THE POLICY THINKSHOP "Think Together"

Public Policy is social agreement written down as a universal guide for social action. We at The Policy ThinkShop share information so others can think and act in the best possible understanding of "The Public Interest."

Five million families and children will now sleep a little easier. How will the new Latino/Hispanic immigrant status impact healthcare policy?

Being “in the shadows” has long been a healthcare access issue.  The broken healthcare system has been aggravated by a broken immigration system. Immigration and healthcare are tied together in many ways, especially for the economically disadvantaged.

According to the New York Times:

What Is President Obama’s Immigration Plan?

President Obama announced on Thursday evening a series of executive actions to grant up to five million unauthorized immigrants protection from deportation. The president is also planning actions to direct law enforcement priorities toward criminals, allow high-skilled workers to move or change jobs more easily, and streamline visa and court procedures, among others. NOV. 20, 2014 RELATED ARTICLE

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Who could be affected?

The president’s plan is expected to affect up to five million of the nation’s unauthorized immigrant population, currently 11.4 million according to the Migration Policy Institute. It would create a new program of deferrals for approximately 3.7 undocumented parents of American citizens or legal permanent residents who have been in the country for at least five years. Deferrals would include authorization to work and would be granted for three years at a time.

It would also expand a program created by the administration in 2012 called Deferred Action for Childhood Arrivals, or DACA, which allows young people who were brought into the country as children to apply for deportation deferrals and work permits. The plan would extend eligibility to people who entered the United States as children before January 2010 (the cutoff is currently June 15, 2007). It would also increase the deferral period to three years from two years and eliminate the requirement that applicants be under 31 years old. About 1.2 million young immigrants are currently eligible, and the new plan would expand eligibility to approximately 300,000 more.

It would not provide a path to full legal status or benefits under the Affordable Care Act. Officials have said that the president’s plan will not provide specific protection for farm workers or parents of DACA-eligible immigrants.

Filed under: ACA and Medicaid, Blogosphere, Data Trends - American Demographics and Public Opinion, Family Policy, Feminization of Poverty, Health Literacy, Health Policy, Healthcare Reform, Immigration, Latinos, Maternal and Child Health, Medicaid, News, Public Health, Public Policy,

RWJF Initiative on the Future of Nursing | The information from the experts has been published. What are you and other community stakeholders doing about it?

Are you familiar with the RWJ report titled “The Future of Nursing: Leading Change, Advancing Health” by the Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Penn Medicine (University of Pennsylvania Health System)?

As we know, initiatives like the one that produced this report, as recent as 2011, come and go.  What remains is the report and what committed professional like yourself and our colleagues do with the information.

We at The Policy ThinkShop were inspired by a nurse colleague not only to pullout this report but to post a comment on our blog for your benefit.

The link to the report follows:

http://www.thefutureofnursing.org/sites/default/files/Future%20of%20Nursing%20Report_0.pdf

According to the report:

“In 2008, The Robert Wood Johnson Foundation (RWJF) approached the Institute of Medicine (IOM) to propose a partnership to assess and respond to the need to transform the nursing profession. Recognizing that the nursing profession faces several challenges in fulfilling the promise of a reformed health care system and meeting the nation’s health needs, RWJF and the IOM established a 2-year Initiative on the Future of Nursing. The cornerstone of the initiative is this committee, which was tasked with producing a report containing recommendations for an action-oriented blueprint for the future of nursing, including changes in public and institutional policies at the national, state, and local levels (Box S-1). Following the report’s release, the IOM and RWJF will host a national conference on November 30 and December 1, 2010, to begin a dialogue on how the report’s recommendations can be translated into action. The report will also serve as the basis for an extensive implementation phase to be facilitated by RWJF.”

The report explains the committee of experts charge in producing the study and report as follows:

The committee may examine and produce recommendations related to the following issues, with the goal of identifying vital roles for nurses in designing and implementing a more effective and efficient health care system:

  • Reconceptualizing the role of nurses within the context of the entire workforce, the shortage, societal issues, and current and future technology;
  • Expanding nursing faculty, increasing the capacity of nursing schools, and redesigning nursing education to assure that it can produce an adequate number of well prepared nurses able to meet current and future health care demands;
  • Examining innovative solutions related to care delivery and health professional education by focusing on nursing and the delivery of nursing services; and
  • Attracting and retaining well prepared nurses in multiple care settings, including acute, ambulatory, primary care, long term care, community and public health.

“In 2008, the Robert Wood Johnson Foundation approached the Institute of Medicine (IOM) to propose a partnership between the two organizations. The resulting collaboration became the two-year Robert Wood Johnson Foundation Initiative on the Future of Nursing at the IOM. The committee was chaired by former U.S. Secretary of Health and Human Services Donna Shalala, and the goal was to look at the possibility of transforming the nursing profession to meet the challenges of a changing health care landscape. The report produced by the committee, The Future of Nursing: Leading Change, Advancing Health, makes specific and directed recommendations in the areas of nurse training, education, professional …”

More on the initiative via About | RWJF Initiative on the Future of Nursing.

Filed under: ACA and Medicaid, Blogosphere, Health Literacy, Health Policy, Healthcare Reform, Leadership, Maternal and Child Health, News, Philanthropy, Policy ThinkShop Comments on other media platforms, Public Health, Public Policy,

Is your doctor happy? With Poll from: Gallup.Com

When you visit your doctor does (s)he look happy?  At the end of the day healthcare is a one on one personal experience.  All the insurance coverage or fancy machines in the world won’t improve medical care if the doctor patient relationship is not optimal.

So what is our healthcare system doing to address physician happiness?  The Gallup organization took a closer look at hospitals, one place where physician practice is defined and sustained–for better or for worse…

“When doctors are frustrated, patient care and hospital revenues suffer. Heres how hospitals can engage their physicians — and make a positive impact on patients and the bottom line.”

via Gallup.Com – Daily News, Polls, Public Opinion on Politics, Economy, Wellbeing, and World.

Filed under: ACA and Medicaid, Behavioral Health Outcomes, Blogosphere, Cancer Treatment & Success, Health Literacy, Health Policy, Healthcare Reform, Maternal and Child Health, Medicaid, Medicaid Expansion, Medical Research, Medicare, New American Electorate, Polls and pollsters, Public Health

Getting into Gear for 2014: Insights from Three States Leading the Way in Preparing for Outreach and Enrollment in the Affordable Care Act | The Henry J. Kaiser Family Foundation

Policy ThinkShop Resources to help you stay on top of today’s leading policy issues:  Healthcare Reform implementation — The Affordable Care Act

http://kaiserfamilyfoundation.files.wordpress.com/2013/09/8480-getting-into-gear-insights-from-three-states.pdf

 

“Fall 2013 will begin to usher in the key health insurance coverage expansions of the Affordable Care Act (ACA), with open enrollment in new health insurance Marketplaces beginning on October 1, 2013, and Medicaid expanding to adults in states moving forward with the ACA Medicaid expansion as of January 1, 2014. During summer 2013, with open enrollment rapidly approaching, many states were in high gear to finalize preparations for outreach and enrollment efforts to help translate these new coverage options into increased coverage for millions of currently uninsured individuals. This report provides insight into preparations in Maryland, Nevada, and Oregon -three states that have established a State-based Marketplace, are moving forward with the Medicaid expansion, and are among the states leading the way in preparing for outreach and enrollment. The findings provide an overview of where these three states are in establishing their Marketplaces; preparing for the Medicaid expansion; planning for marketing, outreach and enrollment; and establishing enrollment assistance resources. They also highlight the challenges that states have encountered and overcome, the successes they have achieved, and the key lessons that may help inform implementation efforts moving forward.”via Getting into Gear for 2014: Insights from Three States Leading the Way in Preparing for Outreach and Enrollment in the Affordable Care Act | The Henry J. Kaiser Family Foundation.

Filed under: ACA and Medicaid, Blogosphere, Children and Poverty, consumers, Health Literacy, Health Policy, Healthcare Reform, Maternal and Child Health, Medicaid, Medicaid Expansion, News, Public Health, Public Policy

A simple list to keep you on top of the current healthcare battle: A Very Quick Guide To Health Insurance Exchanges – Kaiser Health News

You are a leader…   Whether it is for your family, your organization or your company, you need to have a handle on healthcare reform.

The following is a quick guide you can use and share with others in your efforts to stay “intelligent” on the often confusing and misinformed healthcare debate vs. what the law now being implemented really is…

The Kaiser Foundation has some of the most current and accurate information available on this important subject.

Here is a quick guide to what you need to know about them:

1.

The insurance marketplaces are open to nearly everyone, but If you have insurance through work, Medicare or Medicaid, it’s likely you won’t need to shop for coverage there. They are really for people who are uninsured or folks who buy individual policies now.

2.

Many people will qualify for subsidies to make coverage more affordable there. These subsidies – tax credits to help pay your premiums – will be available to people with incomes up to 400 percent of the federal poverty level. That\’s about $46,000 for one person or $94,000 for a family of four. And there are cost-sharing subsidies to reduce deductibles and copayments, depending on your income.

3.

Immigrants who are in this country illegally are barred from buying on the exchanges.

4.

You can enroll until March 31, 2014, though you\’ll generally need to sign up by Dec. 15 of this year, to be covered as of Jan. 1. You can find your state’s marketplace at healthcare.gov.

5.

Through the marketplace, you can compare health plans in your area. The prices are based on where you live, your family size, the type of plan you select, your age and whether you smoke. All the plans have to comply with the Affordable Care Act’s requirement to have a basic benefits package, but the amount you have to pay in premiums, co-pays and deductibles will vary among plans.

6.

When you apply for coverage on the exchange, you will find out if you’re eligible for subsidies to help pay for premiums. Or, if you have a low income, you can also learn if you are eligible for Medicaid coverage.

7.

Your income — not your assets, such as your house, stocks or retirement accounts – will count toward determining whether you can get tax credits. When you buy your plan, you estimate your income for next year, and your tax credit is based on that estimate. The next year, your tax returns will be checked by the IRS and compared against your estimate.

8.

If you qualify for a tax credit to pay your premiums, you can choose to either have the credit sent directly to the insurer or pay the whole premium up front and claim the credit on your taxes. If you qualify for cost-sharing subsidies, that subsidy will be sent directly to the insurer, and you won’t have to pay as much out of pocket.

9.

If your income increases during the year, notify the exchange promptly so that you can avoid having to pay back the credits. On the other hand, if your income goes down, you could be eligible for a bigger subsidy. Either way it\’s important to notify the exchange if your income changes.

10.

Each plan covers 10 “essential health benefits,” which include prescription drugs, emergency and hospital care, doctor visits, maternity and mental health services, rehabilitation and lab services, among others. In addition, recommended preventive services, such as mammograms, must be covered without any out-of-pocket costs to you.

11.

You won’t have to pay more for insurance if you have a medical condition and that condition will be covered when your policy begins. But older people can be charged more than younger people and smokers could face a surcharge.

12.

The prices for the marketplace plans are likely to be similar to those sold privately. If your broker offers you a plan that is also available on the exchange, you may be eligible for subsidies.

13.

Your insurer generally can\’t drop you, as long as you keep up with your insurance premiums and don\’t lie on your application. Generally, people will be able to enroll in or change plans once a year during the annual open enrollment period. This first year, open enrollment on the exchanges will run for six months, from Oct. 1 through March of next year. But in subsequent years the time period will be shorter, running from October 15 to December 7.

14.

There are certain circumstances when you would be able to change plans or add or drop someone from coverage outside the regular annual enrollment period. This could happen if you lose your job, for example, or get married, divorced or have a child.

15.

The number of plans that you can choose from is likely to vary widely. In some states, only a couple of insurers have announced plans to offer policies though the marketplace, while in others there may be a dozen or more. Even within a state, there will be differences in the number of plans available in different areas. You can expect that insurers will offer a variety of types of plans, including familiar models like PPOs and HMOs.

via A Very Quick Guide To Health Insurance Exchanges – Kaiser Health News.

Filed under: Blogosphere, Health Literacy, Health Policy, Healthcare Reform, Maternal and Child Health, Medicaid, Medicaid Expansion, News, Public Health, Public Policy

How to reduce health inequities? | LinkedIn

One of our Policy ThinkShop bloggers posting on other social media regarding poverty policy, or the lack there of, in our country ….

Thanks for the report updating the latest ideas on our ongoing discourse on poverty and for getting us to think about the important connections between education, poverty and health.

The report rehashes, mostly academic, arguments regarding race, statistics, the infamous 1969 poverty measure and the poverty measure’s successive fabrications. I was in graduate school at the University of Chicago in the mid 80s when William J. Wilson led a “one man band” against the Reagan Administration’s and Charles Murray’s assault on “the welfare state, the welfare mother, and so on…”

I sat in Prof. Gary Orfield’s office one day while he fielded a call from the then Ronald Reagan stacked Civil Rights Commission which Prof. Orfield was a member of. It was a turning point for me in how I would henceforth see the role that well-meaning advocates play in our government’s institutions. After nearly four decades experiencing health and human services policy and planning in our nation’s state and local systems, that lesson still holds—facts are not enough, we must do. The problem becomes who is the “we”?

MOre via How to reduce health inequities? | LinkedIn.

Filed under: Blogosphere, Children and Poverty, Culture Think, Education Policy, Family Policy, Feminization of Poverty, Health Policy, Maternal and Child Health, Medicaid, Medicaid Expansion, News, Philanthropy

Texas Senate Approves Strict Abortion Measure – NYTimes.com

Are we really going to let the political barrens impoverish our political discourse yet again with another season of the “abortion debate”?

When a young women agonizes about being pregnant or we, as a society, have to deal with the horror of a baby not being born because the women carrying it chooses not to do so, must we take sides and make a spectacle out of that perinatal situation?  

Those weeks prior to a baby’s birth and the first few weeks of their lives are magical.  But we are not talking here about having a baby or planning to have one.  We are talking about, for whatever reason, an unwanted pregnancy.  To be sure, the abortion debate is more about a women’s choice whether to reach the perinatal period in the first place.  Being pregnant in the early stages is greatly defined by why you are pregnant.  It just is.

But abortion, like so many semantically charged issues, has become a political boogyman in our society that is pulled out in the battle of women’s liberation vs. the self proclaimed “moral majority”.  Imagine that–intelligent people on both sides let the boogyman out.  Today’s media circus allows the few to speak for the many.  In this way, an artificial discourse develops and is seen as real and scientific regarding public opinion.  Public media becomes public opinion.  

Abortion is a sad and horrible fact.  The use of the issue as political fodder is wrong.  The less sexy issue is the feminization of poverty, for example–how so many women are uneducated, disempowered and abused.  Abortion further demonizes these women and their circumstances.  Perhaps people of means who have internal demons are more comfortable with boogymen and as such summon them or at least willingly join the party.  That women get pregnant in circumstances that are not optimal for the commitment to the growth and birth of the fetus is a fact of life that is not likely to go away.  What we do about it as families, neighborhoods and communities to support women’s sexual health is the real issue.  Politicians rallying masses of voters will not help solve the central question. Women’s sexual health is often compromised and the outcome of child birth is too often a big problem.

Smart powerful women, or conservative ladies who have their husband’s power behind them, have the time and wherewithal to go on these intellectual and perhaps spiritual pony rides.  On the other hand you have the women who do not have the means.  Most of these anguishing women  and the fetuses which define their predicament are canon fodder in the “good fight”.  There are four kinds of people in this struggle.  There are the good people fighting the evil people.  There are the people who are considered the evil people by the good.  There are the people who are considered crazy by most bystanders who have to endure the charade.  It’s really difficult to tell who is who–it depends where one is standing.

Abortion has never been a problem for those who have the means to deal with it.  That is, to avoid it and have the baby put up for adoption as many did in before the 1970s when the choice became endorsed and supported–liberating young women seemingly everywhere.    Today, it is still being dealt with by those of means.  That is, conservative politicians looking to drum up support from the believing masses and women’s rights groups who have the wherewithal to define the fight, educate the soldiers, and speak in one voice for such a cacophony of human suffering and hope.   This sanguine struggle pales in comparison to any other civil rights issue because it is so private and at its center is not baby killing but a single women’s choice about her body, her psyche and perhaps her soul.  How many issues involve sex, blood, shame, hell and even death?  But poverty has seized to be the issue of the day and sexuality and babies make for better television.  Long gone are the poor welfare mothers who were the demons of yesterday for some and the soldiers in the minds of liberal causes.  Bill Clinton had his way with so many women, not to mention the million he kicked off of welfare with his Welfare Act.  At last, irony forces all of us to open our eyes and think.  Who is really the friend of these women in their darkest hour?

The truth may be that abortion has become an ideological scapegoat, a powerful political tool and a cattle call. Instead of really coming together and fixing the problems that divide us as a nation and impoverish us as communities, abortion as a maternal and child health perspective divides us, brings out the worst in many, and does not solve the ageless problem of child birth as a challenge that overcomes some.  But abortion is good politics because it gets folks riled up, to dig in their pockets and to pound the pavement for a cause.  Right or wrong–right or left…  It all depends where you stand…  It rarely depends on where the most disempowered young and scared women stand.  The choice is personal, spiritual and perhaps mostly economic.  It’s not about women’s liberation… It’s more about having the means–and in politics having the means means getting votes… Abortion moves people.

Here we go again.  The bread and butter issues were not good enough to rabble up the masses.  It is insane.  It is hardly believable and definitely more difficult to fully comprehend.  We are all getting riled up again about the “A” word.  Never mind that it mostly happens as a consequence of a very private act, without much public notice and with our most private parts.   No… that does not matter to the ideological gladiators right and left who have a ticket to ride because they perceive that their bodies are being controlled or that they must intervene in the most personal and spiritual moment of a women’s life–to help or to judge–to help her make a choice or to make communion with a political church that is pushing popular and political orthodoxy.

“The Texas Senate gave final passage on Friday to one of the strictest anti-abortion measures in the country, legislation championed by Gov. Rick Perry, who rallied the Republican-controlled Legislature late last month after a Democratic filibuster blocked the bill and intensified already passionate resistance by …”

via Texas Senate Approves Strict Abortion Measure – NYTimes.com.

Filed under: Abortion, Blogosphere, ethics, faith-based, Feminization of Poverty, Gender, Gender Policy, ideology, Maternal and Child Health, News, Parenting

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