Health Policy Commons^™

Self-Help Support Groups: Choices In Participation Among Women Facing Systemic Lupus Erythematosus (Sle), Maria A. Pfeifer

Dissertations and Theses

This research study explored the experiences of 19 women who had been diagnosed with, or were still seeking the diagnosis of SLE (lupus) and their decisions regarding support group participation. The aim of this study was to evaluate the variety of factors influencing their choices in types and sources of support, their coping strategies and the reasons behind their decisions to either choose or not choose lupus support groups as a viable support resource. Those women identified as support groups attendees recalled a more emotion-focused response to their diagnosis and showed stronger reliance on seeking emotional forms of support. Conversely, …

The Epidemiology Of U.S. Immunization Law: Translating Cdc Immunization Guidelines Into Practice: State Laws Related To The Use Of Standing Orders Covering Immunization Practice, Alexandra M. Stewart, Marisa A. Cox, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

This pilot study examines how five states -- Georgia, Massachusetts, New York, Oregon, and Texas – approach the legal question of delegation of medical practice powers in an immunization practice context.

Vaccination With Recombinant Aspartic Hemoglobinase Reduces Parasitic Load And Blood Loss After Hookworm Infection In Dogs, Alex Loukas, Jeffrey M. Bethony, Susana Mendez, Ricardo T. Fujiwara, Gaddam Narsa Goud, Najju Ranjit, Bin Zhan, Karen Jones, Maria Elena Bottazzi, Peter J. Hotez

Health Policy and Management Faculty Publications

Background

Hookworms infect 730 million people in developing countries where they are a leading cause of intestinal blood loss and iron-deficiency anemia. At the site of attachment to the host, adult hookworms ingest blood and lyse the erythrocytes to release hemoglobin. The parasites subsequently digest hemoglobin in their intestines using a cascade of proteolysis that begins with the Ancylostoma caninum aspartic protease 1, APR-1.

Methods and Findings

We show that vaccination of dogs with recombinant Ac-APR-1 induced antibody and cellular responses and resulted in significantly reduced hookworm burdens (p = 0.056) and fecal egg counts (p = …

Medicaid's Role In Treating Children In Military Families, Peter Shin, Sara J. Rosenbaum, D. Richard Mauery

Health Policy and Management Faculty Publications

This analysis examines Medicaid's role in meeting the health care needs of children in military families who receive their health insurance coverage through TRICARE. TRICARE is the Department of Defense's worldwide health insurance program for active duty and retired military service members and their families. The 2000-2002 National Survey of Children with Special Health Care Needs, as well as a series of semi-structured telephone interviews, were used to assess Medicaid's role as a supplemental insurer for military children with special health care needs (CSHCN).

America's Public Hospitals And Health Systems, 2003: Results Of The Annual Naph Hospital Characteristics Survey, Jennifer Huang, Joshua Silbert, Marsha Regenstein

Health Policy and Management Faculty Publications

In 2003, members of the National Association of Public Hospitals and Health Systems continued to offer millions of uninsured and underserved individuals access to the medical services so critical for lifelong health and well-being. Delivering these services was difficult, however, given the economic downtown early in the decade and the resulting inadequacies associated with safety net financing. This report examines the operations and activities of NAPH members in 2003, presents the financial challenges they faced, describes the clinical and community services they provided, and profiles the patients they served.

Update - September 2005, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Just Care: Rationing in a Public Health Crisis
-- Editorial
-- Graduate profiles
-- Jack W. Provonsha Lecture Series: Physician-Assisted Suicide: A Religious Perspective

Compendium Of Quality Indicators: Older Adults, Adults With Physical Disabilities, Adults With Mental Retardation/Autism Living At Home, In The Community Or In Long Term Care Facilities, Julie T. Fralich Mba, Stuart Bratesman Mpp

Disability & Aging

Researchers at the Muskie School of Public Service compiled over 15 tools and surveys. Included in the report are Participant Experience Surveys, Performance Indicators, Experience Surveys, Core Indicators, Consumer Surveys, Behavioral Risk Factors, Outcome Measures, and a variety of Quality Measures. Sample questions and tools are shown in this Compendium of Quality Indicators

How Medical Claims Simplification Can Impede Delivery Of Child Developmental Services, Anne R. Markus, Sara J. Rosenbaum, Alexandra M. Stewart, Marisa A. Cox

Health Policy and Management Faculty Publications

This report examines HIPAA administrative standardization and the process of modifying the standardized codes. It assesses the implications of HIPAA standardization for payment of Medicaid-covered early childhood preventive and developmental services, drawing on findings from a 50-state, point-in-time review of readily available state HIPAA compliance documents conducted in December 2004.

Access To Housing For Persons With Disabilities: Lessons Learned From Three Demonstration Projects, Cutler, Disability And Aging, Eileen Griffin Jd

Disability & Aging

The Quality Choices for Maine project was conducted from 2001-2004. This report focuses on Access to Services, one part of the three-year RCSC Quality Grant. The specific housing related goal was “to improve access to community housing for people with disabilities of all types.” Project activities were overseen by the Access to Services Technical Assistance Group and a variety of stakeholders. Read the activity summaries, lessons learned and recommendations on how to sustain the work.

Achieving "Readiness" In Medi-Cal's Managed Care Expansion For Persons With Disabilities: Issues And Process, Sara J. Rosenbaum, Sara E. Wilensky, Peter Shin

Health Policy and Management Faculty Publications

This Policy Brief examines issues that can be expected to arise as California moves to significantly expand the use of mandatory managed care arrangements for Medi-Cal enrollees with disabilities. This analysis is based on information gleaned from more than a decade of Medicaid managed care specification analyses for the federal government and private funders, focusing on both the general beneficiary population and persons with chronic illnesses and disabilities. This Policy Brief also reflects experiences in furnishing technical assistance to state purchasers and in developing model managed care purchasing specifications for both general and special needs managed care populations for both …

Reducing Obesity Risks During Childhood: The Role Of Public And Private Health Insurance, Sara J. Rosenbaum, Sara E. Wilensky, Marisa A. Cox, D. Brad Wright

Health Policy and Management Faculty Publications

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 …

Engaging Local Non-Governmental Organizations (Ngos) In The Response To Hiv/Aids., Helen Cornman, Curt D. Grimm, Sujata Rana

Anthropology

During the past few years, a number of key donor programs have scaled up their global response to the crisis of HIV and AIDS. The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the President’s Emergency Plan for AIDS Relief (PEPFAR), the United Nations’ Millennium Development Goals (MDGs), the World Bank’s Multi-country HIV/AIDS Program (MAP), and other bilateral donors and charitable foundations have raised significant resources to fight HIV/AIDS. Spending on HIV/AIDS in low- and middle-income countries increased from $1 billion in 2000 to $6.1 billion …

Medicare And America's Healthcare System In Transition: From The Death Of Managed Care To The Medicare Modernization Act Of 2003 And Beyond, Rick Mayes

Political Science Faculty Publications

This article traces the transition-in Medicare, specifically, and in the American healthcare system, generally-from the aftermath of the Balanced Budget Act of 1997 to the passage of the Medicare Modernization Act of 2003. During this time, restrictive managed care died under an onslaught of resurgent cost pressures, legislative and legal attacks, and a vehement physician and consumer backlash. The subsequent reversion to more generous (and more expensive) health plans coincided with a recession in 2001 to trigger a return to rapidly escalating healthcare spending and yet another in the Nation's series of healthcare crises. Current trends suggest that future policymakers …

Project Child Health Impact Assessment, Unyi Agba, Kristina Chung, David Diehl, Marisol Olivera, Yolanda Perez

Emerging Leaders Program Team Projects

The 2005 Project Child Health Impact Assessment (CHIA) at the Boston Medical Center (BMC) for the UMass Emerging Leaders Program (ELP) is closely related to one that members of the 2004 ELP cohort assisted with. The 2004 project team provided BMC with preliminary research regarding similar concepts in Europe, Canada and the United States. With this research in hand, the Project CHIA team at BMC decided to research, develop, write and publish pilot analyses that illustrated the impact of public policy on children's health. The 2005 ELP team was asked to provide guidance regarding a communications strategy for these pilot …

An Assessment Of Hospital-Sponsored Health Care For The Uninsured In Polk County/Des Moines, Iowa, Lea Nolan, Marsha Regenstein, Marisa A. Cox

Health Policy and Management Faculty Publications

Health care providers in Polk County are faced with increasing numbers of low-income, uninsured patients who do not have the resources to pay for their health care out of pocket. At the same time, state and local funding sources are limited, and are insufficient to ensure that these individuals have access to the health services that they require. Community leaders are extremely interested in developing information to understand the magnitude of the uninsured problem in Polk County and to identify health care delivery strategies to better serve this population. A Blue Ribbon Steering Committee was convened in October 2004 to …

Update - June 2005, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Universal Access to Health Care and Religious Basis of Human Rights

Stresses To The Safety Net: The Public Hospital Perspective, Marsha Regenstein, Jennifer Huang

Health Policy and Management Faculty Publications

Every year, more than 10 million people receive care from public hospitals and health systems – a complex and diverse set of providers that share a mission to deliver health services to individuals, regardless of insurance coverage or ability to pay. Together with federally funded health centers, free clinics, public health departments and scores of individual physicians and other health practitioners, public hospitals provide critical access points for the nation's uninsured population and form a vast patchwork of providers that is commonly referred to as the health care safety net. Despite their importance, there is no single or stable source …

Caring For Patients With Diabetes At Safety Net Hospitals And Health Systems: What The Patients Say About Their Care, Marsha Regenstein, Jennifer Huang, Dean Schillinger, Daniel Lessler, Brendan Reilly, Melanie Brunt, Jolene Johnson, John Piette

Health Policy and Management Faculty Publications

In 2002, with support from The Commonwealth Fund, the National Public Health and Hospital Institute (NPHHI) created a consortium of safety net hospital systems to work together to address common concerns regarding the care of patients with diabetes. As part of that project, NPHHI conducted a survey of patients with diabetes who received at least some of their care from four Consortium hospital systems: Cambridge Health Alliance; Community Health Network of San Francisco/San Francisco General Hospital; Cook County Bureau of Health Services; and LSU/Medical Center of Louisiana at New Orleans. Patients were surveyed on multiple domains of care, including overall …

A Killer Flu? Scientific Experts Estimate That "Inevitable" Major Epidemic Of New Influenza Virus Strain Could Result In Millions Of Deaths If Preventive Actions Are Not Taken, Margaret A. Hamburg, Shelley A. Hearne, Jeffrey Levi, Kim Elliott, Laura M. Segal, Michael J. Earls

Health Policy and Management Faculty Publications

No abstract provided.

Charting The Legal Environment Of Health Information, Sara J. Rosenbaum, Phyllis Borzi, Lee Repasch, Taylor Burke, John F. Benevelli

Health Policy and Management Faculty Publications

Over the past several years, increased attention has been focused on the importance of health information to health care quality improvement. The level of focus on health information has increased with the advent of electronic medical records and electronic health information systems designed to facilitate the use of health care data. Although these systems are still in their relative infancy, they hold enormous promise for revolutionizing the availability and use of health information to improve clinical performance, empower employers and consumers to better understand health plan choices and facilitate health claims administration. Their potential has been a catalyst for change …

Legal Issues In Health Information: Implications For Public Health Practice And Policy, Sara J. Rosenbaum, Taylor Burke, John F. Benevelli, Phyllis Borzi, Lee Repasch

Health Policy and Management Faculty Publications

Working in support of the availability of a viable primary care workforce for underserved communities is an important priority for the Health Resources and Services Administration (HRSA). Demand for primary care services will continue to increase, especially when considering calls for an overhaul of the national health care system and the increased needs of the many that in recent months have become unemployed and lost insurance benefits. In addition, there are still serious problems with the unequal distribution of health care professionals to rural and inner city urban areas. Many inner-city and rural communities continue to struggle to recruit and …

Act Now For Your Tomorrow: Final Report Of The National Commission On Nursing Workforce For Long-Term Care, Edward Howard, Brian Biles, Robyn Stone, Paul Wing, Kristin Mccloskey, Tim M. Henderson

Health Policy and Management Faculty Publications

The nursing workforce shortage faced by long-term care providers stems from factors both outside and inside the organization and operation of long-term care services. The nursing shortage diminishes quality of care and increases the costs of providing services. Resolution of the long-term care nursing workforce challenge will require improvement of the recruitment and retention of nurses. The leadership for the efforts to improve the long-term care workforce must come from the community itself. New and sustained leadership for action by long-term care leaders is the critical factor necessary to the development of the recommended initiatives and the achievement of the …

Migrant And Seasonal Farmworkers: Health Insurance Coverage And Access To Care, Sara J. Rosenbaum, Peter Shin

Health Policy and Management Faculty Publications

Migrant and seasonal farmworkers are an integral support to the nation's agricultural industry. Nearly three million workers earn their living through migrant or seasonal farm labor. Migrant and seasonal farmworkers and their families confront health challenges stemming from the nature of their work, their extreme poverty and mobility, and living and working arrangements that impede access to health coverage and care. This brief provides an overview of migrant and seasonal farmworkers and the health challenges they face and considers options for improving their health coverage and access to care.

National Security And U.S. Child Health Policy: The Origins And Continuing Role Of Medicaid And Epsdt, Sara J. Rosenbaum, D. Richard Mauery, Peter Shin, Julia Hidalgo

Health Policy and Management Issue Briefs

Medicaid has touched the lives of half of all of the low income young adults of prime military service age. The roots of Medicaid's unique child health eligibility and coverage policies can be traced to a seminal, 1964 government study entitled One Third of a Nation: A Report on Young Men Found Unqualified for Military Service. This study analyzed the underlying causes of the astounding 50 percent rejection rate among the young men drafted into the military in 1962. It documented pervasive evidence of treatable and correctable physical, mental, and developmental conditions, and its findings influenced the course of Medicaid …

“As Tough As It Gets”: Women In Boston Politics, 1921-2004, Kristen A. Petersen, Carol Hardy-Fanta Phd, Karla Armenoff

Publications from the Center for Women in Politics and Public Policy

This study seeks to answer the question: Given the wealth of talent and resources women possess—and the state offers—why is it so tough for women to gain representation in Boston City Hall? To answer this question, and to document the efforts women have made over almost 100 years, we examine the history of women who have run for and won—or lost—election to the Boston City Council in the 20th century. How does the structure and culture of a given urban political arena (i.e., “Boston politics”) affect women’s opportunities as elected officials? What is women’s political culture and how has it …

Factors Affecting Treatment Program Development In A Mental Health Facility Serving Prisoners, Ruby Miranda Meriweather

Dissertations

There is a paucity of literature on how treatment programs for mentally ill prisoners are developed. Federal mandates require that services to mentally ill prisoners be comparable to what is offered in the community. Planners, therefore, must find ways to provide treatment programs that produce that outcome.

This research identified the most important factors that affect treatment program development and implementation to aid planners in designing treatment programs for mentally ill prisoners. This qualitative study, based on grounded theory, used a structured interview with 61 mental health staff (psychiatrists, nurses, psychologists, social workers, and activity therapists) across three categories (Administrative, …

Akinbola E. Akinwumi On Sickness And Wealth: The Corporate Assault On Global Health By Meredith Fort, Mary Anne Mercer And Oscar Gish (Eds). Cambridge: South End Press, 2004. 237pp., Akinbola E. Akinwumi

Human Rights & Human Welfare

A review of:

Sickness and Wealth: The Corporate Assault on Global Health by Meredith Fort, Mary Anne Mercer and Oscar Gish (eds). Cambridge: South End Press, 2004. 237pp.

The Benefits Improvement And Protection Act (Bipa) And Its Impact On The Stability Of Provider Networks In Medicare + Choice Managed Care Organizations (Mcos), Frances R. Nelson

UNLV Theses, Dissertations, Professional Papers, and Capstones

No abstract provided.

A Nation's Health At Risk Iii: Growing Uninsured, Budget Cutbacks Challenge President's Initiative To Put A Health Center In Every Poor County, Michelle Proser, Peter Shin, Dan Hawkins

Health Policy and Management Faculty Publications

No abstract provided.

The Impact Of Program Changes On Enrollment, Access, And Utilization In The Oregon Health Plan Standard Population, Matthew J. Carlson, Bill J. Wright

Sociology Faculty Publications and Presentations

In February 2003, in an effort to expand Medicaid coverage within tight fiscal constraints, the Oregon Health Plan (OHP) underwent a significant redesign of benefits, cost-sharing and premium structure. The OHP2 redesign resulted in two tiers of coverage, OHP Plus and OHP Standard, and a premium subsidy program. The OHP Plus benefit package and cost sharing structure is similar to the original OHP and serves the federally-mandated Medicaid populations: children and pregnant women, low-income elderly and individuals meeting the SSI definition of disability. OHP Standard, designed for Oregon’s expansion population,1 includes a reduced benefit package, expanded co-pays and increased premiums. …