• Making Data Work for You, Monday, August 3
  Instructor: Jennifer Chubinski, The Health Foundation of Greater Cincinnati
• Introduction to Fundraising, Wednesday, August 26 and Thursday, August 27
  Instructor: Jamie Levy, The Center on Philanthropy at Indiana University
• Keep It Short and Simple, Thursday, September 10
  Instructor: Christine Mulvin, The Health Foundation of Greater Cincinnati

• Treating the Whole Person
  There is a lot of "buzz" these days about the integration of primary care and mental health services. Recently, I joined a conference call about the Request for Applications from the Substance Abuse and Mental Health Services Administration's Grants for Primary and Behavioral Health Care Integration. So many people called that the phone system crashed and the call had to be rescheduled. I think this is an indication that the health disparities among people with severe mental illnesses have gotten attention...
• What makes a Good Site Visit?
  I am often asked the question, "What do you want to see in this site visit?" My answer is, "It's not 'what,' it's 'who'." The reality is that a site visit is really a people visit, because people make the project. A good site visit, whether it is related to getting a grant or reporting on an existing grant, has some specific components:...

Medical Homes in Southwestern Ohio

Data from the Ohio Family Health Survey (OFHS), released in March, show the percentage of adults who report NOT having a medical home or usual source of care ranges from a high of 18% in Brown County to a low of 12% in Warren and Butler Counties. The percentage of adults who report not having a medical home in the state of Ohio is 14%. Statewide data and an interactive map are available through HealthLandscape at http://www.healthlandscape.org/hlapps/NoMedicalHome/.

County	% No Medical Home
Adams	14%
Butler	12%
Brown	18%
Clermont	13%
Clinton	17%
Hamilton	15%
Highland	15%
Warren	12%

State of Ohio

14%

The OFHS is the most current data set available on the health status, insurance status, and healthcare use of Ohioans. The 2008 OFHS data tables and county profiles can be downloaded at http://grc.osu.edu/ofhs/datadownloads/index.cfm. For general health data information, please contact Jennifer Chubinski, Director, Health Data Improvement, at 513.458.6608, or jchubinski@healthfoundation.org.

Mental Health Crisis in the Workplace

Mental Health America is presenting an online seminar entitled "Mental Health Crisis in the Workplace" on Monday, June 29, from 10:00 a.m. - 5:00 p.m. Participants will learn:

• Understanding issues of depression, anxiety, stress, and substance abuse in the workplace;
• Recognizing an employee in a mental health crisis, providing the help and support they need, integrating them back into the workplace after recovery; and
• How to create a healthier work environment and reducing the incidences of depression, anxiety and substance abuse, increasing productivity and “the bottom line”

The seminar will also include a round table discussion on mental health parity in employee health insurance; tools and products to reduce costs. The cost is $295 per "viewing station." A viewing station can be one person in front of a computer monitor or a group of people in a meeting room with a speakerphone watching a large monitor or LCD projection. For more information or to register, please visit http://affiliates.elearningu.net/sw/52/CD15/.

ACCESS TO CARE: Employers Could See 9% Increase for Employee Insurance

Companies sponsoring health insurance for their employees could experience cost increases of 9% in 2010, according to a report from consulting firm PricewaterhouseCoopers. The projected 9% increase for 2010 is a slight decrease from the 9.2% increase PWC predicted for this year and the 9.9% increase projected for 2008. The report said a growing use of generic prescription drugs has helped slow the increase. The firm surveyed more than 500 employers and health insurers for the report. According to the survey, 42% of employers said they would increase employees' share of health insurance costs. PWC principal Michael Thompson said, "If the underlying costs go up by 9%, employees' costs actually go up by double digits," which could have a "major, major impact" on workers while employers also are freezing or cutting pay during the recession. According to the report, underlying costs are expected to increase in 2010 in part because workers concerned about losing their jobs are using their health insurance more frequently while they still have it. In addition, the report found that health care providers are shifting costs to private insurance plans to compensate for revenue reductions caused by a rise in the uninsured population or from an increase in their percentage of Medicaid patients (Murphy, AP/Newark Star-Ledger, 6/18). The AP/Newark Star-Ledger article is available at http://www.nj.com/newsflash/index.ssf?/base/business-18/1245278172234590.xml&storylist=business. The report is available at http://www.pwc.com/extweb/pwcpublications.nsf/docid/8656E4061BF5E8D8852575D200620D28.

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ACCESS TO CARE: Recession Results in Cuts to Children's Health Funding, Programs

Recent cuts to state health programs and other services spurred by the economic recession are affecting health care services for children. Many states have responded to the economic slowdown by making changes to their Medicaid programs. Twenty-two million children receive health coverage through Medicaid or a CHIP program. Difficulties recently have arisen in finding physicians, particularly a specialist, who will treat Medicaid beneficiaries. A recent survey by the Medical Group Management Association found that 18% of 1,850 practices polled said they no longer accepted new Medicaid patients, and an additional 11% said they likely would stop taking Medicaid patients in response to the recession. Cuts to Medicaid services also affect privately insured children because children's hospitals have eliminated staff and programs in order to make up the revenue shortfalls. In addition to reducing Medicaid spending, some states also have cut funding for other programs that affect children, such as poison-control call centers (Fuhrmans, Wall Street Journal, 6/17). The Wall Street Journal article is available at http://online.wsj.com/article/SB124519908310621365.html.

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ACCESS TO CARE: Doctors' Group Offers Alternative, Low-Cost Health Insurance

More than 300 Ohio business owners have switched their health insurance coverage to the Physicians' Assurance Corporation, a new group that aims to offer benefits at the same level of other insurers while charging lower premiums. The company was founded by a group of Columbus doctors in 2005, and expanded its coverage recently to include several counties, including Fairfield County. Businesses with as many as 300 employees are eligible to receive health insurance plans through the company as a way to reduce costs. PAC utilizes a third-party administrator. PAC CEO Brett Baby said the company has profit margins that are 6% to 10% lower than those of larger companies. He added that the company is "based on the philosophy that physicians are patient advocates. Over time, what has happened is the insurance industry has gotten away from a patient-centered approach and gone to a business approach." As of June 9, Physicians' Assurance had more than 7,000 total members (Giessler, Lancaster Eagle-Gazette, 6/15). The Lancaster Eagle-Gazette article is available at http://www.lancastereaglegazette.com/article/20090615/NEWS01/906150305/1002/Alternative-health-care-option-now-available-in-the-county.

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ACCESS TO CARE: No-Cost Health Screenings Offered at Predominantly Black Churches

Managed Health Services, a firm that provides health care for low-income children and families, has sponsored three no-cost health screenings in recent months at predominantly black churches in the Indianapolis area. The screenings, staffed by students and faculty members from local medical assistance education programs, also provide educational materials about health and exercise, as well as no-cost samplings of low-fat foods. Martha Bonds, a community liaison working for MHS, said the no-cost clinics offer important services to blacks that address the group's higher rates of heart disease and diabetes compared with other races. This week, prostate screenings for men older than age 40, and those younger than 40 who have a family history of the disease, will be offered at the Greater New Hope Church in Indianapolis. Bonds said, "By providing these screenings, we are trying to shine a light on diseases a lot of blacks might now know they are at high risk for." Judy Ward, a program director for Ivy Tech Community College's medical assistance efforts, said Indiana consistently is above the national average in obesity. She said, "We need to be more active, and (we) have to get that word out" (Tuohy, Indianapolis Star, 6/15). The Indianapolis Star article is available at http://www.indystar.com/article/20090615/LOCAL/906150351/1150/LOCAL0101.

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ACCESS TO CARE: Cleveland Community Health Centers Get Stimulus Money

Three Cleveland community health centers next month will receive about $2.7 million combined from the federal stimulus bill for transitioning to electronic health record systems. Care Alliance, Neighborhood Family Practice and Northeast Ohio Neighborhood Health Services, which are known as federally qualified health centers, hope to better share patient data with local hospitals that have already transitioned to EHRs. In choosing their EHR systems, the facilities will seek to improve patient care while reducing costs by reminding physicians about patients' chronic conditions or medical histories and eliminating the need to order duplicate tests, for example. EHRs also would improve patients' understanding of their own conditions. Jenice Contreras, director of development at Care Alliance, said, "As a community health center, we know we can't provide a lot of specialty care, so we refer a lot of our patients to St. Vincent Medical Center or MetroHealth," so "it's important for our systems to be linked together to improve patient data sharing." Neighborhood Family Medical Director Ann Reichsman said, "You can save more time to talk to patients, which is how you want to be spending your time" (Wu, Cleveland Plain Dealer, 6/19). The Cleveland Plain Dealer article is available at http://blog.cleveland.com/metro/2009/06/three_cleveland_health_centers.html.

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ACCESS TO CARE: University of Louisville Opens Clinic for International Adoptees

The University of Louisville has opened the region's first international adoption clinic, which aims to help families identify and address medical and developmental issues among children adopted from foreign countries. The clinic is one of 30 in the nation and helps adoptive parents identify conditions like tuberculosis, malnutrition, parasites, language delays and psychiatric issues, such as reactive attachment disorder. The team of specialists working at the clinic includes a pediatric infectious-disease specialist, a developmental pediatrician, and professionals in speech and language pathology, child psychology and occupational therapy. The new clinic operates on the second and fourth Tuesday of each month at the Weisskopf Child Evaluation Center in downtown Louisville. Previously, people seeking such services had to travel to the University of Kentucky-Lexington, Cincinnati or Indianapolis. While most of the services are covered by health insurance, some are not, including a $200 medical record review. Federal statistics show a total of 17,438 international adoptions in the U.S. in 2008, with 352 in Kentucky and 477 in Indiana. Experts suggest that number will increase after the economy improves and adoptive nations grow accustomed to a 2008 U.S. adoption agreement (Ungar, Louisville Courier-Journal, 6/14). The Louisville Courier-Journal article is available at http://www.courier-journal.com/article/20090614/NEWS01/906140374/1008/NEWS01.

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MENTAL HEALTH: Ohio Mental Health Funds Divided Unequally Among Counties

Ohio's system for dividing mental health funds among counties is inequitable and negatively affects Franklin County and its low-income and uninsured residents, according to the county's Alcohol, Drug and Mental Health Executive Director David Royer. State leaders agree there is inequity primarily because of an outdated formula based heavily on the use of state mental hospitals. They have begun working to fix the problem in the next 10 years. However, Royer wants a change sooner and is meeting with assistant county prosecutors about the possibility of attaining a plan through court action. The plan likely would increase Franklin County's portion of state mental health funding from $22.8 million per year to $28.2 million; however, other counties, especially Cuyahoga, would have a significant decrease. Department of Mental Health spokesperson Trudy Sharp said a final decision on the matter is expected in the next few weeks (Crane, Columbus Dispatch, 6/15). The Columbus Dispatch article is available at http://www.dispatch.com/live/content/local_news/stories/2009/06/15/UNEVEN.ART_ART_06-15-09_B3_44E6C2F.html.

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RX DRUGS: Kentucky Residents Eligible for Prescription Discounts

A program that allows Kentucky residents to purchase prescription drugs at discounted prices was launched in early June. The KentuckyRxCard is available to state residents at no cost. Pharmaceutical manufacturers and participating pharmacies will offer cardholders an average of 30% off retail prices. Kentucky residents can download the card online or pick it up at certain pharmacies and medical facilities throughout the state. The program is administered by United Networks of America, which assembles networks of health care-related organizations and companies to provide discount services (Louisville Courier-Journal, 6/5). The Louisville Courier-Journal article is available at http://www.courier-journal.com/article/20090605/BUSINESS/906050338/1003/rss03.

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TOBACCO: Ohio Senate Cuts Funds for Prevention, Cessation Efforts

The Ohio Senate in its final version of the state budget plan removed the remaining $6 million from a state anti-tobacco account intended to fund smoking prevention and cessation efforts. Under the state House version of the budget, the money left in the account would be directed to a toll-free quit line, nicotine patches and grants for local anti-smoking programs operated by the state Department of Health. Lawmakers from both chambers will meet to decide on a final budget plan by June 30. The state Senate wants to use the $6 million for unrelated efforts. However, Ohio anti-smoking groups have said the cuts would eliminate the few remaining prevention and cessation programs in the state. They also note that a judge has said the money must be used for anti-tobacco efforts. The anti-tobacco account was created using a portion of the settlement Ohio received from cigarette manufacturers in 1998. Ohio's portion of the multistate settlement was $10.1 billion. State officials originally agreed to leave $330 million to fund a foundation that ran anti-tobacco and smoking cessation programs, but after a few years, part of that total was diverted toward unrelated programs. Then, in 2008, Gov. Ted Strickland (D) and state legislators directed $230 million of the remaining $270 million toward an economic stimulus program to create bioscience jobs. That decision currently is pending in court. Shelly Kiser, director of advocacy for the American Lung Association in Ohio, said, "The help the state is providing to keep kids from smoking is basically on life support." She added that the Senate's action would be "pulling the plug." According to Maggie Ostrowski, a spokesperson for state Senate President Bill Harris (R), the state Department of Health can continue to fund anti-tobacco programs if it so chooses and receive prior approval from the Controlling Board. She said, "We took away their appropriating authority, but the money is not gone" (Nash, Columbus Dispatch, 6/15). The Columbus Dispatch article is available at http://www.dispatch.com/live/content/local_news/stories/2009/06/15/TOBACCOBUCKS.ART_ART_06-15-09_B1_LRE6CEU.html?sid=101.

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TOBACCO: Obama Signs FDA Oversight Bill

President Obama on Monday signed a bill that authorizes FDA to regulate the content, marketing and labeling of cigarettes and other tobacco products (Perlofsky, Reuters, 6/22). The House on June 12 voted 307-97 to give final approval to the bill, known as the Family Smoking Prevention and Tobacco Control Act (Boston Globe, 6/13). The seven Democrats and 90 Republicans who voted against the measure were mostly representatives of states that are home to tobacco manufacturing companies, which could be most affected by the legislation (Miller, Washington Times, 6/13). Under the bill, FDA would establish a new tobacco regulatory center, which would be funded by industry fees. The Congressional Budget Office estimates the fees could amount to as much as $235 million in 2010 and $712 million in 2019 (Abrams, AP/San Jose Mercury News, 6/12). The bill, which the Senate revised and approved on June 11, prohibits FDA from implementing a complete ban on nicotine or tobacco products (American Health Line, 6/12). Obama after the House vote said that the measure would "protect our kids and improve our public health" (Wilson, New York Times, 6/13). He noted, "This bill has obviously been a long time coming," adding, "We've known for years, even decades, about the harmful, addictive and often deadly effects of tobacco products. ... And after a decade of opposition, all of us are finally about to achieve the victory with this bill, a bill that truly defines change in Washington" (CQ Today, 6/12). FDA Commissioner Margaret Hamburg said that the agency is prepared to "roll up our sleeves" to take on the new obligation. "We really do feel, by being able to regulate tobacco and tobacco products, we can reduce the burden of disease," Hamburg said (AP/San Jose Mercury News, 6/12). The Reuters article is available at http://www.reuters.com/article/healthNews/idUSTRE55I4TG20090619. The Boston Globe article is available at http://www.boston.com/news/nation/washington/articles/2009/06/13/bill_to_toughen_tobacco_regulation_sent_to_obama/. The Washington Times article is available at http://washingtontimes.com/news/2009/jun/13/tobacco-regulatory-bill-goes-to-obama/?feat=home_headlines. The AP/San Jose Mercury News article is available at http://www.mercurynews.com/politics/ci_12576366. The New York Times article is available at http://www.nytimes.com/2009/06/13/business/13tobacco.html?_r=1.

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Greater Cincinnati Health Watch is published bi-weekly by The Health Foundation of Greater Cincinnati. Regional and national stories are provided by American Health Line, a division of the Advisory Board Company.

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