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At least 343 records · Page 19Linked to original sources
PubMed1994

State healthcare reform: an arena for the osteopathic medical profession's influence.

While healthcare reform proposals are debated at the national level, states continue to propose and implement reform measures to address Medicaid, health insurance, universal coverage and access, medical liability, and cost-containment. The authors examine the shared responsibility of the federal and state governments for healthcare regulation and the surprising number of powers that reside with the states. They review the major barriers to state reform represented by restrictions within Medicaid and the Employee Retirement Income Security Act of 1974 (ERISA) legislation. Established state programs in Maryland, Hawaii, and Arizona are revisited, and innovative reforms in Oregon, Tennessee, and Washington are examined. Finally, the authors concentrate on the reform measures under way in the five most heavily DO-populated states, pointing out the potential for one of the big three (Michigan, Pennsylvania, and Ohio) to emerge as a model for the larger states. They urge osteopathic physicians to exert influence, based on their record of serving the Medicaid and other underserved populations, in state settings where they can be most effective.

Health Care Reform↗
PubMed1979

Impact of government regulations on two management and clinical information systems in a medical school environment.

Administrative and legal requirements and, in particular, federal and state government health care assistance and social services program regulations all combine to add complexity to the management and operation of ambulatory and inpatient health programs. This paper describes how constantly changing government regulations and differences in interpretations and definitiions have been expensive, time-consuming and sometimes detrimental to health care delivery for two large management and clinical computer-based information systems.

Computers↗
PubMed1994

Board members' influence on the government-nonprofit relationship.

This study examines whether, how, and under what conditions nonprofit boards of directors influence the government and voluntary sector relationship. The survey responses of executive directors and board presidents in a randomly selected sample of 400 nonprofit organizations indicate that boards are not bystanders in the contracting relationship with government. Rather, many boards play multiple roles, simultaneously enhancing interdependence and maintaining the boundary between state government and nonprofits.

Data Collection↗
PubMed2000

Participant-predicted, observed, and calculated peak blood alcohol levels: a gender-specific analysis.

In recent years there has been a push by federal and state governments to lower the maximum blood alcohol level at which drivers are considered intoxicated. Many states have lowered the maximum blood alcohol level to .08%. This paper offers insight into drinkers' ability to predict their level of impairment prior to consuming a given amount of alcohol. It addresses the problem of drinkers not knowing how many drinks they can consume before becoming legally impaired. Results indicate males and females differ in their ability to predict impairment levels.

Accidents, Traffic↗
PubMed2006

Status of iodine nutriture and universal salt iodisation at beneficiaries levels in Kerala State, India.

Iodine deficiency disorders are an important public health problem in India. It is wrongly believed that populations residing in coastal areas do not suffer from iodine deficiency as they consume sea foods which are rich in iodine. A high prevalence of iodine deficiency has been reported in 11 districts of Kerala ranging between 9.3 and 44.5%. In spite of the high prevalence of iodine deficiency, the state government of Kerala has not banned the sale of non-iodised salt in the state. Thus, the present study was conducted to assess the current status of iodine nutriture and level of salt iodisation in Kerala state. The study was conducted in all the 14 districts in the state by utilising the uniform sampling methodology. A total of 2110 salt samples were collected randomly from children. On the spot casual urine samples were collected from 689 children. The results revealed that overall 43.8% of the families in the state were consuming salt with 15ppm and more of iodine. It was found that three districts namely Kasargod, Idukki and Kottayam had median urinary iodine excretion level < 100.0 microg/l and also more than 20% of the samples had urinary iodine excretion levels less than 50 microg/l. The findings of the present study revealed continued iodine deficiency amongst the three districts identified as endemic earlier. This indicates the need of immediate ban on the sale of non-iodised salt for the edible purposes and intensive information, education and communication activities for promotion of consumption of iodised salt.

Child↗
PubMedDate not supplied

MADD rates the states: a media advocacy event to advance the agenda against alcohol-impaired driving.

The "Rating the States" (RTS) Program of Mothers Against Drunk Driving (MADD) is designed to bring public attention to the status of State government efforts to combat alcohol-impaired driving. MADD's 1993 report, which evaluated each State with a grade from A to D, brought renewed visibility to MADD's fight for new prevention policies and helped to advance key State legislation. Because of MADD's national press conference and other media activities, more than 60 million Americans saw or heard a news story related to the program. This article outlines the program's objectives and methodology, efforts to publicize the results, and what was achieved in terms of news media coverage and in advancing public policy change. The RTS Program is a proven media advocacy strategy for prompting State legislatures and Governors to enact new policies. The article concludes with guidelines for other public health advocacy groups that may want to emulate this strategy.

Accidents, Traffic↗
PubMed2004

Psychosocial investigation of individual and community responses to the experience of Ovine Johne's Disease in rural Victoria.

OBJECTIVE: This paper explores the psychosocial outcomes for individuals and communities in rural Victoria who experienced the outbreak of Ovine Johne's Disease (OJD). DESIGN: The study uses a qualitative methodology to analyse the minutes of evidence provided by the inquiry into the control of OJD to identify the psychosocial events, experiences and outcomes associated with the control of this outbreak. The inquiry was undertaken by the Environment and Natural Resources Committee of the Victorian State Government. SETTING: Public hearings were undertaken by the committee across several rural Victorian communities and the state capital, Melbourne. SUBJECTS: The transcripts detail 136 submissions from 98 individuals and 23 organisations. OUTCOME MEASURES: The analysis aimed to provide insight into the impact of the disease on individuals and communities and also to explore the factors individuals perceived as associated with these outcomes. RESULTS: While the paper identifies that aspects of stock loss associated with the outbreak caused substantial emotional and economic distress, for farmers the most significant finding was the impact of the government control program on individuals, families and rural communities. The control program was perceived as having very limited scientific credibility and its implementation was described as heartless, inflexible and authoritarian. Involvement with the program resulted in farmers reporting emotions, such as, trauma, shame, guilt and stigma. Families became discordant and the sense of community within rural townships fragmented. Psychological outcomes of grief, depression and anxiety emerged as prevalent themes within families and communities. CONCLUSIONS: These data highlight the need for significant attention to the management of rural disasters, such as, the OJD program. WHAT THIS PAPER ADDS: There is an acknowledgement in the literature that rural disasters have a significant impact on the well-being of individuals, families and communities. The major focus of the previous research has, however, been on the impact of economic losses with less recognition of the other psychosocial loss experiences that accompany the experience of rural disaster. This paper achieves a clear description of the experiences for individuals (trauma, stigma, sense of personal failure, loss of identity, diminished self esteem and family disruption) and communities (destroyed social cohesion, economic disharmony) caught up in the OJD disaster and explores the factors that individuals perceive as responsible for these outcomes. The mental health outcomes for individuals, such as, loss, grief and depression are also explored within this paper. This paper highlights the psychosocial complexity of the experience of rural disaster for individuals and communities significantly extending the current knowledge base in this area.

Anecdotes as Topic↗
PubMed1995

Position on allied health professions education and funding.

ASAHP recommends that the federal government should, as the largest consumer of health care, play a central role in partnership with state governments and private institutions in reducing shortages of allied health personnel. Furthermore, ASAHP believes that this role should encompass attracting students (particularly from minority and underserved portions of the population) both to academic allied health programs through the provision of entry-level traineeships and advanced programs which prepare allied health professionals for careers as educators and researchers. No federal programs were authorized specifically to support allied health education during the period from 1981 to 1989. PL 100-607, the Health Professions Reauthorization Act of 1988, authorized $6 million ($2 million in each of three categories), but only $737,000 was appropriated in FY 1990 for Allied Health Grants and Contracts. The Bureau of Health Professions subsequently received 122 proposals in February 1990, representing more than $10,000,000 in requests for this limited amount. Since then, the Bureau has received an average of 100 proposals for each annual funding cycle. In addition to providing continuation grants for existing projects, the Bureau is currently able to award an average of 10 new grants each year. The $3,935,000 appropriated for FY 1995 will be used to fund perhaps another 12 to 15 initiatives. ASAHP believes that substantially more financial assistance is required than what is currently being appropriated. Furthermore, the most suitable venue for the federal government to affect reductions in the shortage of allied health professionals is through the advanced training portion of the Section 766 Program, which remains unfunded.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1976

Towards improving the administrative machinery for health care in the Midwestern State of Nigeria.

The paper discusses the present machinery for the administration of health care facilities in the Midwestern State of Nigeria and makes suggestions for improvement. The multiplicity of autonomous authorities involved in the running of health care facilities and the compartmentalization of health care into 'preventive' aspects (managed by the State Ministry of Health and Local Authorities) and 'curative' aspects (managed by the State Hospitals Management Board) are seen as the main disadvantages of the present system. A new administrative set-up is suggested, the highlights of which include the creation of a number of Area Health Boards that will have responsibility for all State Government and Local Authority health care facilities in their respective geographically defined areas of jurisdiction (this will abolish the artificial division between the administrations of 'preventive' and 'curative' aspects of health care), more professional divisions in the state Ministry of Health (which will retain responsibility on behalf of government for policy matters and the provision of health care facilities) than at the moment, a State Health Service Commission and A State Health Advisory Committee. It is important for doctors and other personnel in the health care field to know something about the administrative machinery of the health care delivery system in which they work. Apart from doctors who are trained in certain postgraduate fields, most other doctors do not appear to have any formal training in or early exposure to medical administration and yet, some of them get called upon during their career to undertake administrative duties at a very high level. This paper describes the present system of administration of health care facilities in the Midwestern State and offers suggestions for consideration for improvement. It is a well known fact that the administration of health care facilities in the Midwestern State has improved considerably in recent years. The suggestions in this paper are offered in the belief that they will stimulate discussion and eventually contribute towards further improving the administrative machinery for health care delivery in the State. The geographical entity now known as the Midwestern State was earlier known as the Midwest Region from 1963 until 1967 when it became the Midwestern State. It occupies an area of about 15,000 sq. miles, has a population of nearly three million people and is divided into fourteen administrative divisions.

Delivery of Health Care↗
PubMed2003

Renewing governance.

Globalization's profound influence on social and political institutions need not be negative. Critics of globalization have often referred to the "Impossible Trinity" because decision-making must 1. respect national sovereignty, 2. develop and implement firm regulation, and 3. allow capital markets to be as free as possible. To many, such goals are mutually exclusive because history conditions us to view policy-making and governance in traditional molds. Thus, transnational governance merely appears impossible because current forms of governance were not designed to provide it. The world needs new tools for governing, and its citizens must seize the opportunity to help develop them. The rise of a global society requires a greater level of generality and inclusion than is found in most policy bodies today. Politicians need to re-examine key assumptions about government. States must develop ways to discharge their regulatory responsibilities across borders and collaborate with neighboring jurisdictions, multilateral bodies, and business. Concepts such as multilateralism and tripartism show great promise. Governments must engage civil society in the spirit of shared responsibility and democratic decision-making. Such changes will result in a renewal of the state's purpose and better use of international resources and expertise in governance.

Journal Article↗
PubMed1992

Fiscal impacts of immigration to the United States.

"The purpose of this paper is to fill a gap in the demographic literature by reviewing previous fiscal studies of immigration in the United States. Each study is introduced by describing the data it uses, the methodologies employed in calculating costs and revenues, and the resulting estimates of fiscal consequences. Evaluative comments are also stressed. Seventeen studies are included in this review, divided into those that emphasize national fiscal impacts (these studies aggregate the effects of immigrants across all levels of government), state fiscal impacts, and fiscal effects on local governments."

Americas↗
PubMed1978

Management and programmatic constraints on community mental health services.

While the special needs of the mentally ill are discussed in detail by society in general and by federal and state governments in particular, it is the local mental health services that must develop, integrate, and manage resources from federal and state levels and must deal with the constraints and strings attached to those resources. The author divides the constraints into several categories--clinical, administrative, fiscal, and legal--and offers suggestions for dealing with them, drawing in several cases on examples from the state of California. He feels that the control of mental health services must be kept in the hands of those who are knowledgeable about and have an investment in the delivery of those services.

California↗
PubMed1992

State initiatives in addressing youth suicide: evidence for their effectiveness.

An examination of the period from 1980 to 1987 revealed that state government initiatives were, in general, associated with a beneficial effect on teenage suicide rates in the states of America. Student participation in school-based suicide prevention programs, however, was associated with a detrimental effect on state teenage suicide rates. The implications of these results were discussed.

Adolescent↗
PubMed1980

Financial-ratio analysis and medical school management.

The value of a uniform program of financial assistance to medical education and research is questioned. Medical schools have an uneven ability to compensate for declining federal capitation and research grants. Financial-ratio analysis and cluster analysis are utilized to suggest four adaptive responses to future financial pressures. The four potential avenues of response involve reducing faculty size, expanding faculty involvement in medical practice plans, raising tuition, and in some cases increasing state-government support. Medical schools will also have to strive for better financial management if the 88 institutions revealed to be in poor financial health are to survive.

Education, Medical↗
PubMed1998

Steps to changing state public health structures.

Current interest in controlling costs of health care and improving systems of health services leads state governments to consider reorganizing units of government responsible for health. Based on a case study of the 1989 establishment of the Washington State Department of Health, concepts from political science and organizational theory are linked into a process model useful in planning and supporting reorganization of executive branch agencies. With the model in mind, public health professionals can work more effectively to ensure that the paradigm on which a reorganization is based fits desired public health goals, and can make lobbying more effective.

Health Policy↗