Subject: Studies in the News 03-15 (March 19, 2003)


CALIFORNIA RESEARCH BUREAU
CALIFORNIA STATE LIBRARY
Studies in the News
Health Care Supplement


Contents This Week

Introductory Material HEALTH
   Aging and health care
   Skin cancer prevention and control
   Cancer prevention and early detection
   IQ scores increase over time for premature babies
   Health care costs
   Dental care and Medi-Cal
   Youth illicit drug use prevention
   Children and guns
   Genetic structure of human populations
   Healthy development of young children
   American health care system crisis
   Retention of health insurance for low-income families
   Retiree health benefits
   Emerging issues in Hispanic health
   Immigrant access to health benefits
   Uninsured and their access to health care
    In-home care services
   Medical malpractice insurance
   Health plan expenditures
    Managed care costs, accountability and quality
   Physicians serving Medicaid patients and the uninsured
   The decline in Medicaid enrollment and information systems
   Slowing expansion of Medicaid
   Proposed Medicaid Block-grants.
   Medicaid expenditures
   Building administrative capacity for CHIP and Medicaid
   Medicaid cuts
   Building a better chronic care system
   Medicare spending and level of care
   Medicare beneficiaries and healthcare
   Children's mental health services
   Mortality rates for influenza
   Nurses aid training
   Options for prenatal care
   Prescription drug benefit service contracts
   Prescription drug pricing
PREVIOUSLY IN STUDIES IN THE NEWS
   Studies in the News, February 26, 2003
   Studies in the News, March 7, 2003
   Studies in the News, February 3, 2003
   Studies in the News, January 24, 2003
   Studies in the News, January 10, 2003
Introduction to Studies in the News

Studies in the News is a very current compilation of items significant to the Legislature and Governor's Office. It is created weekly by the State Library's Research Bureau to supplement the public policy debate in California’s Capitol. To help share the latest information with state policymakers, these reading lists are now being made accessible through the State Library’s website. This week's list of current articles in various public policy areas is presented below.

Service to State Employees:

  • When available, the URL for the full text of each item is provided.

  • Items in the State Library collection can be checked out to state officials and staff.

  • Access to all materials listed will be provided by the State Information Reference Center, either by e-mail to cslsirc@library.ca.gov or by calling 654-0261.

The following studies are currently on hand:

HEALTH

AGING

The State of Aging and Health in America. By the Merck Institute of Aging and Health and The Gerontological Society of America. (The Society, Washington, DC) 2002. 20 p.

Full Text at: www.agingsociety.org/State%20of%20Aging%20Report.pdf

["The first section of the report presents data that illustrate changes that have taken place during the last two decades.... The second and third sections present the national and state-by-state report card on healthy aging....The fourth section presents challenges in treating mental illness among the elderly.... The fifth section focuses on the growing gap between older American's health care needs and the knowledge of health professionals who care for them."]

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CANCER

Skin Cancer Prevention and Control. By Stephanie Wasserman, National Conference of State Legislatures. Legisbrief. Vol. 11, No. 9. (NCSL, Denver, Colorado) February 2003. 2 p.

["Skin cancer is the most common form of cancer in the United States. Melanoma is the deadliest form of skin cancer. Increasing awareness about skin cancer has led to laws and policies directed at prevention and control. California has passed several laws addressing skin cancer control."]

[Request #S7545]

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Fulfilling the Potential of Cancer Prevention and Early Detection. By Susan J. Curry and others, National Cancer Policy Board, National Research Council. Executive Summary. (National Academies Press, Washington, DC) 2003. 11 p.

Full Text at: www.nap.edu/catalog/10263.html

["The nation needs new strategies to prevent cancer and, when cancer occurs, to catch it at its earliest stages.... In this report, the Board reviews the evidence that cancer incidence rates can be dramatically reduced and outlines a national strategy to realize the promise of cancer prevention and early detection."]

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CHILDREN

“Change in Cognitive Function Over Time in Very Low-Birth-Weight Infants.” By Laura R. Ment and others. IN: JAMA: Journal of Medical Association, vol. 289 no. 6 (February 12, 2003) pp. 705-711.

[“Very small premature babies born with brain damage are not necessarily doomed to below-normal intelligence after all, according to surprising new study that found that many youngsters’ IQ scores improve over time…. The study found that many youngsters considered borderline retarded make up for lost ground and end up scoring in the nearly normal IQ range by age 8.” Sacramento Bee (February 12, 2003) A14.]

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COST-BENEFIT ANALYSIS

Health Care Costs 101. By the California HealthCare Foundation. (The Foundation, Oakland, California) 2002. 31 p.

Full Text at: www.chcf.org/documents/other/HealthcareCostData.pdf

["Nationally, spending on health care now makes up more than 13 percent of the gross domestic product and is projected to rise rapidly in upcoming years. With health care issues high on the state and national agenda, this report provides a visual analysis of costs and financing trends over the past decade and some predictions of future costs."]

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DENTAL CARE

Denti-Cal Denied: Consumers' Experiences Accessing Dental Services in California's Medi-Cal Program. By Health Consumer Alliance with the Health Rights Hotline. (The Alliance, Los Angeles, California) December 2002. 31 p.

Full Text at: www.healthconsumer.org/DentiCalRpt.pdf

["The study … examined complaints about access to dental care and recommended that the state provide clearer guidelines on covered benefits; improve its treatment authorization review process; and make it easier for dentists and patients to resubmit requests for care or appeal denials. The study examined 466 dental service complaints made to two consumer groups between January 1, 2000 and December 31, 2001.” Sacramento Bee (January 27, 2003) D1.]

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DRUG EDUCATION

Youth Illicit Drug Use Prevention: DARE Long-Term Evaluations and Federal Efforts to Identify Effective Programs. By the U.S. General Accounting Office. GAO-03-172R. (The Office, Washington, DC) January 15, 2003. 20 p.

Full Text at: www.gao.gov/new.items/d03172r.pdf

[“The use of illicit drugs, particularly marijuana, is a problem among our nation’s youth. The adverse effects of illicit drug use play a role in school failure, violence, and antisocial and self-destructive behavior. A recent national survey showed that for 1996 through 2002, more than 30 percent of tenth and twelfth grade students reported using marijuana in the past year."]

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FIREARM INJURIES

"'They're Too Smart for That': Predicting What Children Would Do in the Presence of Guns." By Susan M. Connor and Kathryn L. Wesolowski. IN: Pediatrics, vol. 111, no. 2, (February 2003) pp. e109-e114.

["Results indicate that parental beliefs may effectively relieve adults of responsibility and place the burden on children to protect themselves. The implication for injury prevention is that caregivers’ unrealistic expectations of children’s developmental levels and impulse control may influence storage decisions or the inclination to address gun safety issues with children or other adults with whom children spend time." Connect for Kids(February 10, 2003)]

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GENETICS

"Genetic Structure of Human Populations." By Noah A. Rosenberg and others. IN: New England Journal of Medicine, vol. 298, no. 5602 (December 20, 2002) pp. 2381-2385.

["People the world over are almost identical, yet still so different genetically that they can be easily sorted into five major groups based on ancestry, new research shows. In the largest study of human genetic variation, the international research team separated people by the major migrations of ancient humankind, from Africa into Eurasia, East Asia, Oceania and the Americas, in a way that overturns conventional notions of race." Sacramento Bee (December 20, 2002) A15.]

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HEALTH CARE

Partnering with Parents to Promote the Healthy Development of Young Children Enrolled in Medicaid; Results From a Survey Assessing the Quality of Preventive and Developmental Services for Young Children Enrolled in Medicaid in Three States. By Christina Bethell and others, Commonwealth Fund. (The Fund, New York, New York) 2002. 54 p.

Full Text at: www.cmwf.org/programs/child/bethell_partnering_570.pdf

["This report summarizes findings from the Foundation for Accountability's Promoting Healthy Development Survey, a survey of parents of children under age 4 who were covered by Medicaid.... One of 10 children did not get needed care or got delayed care."]

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Fostering Rapid Advances in Health Care: Learning from System Demonstrations. By Janet M. Corrigan and others. (National Academies Press, Washington, DC) 2002. 108 p.

Full Text at: www.nap.edu/catalog/10565.html?onpi_topnews_111902

["The American health care system is confronting a crisis, states the report.... The health care delivery system is incapable of meeting the present let alone the future needs of the American public.... The Bush administration should immediately test possible solutions including universal insurance coverage and no-fault payment for medical malpractice, in a handful of states."]

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HEALTH INSURANCE

Staying Covered: The Importance of Retaining Health Insurance For Low Income Families. By Leighton Ku and Donna Cohen Ross, Center on Budget and Policy Priorities. Prepared for the Commonwealth Fund. (The Fund, New York, New York) December 2002. 48 p.

Full Text at: www.cmwf.org/programs/insurance/ku_stayingcovered_586.pdf

["Expanded efforts to help people maintain health insurance could substantially reduce the number of uninsured people, according to this study. If every person who began the year with insurance retained coverage throughout the year, the number of low income children who are uninsured would decline by close to two-fifths over the course of a year, while the number of uninsured low income adults would decline by more than one-quarter."

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"Trends: Trends In Retiree Health Benefits." By Lauren A. McCormack and others. IN: Health Affairs, vol. 21, no. 6 (November/December 2002) pp. 169-177.

["Over the past decade, the percentage of large firms with 200 or more employees offering retiree health benefits had declined, according to the paper. More troubling ... is the fact that 9 percent of large firms reported that in the next two years they are likely or somewhat likely to eliminate retiree health benefits for new employees or current employees who have not yet retired, and 6 percent are somewhat likely to very likely to eliminate retiree health benefits entirely." BNA's Health Care Policy Report (November 18, 2002 1527]

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HISPANICS

Emerging Issues in Hispanic Health: Summary of a Workshop. Edited by Joah G. Iannotta, Committee on Population, National Research Council. (National Academies Press, Washington,D.C.) 2002. 56 p.

Full Text at: www.nap.edu/catalog/10485.html

["In order to develop this broad-scale study on issues facing the Hispanic population, the National Research Council ... convened a meeting ... that brought together experts in demography, public health, medicine, sociology, psychiatry, and other fields to examine key issues related to Hispanic health and well-being.... The report summarizes the proceedings of the meeting."]

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IMMIGRATION & IMMIGRANTS

Immigrant Access to Health Benefits: A Resource Manual. By Claudia Schlosberg and Doreena Wong. (Access Project, Boston, Massachusetts) 2002. 198 p.

Full Text at: www.accessproject.org/downloads/Immigrant_Access2002.pdf

[Includes: "Medicaid and State Children's Health Insurance Program(SCHIP) for Immigrants"; "New Responsiblities for Sponsors: Affidavits of Support, Sponsor Liability and Sponsor-Deeming of Income"; "Verification of Status, Confidentiality, and Reporting and others."]

[Request #S7559]

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INSURANCE

The Uninsured and Their Access to Health Care. By The Henry J. Kaiser Family Foundation. (The Foundation, Washington, DC) January 2003. 2 p.

Full Text at: www.kff.org/content/2003/142004/142004.pdf

["Low-income Americans (those who earn less than 200% of the federal poverty level, or $28,256 for a family of three in 2001) run the highest risk of being uninsured. Over a third of the poor and more than a quarter of the near-poor lack coverage. Four out of five (82%) of the uninsured are in working families: 70% live in households with a full-time worker and 12% with a part-time worker. Low-wage workers are at greater risk of being uninsured, as are laborers, service workers and those employed in small business."]

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LONG TERM CARE

Survey of Californians About In-Home Care Services. By Leslie Gray and Lynn Friss Feinberg, the Family Caregiver Alliance. (The Alliance, San Francisco, California) 2003. 8 p.

Full Text at: www.caregiver.org/national_center/FieldReportFinal2.pdf

["This Report summarizes findings in a Field Institute poll surveying older Californians' preferences for, attitudes about, and experiences with in-home care. It finds that while the need is growing, there is little funding available for long-term care at home and an inability of families to afford care."]

[Request #S7561]

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MALPRACTICE

Addressing the Medical Malpractice Insurance Crisis: Issue Brief. By Emily V. Cornell, National Governor’s Association. Center for Best Practices. (The Center, Washington, DC) December 5, 2002. 15 p.

Full Text at: www.nga.org/cda/files/1102MEDMALPRACTICE.pdf

[“In some states, medical liability insurance carriers are getting out of the market, leaving either a few carriers with extremely high rates or no carriers at all. … States have several options open to them to address the medical malpractice insurance problem: insurance market interventions, tort reforms, alternative dispute resolution, and patient safety efforts.”]

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MANAGED HEALTH CARE

Knox-Keene Health Plan Expenditures Summary Fiscal Year 2000-2001. By the California Medical Association. (The Association San Francisco, California) February 2002. 26 p.

Full Text at: www.cmanet.org/download2.cfm/general740.pdf

["This report is a compilation of expenditure data reported from managed care plans to the Department of Managed Health Care, and from reports provided by publicly traded plans to the U.S. Securities and Exchange Commission..... The report also includes the financial status of limited licensees."]

[Request #S7563]

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A Gathering Storm in California Healthcare? Trends in Managed Care Costs, Accountability and Quality. By Naomi Lopez, Latino Coalition Foundation. (The Foundation, Washington, DC) 2002. 28 p.

Full Text at: www.thelatinocoalition.com/issues/pdf/CaliforniaHealthCareStudy.pdf

["California employees and consumers are being asked to pay more for health care through soaring premiums and increasing co-payments, but they should not expect to receive comparable increases in benefits or quality care. Some health plans are citing factors, such as rising prescription drug costs and utilization as the primary reasons why California's health care premiums are soaring"]

[Request #S7564]

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MEDICAID

Mounting Pressures: Physicians Serving Medicaid Patients and The Uninsured: 1997-2001. By Peter J. Cunningham, the Center for Studying Health System Change. Tracking Report No. 6 (The Center, Washington, DC) December 2002. Various pagings.

Full Text at: www.hschange.com/CONTENT/505/505.pdf

["The decline in the number of physicians treating Medicaid patients has not had a substantial effect on beneficiaries' access to care, the report said. But 'the larger decreases in physician charity care are consistent with evidence of a decline in access to physicians among the uninsured' according to the report." Health Care Policy Report (December 9, 2002)1588.]

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Medicaid And Information Systems: Delays In Modifying Information Systems Contributed To The Decline In Medicaid Enrollment After Welfare Reform. By Mark Ragan, The Federalism Research Group, The Nelson A. Rockefeller Institute of Government (The Institute, Albany, New York) January 2003. 16 p.

Full Text at: www.rockinst.org/publications/federalism/RaganMedicaidBrief0103.pdf

["'It is not possible to determine how many individuals inappropriately lost Medicaid eligibility or were denied eligibility because of delays in modifying information systems. Circumstantial evidence ... strongly suggests that many individuals and families were adversely affected by the delays" Health Care Policy Report vol. 11 no. 2 (January 13, 2003)58.]

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State Expansion Of Medicaid Managed Care Slows. By Nicholas W. Jenny and Haidy Brown, The Rockefeller Institute (The Institute, Albany, New York) February 2003. 4 p.

Full Text at: rockinst.org/fiscal_pub/state_news/sn_reports/SFN%203-1.pdf

["According to the report the effort by states over the past 10 years to move more Medicaid recipients into managed care plans appears to have leveled off, with about 57 percent of the overall Medicaid population enrolled in managed care." Health Care Policy Report, vol. 11, no. 6 (February 10, 2003) p. 203.]

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Preliminary Analysis Of New Bush Proposal To Block-Grant Medicaid: Issue Brief. By Families USA (Families USA, Washington, DC) February 12, 2003. 4 p.

Full Text at: www.familiesusa.org/IB_analysis%20of%20bush%20block%20grant.pdf

["Although the proposal has been characterized by the Administration as a way for states to preserve and expand health coverage for their most vulnerable residents, it is very likely to result in reduced access to health care for low income people.... This document summarizes the skeletal information we have."]

[Request #S7568]

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Why Are States' Medicaid Expenditures Rising? By Leighton Ku and Matthew Broaddus, Center On Budget and Policy Priorities. (The Center, Washington, DC) January 13, 2003. 14 p.

Full Text at: www.cbpp.org/1-13-03health.pdf

["The rapid growth of Medicaid expenditures, combined with states' severe budget shortfalls, has led most states to seek Medicaid reductions in their most recent legislative sessions.... State policy officials should be cautious in considering large reductions in Medicaid spending. Medicaid cutbacks can further weaken a slow state economy, especially by costing the state needed federal matching funds.... Measures to provide substantial and rapid state fiscal relief have already been proposed in the new session of Congress."]

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Building Administrative Capacity For CHIP and Medicaid: Image, Outreach, and Organization. By Christopher Plein, West Virginia University. Prepared for The Federalism Research Group, The Nelson A. Rockefeller Institute of Government (The Institute, Albany, New York) December 2002. 16 p.

Full Text at: www.rockinst.org/publications/federalism/PleinBrief1202.pdf

["In an effort to disassociate the program from a 'welfare stigma,' SCHIP plans have been presented as a new form of insurance rather than a government entitlement. The report said 'This complex relation of image distinction and program integration has a positive effect on capacity building for publicly funded health insurance systems at the state level.' Health Care Policy Report (January 13, 2003) 58.]

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Proposed State Medicaid Cuts Would Jeopardize Health Insurance Coverage For One Million People. By Leighton Ku and others, Center on Budget and Policy Priorities (The Center, Washington, DC) January 6, 2003. 11 p.

Full Text at: www.cbpp.org/12-23-02health.pdf

["According to the report nearly 1 million people, mostly parents and children from low-income working families, stand to lose their Medicaid coverage as states are forced to cut eligibility in response to budget shortfalls." Health Care Policy Report (January 6, 2003) 25.]

[Request #S7571]

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MEDICARE

Medicare In The 21st Century: Building A Better Chronic Care System. By The National Academy of Social Insurance (The Academy, Washington, DC) January 2003. 79 p.

Full Text at: www.nasi.org/usr_doc/Chronic_Care_Report.pdf

["According to the report the Medicare program is not adequately supporting providers in the treatment and management of chronic conditions.... Medicare should do a better job of helping support the doctors who care for beneficiaries.... It recommended adjusting payments to physicians to better account for the complexity of chronic conditions." Health Care Policy Report (February 10, 2003) 204.]

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"The Implications of Regional Variations in Medicare Spending. The Content, Quality, and Accessibility of Care." By Elliott S. Fisher and others. IN: Annals of Internal Medicine, vol. 128, no. 4 (February 18, 2003) pp. 273-287.

Full Text at: www.annals.org/issues/v138n4/pdf/200302180-00006.pdf

["Quality of care in higher-spending regions was no better on most measures and was worse for several preventive care measures.... Regional differences in Medicare spending are largely explained by the more inpatient-based and specialist-oriented pattern of practice observed in high-spending regions. Neither quality of care nor access to care appear to be better for Medicare enrollees in higher-spending regions."]

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“Change in the Quality of Care Delivered to Medicare Beneficiaries, 1998-1999 to 2000-2001.” By Stephen F. Jencks and others. IN: JAMA: Journal of American Medical Association, vol. 298, no. 3 (January 15, 2003) pp. 305-312.

[“Medicare patients are getting better treatment than they did just a few years ago for such ailments as heart attacks, pneumonia, breast cancer and diabetes, but the quality of care still varies widely by region and state, a government report card says…. California, which previously had ranked at the lower end among states on Medicare quality indicators, slipped five more notches. It now ranks 44th, down from 39th in the 1998-1999 survey.” San Francisco Chronicle (January 15, 2003) A5.]

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MENTAL HEALTH

Assessing Child Mental Health Services in New York: A Report on Three Focus Groups. By Chris Koyanagi and Rafael Semansky, Bazelon Center for Mental Health Law. (The Center, Washington, DC) Winter 2003. 34 p.

Full Text at: www.bazelon.org/children/newyork/newyorkfocusgroups.pdf

["The report recommends that the state expand the number of Medicaid beneficiaries who can take advantage of the state's federal waiver to cover home- and community-based mental health services; provide additional funding for day treatment, in-home providers and after-school programs; improve crisis response teams; train providers to recognize serious mental illnesses; and encourage agencies serving children to better coordinate efforts." Kaiser Daily Health Policy Report (February 12, 2003)]

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MORTALITY

“Mortality Associated With Influenza and Respiratory Syncytial Virus in the United States.” By William W. Thompson and others. IN: JAMA: Journal of American Medical Association, vol. 289 no. 2 (January 8, 2003) pp. 179-186.

[“Despite the advent of a vaccine four decades ago, flu-related deaths in the United States have risen dramatically since the 1970’s and influenza now claims more lives each year than AIDS, researchers say. The rising death toll is attributed largely to the nation’s growing number of elderly people, who are especially vulnerable to the flu…. Flu death totals … average about 36,000 a year, up from 20,000 in previous estimates.” San Francisco Chronicle (January 8, 2003) A2.]

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NURSES

Nurse Aide Training. By Janet Rehnquist, The U.S. Office of Inspector General, Department of Health and Human Service (The Office, Washington, DC) November 2002. 37 p.

Full Text at: oig.hhs.gov/oei/reports/oei-05-01-00030.pdf

["Training for nurse aides has not kept pace with the changing needs of nursing home patients in the past 15 years, the Department of Health and Human Services Office of Inspector General said in a audit report. Current Federal nurse aide training requirements were spelled out in the Omnibus Budget Reconciliation Act of 1987, but IG auditors learned in recent interviews and surveys that nursing home residents are 'older, sicker, require more assistance with activities of daily living, and take more medication' than when the training requirements were enacted." Health Care Policy Report(December 23, 2002) 1658.]

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PRENATAL CARE

Options for Prenatal Care Under Medicaid and SCHIP. By Leah Oliver, National Conference of State Legislatures. Legisbrief. Vol. 11, No. 10. (NCSL, Denver, Colorado) February 2003. 2 p.

["More women receive prenatal care than ever before. Providing adequate care to pregnant women remains a challenge for states. At least 29 states use Medicaid Section 1931 to expand coverage to low-income families. States may expand SCHIP through an 1115 waiver to cover other groups."]

[Request #S7578]

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PRESCRIPTION DRUGS

Prescription Drug Benefit Plans: A Buyer's Guide. By Mercer Human Resource Consulting. Prepared For California Health Care Foundation. (The Foundation, Oakland, California) January 2003. 36 p.

Full Text at: www.chcf.org/documents/providersystems/PharmacyBuyersGuide.pdf

["Prescription drug benefit plan sponsors face a daunting array of complex purchasing options.... This guide will help sponsors negotiate contracts with prescription drug benefit service administrators.... [and] alert buyers to the nuances and complexities of retail and mail-order pricing, manufacturer rebates, administrative costs, and clinical services."]

[Request #S7579]

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Navigating the Pharmacy Benefits Marketplace. By Mercer Human Resource Consulting. Prepared For California Health Care Foundation. (The Foundation, Oakland, California) January 2003. 42 p.

Full Text at: www.chcf.org/documents/providersystems/NavPharmBenefits.pdf

["This report is intended to help plan sponsors navigate the complex and often confusing financial arrangements that determine the ultimate cost of pharmacy benefits to employers and consumers. The report explores the multitude of forces that influence pricing -- from legislation and market dynamics to the flow of money and interactions among pharmaceutical manufacturers, pharmacies, pharmacy benefit administrators, employers and consumers."]

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PREVIOUSLY IN STUDIES IN THE NEWS
[This section links to items in Studies in the News since the last Environmental Supplement.]

HEALTH CARE

"Health." IN: Studies in the News, 03-13 (March 7, 2003).

Full Text at: www.library.ca.gov/SITN/2003/0313.htm

[Includes: "Health care costs survey;" "Nursing graduate shortages;" "Residential care facilities;" and "Maternity before maturity."]

[Request #S7581]

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"Health." IN: Studies in the News, 03-09 (February 26, 2003).

Full Text at: www.library.ca.gov/SITN/2003/0309.htm

[Includes: "State disability program wasting millions;" "California physical fitness testing;" "Retiree health benefits;" and "Mental health workforce".]

[Request #S7582]

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Health." IN: Studies in the News, 03-06 (February 3, 2003).

Full Text at: http://www.library.ca.gov/SITN/2003/0306.htm

[Includes: "Children losing Healthy Start;" "State profiles of long-term care;" "States plan to cut Medicaid;" "Federal share of state program costs;" and "Medicaid's effect on the California economy."]

[Request #S7583]

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"Health." IN: Studies in the News, 03-04 (January 24, 2003).

Full Text at: www.library.ca.gov/SITN/2003/0304.htm

[Includes: "Attorney General sues drug companies;" "Child obesity;" "Evaluating local readiness;" "Promoting walking and biking;" "Two types of terrorist incidents;" "Rural emergency medical services;" and "Curbing costs of tobacco use."]

[Request #S7584]

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"Health." IN: Studies in the News, 03-02 (January 10, 2003).

Full Text at: www.library.ca.gov/SITN/2003/0302.htm

[Includes: "Antibiotic resistant bacteria in U.S. poultry;" "End-of-life care costly;" "Catholic hospitals health care safety net;" "Medi-Cal overpaid for equipment and supplies." "Proposed warning labels for anti-smoking medications;" and "Untreated sexually transmitted diseases."]

[Request #S7585]

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