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Healthy Start’s final priority—expanded Medicaid eligibility for uninsured women during pregnancy—was part of ill-fated efforts to reform KidCare, the children’s health insurance program. Currently, women with incomes up to 185% of poverty are eligible for Medicaid benefits during pregnancy. Maternal and child health advocates were pushing to expand income levels up to 200% of poverty in response to the growing number of young, uninsured families and increases in unfunded prenatal care borne by community providers.
(Submitted by Carol Brady and Patty McWhirter, Florida Association of Healthy Start Coalitions)

A bill accompanying the budget, HB 7065, implements the integrated fixed payment service delivery system known as Florida Senior Care for Medicaid recipients age 60 and older in AHCA Area 7 (Orlando area) and Area 11 (Miami-Dade area). The bill provides AHCA with the authority to implement the Florida Senior Care program in accordance with approved federal waivers.

This program is very different from the one passed in the 2005 legislature. It makes participation of eligible individuals voluntary at both pilot sites. The Medicaid recipients must affirmatively choose to enroll into the pilot program. The bill specifies that individuals who choose to participate in the pilot may remain in their current licensed residence even if this residence is not under contract to the managed care program operator. It has a 10-business-day prompt payment requirement for participating managed care organizations in the pilot projects to make payment to nursing homes that bill electronically. This bill also clarifies continuation of county participation in nursing home cost contributions. AHCA must now resubmit waivers to CMS for Federal approval before it can move forward with the pilots.
(Submitted by Bob Asztalos, Buigas and Asztalos, Tallahassee)

Legislature Lifts Medicaid HMO Cap on Mental Health Overhead; Service Cuts Anticipated

Mental health care for the poorest and most seriously ill Floridians suffered a blow in the final days of the 2007 Legislative Session. As the result of a last minute and secretive move, language was inserted into a must-pass appropriations bill which eliminated the legislatively mandated cap that required HMOs spend at least 80% of their Medicaid mental health funds on mental health services. That cap has also limited HMO Medicaid funds spent on profit and overhead to 20%, a rate already much higher than allowed by other states.

HMOs in Florida will now be able to determine how much they spend on services and how much they take for profit and overhead. Mental health providers and advocates anticipate cuts to mental health services levels as a result. No justification was provided to explain why HMOs were granted complete authority to determine the new rates.

Not one of the HMOs providing Medicaid funded mental health care has met the 80% legal spending requirement, in spite of state oversight, and all have been required to return dollars to the state. Amerigroup, one of the two largest providers of Medicaid mental health services in Florida, settled with the state for more than $5.3 million for failing to meet the 80% requirement. Wellcare, the other of the top two Florida Medicaid providers, also returned funds to the state yet recently posted profits of 49% over the previous year.

These record profits were attributed to Florida Medicaid contracts by an investment bank, which also suggested Wellcare was overcompensated by Florida for those contracts. Both Wellcare and Amerigroup have provided thousands of dollars to the political campaigns of key legislative leaders over the past several years.
(Submitted by Kate Hale, South Florida Mental Health Association)

The Safe Patient Handling and Movement Bill, sponsored by Rep. Yolly Roberson, RN, (HB. 1193) and Sen. Alex Villalobos (SB 2208) would have required hospitals to adopt safe, machine-assisted, lifting as the norm throughout the hospital so that the backs of nurses and other health care workers will not be damaged in the normal course of a work day.

Such a policy would protect patients and their caretakers from avoidable harm. Similar to bills which have passed in Texas, Washington State, and Rhode Island, the Florida legislation included a financial incentive for hospitals implementing the safe lifting policy within the next five years.

The bill passed unanimously in the Senate Health Regulation committee, but did not get a hearing in Finance and Tax, its next Senate committee of reference. In the House it was workshopped in the Health Care Regulation Committee, but never considered in the Health Care Council.

At the end of session over 750 nurses responded to an appeal by Rep. Roberson, sending emails from our website, and over 3,200 members of the general public signed on to a petition urging the passage of the bill. Governor Charlie Crist also indicated his support.

Both sponsors have expressed determination to bring the bill back next year and have high hopes of moving it forward in the 2008 session.
(Submitted by John Ratliff, SEIU- Service Employees International Union)

The bill, known as the “Prescription Coverage Now Act of 2007,” is designed to increase enrollment in the Extra Help program and Medicare Savings Programs.

It would simplify the application process. For example, applicants would no longer be required to calculate “in-kind support” from family with groceries and bills. It would also raise asset limits to $27,500 for individuals and $55,000 for couples.

The current limits are set too low: $11,500 for an individual or $23,000 for a couple. The asset test penalizes individuals who have accumulated savings over their lifetimes but lack incomes that allow them to purchase expensive medicine.

The fixes proposed in Rep. Doggett’s legislation would also boost the enrollment for the Medicare Savings Programs. Only about two-thirds of people who are eligible for MSPs are enrolled. Those who have not yet enrolled are the very people who need access to medical care.

We urge Congress to support this legislation as a way to increase access to needed health care services.
(Submitted by Alisa Snow, Florida CHAIN)

Claims deadlines are approaching fast!

Three nationwide class action lawsuits against pharmaceutical companies recently settled. Consumers & third party payers (insurance companies, union health & welfare funds) that paid for part or all of the cost of these drugs may be eligible to get payments from these settlements. For information on specific drugs, and a flyer to distribute, visit www.floridachain.org/class action.htm.

State Employee and Child with Disabilities among KidCare Session Losers; Exemplify Need for Changes

On the heels of the recently concluded session, some legislators wring their hands and bemoan the reasons why no progress was made in streamlining KidCare and making it accessible to the children of state workers and legal immigrants. While the ones truly responsible for this fiasco try to lay blame at the feet of advocates and other policy makers who have tried relentlessly to broaden the program to include hundreds of thousands of uninsured children in Florida, parents and caregivers are baffled by the situation and ask why a program that was once touted as a national model is now the labyrinthine “spaghetti factory” Florida Chief Financial Officer Alex Sink recently described.

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

RECENT HEALTH NEWS AND OPINIONS

May 15, 2007

Florida News

KidCare, SCHIP, Healthy Start

Medicare and Medicaid

Medicare Drug Coverage, Drug Costs

Other Medicare, Medicaid

Health Insurance and Costs

Other Health Issues

National News

Medicare, Medicaid, SCHIP

Medicare Drug Coverage, Drug Costs

Other Medicare, Medicaid, SCHIP

Health Insurance and Costs

Other National Health Issues

FLORIDA NEWS & OPINIONS

KidCare, SCHIP, Healthy Start

OPINION: KidCare bill flop not from bickering
This opinion piece by children's advocate Linda Merrell examines the reasons for the Legislature's failure to pass a bill overhauling Florida's KidCare program. "People who care about uninsured children, and specifically the state child health insurance program, KidCare, deserve to know why the KidCare bill failed in the Senate during the final days of session. Rumors and myths have swirled around the demise of the bill. Yet a similar House bill championed by Republicans and Democrats and House Speaker Marco Rubio had broad consensus and passed overwhelmingly by 98 votes two weeks before the end of session. . . . In the long run, uninsured children lose out and Florida taxpayers become donors once again to other state programs. Time for fixes is long overdue and KidCare added to the special session would be the right call for the governor." (5/14/07, Daytona Beach News-Journal)

KidCare needs Gov. Crist's help
Think of the 250,000 people who live in Leon County. Now multiply that number by 2 and imagine putting all of them together in one cramped place in the Sunshine State. That's how many children and young people, ages 5 to 19, are eligible for health-care coverage through Florida's public-private KidCare program but aren't enrolled. According to one estimate, Florida has a total of 750,000 uninsured youngsters throughout the state - at 17 percent, the second-highest percentage of uninsured kids in the nation. Only Texas has more children in this fix. Meanwhile, Florida has lost almost $140 million in federal aid for children's health insurance. This is simply untenable. Avoiding a comprehensive solution until lawmakers return in 2008 is unacceptable. It's wasteful, certainly. But more important, it's wrong. It's not just a government program that needs your help, governor. It's 500,000 kids. (5/12/07, Tallahassee Democrat)

EDITORIAL: Get more done

Our position: Crist should focus lawmakers on kids' health and no-fault insurance.
Surely Floridians ought to expect more from their Legislature. Gov. Charlie Crist expects more, and he ought to follow his instincts and add two important tasks to the lawmakers' agenda: providing more health insurance for poor children and extending the impending deadline for the no-fault auto-insurance law. (5/12/07, Orlando Sentinel)

Florida Lawmakers Ask Governor To Include KidCare Changes in June Special Session
A group of Florida lawmakers on Tuesday sent a letter urging Gov. Charlie Crist (R) to include proposed changes to KidCare, the state's version of SCHIP, on the legislative agenda for a 10-day special session scheduled for June, the AP/Florida Times-Union reports. Florida has more than 500,000 uninsured children, many of whom are eligible for KidCare. Some health care advocates say that KidCare enrollment has dropped in recent years because the enrollment process is too complicated. (5/10/07, Kaiser Network State Watch)

Editorial: Next year, see and hear these Florida children
"We must raise the profile of all children's issues, from education to health," Gov. Crist said two months ago as he opened the legislative session. "As stewards of this state, our greatest obligation is to our children. But often it is their voice that goes unheard, or overlooked." Indeed, legislators largely overlooked voices on behalf of children again this year. The Senate and House did not champion these "unheard" Floridians: children without health insurance; children without families who at 18 "age out" of foster care and are unprepared to fend for themselves; children with cerebral palsy, spina bifida, autism and other developmental disabilities; girls at risk of being diagnosed with cervical cancer and preschoolers.Despite available money and bipartisan support for improving enrollment in the state's subsidized health insurance program for children, the Senate failed to make it easier for working, poor parents to sign up their children and keep them enrolled. Unless Gov. Crist adds KidCare to next month's special session, tens of thousands of eligible children likely will remain uninsured and millions in unmatched money once more will go back to the federal government. (5/9/07, Palm Beach Post)

Kid health-insurance action sought for special session
Florida legislative leaders on Wednesday formally called a special session to cut property taxes, but pressure is building to also use the session to revamp a children's health-insurance program. Ormond Beach children's advocate Linda Merrell said that if lawmakers don't revamp KidCare, the state will have "children waiting again, going through the same convoluted process" and not being able to get into the program. "These children would still be languishing for the next year, rather than trying to get them in," said Merrell, co-coordinator of the Florida Child Health Care Coalition. (5/10/07, Daytona Beach News-Journal)

Group Presses KidCare Repair
Florida risks losing millions of federal dollars if state lawmakers fail to fix the state's health insurance program for poor children during next month's legislative session, U.S. Rep. Kathy Castor said. Castor joined with other top Florida Democrats - U.S. Sen. Bill Nelson and state Chief Financial Officer Alex Sink - in calling on Gov. Charlie Crist and legislative leaders to add KidCare to the agenda of a June special session called to address property tax reform. (5/9/07, Tampa

Lawmakers urge Crist to include KidCare in special session
Democratic legislative leaders wrote to Gov. Charlie Crist on Tuesday urging him to include simplifying KidCare in the list of things lawmakers try to tackle when they return to the Capitol in late June. More than a half million Florida children do not have health coverage and many of those would be eligible for the state subsidized insurance program. Advocates say KidCare has been made too difficult to navigate for parents, and that’s what has caused enrollment to drop dramatically over the last several years. A bipartisan group of lawmakers set out this year to streamline KidCare to remove administrative barriers and eliminate some of the issues causing children to drop out of the program. But the effort broke down in the Senate, as leaders said the different parties trying to negotiate the details of final legislation did not work out their disagreements in time to pass the legislation. (5/8/07, Lakeland Ledger)

EDITORIAL: Hold the applause
Also an outrage was the legislators' inability to deal with the KidCare program. As many as 15,000 children are not receiving health care in the state, even though matching federal funds are available. Too many parents are unaware of the program due to a lack of promotion, which is a classic case of a convoluted system that seems intent on not serving the needy. Crist said he may add KidCare to a special session in June, and he should follow through with that (5/7/07, Florida Times-Union)

Tackle KidCare, legislators urged
Efforts to improve Florida's KidCare program should be included in the special session lawmakers plan to hold next month on property taxes, Chief Financial Officer Alex Sink and U.S. Sen. Bill Nelson said Tuesday. The KidCare legislation, which could have made it easier for families to qualify for the state-backed health insurance program, collapsed in a battle between the House and Senate. Key issues were which agency should have oversight of the program, and whether immigrant children and those of state employees should be allowed to participate. (5/9/07, South Florida Sun-Sentinel)

Big money to insure children wasted
Florida is the third worst state in the country in its number of uninsured children, and the federal money that could help insure them is going to waste, says an analysis by the Children's Campaign Inc., a Tallahassee-based advocacy group. (5/07/07, Ft. Myers News-Press)

Guest columnist: Florida KidCare should support all kids

By STATE REP. RICHARD MACHEK, D-Delray Beach, who represents Florida's 78th House District

In an effort to revitalize the state's KidCare health program, the Florida House expanded eligibility guidelines to include illegal immigrants. Here, two Treasure Coast lawmakers explain why they split on that plan. Today in Florida, 700,000 children, mostly from working families, lack access to health care. These children are uninsured and are deprived of the basic health care that most Floridians expect and rely upon. The Legislature needs to expand the program in order to receive the federal match, continue to improve the eligibility and application requirements and increase the outreach efforts to make the public aware of this program. (5/4/07, Treasure Coast Newspapers)

Guest columnist: Florida KidCare should not support illegal immigrants

By STATE REP. GAYLE HARRELL, R-Port St. Lucie,who represents Florida's 81st House District

Our children are our most precious resource and their health is important. In order to foster healthy kids, Florida established the Florida KidCare program in 1998. It provides free or subsidized healthcare to children in needy households. The program is a state/federal partnership and requires state matching dollars. This past year, Florida spent about $2 billion in state funds to provide health care to more than 1.3 million needy children in Florida. In spite of these efforts, there are as many as 500,000 uninsured children in Florida. Expanding benefits to illegal aliens who are children encourages additional illegal immigration and further strains Florida's health care budget. Why should Florida's taxpayers pay for the failures of the federal government? Yes, our children are our most precious resource. A streamlined KidCare program that provides health care coverage to them can be accomplished without expanding benefits to illegal aliens. I vote yes for our kids! (5/4/07, Treasure Coast Newspapers)

$71.9 billion budget passes Senate, House
Although both chambers agreed to put an extra $55 million into the KidCare program, which provides state-subsidized, low-cost Health Insurance to children, the Senate backed out of a proposal to revamp the program to make it easier for poor families and others to sign up for the benefits or stay enrolled. (5/04/07, Palm Beach Post)

EDITORIAL: Care for kids cannot wait

The Florida Legislature has run out of time on property tax relief, but lawmakers do have time in the last two days of the session to help kids and avoid national embarrassment. (5/03/07, St. Petersburg Times)

Pruitt stops KidCare revamp
Changes to make it easier for poor parents to enroll their children in a state-subsidized insurance program are not going to happen this year, according to Senate President Ken Pruitt. He dug in his heels despite last-ditch efforts from a bipartisan coalition of House members to resurrect a bill that would have provided seamless care for low-income, uninsured families. (5/3/07, Palm Beach Post)

Efforts to expand KidCare hit wall
A bipartisan effort to boost the number of Florida children with health insurance is likely dead for the year, with the Senate unable to agree on a plan to remove administrative barriers to enrollment in the state’s KidCare program. Senate President Ken Pruitt said Wednesday that it’s too late in the legislative session to work out differences of agreement over how to make the state’s subsidized health insurance program easier to navigate so that children won’t be kicked out. Florida Chief Financial Officer Alex Sink said, ‘‘We simply cannot doom Florida’s children to another year trapped in the spaghetti factory that is the current KidCare program.’’ (5/3/07, Gainesville Sun)

Senate will not consider KidCare expansion effort
In a year when state leaders vowed to make children's needs a priority, the Florida Senate is blocking efforts to reform and expand the state's health insurance program for poor children. (5/03/07, Tampa Tribune)

Editorial: No kidding
We urge lawmakers to listen to this champion for affordable children's health insurance that's provided in partnership with parents. Beyond that, we sincerely hope that in the next two days, state senators won't undermine Florida's congressional delegation in its effort to reauthorize federal funding - and that $400 million we are currently leaving on the table when it's so urgently needed by 750,000 children here. (5/2/07, Tallahassee Democrat)

Florida is among states hoping to get more people to buy private insurance
Florida Medicaid officials say rules could be unveiled as early as next month putting Florida at the front of a new wave of partnerships between state Medicaid programs and private insurers. (5/7/07, Sarasota Herald-Tribune)

Immigrants' children eligible for services even if parents aren't
Although most Florida immigrants legal and illegal aren't eligible for government services such as Medicaid, welfare and Social Security, many of their children are. (5/02/07, Ft. Myers News-Press)

Medicare and Medicaid

Medicare Drug Coverage, Drug Cost

Cheap drugs: $4 pricing makes more medicine affordable
Before Wal-Mart and Target decided to sell hundreds of generic prescription drugs for a flat $4 fee in September, Ann Maynard couldn't afford to take the medications her doctor prescribed. "I went, 'Whoa!' "she said, describing her reaction when she realized what the new policy would mean to her life. (05/13/07, Florida Today)

Palm Beach County may consider discount drug plan for public
Following Broward's lead, Palm Beach County Commissioner Mary McCarty wants the county to participate in a free program that offers residents discounts on drug Prescriptions. (5/10/07, Palm Beach Post)

New discount prescription drug card offered to all Broward residents
Broward County government launched a free discount drug card program Tuesday that could cut the cost of prescriptions an average of 20 percent for residents with or without medical insurance. (5/09/07, South Florida Sun-Sentinel)

Plan would give drug discounts to uninsured
A plan is in the works that could save Manatee's uninsured and Medicare Plan D recipients up to 30 percent on their prescription drugs. (5/06/2007, Bradenton Herald)

Other Medicare, Medicaid

Documented denial: New law is causing problems for legal U.S. residents trying to obtain Medicaid
A controversial law that took effect last year requiring low-income U.S. citizens to prove their citizenship in order to obtain or renew Medicaid benefits is causing havoc among some individuals who are legally entitled to receive the government insurance, according to a study. 90 percent of the health centers reported Medicaid enrollment difficulties for patients of all ages because of the citizenship documentation rule. The researchers estimate that the immediate impact of the documentation requirement is it will eliminate Medicaid coverage for as much as 6.7 percent of pediatric and adult Medicaid eligible patients. That translates into as many as 319,500 legal citizens. Apart from the university research, the Florida Department of Children and Families reports that an average of 400 Medicaid applicants are being denied every month because of the inability to prove citizenship. (5/14/07, Naples Daily News)

Off the starting block, Medicaid reform stumbles
In the months leading to the September launch of Florida's Medicaid reform program, state health officials jawboned the merits of privatization. The free market, they said, would offer beneficiaries more choice, lure more doctors to accept the government insurance and put the skids under the state's Medicaid bill. (05/13/2007, Florida Times-Union)

OPINION: Medicaid reform effort hurting those it's supposed to help
BY SARAH R. SULLIVAN, senior staff attorney for the Medicaid Reform Project of Jacksonville Area Legal Aid

To say Florida's reform Medicaid pilot program, under way in Duval and Broward counties, has not always gone smoothly is an understatement. As a result of the Medicaid reforms, recipients have been denied critical medications resulting in hospitalizations. One infant died because a mother was unable to access prenatal services. Many others have almost died. Does that sound like the kind of problem that requires only a minor course correction? Medicaid needs reforming, but it must be done right. Saving the state money and controlling rising health care costs are noble causes, but not at the cost of eliminating meaningful health care services for the poor. (5/13/07, Ocala Star-Banner)

Report: Medicaid reforms push MDs away

Georgetown University researchers say doctors and patients are reporting problems with the new Medicaid experiment in Broward and Duval counties. An independent research group reports finding ''many warning signs'' from patients and doctors in a Medicaid reform program going on in Broward and Duval counties that is being watched carefully by experts nationwide. ''Medicaid reform appears to be reducing the number of physicians participating in the Medicaid program, and those who remain appear to be seeing fewer patients,'' said the report from Georgetown University researchers released on Tuesday. The Agency for Health Care Administration, which oversees the Medicaid reform pilot, issued a statement in response: ``As with all studies based on focus groups and surveys, the information is a snapshot of a specific audience at a specific time. We do not agree with all the findings and have asked the university for their data so we can better understand their analysis and conclusions.'' (5/9/07, Miami Herald)

Study: State Medicaid reform pilot falls short
Florida's Medicaid reform program is drawing fire from both beneficiaries and doctors, according to a study by Georgetown University. Reform has made the Medicaid program more complex, not less, they complain. Beneficiaries surveyed reported problems keeping some, or all, of their doctors under the reform pilot, which was launched in Duval and Broward counties in September. Doctors, meanwhile, complained of difficulties providing needed care to patients. Some physicians have refused to participate in reform plans - spooked by anemic reimbursements and ballooning administrative costs. (5/8/07, Jacksonville Times-Union)

OPINION: Less care for Medicaid recipients
A last-minute change in funding rules for HMOs could have long-term negative consequences for poor, mentally ill Floridians and their communities. (5/02/07, Miami Herald)

OPINION: Advantage, insurance companies
The attempt to further privatize Medicare is a growing failure that undermines the program's long-term stability. Rules for private plans, called Medicare Advantage, favor insurance companies over recipients and taxpayers. (5/11/07, St Petersburg Times)

Medicare to clarify enrollees' coverage
Prompted by massive confusion and reports of enrollment abuses, federal authorities are cracking down on private fee-for-service plans, the fastest-growing product in Medicare Advantage, according to a Centers for Medicare and Medicaid spokesperson. (5/10/07, Tampa Tribune)

Officials: insurers' pitches include improper tactics
Insurance companies have used improper hard-sell tactics to persuade Medicare recipients to sign up for private health plans that cost the government far more than the traditional program, federal and state officials and consumer advocates say. (5/07/07, Tampa Tribune)

HMO sales deceiving, seniors say
Cuba is one of several seniors in the Southridge public housing neighborhood near Lake Many were upset when they found out they had signed up for a new plan and no longer could visit their usual doctors. (5/05/07, Palm Beach Post)

Universal touts federal notice as victory for Any, Any, Any
Universal Health Care says federal authorities have invited all three of its Medicare Advantage plans to participate again next year, including the controversial Any, Any, Any plan. (5/09/07, Tampa Tribune)

Finding 'Any' doctors a real pain in Martin County
Carol Payne says she has been searching for doctors since early January when she and her husband used their Medicare benefits to buy a private health insurance plan through a company she later learned is tangled up in court with state officials. (5/08/07, Stuart News)

No special enrollment for Universal members
Polk County residents enrolled in Universal Health Cares Medicare Advantage plans can't expect any extra help from the federal government as they deal with a dwindling number of local physicians who accept the Universal plans. (05/08/07, Lakeland Ledger)

Officials detail Medicare-bilking scheme
After documenting more than $140 million in Medicare fraud in south Florida, federal officials said Wednesday the will take a more thorough look at other providers of medical equipment. (5/10/07, Sarasota Herald-Tribune)

Florida Democrats Ask CMS To Explain Overcharging Of Medicare Beneficiaries
Florida Democratic Reps. Robert Wexler, Alcee Hastings, Ron Klein and Debbie Wasserman Schultz sent a letter to CMS acting Administrator Leslie Norwalk requesting information regarding a computer glitch that withdrew money from some Medicare beneficiaries' Social Security checks, Tens of thousands of Medicare beneficiaries nationwide who were enrolled in one of the few HMOs that paid all or part of their Part B premiums for 2006 have waited as long as 15 months for refunds of as much as $1,062 because of computer problems. The HMOs sent the payments to CMS for distribution to beneficiaries, but not all beneficiaries have received the refunds. CMS officials earlier this month said computer problems and incorrect data entries caused the delay in distribution of the refunds. (4/13, Kaiser Daily Health Policy Report)

Health Insurance and Costs

New clinic to help residents hurting for insurance
The county's Primary Care Access Network, or PCAN, will be opening a new health-care clinic in July to help the estimated 200,000 people in Orange County who either don't have medical insurance or don't carry enough of it. (5/13/07, Orlando Sentinel)

Short on cash? Orange adds new health-insurance relief
Primary Care Access Network will be opening a new health-care clinic in July to help the estimated 200,000 people in Orange County who either don't have medical insurance or don't carry enough of. Many of those people wind up going to a hospital emergency room, which costs three times more than a typical office visit to a doctor. Those costs are passed on to other patients, driving medical costs higher for everyone."By law, we can't turn anyone away from the emergency room," said Joe Brown, a spokesman for Orlando Regional Healthcare. "We typically see about 1,700 uninsured patients each month."The idea behind more clinics is to provide a safety net for people, as well as keep costs down for everyone. The clinics have a combined annual budget of about $30 million and are funded by Orange County and other federal, state and local public and private contributions. (5/13/07, Orlando Sentinel)

OPINION: Healthcare hodgepodge hurting us
A new report from the Older Women's League tells us the following facts are behind our broken U.S. healthcare system: About one-third of the total healthcare expenditure in the U.S. pays not for actual medical care but for administration. (5/13/07, Miami Herald)

Far from Miami, babies die in rural north Florida
To grasp the disparities between glitzy Miami or Palm Beach and parts of rural Florida that are beset by poverty and infant mortality, visit a small town such as Greenville. Of 233 births last year in Madison County, which includes Greenville, four babies died before their first birthday. The figure is even higher in other counties nearby in the north of Florida. Averaged over the past three years, the infant mortality rate was 9.9 per thousand in Madison county. Among its black population, the rate rises to 17 per thousand, a rate similar to some countries in the Caribbean and Eastern Europe. There are no specialist doctors in Madison County so women must travel to Tallahassee for a prenatal visit. With no buses, women without a car often face missing a day's work. As a result, many pregnant women don't visit a doctor in the first trimester and that, coupled with the fact that local black women suffer high rates of diabetes, high blood pressure and obesity, can imperil a baby's health, Private health insurance is too expensive for many on low wages in the United States and George said pregnant women she saw who lacked insurance often struggled to get adequate health care for themselves. (5/11/07, Washington Post)

With 3 strikes, 55 indigents out of health program

Fifty-five people have been booted from the county's indigent health care program because they've been convicted of committing three or more felonies in the past two years. (5/11/07, Tampa Tribune)

OPINION: Corporate muscle pushing health care reform
A much wider coalition of interests is hopping on the universal coverage bandwagon, big business among them. A national plan isn't just around the corner, but I no longer believe, as I did just a few years ago, that it will never come to pass in my lifetime. Now, at 52, I'm optimistic. When corporate America decides it's needed, and when campaign contributions flow into coffers of candidates who promise to get it done, universal health care will finally come to pass. (5/11/07, Tallahassee Democrat)

Editorial: Keep 'no-fault' system
Insurance companies that want to abolish PIP claim that doing so would save the average customer $250 per year. Other parts of the typical vehicle policy, though, probably would have to rise. Special-interest groups dominate the debate over PIP, but the Florida Hospital Association makes the best selfish point: Abolishing PIP would send more people to emergency rooms, since 4 million drivers have PIP and no other health insurance. That would be bad for the state, not just for the hospitals. (5/11/07, Palm Beach Post)

The doctor is always in, for a fee
There is a new small but growing niche in which patients pay a fee to have 24-hour access to the doctor, who will even go to them for appointments. "The time frame with the patient is getting smaller and smaller, " said Hemstreet, who still accepts insurance and charges regular fees along with a membership price of $500 to $1, 500 a year. "The fee enables me to cover my operating expenses with fewer patients so I can spend as much time with you as you need." (5/9/07, St. Petersburg Times)

Hospitals feel pinch as doctor office surgeries increase
Insurance companies are beginning to balk at insuring treatment at these centers, even if the doctors who run them are covered in the insurance company's network. (5/07/07, Daytona Beach News-Journal)

So much of her lost

A mother of three battles medical providers that haven't settled in her lawsuit over a surgery and infection that almost killed her. (5/7/07, St. Petersburg Times)

Couple with sick son make too much, and it's about to break them
A couple earning $85,000 a year shouldn't be on the brink of financial ruin. But the Hollenbacks are. (5/3/07, Ft. Myers News-Press)

Van takes health care to places its needed
Nearly three years after it first hit the streets, the Boca Raton Community Mobile Health Van keeps rolling. The van targets the underserved, uninsured and senior populations. Stops include soup kitchens, thrift shops, retirement homes and even college campuses as far south as Davie and as far north as West Palm Beach. (5/2/2007, Palm Beach Post)

Other Health Issues

Deal gives condo residents a 'fast pass' for ER care

Long emergency room waits are legendary in Palm Beach County, but one large local condo association thinks it has found a way around them. The Fountains Country Club in suburban Lake Worth and JFK Medical Center in Atlantis are finalizing a deal for condo residents to get "expedited processing through the emergency room department" for a $20 annual fee. (5/12/07, Palm Beach Post)

'Little Clinic' set to open at Publix in Wellington
Publix's first health clinic in a Palm Beach County grocery store is scheduled to open in the village in less than two weeks. (5/10/07, Palm Beach Post)

Turnaround for mentally ill

Department of Children and Families Secretary Bob Butterworth has announced that no inmates who have been declared mentally incompetent have to wait longer than the 15 days the law allows for a bed in a mental institution. The earlier treatment helped stabilize inmates faster, allowing them to go to less expensive community programs rather than a state hospital. The savings then went back into the pilot program, which has already been duplicated in Orange and Broward counties, Butterworth said. Unfortunately, Florida ranks 48th in per capita spending for mental illness. In the $71.9-billion budget approved last week, lawmakers agreed to continue funding the extra hospital beds and even added $4.6-million to enhance the in-jail mental health services. But, without any discussion or debate, lawmakers also eliminated a requirement that HMOs spend at least 80 percent of the money they get to manage Medicaid mental health care directly on care, rather than on overhead or profit. Many of the community clinics that provide the care have laid off workers or closed some services entirely since the HMOs started managing the care a few years ago, according to a recent trade group survey. Often the first positions let go are the case managers. These are the workers who stay in touch with mentally ill clients and ensure they are taking their medicines and keeping their appointments. Without this safety net of supervision, agencies say, the clients are more likely to destabilize and commit crimes that can land them in jail. (5/10/07, St. Petersburg Times)

OPINION: E-prescriptions could cut down on drug abuse

It didn't get a lot of attention, but a significant bill passed last week in Tallahassee will cut down on prescription drug abuse and deaths. It also provides safeguards against adverse drug interactions. (5/08/07,Stuart News)

NATIONAL NEWS & OPINIONS

Medicare, Medicaid, SCHIP

Medicare Drug Coverage, Drug Cost

Other Medicare, Medicaid, SCHIP News

States Are Making More Children Eligible for SCHIP
In an effort to get more middle-class families participating in the State Children’s Health Insurance Program, many states are easing eligibility, even as Health and Human Services Secretary Mike Leavitt says too many families are relying on publicly funded coverage, reports the Associated Press. (4/29/07, AP)

Bush and Republican Presidential Candidates at Odds Over SCHIP Funding
By not increasing funding for the State Children’s Health Insurance Program (SCHIP) in his proposed budget, President George Bush is "sacrificing credibility in one of the biggest health-care policy debates this year." The article examined the "juxtaposition" between President Bush's proposed funding levels for SCHIP in fiscal year 2008 -- which most independent analysts say would not be enough to cover the costs of the program's current enrollment -- and many Republican presidential candidates' proposals to expand SCHIP. Bush also has proposed eliminating SCHIP coverage for adults, which is offered in about a dozen states. (5/3/07, Wall Street Journal)

OPINION: America’s 8.3 Million Uninsured Kids Are "a Stain on the Nation"
Los Angeles Times columnist and United Auto Workers President both endorsed expanded funding for the State Children’s Health Insurance Program in recent columns.(5/2/07, Los Angeles Times) (5/4/07, Detroit News)

Group Seeks Elimination Of Medicare Waiting Period For People With Disabilities

A coalition of 34 consumer groups, led by the Medicare Rights Center, has begun to lobby Congress to revise a law that requires individuals with disabilities to wait two years to become eligible for Medicare after they begin to receive Social Security disability benefits. Medicare implemented the waiting period in 1972, when Congress expanded the program to cover individuals with disabilities, to limit the cost and ensure only those with severe and long-term disabilities would qualify for the program. However, according to a report released earlier this month, the law is "sentencing people to inadequate health care, poverty and death." The center estimates that elimination of the waiting period would cost $8.7 billion annually, although savings of $4.3 billion in Medicaid would offset some of the cost. (4/27/07, Dallas Morning News)

Methods Used by Insurers Are Questioned
Improper hard-sell tactics have persuaded Medicare recipients to sign up for private health plans that cost the government, officials say. Insurance companies have used improper hard-sell tactics to persuade Medicare recipients to sign up for private health plans that cost the government far more than the traditional Medicare program, federal and state officials and consumer advocates say. Bobbie S. Whatley of Columbus, Ga., said a young man who showed up on her doorstep in November and talked to her about insurance forged her signature, and a month later she received mail thanking her for joining a plan. "It turned into a nightmare,"Mrs. Whatley said. Multimedia Graphic Tracking Growth Insurance agents, spurred in some cases by incentives like trips to Las Vegas, have aggressively marketed the private plans, known as Medicare Advantage plans. Enrollment in them has skyrocketed in the last year, and Medicare officials foresee continued rapid growth in the next decade. (5/7/07, New York Times)

Plights of uninsured stir efforts to sway lawmakers
Lawmakers in Congress are "increasingly hearing" from individuals whose families have experienced medical crises because they lacked access to health care, USA Today reports. For example, Tamika Scott has visited Congress to describe how her 14-year-old son, who had advanced kidney cancer, lost Medicaid eligibility for four months when her income rose above the Medicaid cutoff. The boy's chemotherapy was stopped and he had to enroll in free clinical trials for care. His Medicaid eligibility later was restored, but Scott says it was too late to help him. (5/2/07, USA Today)

Health Insurance and Costs

Large Business Coalition Endorses Mandate to Cover all Americans
A coalition of 36 large companies is launching a political campaign that calls for covering all Americans with a plan similar to that proposed by California Republican Governor Arnold Schwarzenegger. (5/7/07, Los Angeles Times)

OPINION: Health Care Crisis Not Dire Enough Yet to Prompt Action
The United States should do away with employer-based health coverage and reform the health care system, but "it’s going to be a long time before the large majority of Americans with decent coverage are persuaded to risk changing what they have." (5/5/07, New York Times)

Many of the Self-Employed Are Simply on Their Own
The small businesses that struggle the most with health insurance may be the smallest of all: those with only one employee. In 11 states, self-employed people have some of the same legal rights as small companies when it comes to dealing with insurers: Colorado, Connecticut, Delaware, Florida, Maine, Massachusetts, Mississippi, New Hampshire, North Carolina, Rhode Island and Vermont. But elsewhere, in dealing with insurance companies, the nation’s estimated 20 million self-employed are on their own. (5/5/07, New York Times)

Small Businesses' Premiums Soar After Illness
Small businesses may become a central issue in the debate over the problem of Americans without health insurance. (5/5/07, New York Times)

Citizen-Lobbyists’ Tragic Tales of Being Uninsured Motivate Lawmakers

Congress and state legislators who "grapple this year with how to help the uninsured" are being influenced by the tales of those who have suffered due to lack of coverage. (5/2/07, USA Today)

Fifth Annual Cover the Uninsured Week Wraps Up
Cover the Uninsured Week, the largest nonpartisan mobilization in history to seek solutions for the uninsured, illuminated a serious and growing national problem (4/28/07, Biloxi Sun Herald)

OPINION: Commentaries on Cover the Uninsured Week Call for Expanded Coverage
As the fifth annual Cover the Uninsured Week winds down, opinion makers endorsed the effort and called for solutions to the continuing problem. (4/23/07, Detroit Free Press)

Other Health Issues

Passage of Drug Safety Bill Was Common Goal for Two Very Different Senators
Senators Edward M. Kennedy and Michael B. Enzi worked together in an unusual display of bipartisanship to make the bill passable. (5/11/07, New York Times)

Senate Approves Tighter Policing of Drug Makers
The bill gives the F.D.A. new power to police drug safety and order changes in drug labels. (5/10/07, New York Times)

Health in Black and White

Medical care itself is hardly the major determinant of health -- social context matters. The American Prospect talks to sociologist David Williams about racial and socioeconomic disparities in health. (4/27/07, The American Prospect)

400 Health Clinics to Open in Wal-Mart Stores during Next Three Years

Wal-Mart Stores, Inc., intends to contract with local hospitals and other organizations to open as many as 400 in-store health clinics over the next two to three years, and if current market forces continue, up to 2,000 clinics could be in Wal-Mart stores over the next five to seven years, Wal-Mart president and CEO Lee Scott [said]...The clinic program’s expansion is the latest in a series of moves by Wal-Mart to help implement customer solutions to America’s health care crisis, including the $4 generic drug prescription program, health information technology and participation in a major coalition supporting comprehensive healthcare reform by 2012. (4/24/07, Wal-Mart Facts)

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.

Deadline: June 15
CVS Caremark Charitable Trust was established with the goal of positively impacting the culturally diverse populations in communities where CVS stores are located. Among its funding priorities are health programs for children under 18 with disabilities, and that address awareness, accessibility, early intervention, and health and rehabilitative services.

WHO Foundation: Women Helping Others
Deadline: second Tues of Sept
The WHO Foundation: Women Helping Others supports grassroots nonprofit organizations in the United States and Puerto Rico serving the overlooked needs of women and children. Specific projects and programs addressing health, education, and social service needs are the Foundation's priority. To qualify for funding a nonprofit organization must have been incorporated for a minimum of three years prior to application. Preference is given to organizations with an operating budget of $3 million or less. Visit the website listed above for more information

Advancing Public Health Practice and Policy Solutions
Brief proposal deadline: June 6
One of the priorities of the Robert Wood Johnson Foundation is to improve public health in the US. This grant program provides support for projects that will discover, implement, evaluate, or disseminate practical and replicable solutions related to public health. Proposals will be accepted from state and local health departments, universities, boards of health, federally-recognized tribes, community-based organizations, and other nonprofit organizations. Applicants must address one of the following topics: public health laws, regulations or policies; public health advocacy or communications; or engaging hard-to-reach and/or high-risk populations. Ten to fifteen grants of up to $200,000 and five to ten grants of between $200,000 and $400,000 will be awarded.

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.

Improving the Health of Immigrant and Refugee Communities
Deadline: July 13
The Robert Wood Johnson Foundation's Vulnerable Populations Portfolio is accepting grant proposals for new community-based approaches to health and healthcare problems faced by immigrants and refugees in the US. The program seeks projects that address how health and social systems can accommodate the unique needs of different and changing immigrant and refugee populations; how communities can engage in helping immigrants and refugees maintain and improve their health; and what strategies can overcome barriers that immigrants and refugees face when trying to access health and social services. To be considered, proposals must address ways for improving the health of new residents by linking social factors – language skills, significant cultural differences, education, and poverty -- to health outcomes. The foundation is interested in projects that focus on helping new populations integrate into their communities, and is especially interested in providing support to organizations outside the formal network of healthcare providers such as grassroots organizations, faith-based organizations, and advocacy organizations. Applicants may be either public entities or nonprofit 501(c)(3) organizations. Grants of up to $300,000 (maximum grant award) for up to three years will be available. The program will fund eight to ten projects for 2007.

Improve Children's Dental Health
Deadline: July 17
The American Dental Association Foundation has issued a Request for Proposals to help improve children's oral health. Established by the ADA Foundation to prevent childhood tooth decay, the Harris Fund annually provides grants of up to $5,000 to educational and preventative programs designed to improve children's dental health. In 2007, the program will award up to $300,000 in grants. Community-based not-for-profit organizations in the US or its territories are eligible to apply. Examples of qualified oral health promotions include dental health education conducted at schools, health fairs, and social agencies via mobile dental clinics or outreach programs; dental health education programs in conjunction with preventive programs such as fluoride and dental sealant application programs; oral health and nutrition education materials designed for parents and/or dental professionals; instruction in the proper use of oral-care products; and development of public-service announcements (PSAs) to increase awareness of and appreciation for proper childhood oral care.

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.

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

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.

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

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

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.

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.

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.

Women and Health Coverage: The Affordability Gap. finds that women are at a disadvantage because they have greater health care needs and lower incomes than men. "Women are more likely than men to go without needed health care services because of costs, yet they still have higher out-of-pocket expenses." The study finds that the high cost of health care services and premiums is forcing many women, even those with health insurance, to go without needed care. In fact, 33 percent of insured women and 68 percent of uninsured women don't get the health care they need because they can't afford it. Moreover, a higher proportion of women than men struggle to pay medical bills. (April 2007, Commonwealth Fund)

Health Coverage in America: Understanding the Issues and Proposed Solutions

Florida has the second-highest rate of uninsured adults under age 65 in the nation, according to the Alliance for Health Reform. In a recent report funded by the Robert Wood Johnson Foundation, the Alliance said 27 percent of working-age adults in Florida lack health coverage, behind only Texas at 31 percent. The uninsured aren’t slackers; more than four out of five are employed or their family members. Now that 20 states have at least one in five non-elderly adults without coverage, the subject of health reform will become an increasing part of the national debate going into the presidential election of 2008. Bone up on the situation with this readable, illustrated, free 24-page guide. (March 2007, Alliance for Health Reform)

As a way to address the flaws of traditional payment methods, like fee-for-service and capitation, the authors of this report suggest a new payment model, based on evidence-informed case rates (ECRs). Under this system, providers are paid a single, risk-adjusted payment across inpatient and outpatient settings to care for a patient diagnosed with a specific condition. Working with experts in the health care field, the authors selected 10 conditions for ECR development, examining issues like diagnosis, services covered by the ECR, and criteria for successful completion of care. This new model, say the authors, can improve health care quality, lower administrative burden, enhance transparency, and support a patient-centered, consumer-driven environment. To further promote quality care, the ECR model calls for a portion of the payment to be withheld and re-distributed based on provider performance on measures of clinical process, outcomes of care, and patient experiences. (April 2007, Commonwealth Fund)

Kaiser Health Tracking Poll: Election 2008
Health care ranked as the second most important issue to voters, after the war in Iraq, in the 2008 presidential election, according to a recent Kaiser Family Foundation poll. Fifty-two percent of respondents said they would like to see a health care reform proposal from a candidate “that would make a major effort to provide insurance for nearly all of the uninsured and would involve a substantial increase in spending. (March 2007, Kaiser Family Foundation)

FamiliesUSA has added three new pieces documenting the risks of Health Savings Accounts (HSAs).

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)

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)

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)

Language Proficiency and Adverse Events in U.S. Hospitals: A Pilot Study
Commonwealth Fund–supported researchers from the Joint Commission report on the type and frequency of adverse events experienced by LEP and English-speaking patients in six U.S. hospitals. Their findings are startling: LEP hospital patients are more likely than their English-speaking counterparts to experience adverse events that result in harm, and the severity of that harm is often greater. The availability of language translation services, provided by trained medical interpreters, is crucial for ensuring the safety and quality of care that LEP patients receive, the authors say. They also recommend that hospitals indicate patients' native language and communication needs in their record and document the language services provided during medical encounters. (April 2007, International Journal for Quality in Health Care)

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,

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.

EDITORIAL: Care for kids cannot wait

Health Coverage in America: Understanding the Issues and Proposed Solutions

Breast and Ovarian Cancer: Prevention, Diagnosis and Treatment

October 12 9:30 am-4:00 pm Jackson Memorial Hospital’s Diagnostic Treatment Ctr