Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “State Government”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed1997

How do states buy health insurance for their own employees?

State governments play many roles in local health insurance markets. This paper focuses on the role of states as employers. As managed care and health care costs continue to grow, state governments engage in a variety of health insurance purchasing practices that influence the structure of health benefits offered to state employees. Descriptive analysis shows that many states have adopted managed competition to some degree, as well as traditional cost-reducing measures such as utilization review and self insurance. The experience of state governments can provide a benchmark for other public and private employers.

Cost Control↗
PubMedDate not supplied

Public funding for contraceptive, sterilization and abortion services, fiscal year 1992.

In 1992, the federal and state governments spent $645 million to provide contraceptive services. According to the results of a survey of health, social service and Medicaid agencies conducted by The Alan Guttmacher Institute, Medicaid accounted for 50% of all public spending on family planning services. State governments, which spent a total of $155 million of their own revenues for contraceptives services, accounted for 24% of public funding, Title X for 17%, and the social services and maternal and child health block-grant programs for nearly 10%. Medicaid expenditures for contraceptive services increased dramatically between 1990 and 1992, and were responsible for a 28% rise in total expenditures for contraceptive services during that period. However, when inflation is taken into account, total public expenditures for contraceptive services have decreased by 27% since 1980, and Medicaid has replaced Title X as the primary source of funding for such services. The federal and state governments together spent $138 million to subsidize sterilization services in 1992, an increase of 46% from 1990. The federal and state governments also spent $80 million to provide 202,622 abortions to poor women; less than 1% was contributed by the federal government. These estimates of expenditures are approximations that, because of methodologic problems and changes over time, may overstate public expenditures for contraceptive services.

Abortion, Legal↗
PubMedDate not supplied

Public funding of family planning, sterilization and abortion services, 1987.

In FY 1987, the federal and state governments spent +386 million to provide family planning services. Medicaid was the leading source of public funding, accounting for 36 percent of all public monies spent on family planning. Title X of the Public Health Service Act provided 34 percent of total public funds, and two block-grant programs--Social Services and Maternal and Child Health--together were responsible for 17 percent of public support in this area. State governments, which spent a total of +50 million of their own revenues for family planning services, accounted for the remaining 13 percent of public funding. The federal and state governments together spent +65 million to subsidize contraceptive sterilization services in FY 1987. The federal government provided 97 percent of the funding, 88 percent through the Medicaid program. In addition, the federal and state governments spent +64 million to provide 189,000 abortions to poor women; less than one percent of these funds were contributed by the federal government. These data come from a survey of state health, welfare and Medicaid agencies carried out by The Alan Guttmacher Institute and should be viewed as approximations rather than as precise figures.

Abortion, Legal↗
PubMed1997

The effect of the proposed national data protection regime on the health sector in Australia.

The Commonwealth Government and a number of State governments are proposing to introduce legislation based on the Information Privacy Principles contained in the Privacy Act 1988 (Cwlth). This will allow individuals access to any personal information held on them by an organisation or person, including private practitioners, private health facilities and State government agencies. This article discusses this proposed legislation and its implications for the health sector. Although in the public health area patients can already gain access to their medical records through the use of the various Freedom of Information Acts and, in the case of Commonwealth government agencies, the Privacy Act 1988 (Cwlth), the proposed data protection legislation will provide more than access rights to individuals. The effect of the proposed legislation on the private sector, where no obligation exists on the part of the doctor to grant a patient access to his or her records, will be substantial.

Australia↗
PubMed2003

Transforming the delivery of rural health care in Georgia: state partnership strategy for developing rural health networks.

Since 1996, 19 networks covering 74 of the 117 rural counties in Georgia have emerged. This grassroots transformation of rural health care occurred through a series of partnerships launched by state government officials. These partnerships brought together national and state organizations to pool resources for investment in an evolving long-term strategy to develop rural health care networks. The strategy leveraged resources from partners, resulting in greater impact. Change was triggered and accelerated using an intensive, flexible technical assistance effort amplified by developmental grants to communities. These grants were made available for structural and organizational change in the community that would eventually lead to improved access and health status. Georgia's strategy for developing rural health networks consisted of 3 elements: a clear state vision and mission; investment partnerships; and proactive, flexible technical assistance. Retrospectively, it seems that the transformation occurred as a result of 5 phases of investment by state government and its partners. The first 2 phases involved data gathering as well as the provision of technical assistance to individual communities. The next 3 phases moved network development to a larger scale by working with multiple counties to create regional networks. The 5 phases represent increasing knowledge about and commitment to the vision of access to care and improved health status for rural populations.

Community Health Planning↗
PubMed1995

State involvement in medical technology assessment.

State governments are reevaluating their role in the assessment of medical technologies. This paper outlines a range of state technology assessment activities, highlighting programs in Minnesota, Oregon, and Washington, and discusses the issues associated with state government involvement. Clinically oriented activities on the state level can inform efforts to contain costs, educate consumers and providers, and facilitate local consensus on the appropriate uses of new and existing technologies. Although current programs are still in their infancy and their viability remains uncertain, the importance of technology assessment is growing as technology continues to fuel increasing costs. The future of state-level technology assessment may lie in collaborative ventures with other states, the federal government, or private industry.

State Government↗
PubMedDate not supplied

Public funding of contraceptive, sterilization and abortion services, 1982.

The federal government and the states spent $328 million to support the provision of contraceptive services in fiscal 1982, 13 percent less than they had spent the previous year. Federal funds for family planning services came from Title X of the Public Health Service Act, Title XIX of the Social Security Act (Medicaid), and the Maternal and Child Health (MCH) and Social Services block grants, which are administered by the states. Title X continued to provide the largest, although a diminishing, share of public funds for contraceptive services--36 percent of all such funds in 1982. (In 1980, Title X had accounted for 44 percent of public funding.) Medicaid expenditures for family planning totaled $94 million; $17 million was spent under the MCH block grant, and $46 million under the Social Services block grant. State governments contributed an additional $53 million, about the same figure reported for the previous year, indicating that the states did not use their own funds to soften the impact of cuts in federal expenditures for contraceptive services in 1982. The federal government and the states spent an estimated $55 million, almost all of it through Medicaid, to provide sterilization services for poor women. The states spent $67 million and the federal government spent $1 million to provide abortions for 210,000 indigent women. These figures come from the 11th annual survey of state health and welfare agencies and state Medicaid programs by The Alan Guttmacher Institute (AGI). The AGI conducted this survey in January 1983 to determine the levels and sources of public funding for contraceptive, sterilization and abortion services in each state during FY 1982.

Abortion, Legal↗
PubMedDate not supplied

Public funding of contraceptive, sterilization and abortion services, 1983.

In 1983, the federal and state governments spent +340 million to provide contraceptive services--four percent more than they spent during the previous year. Title X of the Public Health Service Act, still the leading source of funding, accounted for +117 million, or 34 percent of all public expenditures. Almost as important was the +108 million (32 percent of total expenditures) provided through Title XIX of the Social Security Act (Medicaid). Two block-grant programs--Social Services and Maternal and Child Health--provided +38 million and +19 million, respectively; together, the two were responsible for 17 percent of public support for contraceptive services. State governments, which spent +58 million of their own revenues, provided an additional 17 percent of funding. Some public expenditures for contraceptive services were made in all the states. Nearly all of the four percent increase in total public funds between 1982 and 1983 was due to a 15 percent rise in Medicaid reimbursements. The federal and state governments together spent +69 million to provide about 73,000 sterilizations in 1983. Ninety percent of sterilization expenditures were made by the federal government--86 percent through the Medicaid program. In addition, the states and the federal government spent +71 million to provide 216,000 abortions in 1983. Unlike public funding for either contraceptive services or sterilization, almost all of the funding for abortion came from the states rather than from the federal government.

Abortion, Legal↗
PubMedDate not supplied

Public funding of contraceptive, sterilization and abortion services, 1985.

In FY 1985, the federal and state governments spent $398 million to provide contraceptive services and supplies. The two leading sources of funding were the Medicaid program and Title X of the Public Health Service Act. The former accounted for $137 million, or 34 percent of all public expenditures; and the latter program accounted for $133 million, also 34 percent. Two blockgrant programs--Social Services and Maternal and child Health--provided $40 million and $23 million, respectively; together, they were responsible for 16 percent of public support for contraceptive services. State governments, which spent $64 million of their own revenues, accounted for another 16 percent of funding. The federal and state governments together spent $64 million to subsidize sterilizations in FY 1985. The federal government provided 94 percent of the funding--84 percent through the Medicaid program. In addition, the states and the federal government spent $66 million to subsidize 188,000 abortions; in this case, however, the federal government contributed less than one percent of the funds used. These data come from a survey of state agencies, and should be viewed as approximations rather than as precise figures.

Abortion, Induced↗
PubMedDate not supplied

State agency policy and program coordination in response to the co-occurrence of HIV, chemical dependency, and mental illness.

UNLABELLED: The co-occurrence of HIV infection, chemical dependency, and mental illness challenges federal and state governments to develop flexible and coordinated health policy and financing for public health services. State agencies play a critical role in the organization and support of these services at the local level. With emerging stress upon state government budgets and concomitant increasing need for publicly funded services, state agency coordination may be an important policy safety net to assure services for populations at the margins of health systems. Despite this important potential role, nothing is known about the degree to which state HIV, substance abuse, and mental health agencies coordinate policies and/or programs in response to these co-morbid conditions. OBJECTIVE: This study sought to establish a conservative and initial understanding of state HIV, substance abuse, and mental health agency coordination of policy and program in response to the co-occurrence of HIV, chemical dependency, and mental illness. METHOD: Estimation of coordination was accomplished through the comparison of three surveys conducted among state substance abuse directors (1998), state AIDS directors (1999), and state mental health directors (2000). Data from 38 states were reviewed. RESULTS: The most frequently reported state agency activities included coordinating funding, engaging in integrative planning activities, and conducting staff cross-training. When compared for association with state characteristics, coordination among state agencies was found to be associated with Early Intervention Services (EIS) designation, higher rates of AIDS generally, higher rates of AIDS among African Americans, and higher rates of AIDS among Hispanic populations. Given the limitations of comparing three disparate surveys, we determined the estimate of interagency coordination to be conservative and preliminary. CONCLUSION: While this study was useful as an initial step toward identifying state interagency policy and program coordination in response to the co-occurrence of HIV, chemical dependency, and mental illness, there were methodological challenges that should be addressed in future studies of state agency coordination. Several recommendations were advanced.

Administrative Personnel↗
PubMed1990

Expenditures and sources of funds for mental health organizations: United States and each state, 1986.

EXPENDITURES: Expenditures by the 8 types of mental health organizations covered in this report totaled $18.5 billion in 1986, for the United States and the Territories. Three States (California, New York, and Pennsylvania) accounted for one-third of this total. Nationally, the largest proportion of total expenditures were the expenses of State and county mental hospitals (34 percent, down from 38 percent in 1983) and those of multiservice mental health organizations (20 percent). In all but 19 States, State and county mental hospitals (hereafter called State mental hospitals) had the largest expenditures of any type of mental health organization; in 10 of the remaining 19 states, expenditures of multiservice mental health organizations were largest. Nationally, separate psychiatric services of non-Federal general hospitals, private psychiatric hospitals, and VA psychiatric organizations ranked next, with 16, 14, and 7 percent of total mental health expenditures, respectively. At the other extreme, residential treatment centers (RTCs) for emotionally disturbed children, freestanding psychiatric outpatient clinics, and freestanding psychiatric partial care organizations accounted for 5 percent, 3 percent, and less than 1 percent of national total expenditures, respectively. The $18.5 billion expenditure in 1986 was a 28 percent increase over the 1983 figure, but when adjusted for inflation, the estimated increase was only 5 percent overall and 3 percent on a per capita basis. Constant dollar expenditures (1983 = 100) of most types of mental health organizations increased between 1983 and 1986, but those of freestanding psychiatric outpatient clinics were virtually unchanged, and those of State mental hospitals and VA psychiatric organizations actually decreased. SOURCES OF FUNDS: In 1986, the funds received by mental health organizations totaled $19.0 billion. Of this total, $7.9 billion (41 percent) was provided directly by State governments, predominantly by the State mental health agencies. Direct Federal funds plus Medicare and Medicaid (including the State and local share of Medicaid) provided $4.8 billion, or one-fourth, of total funding. Fees from clients (including private insurance) provided $4 billion, or 21 percent, of total funding; direct local government funds provided 8 percent and all other sources 5 percent. State governments provided 78 percent of the funds received by State mental hospitals and were also the largest single source of funds, although not so dominant, for multiservice mental health organizations, freestanding psychiatric partial care organizations, and freestanding psychiatric outpatient clinics. VA medical centers were funded by the Federal Government, while two-thirds of funding for private psychiatric hospitals came from client fees...

Costs and Cost Analysis↗
PubMed1994

Change of government and health services policy in Victoria, 1992-93 [see comment].

Although constrained by Federal financial dominance, State governments can, nevertheless, significantly shape a number of aspects of health policy within their own jurisdiction. New governments often seek to implement both substantive and symbolic policy changes. This is often also accompanied by alterations to organisational structures and personnel with a view to making implementation more effective. This article chronicles the continuities and changes in health services policy in the first year of the Liberal-National Coalition State Government in Victoria. These include institutional changes, key ministerial and bureaucratic appointments, health workforce issues, health services funding decisions, public and community health, and relations with the Federal Government. The decision-making style of the new government is also discussed. The authors regard the economic imperatives of Victoria's severe deficit as the dominant influence in all areas of public policy, including health services policy, although certain ideological predilections have also been evident. They further argue that the new government has primarily sought legitimacy by appealing to what it regards as its mandate to rectify Victoria's 'economic crisis' by reducing public expenditure and reforming managerial practices in the public sector.

Community Health Planning↗
PubMed2004

State, heal thy physicians: an assessment of the Louisiana Natural Death Act.

In our society, state governments have the major role in regulating physician behavior and actions related to end-of-life decision making. However, in the current confusing and conflicted legal environment, how well are state governments doing with this serious responsibility? The authors of this article report the results of the first statewide survey of Louisiana physicians regarding their knowledge of and compliance with specific parts of one state government's attempt to regulate end-of-life decision making: the Louisiana Natural Death Act (LNDA). Physician respondents were asked to indicate their level of familiarity with the LNDA and several questions examined physician compliance with specific sections contained in the statute. Among many things, the survey revealed most physicians (74%) were not familiar with even the basic provisions of the LNDA, and had not received either medical school or subsequent post graduate training in this area. Based on the results of this survey, the authors offer several policy recommendations that could enhance physician knowledge and subsequent compliance with the LNDA.

Adult↗
PubMed1975

State regulation of health care costs.

State regulation of health care costs has been increasing at the same time as criticism of governmental regulation in other sectors of the economy has been increasing. The authors examine major system elements necessary to effect cost control in health care, present normative models of value preferences which underlie alternative state cost control systems, and indicate control foci and intervention strategies for state government under the alternative models. The authors conclude that state governments should assume responsibility for controlling health care costs. Presently, state regulatory agencies should emphasize development of adequate information systems, strengthening of state regulatory capability, and implementation of experimental reimbursement programs rather than comprehensive and detailed rate setting.

Fees and Charges↗
PubMed1987

Chemical factors governing the state of saturation towards brushite and whewellite in urine of calcium stone formers.

Variations of urinary pH and concentrations of calcium, phosphate, oxalate, magnesium and citrate have been produced by 4 different diets given to 19 idiopathic calcium stone formers. The state of saturation towards whewellite and brushite was directly measured in the 76 urine samples by equilibration with the corresponding salts and was compared to chemical constituents by regression analyses. The state of saturation towards calcium oxalate monohydrate was significantly governed only by the urinary oxalate concentration, and a soluble oxalate fraction not contributing to calcium oxalate chelation was demonstrated. The state of saturation towards brushite was exclusively determined by urinary calcium and pH, the latter below 5.5 showing a high influence on brushite solubility.

Adolescent↗