This is the Health Chairs e-bulletin for March 2006.
These are excerpts from the January, 2006 email update on state health policy resources available on the Internet.
We’ve updated the Health Chairs page with material from the Chicago meeting, including downloadable audio for those who couldn’t come http://www.ncsl.org/programs/health/forum/chairs/chairsdec05.htm. You can also point your members and staff to our newly organized NCSL CHAP (Critical Health Areas Project) pages, which will organize NCSL content related to four areas: access, addiction, workforce, and quality of care for chronic illness http://www.ncsl.org/programs/health/forum/chap/index.htm.
Resources Online
Medicaid and Medicare
Medicaid changes in the budget agreement and implementation of the new Medicare drug benefits—and states’ actions to help people caught in the transition—have been making headlines.
Medicaid provisions of the federal Deficit Reduction Act of 2005 are now available.
NCSL’s summary is at http://www.ncsl.org/statefed/health/ReconDocs0206.htm
The Henry J. Kaiser Family Foundation has prepared a series of analyses of the DRA that can be found at http://www.kff.org/medicaid/reconciliation.cfm
The Congressional Budget Office (CBO) estimates look at numbers of people expected to be affected by copayments, estate recovery, and the requirement to document place of birth http://www.cbo.gov/ftpdocs/70xx/doc7030/s1932updat.pdf.
The National Academy for State Health Policy (NASHP) has summarized provisions related to long-term care at http://www.nashp.org/Files/LTC_issue_brief_1.9.06.pdf, as has the Heartland Institute http://www.heartland.org/Article.cfm?artId=18583.
Consumer-directed purchasing in Medicaid is engendering impassioned debate. A 19-page brief from the RWJ-funded State Coverage Initiatives program identifies four critical success factors for state efforts: protect access; develop policies that anticipate how behavior of all parties will change; reformulate agency roles; and develop and implement new approaches to risk management http://www.statecoverage.net/pdf/issuebrief106.pdf.
Prescription Drugs
NCSL has just released 2006 Prescription Drug State Legislation as an online report. It covers about 400 pending bills in 40 out of the 44 states with 2006 sessions, including 5 already signed into law. Our 22 covered pharmaceutical topics range from Part D wrap around plans and state Rx discounts to price disclosures and regulation of PBMs, wholesalers and internet sales. Updates will be posted weekly for the next two months and regularly throughout the year http://www.ncsl.org/programs/health/drugbill06.htm.
Kaiser has a collection of resources related to the Medicare drug benefit, including a new paper on temporary state activities during implementation http://www.kff.org/medicaid/7467.cfm.
New York State Attorney General Spitzer encourages comparison shopping for lowest priced drugs at a consumer web site http://www.nyagrx.org/. The site claims that savings from selecting the lowest price for each drug reviewed average $17 per prescription http://www.oag.state.ny.us/press/2006/feb/NYAGRX%20savings%20report.pdf.
Long-Term Care and Disability Services
We lost a colleague when Wendy Fox-Grage left NCSL to go to AARP, but at least she is still producing solid, state-focused research on long-term care. Check out this report on Medicaid Managed Long-Term Care, which includes information on nine state programs as well as the 18-state program for all-inclusive care for the elderly (PACE) http://www.aarp.org/research/assistance/medicaid/Articles/ib79_mmltc.html.
You’ll see in the NAMI report below that Connecticut ranked well in services for people with severe mental illnesses. Consumer and Family Perspectives on Services Provided by Connecticut’s State Agencies reviews how various state agencies interacted with persons with disabilities, and may offer insight on how state programs work for this group http://hcbs.org/files/83/4124/2005_Agencies_II_Consumer_Feedback.pdf.
Access
Kaiser has issued its latest overview of who is uninsured and why. In 29 pages, The Uninsured: A Primer gives a detailed discussion of the many causes and effects of lack of coverage. The primer is updated with 2004 data, includes state charts, and highlights facts that may interest policymakers. For example: a disproportionate number of people in poor health lack any insurance, public or private (p.10) http://www.kff.org/uninsured/upload/7451.pdf.
RWJ’s State Coverage Initiatives held their spring meeting last week. There is a great deal of activity going on right now. Time will tell which states make it to the finish line, but we heard about interesting projects and proposals in various stages in New Mexico, Massachusetts, Arkansas, New York, West Virginia, Washington and others. For links to slides from the meeting: http://www.statecoverage.net/0206agenda.htm.
A Brookings Institution meeting on The Causes and Policy Implications of Rising Health Care Spending focused on the President’s new proposals for health savings accounts (HSAs). A webcast and related documents can be found at http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=1667.
Disparities in access to care are a troubling and pervasive problem around the country. Families USA has created a Minority Health Tool Kit. The tool kit provides an accessible introduction to the issue and why it is important. Fact sheets, case studies, and overview of Medicaid’s role and lobbying tools for advocates are all available at http://www.familiesusa.org/resources/tools-for-advocates/kits/minority-health-tool-kit.html
State and federal policies that affect immigrants, both documented and undocumented, are a huge part of the disparities puzzle. The Center for Studying Health System Change has just released a brief, Stretching the Safety Net to Serve Undocumented Immigrants: Community Responses to Health Needs http://www.hschange.org/CONTENT/818/.
Grantmakers in Health published a report with a wealth of information about immigrants (only about a quarter of whom are undocumented), public policy, opinions, and their various needs http://www.gih.org/usr_doc/GIH_Issue_Brief_24_FINAL.pdf.
Retiree Health Benefits continue to decline. The National Health Policy Forum reviews the issue in a backgrounder, Health Benefits in Retirement: Set for Extinction? http://www.nhpf.org/pdfs_bp/BP_RetireeHealth_02-08-06.pdf and a meeting session brief on the topic http://www.nhpf.org/announcements/FS_02-24-06_RetireHCFinance.pdf.
The Medicare Modernization Act created a Citizen’s Health Care Working Group which is taking the pulse of the public on what kinds of benefits and coverage it prefers, how it should be financed and delivered, and what trade-offs it will accept. A series of public hearings is scheduled around the country, and the public is invited to log its opinions in an online survey as well. The activities culminate in a report to the President and Congress this fall. For more information, to give your opinion, and to read their preliminary report go to http://www.citizenshealthcare.gov/.
Costs
New health spending projections through 2015 have been published by the federal government. An article on the projections was published on line by Health Affairs. http://content.healthaffairs.org/webexclusives/index.dtl?year=2006
The data are also available from CMS http://www.cms.hhs.gov/NationalHealthExpendData/03_NationalHealthAccountsProjected.asp
Public Health
NGA is in town, and so is NGA Chairman Arkansas Gov. Mike Huckabee’s Healthy America initiative. Governor Huckabee has led by example by becoming half the man he once was in response to a warning about incipient diabetes. See the wellness framework your partners in government are looking at, including a call for action and publications on healthy states, healthy communities, healthy work and healthy schools http://www.nga.org/portal/site/nga/menuitem.751b186f65e10b568a278110501010a0/?vgnextoid=cd86f8dbc1ff6010VgnVCM1000001a01010aRCRD&vgnextchannel=92ebc7df618a2010VgnVCM1000001a01010aRCRD.
Veterans Affairs and HHS have just announced HealthierUS Veterans, a program that will be reaching out with wellness messages, particularly targeting obesity and diabetes, for veterans and their families which may include as much as a quarter of the US. Learn more at http://www.healthierusveterans.va.gov/.
Child Health
The Maternal and Child Health Bureau has produced a chartbook, The Health and Well-Being of Children: A Portrait of States and the Nation 2005 http://www.mchb.hrsa.gov/thechild/index.htm based on data from the National Survey of Children's Health. It includes measures of children's physical and mental health, health care, and general well-being. Individual state data sheets and links that allow you to directly query the data can be found at http://www.mchb.hrsa.gov/thechild/state.htm.
Mental Health and Substance Abuse
The National Alliance on Mental Illness (NAMI) has released a report on the state of states’ programs for people with serious mental illness, based on surveys of state mental health agencies, received from every state except Colorado and New York, publicly available information and NAMI member reports. The report compares performance of 39 factors grouped into four areas: Infrastructure, Information Access, Services, and Recovery, and includes a “test drive” for consumer friendliness. A handful of states rank at the top with a “B” grade: Connecticut, Maine, Ohio, South Carolina, and Wisconsin, while NAMI flunks eight states. View a clickable map (and find the report in the left-hand column) at http://www.nami.org/content/navigationmenu/grading_the_states/NAMIs_Grading_the_States_2006_Report.htm.
The Minnesota Office of the Legislative Auditor has issued a program evaluation report on substance abuse treatment, both in the community and in state prisons. The report finds that there is wide variation in counties' use of publicly funded treatment, and calls for greater leadership and oversight. The report documents widely varying rates of rearrest and reconviction among chemically dependent persons who completed substance abuse programs in prison – ranging from low recidivism rates for inmates who completed a program that combines chemical dependency treatment with a boot camp environment to high recidivism rates for inmates who completed short substance abuse education programs. The report is available at: http://www.auditor.leg.state.mn.us/ped/2006/subabuse.htm.
Quality
Minnesota has just issued its second annual report (and the first to include ambulatory surgical centers) on “never events” – any of 27 serious adverse events identified by the National Quality Forum. Such reporting is intended to improve patient safety and transparency about the comparative safety and quality of various providers.
Read more at http://www.health.state.mn.us/patientsafety/aereport0206.pdf or read more about the law and related activities at http://www.health.state.mn.us/patientsafety/.
Kaiser has assembled a reference library of resources related to quality as part of the Kaiser.Edu site, which offers tutorials on a range of health policy topics http://www.kaiseredu.org/topics_reflib.asp?id=139&parentid=70&rID=1.
Staff Contacts
Donna Folkemer, Group Director
Forum for State Health Policy Leadership
National Conference of State Legislatures
ph: 202-624-8171 fx: 202-737-1069
Donna.Folkemer@ncsl.org
Kala Ladenheim, Ph. D. Program Director
Forum for State Health Policy Leadership
National Conference of State Legislatures
ph: 202-624-3557 fx: 202-737-1069
kala.ladenheim@ncsl.org
 Health Chairs Project
|
