Strategies for Improving Access to Comprehensive Obesity Prevention and Treatment Services for Medicaid-Enrolled Children

This policy brief builds on our prior work for the Robert Wood Johnson Foundation. In 2005, The George Washington University School of Public Health and Health Services (GW) evaluated the role of public and private insurance in financing preventive care and treatment for at-risk and obese children. One of the key findings from that report was that Medicaid\u27s existing Early and Periodic Screening Diagnostic and Treatment (EPSDT) coverage standards provide for comprehensive, obesity-related pediatric health care interventions. Using data drawn from state Medicaid programs, this report examines the extent to which state programs use the Medicaid EPSDT benefit to address and finance obesity-related services that advance best-practice standards in obesity prevention, treatment and management in children

Managed Care and Medi-Cal Beneficiaries with Disabilities: Assessing Current State Practice in a Changing Federal Policy Environment

This analysis, prepared for The California Endowment, is a follow-on report to our earlier work that raised issues to be considered before moving persons with disabilities into compulsory Medicaid managed care plans and reviewed the extent to which California\u27s legal framework addressed the concerns identified. In this report, the George Washington University School of Public Health and Health Services examines how other states have addressed issues that arise in designing, implementing and overseeing compulsory managed care systems for persons with disabilities and serious and chronic health conditions. The experiences of other states that have developed these types of arrangements offer an important learning opportunity for any state that is beginning the process of evaluating possible reforms. In addition, we evaluate how the changes in the Deficit Reduction Act of 2005 relate to decisions regarding the use of mandatory managed care enrollment for disabled beneficiaries

The US Supreme Court’s Rulings on Large Business and Health Care Worker Vaccine Mandates: Ramifications for the COVID-19 Response and the Future of Federal Public Health Protection

On January 13, 2022, the Supreme Court issued 2 landmark rulings on the federal government’s power to mandate COVID-19 vaccinations. The Court curtailed the government’s ability to respond to the pandemic and may have also severely limited the authority of federal agencies to issue health and safety regulations. In National Federation of Independent Business v Department of Labor, the Court blocked an Occupational Safety and Health Administration (OSHA) emergency temporary standard (ETS) requiring vaccination, subject to religious or disability accommodations, or weekly testing and masking in businesses with 100 or more employees. In Biden v Missouri, the Court upheld a Centers for Medicare & Medicaid Services (CMS) regulation mandating health worker vaccinations, subject to the same accommodations. What do these decisions reveal about the future of federal protection of public health and safety

Reducing Obesity Risks During Childhood: The Role of Public and Private Health Insurance

In a widely publicized decision issued in 2004, the United States Department of Health and Human Services removed language from the Medicare Coverage Issues Manual which stated that obesity is not an illness, a pronouncement that paves the way for Medicare coverage of evidence-based obesity treatments. This determination by HHS also has important implications for public and private insurance coverage of health care services and interventions that have the potential to reduce the risk of lifelong obesity in children. This Report assesses the implications of the 2004 HHS obesity ruling into the context of public and private health insurance for children. It begins with an overview of what is known about obesity risk in childhood, as well as its short-term and long-term health consequences and then reviews the evidence of effective health interventions for children at risk. The Report then considers the implications of the 2004 decision for private health insurance coverage for children, followed by a more extended discussion of its implications for children covered under Medicaid and the State Children\u27s Health Insurance Program (SCHIP). The Report concludes with a discussion of strategies for engaging both public and private insurers in a systematic effort to increase investment in preventive health services for children at risk of obesity

Child Development Programs in Community Health Centers

This report, the third in a series that reviews federal health policy related to child development, examines the role of community health centers in providing child development programs for children age 3 and younger. It also presents an analysis of health centers using the Uniform Data System, a database maintained by the federal Bureau of Primary Health Care (BPHC) that contains user, utilization, and financial information on each reporting center. In addition, the report presents findings from a 2000 survey of four categories of child development programs at 79 health centers; examines the new prospective payment system for health centers and its potential impact on the provision of child development services; and offers recommendations for improved delivery of these services at health centers. Health centers administered by BPHC rely on public funds to provide comprehensive medical services, as well as a variety of social services, to low-income, medically underserved communities. By 2000, about 700 health centers served more than 9 million people at nearly 3,000 locations. As of 1999, 129 clinics designated by the federal government as meeting all standards applicable to federal health center grantees were serving another 1.8 million patients. Health centers are a major health care provider for children. They care for one of every six children of low-income families, and serve 1.3 million children under age 6.3 In 1998, births to health center patients accounted for one of five births to low-income families, or one of 10 of all births nationally. Because of their ability to identify at-risk children and to assess their social and primary care needs, health centers are valuable and essential providers of child development services. Findings presented in this report show that health centers provide many valuable programs and services that promote the healthy growth and development of a large number of young children. Maintaining and expanding their ability to seek out at-risk children, screen and assess their needs, and provide appropriate development services are important to improving the health and welfare of children and their families.This report, the third in a series that reviews federal health policy related to child development, examines the role of community health centers in providing child development programs for children age 3 and younger. It also presents an analysis of health centers using the Uniform Data System, a database maintained by the federal Bureau of Primary Health Care (BPHC) that contains user, utilization, and financial information on each reporting center. In addition, the report presents findings from a 2000 survey of four categories of child development programs at 79 health centers; examines the new prospective payment system for health centers and its potential impact on the provision of child development services; and offers recommendations for improved delivery of these services at health centers

From SCHIP Benefit Design to Individual Coverage Decisions

The majority of states have implemented separate SCHIP (S-SCHIP) programs that significantly depart from Medicaid and resemble less comprehensive commercial products. This difference in program design may result in S-SCHIP potentially being less responsive to children with special needs (CSHCNs). This study explores how responsive insurers are to these higher than average needs. We found that, with one exception, insurers did not agree on the coverage of any specific service, but overall they provided coverage beyond state limits and exclusions. Second, the less acute the childhood condition, the more frequently insurers imposed exclusions. Finally, in the majority of states, some insurers excluded services that arguably should have been covered according to the plan/contract language. We conclude that SCHIP coverage at current levels may not be sufficient to care for CSHCNs, making external reviews of insurers\u27 coverage decisions and coordination with other sources of care important components of SCHIP program design

Women\u27s Health and Health Care Reform: The Economic Burden of Disease in Women

This report estimates the direct and indirect costs of care for women for the major chronic diseases and conditions that women face across the lifespan. It also identifies the key primary care and preventive services that can lead to prevention, early detection or early intervention for these conditions. Health care screening, counseling, early diagnosis, and early intervention health care services are important for women at each stage of their lives. But women typically seek care in primary care settings for family planning services and cancer screening prior to becoming pregnant. As a result, high quality care during the reproductive years offers an important opportunity to identify risk factors and health conditions and to provide appropriate interventions and quality care. Primary and preventive care standards also underscore that screening for cancer, risks for heart disease, family planning services and detection of violence, as well as smoking cessation and nutrition counseling, should begin during the reproductive years. A healthy pregnancy, leading to the best outcome for both mother and child, begins when the woman is in the best possible health prior to conception. Counseling on obesity prevention and smoking cessation are vital prior to pregnancy; delaying counseling until after conception compromises a woman\u27s ability to achieve the best outcomes. Identification of hypertension and/or gestational diabetes in pregnancy provides an opportunity to identify women at higher risk of heart disease and diabetes later in life. Early care is particularly important for women who are members of racial and ethnic minority groups. Approximately one in every three residents of the United States self-identifies as African-American, American Indian/Alaska Native, Asian/Pacific-American, or Latino. Disparities in health status are closely associated with race and ethnicity – in health insurance coverage, psychosocial stress, discrimination and health care access and quality, and in deaths due to breast cancer and pregnancy-related causes

Establishing Foundation Archives: A Reader and Guide to First Steps

This publication is an anthology of papers presented at a conference held at the Rockefeller Archive Center in January 1990, and sponsored by the Council on Foundations. This collaboration of the Archive Center and the Council provided a rare opponunity for foundations to learn both why preserving documents is imponant and how several foundations have approached finding a repository or setting up and managing an archives. Participants in the conference had the added privilege of conferring with experts and seeing an operating archive as they toured the Rockefeller Archive Center.Foundations are institutions that are shaping private initiatives for the public good, so documenting this aspect of American society falls uniquely under the stewardship of the organizations themselves. Foundation documents often provide the only surviving records of the important contributions of nonprofits and foundations to civic life. These records will help to inform future judgments and ensure that the history of the field is not lost. The publication of this volume was intended to make the information shared at the conference more widely available and to provide an entry point and a primer for foundations as they begin their records and archives journey

Measurements of Higgs boson production and couplings in diboson final states with the ATLAS detector at the LHC

Measurements are presented of production properties and couplings of the recently discovered Higgs boson using the decays into boson pairs, H →γ γ, H → Z Z∗ →4l and H →W W∗ →lνlν. The results are based on the complete pp collision data sample recorded by the ATLAS experiment at the CERN Large Hadron Collider at centre-of-mass energies of √s = 7 TeV and √s = 8 TeV, corresponding to an integrated luminosity of about 25 fb−1. Evidence for Higgs boson production through vector-boson fusion is reported. Results of combined fits probing Higgs boson couplings to fermions and bosons, as well as anomalous contributions to loop-induced production and decay modes, are presented. All measurements are consistent with expectations for the Standard Model Higgs boson

Standalone vertex finding in the ATLAS muon spectrometer

A dedicated reconstruction algorithm to find decay vertices in the ATLAS muon spectrometer is presented. The algorithm searches the region just upstream of or inside the muon spectrometer volume for multi-particle vertices that originate from the decay of particles with long decay paths. The performance of the algorithm is evaluated using both a sample of simulated Higgs boson events, in which the Higgs boson decays to long-lived neutral particles that in turn decay to bbar b final states, and pp collision data at √s = 7 TeV collected with the ATLAS detector at the LHC during 2011