Health Policy Commons^™

Projected Financial Losses Experienced By Community Health Centers Under A Scenario Of Major Cuts In Key Sources Of Federal Funding: 2018-2022, Avi Dor, Eric Luo, Ali Moghtaderi, Anne Rossier Markus

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Congress is currently considering options to significantly reduce federal funding for the Medicaid expansion and the Marketplace subsidies implemented under the Affordable Care Act (ACA). Separately, the Health Centers Fund, which currently accounts for 70% of all federal health center grant funding, is set to expire in September 2017. These potential changes in federal funding could have a dramatic impact on health centers and the communities they serve. The purpose of this brief is to simulate the potential combined impact of these major changes in federal funding that will directly affect community health centers. Secondarily, this brief also assesses the …

Rural Opioid Prevention And Treatment Strategies: The Experience In Four States [Working Paper], John A. Gale Ms, Anush Hansen Ms,Ma, Martha Elbaum Williamson Mpa

Mental Health / Substance Use Disorders

Although opioid use rates are comparable in rural and urban counties, rural opioid users tend to be younger, unmarried, have lower incomes, and are more likely to lack health insurance, all vulnerabilities that may negatively impact their ability to seek treatment and recover. Additionally, the rural health care system is characterized by numerous resource, workforce, access, and geographic challenges that complicate the delivery of specialized care for OUDs in rural communities. The nature and scope of the opioid crisis vary across rural communities and require multifaceted, community-based strategies to address the problem. Based on interviews with key stakeholders in Indiana, …

Quality Of Water In Relation To Diarrheal Disease Incidence In Obunga, Tianna Herman

Independent Study Project (ISP) Collection

Kenyan cities are experiencing a serious dilemma in dealing with the large influx of people from rural parts of the country to the cities. Most people come to the city in pursuit of better opportunities and jobs. Rapid urban growth with little planning and preparation by the national and county governments has led to the development of informal settlements. These informal settlements are characterized by poor environmental conditions that predispose their residents for poor health conditions. Because of their illegal status, most residents of informal settlements in Kenya do not receive government services such as water, drainage, sewerage, and rubbish …

What Are The Financial Implications Of Public Quality Disclosure? Evidence From New York City’S Restaurant Food Safety Grading Policy, Rachel Meltzer, Michah W. Rothbart, Amy Ellen Schwartz, Thad Calabrese, Diana Silver, Tod Mijanovich, Meryle Weinstein

Center for Policy Research

Grading schemes are an increasingly common method of quality disclosure for public services. Restaurant grading makes information about food safety practices more readily available and may reduce the prevalence of foodborne illnesses. However, it may also have meaningful financial repercussions. Using fine-grained administrative data that tracks food safety compliance and sales activity for the universe of graded restaurants in New York City and its bordering counties, we assess the aggregate financial effects from restaurant grading. Results indicate that the grading policy, after an initial period of adjustment, improves restaurants’ food safety compliance and reduces fines. While the average effect on …

Reduction Of Unnecessary Scanning To Lower Costs While Preserving The Integrity Of The Legal Health Record, Toni Wood

Graduate Theses & Non-Theses

The purpose of the paper is to explain the efforts taken at Rocky Mountain Clinic to reduce scanning of unnecessary documents into their Electronic Health Record (EHR). An EHR is a digital version of a patient’s medical paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users. (United States Department of Health and Human Services Office of the National Coordinator for Health Information Technology, 2017) The use of an EHR requires paper documents to be scanned into the system so they are available electronically within the patient’s EHR.

Research was completed to determine …

A Bottom-Up Approach To Effectively Implementing A Good Samaritan Policy At Bryant University, Jessica Fleet

Honors Projects in History and Social Sciences

The rising numbers of substance consumption on college campuses are becoming a public concern for higher educational institutions across the United States. The thesis studies the relationship between state laws and private higher education institution laws in regards to substance abuse. Examining state laws and private universities Medical Amnesty and Good Samaritan laws were used to determine what would effectively replace Bryant University’s current Substance Abuse Policy. The current policy lacks an educational element along with stressing the word of mouth ideology that students are protected when in need of drug or alcohol assistance in a medical situation. This is …

Rural Opioid Prevention And Treatment Strategies: The Experience In Four States [Policy Brief], John A. Gale Ms, Anush Yousefian Hansen Ms,Ma, Martha Elbaum Williamson Mpa

Mental Health / Substance Use Disorders

Little is known about what states with large rural populations are doing to combat opioid use disorders (OUD) in rural communities. This qualitative study identified rural challenges to the provision of OUD prevention, treatment, and recovery services and explored promising strategies to tackle the opioid crisis in rural communities.

A Review Of 57 Zone: A Social Media Network For Tb Consultation And Communication In Kunming, China, India Medaris

Independent Study Project (ISP) Collection

Yunnan, a predominantly agricultural province in southwest China, is a province with a high rate of both tuberculosis (TB) and multi-drug resistant tuberculosis (MDR TB), with nearly 25,000 cases of pulmonary TB reported each year. Former TB/MDR TB patients in Yunnan, with the support of Family Health International 360 NGO (FHI) are trying to combat this problem. They have created a social media network for TB consultation and communication, 57 Zone, where TB patients can talk about their medication, adverse drug effects, and nutrition and psychosocial concerns. The goal of this study was the look at what aspects of the …

Water, Sanitation And Hygiene In Rwamwanja Refugee Settlement, Katelyn Bergl

Independent Study Project (ISP) Collection

No abstract provided.

Fruit And Vegetable Bucks: Adams County Grocery Store Snap Incentive Program, Meredith A. Cox, Amy B. Dailey, Kim Davidson, Kathy Gaskin, Etta Saltos, Audrey Hess, Megan Shreve, Cherry Arvin, Elizabeth Weller

Student Publications

Veggie Bucks provides a 50% discount on all fresh fruits and vegetables sold through Kennie’s Market produce department at the point of sale for the 5 highest cost items. The incentive period ran January - April, 2017. Intended outcomes include an increase in the number of fresh fruits and vegetables purchased by SNAP recipients at Kennie’s Market locations in Biglerville and Gettysburg by 10% in January-April 2017 compared to baseline figures obtained in 2016, and to familiarize SNAP recipients with fresh fruits and vegetables and to provide information about the ACFMA markets’ Double Dollars program. SNAP recipients were invited to …

Identificando Los Limites Del Acceso A La Salud Reproductiva: Un Análisis Sobre Las Experiencias Vividas Por Las Mujeres Guaraníes Con Los Servicios De La Salud Reproductiva En La Villa 31 De Buenos Aires, Amelia Mitchell

Independent Study Project (ISP) Collection

In order to serve the ‘public’, public health services must be accessible to everyone, without discrimination based on race, gender, social class, or geographic location, among other facets of identity. Reproductive health services, in particular, are a key service that must be adequately supplied in order to guarantee the health and wellbeing of a population. Reproductive healthcare not only allows individuals to decide if and when they wish to have a child, it also contributes to cancer prevention and the detrimental effects of sexually transmitted diseases. This investigation examines the experiences of Guaraní women that live within “Villa 31” of …

The Disappearance Of Nyoman And Ketut, Laura Michelle Garvie

Independent Study Project (ISP) Collection

No abstract provided.

Economic Burden Of Tuberculosis Among Bangladeshi Population And Economic Evaluation Of The Current Approaches Of Tuberculosis Control In Bangladesh, Mohammad Rifat Haider

Theses and Dissertations

Introduction: Tuberculosis (TB) is major scourge for human history and causes profound economic burden. Bangladesh is a high burden TB country with 12% of its annual death is caused and 362 thousand people are infected by TB. DS-TB is the most prominent type of TB found in Bangladesh and a 6 month drug regimen (2 month intensive and 4 month continuation phase) is followed. But the directly observed treatment short-course (DOTS) differ in delivery through community health workers (CHW) and community members (CM). Bangladesh has also experienced surge in the number of MDR-TB cases with a 29% of MDR-TB cases …

Analysis Of Worcester's Youth Employment Sector, Laurie Ross Phd, Ramon Borges-Mendez Phd, Alex Rothfelder

Mosakowski Institute for Public Enterprise

Overall, the employment rate for Worcester youth has improved since 2000; yet mirroring the nation, Worcester continues to have a smaller share of youth 16-24 employed. This situation is intensified for youth of color and young people facing barriers such as homelessness, exiting foster care, juvenile justice involvement, and limited English proficiency. Mass, Inc. estimates that in Worcester there are 3400 disconnected youth—756 are between 16-19 and 2644 are between 20-24. From the youth employment program inventory, we learned that the city’s programs offer many opportunities for “first job” experiences; has some exemplary programs that integrate youth development and workforce …

Are Our Policy Makers On Board? What Policy Makers Think Of The Social Determinants, Health Disparities, And Health In All Policies, M. Lelinneth B. Novilla, Michael C. Goates, Spencer Calder, Tabetha Ellis, Kraymer Eppich, Laura A. Galvao, Noyra Melissa Quintana, David Mateos

Faculty Publications

BACKGROUND: We impact our health by “how we manage our affairs in society.”¹ The unequal distribution of power, money, and resources creates a collective social milieu with disparities in health between and within countries. Tackling health inequities require addressing the health implications of the “toxic combination of poor social policies and bad politics.”¹ But how do U.S. policy makers view the social determinants of health?

OBJECTIVE: Determine U.S. policy makers’ awareness for the social determinants of health, health inequities, and health in all policies; identify the social determinants of health perceived as legislative priorities; list factors identified/perceived …

How Could Repealing Key Provisions Of The Affordable Care Act Affect Community Health Centers And Their Patients?, Sara J. Rosenbaum, Jessica Sharac, Thao-Chi Tran, Anne Rossier Markus, David Reynolds, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Analyses of repeal of the Affordable Care Act (ACA) have tended to focus on coverage. This study, which gauges the potential effects of repealing certain ACA provisions, looks at the question of primary health care access itself, with a focus on medically underserved communities. A survey developed and fielded in early 2017 asked community health centers to estimate the impact of ending the Health Centers Fund established under the ACA as well as ending expanded Medicaid coverage and subsidies designed to make private insurance affordable for lower income patients. Forty-one percent of health centers responded; 69 percent were located in …

Medicaid And Children With Special Health Care Needs, 2016-2017 Cohort Of New Hampshire-Maine Leadership Education In Neurodevelopmental And Related Disabilities (Nh-Me Lend) Program Trainees

Policy Analysis

Medicaid funds vital services for children and youth with special health care needs and disabilities (CYSHCN). Proposed changes to the structure of Medicaid would significantly reduce federal funding for this important program. The most concerning are the proposed structural changes including per capita caps and block grants, as well as threats to Early and Periodic Screening, Diagnostic and Treatment (EPSDT) and Medicaid Waiver services. Restructuring would have devastating effects on benefits for low-income children and individuals with disabilities, and their families, putting this very vulnerable population at additional risk.

Health Workforce Research Centers (Hwrcs) Key Findings, 2013-2016, Clese Erikson

Health Workforce Research Center Publications

No abstract provided.

Cues To Cervical Cancer Screening Among U.S.-Hispanic Women, Arelis Moore De Peralta, Bonnie Holaday, Ida Mikisa Hadoto

Publications

Introduction: Hispanic women’s cervical cancer rates are disproportionately high. Cues to cervical cancer screening (Cues to Action) are strategies to activate the decision-making process to get screened for cervical cancer. This study used the health belief model to examine which cues prompt Hispanic women to undergo cervical cancer screening and how perceptions could be potentiated by cues to cervical cancer screening.

Method: A cross-sectional survey was conducted among Hispanic women 18 to 65 years old (n = 220). Generalized linear modeling was used.

Results: Spanish media and reminders by mother and doctors were relevant cues. Generalized linear modeling showed …

The Cost Of Cost-Sharing: The Impact Of Medicaid Benefit Design On Influenza Vaccination Uptake, Charles Stoecker, Alexandra M Stewart, Megan Lindley

Health Policy and Management Faculty Publications

ncome persons. State Medicaid policy may affect the uptake of recommended adult vaccinations. We examined the impact of three aspects of Medicaid benefit design (coverage for vaccines, prohibiting cost-sharing, and copayment amounts) on vaccine uptake in the fee-for-service Medicaid population 19–64 years old. We combined previously published reports to obtain state Medicaid policy information from 2003 and 2012. Data on influenza vaccination uptake were taken from the Behavioral Risk Factor Surveillance System. We used a differences-in-differences framework, controlling for national trends and state differences, to estimate the effect of each benefit design factor on vaccination uptake in different Medicaid-eligible populations. …