Health Policy Commons^™

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 …

Keikutsertaan Pria Dalam Program Keluarga Berencana Di Indonesia, Musafaah Musafaah

Kesmas

Pria telah mengikuti program keluarga berencana (KB) sejak dahulu. Metode pantang berkala dan kondom telah dikenal berabad-abad lalu, tetapi sejak ditemukan kontrasepsi wanita, program KB pada pria seakan diabaikan. Keikutsertaan pria dalam ber-KB masih sangat rendah jika dibandingkan dengan Bangladesh, Pakistan, dan Nepal. Penelitian ini bertujuan untuk menganalisis keikutsertaan pria dalam ber-KB meliputi keterpaparan media massa dan kontak informasi KB melalui media massa. Penelitian ini menggunakan data Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2007 dengan pendekatan cross sectional terhadap 6.013 pria menikah usia 15 – 54 tahun. Teknik pengambilan sampel yang digunakan adalah two stage sampling. Analisis data menggunakan …

The Power To Block The Affordable Care Act: What Are The Limits?, John D. Kraemer, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Though Supreme Court upheld most parts of the Affordable Care Act (ACA), Congress’ goals in enacting it could still be frustrated by non-implementation. During his campaign for president, Governor Romney promised “to issue Obamacare waivers to all fifty states.” While such blanket waivers would likely violate the Constitution’s Take Care Clause, the ACA does permit other waivers. To be lawful, however, they must meet certain requirements designed to enhance access and lower cost. A president who opposes the ACA might be able to limit its implementation by refusing to issue premium subsidies in federally operated insurance exchanges, and this might …

Exercise Determined Promise 2003 Logandale, Nevada Plague Prophylaxis Clinic: Exercising The Strategic National Stockpile, Kay Godby, Mary Ellen Harrell, Bonnie Sorenson, Maureen Fanning, Nancy Gerken, Jane Shunney

Nevada Journal of Public Health

The Department of Defense asked the Clark County Health District (CCHD) to participate in the disaster drill entitled Determined Promise ’03 (DP ‘03) from August 18 -23, 2003. The purpose of this exercise was to test the capacities of the U.S. Northern Command (U.S.Northcom) Homeland defense/homeland security mission and integration of the Joint Task Forces-Civil Support (JTF-CS) with state and local responders. Part of the JTF-CS mission was to coordinate military support to civilian state and local authorities when it was requested.

Coverage Of Medicaid Preventive Services For Adults: A National Review, Sara E. Wilensky, Elizabeth A. Gray

Health Policy and Management Faculty Publications

No abstract provided.

"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 …

Medicaid Coverage For Individuals In Jail Pending Disposition: Opportunities For Improved Health And Health Care At Lower Costs, Marsha Regenstein, Jade Christie-Maples

Health Policy and Management Faculty Publications

The Patient Protection and Affordable Care Act (ACA) provides an unprecedented opportunity for millions of poor men and women to obtain insurance coverage to address their substantial acute, chronic, physical and behavioral health care needs. The ACA raises Medicaid eligibility levels to 133 percent of poverty, thereby enabling adults with or without children to qualify for coverage. A substantial percentage of the newly eligible population will be jail-involved individuals – people who have had interactions with the legal system over the course of a year, including as an inmate at a county or city jail. Many of these individuals are …

The Economic Impact Of The Nevada Clean Indoor Air Act In Clark County, Nevada – Preliminary Findings, Robin Mukalian, Fang Lin, Christopher R. Cochran, Jay J. Shen, Nancy L. York

Nevada Journal of Public Health

Objective. The primary purpose of this exploratory study was to quantitatively evaluate the economic impact of the Nevada Clean Indoor Air Act (NCIAA) on businesses in Clark County.

Methods. The goal of this research was to assess economic indicators over a ten year period utilizing measurable data points, including restaurant and drinking establishment employment rates, taxable sales, openings and closings, as well as slot gaming revenues. This ten year time period consisted of a seven year span prior to the enactment of the NCIAA, and three years post enactment. Researchers conceived this study as a means to independently evaluate and …

The Long-Term Coercive Effect Of State Community Benefit Laws On Hospital Community Health Orientation, Charles B. Moseley, Jay J. Shen, Gregory O. Ginn

Nevada Journal of Public Health

This study is an examination of the long-term coercive effect of state community benefit laws (CB Laws) on the provision of community health activities in U.S. acute care hospitals. The sample included all the not-for-profit and investor owned acute care hospitals for which 1994 and 2006 AHA Annual Survey data were available. A panel design was used to longitudinally examine the effect that state CB Laws had on hospital community health orientation activities and the provision of health promotion services, after controlling for the influence of other organizational and environmental variables that might affect these activities and services. The authors …

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 …

Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison

Health Management and Policy Presentations

OBJECTIVES: The nation's public health delivery system comprises nearly 3000 local public health agencies that vary widely in capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources to enhance delivery and improve population health.

METHODS: A longitudinal cohort design is used to analyze changes in the availability and perceived effectiveness of services delivered by local public health providers. A stratified random sample of the nation's 3000 local public health agencies (n=497) were surveyed in 1998 and again in 2006 and 2011 (70% response) to measure the availability of 20 …

Effects Of The Master Settlement Agreement On Smoking Among Nevada Teens: A Decade After Implementation And Implications Of Reduced Funding, Christina A. Demopoulos, Christopher R. Cochran

Nevada Journal of Public Health

Background: Tobacco control programs that have adapted the Centers for Disease Control and Prevention (CDC) Best Practices for a Comprehensive Tobacco Control Program (CTCP) have been effective in reducing the rates of tobacco use. This paper investigates the effectiveness that Nevada’s tobacco control programs have had on teen tobacco use and rates to date and examines changes to programs given reduced Master Settlement Agreement (MSA) funding.

Methods: Aggregate data from the Nevada Department of Health and Human Services/Fund for a Healthy Nevada program was analyzed to determine if the tobacco control programs adapted the CDC’s Best Practices for a CTCP. …

Health Care Reform And Women's Insurance Coverage For Breast And Cervical Cancer Screening, Alice R. Levy, Brian K. Bruen, Leighton C. Ku

Health Policy and Management Faculty Publications

INTRODUCTION:

The Patient Protection and Affordable Care Act of 2010 (ACA) will increase insurance coverage for US citizens and for breast and cervical cancer screening through insurance expansions and regulatory changes. The primary objective of this study was to estimate the number of low-income women who would gain health insurance after implementation of the ACA and thus be able to obtain cancer screening. A secondary objective was to estimate the size and characteristics of the uninsured low-income population and the number of women who would still need National Breast and Cervical Cancer Early Detection Program (NBCCEDP) services.

METHODS:

We used …

Reducing Unlawful Prescription Drug Promotion: Is The Public Health Being Served By An Enforcement Approach That Focuses On Punishment?, Vicki W. Girard

Georgetown Law Faculty Publications and Other Works

Despite the imposition of increasingly substantial fines and recently successful efforts to impose individual liability on corporate executives under the Park doctrine, punishing pharmaceutical companies and their executives for unlawful promotional activities has not been as successful in achieving compliance with the Federal Food, Drug, and Cosmetic Act (FD&C Act) as the protection of the public health demands. Over the past decade, the Food and Drug Administration (FDA) and the Department of Justice (DOJ) have shifted their focus from correction and compliance to a more punitive model when it comes to allegedly unlawful promotion of pharmaceuticals. The shift initially focused …

Twenty Counties In Nebraska Have Uninsured Rate Over 20 Percen, Melanie Kiper

Past Publications

The U.S. Census Bureau recently released 2010 estimates of health insurance coverage for each of the nation’s roughly 3,140 counties.

Small Area Health Insurance Estimates (SAHIE; http://www.census.gov/did/www/sahie/index.html) are the only source for single-year estimates of health insurance coverage status for every county in the nation. These estimates are available by sex, age groups, race and Hispanic origin (for states only), and income-to-poverty ratios.

Deteriorating Access To Women's Health Services In Texas: Potential Effects Of The Women's Health Program Affiliate Rule, Leighton C. Ku, Lara Cartwright-Smith, Jessica Sharac, Erika Steinmetz, Julie Lewis, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Based on an earlier study and an in-depth analysis of five market areas, the authors find that Texas' plan to bar Planned Parenthood clinics from participating in the state Women's Health Program (WHP) would leave tens of thousands of women without a source of care, because Planned Parenthood clinics are the dominant WHP providers in those areas and other local family planning clinics lack the capacity to absorb a large number of additional patients.

The Patient Protection And Affordable Care Act: Why It Is Important For Women’S Health, Mary Fanning

Journal of Interdisciplinary Feminist Thought

President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA) on March 23, 2010 ending the long history of disparity in access to health care services between insured and uninsured persons. Disparity between women and men in obtaining health insurance coverage is also corrected in the act. Women’s organizations that have focused attention on women’s distinctive health needs over the past century and a half laid the foundation for provisions in the legislation that address women’s health. This article addresses health insurance coverage, its impact on health, the particular challenges women have confronted in seeking coverage, …

Supporting Healthy Lives And Vibrant Places: Learning About And Living The Collaborative Leadership Model, Lisa Deangelis, Maureen A. Scully, Andrea Wight

Emerging Leaders Program Team Projects

The 31 fellows in the 2012 UMass Boston Emerging Leaders Program (ELP) worked with community partners to investigate the theme, “Supporting Healthy Lives and Vibrant Places.” They worked in peer self-managed teams, in order to learn collaborative leadership skills first-hand, while engaging with stakeholders and issues where collaboration makes a difference. Their team projects addressed: best practices in corporate wellness initiatives, outreach to support health care access for homeless people, ways to grow awareness of the wide need for affordable housing, ideas for arts-based local economic development, broader funding sources to support innovative research on poverty, and ways to continue …

Assessment Of Migrant Health And Health Disparities Between Immigrants And Swiss Nationals Living In Switzerland, Gabriela Mujica-Martorell

Independent Study Project (ISP) Collection

Switzerland is one of the most diverse nations within the OECD and boasts one of the highest net migration rates; it also has one of the highest rated health care systems in the world. Nevertheless, it has been shown that health disparities exist between the Swiss migrant and Swiss national populations: migrants are especially more prone to overweight/obesity, dental health problems, various forms of physical pain, and psychological distress. The purpose of this investigation is to evaluate to what extent certain health conditions are a problem to the immigrant and Swiss national populations. The study also will explore some of …

Strategies To Improve Health Coverage And Narrow The Equity Gap In Child Survival, Health, And Nutrition, Mickey Chopra

Aboriginal Policy Research Consortium International (APRCi)

Implementation of innovative strategies to improve coverage of evidence-based interventions, especially in the most marginalised populations, is a key focus of policy makers and planners aiming to improve child survival, health, and nutrition. We present a three-step approach to improvement of the effective coverage of essential interventions. First, we identify four different intervention delivery channels—ie, clinical or curative, outreach, community-based preventive or promotional, and legislative or mass media. Second, we classify which interventions’ deliveries can be improved or changed within their channel or by switching to another channel. Finally, we do a meta-review of both published and unpublished reviews to …

Defining And Analyzing A Food Desert, Monique N. Russell, Brian Mikelbank

Undergraduate Research Posters 2012

The purpose of this project is to evaluate the characteristics and GIS methods used to determine an urban food desert. The intention of this research is to implement an improved methodology for determining a food desert and exhibit the value of additional data sources. This should produce a universal GIS method and criteria for profiling a food desert in an urban setting across the United States.

Women’S Political Leadership In Massachusetts, Paige Ransford, Meryl Thomson, Sarah Healey

Publications from the Center for Women in Politics and Public Policy

The Center for Women in Politics and Public Policy (CWPPP) at UMass Boston’s McCormack Graduate School of Policy Studies has been tracking the election of women at the municipal level in Massachusetts since 1996. In 2003, the Project expanded to include all New England states. CWPPP remains the only research center in the United States that regularly tracks women’s political representation at the local level.

A Social Justice Perspective On Medicare Part D In An Age Of Reform: Critical Implications Of Trends In Health Care Policy And Advocacy, Louanne Bakk, Marya R. Sosulski

The Journal of Sociology & Social Welfare

This article examines the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) in its current form and explains why a critical perspective is useful when analyzing the policy and reform efforts. Using this approach, we consider the development of the policy and describe ways that gender and racial differences may hinder equal access to medications for some of the most vulnerable older adults. This article explores the implications of gender and racial disparities under the MMA and ramifications of health care reform efforts that could potentially impede, rather than promote, a social justice agenda. Beyond the political advantage …

Long Term Care Insurance Beyond The Class Program, Amy Restorick Roberts, David B. Miller, Merl C. "Terry" Hokenstad Jr.

The Journal of Sociology & Social Welfare

The Community Living Assistance and Supports (CLASS) program, created under the Patient Protection and Affordable Care Act, established a federally-administered, voluntary insurance program that allows for working adults to purchase insurance to cover the cost of long term support services. The CLASS program is the first step towards moving away from a welfare-based system, improving consumer choice, and creating a stable funding source for long term care needs. Enrollees in the CLASS program who meet benefit eligibility requirements and need care assistance will receive a cash benefit to pay for supportive services such as home health care, adult day services, …

Global Health Governance: Analyzing China, India, And Japan As Global Health Aid Donors, Ann Florini, Karthik Nachiappan, Tikki Pang, Christine Pilcavage

Research Collection School of Social Sciences

Development assistance is a significant mechanism by which major countries exercise influence in the global health arena. Of the major Asian powers, Japan has long provided significant funding, while China and India have primarily been recipients but are beginning to increase their funding roles. This article examines the amounts, channels, modes, disease allocations and the geographic focuses of their foreign health aid, and delineates the institutional structures that govern the formulation and implementation of foreign health aid policy in each of these countries, to explore what influence China, India, and Japan have and may develop in the global health arena. …

Reinventing The 21st Century Public Health Workforce: Innovation, Evaluation & Practice-Based Research, Glen P. Mays

Health Management and Policy Presentations

Compelling opportunities exist for incorporating practice-based research to into the design, implementation, and evaluation of public health workforce training and development programs. Public Health Training Centers (PHTCs) can collaborate with practice-based research networks (PBRNs) to discover and disseminate evidence-based strategies for workforce development.

The Quest For Universal Health Coverage: Achieving Social Protection For All In Mexico, Felicia Marie Knaul, Eduardo GonzáLez-Pier, Octavio GóMez-DantéS, David GarcíA-Junco, HéCtor Arreola-Ornelas, Mariana Barraza-LloréNs, Rosa Sandoval,, Francisco Caballero, Mauricio HernáNdez-Avila, Mercedes Juan, David Kershenobich, Gustavo Nigenda, Enrique Ruelas, Jaime SepúLveda, Roberto Tapia, Guillermo SoberóN, SalomóN Chertorivski, Julio Frenk

Aboriginal Policy Research Consortium International (APRCi)

Mexico is reaching universal health coverage in 2012. A national health insurance programme called Seguro Popular, introduced in 2003, is providing access to a package of comprehensive health services with financial protection for more than 50 million Mexicans previously excluded from insurance. Universal coverage in Mexico is synonymous with social protection of health. This report analyses the road to universal coverage along three dimensions of protection: against health risks, for patients through quality assurance of health care, and against the financial consequences of disease and injury. We present a conceptual discussion of the transition from labour-based social security to social …

Valuing Improvements To Coastal Waters Using Choice Experiments: An Application To Revisions Of The Eu Bathing Waters Directive, Stephen Hynes, Dugald Tinch, Nick Hanley

Working Papers

Planned changes to the European Union’s Bathing Waters Directive (2006/7 EC) will force member states to produce improvements in a number of parameters of coastal water quality. This study uses the choice experiment method to estimate the economic benefits attached to such improvements, based on a sample of recreationalists on beaches in Ireland. The analysis indicates that improvements in all of the bathing water related attributes studied result in positive willingness to pay, and also show evidence of scope effects. Using random parameters and latent class modelling techniques, potential heterogeneity in preferences is then investigated and shown to be present …

Towards Developing Indicators Of Environmental Sustainability For Kathmandu, Nepal, Published Version, Ambika P. Adhikari

Himalayan Research Papers Archive

Sustainability is now considered one of the key objectives in urban planning. However, due to inappropriate planning, weak institutions, limitation of resources, and poor implementation of policies, many big cities in the developing countries have become even less environmentally, economically and socially sustainable than they were in the past. Historically, the Kathmandu valley enjoyed a unique tradition, rich heritage and a moderate state of sustainability in all areas, particularly in the environmental arena. However, the rapidly expanding and modernizing cities in the valley are facing serious problems of sustainability in all fronts: economic, social, environmental and ecological. Whereas environmental and …

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 …