Health Policy Commons^™

Restoring Medicaid And Schip Coverage To Legal Immigrant Children And Pregnant Women: Implications For Community Health And Health Care For Tomorrow's Citizens, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In the coming weeks, Congress will consider the reauthorization of the State Children's Health Insurance Program (SCHIP), whose legislative authorization will expire on March 31, 2009. SCHIP's overarching goal, in tandem with Medicaid, is to assure coverage of low-income children, regardless of race or national origin. As the proportion of uninsured immigrant children grows, a crucial question is whether the SCHIP reauthorization will address the need to restore eligibility for legal immigrant children and pregnant women. Although SCHIP and Medicaid have been successful in improving health insurance coverage for most low-income American children since the mid-1990s, the health coverage gaps …

Health Information Technology In The United States: On The Cusp Of Change, 2009, Sara J. Rosenbaum, Melissa M. Goldstein, Lee Repasch, Catherine M. Desroches, Ashish K. Jha

Health Policy and Management Faculty Publications

In this report we use the data collected for ONCHIT to focus on EHR adoption in the inpatient setting. We report on several important policy issues. These include the rate of adoption of EHRs among U.S. hospitals generally and among safety-net hospitals, changes in both state and federal policy, and the potential of EHRs to change the quality measurement enterprise.

Building The Foundation For A Healthy Life: Individuals, Communities And The State, John W. Seavey, Josephine B. Porter, Barbara Arrington

The University Dialogue

No abstract provided.

Discovery: Defining Health And Discovering Progress, Ned Helms

The University Dialogue

No abstract provided.

Sustainable Food Systems: Perspectives On Transportation Policy, Kameshwari Pothukuchi, Richard Wallace

Urban Studies and Planning Faculty Research Publications

Global agri-food and transportation systems have dramatically expanded food production and distribution worldwide. This integration, however, also adversely affects human health. The negative effects arise from unequal access to healthy food, unequal access to transportation for agri-food workers, increasing geospatial and economic concentration in the agri-food industry, and an emerging competition between food and fuel. Because the health of individuals is inextricably tied to the health of communities, regions, and ecological systems, health and transportation professionals need to act to both mitigate current disparities and enhance the future viability and sustainability of these systems. This paper offers numerous, specific recommendations …

Making A Brighter Future For Foster Youth In York County, Maine, Jennifer Boes

Children, Youth, & Families

The Network Approach and Its Emerging Role in Improving Opportunity for Youth Transitioning from Foster Care

Primary And Preventive Healthcare: A Critical Path To Healthcare Reform For Florida: The Role Of Florida's Fqhcs, Sara J. Rosenbaum, Peter Shin, Brad Finnegan, Ramona Whittington

Health Policy and Management Faculty Publications

Florida's health care system faces numerous challenges: a high proportion of residents without health insurance, a declining supply of primary care physicians at the same time that the state faces a growing need for high quality and cost efficient care for uninsured persons, and a growing emphasis on medical homes, especially for culturally diverse patients with complex chronic conditions. Nearly 3.8 million Florida residents lack health insurance, while more than 8 million lack access to a regular source of primary health care.

Assuring access to timely and high quality primary health care is a key dimension of any health reform …

Why Policy Matters, D. Richard Mauery

Health Policy and Management Faculty Publications

The Editors and Editorial Board of Women’s Health Issues are pleased to publish in this issue the first article in a new category of peer-reviewed manuscripts for our journal, ‘‘Policy Matters.’’

Evaluation Of Hiv Counseling And Testing In Anc Settings And Adherence To Short Course Antiretroviral Prophylaxis For Pmtct In Francistown, Botswana, Carolyn Baek, Tracy Creek, Lee Ann Jones, Louis Apicella, Jennifer Redner, Naomi Rutenberg

HIV and AIDS

The vast majority of children infected with HIV are the result of mother-to-child transmission (MTCT) of the virus during pregnancy, labor, or breastfeeding. Botswana is one of the first countries in the developing world with a national prevention program (PMTCT) to reduce vertical transmission. The Horizons Program of the Population Council, in collaboration with the Centers for Disease Control and Prevention (CDC) and Premiere Personnel in Botswana, conducted an evaluation to describe the adherence of pregnant women to the current PMTCT regimen. The report recommends standardizing post-test counseling content through the use of job aids and adapting existing WHO materials, …

Kenya's Fertility Transition: Trends, Determinants And Implications For Policy And Programmes, Ian Askew, Alex C. Ezeh, John Bongaarts, John Townsend

Reproductive Health

In Africa, fertility rates in the 1990s declined less rapidly than had been projected, and in a few cases the fertility transition appears to have stalled. This development has serious implications for future population growth because projected population size is sensitive to minor variations in current fertility trends. The 16 countries with three DHS surveys in sub-Saharan Africa can be divided into three subgroups: stalled transitions, insignificant declines, and significant declines. Half of the 16 countries experienced a stall, and an additional two experienced insignificant declines. The Population Council prepared a series of demographic and policy analyses that drew from …

Stepping Up: Managing Diversity In Challenging Times, Carol Hardy-Fanta

Publications from the Center for Women in Politics and Public Policy

Since its launch in 2008, Commonwealth Compact has grown steadily, employing several strategies to promote diversity statewide. The Benchmarks initiative has collected data, analyzed in this report, on a significant portion of the state workforce. Guided by Stephen Crosby, dean of the McCormack Graduate School of Policy and Global Studies at UMass Boston, Commonwealth Compact has conducted newsmaking surveys of public opinion and of boards of directors statewide. In addition, it has convened ongoing coalitions with its higher education partners, and established a collaborative of local business schools aimed specifically at increasing faculty diversity. The Compact has sponsored or co-sponsored …

Frequent Users Of The Emergency Department: A Policy Proposal, Tina Ann Olson

All Graduate Theses, Dissertations, and Other Capstone Projects

Research has extensively documented that a small number of Emergency Department (ED) patients make disproportionate use of emergency services (Okin et al., 2000). The term “Frequent Users” is used to describe patients who utilize ED services more than four times per year (Byrne et al., 2003). Frequent Users are often times patients with chronic medical, mental health, alcohol and drug problems, as well as other psychosocial issues (Fulde & Duffy, 2006). Homeless people also appear to have significantly higher ED rates than the general population (Pope et al., 2000). Immanuel St. Joseph’s-Mayo Health System (ISJ) ED appears to have many …

The Implementation Of The Kentucky Transitions: A Money Follows The Person Demonstration Grant Program, Amie Goodin

MPA/MPP/MPFM Capstone Projects

Kentucky Transitions is a Kentucky Medicaid program that is funded primarily by a grant from the Centers for Medicare and Medicaid Services. The purpose of this program is to transition individuals residing in long-term care facilities back into the community, where they will continue to receive health, social, and other benefits but do so in an approved residential setting. Individuals living in the community may experience higher quality of life and the increased ability to choose how and when they receive services, while Medicaid reaps the projected financial benefit of providing less-expensive community alternatives for care.

Though Kentucky Transitions operates …

Policy Issues Affecting Maine’S Hospitals, John A. Gale Ms, Jennifer D. Lenardson Mhs

Rural Hospitals (Flex Program)

Legislators and other policymakers will be continually challenged to balance the needs of hospitals for appropriate reimbursement and oversight with supporting their provision of important services to local communities.

Best Practices For Vulnerable Adult Investigation Policies And Procedures At Blue Earth County, Anna Stindt

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this project is to update the policies and procedures for conducting vulnerable adult investigations in Blue Earth County to reflect changes in the statute and to incorporate current best practices for conducting investigations.

Global Trends In Aids Mortality, John Bongaarts, Francois Pelletier, Patrick Gerland

Poverty, Gender, and Youth

This working paper reviews the evolution of the HIV/AIDS epidemic and provides estimates of past trends and future projections of AIDS mortality indicators, including numbers of AIDS deaths, the proportion of all deaths that are due to AIDS, and life expectancy. A cumulative total of 24 million people have died from AIDS between 1980 and 2007, and by 2030 this total is projected to reach 75 million. Despite the rapid spread of this new disease during the 1980s and 1990s, the epidemic has reached a major turning point in recent years as the rate of new infections peaked and began …

Reference Guides For Health Care Organizations Seeking Accreditation For High-Quality, Gender-Sensitive Reproductive Health Services, Patricia Riveros, Erica Palenque, Ricardo Vernon, Ignacio Carreno, John H. Bratt

Reproductive Health

Bolivia’s Integral Health Coordination Program (PROCOSI), a network of 33 nongovernmental organizations (NGOs) providing reproductive health care, has long promoted gender sensitivity as a necessary component of high-quality health care. PROCOSI encourages member NGOs to address gender-based differences in roles, relationships, access to services, and service needs in their reproductive health programs. The Reference Guides in this publication provide guidance to help health-care organizations and NGOs implement high-quality, gender-sensitive standards to achieve certification for their member clinics and administrative centers. The procedures and standards included here are based on the process developed by PROCOSI, but the approach and standards can …

Reference Guides For Health Care Organizations Seeking Accreditation For High-Quality, Gender-Sensitive Reproductive Health Services—Appendixes, Patricia Riveros, Erica Palenque, Ricardo Vernon, Ignacio Carreno, John H. Bratt

Reproductive Health

Bolivia’s Integral Health Coordination Program (PROCOSI), a network of 33 nongovernmental organizations (NGOs) providing reproductive health care, has long promoted gender sensitivity as a necessary component of high-quality health care. PROCOSI encourages member NGOs to address gender-based differences in roles, relationships, access to services, and service needs in their reproductive health programs. Included in this document are the Appendixes to “The Reference Guides for Health Care Organizations Seeking Accreditation for High-Quality, Gender-Sensitive Reproductive Health Services,” which provide guidance to help health-care organizations and NGOs implement high-quality, gender-sensitive standards to achieve certification for their member clinics and administrative centers. The procedures …

The Refentse Model For Post-Rape Care: Strengthening Sexual Assault Care And Hiv Post-Exposure Prophylaxis In A District Hospital In Rural South Africa, Julia C. Kim, Ian Askew, Lufuno Muvhango, Ntabozuko Dwane, Tanya Abramsky, Stephen Jan, Ennica Ntlemo, Jane Chege, Charlotte Watts

Reproductive Health

The Refentse study aimed to develop a nurse-driven, post-rape care model that could be integrated into existing reproductive health/HIV services within a rural South African hospital, and to evaluate the impact of this model on the quality of care delivered. Following the intervention, there were significant improvements in the quality of clinical history and examination, and the provision of pregnancy testing, emergency contraception, STI treatment, HIV counseling and testing, post-exposure prophylaxis (PEP), trauma counseling, and referrals. The report concludes that it is possible to improve sexual assault services including PEP within a rural South African hospital at modest cost, using …

Universal Health Insurance Coverage: Progress And Issues., Jonathan Gruber

Center for Policy Research

Jonathan Gruber was a key architect of Massachusetts’ ambitious health reform effort, and in 2006 became an inaugural member of the Health Connector Board, the main implementing body for that effort. He delivered this lecture on October 2, 2009, and his references are to Congressional bills that were under consideration on that date. He laid out the universal coverage debate that’s gone on for a long time in the United States; described a new solution that he think they found for Massachusetts; described how the Massachusetts reform works; and how it can be extended nationally. Finally he spent time on …

[Introduction To] Medicating Children: Adhd And Pediatric Mental Health, Rick Mayes, Catherine Bagwell, Jennifer L. Erkulwater

Bookshelf

Why and how did ADHD become the most commonly diagnosed mental disorder among children and adolescents, as well as one of the most controversial? Stimulant medication had been used to treat excessively hyperactive children since the 1950s. And the behaviors that today might lead to an ADHD diagnosis had been observed since the early 1930s as “organic drivenness,” and then by various other names throughout the decades.

The authors argue that a unique alignment of social and economic trends and incentives converged in the early 1990s with greater scientific knowledge to make ADHD the most prevalent pediatric mental disorder. New …

Beyond Public Health : The Cultural Politics Of Tobacco Control In Hong Kong, Wai Yin Chan

Lingnan Theses

This work provides cultural and political explanations on how and why cigarette smoking has increasingly become an object of intolerance and control in Hong Kong. Since the 1980s, the smoking population has been falling. Smoking behavior, sales and promotion of cigarette products have been under close surveillance by the government, medical experts and society at large. Cigarette smoking, as well as smokers, has increasingly been rejected and demonized in the public discourse. What are the conditions that make the growing intolerant discourses and practices against cigarette smoking possible and dominant? Why and how has the tobacco control campaign become prevalent …

Youth Migration And Poverty In Sub-Saharan Africa: Empowering The Rural Youth, Charlotte Min-Harris

Human Rights & Human Welfare

Sangaré, a poor young farmer from a village in southern Mali, leaves his wife and three children to find stable employment in the capital city of Bamako. What he finds is an unrewarding reality that leads him from small job to small job, only earning about US 22 cents per day. These jobs range from selling sunglasses, to shining shoes, to driving a rickshaw. Unfortunately, his income has not proved enough to provide for his family, as his aunt has since adopted his daughter, and his children cannot attend school. The inability to find stable employment in Bamako has forced …

Using Decision Analytic Modelling To Simulate Pregnancy, Jeffrey Cannon

Theses : Honours

Decision analytic modelling enables decision makers to assess the cost-effectiveness associated with a proposed change in a cunent system without physically implementing the changes. This can be achieved by formulating a mathematical model that represents all the major events occuning in the system through fmmulas and algorithms, and estimating the likely outcomes along with their costs. This type of modelling has been identified by the State Health Research Advisory Council (SHRAC) of the Western Australian Depmiment of Health as an asset for the plmming of health care investments in the future. One such area in which the Western Australian Department …

The Effectiveness And Adoption Of Market-Based State Health Care Expansion Programs, Nathan Gregory Myers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Market-based state health expansion programs are alternatives to government programs like Medicaid and SCHIP which also seek to expand access to health insurance for uninsured populations. These programs either utilize the private health insurance market or function according to market principles. The market-based policies at issue in this research are state high-risk health insurance pools, limited benefit plans, group purchasing arrangements, reinsurance programs, and Health Insurance Flexibility and Accountability waivers. This research addresses two separate but related research questions: (1) Do these market-based programs provide general economic and social benefits for the citizens of a state? (2) What role does …

Disease In The Desert: Las Vegas As A Case Study Of How First Responders And Emergency Managers Understand Novel Threats To Human Health And Plan To Respond During Biological Emergencies, Monique Williamson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over recent years it has become clear that technological advancements, globalization, and ecological change, combined with the onset of increased terrorist incidents, are all currently working to create an extremely hazardous environment in terms of pathogenic invasion. Realizing that infectious diseases are both newly emerging and re-emerging in many parts of the world, the question of how prepared an expansive United States will be in the face of an oncoming global pandemic is easily raised. Using Las Vegas as an example of just how unequipped a largely visited U.S. city may be in the face of such a situation, this …

Theorizing And Generalizing About Risk Assessment And Regulation Through Comparative Nested Analysis Of Representative Cases, Jonathan B. Wiener, Brendon Swedlow, Denise Kall, Zheng Zhou, James K. Hammitt

Faculty Scholarship

This article provides a framework and offers strategies for theorizing and generalizing about risk assessment and regulation developed in the context of an on-going comparative study of regulatory behavior. Construction of a universe of nearly 3,000 risks and study of a random sample of 100 of these risks allowed us to estimate relative U.S. and European regulatory precaution over a thirty-five-year period. Comparative nested analysis of cases selected from this universe of ecological, health, safety, and other risks or its eighteen categories or ninety-two subcategories of risk sources or causes will allow theory-testing and -building and many further descriptive and …

Variables In Health Care Policy Making: Resolving A Quandary, George P. Smith Ii

Scholarly Articles

Contemporary debate in health care resource management is tied to a central moral issue: how to achieve the optimum level of reasonable or appropriate treatment based on the medical condition of each patient. Failure to tackle and resolve this issue in a confident and forthright manner ensures that the present approach to health care decision-making will continue in a state of indecisiveness if not, indeed, lethargy. Undergirding this moral issue is the foundational economic dilemma of controlling costs while limiting access to health care resources. Crafting a just solution to an equitable distribution of finite health care resources is, indeed, …