This is the Health Chairs e-bulletin for April 2006.
Looking Ahead
NCSL Spring Forum will take place in DC, April 6-8. No Chairs program, but we hope to see you if you are attending Spring Forum. We will have a short session to highlight our emerging health leaders (CHAP) project and present the new, online State Health Notes. The Spring Forum schedule includes health committee meetings, a rural health pre-conference, and a session on avian flu and public health preparedness.
Hold the date: June 8-10 for the Spring Chairs meeting in Washington, D.C. A limited number of full and partial travel scholarships will be available. Watch your inbox for the invitation and agenda, which will go out in about 10 days. The working theme of the meeting is “Winds of Change: Health Policy in Turbulent Times.” In addition to a day of material on changes in Medicaid due to recent budget legislation, we’ll be looking at state policy responses and pressure for change due to technology, system reorganization, commercial innovation and globalization as well as national policy shifts. AHRQ Director Caroline Clancy, NIH Director Elias Zerhouni and CMS’ Mark McClellan are among the invited speakers. Saturday will include sessions on coverage issues related to retirees and immigrants. See the end of this Chairs Bulletin for a survey you can fax back to us to let us know if you expect to attend the June meeting.
If you want to learn more about Health Information Technology, additional scholarships will be available allowing people to arrive early, June 6 or 7, and take part in National Health IT week. http://www.healthitweek.org/bridge_day.html and http://www.himss.org/summit/.
Cover the Uninsured Week will run from May 1-7 this year. Check out what is planned, and register your own events at http://covertheuninsuredweek.org/.
NCSL’s annual meeting is in Nashville this year, August 15-19. We’ll continue our tradition of a Chairs’ tea that looks at the host state’s Medicaid program. Since Tenncare has such a dramatic tale to tell, we hope to schedule a longer block of time than usual.
More details on the Annual Meeting and the Chairs’ tea will be coming in the next bulletin.
Resources Online
Tradeoffs are an inevitable part of setting health policy with finite resources A new study puts numbers and faces on winners and losers when Utah offered a limited benefit to a wider pool of recipients by reducing existing benefits for poor parents. Can States Stretch the Medicaid Dollar Without Passing the Buck? Lessons from Utah and related reports give details of how the waiver was created and carried out and take stock of the consequences. http://www.kff.org/medicaid/kcmu030706pkg.cfm
A vexing feature of the Medicare drug benefit was the provision that requires states to finance part of the program’s expenses. This issue brief from Kaiser has updated information about state obligations under this reverse intergovernmental transfer. http://www.kff.org/medicaid/upload/7481.pdf
Pharmaceuticals management has been one effective way states have controlled Medicaid costs. A new study from the National Academy of State Health Policy (NASHP) reports on a six state study Using Clinical Evidence to Manage Pharmacy Benefits. If you were with us in Chicago, you heard first-hand about the drug effectiveness review program (DERP). http://www.nashp.org/_docdisp_page.cfm?LID=341D7DA7-A140-4A10-A9AB4F82C47F8850
Insurance tax credits. Urban Institute Senior Fellow Leonard Burman, in testimony before the Senate Finance Committee, describes how insurance and tax policy interact and lays out pros and cons of various proposals now being considered that address the “upside-down subsidy” in Taking a Checkup on the Nation's Health Care Tax Policy: a Prognosis. http://www.urban.org/UploadedPDF/900934_burman_030806.pdf. Testimony by other witnesses and recording of proceedings can be accessed at http://www.senate.gov/~finance/sitepages/hearing030806.htm
Retiree Health Costs are the subject of a 22-page report from California Legislative analysts. www.lao.ca.gov/2006/ret_hlthcare/retiree_healthcare_021706.pdf
QUALITY AND CHRONIC CONDITIONS
The federal Agency for Healthcare Research and Quality (AHRQ) has made the 2005 State Snapshots available on line. This clear and easy-to-navigate site includes “performance meter” graphics that dial up quick comparisons of states with national and regional performance on a number of quality measures. In addition the snapshots site has detailed, customized tables for each state and allows the data to be looked at by type of care, setting and specific measures. The report includes an in-depth focus on diabetes. Other conditions will be added over time. According to AHRQ, the snapshots “Should help State officials and their partners understand health care quality in their State, including strengths, weaknesses, and opportunities for improvements.” http://www.qualitytools.ahrq.gov/qualityreport/2005/state/summary/intro.aspx
Children’s health quality can be compared as well on the National Survey of Children’s Health site. A chartbook based on these data was cited last month. Data from 2003 is organized by state in the survey data resource center at http://nschdata.org/DesktopDefault.aspx?topic=states.
HIV/AIDs The Annual Survey of State AIDS Drug Assistance Programs (ADAP) was released on March 30. Press conference and links to the report can be found at http://www.kff.org/hivaids/hiv033006pkg.cfm . A local advocacy group named DC Appleseed has issued an assessment of Washington DC’s local programs showing improvement since last year but much “room to grow.” http://www.dcappleseed.org/projects/publications/HIVreportcard-3-23-2006.pdf
Quality Care for Persons with Alzheimer's, a brief by NCSL staffer Tara Lubin on state efforts, including disclosure and training requirements for facilities that specialize in care to persons with this disorder, is now on line at http://www.ncsl.org/programs/health/forum/alzheimerqc.htm.
LONG TERM CARE
Rebalancing long term care systems means changing the mix of institutional and home or community-based care. States are taking different paths to accomplish this, according to preliminary summary of a longer report. The CMS-commissioned study, Management Approaches to Rebalancing Long-Term Care Systems in Eight States: looks at eight states: Arkansas, Florida, Minnesota, New Mexico, Pennsylvania, Texas, Vermont, and Washington. http://www.cms.hhs.gov/NewFreedomInitiative/Downloads/Executive Summary.pdf
PROVIDERS AND WORKFORCE
Can the safety net take care of the uninsured? A new study from the Center for Studying Health System Change finds that physicians are providing decreasing amounts of free and charity care, whether in their own offices or in volunteer settings. http://www.hschange.com/CONTENT/826/
In related news, a study published in Pediatrics reached the not-so-surprising conclusion that uninsured children in rural areas were likelier to use health care if there were more primary care doctors in their area or if they lived nearer a safety net provider. In urban areas, adequate safety net funding was a factor. http://pediatrics.aappublications.org/cgi/content/abstract/117/3/e509
New data from the National Association of Community Health Centers includes a clickable map that leads to state-by state data on health center use and maps showing where centers are in each state. The study suggests that using health centers more could save as much as $18 billion annually, http://www.nachc.com/research/ssbysdat.asp
PUBLIC HEALTH
At the request of the Chair of the Assembly Health Committee, A legislative intern in California has written a paper on Racial and Ethnic Health Disparities: A Review of Selected State Programs. The report reviews programs in the Department of Health Services (DHS), Department of Education (CDE), Department of Mental Health (DMH), and Department of Transportation (CalTrans) and how they address eight priority medical issues: Cardiovascular Disease; Breast Cancer; Cervical Cancer; Diabetes; HIV/AIDS; Asthma; Mental Health; and Trauma. It asks how the programs “address health needs for communities of color” , how they collect and use data to identify strategically plan programs related to health disparities. http://www.library.ca.gov/crb/06/02/06-002.pdf
Healthy Community
The American Public Health Association (APHA) sponsors National Public Health Week (NPHW) which starts April 3. The theme this year is “Designing Healthy Communities: Raising Healthy Kids". http://apha.org/news/press/2006/nphw_release.htm For more on the topic—and information about what states are doing-- go to NCSL’s Healthy Community page at http://www.ncsl.org/programs/environ/healthyCommunity/index.htm
CHALLENGING CONVENTIONAL WISDOM
Mental Health Parity doesn’t cost more, if it comes packaged as managed care, according to a new study issued this week in NEJM. http://content.nejm.org/cgi/content/full/354/13/1378
Those of you who took part in our audioconference on this heard this finding last November 8. http://www.ncsl.org/programs/health/webcastnovdec05.htm
Emergency Department Frequent Fliers, often assumed to be uninsured or abusing the system, are actually likely to be insured and sick and are appropriately using the ED to get needed care according to a recently published study funded by the Robert Wood Johnson Foundation. http://www.rwjf.org/research/researchdetail.jsp?id=2515&ia=132
ETCETERA
Podcast from AHRQ.
Ask your junior leg analyst what that means. The federal Agency for Healthcare Research and Quality (AHRQ) is producing a series of downloadable newscasts with the latest news on healthcare research and findings related to quality and safety, from AHRQ’s many projects. To listen from your computer or download the information to a portable device, go to http://www.healthcare411.org. For example, the March 17 ‘cast features the state quality snapshots we featured elsewhere in this Bulletin.
Several months worth of past Chairs e-bulletins are archived at: http://www.ncsl.org/programs/health/forum/chairs/ebull/index.htm
Have any questions you'd like answered? A topic for which you’d like us to gather resources? Do you have a report of your own you'd like to share with your peers? Drop us a line…
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
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
RESPONSE FORM
HEALTH CHAIRS MEETING
June 8-10, 2006
Washington, DC
NAME: ___________________________________
STATE: __________________________________
ADDRESS: ________________________________
PHONE #: ________________________________
FAX#: ___________________________________
E-MAIL: __________________________________
_____ YES, I plan to attend the Health Chairs meeting on June 8-10.
_____ YES, I would like to attend the Health Chairs meeting but can do so only if I receive a stipend
_____ YES, I plan to attend the Health Information Technology meetings, June 6 and 7 .
______ NO, unfortunately my schedule will not permit me to attend the Chairs meeting; however, I would like to designate the following member of my
committee to attend in my place: ________________________________________________________
If you have any questions, please contact Chris Coleman at 202-624-3580 or Kala Ladenheim at NCSL at 202-624-3557 or by e-mail at health.chairs@ncsl.org.
Please fax to Chris Coleman at (202) 737-1069
 Health Chairs Project
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