Thursday, January 28, 2010

Prevention Institute's new website

As 2010 begins, prevention and equity must have increased visibility and additional resources to solidify the important gains we made in the last year. To help make that happen, we've launched Prevention Institute's new website, preventioninstitute.org, to better highlight our commitment, perspective and resources, and to serve as a focal point for bringing communities, policy makers, funders and advocates together.

From a prevention perspective, we can look back on a number of successes from 2009. It took all of us: we saw a preventive emphasis in the stimulus and in health reform legislation, as well as in numerous state and local initiatives. We saw greater prioritization of disenfranchised communities explicit in many of these efforts-though much further emphasis here is needed, especially in this tight economy.

Though the future of real reform seems uncertain, I feel confident that health reform and prevention will move forward. At this critical time, we've designed the new preventioninstitute.org to function as a hub for cross-sector efforts to keep prevention and equity center stage now and in the decades to come. It also makes it easier than ever to make the case for quality prevention, with features and publications that:
• Continue to build momentum and buy-in for quality prevention in health care reform with tools, advocacy opportunities and evidence dedicated to Reforming our Health System, along with updates on the current status of the federal legislation.
• Demonstrate the economic value of prevention, showing how prevention saves money along with saving lives. Reports like Prevention for a Healthier America offer concrete data reflecting the 5-to-1 return on investment of quality prevention efforts;
• Emphasize health, safety and equity in all sectors and policies. Transportation Prescription delineates a new way to think of the nation's investment in getting around. Collaboration Multiplier uses an interactive framework to strengthen and enhance collaborative efforts; and
• Connect outcomes and strategies of successful prevention approaches to new challenges, including violence prevention, health reform, healthy eating and more: from our signature Spectrum of Prevention to a video I recently made, From Kools to Cancer Sticks, that shows how the same approaches used in shaping tobacco prevention policies can be applied to today's pressing health and equity issues.

Wednesday, January 13, 2010

Prevention and Final Health Reform Bill

FOR IMMEDIATE RELEASE: January 7, 2010
CONTACT: Joel Spivak or Marie Cocco, 202-296-5469

Final Health Reform Bill Should Make Prevention a Priority
Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids

WASHINGTON, DC (January 7, 2010) – As Congress negotiates a final health care reform bill, lawmakers should seize this unprecedented opportunity to invest in proven measures that prevent costly diseases from occurring in the first place, which will improve health and reduce health care costs. These include measures to prevent and reduce tobacco use, which remains the leading cause of preventable death in the United States, killing more than 400,000 people and costing the nation $96 billion in health care expenditures annually.
The legislation now being crafted by House and Senate negotiators contains essential disease prevention programs that will improve health and reduce costs. These include: A requirement that Medicaid cover preventive services with demonstrated effectiveness, including treatment to help smokers quit, and creation of a prevention trust fund to finance proven, community-based prevention programs aimed at problems such as tobacco use and obesity.
Medicaid coverage of smoking cessation treatment: The final health care reform legislation should require comprehensive coverage of smoking cessation treatment, including medication and counseling with no cost-sharing requirements, for all Medicaid recipients, as the House-passed legislation would. The Senate bill would require such coverage only for pregnant women receiving Medicaid.
Medicaid coverage of smoking cessation treatment is critical as lower-income Americans have higher rates of smoking than the general population, and health care reform is expected to expand Medicaid coverage to millions of new beneficiaries. In 2007, 33 percent of adult enrollees in Medicaid smoked, according to the Centers for Disease Control and Prevention. The overall rate of smoking among adults in 2008 was 20.6 percent. Medicaid expenditures attributable to smoking total $22 billion annually, representing 11 percent of all Medicaid expenditures, according to the CDC.
Remarkable results recently reported by Massachusetts underscore the benefits of providing Medicaid coverage of smoking cessation treatment. The state found that smoking rates among beneficiaries in its MassHealth program dropped by 26 percent in the first two and a half years after it began providing coverage and promoting use of smoking cessation services in 2006. Costly medical procedures also were reduced substantially. Among the group that enrolled in the smoking cessation program, there were 38 percent fewer hospitalizations for heart attacks and 17 percent fewer emergency-room visits for asthma symptoms in the first year. There were 17 percent fewer claims for maternal birth complications since the benefit was implemented.
Massachusetts’ results are early indicators of how much would be gained with a sustained national effort to reduce smoking among Medicaid beneficiaries. Yet, according to the CDC, only six states in 2007 provided coverage of all tobacco-dependence treatments (FDA-approved medications and counseling) to help smokers quit. Though many states are facing severe budget constraints, tobacco prevention and cessation will result in long-term savings for federal and state governments by reducing tobacco-related diseases and health care costs.
Prevention funds: Both the House and Senate bills also would establish a fund to finance proven community-based prevention programs targeting public health problems such as tobacco use and obesity. Americans spend more than $2 trillion a year to treat disease and manage illnesses, and almost three quarters of that money is spent on caring for people whose illnesses we know how to prevent. For example, smoking causes one in five deaths from heart disease, nearly one-third of all cancer deaths and nine in 10 deaths from lung cancer. The lifetime health care costs for individuals who smoke are $17,500 higher than they are for non-smokers.
The Trust for America’s Health reviewed prevention programs that already have been tried and found that an investment of $10 per person, per year in proven initiatives to prevent smoking, promote physical activity and improve nutrition could save more than $16 billion a year within five years. That’s a return of $5.60 for every dollar invested. While the Congressional Budget Office has not estimated short-term savings from prevention in the health reform bills, it has said that “certain types of preventive services have been found to yield substantial net savings, largely because the initial costs are low and the long-term benefits are large.”
The final legislation should adopt the higher 5-year public health and prevention funding level in the House bill and the ongoing funding stream found in the Senate bill. These funds would help finance community-based prevention activities and media campaigns that promote disease prevention. Effective prevention will mean fewer premature deaths, less disease and more cost-effective health care spending.

DES to cut $57million

Agencies putting cuts in play; DES to whack $57M
By Mary K. ReinhartThe Arizona Guardian
The 15 percent budget-cut scenarios are turning into realities.State agency directors who compiled lists of possible reductions several months ago, at the governor’s request, are now being forced to implement much of them. What remains on the lists -- what directors consider the harshest cuts -- are next.The Department of Economic Security is cutting an additional $57 million over the next six months, including $35 million accrued by freezing the child care subsidy program, reducing or eliminating services for home-bound elderly and grandparents raising grandchildren, and imposing co-pays and fee increases for programs serving disabled children and adults.In the third round of midyear 2010 budget cuts, the Legislature and Gov. Jan Brewer last month approved $75 million in overall agency reductions and another $118 million in fund sweeps and other savings to help balance a $1.5 billion current-year deficit.DES took a $26 million hit, but also must account for a $42 million shortfall in the cash assistance program because a federal contingency fund, created as part of 1996 welfare reform, dried up last month. Absent action from Congress to replenish the fund, Arizona must come up with the money to provide a small monthly benefit to families with children.Those cuts, less about $12 million in one-time contingency and federal stimulus funding, are forcing the welfare agency to implement all but the deepest of cuts to programs for Arizona’s most vulnerable citizens.DES Director Neal Young delivered the news to human service administrators and advocates during a meeting Tuesday, at the same time Brewer was telling a health care crowd about her proposal to cut AHCCCS and mental health care to help bridge an estimated $3.5 billion budget deficit in fiscal 2011.Among the DES changes:* $1.6 million cut to aging and adult services, which will eliminate in-home services for an estimated 700 elderly who need some help to live independently in their homes. The department said the cuts could increase the long-term care costs to the state if those who lose services are forced into nursing homes.* Eliminating the grandparent/kinship care program, which provides a $75 monthly stipend for about 1,000 children in the care of their grandparents.* Eliminating the sight conservation program, scrapping eye exams, glasses and other vision treatment for 9,000 low-income adults.* Continuing a cap on the child care subsidy program, growing a waiting list of nearly 10,000 children whose working parents would otherwise qualify for help paying for child care. Freezing the program is expected to save $35 million this year.Maintaining the cuts imposed in fiscal 2009 throughout the current year, including a 20 percent reduction in monthly cash assistance payments to families with children, will save an estimated $23.5 million. The state, however, will lose $27.5 million in federal funds.A family of three now receives up to $278 a month. That ranks Arizona 42nd nationally compared to what other states were paying in 2006. About 38,000 people receive benefits, a number that has been rising since the recession took hold after several years of declining enrollment. Half of the cases are only children, many of them in foster care.Lawmakers have reduced the DES general fund budget by more than 30 percent, or about $250 million, in the past two budget cycles. The reductions have led to layoffs for more than 800 employees and eliminations or reductions in programs serving tens of thousands of Arizona’s disabled, elderly and poor, as well as virtually all prevention and in-home services for children at risk of abuse. The department figures it will need nearly $250 million in fiscal 2011 just to cover caseload growth and make up for lost federal stimulus funding. In addition to cash assistance, caseloads for food stamps, child welfare, long-term care and developmental disabilities are growing as funding is shrinking. Not yet implemented under the 15 percent plan are cuts that would wipe out entire programs serving larger and more vulnerable groups of people, including $15 million in CPS services for abused and neglected children, $9 million by shrinking the cash assistance program and $8.2 million worth of services to infants and toddlers with developmental delays.
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