Health Policy Commons^™

Affirmative Action, Cuban Style, Fitzhugh Mullan

Health Policy and Management Faculty Publications

Twenty-five percent of the U.S. population is black, Hispanic, or Native American, whereas only 6.1 percent of the nation’s physicians come from these backgrounds. Students from these minority groups simply don’t get into medical school as often as their majority peers, which results in a scarcity of minority physicians. This inequity translates into suffering and death, as documented by the Institute of Medicine. Poorer health outcomes in minority populations have been linked to lack of access to care, lower rates of therapeutic procedures, and language barriers. Since physicians from minority groups practice disproportionately in minority communities, they are an important …

Book Review 2 Optimize Your Life! The One-Page Strategic Planner By Bernhoff A. Dahl, M.D., William C. Mcpeck

William C. McPeck

This is my personal review of Optimize Your Life! The One-page Strategic Planner by Bernhoff A. Dahl and published by Wind-Breaker Press in 2003.

Integrating Hiv Prevention Services Into The Clinical Care Setting In Medicaid And Ryan White Care Act Programs: Legal, Financial, And Organizational Issues, John Palen, Jeffrey Levi, Sara E. Wilensky, Jennifer Kates

Health Policy and Management Faculty Publications

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's 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's 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 …

Hiv/Aids Among Women Of Color In Massachusetts, Erika Kates, Helen Levine, Lakay Cornell

Publications from the Center for Women in Politics and Public Policy

According to a recent report on the status of women in Massachusetts, the Commonwealth has an “extraordinarily high” incidence of women of color with HIV/AIDS. Over 4,200 women are infected and women of color account for a disproportionately high number of these cases.

Management Style, Organizational Climate, And Organizational Performance In A Public Mental Health Agency: An Integral Model, Pamela Sue Meserve Erbisch

Dissertations

This dissertation analyzes and estimates the interactions between domestic investment and each type of capital flow under uncertainty and capital market imperfection in 13 oil-producing countries from 1981 to 2003. First, we discuss the recent development in investment theories under uncertainty, irreversibility, and imperfect capital market. Secondly, decomposing uncertainty into permanent and transitory components--based on C-GARCH--we constructuncertainty measures of broad macroeconomic variables in addition to oil price.

Thirdly, a model of four simultaneous equations is developed to capture dynamic interactions. My contribution is twofold. First, not only do we consider the impact of uncertainty and credit market imperfection on investment, …

The Differences In Performance Between Large And Small Organizations In Mental Health Settings, Randy Parker

Dissertations

The quantitative part of this study examined the relationship between organizational size and staff performance in mental health group home settings.The data from two hundred and sixty-two group homes from small, medium, and large umbrella organizations were examined. The results of independent third party evaluations were compared across these umbrella organizations. Evaluations measured compliance and performance mandated by federal health and safety regulations.

The qualitative part of this study involved on-site interviews with group home staff from various organizations at various professional levels which scored either a low or a high number of errors. A qualitative analysis was conducted to …

The Relationship Between Locus Of Control And Nutrition Health Status Among Adult Wic Participants, Damita Jo Zweiback

Dissertations

The purpose of this study is to examine the relationship between locus of control orientation and the nutrition health status of adult WIC participants in Michigan. The locus of control variable is defined as the degree to which an individual perceives reinforcement or outcomes as contingent upon his or her own behavior. It ranges from internal to external. Internal locus of control is the individual's belief that s/he is an actor and can determine one's fate within limits. External locus of control is the person's belief that s/he is controlled by forces outside of one's self (Lefcourt, 1976; Koger, 1999). …

Mainecare Behavioral Health Care Expenditures State Fiscal Years 1996 – 2002, Susan Payne Phd, Stuart Bratesman Mpp, David Lambert Phd

Disability & Aging

No abstract provided.

Book Review 1 The New Science Of Selling And Persuasion: How Smart Companies And Great Salespeople Sell By William T. Brooks, William C. Mcpeck

William C. McPeck

This is my personal review of The New Science of Selling and Persuasion: How Smart Companies and Great Salespeople Sell by William T. Brooks and published by Wiley in 2004.

The Effects Of Copayments On The Use Of Medical Services And Prescription Drugs In Utah's Medicaid Program, Leighton Ku, Elaine Deschamps, Judi Hilman

Health Policy and Management Faculty Publications

In recent years, a number of states have increased cost-sharing for low-income Medicaid beneficiaries as one approach to Medicaid cost-containment. While copayments have been most commonly applied to prescription drugs, they also have been assessed for other services, such as physician visits, hospital admission, or outpatient clinic use.

Prior research has found that when low-income patients are required to pay more for health care services or for prescription drugs, they use fewer services or medications.[2] In some cases, their health could deteriorate, with the result that they may subsequently require more expensive emergency room or inpatient hospital care. While …

Hearing Their Voices: Lessons From The Breast And Cervical Cancer Prevention And Treatment Act (Bccpta), Kyle Kenney, Sarah C. Blake, Kathleen A. Maloy, Usha Ranji, Alina Salganicoff

Health Policy and Management Faculty Publications

This brief provides: 1) an overview of California breast and cervical cancer screening programs for low-income women, 2) description of California's implementation of the BCCPTA and state-funded treatment coverage, and 3) findings from a series of 15 focus groups with low-income women in San Diego and San Francisco discussions conducted to learn more about BCCPTA coverage and its implementation in California. The purpose of the study was to hear directly from women in California about their experiences, knowledge, and opinions of breast and cervical cancer screening and treatment services after the implementation of the BCCPTA.

Mainecare Managed Care Performance Report 2003, Catherine Ormond, Stuart Bratesman

Disability & Aging

No abstract provided.

Lisa Schechtman On Reproductive Health And Human Rights: Integrating Medicine, Ethics, And Law By Rebecca J. Cook, Bernard M. Dickens, And Mahmoud F. Fathalla. Oxford: Oxford University Press, 2003. 554 Pp., Lisa Schechtman

Human Rights & Human Welfare

A review of:

Reproductive Health and Human Rights: Integrating Medicine, Ethics, and Law by Rebecca J. Cook, Bernard M. Dickens, and Mahmoud F. Fathalla. Oxford: Oxford University Press, 2003. 554 pp.

California’S In-Home Supportive Services Program: Who Is Served?, Debi Waterstone, Taewoon Kang, Cristina Flores, Candace Howes, Charlene Harrington, Robert Newcomer

Economics Faculty Publications

Governor Schwarzenegger's preliminary 2004-05 Budget Bill proposed to eliminate a component of California's In-Home Supportive Services (IHSS) program serving approximately 68,000 individuals. This component, known as the Residual Program, included Protective Supervision and Domestic Care services and services provided by parents and spouses. Under the then existing regulations and the state's approved state plan for Medicaid, these services did not qualify for shared financing with the Medicaid program and were thus funded solely by state and county sources. The objective of the administration's proposal was to obtain an estimated net savings from the IHSS program in Fiscal Year 2005 of …

Bursting At The Seams: Improving Patient Flow To Help America's Emergency Departments, Marcia J. Wilson, Khoa Nguyen

Health Policy and Management Faculty Publications

From 1992 to 2002, the number of annual ED visits increased 23 percent in the U.S., while the number of EDs decreased by 15 percent. Many EDs are overwhelmed by the number of patients needing their services, with 62 percent of the nation's EDs reporting being "at" or "over" operating capacity. Almost daily, newspaper headlines across the country relay stories about patients waiting for hours in the ED before being seen and tales of ambulances being diverted from one hospital to the next due to overcrowding. But while much of the blame for this situation has been placed on broader …

Community Determinants Of Volunteer Participation: The Case Of Japan, Mary Alice Haddad

Mary Alice Haddad

Why are some communities more civically engaged than others? Why do some communities provide services with volunteer labor whereas others rely primarily on government provision? When communities provide both volunteer and paid labor for the same service, how do they motivate and organize those volunteers? This article addresses these questions through quantitative tests of prevailing explanations for levels of civic engagement (e.g., education, TV viewing, urbanization) and qualitative analyses of case studies of three medium-sized cities in Japan, focusing particularly on the service areas of firefighting and elder care. The statistical analyses demonstrate that current explanations that rely on individual …

Universal Coverage And The American Health Care System Crisis (Again), Rick Mayes

Political Science Faculty Publications

Ten years after President Clinton’s ambitious attempt at comprehensive health care reform died, several old and new issues with the health care system have emerged. First, the number of uninsured Americans rose to 43.6 million in 2002—and the numbers have since increased. Also, the costs for those who do not have insurance are rapidly increasing. In addition health care related problems are one of the leading causes of personal bankruptcy in the United States. Finally, the government’s two primary health insurance programs—Medicare and Medicaid—are experiencing considerable financial strain. Dr. Mayes examines these problems in depth before and revisits President Clinton’s …

Medicare Advantage: Déjà Vu All Over Again?, Brian Biles, Geraldine Dallek, Lauren Hersch Nicholas

Health Policy and Management Faculty Publications

The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 expands the role of private health plans in Medicare through prescription drug plans and a revised Medicare+Choice (M+C), renamed Medicare Advantage, program. This paper discusses the factors responsible for the failure of M+C to develop as intended in 1997 and analyzes the challenges for MMA implementation in light of these factors. They include making a complex program understandable to beneficiaries; addressing plans? efforts to avoid enrolling high-cost beneficiaries; ensuring stability of benefits, providers, and plans; dealing with beneficiaries enrolled in unsuitable plans; providing equity of health benefits throughout the …

Update - June 2004, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Examining the Ethics of Praying With Patients
-- Editorial
-- Agape and the Deeply Forgetful
-- Congratulations to this year's clinical ethics graduates

Teaching Medicaid: A Tool For Health Law Teachers (2004 Update), Sara J. Rosenbaum, David Rousseau

Health Policy and Management Faculty Posters and Presentations

A teaching guide examining: (1) Medicaid's role as a health insurer: major themes; (2) Eligibility and services; (3) Where do Medicaid expenditures go and how; (4) Important are they to the health care system?; (5) Medicaid as health care payer and its role in supporting the health care safety net; (6) Medicaid's role in state financing; (7) Medicaid's role as a legal entitlement; (8) Does Medicaid need reform and if so, what should reform accomplish?

Medicaid Prescription Drug Spending And Use, Brian Bruen, Arunabh Ghosh

Health Policy and Management Issue Briefs

No abstract provided.

Economic Stress And The Safety Net: A Health Center Update, Sara J. Rosenbaum, Peter Shin, Julie S. Darnell

Health Policy and Management Faculty Publications

Federally funded health centers provided care to 11.3 million patients in 2002, the vast majority of whom were either uninsured (39%) or covered by Medicaid (34%). This paper provides new information on the demographic profile of health center patients and the revenue sources available for financing their care, including recent increases in federal discretionary funding. It examines the impact of the recent economic downturn on health centers in selected communities, exploring the effect of elevated unemployment levels among lower wage workers, declining private health insurance coverage, and widespread state cutbacks in Medicaid – the single most important source of health …

Science-Based Organic Farming: A Resource For Educators, Charles A. Francis, Mindi Schneider, Brad Kindler

Publications from the Center for Applied Rural Innovation (CARI)

Organic farming is an important and growing part of the United States food system. The organic sector has grown by at least 20% per year for the past two decades, and currently shows no indication of slowing in this growth. There is increasing consumer concern about where and how food is produced, and people want to be assured access to safe and healthy food products. Interest and concern about food security, and discussion about the merits of a local food system as compared to the vulnerable globalized marketplace are also becoming increasingly important. In Nebraska we have only limited local …

Walking A Tightrope: The State Of The Safety Net In Ten U.S. Communities, Marsha Regenstein, Lea Nolan, Marcia J. Wilson, Holly Mead, Bruce Siegel

Health Policy and Management Faculty Publications

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.

Olmstead V. L.C. And The Americans With Disabilities Act: Implications For Public Health Policy And Practice, Joel B. Teitelbaum, Taylor Burke, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

This installment of Law and the Public’s Health examines the meaning of Olmstead v. L.C. for public health agencies administering personal health care programs. Handed down by the U.S. Supreme Court in 1999, Olmstead was a landmark decision that interpreted the Americans with Disabilities Act (ADA or the Act) as it applies to public programs and thus is of great relevance to many public health agencies. Following an overview of the decision and its interpretation by lower federal courts, this column concludes with a discussion of the implications of Olmstead and its progeny for public health policy and practice.

State Efforts To Expand Health Coverage: One Bite At A Time, Christopher Stream

Public Policy and Leadership Faculty Publications

For more than twenty years, health scholars and advocates have warned us about the lack of adequate health coverage among a growing number of Americans. Health insurance premiums are rising. Many employers, especially small employers who employ over half of the country’s workforce, and individuals are seeing premium increases of 30, 40, and even 50 percent. Not surprisingly, America’s uninsured population is rising— to more than 41 million people. States are feeling the budget crunch as the economy sags and more and more people turn to state Medicaid and other public health care systems. This all means that state policy …

Monitoring The Health Care Safety Net: Developing Data-Driven Capabilities To Support Policymaking, Robin M. Weinick, Peter Shin

Health Policy and Management Faculty Publications

Health care organizations are now emphasizing evidence-based medicine, which involves using research findings on the effectiveness of various practices to help make treatment decisions for patients. A parallel practice that is receiving increased attention is using data and the findings from data analysis to inform the policymaking process. The data-driven policy framework presented here involves an explicit statement of priorities and policy questions to be answered by new and existing data and provides general guidance for using data to support the process of developing policy options for the health care safety net.

An Assessment Of The Safety Net In San Diego, California, Khoa Nguyen, Peter Shin, Marsha Regenstein, Marcia J. Wilson, Kyle Kenney, Karen C. Jones

Health Policy and Management Faculty Publications

This report examines key issues that shape the health care network available to uninsured and underserved residents in San Diego. It provides background on the San Diego 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.

An Assessment Of The Safety Net In Atlanta, Georgia, Jennel Harvey, Marsha Regenstein, Karen C. Jones

Health Policy and Management Faculty Publications

This report examines issues that shape the health care network available to uninsured and underserved residents in Atlanta. It provides background on the Atlanta 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 challenges facing providers of primary and specialty care services and specific barriers that some populations face in trying to access them.

An Assessment Of The Safety Net In Fairfax County, Virginia, Lea Nolan, Lissette Vaquerano, Karen C. Jones, Marsha Regenstein

Health Policy and Management Faculty Publications

This report examines key issues that shape the health care network available to uninsured and underserved residents in Fairfax County. It provides background on the 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.