Health Policy Commons^™

Is The United States Prepared For Ebola?, Lawrence O. Gostin, James G. Hodge Jr., Scott Burris

Georgetown Law Faculty Publications and Other Works

The West African Ebola epidemic is a humanitarian crisis and a threat to international security. It is not surprising that isolated cases have emerged in Europe and North America, but a large outbreak in the United States, with its advanced health system, is unlikely. Yet the handling of the first domestically diagnosed Ebola case in Dallas, Texas, raised concerns about national public health preparedness. What were the critical health system vulnerabilities revealed in Dallas, and how can the country respond more effectively to novel diseases in a globalized world?

Provision Of Telemedicine Services By Community Health Centers, Peter Shin, Jessica Sharac, Feygele Jacobs

Health Policy and Management Faculty Publications

The objective of this study was to assess the use of telemedicine services at community health centers. A national survey was distributed to all federally qualified health centers to gather data on their use of health information technology, including telemedicine services. Over a third of responding health centers (37%) provided some type of telemedicine service while 63% provided no telemedicine services. A further analysis that employed ANOVA and chi-square tests to assess differences by the provision of telemedicine services (provided no telemedicine services, provided one telemedicine service, and provided two or more telemedicine services) found that the groups differed by …

Ebola: A Crisis In Global Health Leadership, Lawrence O. Gostin, Eric A. Friedman

Georgetown Law Faculty Publications and Other Works

At the core of the present Ebola crisis in West Africa is a lack of global health leadership. WHO should be the global health leader, following its constitutional charge, yet it is significantly under-resourced, having a direct effect on its rapid response capacity. The Organization's response to this crisis has been constantly behind, from low funding appeals to its delay in declaring this outbreak to be a Public Health Emergency of International Concern under the binding International Health Regulations (2005) (IHR). The IHR themselves have proven insufficient, as countries have failed to cooperate in building the public health capacities that …

Ending Failures, Showing Results, Improving Population Health: Insights From Research & Reform In The U.S., Glen P. Mays

Health Management and Policy Presentations

A growing body of empirical research supports the value of aligning the delivery systems for public health, medical care, and social services for populations with shared needs and risk factors. This presentation reviews selected studies from the field of public health services & systems research (PHSSR) in the U.S. that suggest pathways for achieving greater system alignment in the Canadian context.

How Can Public Health Economics Help Health Systems Focus Upstream?, Glen P. Mays

Health Management and Policy Presentations

Research on the health and economic impact of public health strategies can help newly evolving health care delivery systems focus on upstream health determinants and make evidence-informed decisions about resource allocation across the prevention-treatment spectrum. Examples from research underway in the U.S. have particular relevance for Canada's evolving regional health authorities and their integrated approaches to medical care and public health delivery.

Public Health In The Age Of Ebola In West Africa, Michael T. Osterholm, Kristine A. Moore, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The Ebola epidemic, with its fast-growing toll and real potential for spreading into much of Africa, including major cities, has the makings of a “Black Swan” event. Such events, using the term coined by Nassim Nicholas Taleb, are: 1) unpredictable, outside the realm of regular expectations; 2) have a major impact, and; 3) are rationalized after the fact as being explainable and predictable.

We have learned from this outbreak the potential for an infectious disease to be politically, economically, and socially destabilizing, and that what kills us may be very different from what frightens us or substantially affects our social …

The Impact Of State Mandated Healthcare-Associated Infection Reporting On Infection Prevention And Control Departments In Acute Care Hospitals: Results From A National Survey, Carolyn T. A. Herzig, Monika Pogorzelska-Maziarz, Julie Reagan, Elaine Larson, Patricia W. Stone

Health Policy & Management: Faculty Presentations (2008-2022)

Background: In addition to federally mandated reporting, most US states have adopted legislation requiring hospitals to submit healthcare-associated infection (HAI) data. Evidence that state HAI laws have increased patient safety and reduced HAI rates is inconsistent, however, and resources needed to comply are considerable. We evaluated the impact of state HAI laws on infection prevention and control departments (IPCD).

Methods: Web-based survey of a national sample of hospital IPCD was conducted in Fall 2011; all non-VA hospitals enrolled in the National Healthcare Safety Network were eligible to participate. States with HAI laws effective prior to Fall 2011 were identified using …

Tougher Than Rocket Science, Or Just Messier? Using Research To Improve U.S. Public Health Delivery, Glen P. Mays

Health Management and Policy Presentations

Advances in the field of public health services & systems research (PHSSR) are incorporating complexity in theory and methods to derive strong inferences about the health and economic effects attributable to public health strategies. Opportunities for comparative international research in Canada and the U.S. promise to strengthen these avenues of inquiry.

Children's Use Of Dental Care In Medicaid: Federal Fiscal Years 2000-2012, Erika Steinmetz, Brian K. Bruen, Leighton C. Ku

Health Policy and Management Faculty Publications

This report presents with national and state-specific analyses about dental services received by children ages 1 to 20 under Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit in federal fiscal years (FFY) 2000-2012. These analyses are based on data reported by state Medicaid agencies using Form CMS-416 (Form 416); all data reflect updates received by CMS as of April 3, 2014. This report focuses on the number of children who received any dental service, any preventive dental service (e.g., dental cleaning or application of dental sealants) and any dental treatment service (e.g., filling a cavity). The national trend …

Hidden In Plain Sight: Exploring The Vulnerabilities Of Street-Working Boys In Se Asia, Jarrett Davis, Glenn Miles

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

The sexual exploitation of men and boys is often little understood and commonly goes ignored. Internationally, it is said that 1 in 6 boys are sexually abused before reaching adulthood and in some nations the exploitation and abuse of boys far outweighs that of girls. Social and cultural norms often assume men and boys to be inherently strong and/or invulnerable to sexual exploitation; however, research in this area continues to show these assumptions to be false. Because of this lack of awareness, the efforts of the organizations and individuals who work to provide for the needs of male victims are …

Analysis Of Human Trafficking Cases In Rhode Island, 2009-2013, Donna M. Hughes, Rachel Dunham, Faith Skodmin, Lucy Tillman, Jessica Wainfor

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

This presentation is an analysis of seven state and federal cases of human trafficking, including forced labor and sex trafficking, in Rhode Island from 2009 until 2013. In 2009, Rhode Island passed a comprehensive human trafficking law. Since then there have been six cases of sex trafficking and one case of forced labor. Sources for information on the human trafficking cases were police reports, witness statements, court documents and media reports. This presentation will briefly summarize the cases and discuss the similarities and difference among the cases and discuss of some key findings from these cases, which include:
1) Victims …

Access To Comprehensive Perinatal Services Among Pregnant Women Enrolled In Both Medi-Cal And Covered California: Aligning And Integrating Care, Sara J. Rosenbaum, Carla Hurt, Mark Dorley, Sara Rothenberg, Nancy Lopez

Health Policy and Management Faculty Publications

Medi-Cal-enrolled women who are pregnant are entitled to coverage for enriched pregnancy-related care under Medi-Cal’s Comprehensive Perinatal Services Program (CPSP), a national landmark in the care and management of pregnant women with elevated health risks due to their low economic status. This entitlement applies to all pregnant women enrolled in Medi-Cal, including women who also are enrolled in subsidized health plans purchased through Covered California. The task that jointly faces Medi-Cal and Covered California is how best to align these two sources of pregnancy care financing in order to achieve a central goal of SB 857 – ensuring that dually …

The Iom Gme Report: Gme Financing Reform, Workforce Needs And The Resistance To Change, Edward Salsberg

Health Workforce Speaker Series

No abstract provided.

Human Trafficking To Northern America: The Balkan Connection, Natalya Timoshkina, Naser Miftari, Antonela Arhin

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

This paper draws on the results of a large multi-method study, which examined human trafficking from the former Eastern Bloc to Northern America (Canada and the United States). The study was conducted in 2011-2013, and funded by the Social Sciences and Humanities Research Council of Canada (SSHRC). The analysis is grounded in the findings from 9 countries of the Balkan region included in the study: Albania, Bulgaria, Bosnia and Herzegovina, Croatia, Kosovo, Macedonia, Montenegro, Serbia, and Slovenia. The following data sources were used: (a) national and international reports, media and academic articles, and various documents (in English and official languages …

Human Trafficking, Education And Migration At Ngos In Cambodia And Thailand, Robert Spires, Xinyi Duan

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

This presentation is based on in-progress collaborative research between researcher Dr. Bob Spires and Hong Kong-based NGO Liberty Asia. The research involves interviews and observations conducted at multiple NGOs in Cambodia and Thailand working to address human trafficking and incorporating educational components into their programs. The study uses comparative lenses to examine issues of education and migration in both the Cambodian and Thai context for human trafficking survivors and at-risk populations. The study is interdisciplinary, drawing on the work on human trafficking in several social science fields. The framework for the research is based on Frank Laczko and Elzbieta Gozdziak’s …

Bra’S For A Cause: A Service Learning Project In A Freshman Level Human Trafficking Course, Beth A. Wiersma

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

Women and Children for Sale: The Global Problem of Human Trafficking is a General Studies Portal course for college freshman at a Midwestern university. The students in the course were surveyed the first day of class about why they chose the course, what they hoped to get out of the course, what they believed to be true about human trafficking, and how they learned about human trafficking. During the semester the students planned and carried out a service learning project “Bras for a Cause”. This project involved educating others about human trafficking and collecting bras. The bras are sent overseas …

The Problem Of State Intervention In Post-Abolition Slavery: A Critique Of Consensus, Anthony Talbott, David Watkins

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

Slavery is now illegal by all states and under international law. Contrary to the hopes of abolitionists, this state of affairs has transformed rather than eradicated slavery as an institution. Furthermore, responses by states to post-abolition forms of slavery have often been less than ideal. This paper begins by comparing two state responses to slavery in the early 20th century: the federal peonage trials in Montgomery, Alabama from 1903-1905, and the federal response to an alleged epidemic of “white slavery” from 1909-1910, culminating in the passage of the White Slave-Traffic Act. Taken together, these responses engender pessimism about the state …

An Analysis Of Political And Legal Debates Concerning Medicaid Expansion In Virginia, Rick Mayes, Benjamin Paul

Political Science Faculty Publications

The Supreme Court’s historic June 2012 ruling regarding the Affordable Care Act (ACA) in National Federation of Independent Business v. Sebelius set the stage for a massive federalism battle over Medicaid expansion in the United States. The original language of the Act was intended to nationalize Medicaid by having every state expand their program’s eligibility to all individuals up to 138% of the federal poverty level. This would have significantly reshaped Medicaid, a joint federal-state health insurance program, into a universal entitlement for all low-income citizens. Currently, Medicaid eligibility varies dramatically from state to state. The Court held that the …

Giving The Homeless Population A Chance To Become Healthier: An Initial Needs Assessment Of The Homeless Population Of Portland, Maine, Annarae Andresen, Oana Butnarasu, Jayme Keith, Sarah Kou, Dana Mccoy, Stephanie Sheehan, Jessica Takatsuki, Zoe Hull, Ian Imbert, Suzanne Dunn, Tara Lonneman, Marissa Prezanno, Catherine Bixby

Homeless Needs Assessment

Research poster stemming from IPEC mini-grant student project Homeless Needs Assessment. The project was designed to assess the greatest needs for people experiencing homelessness in Portland, Maine. UNE Students from several healthcare professions partnered together to provide a holistic approach to the community needs with hopes of developing and implementing intervention strategies. Goal was to conduct surveys of at least 100 homeless individuals.

The Ecology Of Infancy And Early Childhood In Rural Senegal; A Five Year Old Can Boot But Not Foot, An Exploration Of Where Biology Meets Culture, Heather Mills

Independent Study Project (ISP) Collection

This research project explores the life stages of infancy and early childhood in the village of Ndiane in the Thies region of Senegal. I will discuss how biology meets culture to influence children, parenting styles, and expectations of the life stage. How does ecology, the interaction of physical, biological and cultural landscapes, characterize childhood and the intertwined belief systems that influence parenting? The information was gathered using a combination of participant observation and free list interviews.

Physicians' Perspectives On The Current Handling Of Medical Malpractice In Jordan, Jason Yohan Hwang

Independent Study Project (ISP) Collection

Research on medical malpractice has increased over the past few decades. However, such studies have primarily focused on malpractice in Western countries like America. In areas like the Middle East, studies on malpractice has been lacking. Thus, this study tries to fill this gap. The purpose of this study is to understand physicians’ perspectives on the current handling of medical malpractice in Jordan. To answer this research question, the study uses both surveys and interviews to focus on three main themes: one, physicians’ understanding of the term, malpractice; two, evaluation of the current malpractice system; and three, attitudes toward a …

Human Rights Infringements In Brazil’S Penitentiary System Understood Through Access To Healthcare, Sara Morris

Independent Study Project (ISP) Collection

Brazil has a reputation of being home to some of the worst penitentiary conditions worldwide, eventually leading the United Nations to make an appeal to the Brazilian government in 2003 to analyze their systems and make necessary improvements. The poor conditions and lack of access to legal counsel, living space, and specifically healthcare, cause riots and uprisings within prisons that in the past have lead to death of prisoners and guards. Prisons serve a very specific purpose in society, and according to most social theorists that is to reform, not to torture. In Brazil there is no capital punishment, so …

Migrating Faculty Publications From A Department Website To An Institutional Repository, Meaghan Corbett, Christopher D. Cook

Himmelfarb Library Faculty Posters and Presentations

In October 2013, George Washington University's School of Public Health and Health Services (now the Milken Institute School of Public Health) approached the Himmelfarb Health Sciences Library about moving a large collection of Health Policy Department publications and citations from the school's website into the Health Sciences Research Commons (HSRC) institutional repository. After a project planning meeting with the school's representative, library staff began uploading documents and citations from the collection. Working from a spreadsheet and file set provided by the school, library staff processed 604 citations (including 319 full-text files) dating back to 1996. Despite some problem files and …

Mainecare Health Homes Enrollment In The First Year Of Implementation, Kimberley S. Fox Mpa, Carolyn E. Gray Mph, Katherine Rosingana

Population Health & Health Policy

The MaineCare Health Homes Initiative is designed to improve care coordination for MaineCare members with complex chronic medical conditions. The program is being implemented in two stages: Health Homes (HH), which began in January 2013, focuses on members with chronic health conditions. Behavioral Health Homes (BHH), which began in April 2014, is designed to meet the needs of people with Severe Mental Illness (SMI) or Serious Emotional Disturbances (SED).

The HH first stage builds off the State’s existing multi-payer Patient Centered Medical Home (PCMH) Pilot project and Medicare Advanced Primary Care Practice (MAPCP) Demonstration by providing addon payments to qualifying …

Many Paths To Primary Care: Flexible Staffing And Productivity In Community Health Centers, Leighton C. Ku, Bianca K. Frogner, Erika Steinmetz, Patricia Pittman

Health Policy and Management Issue Briefs

No abstract provided.

The Ebola Epidemic: A Public Health Emergency Of International Concern, Lawrence O. Gostin, Daniel Lucey, Alexandra Phelan

Georgetown Law Faculty Publications and Other Works

On August 8, 2014, the World Health Organization (WHO) Director-General Margaret Chan declared the West Africa Ebola crises a “public health emergency of international concern,” triggering powers under the 2005 International Health Regulations (IHR).

The most affected West African states have attempted classic public health measures with varied success, including quarantine and isolation, social distancing, risk communication, and travel restrictions. These have involved a trade off between population health and human rights; sometimes to the disadvantage of both. At the same time, the countries’ health systems and human resources are fragile, impeding an effective response.

Beyond the public health and …

The Historic Role Of Boards Of Health In Local Innovation: New York City’S Soda Portion Case, Lawrence O. Gostin, Belinda H. Reeve, Marice Ashe

Georgetown Law Faculty Publications and Other Works

Childhood and adult obesity pose major risks for cancer, diabetes, and cardiovascular disease, with the poor and racial minorities suffering from disproportionately high burdens of obesity and chronic disease. With current policies failing, cities and states have moved forward with creative prevention measures–-with boards of health driving policy innovation in many local jurisdictions. The New York City Board of Board of Health’s (NYCBH) soda portion limit pushed the boundaries of innovation, but was struck down on June 26, 2014 by New York State’s highest court, which held that the Board trespassed on the City Council’s authority.

The Court’s decision ignored …

Virus Sharing, Genetic Sequencing, And Global Health Security, Lawrence O. Gostin, Alexandra Phelan, Michael A. Stoto, John D. Kraemer, K. Srinath Reddy

Georgetown Law Faculty Publications and Other Works

The WHO’s Pandemic Influenza Preparedness (PIP) Framework was a milestone global agreement designed to promote the international sharing of biological samples to develop vaccines, while that ensuring poorer countries would have access to those vaccines. Since the PIP Framework was negotiated, scientists have developed the capacity to use genetic sequencing data (GSD) to develop synthetic viruses rapidly for product development of life-saving technologies in a time-sensitive global emergency—threatening to unravel the Framework. Access to GSD may also have major implications for biosecurity, biosafety, and intellectual property (IP).

By rendering the physical transfer of viruses antiquated, GSD may also undermine the …

Ebola: Towards An International Health Systems Fund, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The current outbreak of Ebola virus disease (EVD) in West Africa is spiraling out of control, but it never had to happen. What can the international community do now to bring the epidemic under control, and how can we prevent the next one?

The counties most affected by Ebola (Guinea, Liberia, and Sierra Leone), rank among the lowest in global development, lacking essential public health infrastructure. If the affected countries had adequate public health systems, they probably would have contained Ebola within rural settings, avoiding the first outbreak in major urban areas.

More than 130 health workers have died from …

Grant Application: Homeless Needs Assessment Project, Annarae Andresen, Oana Butnarasu, Jayme Keith, Sarah Kou, Dana Mccoy, Stephanie Sheehan, Jessica Takatsuki, Ian Imbert, Zoe Hull, Tara Lonneman, Marissa Prezanno, Suzanne Dunn

Homeless Needs Assessment

IPEC Mini-grant application for funding of UNE student project Homeless Needs Assessment. The Homeless Needs Assessment Project was designed to assess the greatest needs for people experiencing homelessness in Portland, Maine. UNE Students from several healthcare professions partnered together to provide a holistic approach to the community needs with hopes of developing and implementing intervention strategies. Goal was to conduct surveys of at least 100 homeless individuals.