Medically Needy:  TAKE ACTION
Newborn Citizenship Proof for Medicaid

Medicare Part D
Children's Health Care: Post Election  TAKE ACTION

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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 16, 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

Rule change to drug subsidies could be costly; Drug subsidies worth hundreds to some people
Because of tangled government eligibility rules, up to 37,000 Floridians with chronic and costly illnesses are at risk of losing low-cost Medicare and Medicaid prescription coverage. As a result, they will face sharply higher medical bills. Patients and advocacy groups fear the big bills will drain thousands of dollars every month from people who can afford it least, possibly forcing some to skimp on medicine and doctor visits -- for at least a few months. The problem springs from complex eligibility rules. These patients -- including about 2,000 in Broward County and 1,000 in Palm Beach County -- earn too much to qualify for regular state Medicaid available to low-income people, but because of large medical bills, they were eligible for a state "medically needy" program that paid all their costs. This year, medically needy patients were moved into Medicare's new drug program and pay subsidized prices of $0 to $5 per prescription. But because Medicare now covers the bulk of their drugs, most of them no longer will qualify as medically needy Jan. 1. That's the Catch-22. As a result, these patients will also lose eligibility for those Medicare discounts and must pay regular drug co-pays. (11/11/06, South Florida Sun-Sentinel)

'Catch-22' in U.S. rules could be costly for thousands with chronic illnesses
Because of tangled government eligibility rules, up to 37,000 Floridians with chronic and costly illnesses are at risk of losing low-cost Medicare and Medicaid prescription coverage. As a result, they will face sharply higher medical bills. Patients and advocacy groups fear the big bills will drain thousands of dollars every month from people who can afford it least, possibly forcing some to skimp on medicine and doctor visits -- for at least a few months. "I'm just able to scrape by now. If I had to pay more, I don't know what I would do," said Bruce Bernstein, a Boynton Beach heart transplant recipient who is disabled at age 59. "I might lose my home." (11/10/06, South Florida Sun-Sentinel)

Klein predicts quick changes to drug law

A week after being elected to the U.S. House of Representatives, Ron Klein said senior issues played a major role in his campaign and predicted the Democratic-dominated Congress would act quickly to alter the Medicare prescription drug law. Klein, a Democrat from Boca Raton, predicted the House quickly would agree to allow the federal government to negotiate prescription drug prices with manufacturers on behalf of Medicare beneficiaries. But efforts to change the law could run into hurdles in the Senate, where the Democrats' 51-vote majority would not be enough to overcome a filibuster, and from the Bush administration, which opposes negotiations as a form of government price control. He predicted Congress would vote to eliminate the 1 percent per month penalty on late enrollment in the drug program. (11/15/06, Palm Beach Post)

Study drug plan options in Medicare; Multitude of choices can be confusing
Health advocates and officials expressed concerns that seniors may be complacent or weary about shopping for Medicare prescription drug benefits, as the nation today begins a six-week sprint to sign up for 2007 coverage. Facing so many options -- more than 115 plans in South Florida -- retirees and disabled people may simply stay with their present Medicare drug plans, even though advocates advise studying the options because most plans are changing costs and coverage. (11/15/06, South Florida Sun-Sentinel)

Enrollment for Medicare Part D starts Wednesday; Array of complex choices requires review
"Everyone needs to do a thorough review because for almost every plan, premiums are going up, and [the drugs that are covered] may be changing," said Paulette Geller with the Winter Park Health Foundation, one sponsor of the Medicare fairs that will help people enroll throughout the region. (11/12/06, Orlando Sentinel)

Variety of options are available; Medicare HMOs offer coverage through Part D's doughnut hole.

In addition to the some 58 Part D stand-alone prescription drug plans offered in Florida, seniors will have scores of options available if they choose to enroll in a Medicare HMO come Wednesday, when the benefit enrollment period opens for 2007. Also called Medicare Advantage Plans -- in which private companies offer Medicare benefits for seniors over 65 and people with disabilities -- most will offer prescription drug coverage as well as a sprinkling of new perks. (11/12/06, Miami Herald)

Experts: Explore all drug plans
Insurance counselors say they behoove everyone eligible for Medicare Part D to take a second look at their prescription drug plan when the benefit enrollment period begins on Wednesday. For Florida seniors enrolled in a Medicare Part D drug plan, 2006 has been a year of trial, and, for some, a year of error. Take Nelson and Ann Dembs who, to their deep chagrin, reached the coverage gap far sooner than expected because they misunderstood their plan's structure. When the enrollment period for next year's Medicare prescription drug benefit opens on Wednesday, the Dembs -- from Hollywood -- said they will explore plans providing coverage of their medication through the so-called doughnut hole. (11/12/06, Miami Herald)

OPINION: Democrats looking for impact? Get started on high drug prices
If Democrats in Congress want to know where to start with their new majorities in Congress, they don't have to look far for significant problems waiting for a solution. Here's one: Retirees across Northwest Florida and the entire nation will benefit from quick action on high drug prices. On its first day, the Democratic Congress should reverse the prohibition -- put into the Medicare prescription drug benefit by the Republican Congress in 2003 -- against Medicare being able to negotiate for lower drug costs. (11/10/06, Pensacola News Journal)

With more options and changes from last year, studying choices is important
Medicare recipients may feel they finally have recovered from the turmoil of the first year of the government's prescription drug program. Sorry, but it's time to think about it again. The 2007 enrollment period for Medicare drug plans and health plans begins Nov. 15, and if anything, the choice will be harder this time around. A year ago, South Florida seniors and disabled people in Medicare had about 100 plans to choose from. This year, they have 131 choices in Broward County, 115 in Palm Beach County. Even if you like the coverage you have, you should shop anyway. At least 14 new plans are coming to South Florida seeking a foothold. Some existing plans are offering new coverage options, and some are sharply changing prices and benefits. (11/5/06, South Florida Sun-Sentinel)

Seniors' drug options dizzying Medicare Part D sign-up will begin Wednesday

Sandie Horvath is a nurse and likes to think she has a good handle on medical matters. But as she left a seminar on Medicare's fledgling prescription drug program last week, Horvath admitted even she was a little overwhelmed. "It makes a giant puzzle, and many of us in the professional field are still trying to sort through it," said Horvath, a North Fort Myers resident  who is on Medicare herself. Wednesday, some 43 million seniors will be eligible to enroll in Medicare's year-old prescription drug plan. The federal government introduced the drug plan this year to help seniors manage the costs of their medications. Uncle Sam may have been feeling benevolent, but he certainly wasn't feeling user-friendly. (11/13/06, Naples News-Press)

Drug benefit Round 2 looms; As Medicare Part D enters Year 2, review options thoroughly.

After a shaky beginning and strong recovery in 2006, Medicare’s drug benefit faces a murky future as it prepares for its second year. Democrats will control Congress, and many want to eliminate dozens of private plans and have Medicare negotiate drug prices directly with manufacturers. But such an overhaul could take years. So people who want a Medicare drug plan next year still face a smorgasbord of choices. In Florida, 26 companies offer 58 Part D drug plans for 2007. Premiums range from $10.20 a month to $83.70. Sign-up begins Wednesday and runs through Dec. 31. (11/12/06, St. Petersburg Times)

OPINION: Profits up, coverage down
By William L. Reider, past president of the Voter's Coalition of Palm Beach County and a past board member of a physicians-owned insurance company in New York. 
Three recent new studies have added more pressure to our already overburdened health care delivery system. A study found that new Medicare drug benefits will require higher premiums from senior citizens. Our health care delivery system is failing on an ongoing basis to control expenditures. Over 47 million of our citizens are now without any health care insurance, and the number is growing. And the upward pressure on costs will only continue to worsen. Meanwhile, our Congress is failing to pass even the most elementary remedies. A second new study links doctors' errors and bad diagnoses to increased malpractice insurance rates, which ultimately have an effect on health care costs. A third study suggests a growing trend: More and more health insurers are finding ways to cancel health insurance during or after an illness with patients holding private contracts. Health care will soon pass manufacturing as America's No. 1 industry. Yet the industry is not responsive to many of its customers. It is geared for profit, not quality health care. Because health care insurance is becoming more unaffordable, only the most affluent can afford to be without it. Yet employers are dropping coverage for many workers, or resorting to minimal benefit coverage, individual policies are vulnerable to cancellation and group policies often leave huge gaps in coverage. Still, insurance industry profits continue to rise inexorably. (11/6/06, South Florida Sun-Sentinel)
 

Other Medicare, Medicaid

EDITORIAL: Newborns bear brunt of HHS rule
As the Bush administration moves immigration reform into the pediatric ward, babies now get to pay the price. Though the Constitution considers anyone born in the United States to be a citizen, the Department of Health and Human Services has added an astonishing bureaucratic postscript. "A child born in the U.S. to an illegal alien mother," HHS writes, "... is not a deemed newborn." "Deemed newborn" is regulator-speak for deciding which babies get tossed out of hospitals, and it is thoroughly indecent. The American Academy of Pediatrics, which opposed the new Medicaid eligibility rule, described the inevitable medical consequence in four words: "Children will be hurt." The change defies common sense. Under a 22-year-old Medicaid law, illegal immigrants are covered for emergency hospital treatment that includes childbirth. (11/14/06, St. Petersburg Times editorial)

Advocates fear law deters health care for babies of undocumented parents
Florida has about 2.3 million Medicaid recipients, according to Alisa Snow, public policy director of the Florida Community Health Action Information Network. Of those, 1.2 million are children. "This new law puts the burden on emergency rooms to provide the care that babies need," Snow said. "It's a really big cause for concern." Some Medicaid officials were skeptical that the new rules would result in babies being denied coverage. "If people know of an instance where a state has denied eligibility because someone couldn't produce evidence of citizenship ... we would be interested in knowing about that," said Leslie V. Norwalk, acting administration for the Center for Medicare and Medicaid Services. Mothers throughout Florida are feeling the effects of the law. (11/3/06, South Florida Sun-Sentinel)

EDITORIAL: Treat these newborns
Denying children health care will not solve America's problem with illegal immigration or Medicaid fraud. But tucked into the Deficit Reduction Act that the president signed in February are new Medicaid documentation rules that aim at illegal immigrants and snare American newborns. The new federal policy, which took effect in July and is gaining notice and enforcement, requires a Medicaid application to be filed for a child and for parents to prove the child's citizenship before Medicaid will pay for any services. Medicaid officials have said the rules were tightened because of fear that illegal immigrants were faking U.S. citizenship to gain Medicaid benefits. In the past, under a 1984 law, a child born to a woman who received emergency care under Medicaid for childbirth automatically was eligible for coverage, which continued for the first year of life. The new policy will create especially perilous conditions for newborns, who require medical care immediately and repeatedly until their first birthday. (11/13/06, Palm Beach Post)

Our view: Punishing the helpless: Don't jumpstart immigration reform by denying infants medical care

Most Americans agree the nation must reform its immigration policies. But surely few want to start the process by punishing infants. That's what's starting to happen in some states now, because of new federal policy that can deny health coverage through Medicaid to babies born to poor illegal immigrants. Under previous rules, one year of coverage for infants born in U.S. hospitals was automatic, because they are citizens. Now undocumented parents must apply for Medicaid for newborns, a process that could take months and delay essential care if states hold to strict interpretations of the new policy.  (11/6/06, Florida Today)

Medicaid Changes Worry Community
Illegal immigrants are generally excluded from Medicaid, which draws federal and state funding. Under the previous policy, women without legal status received Medicaid coverage for labor and delivery, and states covered health-care costs for the baby's first year of life. Babies of illegal residents are still eligible for Medicaid, but now their parents must apply and provide proof of the child's citizenship. Local advocates for immigrants denounced the change, while medical officials said it's unclear what the effects will be. Some predicted undocumented immigrants won't pursue Medicaid coverage for their children because of concerns about making their presence known to the government. "It's making everything more difficult for undocumented women who, out of fear of having their illegal status exposed, would rather put their babies' health in danger," said Juan Mojica, a local activist with United Latino Immigrants of Florida. "Not only will the child's life be in danger, but (that of) the mother, who instead of going to a hospital may rely on a midwife to give birth." (11/4/06, Lakeland Ledger)

Petition Seeks More Medicaid Funding
Two hundred dollars a month is not enough to live on. That's what chronically ill patients hope to convince state lawmakers of with a new statewide petition drive. Last week, a coalition of patient and health care groups launched the campaign to pressure the state to shoulder more of the medical costs that burden the chronically ill. The state's Medicaid Medically Needy program assists such patients if their monthly medical bills are high enough, but it leaves them with only $200 to cover the month's rent, food and other expenses. That's what the patients and advocates want to change; $200, they say, is too little. Some Tallahassee lawmakers say they are ready to listen - especially since a new glitch in the federal Medicare program has made it even harder for some patients to qualify for help through the Medically Needy program. Change will come at a price, however, and lawmakers warn of new pressures on the health care budget next year. (11/6/06, Tampa Tribune)

Health Insurance and Costs

McHouse Calls Made
The Ronald McDonald fast food icon's decals cover the van's exterior - its charitable arm funds it - but health care, not hamburgers, is offered inside. The Care Mobile, a free clinic housed in a 40-foot-long van, has treated about 1,100 students at 31 Hillsborough County schools since opening in February. The van is staffed by doctors and nurses from USF Health, who travel to a different school each day, treating up to 15 students in four hours. The medical team works only at Title 1 schools, where more than half the students receive free or reduced-price lunches. Nearly 70 percent of the students treated don't have health insurance. Some students are insured, but obstacles such as transportation or the cost of co-payments keep them from going to the doctor. (11/14/06, Tampa Tribune)

Gathering focuses on state's health insurance woes

Local leaders and national experts on healthcare met in Fort Lauderdale to discuss the growing problem of Floridians without health insurance. Imagine getting frequent-flier miles for walking your dog. Humana has recently made it a reality as part of a new way to encourage the growing number of Americans without health insurance to buy coverage. It's called HealthMiles Plus, and the more customers stay active, the more points they earn to turn into cash or miles with Humana's partner, Virgin Atlantic Airways. The plan was among several discussed at Broward General Medical Center in Fort Lauderdale Thursday, when more than 200 experts in healthcare and local politicians shared ideas on how to curb the growing number of Floridians without health insurance. Those in attendance included representatives from the American Medical Association, Microsoft and Wal-Mart. (11/13/06, Miami Herald) 

'Angels of mercy' Health department provides care for uninsured
"Many uninsured Americans have regular jobs," said Paul Duncan, chairman of Department of Health Services Research, Management and Policy at University of Florida. "But they are more likely to have lower wages," he said in a recent presentation at the weekly Public Policy Institute of Marion County meeting. Duncan said, on average, health insurance costs about $12,000 a year for a family of four. With an average income of $40,000 a year, and after taxes, housing and food, only $10,000 would be left for "everything else", including health insurance. The average household income in Marion County is $37,000. Locally, about 16 percent of county's population is uninsured, and if it weren't for the county's initiative, their only source of care would have been the hospitals' emergency rooms. Marion County conducted a needs assessment more than a decade ago to address issues of limited accessibility and availability of primary and specialty care to the medically underserved, low income, uninsured and underinsured residents of the county. The findings led to establishment of Marion County Indigent Care System, a public-private health care partnership. As a result, the Community Health Services of Marion County was established to serve as a care center for small emergencies for the uninsured and underinsured population. (11/2/06, Ocala Star-Banner)

Web site lets Floridians compare plan costs
Florida residents now can compare costs, benefits and other information on health care plans in their county thanks to new plan information at www.FloridaCompareCare.gov. The Web site also allows consumers to compare hospitals and ambulatory surgery centers in their area. An ambulatory surgery center is an outpatient facility. A month ago, the Florida Agency for Health Care Administration added information to the site, allowing consumers to educate themselves before making a decision. (11/11/06, Bradenton Herald)

Insurer gets doctor as meds run low; Bill dispute left man in lurch
Just before his pain medication was about to run out for his back problems, Patrick Whiley's health insurance company found him a doctor to refill his medication, his parents said Monday. Whiley, 43, is the Palm Bay man featured Sunday in FLORIDA TODAY about his and his parents' struggle to find treatment for him after his doctor dropped him as a patient because of a billing dispute with WellCare Health Plans, his insurer. According to Ray and Shirley Dorson, his parents, a WellCare representative called them Monday morning to say the company has found a doctor in the Orlando area to treat Whiley, and that the company also would provide transportation to and from his doctor visits. (11/7/06, Florida Today)

Disputes may endanger patients
Patrick Whiley of Palm Bay deals with excruciating back pain with the daily aid of painkillers injected about every two months into a time-release pump implanted in his abdomen. The problem is he will run out of the pain medication Thursday, and his doctor, Todd Jaffe, no longer is treating him because of a billing dispute with Whiley's health care insurer, WellCare Health Plans, a Tampa-based Medicaid and Medicare health maintenance organization. Whiley and his parents can't find another doctor in the insurance company's network. They said the company has been unresponsive to their calls for help.  (11/5/06, Florida Today)

Other Health Issues 

Officials Clash Over Mentally Ill in Florida Jails
The state is threatened with steep fines if it does not move mentally ill inmates from jails to hospitals. For years, circuit judges here have ordered state officials to obey Florida law and promptly transfer severely mentally ill inmates from jails to state hospitals. But with few hospital beds available, Gov. Jeb Bush’s administration began flouting those court orders in August. Now, in a growing standoff between the government of Florida and its judges, the state is being threatened with steep daily fines if it does not comply. And at least one judge has raised the possibility that the secretary of the Florida Department of Children and Families could go to jail for contempt of court. (11/15/06, New York Times)

Palm Beach County group takes on surgeon scarcity at local hospitals; County's hospitals often forced to send their patients south
As Palm Beach County takes measured steps toward bringing on-call surgeons back into hospital emergency departments, frustration is growing south of the county line, where Broward County specialists are caring for more high-risk transfers. "We feel like we're asked to fix a problem that's occurring in Palm Beach," said Dr. Amos Stoll, a neurosurgeon at Broward General Medical Center in Fort Lauderdale. "We didn't get on staff at Broward General to take cases from Palm Beach. They really need to get their own neurosurgeons up there." (11/12/06, South Florida Sun-Sentinel)

Doctors shunning geriatric medicine; Lack of specialists raises concerns for seniors' health care.

Promoters of geriatric medicine long have been concerned by the imbalance between the number of geriatricians, and patients who need their expertise. A 2005 American Geriatrics Society report found that of more than 650,000 practicing physicians nationwide, fewer than 7,000 were certified geriatricians, or one for every 5,000 Americans age 65 and older. And it appears the slim ranks have been shrinking recently. There were about 440 fewer geriatricians in 2006 than in 2004, according to the American Board of Medical Specialties. By 2030, the geriatrics society estimates, the nation will be about 36,000 geriatricians short. (11/5/06, South Florida Sun-Sentinel)

Other Medicare, Medicaid, SCHIP News

Health Insurance and Costs

Democratic Wins Portend New Focus on Health Policy
USA Today predicts that the Democrats' "stunning electoral gains" will lead to "more populist debates," including "a re-invigorated debate on ways to help the ninsured." (11/9/06, USA Today)

Insurance Industry Proposes Measures Leading to Universal Coverage
In the wake of the mid-term elections, American's Health Insurance Plans, the main lobby group for the health insurance industry, issued a proposal that would guarantee coverage for all children in three years and for essentially all adults within a decade, according to a widely reported story. (11/14/06, New York Times)

OPINION: Uninsured and Health Costs Likely to Be Issues in the Presidential Election
While the mid-term elections involved almost no debate about health care or other big economic problems, health care—including the rising number of uninsured—is one of the four biggest issues likely to dominate the 2008 presidential election. (11/8/06, New York Times)

Health Care Reform Likely Will Not Become An Issue In The Near Future
The U.S. health care system "continues to weaken" as the number of uninsured U.S. residents increases, health care costs rise and companies reduce or eliminate workers' health benefits, but "chances are slim" that the U.S. will adopt a "far less expensive 'single-payer' health system ... anytime soon." (11/6/06, Christian Science Monitor)

The Uninsured Are a Likely Focus of the Next Congress, but Solutions Vary by Party
Health care policy, including the uninsured, is expected to be a focus for the next Congress, though the priorities will be different depending on whether Democrats or Republicans dominate in the election. (11/3/06, Washington Times)

Americans Are Unlikely to Opt for a Single-Payer Health Care System

Though the health care system in the United States is "eroding" due to rising costs and the rising number of uninsured, the nation is unlikely to choose a single-payer system like the one in Canada. (11/6/06, Christian Science Monitor)

Former Intel Executive Promotes Reforms to Cover the Uninsured

Alarmed by "several structural issues involving health care in America, notably, the huge number of uninsured, who are often forced to get primary care in emergency rooms," former Intel CEO Andy Grove is promoting his health care reform ideas. (11/1/06, Wall Street Journal)
 

Grades to transform U.S. healthcare, secretary says
A scorecard that lays out how well a hospital or doctor does on a treatment -- and how much they charge for it -- can help transform U.S. health care, Health and Human Services Secretary Mike Leavitt said on Monday. Leavitt said the federal government will urge private insurers and employers to help develop and use such a scorecard so patients can make informed choices on where to get care and who to get it from. He said Medicare's prescription drug benefit plan serves as a perfect model for such a scorecard. "It's working. People are happy. They are enrolled," Leavitt told reporters. "We believe that if you give people choices, they make good choices." Democrats and other critics have assailed the Medicare plan as a boon for drug and insurance companies and say it is confusing for the 43 million Medicare beneficiaries. Democrats say they hope to make some changes when they take control of the House of Representatives and the Senate in January. (11/13/06, Reuters)

HEALTH ADVOCACY RESOURCES

November 16, 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

Continuing grant listings, in order of submission deadlines

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.

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/Updated Resources Medicare Drug Plan Resources
In advance of the 2007 Medicare drug plans open enrollment period beginning Nov. 15, Kaiser Family Foundation has issued a series of new and updated resources based on ongoing research including consumer surveys:

Updated fact sheet providing state-specific data about Medicare drug plan options for 2007, including stand-alone drug plans and Medicare Advantage plans, and information on premiums, gap coverage, and availability to beneficiaries who qualify for full low-income assistance.

Updated Medicare Prescription Drug Benefit fact sheet, with a revised estimate that 4 million people will be affected by the coverage gap in 2006, as well as current enrollment and low-income subsidy participation and updated Medicare per capita drug spending.

Updated Talking About Medicare online consumer guide, reflecting 2007 benefit changes, to help people with Medicare and their families understand options and make decisions based on their personal situations; includes information about financial assistance for those with limited incomes, supplemental insurance options, and Medicare Advantage.

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.