From Page 1

May 31, 2006

FLORIDA ACTION

Medicaid Reform Plan Effective Sept. 1 for First Beneficiaries

NATIONAL ACTION

First Medicare Part D Enrollment Period's Unresolved Issues

Senate Introduces Bill to Waive Enrollment Penalty

Don't Keep Medicare Beneficiaries Locked Into Wrong Plans

Citizenship Proof Required for Medicaid Starting July 1

U.S. House Approves Irresponsible Budget; No Medicare, Medicaid Cuts

FLORIDA ACTION

Medicaid Reform Plan Effective Sept. 1 for First Beneficiaries

Health care coverage under Florida’s Medicaid reform plan will become effective on Sept. 1 for the first group of beneficiaries, not July 1 as previously anticipated, according to Agency for Health Care Administration officials. Instead, July 1 is the date that AHCA officials plan to mail informational brochures to select Medicaid beneficiaries in Broward and Duval counties, the sites where the state’s new Medicaid reform plan will take place.

AHCA officials explained the new timeline during public hearings last week in those counties. Some 280,000 current Medicaid recipients will enroll in “reform” health care plans over an eight-month period, according to Sybil Richard, assistant deputy secretary for Medicaid.

Who will enroll first?

The first group of beneficiaries eligible for enrollment are MediPass participants whose primary care physicians have not yet joined a Medicaid reform health care network, according to AHCA officials. The MediPass program will eventually be phased out.

The first group of beneficiaries will have 30 days to select from the plans offered in their county. AHCA is currently reviewing the applications of nearly two dozens health maintenance organizations (HMOs) and provider service networks (PSNs) interested in offering plans under the Medicaid reform program, Richard said.

How will they get information?

State officials have hired Florida State University to design the Medicaid reform brochures. The state has also hired Affiliated Computer Systems (ACS) to provide a toll-free hotline and counselors who will advise beneficiaries of their health care plan options. Click here for more AHCA information about the marketing plan.

What is “Medicaid reform” about?

The program – engineered by Gov. Jeb Bush and approved by federal officials – marks a significant shift in the way the state pays for Medicaid services. For years, Medicaid programs across the country have reimbursed physicians, hospitals and other providers for the cost of providing medical care to beneficiaries. Florida’s program sets up a system by which the state pays the insurance premiums of each beneficiary enrolled in a “reform” HMO or PSN, which in turn manage health care services.

Medicaid beneficiaries will also have the opportunity to use the state subsidy to buy insurance coverage from their employers.

NATIONAL ACTION

First Medicare Part D Enrollment Period Ends with Key Unresolved Issues

May 15 marked the end of the first Medicare Part D enrollment period. Yet, as Families USA chronicles, the problems continue. Their resolution will help determine the success of the program. Advocacy organizations will be monitoring these concerns closely; look for updates and action steps as they develop.

Among the problems are: skyrocketing drug prices with no limits imposed; potential Part D plan changes in premiums, deductibles and copayments after initially securing a large share of the market; attrition in plans with low enrollment; unknown actual per capita costs to the drug plans; how beneficiaries will manage to pay for their medications during the "doughnut hole" gap in coverage between $2,250 and $5,100 with no help from their drug plans and while they continue to pay their premiums; and access to subsidies for low income seniors.

Just prior to the May 15 deadline, reports indicated that more than three out of every four low-income seniors eligible for special drug subsidies were not receiving them - despite extensive outreach efforts. Fortunately, the Bush Administration extended the enrollment period and waived the late-enrollment penalty for this group. There is some effort to get the assets test eliminated as a barrier to low-income persons with even small savings to supplement other retirement income. Read more.

Senate Introduces Bill to Waive Enrollment Penalty

Immediately after it went into effect, U.S. Senators Charles Grassley (R-IA), Max Baucus (D-MT), Bill Nelson (D-FL), and Mike DeWine (R-OH) indicated that they will work together to waive the Medicare Part D late enrollment penalty this year. Families USA commended this action, noting "This new legislation is a much needed fix for the ill-conceived policy that will levy penalties on seniors, who have been confused by this overly complicated new Medicare program. . . . . Seniors should not have to pay a penalty for the rest of their lives because Congress created a program that is so confusing and complex.” Read more.

Don’t Keep Medicare Beneficiaries Locked Into Wrong Plans

Click here to tell President Bush not to lock people into their plans. People with Medicare should not be locked in to a prescription drug plan or HMO that does not cover the drugs or medical services they need. But lock-in for drug plans began on May 16 and will begin for HMOs on July 1.

As the Medicare Rights Center states, the Part D drug benefit has presented older Americans with confusing choice of plans, each covering different drugs and charging different premiums and copayments. Good information is hard to come by and deceptive marketing by the plans is common. The situation is even worse for HMOs. Many of these plans present themselves as drug plans; individuals enroll without knowing there will be limits on their choice of doctors or hospitals.

Necessary protections Medicare beneficiaries are not in place to ensure these HMOs and drug plans cover the medicines and medical services individuals need. Lock-in creates serious barriers to medically necessary care.

President Bush has legal authority to prevent lock-in by extending a special enrollment period to all Medicare beneficiaries due to the extraordinary circumstances surround the first year of the drug benefit.

Click here to tell President Bush not to lock people into their plans.

Citizenship/Nationality Proof Required for Medicaid Starting July 1

As a result of the Deficit Reduction Act, as of July 1 individuals declaring to be a citizen or national of the U.S will be required to present “satisfactory documentary evidence of citizenship” (or nationality). This new requirement was intended to keep illegal immigrants from fraudulently enrolling in Medicaid. However, its main impact is likely to be to impede or delay coverage for significant numbers of eligible U.S. citizens.

This requirement applies both to new applicants for Medicaid and also to existing beneficiaries at the time of renewal of eligibility (generally every 6 or 12 months). The federal government will not match the state costs of Medicaid services anyone declaring to be a citizen who does not meet this documentation requirement.

This requirement is expected to pose great hardship for elderly African Americans and others who were not born in hospitals, for the physically or mentally impaired, for those who have experienced house fires or natural disasters, and for many others who also do not have birth certificates or passports.

CMS has indicated that guidance will be issued as part of a "final interim regulation." Read more from the Center on Budget and Policy Priorities. Apparently, alternatives to proving citizenship or nationality are under consideration, such as: affidavits by familiar persons; voting records; medical or school records for children under 16; and other documents to prove identity.

U.S. House Approves Irresponsible Budget; No Medicare, Medicaid Cuts

After months of failed attempts, the U.S. House approved an FY 2007 budget resolution on May 18 by a 218-210 vote. Advocates forestalled this onerous budget from being passed for many weeks, kept the President's proposed Medicare and Medicaid cuts from being included, and led to some modest improvements that might otherwise not have passed.

Conservatives demanded that funding for domestic programs not exceed the President’s $873 billion, and by moderates worked to add funds to prevent at least some cuts. Moderates did get a promise, that must be considered tentative, that programs of the Depts. of Labor, Health and Human Services and Education may receive an addition of nearly $7.2 billion.

The budget maintains the President's proposed $874 billion for domestic annually appropriated programs; an amount more than $10 billion below that needed to continue the current level of services next year. Further, the budget establishes a reserve fund of $3 billion for domestic programs, but only if those funds come from cuts or savings in entitlement programs.

TAKE ACTION: Check here to see how your U.S. Representative voted on the budget. Then click here to write your Representative.Thank those who voted against it know you noted and appreciate their courageous stand against cuts that will hurt so many vulnerable people. Let those who voted nay know how glad you are that Medicare and Medicaid were not cut, but how disappointed you are in their overall lack of foresight and compassion in passing a budget $10 billion below what is needed to continue the current level of critical domestic human services.

Florida CHAIN thanks the many advocates who have taken the time to respond to our recent Get Active alerts. Your messages do make difference. Look for increased reporting on state legislation and weekly calls to action during the Florida session.

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PARTNER OF THE MONTH

North Florida Educational Development Corporation

May 31, 2006

L-R NFEDC's Shinita Jenkins, Exec. Dir. Carolyn Ford and Sylvia Martin

North Florida Educational Development Corporation (NFEDC) is a grassroots community-based organization established in 1986. Led by Executive Director Carolyn Ford, NFEDC’s mission is to empower individuals and families in Gadsden County, in the rural panhandle of North Florida bordering the Florida-Georgia line, to become more self-determined, self-sufficient and self-sustaining. To achieve its mission NFEDC coordinates education programs, job training and job development, hunger relief, affordable housing and community development initiatives.

Among its recent accomplishments, NFEDC established a Wellness Center in Quincy that averages about 350 clients a month, who visit with a nurse and a Health Educator for advice on issues from health care to best practices in nutrition.

A long-time partner and LINC (Local Initiatives Networking Communities) of Florida CHAIN, NFEDC serves an area of over 41,000 people and a poverty rate of 28%. Florida CHAIN and NFEDC are working together to establish a series of workshops and educational forums on issues ranging from Medicare Part D to KidCare and Tobacco Tax legislation.

Historically, the residents of Gadsden County depended on a strong agricultural base to sustain their economic wellbeing. In 1965, the tobacco industry provided work for approximately 18,000 people. The number of people employed on farms in the county decreased by one-half from 1978 to 1985. No other industry has replaced tobacco as the backbone of Gadsden County’s economy.

NFEDC began as Project HOPE, a literacy program organized by a community task force in an attempt to alleviate the high illiteracy rate in Gadsden County. NFEDC has evolved to include many programs in community and youth development, as well as housing and economic development. The Florida Housing Finance Agency has designated NFEDC as a CHDO (Community Housing Development Organization). NFEDC requires by law that fifty percent of its board are low-income residents.

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REAL STORIES

May 31, 2006

To share your own story, click here.

PREFACE:

This interview depicts one type of complication among many that Floridians have experienced in the transition to Medicare Part D.

Jim Leadbetter is a resident of Inverness, Florida

I had no trouble with my registration with AARP medicare Rx but my inlaws' situation is completely different. I signed them up and have yet to receive a letter with their ID #'s.

Have been calling every day only to be told all reps to busy and to call back. The pharmacist could not get through even after the one time the recording I got said to have the pharmacist call. The only problem was the pharmacist can't hold for 40 minutes.

I have sent emails to CMS and to all the people suggested and as of now no results. My inlaws are very elderly and can't afford to pay out of pocket and wait for a refund so my wife and have been truing to help where we can.

I know you have your hands full but I just had to let off a little flustration.

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RECENT HEALTH ARTICLES

May 31, 2006

KidCare

Other Florida Health Issues

Medicare and Medicaid

Medicare Drug Coverage, Drug Costs

Other Medicare, Medicaid

Health Insurance and Costs

Other Health Issues

KidCare

OPINION: Could Legislature care less? Funding cut hurts uninsured children – again
The number of young people enrolled in KidCare, the state's subsidized health-insurance program for needy children, has plummeted by 120,000 since 2004. The ever-optimistic -- and myopic -- Legislature apparently thinks this qualifies as progress. . . . the lawmakers decided to cut $170 million from the KidCare budget. Next, they rejected a proposal to restore coverage to the children of legal immigrants -- a plan that would have cost $15 million, a fraction of the state's multibillion-dollar budget surplus. . . . If this is compassionate conservatism, it should be rushed to the emergency room. State officials estimate that Florida has 520,000 uninsured children. Many of them will remain so in the coming year -- unless, of course, their folks win the lottery. (5/12/06, Sarasota Herald-Tribune)

Other Florida Health Issues & Coverage

$3.7 Million to Tighten Medicare Part D Gap

Federal officials promoting Medicare Part D say it provides unprecedented drug coverage to millions of seniors and people with disabilities. The program, however, also has cost some of its most vulnerable beneficiaries coverage of the drugs that keep them alive. Medicare Part D does not cover vital drugs for organ transplant recipients and many cancer patients. Not only that, a glitch in the program has caused many of those patients to lose coverage under a separate Medicaid program. In response, state lawmakers this month earmarked $3.7 million to ensure those patients continue to receive their drugs. Patient advocates applaud the bipartisan effort, but they also lament that it falls short of what they think is needed to clean up the bureaucratic mess. (5/22/06, Tampa Tribune)

Abbott Laboratories accused of inflating Medicare, Medicaid drug prices

The government and a tiny Key West pharmacy accuse Abbott Laboratories of wasting taxpayers' money

Federal prosecutors in Miami announced Thursday a lawsuit against Abbott Laboratories, accusing the pharmaceutical giant of defrauding Medicare and Medicaid out of tens of millions of dollars. The lawsuit accuses Abbott of grossly inflating prices of drugs, particularly injectables, for which it billed federal programs at least $175 million. In some cases, the taxpayer-funded programs were charged more than 10 times what others were paying for the drugs. (5/19/06, Miami Herald) Department Of Justice Joins Lawsuit (5/22/06, Medical News Today)

Florida's Medicaid Anti-Kickback Statute Conflicts With Federal Law, State Supreme Court Says

The anti-kickback provision of Florida's Medicaid fraud statute conflicts with federal law because it doesn't feature some of the same exemptions, the state's Supreme Court ruled Thursday. The ruling comes in the case of Gabriel Harden, a Florida dentist who was charged along with nine colleagues for violating the kickback law, which prohibits providers from paying people to recruit Medicaid-eligible patients to their facilities. (5/18/06, Florida Times-Union)

Thousands in S. Florida miss sign-up deadline for Medicare drug program

Monday was D-Day -- deadline day -- for first-time enrollment in the new, Medicare-prescription drug benefit plan. Hundreds of South Florida seniors called telephone help lines or made last-minute visits to Medicare counseling centers, nervous about missing out or wanting reassurance about a choice they already had made. (5/16/06, South Florida Sun-Sentinel)

Put off enrolling until Monday? You weren't alone

Tens of thousands of procrastinating seniors kept Medicare's operators busy Monday during the final hours of enrollment for the government's new drug benefit. (5/16/06, Ocala Star-Banner/AP)

State Sen. Ron Klein assails confusing details of Medicare program

The new Medicare prescription drug program is a payoff to pharmaceutical companies and contains confusing details that deny benefits to thousands of seniors, a Democratic candidate for Congress said Saturday. ``While any prescription drug help to older Americans is a good thing for many, millions are confused and are having a tough time navigating the options and confusing details buried in the fine print,'' Florida State Sen. Ron Klein, said in his party's weekly radio address. (5/14/06, Naples Daily News/AP)

Applying for Medicaid? Be ready to show identification

A provision of budget legislation will require all U.S. citizens applying for Medicaid to prove their citizenship with a passport or birth certificate. Tuck your passport or birth certificate into a pocket the next time it’s necessary to make a trip to the emergency room or walk-in clinic. For low-income people, the documents could make all the difference in the world when it comes to the bills. A provision of budget legislation that President Bush signed in February will require all U.S. citizens applying for Medicaid or renewing their coverage to prove their citizenship. (5/14/06, Naples Daily News)

Tightened Medicaid rules create concern at Palm Beach County hospitals
A new law requiring Medicaid recipients to prove they're eligible to keep benefits has hospitals worried about an increase in uninsured patients and immigrant advocates frustrated by the growing animosity toward foreign-born people. The change, effective July 1, will require the state's 2.2 million Medicaid-eligible residents to show their birth certificates, passports or other documents to receive the government-subsidized health care. . . . Poor, elderly blacks who weren't born in hospitals because of discrimination and don't have birth certificates could be one of the largest groups impacted. Others could be Native Americans, those with mental or physical disabilities, people who have lost their documents during natural disasters, and possibly children of undocumented immigrants. (5/12/06, South Florida Sun-Sentinel)

OPINION: Drug plan headache: 'Part D' penalties are unjustified

President Bush "is too casually dismissing efforts to end a permanent financial punishment" when Medicare beneficiaries "don't conquer the enrollment options" of the prescription drug benefit before the deadline, a Democrat editorial states. The editorial states that enrollment "is far from easy for many older people," adding that the process "shouldn't add to the trauma of those Medicare recipients the insurance plan is meant to serve" (5/11/06, Tallahassee Democrat)

Unhealthy, and paying a steep price for it

OPINION: RETHINK OUR APPROACH TO HEALTH AND MEDICAL CARE

A new study is reviving interest in an old question: Why are Americans sicker than their industrial-world counterparts despite spending about twice as much per capita on healthcare? Researchers comparing middle-aged populations here and in England confirmed that Americans have much higher rates of chronic diseases such as diabetes, heart disease and cancer. Yet the study doesn't fully explain what causes the disparity. (5/5/06, Miami Herald)

NATIONAL ISSUES

Medicare and Medicaid

Medicare Drug Coverage, Drug Costs

More Lawmakers Consider Medicare Prescription Drug Benefit 'Work In Progress'

Knight Ridder on Thursday examined the political implications of the Medicare prescription drug benefit and the belief among lawmakers and the Bush administration that the program "is a work in progress, rather than a finished product." Republicans had expected the drug benefit to be a "political knockout" when the legislation was passed, but confidence in the public's support waned as the program's "flaws and shortcomings were exposed early and often" in its initial months. (5/26/06, Kaiser Network)

CMS Clarifies 2007 Marketing Rules on 'Co-Branding' Medicare Rx Drug Plans

In 2007 marketing guidelines for Medicare drug plans released on Wednesday, CMS said that co-branding still will be allowed in promotional materials but that drug plans must not list partner organizations on Medicare drug cards. According to CQ HealthBeat, co-branding on the drug cards has confused some beneficiaries who mistakenly think they can only fill prescriptions at the pharmacies listed on their cards. (5/25/06, Kaiser Daily Health Policy Report)

Pharmacists Urge Passage Of Bills Requiring Faster Payments, Higher Reimbursements Under Medicare Rx Benefit

New drug law spawns criticism; Retailers cite slow payments
Independent pharmacists said Monday that low and slow payments under the Medicare prescription drug program could force them out of business. "If something is not done, community pharmacies may be out the door," Bill Rustin, vice president of the Association of Community Pharmacists Congressional Network, warned at a news conference. Several hundred pharmacists are expected to lobby Congress today for higher fees and quicker payments. (5/23/06, Atlanta Journal-Constitution)

Bush Administration Officials Call Medicare Rx Benefit Enrollment Efforts A 'Success'

Hours after the deadline for older Americans to sign up for Medicare drug benefits, President Bush's top health advisers yesterday rushed out a preliminary tally that they said shows 90 percent of the 42.5 million eligible people have federal or other kinds of coverage for medicine -- including at least 1 million who enrolled during a final blitz in the past week. . . . The agency's figures have drawn criticism from Democrats and some patient advocacy groups, which say the agency is counting some people more than once. And some recent surveys of older Americans have found relatively large proportions saying they do not plan to sign up. (5/17/06, Washington Post)

Don't Penalize Latecomers To Medicare Drug Benefit Say Many Lawmakers

Now that Monday's deadline has passed, more lawmakers are openly asking that penalties for late enrolment be dropped. (5/17/06, Medical News Today)

Final Rush to Make Deadline for Drug Coverage
Medicare beneficiaries flocked to senior centers and made frantic phone calls to sign up for prescription drug plans. (5/16/06, New York Times)

Medicare Deadline Spurs a Debate Over Penalties

Enrollment in Medicare's new prescription drug benefit lurches to a conclusion on Monday, with beneficiaries, insurers and many lawmakers saying Congress should eliminate the financial penalty for people who sign up late. (5/15/06, New York Times)

The Truth On Part D Enrollment

Statement by Robert M. Hayes, President, Medicare Rights Center
No amount of exaggeration can disguise two central facts: over 80 percent of impoverished people with Medicare eligible for a comprehensive drug benefit have not been enrolled; nearly 51 percent of the people with Medicare who had no drug coverage on January 1st, still have no coverage. The Social Security Administration continues to report that just 1.7 million of the estimated 8.2 million people eligible for the low income subsidy have been enrolled. The Bush Administration has left behind the neediest Americans, the men and women who were supposed to benefit most from drug coverage. . . . The Bush Administration today has stated that 6 million people with Medicare lack drug coverage. But there are another 5.8 million people who the Administration recently decided to count as having drug coverage. These claims are without substantiation. Click here for full statement. (5/12/06)

Whether Medicare Drug Plans Can Drop Coverage for Certain Medications

Medicare plans previously were allowed to make changes to their drug formularies at any point in the year if they also provided notice to beneficiaries enrolled in the plan. However, the Bush administration recently implemented changes that prohibit drug plans from dropping medications that beneficiaries are taking unless the drug is found to be unsafe or if the plan covers a generic equivalent. (5/12/06, Kaiser Daily Health Policy Report)

Majority Of Beneficiaries Eligible For Low-Income Subsidies Have Not Enrolled In Medicare Rx Benefit, Study Finds

A report out today by Families USA, a liberal health care advocacy group, shows that only 24% of the 7.2 million people projected to be eligible for low-income subsidies have been approved. The participation rates vary from 12% in Arizona to 41% in Kentucky. (5/8/06, USA Today)

Other Medicare, Medicaid News

Coalition Urges Flexibility in Documenting Citizenship for Medicaid

In a letter, the American Hospital Association and seven other health care organizations asked Health and Human Services Secretary Mike Leavitt to allow "maximum flexibility" in the ways that Medicaid applicants can prove they are U.S. citizens. Section 6036 of the Deficit Reduction Act, which takes effect July 1, requires program applicants to show "satisfactory documentary evidence" of citizenship or nationality to qualify for benefits. The groups urged the secretary to use that authority to prevent "unintended enrollment barriers...for millions of low-income citizens who would otherwise meet all Medicaid eligibility requirements." (5/12/06)

OPINION: Financial Problems Of Medicare Make Tax Cut Extension IrresponsibleAn Irresponsible President: Deficits? Let the next White House worry.

SHEER COINCIDENCE: Last Monday, the Social Security and Medicare trustees released their annual depressing report. On Tuesday, congressional negotiators handed President Bush a "victory" -- his assessment -- in agreeing to extend his capital gains and dividend tax cuts. Mr. Bush and his fellow tax-cuts-above-all proponents would like you to believe that the two events are unrelated. But taken together they underscore the terrible fiscal predicament that Mr. Bush has chosen to bequeath to his successor. (5/8/06, Washington Post)

Health Insurance and Costs

The Check Is Not in the Mail
Insurance companies' tardiness or refusal to pay medical claims may add as much as 15 to 20 percent in overhead costs for the nation's physicians. (5/25/06, New York Times)

OPINION: Federally Funded Universal Coverage Will Help Businesses as Well as the Uninsured
Former U.S. Senator from South Dakota and 1972 Democratic presidential nominee George McGovern writes of his support for universal health care coverage. (5/22/06, Los Angeles Times)

OPINION: Legislative Compromise on Uninsured Requires a Broader Approach
Health care is one of America's most complex domestic problems, but the president and Congress have failed to "think big enough to forge comprehensive solutions," writes columnist Ronald Brownstein. (5/21/06, Los Angeles Times)

Former President Clinton Calls for a Gradual Shift to Universal Coverage
Former President Bill Clinton said health care spending was depressing the nation's competitiveness and called again for universal health coverage. (5/19/06, AP)

House Rodham Clinton To Introduce Bill Requiring State Medicaid Programs To Cover Family Planning Services, Resolution To Support Family Planning

Sen. Hillary Rodham Clinton said she would back a bill requiring state Medicaid programs to cover family planning services and supplies, and she and Rep. Nita Lowey announced that they plan to introduce a resolution this week expressing congressional support for family planning services. (5/19/06, Kaiser Women’s Daily Health Report)

New uninsured: The middle class
Once upon a time, (not so very long ago), not having health insurance was a problem for the working poor. Increasingly, it's a problem for workers on the next rung up the economic ladder, those who earn $20,000 to $40,000 a year. More working people across the nation are losing their health insurance because premiums have increased rapidly. That's leading many employers to stop offering the benefit. And that's a fast-moving threat to people at the lower end of the middle class. (5/18/06, Fort Morgan Times)

New Jersey Lawmakers Advance Bill Mandating Employer-Sponsored Health Care

A bill that would force large New Jersey employers to spend more on health care cleared the state Senate Labor Committee yesterday despite vehement objections from businesses. The measure targets companies that have at least 1,000 employees but don't pay a specified amount on health care for each worker. The amount would be phased in, reaching $3.30 an hour per employee in 2009, then annually adjusted for inflation. The money would go into a state fund to pay for treating the uninsured. Nearly one million New Jerseyans, including an estimated 250,000 children, lack health insurance. (5/18/06, Philadelphia Inquirer)

Tennessee Senate, House OK Cover Tennessee, a health care plan for the working poor
Gov. Phil Bredesen's signature legislative measure — Cover Tennessee, a health care plan for the working poor — passed in the Senate and the House Wednesday and will almost certainly be headed for the governor's desk in a matter of days. . . . Some Republican changes: Only U.S. citizens can tap into the plan; there are now incentives in the form of tax breaks for small businesses to use the insurance program. . . . A $150 monthly premium would be divided equally among the state, the employee and the employer. If the employer chooses not to participate, the individual would take over that share. In some ways, Cover Tennessee replaces TennCare, the state's insurance plan for the poor that was beset by out-of-control costs. Bredesen cut almost 190,000 people from the program last year. About 580,000 Tennesseans, 9.8% of the population, were reported to have no medical insurance even before those cuts. (5/18/06, The Tennessean)

Michigan Governor Announces Proposal To Cover All Uninsured Residents

Gov. Granholm unveiled a universal health care plan for Michigan on Thursday designed to cover all 1.1 million state residents who are currently uninsured.The proposal, patterned after a law recently passed in Massachusetts, is an expansion of a plan announced in January that would provide health coverage to the 550,000 Michiganians below 200 percent of the poverty level -- which is $38,700 for a family of four. Her new plan also would offer health care insurance to the working poor above that level who don't have coverage. The state would subsidize premiums on a sliding scale depending on family income. (5/18/06, Detroit News)

Small Businesses, Plagued by Rising Premiums, Retool Health Insurance Plans
Of the 45 million uninsured Americans, 60 percent are from families where the primary earner owns or works for a small business, reports this article examining strategies small businesses are using to combat the problem. (5/16/06, Chicago Tribune)

OPINION: Federal Government Should Support State Solutions to the Uninsured

Columnist E.J. Dionne recommends "enhancing the ability of states to solve problems that our current federal government won't confront," such as health care. (5/12/06, Washington Post)

Vermont Moves Closer to Universal Coverage

A "historic" health reform bill that would expand insurance coverage to about 30,000 uninsured Vermonters cleared a hurdle in the legislature and is waiting for a "promised signature" from Republican Governor Jim Douglas. 5/11/06, Burlington Free Press)

Target Corp. Plan to Shift to Employee-Funded Health Care Is Watched by Other Businesses
To offset soaring health costs, Target Corp. is offering employee-funded health savings accounts and is considering "taking the unusual step" of dropping traditional coverage altogether. (5/11/06, Minneapolis Star Tribune)

OPINION: Washington Post Columnist Chides Congress for Inaction on Health Care
Urging compromise, columnist Steven Pearlstein writes that a deal that would help small businesses buy affordable health care coverage would be possible, except that Congress lacks "the political will to get it done." (5/10/06, Washington Post)

Shopping for health care prices can be pretty confusing

From the president of the United States to the president of the biggest employer in town, it seems as if everyone is urging Americans to become better "shoppers" for health care. Get a high-deductible insurance plan. Open a health savings account. Call around and find the best deal on medical treatments, then pocket the savings. Sounds great: But just try it. (5/9/06, USA Today)

Other Health Issues

Upward Mortality

Nothing could hold my father back. Nothing except for the curse that is felling a generation of successful black men...The lifestyle, or "conditioning," argument blames obesity and inactivity, both of which happen to be more prevalent among African Americans. This same genes-versus-lifestyle debate applies to a range of deadly illnesses that disproportionately plague black America—and middle-class black America in particular. From heart disease to AIDS, African Americans are dying from preventable illnesses in disturbing numbers. (May/June 2006, Mother Jones)

Rising Diabetes Threat Meets a Falling Budget
Spending has been cut despite the growth of a disease that figures in the deaths of 225,000 Americans each year. (5/16/06, New York Times)

US Infant Mortality Rate Fails To Improve
Nearly 28,000 babies died before their first birthday, according to new infant mortality statistics for 2003 released by the National Center for Health Statistics (NCHS). The infant mortality rates showed no significant improvement in 2003 after increasing in 2002 for the first time since 1958. (5/12/06, Medical News Today)

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HEALTH ADVOCACY RESOURCES

May 31, 2006

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

Medicare, Medicaid and SCHIPS

Health Insurance, Health Costs, Health Care Reform

New Listings: Health Equity Issues

New Listings: 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

FLORIDA CHAIN WEB SITE RESOURCE UPDATE

Medicare Part D Consumer Fact Sheet on Getting Drugs After the Transition Period

Provided by US Dept. of Health and Human Services.

Provider’s Guide to Immigration Issues Regarding Florida KidCare

Florida CHAIN has posted The Refugee and Entrant Project's one page guide that answers many frequently asked questions about Florida KidCare that are specific to refugee families. For additional support, it also provides a list of Florida KidCare hotline numbers.

The Florida CHAIN web site now includes resource information in Spanish. To access, click here.

GRANTS AND FELLOWSHIPS

New grant listings

Agency for Healthcare Research and Quality -- Large and Small Conference Support

Deadlines: June 1 (Large Conference Programs)

June 20 (Small Conference Programs)

The Agency for Healthcare Research and Quality (AHRQ) is accepting applications for Conference Grant Funding Opportunity. The purpose of this program is to support conferences on the subjects of improving the quality, safety, efficiency and effectiveness of health care. Conferences eligible for support include: 1) research development; 2) design and methodology; 3) dissemination conferences; and/or 4) research training, infrastructure and career development conferences. Emphasis is placed on conferences that include plans for disseminating information and materials to audiences beyond participants in the meeting. Eligible applicants include domestic (U.S.) public organizations, such as governmental units and nonprofit and for-profit organizations. Large conferences are eligible for up to $100,000 and small conferences are eligible for up to $50,000.

Historically Black Colleges and Universities Grant Program
Letters of intent deadline: June 7
Application deadline: July 6
The purpose of the Centers for Medicare & Medicaid Services' Historically Black Colleges and Universities (HBCUs) Health Services Research Grant Program is to support HBCU researchers in carrying out health services research activities to meet the needs of diverse CMS beneficiary populations. This is the 10th year for the grant program.

American Dental Association Samuel Harris Fund for Children's Dental Health Dentistry Grant Program

Deadline: July 10

The Harris Fund will award competitive grants of up to $5,000 to applicants whose oral health promotion programs are designed to improve and maintain children’s oral health through community education programs. In 2007, a total of $210,000 will be available for the program. The grant program’s main objective is to help children whose socio-economic status impacts on their access to professional oral care and adversely affects their oral health habits at home. The program philosophy seeks to increase access to, and education on, oral health care by encouraging volunteerism in the health professions community. Proposals of up to $5,000.00 by community-based, not-for-profit, oral health promotion programs in the United States and its territories will be considered.

AcademyHealth Health Services Research (HSR) Impact Award
Deadline: July 28
AcademyHealth requests nominations of health services researcher that has made a positive impact on health policy and/or practice. The lead researcher of the winning impact will receive $2,000, and the research will be disseminated widely as part of AcademyHealth's ongoing efforts to promote the field of health services research and communicate its value for health care decision-making. The award will be announced at the 2007 National Health Policy Conference on February 12-13, and the winner will receive complimentary registration, travel and lodging to the conference.

Packer Policy Fellowships
Application deadline: August 15
On behalf of the Australian Department of Health and Ageing, The Commonwealth Fund announces this Australian-American health policy fellowship program. The Packer Policy Fellowships offer a unique opportunity for outstanding, mid-career U.S. professionals--academics, physicians, decision-makers in managed care and other private health care organizations, federal and state health officials, and journalists--to spend up to 10 months in Australia conducting original research and working with leading health policy experts on issues relevant to both countries.

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.

Continuing grant listings, in order of submission deadlines

Allegany Franciscan Ministries Palm Beach, Martin and St. Lucie Counties
Tau Grants Deadline: July 14
Ten Tau 2006 Palm Beach Region grants are anticipated, with amounts up to $5,000.
Lorraine Gallagher Freimann Healthcare Initiative Grants
Allegany Franciscan Ministries and Palm Healthcare Foundation make these funds available on an annual competitive basis to organizations providing services to underserved populations in Palm Beach County. They seek programs that remove barriers to healthcare access for underserved and indigent populations, focusing on language access and medical translation services and healthcare navigation for diverse communities. Look for a request for proposals in May.

American Heart Association, Clinton Foundation, Robert Wood Johnson Foundation to Help Schools Create a Healthier Environment for Nation's Students

Applications available July 1

The Alliance for a Healthier Generation has announced a new collaboration with schools to create environments that foster healthy lifestyles and prevent overweight and obesity among students. The Alliance works to address the issues that contribute to childhood obesity and to inspire all young Americans to develop lifelong healthy habits. The Robert Wood Johnson Foundation awarded the Alliance $8 million to support the Healthy Schools Program.

Robert Wood Johnson Foundation -- Local Initiative Funding Partners
Deadline: July 6 (Stage I)
Local Initiative Funding Partners (LIFP) is a partnership program between the Robert Wood Johnson Foundation and local grantmakers to fund projects to improve the health and health care of vulnerable people in their communities. Projects must be new, innovative, collaborative and community based, and must be nominated by a local grantmaker interested in participating as a funding partner. Up to $6 million in funding is available for 14 matching grants of $200,000 to $500,000. Eligible applicants are local funding partners, including independent and private foundations, family and community foundations, and corporate and other philanthropies.

Alzheimer’s or Related Dementia Group Respite Program Seed Grants

Deadline: July 6

The Brookdale Foundation's National Group Respite Program awards seed grants to organizations to develop and implement social model group respite programs. These day programs serve elders with Alzheimer's disease or related dementia and their family caregivers.

American Psychiatric Foundation Offers Grants for Mental Illness Public Education and Outreach
Deadline: September 1

The American Psychiatric Foundation, a charitable and educational subsidiary of the American Psychiatric Association, is making up to $750,000 in total grant funds available over the course of three years (2005-07) to fund public education, information, and outreach initiatives that promote the early recognition and treatment of mental illness. The foundation seeks to fund new and innovative ideas and programs that promote public awareness of mental illness, the effectiveness of treatment, and the importance of early intervention.

Blue Foundation for a Healthy Florida Winter 2006 Grant Cycle
Deadline: September 15
The Blue Foundation for a Healthy Florida supports philanthropic, community-based solutions that address many different health care challenges facing Florida both today and in the future. Grants will be awarded to improve program capacity and reduce barriers to access, with a particular focus on the uninsured and underserved. The Foundation will focus a significant portion of its resources to maximize impact in the area of community-based health clinics and outreach services. The Foundation awards up to $1 million annually. Grants range in size from $10,000 to $100,000. Eligible applicants include nonprofit organizations with 501 (c)(3) status and located in Florida.

CVS/pharmacy Accepting Applications for Community Grants Program
Deadline: October 31
CVS/pharmacy supports the communities it serves by offering nonprofit organizations the CVS/pharmacy Community Grant. The Community Grants program is currently accepting proposals for the following: 1) Programs targeting children under the age of 18 with disabilities that address any of the following: health and rehabilitation services; public schools promoting a greater level of inclusion in student activities and extracurricular programs; and creating opportunities or facilities that give greater access to physical movement and play. 2) Healthcare services for uninsured people. All CVS/pharmacy Community Grant applications must be submitted online between January and October of each calendar year.

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

Allegany Franciscan Ministries Capacity Building Scholarship

Allegany Franciscan Ministries will award, in Miami-Dade, Tampa Bay, and Palm Beach, Martin and St. Lucie areas, Capacity Building Scholarships throughout 2006 as long as funds are available. Scholarships of up to $300 may be requested to pay registration fees for conferences, seminars and other training opportunities for the staff and volunteers of nonprofit organizations in order to increase their capacity to deliver efficient and effective services to those in need. Organizations may submit scholarship applications at any time, preferably at least six weeks prior to the registration deadline of the conference or training program.

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.

ORGANZATIONS AND SERVICES

Newly posted resources are at the top of the list.

Medicare Rights Center (MRC) is a comprehensive independent source of health care information and assistance for older adults and people with disabilities. Multiple 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. Publications include:

Questions to Ask when Considering a Medicare Health Plan; What do I need to know about the new drug benefit if I am in a Medicare HMO or other private health plan?; Medicare: A National Treasure for 40 Years.

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.

Movement For Medical Privacy Grows In The USA

As Congress moves rapidly to build a national electronic health system, a coalition of 26 organizations representing constituencies across the political and ideological spectrum will urge the U.S. House of Representatives to build a patient-centered system with patient privacy rights at the core of any national HIT legislation. (Patient Privacy Rights Foundation)

MANUALS, GUIDES, TOOLKITS

Newly posted resources are at the top of the list.

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

Medicare Part D Consumer Fact Sheet on Getting Drugs After the Transition Period

Provided by US Dept. of Health and Human Services.

Fact Sheet Summarizes Medicaid and SCHIP Eligibility Rules for Immigrants

A new fact sheet from the Foundation's KCMU provides an overview of the current rules on immigrants' eligibility for Medicaid and the State Children's Health Insurance Program.

Medicare Rights Center Resources to Fix Part-D

MRC promotes fixing Part-D by making it available under Original Medicare and negotiating drug prices. Here are four resources to help educate others:

Presentation (Powerpoint) on Why We Need a Drug Benefit Under Original Medicare

"Part D - No Guarantee" Confusion Chart Flier

Why is the Privatized Part D Drug Benefit a Disaster?

The New Part D Prescription Drug Program: A Gamble for All Americans

Guide for Communicating with African-American Men about Prostate Cancer

Florida A&M University Center for Minority Prostate Cancer Training and Research has released a resource guide for health care providers, educators and researchers to assist in communicating with African-American men about prostate cancer screening, clinical trials and treatment. African-American men are 2.4 times more likely to die of prostate cancer when compared to White men. They also have the highest incidence of the disease compared to other racial/ethnic groups in the United States. The Center has received over $1M from the U.S. Army Department of Defense to study prostate cancer disparities experienced by African-American men.

Applying for the Low-Income Subsidy: A Tool Kit for Advocates
Access to Benefits Coalition provides these Tools You Can Use to help people apply for the extra help available through the new Medicare Prescription Drug Coverage.

Families USA is offering a new resource, 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.

2005-2006 Healthy Kids Marketing and Public Relations Tool Kit now available

Healthy Kids asks users to please forward updates on items used, including how they were used, numbers distributed and feedback on effectiveness. Call center staff need to be aware of any efforts so they know which items are out in each community and are prepared to address questions. To make changes or additions to any design or use the trademarked logos or phone numbers, prior approval is required to ensure that accurate information is distributed. Send requests to floyda@healthykids.org or fax to 850/224-0615.

Health Literacy Fact Sheets

This series of nine fact sheets was created for those who are designing patient education materials for consumers with low health literacy skills. The sheets define health literacy, describe its impact on health outcomes, provide strategies to prepare appropriate educational materials to assist low-literate consumers, and provide resources for additional health literacy information and publications.

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

Turning the Tide: Why Acting on Inequity Can Help Reduce Chronic Diseases, a tool kit now available from the Public Health Agency of Canada's Atlantic Regional Office, is designed to support the use of the document, The Tides of Change: Addressing Inequity and Chronic Disease in Atlantic Canada; A Discussion Paper. The package was produced for use by community organizations in examining their work and policies and contains a variety of hands-on resources for use in presentations and group discussions.

Trends and Indicators in the Changing Health Care Marketplace is an online chartbook that presents up-to-date information on key health care marketplace trends. The chartbook highlights national health expenditures, health care spending and costs, employee and retiree health coverage, HMO enrollment, hospital data, and public views on topics such as managed care, medical errors, and quality information.

TECHNOLOGY AND AUDIO/VIDEO RESOURCES

Audio Conferences and Webcasts

Dated events listed chronologically; standing webcasts listed last

Ask the Experts: Mental Health Care

June 1 2:00 pm

Live Webcast from Kaiser Network will feature a panel of experts addressing the significant number of people suffer from mental disorders in the U.S. who do not receive the treatment they need. They will answer questions about the financing and delivery of mental health care in the U.S. Send questions in advance to ask@kaisernetwork.org.

Operation Access: Providing Donated Outpatient Surgery to Uninsured People

June 15 ACHI audio conference

YMCAs and Hospitals: Successful Collaborations for Healthier Communities

July 20 ACHI audio conference

Policies and Procedures to Strengthen Community Benefit Accountability

Sept. 21 ACHI audio conference

Video/Forum to Assess Medicare Drug Benefit Implementation for Low-Income and Dual Eligible Beneficiaries

Explores key challenges in reaching low-income people on Medicare and reviews potential strategies for improving participation in the low-income subsidy program. Panelists discuss the early experiences of these beneficiaries and consider how to address ongoing challenges. A new video, produced by the Kaiser Family Foundation, Transitions 2006, which explores some of the issues and challenges experienced by dual eligibles, is also presented. (5/18/06, Kaiser Network)

The State of Latinos and HIV/AIDS in the United States

This Bienestar and AIDS Institute briefing allows members of Congress to learn more about the issues related to HIV/AIDS in the Latino community. Web page includes several power point presentations. (5/3/06, Kaiser Network)

Medicare Advantage: Early Views and Trendspotting Webcast
Alliance for Health Reform and Commonwealth Fund hosted this May 19 briefing on the Medicare managed care program, Medicare Advantage. These questions and others are discussed: Is the Medicare Advantage program now growing again after a period of declining enrollment? How do beneficiary costs in Medicare Advantage compare to costs for beneficiaries in the traditional fee-for-service program? Are the payments provided under the 2003 law being used to offer more comprehensive coverage for prescription drugs and other health benefits? For more information, please visit the Alliance's briefing Web site.

Families USA Conference Call Audio Playbacks

Throughout 2006, Families USA is holding a series of conference calls on a range of health care topics for state and local advocates. Interested, but can't make it? Don't worry. You can catch up on what you missed by listening to the audio playback. To listen to these conference calls, you will need RealPlayer or Windows Media Player. Click here for listening instructions.

ACHI Spring Training for Health Champions Conference Sessions
(March 14-16, 2006) Download and view more than 30 presentation files from the meeting.

Catholic Health Association/VHA Community Benefit Conference Session Presentations
This year's conference highlighted the core components of community benefit programming with a special focus on program evaluation, how to count community benefits and innovation in the field.

The Causes and Policy Implications of Rising Health Care Spending
Webcast of panelists at this Brookings Institution event discussing President Bush's health care policies that will expand the use of health savings accounts in an effort to place more responsibility on individuals.

Media Programming

Let's Just Play Go Healthy Challenge on Nickelodeon
The Alliance for a Healthier Generation believes that the best way to make kids healthier is to help THEM take charge of their own health. In partnership with Nickelodeon, the Alliance spreads the word about good health and motivates kids to join the Healthier Generation movement. The Let's Just Play Go Healthy Challenge was launched April 30th, with the introduction of four real children on their quest to eat better, play harder, and feel better.

How Hospitals Heal Themselves

A one-hour documentary airing on public television Spring and Summer 2006

Call your local PBS station for time of broadcast

This rare good news documentary reports on a surprising solution to escalating costs, unnecessary deaths and waste in America's hospitals. Doctors and nurses tell how they did their best, working overtime, while hospital conditions worsened. They were delighted to learn a new way to improve patient care dramatically and reduce unnecessary deaths, suffering, errors, infections and costs without additional resources or government regulations.

Remaking American Medicine?...Health Care for the 21st Century
Crosskeys Media® and Devillier Communications, Inc. announce a four-part series to be broadcast on PBS nationally every Thursday at 10 p.m. in October. Line-up and date for each show:

Silent Killer - October 5

Every year at least 98,000 Americans die - and countless more are injured - as a result of medical errors. This program begins by profiling the efforts of Sorrel King, whose 18-month-old daughter Josie was killed at one of the most respected hospitals in the world, Johns Hopkins.

First Do No Harm - October 12

This program focuses on the impact of medical errors in two hospitals and follows the efforts of physicians who are challenging their colleagues to live up to their oath to First Do No Harm. Confronts one epidemic of hospital-acquired infections that are shattering the lives of their victims.

The Stealth Epidemic - October 19

Chronic diseases like diabetes and congestive heart failure affect nearly 100 million Americans, and treatment of these illnesses consumes nearly 70 percent of all health care resources. Yet doctors are often unable to prevent needless suffering or even death, and these failures are threatening the viability of our entire health care system.

Hand in Hand - October 26

As medicine continues to become more and more technologically sophisticated and the systems that deliver medical care become more complex, the relationship between providers, patients and families is more important than ever.

"60 Minutes" Targets Hospitals' Billing of the Uninsured

"60 Minutes" segment transcript
"60 Minutes" responses to segment transcript

Web Sites, Web Features & Databases

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

State Web Resources

Florida Voter Registration Application Online
To apply to register to vote, fill in the PDF application online and print it out, or print the application and write in the information. Please use a black ballpoint pen. THE FLORIDA VOTER REGISTRATION APPLICATION REQUIRES AN ORIGINAL SIGNATURE. If the PDF application is filled in online, it must be printed out and signed prior to mailing.

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.

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.

DCF Offers Medicare Part D Powerpoints Re: Persons with Mental Illness
Florida Department of Children and Families has made available powerpoint presentations used on a December 2nd Video Teleconference sponsored by the Florida Department of Children and Families, Florida Agency for Health Care Administration and Florida National Alliance for the Mentally Ill. The first is an overview of the new Medicare Part D (pharmacy benefit), the second about Medicare pharmacy plans and the third about steps for low income Medicare beneficiaries to get extra help from Social Security in paying for pharmacy benefits. Other portals link to CMS for information about the Medicare Part D pharmacy plans, benefits and enrollment; and a Social Security website for low income persons who have Medicare ONLY and need to apply for extra help in paying for Part D pharmacy benefits. The Florida SHINE (Serving Health Insurance Needs of Elderly) program is a statewide, volunteer based program that provides free information, counseling and assistance on Medicare (including Part D), Medicaid and Medicare supplemental insurance. SHINE can be accessed at 1/800-963-5337.

Florida Kids insurance application can be done online

Families wanting to apply for the state's health insurance program for children can now apply online. Florida Healthy Kids has redesigned its Web site at www.healthykids.org to allow people to apply electronically for the KidCare programs, which include Healthy Kids, Children's Medical Services and MediKids. (2/16/06, Daytona News-Journal) More

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

National Web Resources

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.

Access to Care for People with Disabilities

New KaiserEDU.org Tutorial provides an overview of policy issues related to accessing health care for people with disabilities, as well as information on the types and prevalence of disabilities in the U.S., the major health care financing mechanisms, and the interaction of the Medicaid program with the ADA.

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

Guide to Health Insurance Options for Small Businesses includes a Small Business 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.

Health Coverage and the Uninsured - Updated Tutorial

Kaiser Commission on Medicaid and the Uninsured, this tutorial has been updated and expanded to include the latest national and state-level data on insurance coverage. It also now includes current policy proposals for expanding coverage to the uninsured and criteria for evaluating the different proposals.

Updated Fact Sheet on Medicaid's Role for Dual Eligibles

Kaiser Family Foundation's Commission on Medicaid and the Uninsured has updated a fact sheet on Medicaid's role in providing care to dual eligibles, low-income Medicare beneficiaries, and the transitioning of their prescription drug coverage from Medicaid to the new Medicare drug benefit.

Medicare/Medicaid Dual Eligibles Tutorial
This new narrated slide tutorial provides an overview of dual eligibles -- beneficiaries covered by both Medicare and Medicaid. The tutorial presents a profile of dual eligibles, reviews eligibility, benefits and financing for duals, and discusses their transition into the new Medicare prescription drug coverage program.

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.

Centers for Medicare & Medicaid Services (CMS) Medicare Part-D Resources
CMS fact sheet that addresses Medicare Part D and homeless clients
Recently revised Medicare Basics: A Guide for Families and Friends of People with Medicare

New Fact Sheet for Physicians on Part-D Transition Policy and Exceptions and Appeals Processes

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.

2006 Federal Poverty Guidelines

The Southern Institute on Children and Families, National Program Office for Covering Kids & Families has made available the 2006 Federal Poverty Guidelines. Compiled from the 2006 HHS Poverty Guidelines, these guidelines provide income levels for families at 50%, 100%, 125%, 133%, 150%, 185% and 200% of the Federal Poverty Level.

Primer on Low-Income Working Families

Many low-income working families live one health crisis or job setback away from catastrophe. Some barely make ends meet despite "playing by the rules," and more than 9 million working families with children lead this precarious existence. Yet, we know little about their dynamics. This Urban Institute web feature provides a foundation for better understanding this at-risk population.

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.

Videos

Public Health Foundation Media Resources

Several publications and videos related to minority health are now available through the Public Health Foundation's (PHF) online bookstore. Topics include: breastfeeding promotion in minority communities, epidemiology of diabetes, social determinants of health, neighborhoods and health disparities, as well as introductory Spanish for the healthcare worker. For a full list of resources on minority health, go to PHF's Learning Resource Center, click here.

PERIODICALS AND BOOKS

The National Center for Health Education (NCHE) is happy to share with you our May/June '06 Volume 5, Issue 3 of the NCHE Growing Healthy Youth, Parents and Communities (YPC) newsletter. This issue features information, activities and resources. You’ll also find activities for students, current health research, heath education resources, funding opportunities, upcoming events, and NCHE news. To receive notice of future issues directly, write jeanne@nche.org

Wellness Program Management Yearbook, Third Edition
The key ingredients for successful programs, comparative statistics, best practices in workplace wellness programs, how to motivate employees, "real-world" management methods, new and emerging trends in health promotion and disease prevention and what other companies are doing, all organized and compiled in this desk reference.

What Works in Tackling Health Inequalities?: Pathways, Policies and Practice Through the Lifecourse Studies in Poverty, Inequality & Social Exclusion
In recent years, tackling health inequalities has become a key policy objective in the UK. However, doubts remain about how best to translate broad policy recommendations into practice. One key area of uncertainty concerns the role of local level initiatives. This book identifies the key targets for intervention through a detailed exploration of the pathways and processes that give rise to health inequalities across the lifecourse.

Health Benefits Newsletter

Titles include: Variety of Strategies Needed to Curb Health Costs; Lower Medical Bills Through Health Coaching; Unveiling the True Cost of Health Care - For a Price; Obesity and Diabetes Rates Soar Among Hispanics, and Employers More Aware of Behavioral Risks.

Kaiser Family Foundation offers a weekly Medicare Q&A column that is being distributed by Knight Ridder/Tribune News. The column answers questions from readers related to the new Medicare drug benefit.

REPORTS AND STUDIES

New Listings

New Listings: Medicare, Medicaid and SCHIPS

Study Shows Need for Overhaul in How U.S. Manages Chronic Illness
Report Adds to Evidence that More Care is Not Better Care

A new report by researchers at Dartmouth Medical School finds striking variation in spending and resources used to manage care of chronically-ill elderly patients. Medicare could have saved $40 billion—or nearly one-third of what the government spent for patient care during a four-year period—if all U.S. hospitals practiced according to specific standards identified in the study. The authors call for overhauling the way America cares for people with chronic illness. (5/16/06, Dartmouth Atlas Project)

Medicare Beneficiary Out-of-Pocket Costs: Are Medicare Advantage Plans a Better Deal?

A new study found that in 19 out of 88 plans examined, people with Medicare Advantage plans who are in poor health spend more—up to $2,195 more—in annual out-of-pocket costs for their care than if they had Original Medicare plus a Medigap plan. (5/06, Commonwealth Fund)

Americans Locked Into Medicare-Approved Drug Plans That Refuse Assistance
People Must Be Allowed to Change Their Drug Plan

Older and disabled Americans must be allowed to switch out of Medicare private drug plans because confusion, misinformation from the government, and deceptive drug plan marketing practices have led many people to enroll in plans that do not cover their medications, reports the Medicare Rights Center. (5/06, Medicare Rights Center)

Rejected Prescription Claims Grew 24% with Medicare Part D

The number of rejected prescription claims grew by 24 percent between the fourth quarter of 2005 and the first quarter of 2006, a time period coinciding with the introduction of the Medicare prescription drug benefit, according to the latest research. The top reason, totaling 770,998 prescriptions, why people were not dispensed medicines under Medicare between January and March was because the prescriptions were not covered by the Part D plan. (May 2006, Wolters Kluwer Health).

New Listings: Health Insurance, Health Costs, Health Care Reform

Putting Healthcare Dollars Into The 'right' Prevention Services

A series of articles and commentaries address the need to channel resources into those areas of preventive care which will benefit the most people for each dollar spent. Former Surgeon General of the United States David Satcher, MD, chaired the National Commission on Prevention Priorities, which guided the approach used to rank these services. He writes, "Our intent was to identify preventive services that produce the greatest population health benefit and cost effectiveness in order to help inform decision makers at multiple levels about which preventive services are most valuable." (July 2006, American Journal of Preventive Medicine)

Millions Squandered In Unnecessary Tests Ordered In Routine Doctor Visits

More than one-third of U.S. adults undergo diagnostic tests for conditions for which they have no symptoms, which adds to health care costs and increases patient stress, according to a study in the June issue of the American Journal of Preventive Medicine. . . . Projecting that rate of occurrence across the U.S. population, the study estimates that the annual direct medical cost from inappropriate use of the three tests is between $47 million and $194 million. (5/22/06, Kaiser Daily Health Policy Report)

Coping with the health insurance blues: Growth In Number Of Small Businesses Offering High-Deductible Health Coverage

About 60% of the 45 million uninsured U.S. residents "come from families where the primary breadwinner owns or works for a small business," as "the percentage of small businesses offering coverage is plunging." Because of increasing insurance costs, "a growing percentage of small businesses are turning to insurance plans with deductibles of $1,000 or more for individual coverage and $2,000 or more for family coverage. (5/16/06, Chicago Tribune)

U.S. Health Care Spending Highest Among Industrialized Countries

The U.S. spent the most money on health care per capita among industrialized countries in 2003, according to a report published Tuesday in the journal Health Affairs. Researchers from Johns Hopkins University and Princeton University found that the U.S. spent $5,635 per person on health care in 2003 -- two-and-a-half times the $2,280 average among industrialized countries. U.S. spending was 48% higher than Norway, which was the second-highest spender per capita at $3,807. (5/10/06, Kaiser Network)

1% Of Americans Account For 22% Of Health Care Spending

Health care spending in the United States has remained heavily concentrated in a small portion of the total population, according to HHS' Agency for Healthcare Research and Quality. In addition, an increasing portion of these individuals remained in the highest-cost groups from one year to the next, according to data from 2002 and 2003. (5/06, Agency for Healthcare Research and Quality)

Why Do People Lack Health Insurance?

Forty-six million people--nearly one in five non-elderly adults and children--lack health insurance, an increase of 6 million since 2000. This brief looks at the reasons people report for being uninsured. The high cost of insurance is a rapidly rising concern for uninsured, whether old or young, healthy or disabled, with high incomes or well below the poverty line. (5/4/06, The Urban Institute)

Shifting Ground: Changes in Employer-Sponsored Health Insurance

The US health care system is based on employer-sponsored coverage with over 90 percent of privately insured individuals receiving coverage from their own or a family member's employer (US Census Bureau 2005). In this report we sue data from an ongoing federal survey of employers to examine trends in employer-sponsored health insurance coverage and take-up rates across all 50 states and the District of Columbia. (5/4/06, Robert Wood Johnson Foundation)

Snapshots: Health Care Costs

Series of online publications written by Kaiser staff that use charts, data and analysis to provide insight into the political and policy debates about the cost of health care in the United States. The publications are designed to encourage an informed policy discussion as leaders in Washington and across the country weigh strategies for controlling the rising cost of health care for people, businesses and government alike: Comparing Projected Growth in Health Care Expenditures and the Economy; Distribution of Out-of-Pocket Spending for Health Care Services

New Listings: Health Equity Issues

From Disparity to Difference: How Race-Specific Medicines May Undermine Policies to Address Inequalities in Health Care

On June 23, 2005, the U.S. FDA formally approved the heart failure drug BiDil to treat heart failure in "self-identified black patients." The drug itself is not actually new; it is merely a combination of two generic drugs that have been used to treat heart failure for over a decade. BiDil's newness derives primarily from its public presentation as the world's first ethnic drug. (5/16/06, Southern California Interdisciplinary Law Journal)

Medicaid's Role for Women
In recent years, there have been significant changes to Medicaid that have the potential to reshape program coverage for the nearly 19 million women who rely on the program. This policy forum focused on recent federal and state policies, including the federal Deficit Reduction Act and state waiver programs, and their impact on low-income women, who make up approximately 70% of Medicaid's adult beneficiaries. (5/11/06, Kaiser Family Foundation)

U.S. Newborn Survival Rate Ranks Low

America may be the world's superpower, but its survival rate for newborn babies ranks near the bottom among modern nations, better only than Latvia. U.S. ranking is driven partly by racial and income health care disparities. Among U.S. blacks, there are 9 deaths per 1,000 live births, closer to rates in developing nations than to those in the industrialized world. The researchers also said lack of national health insurance and short maternity leaves likely contribute to the poor U.S. rankings. Other possible factors in the U.S. include teen pregnancies and obesity rates, which both disproportionately affect African-American women and also increase risk for premature births and low birth weights. (5/9/06, CBS News)

Methods for Measuring Cancer Disparities: Using Data Relevant to Health People 2010 Cancer-Related Objectives
This report raises some conceptual issues and reviews different methodological approaches germane to measuring progress toward the goal of eliminating cancer-related health disparities.

New Listings: Other Health Issues

Many Adults Question Ability To Ensure Rx Drug Safety, Survey Indicates
Fifty-eight percent of U.S. adults rate the FDA’s ability to ensure the safety of new prescription drugs as fair or poor, compared with 37% in a 2004, according to a recently released May 12 and May 16 Wall Street Journal Online/Harris Interactive poll. 36% of respondents rated the ability of FDA to ensure the safety of new prescription drugs as good or excellent, compared with 56% in 2004. (5/24/06, Wall Street Journal)

Many Off-Label Uses For Rx Drugs Are Not Based On Solid Evidence

More than one of seven prescriptions for common drugs are for off-label uses lacking scientific support, a study out Tuesday suggests. According to a recent Archives of Internal Medicine study, medications prescribed for off-label uses account for about 20% of all prescriptions, and about three-fourths of those uses are not supported by scientific evidence. (5/23/06, USA Today)

Very Few Combat Stress Vets Referred For Treatment Or Evaluation
According to a new study by the US Government Accountability Office (GAO), only about 22% of Iraq and Afghanistan veterans with symptoms of post-traumatic stress disorder (PTSD) are ever referred for treatment or evaluation. Of 9,145 interviewed veterans who were considered at risk of suffering from PTSD, only 2,029 were referred for treatment or further evaluation. The report says approximately 5% of all veterans interviewed seem to have some kind of post-traumatic stress disorder. Who is referred for treatment is determined differently and depends which military service the veteran comes from. The report states that the US Defence Department does not guarantee treatment for all veterans who need it, for PTSD. (5/11/06, Medical News Today)

Florida Reports

Uninsured children hospitalized for injury die at a higher rate than children with coverage

This USF Health newsletter article describes Childhood Injury in Florida, 2002: A Report on Hospitalized Care & Prevention Information.

Florida KidCare’s web site has these reports for download: Florida KidCare Statewide Enrollment Trend, Title XXI Enrollment and Major Program Changes.

Grading State Systems for Adults with Serious Mental Illness
A National Alliance on Mental Illness report grades each state's public mental health system for adults with serious mental illness, and assigns the nation an overall grade of D. The report grades states on 39 criteria in the areas of infrastructure, information access, services and recovery based on a survey of state mental health agencies last October and November.

Medicare, Medicaid and SCHIPS

US Medicare Fund 12 Years From Running Out: Trustees
The U.S. Medicare trust fund will be exhausted in a dozen years, two earlier than forecast last year, because of increasing health care costs, the funds' trustees said in their report on May 1. The trustees predicted that general tax revenues would fund 45 percent of Medicare expenditures by 2012, with the remaining funding derived from payroll taxes and premiums paid by people with Medicare. The Bush administration has indicated the warning should trigger across the board cuts to Medicare reimbursement for doctors, hospitals and other providers.

The Center on Budget and Policy Priorities issued a statement, Regarding the Social Security and Medicare Trustees' Report stating, "The Trustees’ Report also provides further evidence that while Social Security faces a significant long-term problem, the problem is manageable — one that resembles a house with a leaking roof in need of repair rather than a boat headed for an iceberg." CBPP also published an analysis, Trustees' Report Will Focus Attention on Misguided Medicare "45-Percent Trigger"

Asclepios, a publication of the Medicare Rights Center, the largest Medicare advocacy organization, has stated in their response to the trustees’ report, "It is a phony ploy that is part of a campaign to undermine Medicare, the single most successful domestic program of the past 40 years."

Medicaid and the Deficit Reduction Act

Beginning July 1, 2006, millions of U.S. citizens enrolled in Medicaid will have to provide documentation to prove their citizenship status. This is an unprecedented change that could result in many eligible citizens being denied access to the health care services to which they are entitled. This new requirement is one of several damaging changes to the Medicaid program caused by the Deficit Reduction Act of 2005. It will especially hurt African Americans, who are disproportionately less likely to have the documentation necessary to prove their citizenship, states this Families USA Policy Analysis. S. 1932, Deficit Reduction Act of 2005

Medicaid Hospital Waivers in California, Florida, and Massachusetts

This publication provides side-by-side comparisons of three similar waivers recently approved by the federal government. For each waiver, it includes an examination of special terms and conditions, major actions, and unresolved issues related to financing of hospital services. A revision of an August 2005 study, this brief highlights major implementation challenges in the first year of the waiver. (4/06, California HealthCare Foundation)

An Early Look At Ten State HIFA Medicaid Waivers
An examination of ten Health Insurance Flexibility and Accountability(HIFA) demonstrations, a major Medicaid initiative of the Bushadministration, found that states have adopted varied programdesigns, reflecting their particular goals and circumstances.Nationally, it estimates that 300,000 people were covered underHIFA demonstrations as of Dec. 2005. Although this is asizable number, coverage has fallen far short of the 820,000expected. (4/06, Health Affairs)

Has Medicare Been Privatized? Implications of the Medicare Modernization Act, Beyond the Drug Benefit

Each [Part D] plan can, and typically does, differ on (a) cost sharing; (b) formulary (i.e., which drugs are covered); (c) pharmacy network; and (d) premiums. This set of choices has proven confusing to beneficiaries. In some cases, this may mean that seniors mistakenly join private plans for all benefits rather than prescription drug plans. It could also make the option of a single private plan that covers everything more appealing. Lastly, insurers may be offering drug-only products as a way to market for their private plan options. For example, Humana offers both types of plans and aims to ‘enroll and migrate’ enrollees from its drug plan to its "full benefit plan.” (2/06, Center for American Progress)

New Medicare Part-D Survey Finds Many Satisfied, Difficulties for Others

A new survey of 896 seniors 65 and older commissioned by the Medicare Rx Education Network found that while some Medicare Part-D beneficiaries are encountering difficulties in signing up, most find the benefit works well and is worth the time and effort once they are enrolled. Those enrolled in stand-alone plans report more difficulties: 58% said it was not difficult to sign up for a plan; 38% said it was difficult. Among those not yet enrolled, 59% of those surveyed said that choosing a plan is difficult, and 47% of those actively looking said they did not have enough information to make up their minds. Results indicated that beneficiaries need one-on-one counseling to help them identify a plan, transportation to resources, and other assistance.

Snapshot: Health Care Costs 101, 2006 Edition
Now in its third edition, this presentation provides a concise, visual snapshot of national health care spending trends for use by journalists, policymakers, or anyone interested in health care cost issues. Based primarily on National Health Expenditures data from the Centers for Medicare and Medicaid Services, the slides show how spending is distributed by type of service and illustrate growth in spending categories such as hospital services and prescription drugs. For the first time, it also examines how contributions from households, business, and government are blended to finance both public and private health coverage. (March 2006, California HealthCare Foundation)

50% Medicaid Enrollment Increase Over Last Five Years

USA Today reports that Medicaid enrollment increases over the last five years were over 50%, higher than any other major government program. According to the findings, Medicaid enrollment increased 50.4% from 2000 to 2005 and spending reached $198 billion. (3/13/06, USA Today)

Medicaid Provisions of the Deficit Reduction Act of 2005

Kaiser Family Foundation issue brief summarizing the Medicaid policy changes of the recently signed budget reconciliation law and discussing the potential impact for states and beneficiaries.

Medicaid Spending and Enrollment

Updated data on Medicaid spending and enrollment from Kaiser Commission on Medicaid and the Uninsured based on analysis of CMS data for FY2002 are now available by state and region. Total payments for all enrollment groups - children, adults, elderly, and individuals with disabilities - and payments per enrollee have been updated.

The Transition of Dual Eligibles to Medicare Part D Prescription Drug Coverage: State Actions During Implementation
This Kaiser Family Foundation publication is a survey of Medicaid officials assesses states' early experience in the transition of low-income seniors and people with disabilities enrolled in both Medicaid and Medicare (dual eligibles) to the Medicare Part D drug benefit. The survey covers the types of problems observed by states during the transition of dual eligibles, state actions to correct problems and ensure temporary coverage, and specific data on costs incurred by states from these temporary programs.

Turning Medicaid Beneficiaries into Purchasers of Health Care: Critical Success Factors for Medicaid Consumer-Directed Health Purchasing This State Coverage Initiative Issue Brief finds state policymakers interested in applying the concepts of consumer-directed care to the Medicaid program. Various models are emerging. These reforms fundamentally would alter the role of the state, the state’s expectations of Medicaid beneficiaries, and the behavior of participants. Consumer-directed health purchasing programs would create new opportunities and risks for Medicaid beneficiaries.

Families USA Report on Medicaid Part-D

This latest report found that the vast majority of new Medicare Part D beneficiaries already had prescription drug coverage before the program started earlier this year and, in an effort to downplay this situation, the Administration has significantly lowered its own enrollment projections. You can read the full report or a press release announcing the report.

Taking a Checkup on the Nation's Health Care Tax Policy: A Prognosis

statement before the US Senate Committee on Finance summarizes the latest data on who has health insurance and who doesn't, outlines the various tax subsidies that exist for health insurance, examines how those subsidies affect the market for health insurance and employment, and briefly comments on some reform options. (3/8/06, Urban Institute)

New State-By-State Data on Medicaid and SCHIP's Success in Reducing the Coverage Gap for Children

Georgetown University Health Policy Institute Center for Children and Families reports the surprisingly positive trends in coverage for children, largely due to Medicaid (and to a lesser extent, its smaller companion program, SCHIP), that provide affordable health insurance coverage to children in low-income families. However, there is significant variation across the states. Tables Methodology

A special report on Medicaid, by the Pew Center on the States, seeks to analyze the real-world experiences of states, highlight examples of what works and what doesn't, and inform a crucial policy debate that will affect the lives of millions of Americans. Federal policy has encouraged enrollment of Medicare beneficiaries in health plans, the majority of which are for-profit plans.

In Quality of care in for-profit and not-for-profit health plans enrolling Medicare beneficiaries, researchers from Harvard School of Public Health and Harvard Medical School report that not-for-profit health plans provided significantly higher quality of care to enrollees than for-profit plans on four important clinical services; breast cancer screening, diabetic eye examination, beta-blocker medication after heart attack and follow-up after hospitalization for mental illness.

Mathematica gives good marks in its report to Congress on the State Children's Health Insurance Programs (SCHIPs) that offer health care coverage to children in families with incomes up to 200 percent of the federal poverty level and beyond. In almost all areas examined – outreach, enrollment and access to services – the programs are succeeding.

Most studies of health coverage expansion policies focus on their potential national impact. Variations in the Impact of Health Coverage Expansion Proposals across States finds that federal strategies have greatly varied effects on different states with regard to economic characteristics, health care markets, and numbers of uninsured.

Two new reports provide the latest data on how much Medicaid spending is used to cover mandatory versus optional populations and services. Medicaid: An Overview of Spending on "Mandatory" vs. "Optional" Populations and Services, offers a brief summary of the data and a discussion. report, Medicaid Enrollment and Spending by "Mandatory" and "Optional" Eligibility and Benefit Categories” offers a more detailed examination.

Financing for the nation’s health care safety net is fragmented, and providers must knit together resources from many different funding sources to cover the costs of providing a broad range of services. Stresses to the Safety Net: The Public Hospital Perspective describes those sources of revenue, documenting that nearly 40 percent of all safety net revenues come from Medicaid.

Over the past few years, a number of states have implemented new or increased out-of-pocket costs for beneficiaries in their Medicaid, SCHIP, or other public programs. Increasing Premiums and Cost Sharing in Medicaid and SCHIP: Recent State Experiences reviews the key findings from this activity, including the impact on enrollment in public coverage programs, on providers, and on access to care.

Federal Budget/Health Care

The House Budget Committee’s New Budget Plan: A Brief Analysis

This Center on Budget and Policy Priorities analysis finds the House Budget Committee's budget plan harsher than the Senate plan in several respects. The House plan would cut funding for domestic “discretionary” (or non-entitlement) programs by $8.8 billion in fiscal year 2007 and $169 billion over five years, relative to CBO's current-services baseline. The plan also would reduce entitlement programs by $5.1 billion over five years. The savings from these program reductions would not, however, be used for deficit reduction. They would instead be used to offset a portion of the cost of the budget plan’s $228 billion in tax cuts, as well as its defense spending increases. The net result would be significant further increases in the deficit. The plan would increase the deficit over the next five years by $256 billion above what deficits would be if current policy was left unchanged.

Administration’s Fiscal Year 2007 Budget is Likely still to Leave SCHIP Coverage for Low-Income Children in Jeopardy finds that the Administration’s budget proposal will fall short of fully funding states’ needs for SCHIP funding in 2007 — and could lead more than 200,000 children to go without SCHIP coverage next year.

Center on Budget and Policy Priorities recent Budget Analysis reports:

Program Cuts in the President’s Budget: Cuts Grow Deeper Over Time and Will Hit States Hard

The President's budget proposes substantial cuts in funding for domestic discretionary programs over the next five years. The budget specifies the funding level for each program in 2007, but the levels for specific programs for years after 2007 — the years in which the overall level of reductions in domestic discretionary programs would grow substantially — are hard to discern from the budget documents the Administration released publicly. This analysis uses Administration materials not widely distributed — including a key Office of Management and Budget (OMB) computer run that apparently was released inadvertently — to show the multi-year impact of the proposed cuts on a number of important domestic discretionary programs. Summary or Full Report with program cuts by state.

The Skewed Benefits of Tax Cuts 2007-2016: If the Tax Cuts Are Extended, Millionaires Will Receive More than $600 Billion over the Next Decade

Administration Defense of Health Savings Accounts Rests on Misleading Use of Statistics

The Cost and Coverage Impact of the President’s Health Insurance Budget Proposals finds that the Administration's proposals to expand tax breaks for Health Savings Accounts (HSAs) would cause a net increase in the number of uninsured Americans.

Analysis of Medicaid Provisions in the Bush Administration 2007 Budget explains how most of the provisions in the budget, which include both legislative proposals and regulatory changes that the Administration is planning to make without legislative action, will shift Medicaid costs to the state. These funding cuts are on top of the significant federal Medicaid cuts enacted as part of the budget reconciliation bill signed into law.

The Administration’s Medicaid Proposals Would Shift Federal Costs to States finds that more than four-fifths of the Medicaid savings proposals in the Administration’s new budget would reduce federal Medicaid expenditures by shifting costs directly to the states. This likely would lead some states to scale back their Medicaid programs significantly by restricting eligibility and reducing coverage.

New Congressional Budget Office Estimates Indicate Millions of Low-Income Beneficiaries Would Be Harmed by Medicaid Provisions in Budget Bill

Health Insurance, Health Costs, Health Care Reform, Budget

Study Heralding the Start of Cover the Uninsured Week
An analysis of government data by the Robert Wood Johnson Foundation which sponsors Cover the Uninsured Week, found that cost prevented 41.1 percent of uninsured adults from seeing a physician, compared to 9.2 percent of those with insurance.

Uninsured Number Increases

Cover the Uninsured Week released a new report that confirms there is a significant gap in the amount of health care accessed by people who do and do not have health care coverage in every state and the District of Columbia. Nationally, uninsured adults are nearly four times more likely not to see a doctor when they need to compared to people who have health coverage.

Study Finds More Workers Are Dropping Health Coverage
A recent 42 percent jump in health premiums is forcing more American workers to turn down coverage offered by their employers. (5/5/06, AP/Reuters)

Gaps in Health Insurance: An All-American Problem

Findings from the Commonwealth Fund Biennial Health Insurance Survey show that, while lack of insurance continues to be highest among families with incomes under $20,000, uninsured rates for moderate- and middle-income earners and their families are rising, putting their health and financial security at risk. (4/06, Commonwealth Fund)

The Coverage Gap: A State-by-State Report on Access to Care
Using data from the Centers for Disease Control and Prevention's 2004 Behavioral Risk Factor Surveillance System (BRFSS) – a national survey of preventive and health risk behaviors – the researchers analyzed health disparities between insured and uninsured adults. Using data from the US Census Bureau Current Population Survey from 1994, 1995, 1999, 2000, 2004 and 2005, they also looked at the number of Americans age 50-64 that are without health care coverage. The report is being released to launch Cover the Uninsured Week, the largest mobilization in history to promote health coverage for all Americans.

Sharp Rise in Out-of-Pocket Spending on Healthcare for American Families
New statistics from the Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) underscore how rapidly rising healthcare costs are eating into the budgets of America's families. Data from AHRQ's Medical Panel Expenditure Survey (MEPS) show that the percentage of Americans under age 65 whose family-level out-of-pocket spending for healthcare, including insurance, exceeds $2000 a year rose from 37.3% in 1996 to 43.1% in 2003 -- a 16% increase. (5/3/06, Medscape)

Half of Young Adults Are Uninsured at Some Point, Survey Finds
A new government survey found that half of all young adults in the U.S. are uninsured; more than 15 million Americans were uninsured for four years in a row; the poorest Americans are the least likely to be covered; and Hispanic Americans are the ethnic group most likely to be uninsured, according to a report released last week by the Agency for Healthcare Research and Quality. (4/18/06, Reuters)

More States Extend the Age at Which Children Can Still Be Covered by Parents' Insurance
The Wall Street Journal examined laws being passed in a growing number of states that require health insurers to maintain the coverage of adult-age children under their parents' policies. (4/11/06, Wall Street Journal)

Cancer Patients Who Are Uninsured Have a Higher Risk of Dying, Study Finds
Uninsured adults with cancer face a 25 percent greater chance of dying than cancer patients with health care coverage, according to a study by the Intercultural Cancer Council. (4/26/06, Chicago Sun-Times)

Kaiser Family Foundation Reports & Chartbooks on the Uninsured

Health Coverage in America, 2004 Data Update

Employer Health Benefits 2005 Annual Survey

Sicker and Poorer: The Consequences of Being Uninsured

The Cost of Care for the Uninsured: What Do We Spend, Who Pays, and What Would Full Coverage Add to Medical Spending?

Threadbare: Holes in America’s Health Care Safety Net

Challenges and Tradeoffs in Low-Income Family Budgets: Implications for Health Coverage

Three Reports on Enrollment and Outreach for Public Health Coverage Programs

In a Time of Growing Need: State Choices Influence Health Coverage Access for Children and Families

Opening Doorways To Health Care For Children

Outreach Strategies For Medicaid And SCHIP

Health Care Coverage in America: Understanding the Issues and Proposed Solutions

includes a corresponding PowerPoint presentation. (Cover the Uninsured)

Guide to Health Insurance Options for Small Businesses

includes a Small Business PowerPoint presentation. (Cover the Uninsured)

The Community Safety Net and Prescription Drug Access for Low-Income, Uninsured People

While the new Medicare drug benefit has helped alleviate concerns about prescription drug access for elderly and disabled Americans, many low-income, uninsured people under age 65 continue to rely on community safety nets to get needed medications. As the number of uninsured Americans increases, safety net providers are stretching limited resources to meet growing prescription drug needs. (4/06, HSC)

The Struggle to Provide Community-Based Care to Low-Income People With Serious Mental Illnesses

This paper describes gaps in services for low-income people with serious mental illnesses as reported by mental health professionals and other observers in twelve U.S. communities. According to respondents, service gaps have grown in recent years—especially for uninsured people—as a result of state budget pressures and Medicaid cost containment policies. (4/06, Health Affairs)

Five New Kaiser Family Foundation Reports Explore Long-Term Care Issues Included in the Deficit Reduction Act

The Deficit Reduction Act of 2005, which became law this February, includes several significant changes to Medicaid long-term care policies. The Kaiser Family Foundation's Commission on Medicaid and the Uninsured has released five new reports on long-term care issues that were addressed by the DRA changes. Long-term care accounts for 36 percent of Medicaid spending (over $100 billion annually) and is utilized by many of Medicaid's most costly beneficiaries, the low-income elderly and individuals with disabilities. (4/17/06, KFF)

Revived House Budget Plan Would Cut Domestic Programs Yet Increase Deficits
This Center for Budget and Policy Priorities analysis finds that: 1) The plan would cut 2007 funding for domestic discretionary programs $12 billion below the Senate-passed level; 2) The plan would allow much larger tax cuts in 2007 through 2010 than are currently allowed; and 3)Despite its proposals to reduce domestic programs, the plan would increase the deficit by $254 billion over five years, because of the effect of its tax cuts and defense spending increases.

Massachusetts Health Reform
On April 4th, by overwhelming margins, the Massachusetts House and Senate voted to approve legislation that will extend health insurance coverage to hundreds of thousands of Massachusetts residents. At the same time, the legislation leaves many critical questions about the scope and cost of benefits and the obligations of individuals to purchase coverage unanswered. Already commentaries are flying— some are calling the bill a national model, others unconscionable and misguided. This Community Catalyst report looks at: What does the MA legislation really do? What are the factors that led to its passage? What are the important unknowns? What are the lessons for other states?

Articles Examine Community-Based Coverage Initiatives

Five articles published by Health Affairs highlight community approaches to providing care for the uninsured. (4/11/06)

A Brief Overview of the Major Flaws With Health Savings Accounts

This Center for Budget and Policy Priorities analysis finds that the Administration's proposals for substantial new HSA tax subsidies — and HSAs in general — suffer from several serious problems, including weakening the existing health insurance and increasing the number of uninsured; shifting risks to individuals, leaving those less healthy to face substantial costs with potential worse health outcomes; little potential to improve the health insurance system; increasing the federal budget deficit for decades to come; and providing the largest tax breaks to those who least need help paying for health coverage. (4/5/06)

Few U.S. Adults Are Willing to Pay Significantly Higher Premiums for Superior Care

A new Wall Street Journal Online/Harris Interactive Health-Care Poll shows that many U.S. adults believe it is fair to assess healthcare quality, but they are ambivalent and confused about whether or not payments to doctors and hospitals should be linked to quality metrics...only one in five (19%) adults think it would be fair for patients to pay more to be treated by medical groups or hospitals that have been shown to provide better care, and fewer adults (14%) say they themselves would be willing to pay a significantly higher premium for such care. (4/4/06, Harris Interactive Poll)

Medication Assistance Program Unveils Database of Free Clinics

Officials from the Partnership for Prescription Assistance, a national clearinghouse designed to connect patients with programs that help them pay for their drugs, said at a news conference in Greensboro Wednesday that it had launched a national database of free health clinics. The clinic database is designed to help people who call the organization or visit its Web site find local doctors. (4/3/06, The Business Journal of the Greater Triad Area)

Most ER Patients Are Insured, Study Says

The uninsured, long blamed for crowding in the emergency room, account for 15% of visits.

Challenging a common notion that uninsured patients are clogging hospital emergency rooms, a new study has found that the vast majority of adults who turn up there frequently have health insurance and regular doctors... Emergency visits increased 26% between 1993 and 2003, according to the Centers for Disease Control and Prevention. "It is the only door that is open 24 hours," said Brian Johnston, the medical director of the emergency department at White Memorial Medical Center in Boyle Heights. (3/29/06, Los Angeles Times)

The Long-Term Uninsured in America, 2000-2003: Estimates for the US Population under Age 65
When estimating the size of the uninsured population, it is important to consider the distinction between those uninsured for short periods of time and those who are uninsured for several years. (March 2006, Medical Expenditure Panel Survey of the Agency for Healthcare Research and Quality)

Congress's Policy Priorities: Assessing Health Care Experts' Views

Expanding coverage of the uninsured should be Congress' top health policy priority, says a majority of respondents to the Fund's latest Health Care Opinion Leaders survey. Leaders also say that a good way to expand coverage is to let individuals and small businesses buy into the Federal Employees Health Benefits Program or a similar option. (3/24/06, Commonwealth Fund)

How States Are Cutting Pharmacy Costs without Limiting Access

Many states believe that clinical evidence about drug effectiveness can be used to curtail pharmacy costs, while also ensuring that beneficiaries have access to their medications. A new Fund issue brief explains how six states are doing it. (3/23/06, Commonwealth Fund)

The Commonwealth Fund Health Care Opinion Leaders Survey: Assessing Congressional Policy Priorities

Expanding coverage to the uninsured should be Congress's top health care policy priority for the next five years, say a majority of respondents to the latest Commonwealth Fund Opinion Leaders survey--just as they said a year ago when asked about health care policy priorities. Leaders also agreed, once again, that one of the best ways to expand coverage to the uninsured is to allow individuals and small businesses to buy into the Federal Employees Health Benefits Program or a similar federal group option. [Jan-Feb 2006, Harris Interactive Survey)

US Physician Charity Care Continues Decade-Long Decline

The proportion of US physicians providing charity care dropped 8 percentage points in the last decade, falling to 68 percent of physicians in 2004-05 from 76 percent in 1996-97, according to a national study released by the Center for Studying Health System Change. The drop in physician charity care occurred as the number of uninsured Americans grew to 45.5 million in 2004, signaling growing stress on the health care safety net. (3/23/06, Center for Health System Change)

Advocacy group to post hospitals' pricing policies for the uninsured

Consejo de Latinos Unidos (Council of United Latinos) announced plans to establish a Web site where it will post hospitals' pricing policies for the uninsured and monitor whether hospitals are complying with and informing uninsured patients about their discount and pricing policies. Consejo has close ties to Archie Lamb, a class-action trial lawyer who along with Richard Scruggs has sued hundreds of hospitals across the country challenging hospitals' tax-exempt status and alleging unfair billing and collection practices. Nearly all of the federal lawsuits have been dismissed or withdrawn. (3/16/06, American Hospital Association NewsNow)

Dimensions of the Local Health Care Environment and Use of Care by Uninsured Children in Rural and Urban Areas Despite concerted policy efforts, a sizeable percentage of children lack health insurance coverage. This article examines the impact of the health care safety net and health care market structure on the use of health care by uninsured children [and concludes that U]ninsured children had low levels of utilization over a range of different health care provider types and settings. (3/06, Pediatrics)

Health and Well-Being of Children: A Portrait of States and the Nation 2005

The National Survey of Children's Health, conducted (by the National Center for Health Statistics of the CDC) for the first time in 2003, addresses multiple state and national aspects of child health as well as aspects of the family and the neighborhood that can affect children's health.

Health Care Reform: 2006 Perspectives
The Commonwealth Fund-supported research provides perspective on approaches to addressing the issues of health care costs, quality and coverage, and details promising innovations to help the U.S. move toward a truly high-performance health care system.

State of the States: Finding Their Own Way on Health Coverage, a Robert Wood Johnson Foundation program that works with states to expand health insurance coverage, today issued its latest annual "State of the States" report, summarizing strategies states are implementing or considering to expand health coverage.

Rising Out-of-Pocket Spending for Medical Care: A Growing Strain on Family Budgets

Since the late 1990s, accelerated growth in health care spending has translated into increased burdens on family budgets. In 2001–02, an average of 13 million families per year had direct out-of-pocket (OOP) costs equal to or exceeding 10 percent of family income. When premium costs are added into the equation, even more families are devoting a substantial share of resources to health care expenses. From the Commonwealth Fund.

Health Coverage for Aging Baby Boomers

Rising out-of-pocket health care costs and sluggish wage growth threatens workers' ability to save for retirement. This is particularly true for adults ages 50 to 64, or "baby boomers," whose per capita health care expenditures are more than twice those of younger adults. This January 2006 published analysis of The Commonwealth Fund Survey of Older Adults found: older adults have high rates of chronic health conditions; many have unstable insurance coverage; those who have low income, individual coverage, or no insurance spend a substantial share of their income on coverage and health care and have reduced access to care.

A recent Urban Institute report, Lowering Financial Burdens and Increasing Health Insurance Coverage for Those with High Medical Costs, reviews evidence that the health care system is doing a poor job of ensuring care for those who most need it and offers options for subsidizing health care coverage for high-cost, high-risk populations.

Young adults are one of the largest and fastest-growing segments of the U.S. population without health insurance. They often lose coverage under their parents' policies at age 19 or when they graduate from high school or college. The updated Rite of Passage: Why Young Adults Become Uninsured and How New Policies Can Help suggests several policy changes that could extend coverage to uninsured young adults.

Health Equity Issues

Making Disparities Disappear: Using Nationally Tested Tools for Community-Based Action
Today, while the overall quality of healthcare delivered in America is slowly improving, large segments of our population continue to experience disparities in the quality of healthcare they receive. For example, as seen in the third annual National Healthcare Disparities Report recently published by our agency, Hispanics received poorer quality of care than whites in 53% of the most important measures; blacks received poorer quality of care in 43% of these measures; and American Indians and Alaska Natives received poorer quality of care in 38% of the key measures. (5/1/06, Medscape)

The Concentration of Negative Child Outcomes in Low-Income U.S. Neighborhoods

At the end of the 20th century, one in every five children in the United States lived in neighborhoods in which at least 20 percent of the population lived in poverty. Research has shown that children growing up in poor neighborhoods are at higher risk than children of affluent communities for health problems, teen pregnancy, dropping out of school, and other social and economic problems. And researchers often make reference to a "critical threshold" of neighborhood poverty, a percentage beyond which negative outcomes for families and individuals increase exponentially. (3/06, Population Reference Bureau)

New Cross-National Comparisons of Health Systems: U.S. Ranks Lowest in Patient Surveys, Has Greatest Inequity for Lower-Income Patients

Despite spending more than twice as much per capita as other countries do on health care, the U.S. health care system ranks lower than several other countries in patients' perspectives of the safety, efficiency, equity, and patient-centeredness of health care. The U.S. scored well on effectiveness of care, especially preventive care. However, the U.S. also stands out for having wide and pervasive health care disparities based on income. (4/4/06, Commonwealth Fund)

Racial Differences in Trust in Health Care Providers

Background Although trust in health care providers (physicians, nurses, and others) may be lower among African Americans compared with whites, limited information is available on factors that are associated with low trust in these populations. This study evaluated the association between trust in health care providers and prior health care experiences, structural characteristics of health care, and sociodemographic factors among African Americans and whites.(4/24/06, Archives of Internal Medicine)

America's 'Near Poor' Are Increasingly at Economic Risk, Experts Say
Americans on the lower rungs of the economic ladder have always been exposed to sudden ruin. But in recent years, with the soaring costs of housing and medical care and a decline in low-end wages and benefits, tens of millions are living on even shakier ground than before, according to studies of what some scholars call the "near poor." "There's strong evidence that over the past five years, record numbers of lower-income Americans find themselves in a more precarious economic position than at any time in recent memory," said Mark R. Rank, a sociologist at Washington University in St. Louis and the author of "One Nation, Underprivileged: Why American Poverty Affects Us All." (5/8/06, New York Times)

Views on Hospital Community Benefit from a Recent Survey
Perhaps a reflection of the growing public demand for public accountability from not-for-profit hospitals, community-benefit programs are expanding and partnering with more community organizations, according to a recent survey by CHA and VHA. Still, lack of financial and human resources as well as support from top leadership continues to stymie the fledgling programs, although they are getting more internal support than in past years. (5/8/06, Modern Healthcare)

Hospital Pricing Transparency
Hospitals are committed to sharing information that will help people make important decisions about their health care. Hospital prices can vary based on patient needs and the services they use; prices reflect the added costs of hospitals' public service role – like fire houses and police stations – serving the essential health care needs of a community 24 hours a day. The objectives of this position paper include: creating common definitions and language to describe pricing information for consumers; explaining how and why the price of care can vary, and encouraging the consideration of price as only one of several influencing health care decisions. (4-29-06, AHA Position Statement)

Better Health Care Doesn't Erase Racial Gap
Efforts to improve health care quality can help reduce some - but not all - of the inequalities in medical care provided to black patients compared with whites, a new study shows. Four years after launching a program to improve the quality of diabetes care, a large Boston-based physician group found that racial disparities in cholesterol screening were reduced, but blacks remained less likely than whites to be taking statins to get their LDL ("bad") cholesterol down, or to have their blood sugar under long-term control. (4/7/06, Reuters)

US Ranks Poorly on Many Measures in Cross-National Patient Surveys

This report, based on two cross-national surveys, finds that the U.S. health care system scores well on effectiveness from a patient perspective but is viewed poorly on many other measures, including safety and equity. (4/4/06, Commonwealth Fund)

Lower Income Linked with Poorer Care Experiences

An analysis of patient survey data by the Fund finds that U.S. adults with below-average income fare worse than those with above-average income on 21 of 30 measures of primary care access, coordination, and doctor–patient relationships. (4/4/06, Commonwealth Fund)

Health Disparities and Health Equity: Concepts and Measurement

There is little consensus about the meaning of the terms "health disparities," "health inequalities," or "health equity." The definitions can have important practical consequences, determining the measurements that are monitored by governments and international agencies and the activities that will be supported by resources earmarked to address health disparities/inequalities or health equity. This paper aims to clarify the concepts of health disparities/inequalities (used interchangeably here) and health equity, focusing on the implications of different definitions for measurement and hence for accountability. (April 2006, Annual Review of Public Health)

New Resources on Coverage, Quality, and Efficiency

The Fund's Commission on a High Performance Health System has released a new series of briefs on key topics in health policy, such as health insurance coverage, health care costs and spending, and the drive for a higher-performing health system. (3/28/06, Commonwealth Fund)

Prescription Monitoring May Increase Racial Gap in Access to Care

A program designed to reduce inappropriate benzodiazepine prescribing had the unintended consequence of increasing racial disparities in access to care, according to a report in the Archives of Internal Medicine for March 13th. "This is the first well-controlled study to show that health policies designed to reduce drug costs and abuse can increase racial disparities in access to effective care for those with chronic illnesses, like schizophrenia," lead author Dr. Sallie-Anne Pearson, from the University of New South Wales in Sydney, Australia, said in a statement. (3/13/06, Reuters)

Quantitative Techniques for Health Equity Analysis: Technical Notes

Have gaps in health outcomes between the poor and better off grown? Are they larger in one country than another? Are health sector subsidies more equally distributed in some countries than others? Is health care utilization equitably distributed in the sense that people in equal need receive similar amounts of health care irrespective of their income? Are health care payments more progressive in one health care financing system than another? What are catastrophic payments? How can they be measured? How far do health care payments impoverish households? (2006, The World Bank)

Jobs Lacking Coverage Biggest Reason for Immigrants' Low Insured Rates, in Economic Research Initiative on the Uninsured This research highlight examines a study "Immigrants and Employer-Provided Health Insurance," finding immigrants almost three times more likely to be uninsured than native-born U.S. citizens. The primary reason for the difference is that more immigrants work for employers that do not offer health insurance. The research highlight includes a Q&A "Research Highlight: Jobs Lacking Coverage Biggest Reason for Immigrants' Low Insured Rates." (March 2006)

Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business

The range of diseases and conditions for which there are differences spans virtually all biomedical disciplines. There are complex, interrelated social, economic, behavioral, health care and other environmental aspects - and the differences, their features, and the roles of contributing factors vary among affected populations and subpopulations. The review committee sees the opportunity and need for NIH to focus even more on health disparities as a research entity and move knowledge and understanding forward as no other agency or setting can. (Board on Health Sciences Policy 2006 US National Academies of Sciences)

Latino Health Care Is Being Left Behind

The recent National Healthcare Quality Report from the U.S. Department of Health and Human Services found that overall quality of care for Americans improved at a rate of 2.8 percent. It sounds small, but that's actually quite impressive for a nationwide improvement. For Latinos, however, quality of care worsened. (3/21/06, San Francisco Chronicle)

Latino Doctors Partner with HHS to Tackle Health Disparities

To tackle health disparities and soaring obesity and diabetes rates among Latinos, the National Hispanic Medical Association is partnering on an initiative with the U.S. Department of Health and Human Services' Office of Minority Health (OMH) to develop leadership training, education and outreach programs to improve Hispanic health. (3/20/06, Hispanic PR Wire)

A Randomized, Controlled Trial of the Effectiveness of Community-Based Case Management in Insuring Uninsured Latino Children

Uninsured children were assigned randomly to an intervention group with trained case managers or a control group that received traditional Medicaid and State Children’s Health Insurance Program (SCHIP) outreach and enrollment. Case managers provided information on program eligibility, helped families complete insurance applications, acted as a family liaison with Medicaid/SCHIP, and assisted in maintaining coverage. Intervention group children were significantly more likely to obtain health insurance and had 8 times the adjusted odds of obtaining insurance. (12/05, Pediatrics)

Who Is at Greatest Risk for Receiving Poor-Quality Health Care?

American adults frequently do not receive recommended health care. The extent to which the quality of health care varies among sociodemographic groups is unknown. The study used data from medical records and telephone interviews of a random sample of people living in 12 communities to assess the quality of care received by those who had made at least one visit to a health care provider during the previous two years. The differences among sociodemographic subgroups in the observed quality of health care are small in comparison with the gap for each subgroup between observed and desirable quality of health care. (3/16/06, New England Journal of Medicine)

New England Journal of Medicine Faces Challenge from Health Experts

Researchers, advocates and lawmakers question study that minimizes race-based health disparities (3/16/06, Applied Research Center)

Health Status of Children in Immigrant Families

Children who are born in the United States to noncitizen parents, foreign-born children with noncitizen parents, and foreign-born children who are naturalized citizens are all likely to have limited access to health insurance and health care. (April 2006, American Journal of Public Health)

Burden of Disease Associated with Being African-American in the United States and the Contribution of Socio-Economic Status

The burden of disease associated with being African-American in the US, and the contribution of socio-economic status (SES) to that burden have not been quantified. The study found SES differences between African-Americans and whites appeared to explain all the Health Related Quality of Life disparity but only half the mortality disparity. Better understanding of the disparate effects of SES may inform interventions to address health disparities adversely affecting African-Americans. (May 2006, Social Science & Medicine)

Methods for Measuring Cancer Disparities: A Review Using Data Relevant to Healthy People 2010 Cancer-Related Objectives

Healthy People 2010 has two overarching goals: to increase the span of healthy life and to eliminate health disparities across the categories of gender, race or ethnicity, education or income, disability, geographic location, and sexual orientation. This report raises some conceptual issues and reviews different methodological approaches germane to measuring progress toward the goal of eliminating cancer-related health disparities.

Reaching an Immigrant Population

Saint Francis Medical Center listened to its Latin American immigrant community and answered with a number of innovative programs to improve communication, services and wellness. (March 2006, Hospitals & Health Care Networks)

Social Determinants of Health and Nursing: A Summary of the Issues
It is well-established that poorer people have substantially shorter life expectancies and This Canadian civil service study compared the health status of individuals over time with their position in a well-defined job hierarchy. Those lower in the hierarchy experienced three times the risk of death from heart disease, stroke, cancer, gastrointestinal disease, accident and suicide compared with those at the top of the hierarchy.

Stretching the Safety Net to Serve Undocumented Immigrants
A small but increasing proportion of immigrants to the United States is undocumented. This Health System Change Issue Brief found that because most undocumented immigrants lack health insurance, they primarily rely on safety net providers for care. Communities with more developed safety nets and historically large numbers of immigrants appear more adept at caring for both legal and undocumented immigrants.

The 2005 National Healthcare Quality Report (NHQR) and 2005 National Healthcare Disparities Report (NHDR) are now available on AHRQ's Web Site. The 2005 NHQR is a comprehensive national overview of quality of health care in the United States. The 2005 NHDR tracks disparities in both quality of and access to health care in the United States for both the general population and for congressionally designated priority populations.

Few Hospitals Use Patients' Race, Ethnicity and Language Data to Improve Quality of Care
Health care stakeholders urge all U.S. hospitals to use patient data to improve the quality and consistency of care their patients receive. The study was conducted by the National Public Health and Hospital Institute with support from the Robert Wood Johnson Foundation.

Other Health Issues

The Oral Health of Children A Portrait of States and the Nation 2005

The Health Resources and Services Administration presents this chartbook highlighting the major findings of the National Survey of Children's Health on children's oral health. This survey, the first of its kind, presents national- and State-level information on the health and well-being of children and their use of health services, including oral health and dental care. The survey includes many positive findings about children's oral health.

Federal Monitoring System Underestimates Work-Related Injury And Illness, USA
(4/06, Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine)

A Tree in the Storm: Philanthropy and the Health of the Public

"We believe now more than ever that the key lies in how all sectors of a community rally to overturn an unacceptable status quo and work together in protecting the safety of their own residents and improving the overall health of the entire community. It's called "connectedness" and it is at the heart of how public health must transform itself in the 21st century." (Risa Lavizzo-Mourey, M.D., M.B.A., RWJF president/CEO)

Latest Estimates on US Obesity and Overweight

The prevalence of obesity in adults doubled and the prevalence of overweight in children and adolescents tripled in the United States between 1980 and 2002, the National Center for Health Statistics reported in an article published in the Journal of the American Medical Association. (April 2006)

States in Action: A Quarterly Look at Innovations in Health Policy

A profile of Washington State's approach to drug purchasing, snapshots of coverage expansion efforts in Pennsylvania, Illinois, and Maryland, and more. Plus: how the federal Deficit Reduction Act will affect Medicaid programs and beneficiaries and the nation's first-ever "individual mandate" legislation. (3/30/06, Commonwealth Fund)

Reflections on a Decade of Tracking Health System Change
Lots of change; little progress on slowing cost growth or improving care quality and access In the commentary, Ginsburg and coauthor Cara S. Lesser, HSC director of site visits, point out that in the course of all the "mergers and break-ups and alphabet soup of new types of organizations, management strategies and payment arrangements...In many respects, we're no better off than we were a decade ago." (3/15/06, Center for Studying Health System Change)

STATE HEALTH EVENTS AND NOTICES

May 31, 2006

NORTH FLORIDA

Division of Elections National Voter Registration Act Workshop: Tallahassee

June 16 9:00 – 11:00 am

R.A. Gray Bldg. Heritage Hall Auditorium, 500 S. Bronough St., Tallahassee

Click here for the workshop registration form (on page2) or call 850/245-6290.

CENTRAL FLORIDA

The Blue Foundation 100^th Grant Symposium: Celebrating Innovation, Excellence and Renewal; A symposium on Best Practices in Florida's Health Care Safety Net

June 2 8:30 am – 4:00 pm Orlando, Hyatt Grand Cypress in Lake Buena Vista

Plenary and workshops detailing public policy, program administration, infrastructure and service delivery practices from all corners of the state. Features sessions on health care safety net issues and excellence and innovation in reaching Florida's uninsured populations. Meet with colleagues to discuss and exchange information on cutting edge practices for improving access to care. $85 per person. Click here for more information. Click here to register via e-mail.

Promotores de Salud: Volunteer's Patient Navigator Program Training

June 9-11 8:30 am-4:30 pm HHI, 210 Live Oak Blvd, Casselberry

Hispanic Health Initiatives, Inc. (HHI) is starting a volunteer's patient navigator program (Promotores de Salud) to help cancer and diabetes patients navigate the health and social services system in Central Florida (Orange, Osceola, Seminole and Volusia). Trainees must commit to helping the community. CBOs and Churches are encouraged to share in this training so their communities will benefit from the promotores services. This is a proven approach to help uninsured, low-income wage earners address some of their health needs and to empower them to access the health care and social services available to them in their communities. For many, outreach is not enough. The June class is the first of three training workshops. Contact HHI2001@aol.com or call 407/339-2001 or 866/377-2583.

WEST CENTRAL FLORIDA

Medicare Part D Town Hall Meeting

June 1 2:30-4:30 pm Palm Harbor Town Hall, 1500 16th St.

Come speak out to your Congressional Representatives on enrollment period penalties, coverage gaps, choices, and more. View the Florida debut of a new Part D film narrated by Walter Cronkite. Refreshments will be served. For more information, call 1-866/877-8712 or go to www.fcan.org

Beyond Survival: Emerging Best Practices in the Field of Trauma and Torture Treatment
June 2 9:00 am-4:00 pm Tampa, Wyndham Westshore Hotel
A national panel of experts will present sessions. Up to 4 CEU's Provided For All Mental Health Professionals including psychologists, LCSW's & MFT's. Lunch included. Registration required. Call 727/450-7273 or 813/987-6700 to register.

Division of Elections National Voter Registration Act Workshop: Clearwater

June 7 1:00 – 3:00 pm

Pinellas County Supervisor of Elections Training Room, 13001 Starkey, Largo

Click here for the workshop registration form (on page2) or call 727/464-6108.

16^th Annual Social Marketing in Public Health Conference

June 21-24 Clearwater Beach

University of South Florida College of Public Health and Academy for Educational Development are co-sponsoring this event. The Social Marketing in Public Health field school will offer three courses - Health Message Design, Focus Groups and Public Sector and Non-profit Marketing – immediately before and after the conference. For more info click here.

SOUTHWEST FLORIDA

Division of Elections National Voter Registration Act Workshop: Naples

June 22 10:00 am – Noon

350 7^th St. North, Naples

Click here for the workshop registration form (on page2) or call 239/774-8450.

SOUTHEAST FLORIDA

Events

Imagine Miami's “Miami-Dade: A Community of Infinite Possibilities”

June 6 6:30 – 8:00 pm HSC 260 NE 17^th Terr., Suite 200

This Monthly Conversation for Change, a project of Human Services Coalition, will discuss and explore the concept of Appreciative Advocacy, and how it can be used to identify, promote and support current effective strategies and civic assets that strengthen individual, collective and organizational capacities to build a prosperous Miami-Dade. For more information, call 305/576-5001 ext. 32 or visit www.ImagineMiami.org.

Legislative Review: A Look at Human Services
June 7 10:00 – 11:30 am Knight Foundation, 200 S. Biscayne Blvd.

The Legislation and Policy Committee for the Alliance for Human Services will meet to review the 2006 Legislative Session to evaluate how Miami-Dade human services fared.

Imagine Miami's Youth Advocacy Institute

June 9 YWCA's Marta Sutton Weeks Bldg., 351 NW 5th St.

This True Leadership workshop is funded by The Children's Trust. Develop leadership skills, receive a leadership assessment and get tools and worksheets to learn how to lead change in your organization or community. Click here for registration forms, call 305/576-5001 ext. 32, or write adim@hscdade.org.

American Society of Clinical Oncology Conference Update

June 22 6:30 - 8:30 pm Gilda's Club South Florida, 119 Rose Dr., Ft. Lauderdale

This annual free "open to the community" event will feature Dr. Atif Hussein, Dr. Sandra Franco, and Dr. Alejandra Perez. Space is limited. Call 954/763-6776 for additional information and to reserve
your seat for dinner.

FREE HIV Testing

June 27 Planned Parenthood Boca Raton & Broward Health Centers

In honor of National HIV Testing Day, Planned Parenthood of South Palm Beach & Broward Counties will be providing FREE anonymous and confidential rapid HIV tests at their health centers in Boca Raton-561/368-1023, Ft. Lauderdale-954/561-1905, Pembroke Pines-954/963-9889, and Tamarac-954/721-5580.

Southeast Florida Cancer Control Collaborative Meeting

August 3 10:00 am-3:00 pm

Miami-Dade County Health Dept, 9334 NW 17 St., Miami
Most of the meeting will be devoted to strategic planning. Click here to request more info.

Conference on Intervention

October 2-4 The Breakers Palm Beach Hotel

Click here for more information on this and four other events scheduled for 2006.

The Alliance for Human Services 4th Annual Institute hosts its 4th Annual Institute
October 27 Miami Beach Convention Center

Over 400 individuals (business leaders, social service providers, not-for-profit agencies, faith-based organizations, human service consumers) will gather to discuss and receive valuable information and innovative solutions on social service issues. The Alliance is dedicated to improving quality of life for Miami-Dade County residents through partnerships, coordination of resources, and community involvement. For more information, call 305/646-7274 or write ggrey@alliance4hs.org.

Southeast Florida Notices

New Healthy Start Coalition Of Miami-Dade Website LAUNCHED! The website at www.hscmd.org will increase community awareness about the Healthy Start Coalition’s activities and accomplishments, and serve the women, infants and families of Miami-Dade County.

A Partnership to Reduce Cancer Mortality Among African Americans

100 Black Men of South Florida, Inc. and Aventura Hospital and Medical Center announced this month their partnership to address the health disparities among the African American community as it relates to cancer, heart disease and diabetes. For more information on this and other community outreach programs, please contact 305/682-7135 or Debra.Eddington@hcahealthcare.com

STATEWIDE

Events

Sharing the Vision of a Tobacco-Free Florida
June 1 9:30 am - 3:30 pm Hyatt Regency Orlando Airport Hotel

Sponsored by Florida Leadership Council for Tobacco Control and the Florida Dept. of Health, Tobacco Prevention and Control for local, state and national organizations and grassroots advocates. Click here to register online.

5th Annual Medicaid Research Conference: Patient Empowerment and Health Literacy

June 1-2 Tallahassee, Doubletree Hotel

Hosted by Florida Center for Medicaid and the Uninsured and AHCA, this year's conference will explore patient empowerment and health literacy, principles of reform driving Florida's Research and Demonstration Waiver. Panels will focus on three primary areas of discussion: Consumers, Communication, and Choice Counseling; Racial and Ethnic Health Disparities, Cultural Competencies; and the Role and Application of Technology in Health Literacy. Free of charge. Click here for more info or to register online.

2006 National Conference on Latinos and AIDS
July 24-25 Wyndham Miami Beach Resort
Sponsored by Minority Healthcare Communications, Inc., this event will update the knowledge, skills, and attitudes of health providers who care for patients with HIV/AIDS. It is also designed for healthcare media, federal and state legislators, AIDS service organization officers, social workers, pharmacists, nurses, peer counselors, church leadership and corrections healthcare personnel. It will cover the epidemiology of HIV in the US, current guidelines and new clinical modalities for HIV management, current research encompassing drug abuse and its connection to the HIV epidemic, social and psychiatric concerns of the HIV-infected patient, policy initiatives, trends and political issues. CME credits available. Click here for more information.

Florida Conference on Aging 2006

August 14-17 Tampa Marriott Waterside Hotel and Marina

For more information, click here.

2006 United States Conference on AIDS
Sept. 21-25 Hollywood Westin Diplomat
National Minority AIDS Council presents the largest AIDS-related gathering in the US, for over 4,000 case managers, physicians, public health workers and advocates to build national support networks, exchange the latest information and learn cutting-edge tools to address the challenges of HIV/AIDS. Click here for registration and more information including scholarships access.

Statewide Notices

Florida Cancer Clinical Trials Cooperative, Inc. (FCCTC) is a public resource that provides information about cancer clinical trials to Florida residents. They have a web-based and a phone-based Clinical Trial Matching Service that provides users with an opportunity to search for cancer clinical trials for which they might be eligible. The program allows people to print (or be mailed) information about potential trials to discuss with their physicians. The Florida Dialogue on Cancer established the FCCTC in 2004 and received a federal grant to create a clinical trials information system in Florida. Their data base includes current information about clinical trials at hospitals and research facilities throughout the state, including pediatric cancer trials. Information is available in English and Spanish. Go to http://www.floridacancertrials.com or call 1/800-584-9976

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NATIONAL EVENTS AND NOTICES

May 31, 2006

CONFERENCES AND EVENTS

Take Notice, Take Action! 3rd Annual Asian American Health Conference

June 1 Submissions deadline

Sept. 29-30 Conference in New York, NY

The Center for the Study of Asian American Health is currently seeking abstracts for this event. Click here for details.

The National Obesity Action Forum

June 5-6 Bethesda, MD

This meeting aims to address the problem of overweight and obesity in our nation, bringing together federal, state, and local public health officials; leaders of community organizations and advocacy groups; nutrition and physical fitness experts; health care providers; school and food industry reps; and interested consumers. Click here for more information.

Empowering Partners for Effective Integration: Charting a New Generation of Cancer Control Partnerships
July 12-13 Washington, DC

This is the 2006 CDC Cancer Partners Summit. Click here for more information.

6th Annual Summer Evaluation Institute

June 12-14 Atlanta Marriott Marquis

Co-sponsored by CDC and AEA with support from the National Association of Chronic Disease Directors (NACDD), the Institute welcomes all CDC, state, local, and community staff who do or use program evaluation. This year's Institute features three days of intensive, small-group sessions. Go to the web site for a complete agenda, course selection, lodging information, and to register and pay on-line. For further help, contact heidi@eval.org or 888/232-2275. For questions on Institute content, write TChapel@cdc.gov.

Disparities in Health in America: Working Toward Social Justice
June 24-30 Houston

This workshop is intended to provide a comprehensive approach to the issue of health disparities, so attendees will gain a broad base of knowledge to address disparities with a biopsychosocial approach. It will be of value to physicians, nurses, social workers, health educators, and other healthcare professionals, and students, as well as active members of the community and community organizations. Lectures, Panel Discussions, and Question-and-Answer Sessions. Continuing ed credits in many fields. Click here for more info.

National Leadership and Education Conference: For your patients ... For your community

June 28-29 Chicago

Cultural competency, mentoring, recruitment and retention, diversity among leadership and hospital trustees ... hospital and health system leaders grapple with these issues every day and ask how they can ensure that their health care workforce – particularly their health care managers – reflect the demographics of the communities they serve. The theme exemplifies the mission of hospitals throughout the country to provide culturally competent care for every patient who walks through their doors. Click here for more information.

Health as a Human Right: Health Education, Equality and Social Justice for All

November 2-4 Boston

Society for Public Health Education’s 57th Annual Meeting will examine the impact of reciprocal influences of health and human rights, including the impact public health programs and policies have on human rights and health disparities, the consequences human rights violations have on health, the importance of health in realizing human rights, and the ways in which health educators can ensure that human rights are integrated into public health strategies to eliminate disparities. Click here for more information.

Making Methods and Practice Matter for Women, Children and Families

December 6–8 Atlanta

Maternal and Child Health Epidemiology (MCH EPI) conference organizers invite you to join MCH professionals in sharing experiences, enhancing knowledge, and generating new ideas for improved MCH data use and informed policymaking. Click here for details.

Association for Community Health Improvement's Spring Training for Health Champions

March 7-9, 2007 New Orleans

Click here for ACHI's conference timeline.

AUDIO CONFERENCES AND WEBCASTS

Ask the Experts: Mental Health Care

June 1 2:00 pm

Operation Access: Providing Donated Outpatient Surgery to Uninsured People

June 15 ACHI audio conference

YMCAs and Hospitals: Successful Collaborations for Healthier Communities

July 20 ACHI audio conference

Policies and Procedures to Strengthen Community Benefit Accountability

Sept. 21 ACHI audio conference