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May 2007
In this Issue:
New Resources
NEW MEDIA:
PUBLICATIONS:
Activities in the Field
Policy Updates
Children's Health Coverage
Indian Health Care Improvement Act
Upcoming Events
NEWS MEDIA:
- Families USA has posted a new PowerPoint presentation, MA Windfall Payments: A Source of Help for Low-Income Children and Seniors?, that looks at overpayments to private Medicare Advantage plans. The presentation explores whether extra payments are truly necessary to serve seniors from communities of color, or whether these federal dollars might be put to better use covering kids and helping low-income seniors.
- Refugee Health Information Network is a new Web site created by a national collaborative partnership of refugee health professionals. The site features a database of multilingual public health resources for those providing care to resettled refugees and asylees.
PUBLICATIONS:
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National Health Law Program (NHeLP)
Language access continues to be a significant barrier to health care for individuals with limited English proficiency. Over 23 million individuals—almost 9 percent of the population—speak English less than “very well” and likely need assistance communicating in the health care arena.
In mid-April, the National Health Law Program and the American College of Physicians released Language Services for Patients with Limited English Proficiency: Results of a National Survey of Internal Medicine Physicians. Nearly two-thirds of internists report having active patients with LEP, comprising an average of 12 percent of active patients in their practices. Physicians encounter such patients on a fairly frequent basis—54 percent report that their practice encounters such patients at least once a day or a few times a week; another 27 percent encounter LEP patients a few times per month. These results mirror results from a national survey of hospitals released last fall, which found that 63 percent of hospitals encounter LEP individuals at least weekly and another 17 percent encountering them at least monthly.
The report’s recommendations include: making language services available to improve the provision of health care services to patients with LEP, providing reimbursement through Medicare for the added expense of language services and the additional time involved in providing clinical care for patients with LEP, and establishing a national clearinghouse to provide translated documents and patient education materials.
Attempting to provide some tools for health care providers and others, NHeLP has released a series of reports outlining promising practices for providing language services in health care settings. The most recent, Providing Language Services in State and Local Health-Related Benefits Offices: Examples from the Field, released by The Commonwealth Fund in January, outlines how state and local benefit offices can provide language services. NHeLP also has a Language Services Resource Guide for Healthcare Providers which offers information on how to provide language services including information on interpreter/translator associations and agencies, training programs, and health care symbols.
For additional information or to order print copies of publications contact Mara Youdelman, Youdelman@healthlaw.org or 202-289-7661.
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Children’s Health Coverage
Over the past ten years, the State Children’s Health Insurance Program (SCHIP) has been critical to improving children’s health, and has helped to reduce racial and ethnic health disparities by increasing access to necessary health care services for children from communities of color. In 1998, the year after SCHIP was enacted, roughly 30 percent of Latino children, 20 percent of African American children, and 18 percent of Asian American and Pacific Islander children were uninsured. By 2004, those numbers had dropped to about 21 percent, 12 percent, and 8 percent respectively, primarily due to coverage obtained through SCHIP.
With the SCHIP program up for reauthorization in September 2007, several pieces of legislation have been introduced to not only continue, but also strengthen, this vital program. One such proposal is the Children’s Health Insurance Program (CHIP) Reauthorization Act of 2007 or S.1224, which was introduced on April 25, 2007 by Senators Rockefeller (D-WV), Snowe (R-ME), and Kennedy (D-MA). This legislation would increase federal funding to the states, allowing them to develop financially stable programs, increase efforts to enroll already eligible children, and launch efforts to expand eligibility and cover more children.
There are several key policy priorities in this bill which would help to reduce disparities in access. Particularly important is the effort to streamline enrollment procedures and increase enrollment for already eligible children. Based on the 2003 eligibility standards, it is estimated that more that 70 percent of uninsured Hispanic children and 80 percent of uninsured black children are eligible for SCHIP or Medicaid.
Policies in the S.1224 bill that would increase enrollment include:
- An “express lane” eligibility option, which would allow states to enroll children in SCHIP based on their enrollment in other federal assistance programs such as the Women, Infant and Children (WIC) program or the National School Lunch Program;
- Additional resources to increase outreach efforts;
- Flexibility in citizen documentation requirements; and
- The Immigrant Children’s Health Improvement Act (ICHIA). (For more on ICHIA click here)
S.1224 provides a great platform from which to begin the debate about how best to provide health care to America’s children. As additional reauthorization bills are introduced, we will continue to analyze the proposals to make sure that they too meet the goals of expanding children’s health coverage and reducing racial and ethnic disparities in access to care.
Indian Health Care Improvement Act
Also on April 25, 2007, the House Natural Resources Committee approved legislation, H.1328, to revise and reauthorize the Indian Health Care Improvement Act Amendments of 2007. The bill will now go on to a vote in the full House. The bill was also introduced in the Senate on April 24, 2007 as S.1200.
The Indian Health Care Improvement Act (IHCIA - not to be confused with ICHIA) aims to modernize and improve American Indian health care services and delivery. Key provisions of the legislation would allow for programs to address both behavioral and mental health in American Indian Communities, as well as allow for in-home care of the elderly American Indian population.
While most major laws are amended and reauthorized every four to seven years, it is important to note that IHCIA has not been updated in over 14 years. Supporters advocate that this outdated law be modernized and reauthorized to address the huge health disparities experienced by American Indian populations across the nation.
The new legislation:
- Requires American Indian health organizations to help enroll American Indians into public programs including Medicare, Medicaid, and SCHIP;
- Includes provisions to increase representation of American Indians in the medical field;
- Establishes permanent programs for specific diseases such as diabetes and cancer;
- Authorizes funding for hospice and assisted living facilities;
- Creates a behavioral health program to address mental health and substance abuse issues; and
- Creates a youth program to address mental and physical health issues.
Aside from these provisions, the legislation also sets requirements to replace the current Urban Health Programs Branch with a Division of Urban Health that would take over providing services to American Indians in urban areas.
We are hopeful that the renewal and strengthening of this legislation will help to improve American Indian and Alaska Native health in the years to come.
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We’d like to hear from you!
If you would like to see your organization or event highlighted in a future edition of our newsletter, please send us a brief description of your organization and its activities, as well as your contact information. We also welcome guest authors for the Activities in the Field section of the newsletter. This section provides members of the minority health field with the opportunity to share their experiences and insights with other advocates. Please send all correspondence to: minorityhealth@familiesusa.org.
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