states adopted innovative outreach strategies and simplified and streamlined their enrollment processes in order to reach as many eligible children as possible...SCHIP spending was initially low, but now threatens to exceed available funding. (2/15/07, GAO Testimony)

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Health Insurance, Health Costs

 

The Uninsured Experience Worse Outcomes
A new study commissioned by the Kaiser Family Foundation and authored by Dr. Jack Hadley of The Urban Institute documents that people who are uninsured receive less care and have worse outcomes following an accident or the onset of a new chronic condition than those with insurance. The study -- based on analysis of eight years of data and over 30,000 observations -- finds that following an accidental injury, the uninsured were less likely than the insured to receive any medical care. (3/14/07, Kaiser Family Foundation)

 

Whose Kids Are Covered? A State-by-State Look at Uninsured Children
New research data shows lower-income families are often doubly squeezed: They are less likely to be offered health coverage by their employers, and less able to afford it on their own. View the entire report or the press release. (March 2007, Robert Wood Johnson Foundation)

 

Coverage Counts: Supporting Health and Opportunity for Children
Nearly one in nine children in the US is without health insurance.  These children are at a disadvantage that extends into adulthood...Failing to get timely care can exacerbate acute and chronic conditions and may lead to long-term adverse health effects. (February 2007, AHA Trendwatch)

 

The Uninsured and the Affordability of Health Insurance Coverage
indicates that more than half of the nation's uninsured are ineligible for public programs and do not have enough resources to purchase coverage themselves. Childless adults made up the largest block of those who are uninsured and ineligible for public coverage, which the study attributes to a lack of eligibility for public programs such as Medicaid. (Jan/Feb 2007, Health Affairs)

Uninsured in America: Problems and Possible Solutions
The United States is the only major industrialised nation without universal health insurance, and coverage has deteriorated in the past six years. The consequences are increasingly well known: inequities in access to care, avoidable mortality and poor quality care, financial burdens on people who are uninsured or underinsured, and lost economic productivity. The US spends twice as much on health care as the median industrialised nation but does not systematically achieve the best quality care. What are the prospects for reform? (2/17/07, BMJ)

 

Cumulative Social Disadvantage and Child Health
The accumulation of social disadvantage among children was strongly associated with poorer child health and having insurance did not reduce the observed health disparities. (Pediatrics, vol 117, No. 4)

 

Health Equity Issues

 

CBO Estimates That States Will Face Federal Schip Shortfalls Of $13.4 Billion Over Next Five Years
On February 23, the Congressional Budget Office issued estimates of the federal funding shortfalls states will face if annual funding for the State Children’s Health Insurance Program (SCHIP) is frozen at the current funding level of $5 billion a year, as is assumed under the budget “baseline.” Among eligible children in fair or poor health, 80 percent are enrolled. Since SCHIP began, the number of children without insurance has fallen, particularly in low-income families. Still, according to the most recent CPS estimates, about 9 million children lack health insurance, a figure that other Urban Institute research indicates may be on the rise. Only 25 percent of SCHIP enrollees live in families with access to employer-sponsored insurance, far below the 40 percent figure assumed by the Congressional Budget Office in 1997. (2/26/07, Center for Budget and Policy Priorities)

 

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

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

Kaiser Family Foundation)

 

National Healthcare Disparities Report, 2006
The 2006 NHDR uses the same measures of quality as its companion National Healthcare Quality Report (NHQR) to monitor the Nation's annual progress toward eliminating disparities in health care. Racial/ethnic group comparison focus on 22 core measures of quality and 6 core measures of access that support reliable estimates for Whites, Blacks, Asians, American Indians/Alaska Natives, and Hispanics; income group comparisons highlight 17 core quality measures and 6 core access measures.

 

America's Health Rankings: A Call to Action for People and their Communities
The United Health Foundation, the American Public Health Association and Partnership for Prevention?, have released this 2006 edition, to stimulate public conversation concerning health in our states, as well as provide information to facilitate citizen participation. Participation in all elements is encouraged: personal behaviors, community environment, clinical care and public and health policies. Florida's rank among states went from 40 in 2005 to 41 in 2006.

Other Health Issues 

 

The State of Aging and Health in America 2007 Report
By 2030, the number of older Americans will have more than doubled to 70 million, or one in every five Americans...Chronic diseases exact a particularly heavy health and economic burden on older adults due to associated long-term illness, diminished quality of life, and greatly increased health care costs. Although the risk of disease and disability clearly increases with advancing age, poor health is not an inevitable consequence of aging. (3/8/07, Centers for Disease Control) 

 

Most US Adults Support Paid Sick Time Requirements

80% of U.S. adults are in favor of requiring some or all employers to provide paid sick time to their employees, and similar numbers (78%) say employers who don't give their employees paid sick time pay for it in other ways. (3/7/07, Wall Street Journal Online/Harris Interactive Healthcare Poll)

 

Health, United States, 2006
This 30th report on the health status of the nation is submitted by the Secretary of the Department of Health and Human Services to the President and Congress of the United States in compliance with Section 308 of the Public Health Service Act. The 559-page report was compiled by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC). The National Committee on Vital and Health Statistics served in a review capacity. The Health, United States series presents national trends in health statistics. Each report includes an executive summary, highlights, a chartbook, trend tables, extensive appendixes, and an index. Contents include:  Fertility, Natality, Life Expectancy and Mortality; Health Behaviors, Status, Risk Factors, Determinants and Measures; Health Care Access, Utilization, System Influences, Expenditures, Resources and Personnel; Health Insurance Coverage and Payors; Uninsured Population; Age, Race and Ethnicity and Poverty; Alcohol and Drug Use; Physical Activity and Limitations; Dental Care and Access; and a Special Section on Pain. (November 2006, HHS, CDC, NHCS)

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ACTION ALERT: Fully Fund the Combating Autism Act of 2006
The deadline for U.S. Senators to sign is April 9.
Late last year, Pres. Bush signed into law the Combating Autism Act of 2006. The Act authorizes $168 million for autism spectrum disorders (ASD) related activities in FY 2008, an increase of $25 million.  This increase would benefit research on ASD through the NIH and CDC. The Act also provides the first step to expand the interdisciplinary training of professionals to identify and support children with ASD and their families. Unfortunately, no new money was proposed in the President’s FY 2008 budget request to implement the Act. The 110th Congress should provide the necessary funds to focus our country’s researchers on explaining the apparent increase in prevalence, on finding the causes, and on determining the most effective ways of supporting children and adults with ASD by fully funding the Combating Autism Act. A letter by Senators Chris Dodd (D-CT) and Chuck Hagel (R-NE) is urging Senate appropriators to provide full funding for the Combating Autism Act. Please contact your Senators and ask them to sign onto the Dodd-Hagel letter in support of fully funding for the Combating Autism Act.  If interested, they should contact: in Sen. Dodd’s office: sharon_lewis@help.senate.gov 202.228.3453 (phone) and  in Sen.Hagel’s office: Martha_Petkovich@hagel.senate.gov, 202.224-4224.

JAMA Theme Issue: Interventions to Improve Health among the Poor
Call for Papers Manuscripts Deadline: May 1
Poverty is an inveterate consequence and cause of ill health.  Without financial resources, people cannot pay for basic human needs: food, water, sanitation, housing, and health care services. To help disseminate research into interventions that specifically address the needs of the poor, JAMA will publish a theme issue on poverty and human development in October 2007. JAMA will consider manuscripts that report original research of interventions targeted to address poverty, hunger, access to care, and prevention of disease that are based on careful consideration and analysis of local context, evidence, and environments and that are directly targeted to serve the poor.

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