Health Policy Commons^™

Commentary: Moving Beyond The Numbers, Effectively Using Research To Influence Policy, F. Douglas Scutchfield, Marylou Wallace

Frontiers in Public Health Services and Systems Research

This seventh issue of Frontiers reflects the variety of PHSSR. One emerging theme, however, is the notion of public health and its role in policy and policy development. PHSSR focuses on several potential users, researchers, practitioners and policy makers. As it concerns policy makers, PHSSR delivers research that allows them to make decisions about policy change that not only influences public health status, but creates healthy conditions. In this way, PHSSR essentially influences decisions about support for public health services.

Diffusion Of Innovation Across A National Local Health Department Network: A Simulation Approach To Policy Development Using Agent-Based Modeling, Mark Orr, Jacqueline Merrill

Frontiers in Public Health Services and Systems Research

The network that local health officials use to communicate about professional issues is sparsely connected, which may limit the spread of innovative practices. We used agent-based simulation modeling to find out if a policy to promote more connections improved the network’s capability to diffuse innovation. We found that unanticipated effects could result, depending on the requirements of the policy and the proportion of health officials involved. With carefully crafted assumptions and reliable data it is possible to untangle complex processes using simulation modeling. The results represent how the world might actually work which may provide useful decision support for policymakers …

Addressing Health Inequalities In The United States: Key Data Trends And Policy Action, Sara N. Bleich, Marian P. Jarlenski, Caryn N. Bell, Thomas A. Laveist

Frontiers in Public Health Services and Systems Research

Health inequalities, which have been well documented for decades, have recently become policy targets in the United States. This report summarizes current patterns and trends in health inequalities, commitments to reduce health inequalities, and progress made to eliminate health inequalities. Time trend data indicate improvements in health status and major risk factors but increases in morbidity, with black and lower-education individuals experiencing a disproportionate burden of disease. A common policy response has been priority setting in the form of national objectives or goals to address health inequalities. More research and better methods are needed to precisely measure relationships between stated …

Global Budgets, Payment Reform And Single Payer: Understanding Vemont's Health Reform, Trish Riley

Population Health & Health Policy

The Muskie School of Public Service hosted two health policy colloquia this April to promote informed discussion throughout the state regarding MaineCare coverage options under the ACA and the implications of Vermont’s move toward a single-payer system.The series, sponsored by the Muskie School Board of Visitors, offers community conversations in which experts from various disciplines and perspectives inform and engage the broader public to explore and debate critical policy issues. On April 22, community and sector leaders joined for Global Budgets, Payment Reform, and Single Payer: Understanding Vermont's Health Reform. Participants discussed Vermont's recent movie toward single payer health …

Providing Long Term Services & Supports To People With Impaired Decision-Making Capacity: Results Of Data Analysis And Interviews Examining Needs And Characteristics Of Persons With Impaired Decision-Making Capacity In Maine, Eileen Griffin Jd, Louise Olsen, Julie T. Fralich Mba

Disability & Aging

This document:

• Reviews the prevalence of impaired decision-making capacity among adults and older adults receiving publicly funded home care services and supports in Maine, the characteristics of this population group, and the caregivers caring for persons with impaired decision-making capacity.
• Reports on interviews with providers describing their ideas for helping people with impaired decisionmaking capacity live in the community longer.
• Reviews the legal status of persons receiving long term services and supports in Maine, including the presence of a guardian or a Power of Attorney, among those with impaired decision-making capacity across settings.
• Reports on interviews with providers, describing kinds …

Federal Health Care Reform: An Overview, Andrew F. Coburn Phd

Population Health & Health Policy

This policy brief discusses three of the main components of the Patient Protection and Affordable Care Act (ACA), also known as "Obamacare". These components are helath insurance coverage, delivery system improvement, and cost containment. The policy brief highlights some of the provision of the law that have already been implemented and those where importnat implementation decisions will have to be made. The brief is authored by Dr. Andrew Coburn, PhD, Professor of Public Health and Director of the Population Health and Health Policy program at the USM Muskie School, and was presented at the Maine Policy Leaders Academy Health Care …

Children And Adults With Long Term Services And Support Needs: Mainecare And Medicare Expenditures And Utilization, State Fiscal Year 2010, Stuart Bratesman Mpp, Julie T. Fralich Mba, Tina Gressani, Eileen Griffin Jd

Disability & Aging

This report is one of a series of reports prepared by the USM Muskie School on MaineCare members who are dually eligible for MaineCare and Medicare Services. An earlier report provided a high level overview of the MaineCare and Medicare use and expenditure patterns for all members who were dually eligible in state fiscal years (SFY) 2008 to 2010. Both reports were prepared as part of the Maine State Profile Tool grant funded by the Centers for Medicare & Medicaid Services. This second report analyzes the characteristics, use and expenditure patterns of sub-populations of long term service users including adults …

Satisfaction Survey Results And Lessons Learned: Maine's Aging & Disability Resource Center (Adrc) Project, Julie T. Fralich Mba, Louise Olsen, Mark Richards Bs, Jennifer Pratt, Taryn Bowe

Disability & Aging

The primary goal of Maine’s Aging and Disability Resource Center (ADRC) Project was to empower consumers to make informed decisions about long-term services and supports and to streamline access to existing services and supports through an integrated system. With funding from the Administration on Aging to strengthen and expand the number of Aging and Disability Resource Centers (ADRCs) in the state, all five of the Area Agencies on Aging were committed to becoming and/or strengthening their capacity to be fully functioning ADRCs.

This report provides a summary of the results of consumer satisfaction surveys that were conducted for three years …

Maine Direct Service Workforce Survey Results 2012 [Chartbook], Julie T. Fralich Mba, Eileen Griffin Jd, Danielle Wescott

Disability & Aging

Direct service workers play a central role in the quality of the long-term services and supports provided to older people and people with disabilities in home and community settings. Nationally, and at the state level, there is a critical need for more information about this workforce in order to inform workforce policy and measure improvements in workforce quality and stability over time. Maine was one of seven states to administer baseline surveys under a grant funded by the U.S. Centers for Medicare and Medicaid Service. Survey questions focused on workforce volume, stability, and compensation, as well as, cultural competence, workforce …

"Homelike" Characteristics Of Maine's Residential Services: A Survey Of Maine's Residential Service Settings (2010), Julie T. Fralich Mba, Eileen Griffin Jd, Catherine Mcguire Bs

Disability & Aging

To better understand the nature of the residential facilities serving more than 19 percent of Maine’s Long Term Services and Supports (LTSS) population, the Maine Department of Health and Human Services commissioned the Muskie School to conduct a survey of residential facilities as part of its update to Maine’s LTSS profile. The goal of the Maine Residential Settings Characteristics Survey, conducted between July and September 2010, was to measure the "homelike" characteristics of residential settings.

The survey sample comprised a total of 636 facilities which included all licensed residential care facilities or private non-medical licensed institutions. The survey response rate …

Members Dually Eligible For Mainecare And Medicare Benefits: Mainecare And Medicare Expenditures And Utilization, State Fiscal Year 2010., Catherine Mcguire Bs, Tina Gressani, Stuart Bratesman Mpp, Julie T. Fralich Mba, Eileen Griffin Jd

Disability & Aging

This report is one of a series of reports prepared by the USM Muskie School on MaineCare members who are dually eligible for MaineCare and Medicare Services. This first report provides a high level overview of the MaineCare and Medicare use and expenditure patterns for all members who were dually eligible in state fiscal years (SFY) 2008-2010. This report provides baseline data on the characteristics of Medicare-MaineCare members who are dually eligible, the distribution of expenditures across categories of service for MaineCare and Medicare, and the cost of care for people with select chronic conditions. The report includes information on …

Superfund Evaluation: The Families Of Tar Creek, Gary D. Wilson

Graduate Theses and Dissertations

The Tar Creek Superfund Site is located in far northeastern Oklahoma near the Oklahoma/Kansas border in Ottawa County. The Site generally consists of a forty-square-mile area which is also part of the larger Tri-State Mining District that includes areas of Kansas and Missouri. The Site includes parts of five communities: Picher, Cardin, Quapaw, North Miami, and Commerce in Oklahoma. It also includes Treece, Kansas, and affects a total population of roughly 30,000 residents. Following Superfund designation, families in the Tar Creek area had to decide whether to accept or reject buy-out offers. This project explored the decision-making processes employed by …

Defining Development And Foreign Aid, Evangelical Advocacy: A Response To Global Poverty

Bibliographies

A bibliography featuring primary authors, leading books, important papers, and other key publications introducing international development and offering a comprehensive overview of foreign aid.

Personal Experiences With Mainecare Services From People Who Use Elder And Adults With Disabilities Waiver And Private Duty Nursing/Personal Care Services., Julie T. Fralich Mba, Katherine Rosingana, Mark Richards Bs, Louise Olsen, Vanessa Bell, Jennifer Pratt

Disability & Aging

This report provides the results from a survey and personal interviews that were conducted with MaineCare members who use long term services and supports -- specifically those who are on the Elder and Adults with Disabilities Waiver and those using Private Duty Nursing (PDN) Services. People who are eligible for these services generally need nursing care and assistance with a combination of activities of daily living (e.g. eating, toileting, mobility, transfer) and instrumental activities of daily living (e.g. meal preparation, grocery shopping, housework). People on the Waiver are medically eligible to be in a nursing home. The purpose of the …

Sex Education Decision Making At The Independent School District Of Boise, Annabeth D. Elliott

Boise State University Theses and Dissertations

A needs assessment was conducted in Boise in 2008 to address pregnancy, abortion. and sexually transmitted diseases in teens. Key informants indicated students lacked knowledge about sexuality and agreed that comprehensive sex education was the best strategy for improving teen sexual health (Elliott, 2008). Because the Independent School District of Boise (ISDB) had an abstinence-only policy, the strategy could not be implemented until the policy was changed.

The purpose of this case study was to cultivate an in-depth understanding of the influences on sex education policy decisions at the ISDB and to add to the body of knowledge, which may …

Head Start: It Works For Indiana Children And Families!, Jennifer Dobbs-Oates, James Elicker, Volker Thomas

Center for Families Publications

This technical report summarizes new and existing data to address the question, “Does Head Start work for Indiana children, families, and communities?” Data sources consulted in this study include the state Head Start Program Information Report, local Indiana Head Start and Early Head Start Programs, existing national studies of Head Start and Early Head Start, and local and national data available on children’s development in early care and education programs for low-income families. This report concludes that Indiana’s Early Head Start and Head Start programs are indeed providing substantial benefits to children, families, and communities. The report summarizes the outcomes …

Avoiding Tough Policy Choices In An Influenza Pandemic: The Role Of Kettl's Rocket Science Model In Public Health, Danny Lambert

Electronic Theses and Dissertations

The security and social inequality approaches to public health present distinct answers to policy objectives relative to a pandemic. However, each approach leaves us with tough choices between the most valued objectives. I demonstrate how the networked approach, which Kettl's Rocket Science Model (RSM) exemplifies, does not leave us with such choices. Furthermore, I connect the epidemiological concepts public health practitioners apply toward communicable disease pandemics to RSM concepts. Finally, drawing on the disease parameters of a worst-case scenario influenza pandemic, I demonstrate how the networked approach helps public health practitioners expand capacity such that tough choices are unnecessary.

Profiling Maine’S Long Term Support System [Project Brief], Eileen Griffin Jd

Disability & Aging

A recent report by the Muskie School and the Maine Department of Health and Human Services provides a new way of looking at the state’s long term support system. With an emphasis on developing a common approach for description and analysis across programs, the profile reveals that users of long term services and supports in Maine span all age groups and types of service users. In fact, 28% are ages 17 or younger and 29% are between the age of 35 and 64. Long term service users include people with physical impairments, cognitive and intellectual disabilities, and people who need …

Pemenuhan Hak Konsumen Di Institusi Pelayanan Kesehatan Di Kota Bandung Dan Kota Cimahi, Juariah Juariah

Kesmas

Kebijakan pelayanan medis secara legal formal telah memberikan perlindungan hak konsumen kesehatan. Namun, sampai kini belum terungkap upaya institusi pelayanan kesehatan untuk memenuhi dan melindungi hak konsumen kesehatan. Penelitian ini bertujuan mengeksplorasi berbagai kebijakan pemenuhan hak-hak konsumen kesehatan oleh institusi pelayanan kesehatan pemerintah dan swasta. Penelitian yang menggunakan pendekatan kualitatif dengan metode studi ini dilaksanakan pada Agustus 2008 - Januari 2009 di institusi pemerintah RSUD Cibabat-Cimahi, RSKIA Astanaanyar dan Puskesmas Garuda serta institusi swasta RS Muhammadiyah dan RB Barokah. Data dikumpulkan dengan telaah dokumen dan wawancara mendalam terhadap lima orang informan serta dianalisis dengan analisis isi. Hasil penelitian meliputi: tiga …

Cross-System Profile Of Maine's Long Term Support System: A New View Of Maine's Long Term Services And Supports And The People Served, Eileen Griffin Jd, Julie T. Fralich Mba, Catherine Mcguire Bs, Louise Olsen, Stuart Bratesman Mpp, Kathy Bubar, Romaine Turyn

Disability & Aging

This document provides a new way of looking at Maine's long term services and supports, with an emphasis on developing a common approach for describing and analyzing long term services and supports across programs. A conscious effort was made to organize this profile around the populations served rather than the programs serving them. For that reason, the profile captures information on all of the services accessed by each population group, not only those services administered by a particular program. This broader view provides important information about the full range of service utilization for each population group.

Tracing The History Of Medicare Home Health Care: The Impact Of Policy On Benefit Use, Joan K. Davitt, Sunha Choi

The Journal of Sociology & Social Welfare

We trace key policy changes that affected use of the Medicare home health benefit from the 1980s through the prospective payment system implemented in 2000, analyzing the impact on three measures of home care use: expenditures, users and visits. We demonstrate the impact of policies generated in the legislative, the judicial, and the executive branches of government and the gaming behavior of home health agencies in response to policy changes. Our analysis suggests that the policy itself and the implementation process are critical to understanding benefit use. The incentives in the policies and agency reactions had the potential to generate …

Assessment Of Maine's Long-Term Care Needs Baseline Report: Demographics And Use Of Long Term Care Services In Maine, Stuart Bratesman Mpp, Julie T. Fralich Mba, Karen Mauney, Catherine Mcguire Bs, Louise Olsen, Jasper Ziller

Disability & Aging

In 2006, the Office of Elder Services requested the assistance of the Muskie School in developing an assessment of long term care service use in Maine. This report provides baseline information on the demographic characteristics, participant characteristics and service use trends for people accessing long term care services in this State.

For purposes of this report, we have excluded people with MR/DD. Long term care services do not include community support services for people with mental illness.

In this report, long term care services include:

• Nursing Facility Services
• Private Non-medical Institutions
• Consumer Directed Attendant Services
• Day Health Services
• Elder and …

Women Of Talent: Gender And Government Appointments In Massachusetts, 2002–2007, Carol Hardy-Fanta, Kacie Kelly

Publications from the Center for Women in Politics and Public Policy

Despite the high educational and occupational attainment—and considerable talent—of women in Massachusetts, the state ranks just 22nd in the nation on women's overall share of top executive, legislative, and judicial posts, compared to their share of the population. The goals of this study were to (1) calculate the percentage of women holding senior-level positions in state government at these four points in time; (2) analyze the distribution of appointments by type of position and executive office; (3) provide possible explanations for the status of women’s representation in these positions; and (4) offer recommendations that will serve to promote the appointment …

Pastoral Care In Education, Lydia Hearn, Renee Campbell-Pope, Joanne House, Donna Cross

Research outputs pre 2011

EXECUTIVE SUMMARY

1. During the past decade, there has been growing recognition the school environment plays a major role in the social and emotional competence and wellbeing of children. As a consequence, increasing national and international commitment has been directed towards the development of Health Promoting Schools2, with efforts being made to assess how curriculum and pastoral practice can best contribute to students’ social, emotional, physical and moral wellbeing. Within Australia, the National Safe Schools Framework3 has set as a key priority the importance of achieving a shared vision of physical and emotional safety and wellbeing for all students …

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

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.

Access Choice And Control: A Comparative Analysis Of Maine's Personal Assistance Services Programs, Eileen Griffin Jd

Disability & Aging

The purpose of this analysis was to identify opportunities for eliminating unnecessary inconsistency and increasing consumer choice and control across Maine's personal assistance services (PAS) programs. Thirteen recommendations were made based on the findings which indicated that Maine PAS programs vary in the level of support they offer but the difference in support cannot necessarily be explained by differences in the level of need. Additionally, Maine PAS programs have been and are currently working toward increasing opportunities for expanding consumer choice and control over services.

The Citizens Health Prescription: Coping With Rising Drug Costs, Shannon Cadres

New England Journal of Public Policy

Prescription drug prices have climbed to unaffordable levels in recent years, creating a serious public policy problem for lawmakers at both the state and federal levels. The U.S. Medicare program only covers the costs of inpatient prescription drugs, and only seventy-five percent of beneficiaries are receiving coverage through some other means. But because of the tremendous power of the pharmaceutical industry on Capitol Hill, lawmakers in Washington have been unable to agree upon a workable solution. As a result, many states are experimenting with different strategies to provide some relief. Massachusetts has attempted to solve the problem through the Prescription …