The Heart of the Matter: The Relationship Between Communities, Cardiovascular Services and Racial and Ethnic Gaps in Care

As part of an initiative to address racial/ethnic disparities in the diagnosis and treatment of heart disease, examines factors behind the segmentation of healthcare access and service patterns by income and insurance status and its effect on minorities

Examining the Evidentiary Basis of Congress's Commerce Clause Power to Address Individuals' Health Insurance Status

Outlines the issues involved in whether the 2010 Affordable Care Act's individual mandate is constitutional under the commerce clause, presents research literature on the effect of uninsurance on the broader economy, and reviews the lower courts' rulings

An Assessment of the Safety Net in Queens, New York

This report examines key issues that shape the healthcare network available to uninsured and underserved residents in Queens. It provides background on the Queens health care safety net and describes key characteristics of the populations served by the safety net. It then outlines the structure of the safety net and funding mechanisms that support health care safety net services. The report also includes an analysis of key challenges facing providers of primary and specialty care services and specific barriers that some populations face in trying to access them

Experiences of Black and Latino Residents During the COVID-19 Response in Missouri

Experiences of Black and Latino Residents During the COVID-19 Response in Missouri centers conversations from focus groups and interviews with Black and Latino Missourians from the St. Louis and Southwest regions during the state’s response to COVID-19. The report examines challenges that Black and Latino Missourians faced during the pandemic and how inequities in response efforts hampered their reach, effectiveness, and further exacerbated the pandemic’s impact on people of color in Missouri. Lessons learned from these conversations provide ways that leaders in public health, health care, social service, and government sectors can create stronger, more equitable systems of care. The findings in this report focus on the period of the pandemic from March 2020 through May 2021, before the proliferation of the delta and omicron variants. The Public Health Response to COVID-19 in the Southwest Region of Missouri, The Public Health Response to COVID-19 in the Northeast Region of Missouri, The Public Health Response to COVID-19 in the St. Louis Region of Missouri, and Experiences of Black and Latino Residents During the COVID-19 Response in Missouri, are part of a series of reports that were used to inform the state-level recommendations in the report Missouri’s Public Health Response to COVID-19: Key Findings and Recommendations for State Action and Investment

Promoting the Integration and Coordination of Safety-Net Health Care Providers Under Health Reform: Key Issues

The Affordable Care Act includes several provisions designed to encourage greater coordination and integration among health care providers, including the promotion of accountable care organizations and health homes. While much discussion has focused on how these strategies might be adopted by Medicare and private insurers, little attention has focused on their application among safety-net health care providers. Such providers face particular challenges in coordinating care for their low-income and uninsured patients, and no single approach is likely to meet their diverse needs. Successful efforts will require federal, state, and local financial resources to sustain the safety net and make the investments needed to upgrade capabilities. In addition, they will require flexible strategies that can accommodate variations in community and state needs

Promoting the Integration and Coordination of Safety-Net Health Care Providers Under Health Reform: Key Issues

The Affordable Care Act includes several provisions designed to encourage greater coordination and integration among health care providers, including the promotion of accountable care organizations and health homes. While much discussion has focused on how these strategies might be adopted by Medicare and private insurers, little attention has focused on their application among safety-net health care providers. Such providers face particular challenges in coordinating care for their low-income and uninsured patients, and no single approach is likely to meet their diverse needs. Successful efforts will require federal, state, and local financial resources to sustain the safety net and make the investments needed to upgrade capabilities. In addition, they will require flexible strategies that can accommodate variations in community and state needs

Challenges in language services: Identifying and responding to patients\u27 needs

Objective: Identify characteristics of hospitalbased language services (LS), and describe practices of identifying patients with limited English proficiency (LEP) and interpreter training. Participants: Seventy-one hospitals applied to participate in a national initiative. Applicants were non-federal, acute care hospitals with substantial LEP populations, at least 10,000 discharges, and in-person interpreters. Methods: Descriptive statistics were generated on language, collection of language data, LEP volume and service utilization, staffing and training requirements and organizational structure. The relationship between admissions and encounters was analyzed. Results Ninety percent of hospitals collect primary language data. Spanish is the most common language (93% of hospitals). We found no statistically significant correlation between admissions and encounters. Eighty-four percent require training. Eightynine percent have a designated LS department but no clear organizational home. Conclusions: Hospital-based LS programs are facing challenges identifying patients with language needs, staffing and training a workforce, and creating an organizational identity. Need is not associated with utilization, suggesting that LS are not reaching patients

Walking a Tightrope: The State of the Safety Net in Ten U.S. Communities

This report presents the findings from the Urgent Matters safety net assessments and identifies common characteristics, opportunities and challenges for communities that wish to better serve the health care needs of uninsured and underserved individuals. It also illustrates differences across many of the communities, especially in terms of the structure and financing of their safety nets. It is a companion report to the individual safety net assessments and provides an overarching perspective of problems that affect safety nets across the country

Examining the evidentiary basis of Congress\u27s commerce clause power to address individuals\u27 health insurance status

Chief among the issues that the United States Supreme Court considers in United States Department of Health and Human Services et al. v Florida et al. is the questionof whether Congress has the constitutional power to apply a “minimum essential coverage requirement” on most nonelderly Americans. Opponents of the provision (referred to under the Act as the “Individual Responsibility” requirement) argue that compelling individuals to buy affordable health insurance coverage exceeds Congressional powers. By contrast, the United States Department of Justice and supporters of the law assert that the minimum coverage requirement is consistent with a long line of Supreme Court decisions regarding the power of Congress to regulate individual conduct. The Administration, in a brief filed on January 9, 2012, argues that Congressional authority to act can be found under both its taxing powers as well as its power under the Commerce Clause and Necessary and Proper Clause to regulate interstate commerce. The Commerce Clause arguments are of special interest, because it is this basis of power that has received so much attention in the lower court decisions to date

Examining the evidentiary basis of Congress\u27s commerce clause power to address individuals\u27 health insurance status

Chief among the issues that the United States Supreme Court considers in United States Department of Health and Human Services et al. v Florida et al. is the questionof whether Congress has the constitutional power to apply a “minimum essential coverage requirement” on most nonelderly Americans. Opponents of the provision (referred to under the Act as the “Individual Responsibility” requirement) argue that compelling individuals to buy affordable health insurance coverage exceeds Congressional powers. By contrast, the United States Department of Justice and supporters of the law assert that the minimum coverage requirement is consistent with a long line of Supreme Court decisions regarding the power of Congress to regulate individual conduct. The Administration, in a brief filed on January 9, 2012, argues that Congressional authority to act can be found under both its taxing powers as well as its power under the Commerce Clause and Necessary and Proper Clause to regulate interstate commerce. The Commerce Clause arguments are of special interest, because it is this basis of power that has received so much attention in the lower court decisions to date