WORKING: The Newsletter of the New York Makes Work Pay Initiative

WELCOME to the inaugural issue of Working, a print and elec¬tronic newsletter produced by the New York Makes Work Pay Initiative. This Initiative is a Comprehensive Employment Ser¬vices Medicaid Infrastructure Grant funded by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) to the New York State Office of Mental Health (OMH) and its management partners the Burton Blatt Institute (BBI) at Syra¬cuse University and the Employment and Disability Institute (EDI) at Cornell University. The New York Makes Work Pay Initiative is currently funded for calendar years 2009 and 2010 and will provide an array of services to individuals with disabilities, the agencies and advocates that serve them, and employers, helping to remove obstacles to work and pave the way to self-supporting employment

Nursing School Makes MU History

Published Nov. 5, 2012."MU's largest research grant will improve care for older adults. ... Marilyn Rantz has been busy. On Nov. 5, 2012, the University of Missouri Sinclair School of Nursing announced MU researchers, led by Rantz, secured a $14.8 million grant from the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS) -- the largest research award in the history of the university. This comes only three weeks after Rantz, a Curators' Professor of nursing, was admitted to the Institute of Medicine, one of the highest honors in the field."Story by Kelsey Allen

Working: The Newsletter of the NY Makes Work Pay Initiative. Issue 1, April 2009

elcome to the inaugural issue of Working, a print and electronic newsletter produced by the New York Makes Work Pay Initiative. This Initiative is a Comprehensive Employment Services Medicaid Infrastructure Grant funded by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) to the New York State Office of Mental Health (OMH) and its management partners the Burton Blatt Institute (BBI) at Syracuse University and the Employment and Disability Institute (EDI) at Cornell University. The New York Makes Work Pay Initiative is currently funded for calendar years 2009 and 2010 and will provide an array of services to individuals with disabilities, the agencies and advocates that serve them, and employers, helping to remove obstacles to work and pave the way to self-supporting employment. To learn more about this initiative, go to www.NYMakesWorkPay.org

In Search of Dental Care: Two Types of Dentist Shortages Limit Children's Access to Care

Each year in the United States, tens of millions of children, disproportionately low-income, go without seeing a dentist.This lack of access to dental care is a complex problem fueled by a number of factors, with two different dentist shortages compounding the issue: An uneven distribution of dentists nationwide means many areas do not have an adequate supply of these practitioners. As a result, access to care is constrained for people in these communities regardless of income or insurance coverage.The relatively small number of dentists who participate in Medicaid means that many low-income people are not receiving dental care.National standards set by dental and pediatric organizations call for children to visit a dentist every six months.The federal government requires state Medicaid programs to enact their own standards after consulting with these organizations, but new data show that more than 14 million children enrolled in Medicaid did not receive any dental service in 2011.According to the most recent comparison, in 2010, privately insured children were almost 30 percent more likely to receive dental care than those who were publicly insured through Medicaid or other government programs, even though low-income children are almost twice as likely as their wealthier peers to develop cavities.4 In 22 states, fewer than half of Medicaid-enrolled children received dental care in 2011.In 2012, Dr. Louis W. Sullivan, secretary of health and human services under President George H.W. Bush, said, "In a nation obsessed with high-tech medicine, people are not getting preventive care for something as simple as tooth decay." He pointed to the inadequate dental workforce as a driving factor, stating, "The shortage of dental care is going to get only worse."This issue brief examines the lack of access to dental care, especially for low-income children and families, in the United States. It also explores strategies states are employing -- particularly expansion of the dental team by licensing additional types of providers -- to address workforce shortages and better serve low-income children

How Much Does the Federal Government Spend to Promote Economic Mobility and for Whom?

Tracks and projects federal expenditures and tax subsidies aimed at enhancing economic mobility, such as employer-related work subsidies, homeownership, savings and investment incentives, and education and training, and who benefits from them

Preventing Disability Among Working Participants in Kansas’ High-risk Insurance Pool: Implications for Health Reform

Health conditions that prevent individuals from working full time can restrict their access to health insurance. For people living in the 35 states that offer high-risk pools, coverage is available but premiums are 125–200% of standard rates. Additionally, high cost-sharing means enrollees often defer needed care because they must pay large amounts out of pocket. Lack of access may lead to poor health outcomes and disability. The Kansas DMIE investigated whether improving insurance coverage for such a group would improve their health status and reduce their risk of transition to full Social Security disability. Half of the 508 participants received enhanced benefits and nurse case management, the other half received usual risk pool coverage. Outcomes were measured through telephone surveys, focus groups, and claims analysis. Utilization of services increased and health status stabilized for the intervention group, while health status of the control group significantly declined. These findings have broad implications because some plans to be offered under the Patient Protection and Affordable Care Act of 2010 (P.L. 111–148) have similarly high out-of-pocket costs. Considering the long-term cost of full disability, providing adequate health insurance benefits for individuals at high risk of disability may be cost effective.Kansas Health Policy Authority, U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (no. 11-P-92389/7-01)

Covering Kids & Families Evaluation Case Study of Michigan: Exploring Medicaid and SCHIP Enrollment Trends and Their Links to Policy and Practice

Evaluates the impact in Michigan of the RWJF project to increase enrollment in Medicaid and State Children's Health Insurance Programs. Outlines state policy changes and local- and state-level findings on the links between activities and enrollment trend

Reining in Medicaid spending--states respond to declining revenues

Medical care, Cost of ; Medicare

Health Care Behaviors and Decision-Making Processes Among Enrollees In A State High Risk Insurance Pool: Focus Group Findings

Purpose-To better understand the relationship between health insurance coverage and health care behaviors of persons with potentially disabling conditions enrolled in a state high risk insurance pool. Approach or Design-Six focus groups with risk pool enrollees in two sites. Setting-Suburban areas in the state of Kansas. Participants-Forty-two individuals ages 29 to 62 years, all with potentially disabling physical or mental health conditions. Method-Qualitative analysis of focus group transcripts using pile sorting and theme identification. Results-High premiums and deductibles limit participants’ ability to afford basic health services and access to prescription medications despite their middle-class socioeconomic status. Participants report delaying or forgoing needed medical care due to lack of coverage and/or out-of-pocket costs. They employ numerous and potentially dangerous strategies to minimize costs, especially for prescription medications. Some report “saving up” needed procedures until their total costs will exceed that year’s deductible. Conclusion-Individuals in the risk pool were making medical decisions on the basis of cost rather than need. Many shared stories of medical complications as a result of delayed care and most expressed stress related to the difficulty of making decisions about their care and use of prescribed medications. The individual, nongroup insurance market, with its higher out-of-pocket costs, may not meet the needs of people with chronic health conditions.Kansas Health Policy Authority, U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (11-P-92389/7-01

Covering Kids & Families Evaluation: Case Study of Illinois: Exploring Links Between Policy, Practice and the Trends in New Medicaid/SCHIP Enrollments

Evaluates the impact in Illinois of the RWJF project to increase enrollment in Medicaid and State Children's Health Insurance Programs. Outlines state policy changes; outreach, simplification, and coordination activities; and 1999-2005 enrollment trends