2003 State of the State Addresses: Governors\u27 Discussions of Budget and Health Care Issues

A series of tables examines State of the State addresses nationwide to examine the frequency and content of Governors\u27 discussions of budget and health care issues

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

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

Integrating HIV Prevention Services into the Clinical Care Setting in Medicaid and Ryan White CARE Act Programs: Legal, Financial, and Organizational Issues

This policy brief examines the structural-level opportunities and challenges associated with the delivery of HIV prevention services in or closely linked to the clinical care setting. It focuses on two of the major public programs for HIV care in the U.S: Medicaid, the nation\u27s major public health program for low-income Americans, and the largest source of public financing for HIV/AIDS care in the U.S.; and the Ryan White CARE Act, the nation\u27s only HIV-specific care and support services grant program which operates as the payer of last resort at the state and local level. Together, these programs provide care and support services to a significant proportion of those at risk for and living with HIV and therefore provide an important focus for assessing current prevention integration practice, identifying strategies to enhance integration, and targeting such efforts

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

Health centers and health insurance: Complements, not alternatives

While some consider health centers and universal health insurance to be opposing concepts, we consider them to be complementary. Health centers play a vital role regardless of the type of insurance system in place because they reduce barriers to care and provide quality culturally competent care to vulnerable populations. The current private employer-based US healthcare system does not create incentives for providers to care for low-income and vulnerable populations. Even in countries with universal health coverage, health centers increase access to care and improve health outcomes. Instead of arguing whether health centers or health insurance should be expanded, the debate should focus on how best to use safety net providers as health insurance coverage expands

Essentials of Health Policy and Law

As one of the newest offerings in the Jones and Bartlett Essential Public Health series, Essentials of Health Policy and Law provides students of public health with a firm foundation of the basics of American health policy and law. Given the prominent role played by policy and law in the health of all Americans, the aim of this book is to help readers understand the broad context of health policy and law, the essential policy and legal issues impacting and flowing out of the health care and public health systems, and the way health policies and laws are formulated. Think of this textbook as an extended manual introductory, concise, and straightforward to the seminal issues in U.S. health policy and law, and thus as a jumping off point for discussion, reflection, research, and analysis