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Florida CHAIN & MRAC Hold Medicaid Reform Forums

  October 20, 2006

Florida CHAIN and the Medicaid Reform Advocates Coalition (MRAC) have just sponsored two Broward activities allowing those affected by Medicaid reform to share their opinions of the process to date with AHCA officials and independent evaluators.

ACORN members speak at Hollywood City Hall Town Hall Meeting

 Ms. Richard, Rep. Sobel, Dr. Thorpe

On Tuesday, October 17th, MRAC sponsored a Town Hall Meeting in Hollywood co-hosted by State Rep. Eleanor Sobel and Dr. Marion Thorpe, Jr., of Care Broward and MRAC member.  Participating on behalf of AHCA was Ms. Sybil Richard, COO, who answered questions posed by the public and promised to follow up on many of the issues raised.

 

The town hall format allowed speaker after speaker representing different constituencies affected by reform to express their concerns regarding the process. In one instance, Ms. Richard was visibly surprised to hear from independent therapists that many children with special needs who should not be included in reform at this stage have in fact received notices of mandatory enrollment. In another instance, following numerous complaints by consumers as to the level of knowledge and support provided by choice counselors, she admonished representatives from ACS, the company responsible for providing the service, indicating that she was taking heed of the complaints raised and hoped they would be addressed.

 

Mary Woods, mother of severely disabled child

who has been auto enrolled in Medicaid reform plan

“I appreciate the opportunity to hear directly from consumers, because until I do my impression is that everything is going just fine with Medicaid reform,” she said. Echoing the importance of consumer input in the evaluation of reform, Dr. Thorpe expressed concerns that Tom Arnold, State Director of Medicaid, was recently quoted in the media as believing that Medicaid reform is a success. “This is like saying today that we are happy the Miami Heat have repeated as NBA champions. It’s somewhat premature,” he said.

 

Rep. Sobel and others were also unimpressed about the effectiveness of outreach efforts to many in the Medicaid community, especially the disabled. A show of hands by the dozens of Medicaid recipients in the crowd revealed that none present had seen or heard any part of the outreach campaign. Ms. Susanne McDonald, CEO of Circle of One, the company hired by ACS to provide outreach to Medicaid consumers, spoke about the media campaign as being rolled out on a staggered basis because “the budget is limited and we want to make sure that we continue reaching people over the next few months (of reform).”

 

 Ms. Elaine Schwartz

The meeting concluded with some words by Ms. Elaine Schwartz, candidate for the State seat being vacated by Ms. Sobel due to term limits. Ms. Schwartz expressed her belief that while Medicaid reform is being rolled out without appropriate quality control safeguards, “people could be dying.”

 

On Wednesday, October 18th Florida CHAIN hosted a Medicaid Consumers’ Roundtable. This was an opportunity for Medicaid recipients who have already received mandatory enrollment materials to share their experiences with Florida CHAIN and MRAC by answering a set of specific questions. The format had a number of consumers and a facilitator at different tables discussing issues pertaining to the beginning stages of reform, such as their reaction to the packaging of enrollment materials and the effectiveness of Choice Counselors in helping them select a managed care plan appropriate to their needs.

 

Roundtable participants

Florida CHAIN is working to include the results of this and subsequent consumer roundtables funded by a grant form the Community Foundation of Broward in materials legislators will consider prior to approving Reform statewide. Representatives of the University of Florida (contracted by AHCA to provide the official reform evaluation) and Georgetown University (conducting an independent evaluation) were also present as observers.

 

Roundtable participants

 Over the course of two hours, Medicaid recipients from constituencies including low-income, disabled, homeless and mentally ill individuals and their caregivers took the opportunity to both lambaste and praise different elements of Medicaid reform. Some common themes included complaints that Choice Counselors were unable to effectively answer questions posed or expected consumers to do much of the legwork by just suggesting they call the different plans themselves for answers. Some were pleasantly surprised as to the ability to easily reach a "live person" on the line. Some of the concerns centered on the inability, by those who see different specialists, to be able to continue seeing them as many are not in the same managed care plans. Others were concerned about the changes in the process of approval of prescription drug medicines and who would decide as to what is "medically necessary."

 

“For the last few years I have been visiting the same primary care physician and gynecologist. Since they are not both on any of the plans offered I had to decide which one to stay with,” said one of the participants. “I am staying with my gynecologist," she said.

 

Special thanks to Cooperative Feeding Program for allowing the use of their facility and helping in the recruitment of consumers; to MRAC partners Z. Felicia Jordan, Esq. of Coast to Coast Legal Aid and Marc Dubin. Esq. of Center for Independent Living of Broward for their participation as facilitators; and other community partners who helped recruit consumers included Crossroads Food Bank, ACORN, and NAMI, among others.

Roundtable participants

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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WOMEN'S HEALTH RETREAT
Combines Wellbeing with Political Action

 November 2, 2006

It may be early for New Year’s resolutions, but the twenty or so women who participated in a Florida CHAIN sponsored “Mini Health Retreat” last week were intent on more than just paying attention to their physical and mental wellbeing. By the end of the activity, many were ready to take on policy makers to ask for easier access to health care.

The retreat, hosted by Cooperative Feeding Program in Fort Lauderdale and led by Florida CHAIN Executive Director Lisa Margulis, is part of a broader Expanding Opportunities to Improve Women's Health project funded by Community Catalyst.  As part of the grant, bilingual Women’s Health Resource Guides have also been produced for Broward and Volusia-Flagler counties.

 

 

 

“Women are often the ones entrusted not only with their own wellbeing but that of their families, as well. Too often women are concerned with taking care of others without taking the time to make sure they are well,” said Ms. Margulis.  The afternoon began with a series of simple stretching and breathing exercises and a reminder of the importance of doing something for one’s own wellbeing every day.

 

The participants, women of all ages and diversity, were also treated to lunch and gifts. After being given the opportunity to share with each other information on health care access for low and moderate income women and families, participants took time to discuss what services are not readily available to those who need them in Broward County.

 

These included affordable dental and podiatry care, reliable public transportation to providers’ offices, and clinics that offer more continuous services. These and other issues were then summarized in a petition many of those present agreed to present at a future County Commission meeting following the November 7 elections.

 

To find out more about the Expanding Opportunities to Improve Women's Health project or to receive copies of the Women’s Health Resource Guides for Broward and Volusia-Flagler, contact Andrew Leone at andrewl@floridachain.org or 954/684-9895

 

 

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Florida CHAIN Seeks Stories

Florida CHAIN welcomes contributions from health care consumers who are interested in sharing their experiences with readers of CHAIN Reaction. If you have a story to share, please contact Andrew Leone at 954/684-9895 or andrewl@floridachain.org

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 RECENT HEALTH ARTICLES

November 2, 2006 

Florida News & Opinions

    KidCare and SCHIP

    Medicare and Medicaid

        Medicare Drug Coverage, Drug Costs

        Other Medicare, Medicaid

    Health Insurance and Costs

   Other Health Issues

National News & Opinions 

     Medicare, Medicaid, SCHIP

        Medicare Drug Coverage, Drug Costs

        Other Medicare, Medicaid, SCHIP

     Health Insurance and Costs

     Other National Health Issues

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FLORIDA NEWS & OPINIONS

Medicare and Medicaid

Medicare Drug Coverage, Drug Cost

Winn-Dixie opening walk-in health clinics in Florida stores
Winn-Dixie Stores Inc. announced Monday that it's jumping on the bandwagon of grocery and drug store retailers featuring walk-in medical clinics. The Jacksonville-based grocery store chain partnered with Birmingham, Ala.-based Wellspot Medical Clinics Inc. to open medical clinics in three Jacksonville area stores in mid-November. In January, the company will begin to open clinics at stores with pharmacies elsewhere in Florida, as well as Georgia, Alabama, Mississippi and Louisiana, said company spokeswoman Terry Derreberry. There are 97 Winn-Dixie Stores in South Florida, and 63 have in-store pharmacies. (10/31/06, South Florida Sun-Sentinel)
 

Other Medicare, Medicaid

Region ranks in Medicare top five

The Sarasota-Bradenton-Venice area ranked as one of the top five areas in the country in percentage of people enrolled in a Medicare program in 2004, the Census Bureau said this week. (10/28/06, Herald Today) 

Health Insurance and Costs

 
Employer-Based Coverage Declines, Studies Show
More Americans are working for companies that don't offer health insurance plans, two reports released Thursday concluded. One report found that the percentage of the population with employer-sponsored insurance continued to drop despite an upturn in the economy. Another report found that about three-fourths of the decline in coverage was due to a lack of employers offering it or ineligibility. Both reports, sponsored by the Kaiser Family Foundation and the Alliance for Health Reform, indicated that Americans who are self-employed or work for small businesses are more likely to be uninsured than those who work for larger companies. One of the studies showed that the percentage of Americans in the labor force with insurance fell from 81.2 percent in 2001 to 77.4 percent in 2005, or about 2.2 million workers, despite an economic upturn during this period. One of the reports also indicated that the number of uninsured Americans coincides with a shift in the population toward the South and West, where there are more uninsured workers than in other areas of the country. (10/20/06, Miami Herald)

So far, it seems to be working in Polk County: When seeking a model of how to do things right, Leon County officials point to Polk County
In 2004, voters in the sprawling conservative county between Orlando and Tampa were asked to support a half-percent sales tax to fund an HMO-style program for low-income uninsured. The 15-year tax generates about $35 million a year for primary and specialty care for adults who don't qualify for health insurance or can't afford it. About 75,000 of the county's 420,000 adults younger than 65 lack health care, according to the Florida Health Insurance Study. With county commissioners' promise to end 75 years of property-tax support for indigent health care - and with the endorsement of all the area chambers of commerce and other business groups - the tax passed nearly 2-to-1. "The way they approached it was pretty simple," said Polk County Commissioner Paul Senft. "It's a situation where everyone benefits if the community is healthy." Today, the Polk HealthCare Plan is widely considered a success. It closely resembles what Leon County is proposing, including a network of medical providers, a limited but comprehensive package of benefits and required patient co-pays. (10/29/06, Tallahassee Democrat)

Programs offer low-income residents in Palm Beach County a safety net for health care
residents gamble with their health without the protection of insurance. As the ranks of the uninsured climb skyward across the nation, safety-net health providers are responding more aggressively to give struggling families at least a thin security blanket of low- or no-cost health care. Their goal is to turn hundreds of participants into hundreds of thousands. Unfortunately, you have to do enrollment one at a time," said Paul Gionfriddo, executive director of Palm Beach County's Community Health Alliance, which this year began to use computer software that matches residents with low-cost plans from government or nonprofit groups. The idea is to grow the network by enrolling 2,000 to 3,000 people this first year and every year after. Eventually, enrollment would snowball to match the population of about 250,000 uninsured. In Palm Beach County, it's mostly young women who lack coverage. The trend is reflected across the nation as more 18- to 34-year-olds, a demographic prized by television advertisers, can hardly afford health insurance. (10/24/06, South Florida Sun-Sentinel)

Boca Raton Studying Domestic Partner Benefits
At the request of the Palm Beach County Human Rights Council ("PBCHRC"), the City of Boca Raton is looking into the possibility of providing domestic partner benefits to the City's 1,331 employees. PBCHRC is a local nonprofit organization founded in 1988. It assists local employers in establishing domestic partner benefit programs. In the past few months, the City of Delray Beach and the Office of the Palm Beach County Tax Collector both commenced domestic partner benefits for their employees. Palm Beach County, the Office of the Clerk and Comptroller and the City of West Palm Beach recently expanded the domestic partner benefit program for their employees. Other local public employers offering domestic partner benefits include, the Sheriff's office, the the the Property Appraiser's Office, the Office of the Supervisor of Elections, the Port of Palm Beach, the Palm Beach County School District, and the City of Lake Worth. The City of Palm Beach Gardens is also considering offering domestic partner benefits to its employees. Outside of Palm Beach County, other public employers in Florida offering domestic partnership benefits for their employees include Broward County, Monroe County, the Broward County School District, the Miami-Dade County School District, the University of Florida, Florida International University, Broward County Community College, Hillsborough Community College, Miami-Dade College, and the cities of Gainesville, Hialeah, Key West, Miami Beach, Miramar, North Miami, Tampa and Wilton Manors. (10/26/06, Out in West Palm Beach)

Boutique medicine: When wealth buys health 
Dr. Bernard Kaminetsky sees about a dozen patients during a typical day at his Boca Raton, Florida, practice. His patients have his personal phone number and can schedule a same-day appointment with him. Kaminetsky left his traditional practice in 2001 to join MDVIP, one of the leaders in the small but growing trend toward concierge, or boutique, medicine -- highly personalized care for patients who pay an annual fee. Patients pay from $1,500 to $1,800 per year to join MDVIP. In exchange, they get a full physical and wellness plan, 24/7 access to their doctor, wallet-sized CDs with their medical data recorded on it and other services. They also get a doctor with only 600 patients, compared to about 2,500 at a traditional practice. MDVIP promises same-day or next-day appointments that last as long as the patient needs. (10/19/06, CNN) 

Other Health Issues 

EDITORIAL: Vote YES on Amendment No. 4
At first glance, the anti-smoking amendment appears to be an ill fit for a bedrock document that defines the basic structure of Florida government. Voters, however, should vote YES on Amendment 4 because the health concerns it seeks to address will profoundly affect the operation of state government. The amendment is necessary because the Legislature has drastically cut funding to Florida's Tobacco Control Program, which consisted of public education, marketing campaigns and funds to enforce laws governing

youth and tobacco sales. The program was a national model and a key tool in keeping the Sunshine State's adolescent tobacco consumption rates in check. But, cutting a budget from $70 million a year to $1 million can change things. (10/26/06, South Florida Sun-Sentinel Editorial Board)

Chiles' Tobacco Program Going Up In Smoke
The Legislature and Gov. Jeb Bush allowed the Tobacco Control Program to languish, going from $70 million in funding in 1999 to a $1 million token expenditure in 2003, where it has remained, leading to the creation of Floridians For Youth Tobacco Education's campaign for Amendment 4. Even the $57 million that would go to a renewed smoking control program is a pittance when one realizes Florida also collects about $829 million from the industry in settlement money and cigarette taxes, not to mention gains made from nearly half-a-billion pension fund dollars invested in tobacco. (10/21/06,Tampa Tribune)

Inpatient mental health care ends in county as Oaks closes
A decision by Seven Rivers Regional Medical Center to shutter its mental health facility has left Citrus County with no inpatient psychiatric services. "Everything has closed," said Mary Lee Cubbison, director of the Centers formerly Marion-Citrus Mental Health in Lecanto. "There isn't one inpatient bed in the entire county." Representatives from Seven Rivers said the decision to convert 16 beds dedicated to psychiatric services - known as "the Oaks" - to acute care beds was based on community needs. "Because of advancements in outpatient care and medication, people don't need inpatient care as much anymore," said Dorothy Pernu, spokeswoman for Seven Rivers. But mental health advocates say Florida faces a shortage of inpatient psychiatric beds. The state received the lowest score possible in terms of access to inpatient services, according to a recent study by the National Alliance on Mental Illness. "There are about 3,000 more beds needed in the state," said Sue Homant, executive director for NAMI Florida. "My personal guess is the number is even higher than that." (10/29/06, St. Petersburg Times)

Marion County's Hispanics face an AIDS epidemic
Marion County ranks seventh in the state when it comes to the number of Hispanics living with HIV/AIDS, according to data collected by Alachua County Health Department. The county ranks 28th in the state for HIV/AIDS infection rates in the white population and 40th in the black population. "We know that the Hispanic community is the fastest growing group when it comes to HIV/AIDS infection," Euriba said. HIV/AIDS, in fact, is among the greatest health threats to Hispanic communities, according to the federal government. While accounting for 14 percent of the U.S. population, Latinos currently constitute 19 percent of the cumulative 944,306 AIDS cases diagnosed since the beginning of the epidemic. In Marion County, 14

percent of people living with AIDS are Hispanic, so are 13 percent of those living with HIV. Hispanics make up only 8 percent of the county's population. Various factors — such as discrimination, stigma, homophobia, socioeconomic hardship, overcrowding, poverty, rigid gender roles, high mobility and isolation from family — paint part of the complex picture of the HIV/AIDS epidemic in the U.S. Hispanic population, according to a report released last week by the National Council of La Raza, housed in the Institute of Hispanic Health in California. In addition, many Hispanics continue to face challenges in accessing health care, prevention services and treatment. (10/23/06, Ocala Star-Banner)

Daunting data: Hospital flaws go public: Online comparisons of hospital quality are lifting the cloak of secrecy -- but few consumers use them, finding them confusing.
Patients with severe strokes who go to Broward General are more likely to die than those who go to Aventura. A patient at Mercy is less likely to get an infection than one at Memorial West. Pneumonia patients at Baptist Hospital are more likely than those at Cedars to be given the most appropriate antibiotics. All of those comparisons -- and many more -- are now available online, part of a movement to empower consumers by removing the traditional secrecy that has surrounded the performance of hospitals and doctors. The hope is that bringing market transparency to healthcare will drive business to the providers that deliver the best care at the lowest price, reducing costs and improving outcomes. The reality, at least for the moment, is murkier. (10/29/06, Miami Herald)

Florida gets B for telling public about doctor errors
At least one consumer watchdog group, Public Citizen, warns that most states don't live up to their obligation to protect patients from doctors who aren't practicing medicine in the best manner. According to the Public Citizen's health research group, Florida earns a B grade for the user-friendly information the state provides on public Web sites about disciplinary actions against physicians. (10/21/06, Gainesville Sun)

Health Insurance and Costs

New Poll Highs: 25 Percent Report Problems Paying Medical Bills, Nearly 3 Out of 10 Put Off Treatment Because of Costs
Costs in the nation's health care system are ensnaring millions more Americans: One in four report

problems paying their medical bills, and nearly three in 10 -- rising to nearly half of women with children -- have put off treatment because of the cost, often despite a serious illness or condition. Both are new highs in polls dating back a decade or more. Such problems contribute to substantial public disapproval of the country's health care system overall, in terms of its cost, the level of uninsured Americans, and to a lesser extent, the quality of care. Yet most people remain satisfied with their own personal costs, coverage and care --experience that makes the risk of change less attractive. Still, support for change does exist. Most Americans, 56 percent, favor shifting from the current health system to a taxpayer-financed universal health insurance program. But there are provisos: Support has slipped a bit from its 2003 level, as Republicans have moved farther away from the idea. And support for universal coverage drops sharply if it means higher costs, waiting lists for some care or less choice of doctors or treatments. Support goes much higher for other, somewhat less fundamental, changes. Large majorities favor employer mandates, expanded government health insurance programs and special aid to provide low-income Americans with health coverage. Many of these are not only supported by much of the public, but "strongly" so. (10/16/06, ABC News, USA Today, Commonwealth Foundation)

Proposal to Provide Health Care Coverage for All Uninsured U.S. Residents
America's Health Insurance Plans on Wednesday said it will announce a plan next month to provide health care coverage to all uninsured U.S. residents, CQ Today reports. According to  AHIP President and CEO Karen Ignagni, the plan -- expected to be introduced Nov. 13 -- would involve private sector and government cooperation but would not necessarily mandate a new federal agency. (10/28/06, Kaiser Network) 

The Uninsured Are a Top Health Care Concern for Americans, Poll Finds
Reducing the percentage of uninsured Americans is a leading health care priority for 42 percent of Americans, according to a national WallStreetJournal.com/Harris Interactive poll, though many Americans lack confidence that either Democrats or Republicans will be able to "tackle" this or other health care problems. (10/24/06, Wall Street Journal)

Americans Are Increasingly Unhappy over Health Care Costs, According to Poll

Americans are uneasy about the economy, in large part because "frustration with the rising costs of health coverage surged sharply this year," according to a poll. (10/25/06, Los Angeles Times)

Health Insurance Cost Increases Far Outpace Wage Gains

Health insurance premiums that rose far faster than wage increases between 2000 and 2006 threaten to throw more people into the ranks of the uninsured, according to a Families USA study. (10/18/06, Philadelphia Inquirer)

OPINION: USA Today Editorial and Commentary on U.S. Health Care
The American health care system is headed for "an all-out crisis;" a commentary advocates for universal coverage as a solution. (10/17/06 and 10/19/06, USA Today)

Hospitals Try Free Basic Care for Uninsured
With the number of uninsured people in the United States reaching a record 46.6 million last year, up by 7 million from 2000, Seton is one of a small number of hospital systems around the country to have done the math and acted on it. Officials decided that for many patients with chronic diseases, it would be cheaper to provide free preventive care than to absorb the high cost of repeated emergencies. (10/25/06, New York Times)

Health Care Is Not a Top Election Issue, Despite Voter Concern about Costs and Uninsured
Health care, especially the growing number of uninsured and rising costs, is a "large and growing concern" for Americans, but politicians and voters lack "fresh ideas" about how to address it. (10/15/06, Baltimore Sun)

Universal Health Care Won't Be a Priority for Democrats If They Win the House
If Democrats emerge victorious in the House of Representatives in the coming election, they are likely to "temper their liberal ambitions" and advance a moderate agenda. (10/29/06, San Francisco Chronicle)

Hospitals Find Cost Savings in Giving the Uninsured Free Basic Care
Some hospitals are offering free preventive care to the uninsured with chronic diseases as a way to avoid the high costs of repeat emergency care. (10/25/06, New York Times)

OPINION: Auto Industry Should Advocate for Universal Health Care
The auto industry's "staggering" health care costs are expected to be a major topic next month when industry leaders meet with President Bush and may promote change. (10/29/06, San Francisco Chronicle)

Universal care appeals to USA
Universal health insurance — the idea that every resident would have medical coverage from birth to death — has been labeled everything from a communist plot to the only thing that will solve America's growing problem of the uninsured. Presidents from Harry Truman to Richard Nixon and, most recently, Bill Clinton, have proposed various plans for universal coverage, but all have been defeated.Still, Americans consistently tell pollsters they embrace such an idea. (10/17/06, USA Today)

Consumer unease with U.S. health care grows
The U.S. health care system — touted as providing the best medical care in the world — is becoming more precarious to most Americans, who are rattled by rising costs, questions about quality and fears about the future.(10/16/06, USA Today)

Health Prevention as a Priority: Creating a "Wellness Trust"
U.S. health care policy should make prevention like homeland security, where success is measured by the absence of tragedy. 10/18/06, New York Times)

Economix: A Lesson From Europe on Health Care
Strangely, we talk about medical spending as if it were nothing more than a drag on the economy, rather than an investment in the most important thing of all. (10/18/06, New York Times)

Competition Good for Your Health (Care)
Choice and competition work in health care. Unfortunately, most of us aren't lucky enough to have access to a market driven and shaped by them. This year employer health-care costs have risen 7.7 percent, according to a Kaiser Family Foundation survey, more than twice the rate of inflation or workers' wage growth. This is lower than in recent years (costs rose almost 14 percent in 2003). But health costs are still high -- and likely will go even higher next year. (10/19/06, Washington Times)

 
Hallmark of quality care: Efficiency experts say that better care tends to be more efficient
"You don't have to trade quality for cost," says Donald Berwick, the  Institute for health care Improvement's president and CEO.  "It's just the other way around: More reliable systems are lower-cost." Experts say it makes sense to pay doctors and hospitals in a way that encourages them to improve. According to an analysis by a private company collaborating with Medicare, hospitals nationwide could save up to $1.3 billion if they met even three out of four recommended standards for patients with these five conditions. Patients who choose safer, more efficient hospitals also may save money. Patients who get well quickly spend less time in hospitals, need fewer medications and spend less on co-pays and deductibles. These savings potentially could help reduce health care costs for insurance plans and employers, who may pass on savings to workers and plan members. (10/20/06, USA Today)

 
New Rx: Help people to avoid getting sick
On Sept. 28, the American Cancer Society released new guidelines on nutrition and physical activity for cancer prevention. It concluded that only by creating a "social environment that promotes healthy food choices and physical activity" can the nation whittle away at the nearly 170,000 of 500,000 annual cancer deaths linked to obesity, junk food and a lack of exercise. No one questions that prevention is the solution, but the costs of taking care of the sick consume roughly 96% of the health budget, leaving about 4% for prevention. In practical terms, that means most people are floundering without the support they need to live healthier lives, says Allan Brandt of the Harvard School of Public Health.  (10/18/06, USA Today)

Debate surrounds end-of-life health care costs
While not the major factor driving health care spending, costs involved in sustaining patients in their final days are likely to get a closer look by both Medicare and private insurers as health costs continue to spiral and the population ages. Why is it more expensive to die in some areas of the country than others? The number of doctors and hospital beds is part of it: The more there are, the more care a person gets. Also playing roles: the expectations of patients and the practice patterns of doctors. Complicating matters is that medicine often doesn't know what the most effective treatments are. And doctors are trained to save lives. As a result, some patients may be pushed into more than they want by a medical system that values doing something over doing nothing, even when futile. (10/19/06, USA Today)

In medicine, evidence can be confusing
Critics condemn evidence-based medicine as "cookbook medicine" that devalues the doctor's experience and the patient's preference. Proponents argue that evidence from randomized controlled trials has stanched the flow of private and public dollars for useless or even harmful treatments. More important, they say, the information has saved countless lives. Both sides agree on one point: Keeping up with the latest evidence is virtually impossible.  (10/16/06, USA Today) 

HEALTH ADVOCACY RESOURCES

November 2, 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

        New Listings: Medicare, Medicaid    

        New: Health Insurance, Health Care Costs

        New: Health Equity Issues

        New: Other Health Issues

     Florida Reports

     Medicare, Medicaid and SCHIPS

     Federal Budget/Health Care

     Health Insurance, Health Costs, Health Care Reform

     Health Equity Issues

     Other Health Issues

 FLORIDA CHAIN WEB SITE RESOURCE UPDATE

Florida Medicaid Reform PowerPoint Presentation

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

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

GRANTS AND FELLOWSHIPS

New grant listings

Community Education Grant Program to address Cancer Disparities
Deadline: Nov. 15

(Call your local ACS Area Office to confirm the local submission deadline)

Proposals are requested by American Cancer Society, Florida Division, for the 2007 Funding Cycle One of the Hispanics/Latinos and Black/African American Community Education Grant Program. The grant program is open to nonprofit community partners interested in support to implement a community education initiative which impacts breast or colorectal cancer. Events can be funded up to $3,000 and Projects can be funded up to $30,000. For details, contact Chelsea.Hall@cancer.org or 305/779-2859.

Dept. of Health Comprehensive Cancer Control (CCC) Program 2007 - 2012 funding cycle
Deadline: Nov. 22
This grant from the Center for Disease Control and Prevention (CDC) provides funding for the CCC Program's personnel, cancer education, and statewide activities. In addition to the programmatic grant funds, the CDC may make available additional dollars to address specific cancers.  To apply for these categorical funds, CCC must submit a separate application for each cancer, which historically has included colorectal, skin, prostate, ovarian, and blood cancers. CCC would like to get a head start and begin collecting ideas to do preliminary writing for the grant submission. To do this, CCC asks everyone to submit data driven, evidence-based projects they would like to see implemented in Florida addressing one of the five cancers listed above.  Note that grant dollars may not be used for screening or treatment. Submit project descriptions with target population, recommended intervention, and any additional pertinent information. To discuss potential projects, call 850/245-4330 or email Mary_Shafer@doh.state.fl.us, Laurie_Osgood@doh.state.fl.us, or Sue_Higgins@doh.state.fl.us.

Fund for Community Organizing Grants for Miami-Dade & Central Florida
Deadline: Nov. 30
Dade Community Foundation is accepting proposals for this partnership between Dade Community Foundation and the Edyth Bush Charitable Foundation in Winter Park, Florida.  $5,000-$15,000 grants will be awarded for the period March 1, 2007-Feb. 29, 2008 to foster community organizing through support of groups engaged in or seeking to pursue organizing strategies,a s a way to build stronger, more equitable communities and sustained civic engagement, and to achieve community change. Download details and the application. For more information, write grant@dadecommunityfoundation.org  

Echoing Green Fellowship
Online application deadline: Dec. 1
Echoing Green's mission is to spark social change by identifying, investing and supporting the world's most exceptional emerging leaders and the organizations they launch.  Through a two-year fellowship program, they help a network of visionaries develop new solutions to society’s most difficult problems.  These social entrepreneurs and their organizations work to close deeply-rooted social, economic and political inequities to ensure equal access and to help all individuals reach their potential. The fellowships are only for startup organizations, and include up to $90,000 in seed funding and technical support.

Leadership Academy on City Roles in Combating Childhood Obesity

City officials can now apply to receive subsidies for attending a Leadership Academy on city-school strategies to combat childhood obesity in Nashville, Tenn., during the week of Jan. 29, 200. The leadership academy will be hosted by National League of Cities' Institute for Youth, Education, and Families and the American Association of School Administrators (AASA), with support from the Robert Wood Johnson Foundation. The two-day academy will focus on the implementation of federally mandated school wellness plans as a catalyst for community-wide efforts to address childhood obesity.  Two-person teams composed of one elected city official or senior municipal staff person and one superintendent or assistant superintendent may apply to attend the leadership academy.  Selected participants will be reimbursed for travel-related expenses (airfare, hotel, meals, parking, etc.).  Participating teams will also be given preference for a follow-up school wellness planning technical assistance project involving four to six cities. For more information, contact andrews@nlc.org.

Continuing grant listings, in order of submission deadlines

University of Toronto Fellowships
Deadline: Nov. 10

The Comparative Program on Health and Society (CPHS) at the Munk Centre for International Studies invites applications for the 2007/8 New Faculty Fellowship and Distinguished Visitor Fellowship.  The CPHS supports research on the social determinants of health from a wide variety of disciplinary and methodological perspectives.  Projects of particular interest examine: i. the relationship between socio-economic status and health outcomes; ii. access to health and health-related services; or iii. accountability mechanisms in the governance of health and health-related services.  Email: cphs.munk@utoronto.ca

Florida Healthy Kids
The Florida Healthy Kids Corporation has released a Call for Grant Proposals – Round Two (CGP). The CGP seeks innovative proposals from community organizations, governmental entities and others to provide marketing and outreach activities that will result in reaching the enrollment target for the Florida KidCare Program.  

Substance Abuse Policy Research Program—Round XI
Deadline:  Nov. 14
This Robert Wood Johnson Foundation Program is designed to encourage experts in public health, law, political science, medicine, sociology, criminal justice, economics, psychology and other behavioral and policy sciences to address issues related to substance use, one of the most pressing public health problems facing our nation. Projects are expected to increase understanding of public and private policy interventions to prevent, treat and reduce the harm caused by the use of tobacco, alcohol and other drugs.   

CIHR Strategic Training Program in the Transdisciplinary Approach to the Health of Marginalized Populations

Deadline: Nov. 15

The Centre for Research on Inner City Health (CRICH) of St. Michael's Hospital, Public Health Science, University of Toronto invites students and fellows of all disciplines to respond to their 2007/2008 Call for Applications.  The goal of the CIHR Strategic Training Program is to promote a new generation of health researchers in a transdisciplinary approach, using both quantitative and qualitative research methodologies, to understanding the health of marginalized populations. The program aims to enable investigators-in-training to: 1) develop the knowledge, skills, and mentality needed to build their own research agenda designed to improve the health of marginalized groups; 2) reach beyond the boundaries of their own disciplines and methodologies in understanding and interpreting their research; 3) translate their findings to researchers, clinicians, policy makers, community partners, and other stakeholders. 

Robert Wood Johnson Health Policy Fellowship
Deadline: Nov. 17
Administered by the Institute of Medicine, this is the nation's most prestigious learning experience at the nexus of health science, policy and politics. The fellowship is an outstanding opportunity for exceptional midcareer health professionals and behavioral and social scientists with an interest in health to experience and participate in the health policy processes at the federal level and to use that experience to provide leadership to improve health, health care and health policy at the national, state or local levels. 

ACHI Youth Obesity Collaborative
Deadline: Nov. 17
The Association for Community Health Improvement is seeking proposals from rural and suburban hospitals interested in joining its youth obesity collaborative, a national network launched last February to identify effective community strategies to reduce youth obesity. The learning collaborative strives to enhance the effectiveness of participants' initiatives and also to develop guidance for other hospital-based partnerships seeking to impact youth obesity. The Learning Collaborative benefits each participant directly through a facilitated peer learning network and expert consultation, to support program enhancements and improved program outcomes.  The project pays participants’ travel costs to Learning Collaborative events and the costs of expert consultation made available to the collaborative.  Participants do not receive cash grants to fund staff or programs.

Applied Epidemiology Fellowship at CDC for Medical Students

Deadline: Dec. 4

Funded by Pfizer Inc. and administered by the CDC Foundation, this fellowship provides medical students with applied hands-on training experience in epidemiology and public health.  Up to ten 3^rd-4^th year medical students from around the US will spend up to a year at the CDC, carrying out epidemiologic analyses in areas such as birth defects, injury, chronic disease, infectious disease, environmental health, reproductive health, and minority health.  The program provides a stipend for living expenses.

2007 Barbara Jordan Health Policy Scholars Program
Deadline: Dec. 15
Operated in partnership with Howard University, the Scholars Program brings talented African American, Latino, American Indian/Alaska Native, and Asian/Pacific Islander college seniors and recent graduates to Washington, D.C., for placement in congressional offices to learn about health policy. Through the nine-week program (May 21- August 3, 2007), Scholars gain knowledge about federal legislative procedure and health policy issues, while further developing their critical thinking and leadership skills. In addition to gaining experience in a congressional office, Scholars participate in seminars and site visits to augment their knowledge of health care issues, and write and present a health policy research paper.

Funding for Mental Illness Information and Outreach Initiatives
Deadline: Dec. 22
The American Psychiatric Foundation is making up to $750,000 in 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. Grants from the foundation can support a wide variety of public education activities in this arena. 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. 

Fellowship in Minority Health Policy (2007-8)

Application deadline: Jan. 2
Supported by The Commonwealth Fund, administered by the Minority Faculty Development Program at Harvard Medical School, this innovative fellowship is designed to prepare physicians, particularly minority physicians, for leadership roles in formulating and implementing public health policy and practice on a national, state, or community level.  Five one-year, degree-granting fellowships will be awarded per year.  Fellows will complete academic work leading to a Master of Public Health (MPH) degree at the Harvard School of Public Health, and gain experience in and understanding of major health issues facing minority, disadvantaged, and underserved populations. CFHUF also offers a Master of Public Administration (MPA) degree at John F. Kennedy School of Government to physicians possessing an MPH. It is expected that CFHUF will support the development of a cadre of leaders in minority health, well-trained academically and professionally in public health, health policy, health management, and clinical medicine, as well as actively committed to careers in public service.

2007 NCHS/AcademyHealth Fellowship
Deadline: January 8
Sponsored by National Center for Health Statistics (NCHS) and AcademyHealth, this fellowship program brings visiting scholars in health services research-related disciplines to the National Center for Health Statistics (NCHS) in Hyattsville, Md. for a period of 13-24 months to conduct studies of interest to policymakers and the health services research community. Fellows have access to NCHS data resources for use in their proposed studies, and also work on collaborative projects with NCHS staff.

HRET Cultural Competence Leadership Fellowship
Deadline: Jan. 30
The Health Research and Educational Trust and the Institute for Diversity in Health Management (IFD), in partnership with the National Center for Healthcare Leadership (NCHL), Health Forum, and the American Hospital Association (AHA), are now accepting applications for the Cultural Competence Leadership Fellowship. Now in its second year, the program equips participants with critical skills to lead their organizations in providing safe, high quality care to multicultural patients and communities.  Fellows explore practical approaches to assessing organizational competence, enhancing patient-provider interaction, and using systems approaches to reduce disparities. Community practitioners and teams are encouraged to apply. 

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

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

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

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

Directory Of Health Policy Fellowships

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

ORGANZATIONS AND SERVICES

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

MANUALS, GUIDES, TOOLKITS

Newly posted resources are at the top of the list.

New Action Kit on Combating Childhood Obesity

A new action kit for municipal leaders on Combating Childhood Obesity will be available this month.  The National League of Cities' YEF Institute publication reflects on the impact that increasing childhood obesity has on cities and their youngest residents, and highlights a broad array of city strategies to combat the childhood obesity epidemic by promoting physical activity, access to healthy foods, and healthy eating among children and youth.  In addition, the action kit features city examples that showcase progress being made at the local level, as well as additional resources for further information.

Medicare Part D Extra Help/Low Income Outreach Toolkit
CMS now offers an Extra Help/Low Income Outreach Toolkit.  The outreach and education initiatives outlined in this plan are designed to identify all remaining likely Low Income eligible beneficiaries; ensure that they complete applications; and encourage them to actively choose their Medicare drug plans. Estimates show approximately 3 million Medicare beneficiaries remain who are likely to qualify for Extra Help but have not yet applied for it or enrolled in a Medicare drug plan. There is a May 16 - Nov. 15, 2006 Special Enrollment Period so those eligible for Extra Help can join a Medicare drug plan immediately without paying a penalty.