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CHAP Winter Meeting: Gearing Up to Govern
Additional Resources

December 4-5, 2006
San Antonio, Texas

Chronic Care and Quality | Health Care Access | Addiction Prevention and Treatment | Providers and Workforce

Quality Care for People with Chronic Conditions

Information on treating chronic physical conditions and mental health conditions

• Pilot project from the state of Washington (WMIP): http://fortress.wa.gov/dshs/maa/MIP/
• Report on Medicaid cost offsets associated with Mental Health Care From Washington: http://www1.dshs.wa.gov/rda/research/3/28.shtm
• Other states with similar integration programs:
  • Wisconsin: http://www.dhfs.state.wi.us/WIpartnership/
  • Minnesota: http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_006271
  • Texas: http://www.hhsc.state.tx.us/starplus/Overview.htm
• Depression and Primary Care
  • MacArthur foundation project with Duke and Dartmouth: http://www.depression-primarycare.org/
  • Robert Wood Johnson Project: http://www.wpic.pitt.edu/dppc/

Information about chronic disease

• Overview of the most common chronic diseases and their prevalence including information on costs: http://www.cdc.gov/nccdphp/overview.htm
• Overview "At a Glance" reports on common chronic diseases: http://www.cdc.gov/nccdphp/publicat.htm
• State profiles on chronic disease: http://www.cdc.gov/nccdphp/states/index.htm
• Overview of chronic disease: http://www.partnershipforsolutions.com/DMS/files/chronicbook2004.pdf

Cost impacts

• Power point presentation about the burden of chronic disease including costs: http://www.cdc.gov/nccdphp/burden_pres/
• The Burden of Chronic Diseases and their risk factors,, 2004: http://www.cdc.gov/nccdphp/burdenbook2004/pdf/burden_book2004.pdf
• Costs associated with obesity: http://www.cdc.gov/nccdphp/bb_nutrition/index.htm

Treatment

• Evidence-based practice: http://ahrq.gov/clinic/epcix.htm
• Information on effective healthcare: http://effectivehealthcare.ahrq.gov/aboutUs/index.cfm

Disease Management

• Chronic Care Model: http://www.improvingchroniccare.org/change/index.html
• Indiana Chronic Disease Management Program: http://www.indianacdmprogram.com/
• Definition of Disease Management: http://www.dmaa.org/definition.html

Quality

• The Robert Wood Johnson Foundation Quality Health care site: http://www.rwjf.org/portfolios/interestarea.jsp?iaid=142
• Fact sheets on quality: http://ahrq.gov/consumer/index.html
• National Quality Measures Clearinghouse: http://www.qualitymeasures.ahrq.gov/
• Information on quality and patient safety: http://ahrq.gov/qual/
• Institute of Medicine Health Care Quality Initiative: http://www.iom.edu/focuson.asp?id=8089

Prevention

• Promising Practices in Chronic Disease Prevention and Control: A Public Health Framework For Action, 2003: http://www.cdc.gov/nccdphp/promising_practices/index.htm
• Reports on prevention and wellness: http://ahrq.gov/consumer/index.html
• Information on preventive services: http://ahrq.gov/clinic/prevenix.htm
• Prevention Fact Sheets:  http://www.cdc.gov/nccdphp/publicat.htm
• Databases with information on chronic disease prevention: http://www.cdc.gov/nccdphp/publicat.htm

Research

• Research Fact sheets: http://ahrq.gov/news/factix.htm
• Information on chronic care: http://ahrq.gov/populations/chronix.htm

Data

• Interactive databases that track chronic disease trends: http://www.cdc.gov/brfss/
• The Burden of Chronic Diseases and their risk factors,, 2004, includes state profiles: http://www.cdc.gov/nccdphp/burdenbook2004/index.htm

State Programs

• Information on exemplary state programs: http://www.cdc.gov/nccdphp/exemplary/index.htm
• Examples of state activities: http://www.cdc.gov/nccdphp/bb_nutrition/index.htm

Presenters Resources:

• Irene Fraser, Agency for Healthcare Research and Quality:  http://ahrq.gov/
• Nikki Highsmith, Center for Health Care Strategies, Inc. : http://www.chcs.org/
• Doug Stratton, 317-877-5376 stratton@insightbb.com

NCSL Resources:

• Chronic Disease Prevention and Health promotion: http://www.ncsl.org/programs/health/chronic-new.htm
• Disease Prevention and Control: http://www.ncsl.org/programs/health/chronicdisprev.htm
• Disease Management: http://www.ncsl.org/programs/health/dmres.htm

Health Care Access

The State Coverage Matrix is a deceptively simple table of state policies related to access, although the table has not been updated for about year.  Click on any of the cells in the table, and you go to a page that describes the program and links to related sites, including state and national reports on the program.  Click on a header and you’ll get a description of the category and a table with thumbnail sketches for each state in the category.  And of course, clicking on the state will take you to links for all of its access programs.  This site is part of the Robert Wood Johnson Foundation’s (RWJ) State Coverage Initiative at AcademyHealth. http://www.statecoverage.net/matrix.htm

Lots of other resources are available on this site including a database of state reports, and publications on coverage from AcademyHealth.

State Health Facts, brought to you by the Henry J Kaiser Family Foundation, is a great starting point for background information and interstate comparisons.  It is very easy to use and contains a wealth of state data.  You can look at information by state or nationally, and tailor comparisons using maps or tables. Information can be sorted by state name, rank or region.  Public Insurance is Kaiser’s strong suite, and that shows in strong details for Medicaid, Medicare and SCHIP, but this site also has a wealth of information on demographics, health status, health costs, insurance, http://www.statehealthfacts.org/

While you are on the Kaiser site, you may also want to check out their latest reports (http://http://www.kff.org/), see what new webcasts are available at http://kaisernetwork.org/ and explore the background material they’ve created for policy students at http://www.kaiseredu.org/

The Centers for Medicare & Medicaid Services (CMS) is the federal agency concerned with these two public insurance programs.  http://www.cms.hhs.gov/researchers/default.asp  takes you to a variety of federal data resources related to Medicaid and Medicare. http://www.cms.hhs.gov/researchers/statsdata.asp lists available data.  Note the dates.  It still takes a couple of years to reconcile and clean up data for the national compilation. The Kaiser site listed above also summarizes much of their data and may be easier to use.

Center for Studying Health System Change (HSC) designs and conducts studies focused on the U.S. health care system and the national and local market forces driving change.  It is an excellent source for data on current trends and policy-oriented analysis.  This project is also funded by RWJ. http://www.hschange.com/

Some other sources for information on health coverage and access policies

In addition to RWJ and Kaiser, a number of foundations support coverage expansions  and in some cases publish results of research and program activities.  Among them:

Additional RWJF-sponsored coverage research is summarized at  http://www.rwjf.org/research/researchlist.jsp?ia=132

Kaiser is particularly noteworthy for the research that it funds on Medicaid, SCHIP and the uninsured.  http://www.kff.org/medicaid/index.cfm; http://www.kff.org/uninsured/index.cfm Kaiser also provides basic fact sheets that give a good description of how the Medicaid program works as well as summarizing the profile of the uninsured.  http://www.kff.org/medicaid/upload/7235.pdf; http://www.kff.org/uninsured/upload/The-Uninsured-and-Their-Access-to-Health-Care-Oct-2004.pdf

The Alliance for Health Care Reform, a nonpartisan and nonprofit organization dedicated to providing information on health care reform, published a book in 2006 – Covering Health Issues - that provides a comprehensive look at health care issues, from children’s health issues to long term care.  Covering Health Issues is available online at http://www.allhealth.org/sourcebook2006/toc.asp

The Commonwealth Fund supports and publishes research on private coverage approaches. http://www.cmwf.org/topics/topics.htm?attrib_id=12001&portal=yes

A trio of other research and advocacy organizations with a focus on access: http://www.cbpp.org/ – Center for Budget and Policy Priorities focuses on publicly funded programs;  http://www.ebri.org/  --  Employer Benefit Research Institute pays special attention to coverage issues that affect employers, particularly large ones.  They publish annual analyses of the number  of uninsured, based on the March Census survey; http://www.ncpa.org/ The National Center for Policy Analysis emphasizes market-based strategies.

NCSL Resources

State Health Notes is a biweekly NCSL newsletter that provides information about health policy news for state legislators as well as the public.  This newsletters is available online at http://www.ncsl.org/shn/

Other items of interest on the NCSL website include

• Web page on State Medicaid Reforms including recent sec. 1115 waivers http://www.ncsl.org/programs/health/1115waivers.htm;
• Other Medicaid info http://www.ncsl.org/programs/health/h-medicaid.htm;
•  SCHIP info http://www.ncsl.org/programs/health/chiphome.htm;
• Universal health—state legislation http://www.ncsl.org/programs/health/universalhealth2006.htm;
• Health savings accounts (HSAs) http://www.ncsl.org/programs/health/hsa.htm

NCSL resources on Massachusetts reform http://www.ncsl.org/programs/health/massoverview.htm

Addiction Prevention and Treatment

Reliable Information about Drugs

• The federal government finances most of the scientific research that tracks the extent of the drug problem in the United States. One way to find this information quickly is via a chart prepared by the White House Office of National Drug Control Policy. The chart contains numerous links that will take you directly to the source information. http://www.whitehousedrugpolicy.gov/drugfact/sources.html

Drug Effects

• Three federal agencies finance nearly all of the biomedical research about the effects of drugs on the brain and body. The first two listed here are National Institutes of Health.
  • Drugs http://www.nida.nih.gov/ 
  • Alcohol http://www.niaaa.nih.gov/ 
  • Tobacco http://www.cdc.gov/

Prevalence

• The nation's two benchmark surveys track drug use among various age groups. They are: http://monitoringthefuture.org/ and http://www.oas.samhsa.gov/nsduh.htm

Consequences

• The Drug Abuse Warning Network (DAWN) records hospital emergency room admissions for drug problems and drug related deaths from medical examiners' reports. The Robert Wood Johnson Foundation has released a comprehensive report on the cost of substance abuse to the nation, which is a rich resource for journalists. http://dawninfo.samhsa.gov/ and http://www.rwjf.org/publications/substanceAbuseChartbook.jhtml

Treatment

• A rich body of research about effective treatment for drug addiction is available from the National
  Institute on Drug Abuse. The Substance Abuse and Mental Health Services Administration houses the nation’s treatment services agency, the Center for Substance Abuse Treatment, and maintains a directory of treatment facilities, which can be searched by zip code. http://www.nida.nih.gov/PODAT/PODATIndex.html, http://csat.samhsa.gov/, and http://www.findtreatment.samhsa.gov/

Prevention

• A rich body of research about effective substance abuse prevention is available from the National Institute on Drug Abuse. The Substance Abuse and Mental Health Services Administration also houses the nation’s prevention services agency, the Center for Substance Abuse Prevention and maintains a registry of evidence-based effective programs. Columbia University hosts the National Center on Addiction and Substance Abuse, which conducts research on substance abuse prevention. Community Anti Drug Coalitions of America consists of local coalitions across the nation. National Families in Action helps parents prevent drug abuse in their families and communities. http://prevention.samhsa.gov/, http://www.modelprograms.samhsa.gov/, http://www.casacolumbia.org/, http://cadca.org/, and http://www.nationalfamilies.org/

Policy Research

• The Robert Wood Johnson Foundation has a national program office, the Substance Abuse Policy Research Program, that focuses on substance abuse policy research. http://www.saprp.org/

State Substance Abuse Policy

• The Treatment Research Institute’s Center for Evidence-Based Policy and the National Conference of Legislatures are the national resources for state substance abuse policy. http://www.tresearch.org/, http://www.ncsl.org/programs/health/saldata.htm, http://www.ncsl.org/programs/health/forum/saguidebook.htm, http://www.ncsl.org/programs/health/satmeasure.htm, and http://www.addictionstudies.org/

The Outcomes of Addiction Treatment and Approaches to Measuring Performance

• “The Burden of Public Responsibility,” a presentation by Mady Chalk, Ph.D. before the Massachusetts State Legislature, March 2006. http://www.tresearch.org/resources/presentations/ChalkLegisl2006.ppt
• “Reconsidering Addiction Treatment: How Can Treatment be More Accountable and Effective?” A presentation by A. Thomas McLellan, Ph.D. before the Colorado State Legislature, March 2006 http://www.tresearch.org/resources/presentations/McLellanNCSL.ppt
• SSI Cost-Offset Study from Washington State, available at: http://www1.dshs.wa.gov/pdf/ms/rda/research/11/125.pdf
• Report from the National Quality Forum: “Evidence-Based Treatment Practices for Substance Use Disorders” http://www.tresearch.org/resources/pubs/NQFReport.pdf
• National Expenditures Report from SAMHSA http://www.samhsa.gov/spendingestimates/toc.aspx
• Fact Sheet on SAMHSA’s National Outcomes Monitoring System: “NOMS” http://www.nationaloutcomemeasures.samhsa.gov/outcome/index.asp
• “The Economic Benefits of Substance Abuse Treatment,” a report by TRI’s Steven Belenko, Ph.D. http://www.tresearch.org/resources/specials/2005Feb_EconomicBenefits.pdf
• “Drug Dependence, A Chronic Medical Illness: Implications for Treatment, Insurance, and Outcomes Evaluation” by A. Thomas McLellan, Ph.D. http://www.tresearch.org/resources/pubs/09_McLellan_JAMA.pdf
• “Rewarding Results: Improving the Quality of Treatment for People with Alcohol and Drug Problems.” Recommendations from a national policy panel convened by Join Together. http://www.tresearch.org/resources/pubs/JoinTogether.pdf
• Report on the Costs and Effectiveness of Alcohol and Drug Abuse Programs in Colorado. http://www.cdhs.state.co.us/ohr/adad/hewi03.pdf
• Reconsidering Addiction Treatment, a presentation by Mady Chalk, Ph.D., before the Select Committee on Mental Health and Substance Abuse, Casper Wyoming, May 15, 2006. http://www.tresearch.org/resources/presentations/ChalkWY2006.ppt
• Expanding Alcohol/Drug Treatment: An Investment in Health Care Cost Containment and Public Safety, by Antoinette Krupski, Ph.D., before the Select Committee on Mental Health and Substance Abuse, Casper Wyoming, May 15, 2006. http://www.tresearch.org/resources/presentations/KrupskiWY2006.ppt

Health Care Providers and Workforce

Health care workforce in general

• Association of American Medical Colleges http://www.aamc.org/
• The Council on Graduate Medical Education http://www.cogme.gov/
• The Center for the Health Professions, University of California, San Francisco http://www.futurehealth.ucsf.edu/cchws.html
• HRSA Bureau of Health Professionals
  National Center for Health Workforce Analysis (includes state health workforce profiles, reports such as “The Health Care Workforce: Education, Practice & Policy” and databases, etc.) http://bhpr.hrsa.gov/healthworkforce/default.htm
• American Medical Association http://www.ama-assn.org/
• American Nurses Association http://www.nursingworld.org/
• Center for Studying Health System Change http://www.hschange.com/
• American Hospital Association http://www.aha.org/

Telemedicine and health care providers

• Telemedicine in Arizona – Issue Brief http://www.azleg.gov/briefs/Senate/TELEMEDICINE.pdf
• Center for Telehealth and Distance Education
  The University of Texas Medical Branch (UTMB) has a long-standing history of advancing the use of telecommunications technology for the purpose of improving health care delivery to rural and underserved populations of Texas. Service areas include clinical services, educational programs, and research and development. Distance education represents a major component of the mission of the UTMB Telehealth Center. http://www.utmb.edu/telehealth/
• Response to the Institute of Medicine’s Report
  To Err is Human: Building a Safer Health System
• AACN White Paper: Distance Technology in Nursing Education http://www.aacn.nche.edu/publications/positions/whitepaper.htm
• The Arizona Rural Telemedicine Network
  Q & A with Associate Director Dr. Kevin M. McNeil http://www.digitaldivide.net/articles/view.php?ArticleID=323
• Telemedicine Information Exchange – Telemedicine 101 http://tie.telemed.org/telemed101/
• Innovations in Distance Education for Health Professionals – Interdisciplinary Training in Telemedicine (educating health professionals about using telemedicine) www.atmeda.org/news/2005_presentations/m3c2.Lamb.ppt

NCSL Resources on the health care workforce

State Health Notes is a biweekly NCSL newsletter that provides information about health policy news for state legislators as well as the public.  This newsletters is available online at http://www.ncsl.org/shn/

Other items of interest on the NCSL website include

• Cultural Competency for Providers audioconference materials http://www.ncsl.org/programs/health/oct2006webcasts.htm#providers
• Telemedicine legislation http://www.ncsl.org/programs/health/teleleg.htm
• Pharmacist Conscience Clauses: Laws and Legislation http://www.ncsl.org/programs/health/conscienceclauses.htm
• States Tackle the Nursing Shortage by Kristine Goodwin (State Legislatures magazine) http://www.ncsl.org/programs/pubs/1002nurse.htm
• State Experience with Dental Loan Repayment Programs http://www.ncsl.org/print/health/sedlrp%20.pdf

 Gearing Up to Govern