Highlights

MEDICAID

Coverage for Infants

The Centers for Medicare & Medicaid Services announced March 20 that infants born to undocumented immigrants whose deliveries are covered by Medicaid will automatically be eligible to receive coverage under the program for one year, a reversal of previous policy. Under an interim final rule issued in July 2006, CMS said that infants born to undocumented immigrants and others whose deliveries are covered by an emergency Medicaid provision would not automatically receive coverage under the program. The rule required that undocumented immigrants provide documentation to prove the citizenship of their infants before they could receive Medicaid coverage. A number of state officials, hospitals and pediatricians criticized the policy because infants born in the United States are considered citizens under the 14th Amendment to the Constitution. Under the new rule, undocumented immigrants would have to provide documentation to prove the citizenship of their children after one year to maintain their Medicaid coverage. The new rule will not affect Medicaid proof-of-citizenship requirements for adults or children older than age one.

MENTAL HEALTH

Services to Kids in Need

On March 1, The Robert Wood Johnson Foundation announced a new national campaign to reduce emotional and behavioral health problems among school children in low-income, immigrant and refugee families. The program has awarded $4.5 million in grants to 15 communities nationwide to bring school-connected mental health services to poor children. Grant recipients will provide assistance to immigrant and refugee children and their families to overcome the cultural and language barriers to mental health services. Immigrant communities to be served include Vietnamese, Mexican, Liberian, Somali, Sudanese and Bosnian. The project is being coordinated by the Center for Health and Health Care in Schools at the George Washington University School of Public Health and Health Services, in Washington, D.C. For more information on “Caring Across Communities: Addressing Mental Health Needs of Diverse Children and Youth,” visit http://www.healthinschools.org/cac.asp.

COVERAGE

Report Analyzes Health Reform Proposals

The Commonwealth Fund recently published a report that examines a series of federal attempts to reform the country’s health care system. The study analyzed ten proposals introduced in the current Congress as well as President Bush’s proposal. Many of the proposals would scale back or eliminate the role of employers in providing health insurance. All of the proposals—with the exception of the President’s—would mandate coverage for all individuals and would provide premium subsidies for people of lower income, and most of the proposals would pool health risks into large groups in order to equalize health care costs. The cost for states vary under the plans, although many look to increase federal contributions to Medicaid and SCHIP or shift dollars away from these programs toward private insurance or more federal control.

PARITY

Hospices Targeting Minorities

Hospices in the Boston area are attempting to address disparities in end-of-life care by marketing themselves to minorities. The Beacon Hospice, a for-profit hospice, and two other hospices are taking steps such as opening offices in urban areas and hiring a more diverse staff. Minorities tend to use less hospice care than whites. Figures quoted by the Boston Globe show that 10 percent of non-whites in the state use hospice care, whereas the overall nonwhite population of the Bay State is 17 percent. Some of the reasons given for the disparities include mistrust of the healthcare system by nonwhites and hospices putting a larger emphasis on serving suburban clients. “If you are not culturally competent, people feel this,” Eric Hardt, medical director of Beacon Hospice's location in Roxbury, told the Globe. Additionally, minorities – African-Americans in particluar – are more likely to forgo hospice treatment in favor of more aggressive care during the end of life, according to an ongoing research project at Harvard that is examining the issue.