Medicaid and Access to Health Care Resources

Medicaid

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NCSL Resources:  Articles and Maps | Conference Sessions 

Other Resources: Publications | Websites

CHIP

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NCSL Resources:  Articles and Maps | Conference Sessions

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Access to Health Care

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NCSL Resources:  Articles and Webpages | Web Assisted Audio Conferences

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Disparities in Health

Disparities home page

NCSL Resources:  Articles and Maps | Conference Sessions | Webpages 

Other Resources: Publications | Websites

Medicaid

NCSL Articles and Maps

• Health Care Reports: Medicaid Disease Management
  

  NCSL report concerning coordination of health care for Medicare patients who suffer from chronic diseases to improve delivery of care and overall health outcomes. (September 2008)

• Medicaid: A Snapshot for State Legislatures
  An NCSL  "101 introduction" to Medicaid.  This 28 paged document that was originally published in October 2004 gives a basic overview and information about Medicaid.  [member password or login required]
   

• A New Medicaid
  This article from NCSL's State Legislatures Magazine addresses how Congress' budget reconciliation bill in 2005 gave state officials greater latitude
  in shaping Medicaid reforms. (April 2006)

• Medicaid Extreme Makeover
  This article from NCSL's State Legislatures Magazine addresses how states seek out radical changes to Medicaid as a result of the growing numbers of uninsured people and out of control costs. (February 2006)
   
• Medicaid 
  A menu page that provides links to Medicaid-related topics such as HIFA, Long-Term Care, Medicaid Prescription Laws and Strategies, Pharmacy Plus, and Ticket to Work. 

NCSL Conference Sessions

• Medicaid: Can Investment in Quality Contain Costs? 
  This links to a descriprition of the meeting, presentations, and speaker biographies from a Legislative Summit 2009 session in Philadelphia.

• Building Blocks

  This set of briefing papers on the State Children’s Health Insurance Program (SCHIP) is part of an orientation package for state legislators on the fundamentals of state health policy. 

• Redesigning Medicaid: New Attempts at Reform

  This links to the presentation slides from different speakers that address the goals of Medicaid redesign in the states, options under consideration, the role of legislators and other stakeholders, and implications for states. - Fall Forum, December 2004

• The Medicare Modernization Act:  Implications for the States
  This links to presentation slides on the major areas where the Medicare Modernization Act (MMA) impacted states and includes a discussion of the treatment Medicaid/Medicare dual eligibles.  Also, this presentation addresses states' responsibilities regarding the implementation of the new Medicare drug benefit program. - Health Conference December 8, 2004

• Medicaid: Opportunities and Challenges
  This links to presentation slides which examine the Health Insurance Flexibility and Accountability initiative approved for Arizona, along with other state response. - Annual Meeting 2002

Other Resources on Medicaid - Publications

• Policies and Strategies to Make Medicaid Managed Care Work for FQHCs: Experiences from Two States (2009)
  State policies have a strong influence on the ability of Federally Qualified Health Centers (FQHCs) to participate in managed care arrangements. The 2000 Institute of Medicine report, “America’s Health Care Safety Net: Intact but Endangered,” examined the impact of Medicaid managed care on the future integrity and viability of safety net providers, such as community health centers. The report warned federal and state policy makers that managed care policies need to explicitly take into account the unique mission of safety net providers, reflected through fair rates and policies, lest the safety net structure be significantly weakened. With this message in mind, the National Academy for State Health Policy (NASHP) visited two states in spring of 2008 with two different kinds of managed care programs (primary care case management and managed care organizations). Based on those site visits, this publication looks at Alabama’s and Michigan’s managed care policies and strategies particularly as they affect FQHCs with regard to: enrollment and assignment; access to providers; monitoring and quality; and, financing.

• The Basics: SCHIP (2009)
  This publication briefly summarizes the State Children's Health Insurance Program (SCHIP) and explains who is eligible, what services are covered, and where finances come from. 

• 2008 Actuarial Report on the Financial Outlook for Mediciad (2008)
  The U.S. Department of Health and Human Services has issued the first actuarial report on Medicaid spending since the program's inception 42 years ago. This report contains analysis of past program trends and projections of Medicaid expenditures and enrollment for the next ten years. The report projects that Medicaid benefits spending will increase 7.3 percent from 2007 to 2008, reaching $339 billion and will grow at an annual average rate of 7.9 percent over the next 10 years. That compares to a projected rate of growth of 4.8 percent in the general economy.

• Congress approved a total of $150 million for these Medicaid “transformation grants” in the Deficit Reduction Act of 2005 (DRA) to be distributed over fiscal years 2007 and 2008.  Today’s award follows grants of $98 million that were distributed last January to 26 states.

• CMS Issues Proposed Rule Limiting The Use Of Governmental Transfers 
  On March 19, NCSL urged the Centers for Medicare and Medicaid Services (CMS) within HHS to withdraw a proposed rule that would severely limit the use of intergovernmental transfers by redefining what constitutes a governmental entity. 

• FY 2008 Budget Overview - Selected Health Program

• CMS Issues Guidance to States Interested in Medicaid Peer Support Services (2007)
  The Centers for Medicare and Medicaid Services (CMS) released a State Medicaid Director letter to provide guidance to States interested in peer support services under Medicaid. Peer support services are an evidence-based mental health model of care which consists of a qualified peer support provider who assists individuals with their recovery from mental illness and substance use disorders.  The experiences of peer support providers, as consumers of mental health and substance abuse services, can be an important component in a State’s delivery of effective treatment.  CMS is reaffirming its commitment to State flexibility, increased innovation, consumer choice, self-direction, recovery, and consumer protection through approval of these services.

• CMS Issues Guidance Regarding Reasonable Crowd-Out Procedures (2007)
  The Centers for Medicare & Medicaid Services (CMS) released guidance to State Medicaid agencies clarifying the application of existing statutory and regulatory requirement in State requests to extend eligibility under the State Children’s Health Insurance Program (SCHIP) to children in families with effective family income levels above 250 percent of the Federal poverty level (FPL).  These requirements ensure that extension of eligibility to children at these higher effective income levels does not interfere with the effective and efficient provision of child health assistance coordinated with other sources of health benefits coverage to the core SCHIP population of uninsured targeted low income children. 

• CMS Releases Guidance to State Medicaid Directors on Implementing Tamper-Resistant Prescription Pads (2007)
  The Centers for Medicare & Medicaid Services (CMS) issued guidance, through a State Medicaid Director Letter, concerning section 7002(b) of the U.S. Troop Readiness, Veterans’ Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007, which requires that all written, non-electronic prescriptions for Medicaid outpatient drugs must be executed on tamper-resistant pads in order for them to be reimbursable by the federal government. The Letter gives baseline requirements to States to define and implement tamper-resistant prescription pads.

• Medicaid: A Primer (2007)
  A Kaiser Foundation 2007 publication with key information on Medicaid.

• Senate Committee Passes SCHIP Reauthorization Bill (July 25, 2007)
  This news article from the American Academy of Physicians explains the details of the bill and also includes a link to the full text of the Senate bill.  

• Issue Brief: SCHIP Reauthorization (2007)
  This issue brief from the National Association of State Budget Officers (NASBO) examines SCHIP funding problems facing states, funding and other issues that are expected to be at the forefront of the fast-approaching reauthorization debate, and current actions in the states aimed at expanding the SCHIP program.

• The Medicaid Program At A Glance (2007)
  This publication briefly summarizes the Medicaid Program and explains who is eligible, what services are covered, and where finances come from. 

• Physician Pay-for-Performance in Medicaid: A Guide for States(2007)
  Developed by the Center for Health Care Strategies (CHCS), this guide offers actionable steps to help states design and implement physician-level P4P (pay-for-performance)strategies within the Medicaid program.

• More Medicaid Means Less Quality Health Care (2007)
  This article from the Heritage Foundation explores the option of mainstreaming low-income families into the private health insurance markets, enabling them to secure the kind of coverage that best meets their personal needs as opposed to states expanding Medicaid coverage.

• Florida and South Carolina: Two Serious Efforts to Improve Medicaid (2005)
  This article depicts how Florida and South Carolina reformed their respective Medicaid programs as they pursed federal waivers so that they can bring the principles of choice, individual control, and competition into Medicaid.

• Medicaid: The Next 40 Years (2005)
  This article summarizes the latest Commonwealth Fund Health Care Opinion Leaders survey, and explains the widespread agreement about the need to expand coverage to more of the working poor, ease administrative burdens, and use pay-for-performance strategies to improve the quality and efficiency of care.  

Other Websites on Medicaid

• Center for Medicare and Medicaid Services (CMS)
  This site contains links to general and specific information on many aspects of Medicaid such as Medicaid coding, initiatives, prescription drugs, consumer enrollment, and coverage. Click here for specific information from CMS on the State Children's Health Insurance Program (SCHIP).  
   
• Safety Net Monitoring
  A resource of data and tools provided by the Agency for Healthcare Research and Quality (AHRQ) to monitor the status of local safety nets.
   
• Statehealthfacts.org
  A website source for individual state health data.

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NCSL Articles, Webpages, and Webcasts on Access to Health Care

• Health Reform and Workforce Shortages Webinar
  NCSL/ASTHO web assisted audio conference on health reform and the implications it will health primary care workforce shortages. (August 2009)
   
• Health Care Reports: Community Health Workers
  NCSL report examining state efforts to improve access and outreach using community health workers. (September 2008)
   
• Increasing the Health Care Workforce
  This NCSL Legisbrief addresses the health care worker shortage including strategies states are using to to improve recruitment and retention of rural health care workers. (August 2008)
   
• Health Insurance Coverage for Young Adults 
  NCSL Legisbrief confronting the coverage gap young adults face after coverage under parental insurance or SCHIP ends and before an alternative insurance option becomes available. (June 2008)
   
• State Funding for Community Health Centers
  NCSL postcard showing the funding levels for community health centers by state. (June 2008)
   
• Community Health Workers: Expanding the Scope of the Health Care Delivery System
  A report by NCSL staff on the use of community health workers to complement and support more formal health care networks to provide more comprehensive and supportive care in underserved communities. (April 2008)
   
• How Secure is the Safety Net?
  This article from NCSL's State Legislatures Magazine addresses the issue of financing safety net providers specifically community health centers. (March 2005)
   
• Health Centers
  A menu page that provides links to publications and web resources related to health centers.
   
• Federally Qualified Health Centers in the United States
  Federally Qualified Health Centers (FQHCs) are non-profit, consumer-directed corporations that provide high quality of care and cost-effective treatment to the underserved and the uninsured. (2003)

Other Publications on Access to Health Care

• Health Care Reconsidered: Options for Change a Two-Part Series on Health Care Policy  (General Overview of Forum)
  The Brooklings Institute launched the Hamilton Project in which the first panel of the two-part series focused on making health care more affordable while improving its effectiveness.  The second panel in the series highlighted a range of policy proposals for achieving the goal of universal health care coverage for all Americans.  Please click the links above for web/podcasts, transcripts and presentation slides from these forums. (April/July 2007)

• State Scorecard
  This interactive U.S. map draws from the Commission on a High Performance Health System's report, Aiming Higher: Results from a State Scorecard on Health System Performance.  Use this map to view state-specific rankings and results compared to benchmarks, and to view the number of lives and dollars each state could save by achieving benchmark levels of performance. (2007)

• Covering the Uninsured: How States Can Expand and Improve Health Coverage
  This article explains how governors and state legislators can make significant headway in reducing the number of America's uninsured, improving access to quality health care, and expanding choice and competition in the state health insurance markets. (2003)

Other Websites on Access to Health Care

• Cover the Uninsured Week
  A website that provides information about Cover the Uninsured Week along with other resources addressing the uninsured such as fact sheets, chart books, and state-by-state profiles.
   
• Economic Research on Initiative on the Uninsured (ERIU)
  An initiative housed at the University of Michigan and funded by the Robert Wood Johnson Foundation that conducts research on health coverage topics.
   
• Families USA: The Uninsured
  Families USA is a national non-profit, non-partisan organization that has a website with news, publications, and other resources on the topic of the uninsured.
   
• Health Coverage and the Uninsured
  A Kaiser Commission on Medicaid and the Uninsured website that provides resources and information related to health insurance coverage and the uninsured.
   
• Health Insurance Coverage in America: 2006 Data Update
  A chartbook by the Kaiser Commission on Medicaid and the Uninsured about health insurance coverage data from 2005.

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NCSL Articles and Maps on Disparities in Health

• Improving the Odds (September 2009)
  This NCSL State Legislatures magazine article describes insurance coverage, social factors, gaps in quality, cultural barriers, and state plans in relation to health disparities and minority health.

• States Address Health Disparities (July 2009)
  An NCSL Legisbrief that discusses how states are addressing health disparities.

• Disparities in Cardiovascualr Disease (February 2009)
  An NCSL Legisbrief that discusses how states are addressing disparities in cardiovascular disease.

• Podcast on Disparities in Cardiovascular Health (February 2009)
  In this edition of the Buzz, state actions to prevent disparities in cardiovascular care and how these disparities could end up costing states is discussed.  

• State Funding for Community Health Centers
  NCSL postcard showing the funding levels for community health centers by state. (June 2008)
   
• Health Epidemics on Tribal Lands 
  An NCSL Legisbrief examining health problems facing tribal communities such as obesity, diabetes and cardiovascular disease. (June/July 2006)
   
• Health Status and Utilization 
  State Health Notes article highlighting racial discrepancies in doctor's visits. (April 2006)
   
• HIV Epidemic Hits Minorities Harder
  This NCSL document examines the HIV epidemic's effect on minorities. (February 2006)
   
• 2005 National Health Care Quality and Disparities Reports
  Provides the 2005 National Healthcare Quality Report as well as additional resources.
   
• Health Care in Indian Country
  Discusses illnesses that disproportionately afflict Indians as well as some of the factors that contribute to poor Indian Health. (October 2005)
   
• States and Tribes: A Healthy Alliance
  This NCSL State Legislatures magazine article describes some of the ways in which health care models states and tribes are developing for Native Americans could be used for other residents. (April 2005)
   
• Indian Country Concerns An article from NCSL's State Legislatures magazine highlighting the political relationship between states and tribal governments as well as specific concerns of Indian lawmakers. (April 2005)
   
• Community Health Centers
  This NCSL Legisbrief discusses both state and federal action taken regarding state funding of community health centers. (January 2005)
   
• Montana Paves the Way for Collaboration Between Indian Tribes and State
   A new Montana law looks to improve access to Medicaid for American Indians. (Oct. 2004)
   
• Reducing Disparities in Health Care One Community at a Time
  An NCSL StateStats article examining community health centers and their impact on reducing minority health disparities. (Sep. 2004)
   
• The Indian Child Welfare Act and the States
  An NCSL Legisbrief highlighting both enforcement problems and state actions regarding the Indian Child Welfare Act. (Aug/Sep. 2004)
   
• Reducing Racial and Ethnic Health Disparities through Community Health Centers  50 State Snapshot of Racial Disparities and Community Health Centers. (August, 2004) 
   
• Linking the Environment to Racial and Ethnic Health Disparities 
  This State Health Notes article explores why low-income minorities are disproportionately affected by chronic diseases. (March 2004) 
   
• Institute Report: Minorities Get Poorer Health Care
  An article from NCSL's State Legislatures magazine. (July/Aug. 2002)
   
• Racial and Ethnic Disparities
  This State Health Lawmakers' Digest is a product of NCSL.
   

• State Offices, Commissions, Councils and Advisory Panels on Minority Health
  This map highlights states that have created offices, commissions, councils and advisory panels on minority health. 

NCSL Conference Sessions on Disparities in Health
 

• The Economic Burden of Health Inequalities in the United States (2009)
  A study by the Joint Center for Political and Economic Studies provides information on how much of a financial burden racial disparities are putting on our health care system and society at large. Researchers examined the direct costs associated with the provision of care to a sicker and more disadvantaged population, as well as the indirect costs of health inequities such as lost productivity, lost wages, absenteeism, family leave, and premature death, released September 2009.

•  Poverty's High Cost to Health (2009)
  This report discusses social and economic factors that influence health, including access to high quality health care, healthy neighborhoods and grocery stores, released September 2009.

• Eliminating Racial and Ethnic Health Disparities; A Business Case Update for Employers (2009)
  An issue brief from the Center for Prevention and Health Services National Business Group on Health released February 2009.

• Reducing Disparities and Improving Quality in Healthcare
  This session will discuss what states have done and what they can learn from private sector partners about how to make the whole state healthier by thinking differently about meeting the needs of some of their most vulnerable residents. (2006)
   
• Paying for Access in Indian Country
  This web-assisted audio conference will highlight Montana House Bill No. 452, now law, which brings the state and tribes together to improve and protect tribal access to Medicaid financing. (2006)
   
• Cost-Effectiveness and Health Outcomes of Community Health Centers - Web-Assisted Audioconference 
  This event featured experts in this field who provided an overview of CHCs (populations served, services provided, cost of operation, health disparities collaboratives, cost savings and health outcomes) followed by presentations that shared two health disparities collaborative experiences in diabetes and depression. The archive containing the audio and visuals and the speaker slides are available at this website. (February 2004)
   
• Audioconference on Reducing Health Disparities
  View speaker slides from a recent NCSL audioconference on reducing health disparities. Dr. Helen Burstin (AHRQ) and Dr. Felicia Collins (HRSA) provide current statistics on health disparities, explain contributing factors as well as strategies for closing the disparities gap.  Comments of Connecticut State Senator Toni Nathaniel Harp from the NCSL Health Policy Conference in Charlotte, North Carolina. (December 2000)
   
• Bridging the Gap: Eliminating Racial and Ethnic Health Disparities
  This is a transcription of a session at NCSL's Annual Meeting. (July 2000)
   
• Connecticut's Multicultural Health Initiatives - The Beginning
  Comments of Connecticut Senator Toni Nathaniel Harp from the NCSL Health Policy Conference in Charlotte, North Carolina. (December 2000)

NCSL Webpages on Disparities in Health

• Immigration Policy Project 
   This website links to and summarizes other resources that address Immigrant Policy on Health that address the issues of access to health care for immigrants with particular focus on Medicaid, SCHIP and Language Access.  
   
• Commissions, Offices, and Task Forces on Women's Health Legislation
  This website contains summaries of statutes that create commissions, offices, and task forces on women's health.
   
• Health Promotion and Disease Prevention Webpage
  This website contains an overview of, and links to, health promotion and disease prevention and management health topics.
   
• Minority Health Commissions and Offices of Minority Health
  This website contains summaries of statutes that create commissions and offices of minority health.
   
• State Legislation Database on Native American Issues
  A NCSL legislative database of bill summaries that specifically address American Indians, tribes and reservations. It includes introduced legislation on topics including health and human services.

Other Resources on Disparities in Health - Publications

• Health Centers' Role in Reducing Racial and Ethnic Health Disparities 
  A National Association of Community Health Centers fact sheet on how community health centers help to reduce or even eliminate racial and ethnic health disparities among their patients. (May 2008)

• A Sketch of Community Health Centers
  This chart book is an overview of the federal health center program and the communities they served provided by the National Association of Community Health Centers (NACHC). (2008)

• Issue Brief: Racial and Ethnic Disparities 
  An issue brief explaining how other policy areas contribute to the increase of racial and ethnic health disparities and places emphasis on the policy makers role in narrowing the health gap. (2007)

• New Study Shows Hospital Care in America Today is Separate but Not Equal
  This article summarizes a study that examined quality and hospital care for elderly African-American patients. (2007)

• Why Are Latinos the Most Uninsured Racial/Ethnic Group of U.S. Children?                                                                                                                                  A summary of a research project finding three major risk factors responsible for uninsured Latino children: U.S. citizenship, having two working family and low family income. (2007)
   
•  Racial and Ethnic Disparities in Adolescent Health and Access to Care 

  This fact sheet provides new national information on disparities in health status and
  access to care among Hispanic, Black, and White adolescents ages 12 through 17. It
  addresses racial and ethnic disparities for a broad set of indicators and also examines the
  impact of income, insurance, and mother’s or household education on these indicators. (2007)     

• National Healthcare Disparities Report  
  A report by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) which measures disparities in access to health care for minorities and poor people.  Click here for the 2005 National Healthcare Disparities Report. (2006)
   
• National Health Quality Report  

  This report examines the quality of health care and measures its improvement and deterioration nation-wide (Also provided by AHRQ). Click here for the 2005 National Health Quality Report. (2006)   

• Disparities In Maternal And Infant Health: Are We Making Progress?
  This issue brief prepared by researchers at the University of California at San Francisco and the Kaiser Family Foundation, analyzes changes in racial/ethnic and socioeconomic disparities in maternal and infant health in California in 1994/1995 and 1999/2001. The issue brief also reviews the policy implications of these differences and offers general recommendations for health care policymakers to consider in addressing health disparities. (October 2004)

• Is Racism the Real Culprit? What the Data Does and Don't Show about the Racial Health Gap 
  A video/audio conference hosted by the Heritage Foundation that addressed the issue of the health gap and questions whether racism is entirely responsible for disparities among minorities and poor people. (September 2004)

• A State Policy Agenda to Eliminate Racial and Ethnic Health Disparities
  This report from the Commonwealth Fund provides state policymakers with a menu of policy interventions that have been implemented to address disparities in minority health and health care. (June 2004)
   
• Unequal Access: Insurance Instability Among Low-Income Workers and Minorities  Commonwealth Fund study finds that low-income minority workers lack private health coverage at higher rates than white workers. (April 2004)
   
• Reducing Racial and Ethnic Health Disparities:  Estimating the Impact of High Health Center Penetration in Low-Income Communities  
  A study by The George Washington University Medical Center. (September 2003)
   

• Reducing Health Disparities Among Children: The Role of Insurance Expansions
  A report by The Future of Children on the role of health insurance coverage for low-income children in the reduction of health disparities. (Spring 2003)

Other Websites on Disparities in Health

• Health Disparities Collaboratives    
  The Bureau of Primary Health Care's initiative on improving the health outcomes of the poor, minorities, and the underserved.
   
• National Center for Minority Health and Health Disparities (NCMHD)
  This site is part of the National Institutes of Health's efforts to reduce and eliminate health disparities.
   
• Center to Reduce Cancer Health Disparities (CRCHD)
  Another National of Institutes of Health site dedicated to research and the reduction of cancer-related health disparities.
   
• Asian and Pacific Islander American Health Forum (APIAHF)
  The official site of APIAHF, a national advocacy organization, that is dedicated to promoting policy, program, and research efforts for the improvement of the health status of all Asian American and Pacific Islander communities.
   
• Asian Health Services Online
  A site dedicated to serve and advocate for the immigrant and refugee Asian community regarding its health rights and access to care.
   
• Association of American Indian Physicians
  The site of the AAIP which is dedicated to improving the health status of American Indian and Alaska Native people. 
   
• Underserved Populations 
  The Commonwealth Fund's minority health site. The Commonwealth Fund is a national foundation for independent research on health and social policy issues.
   
• The Congressional Black Caucus Foundation
  This web site is provides information regarding key legislation or public policy issues, health initiatives and local events that pertain to the public health of people of African descent worldwide. Topics covered include AIDS/HIV, cancer, diabetes, heart disease, asthma, sickle cell anemia, health care, public policy, prevention, mental health, environmental justice and research.
   
• Center for Research on Minority Health
  The Center for Research on Minority Health at The University of Texas M. D. Anderson Cancer Center in Houston, Texas.  The CRMH has been able to successfully implement unique model programs to address different areas of heath disparities.
   
• Diversity RX 
  This site is a clearinghouse of information on how to meet the language and cultural needs of minorities, immigrants, refugees, and other diverse populations seeking health care.  The site is sponsored by NCSL, the Henry J. Kaiser Family Foundation and Resources for Cross Cultural Health Care.
   
• Health Resources and Services Administration, Office of Minority Health
  HRSA's Office of Minority Health provides leadership for programs and activities, which address the special health needs of racial/ethnic minorities to eliminate disparities, while improving health status.
   
• National Council of La Raza
  This site contains links to areas.  Featured NCLR's programs, publications and includes discussion on health policy that addresses health disparities in the Latino community.
   
• Racial and Ethnic Approaches to Community Health
  A Centers for Disease Control and Prevention program that is aimed at eliminating disparities in health status experienced by ethnic minority populations in key health areas.

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NOTE: NCSL provides links to other Web sites from time to time for information purposes only. Providing these links does not necessarily indicate NCSL's support or endorsement of the site.

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