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Policymakers in Connecticut are considering various state-funded policy options to improve insurance coverage among undocumented and legally present recent immigrants in the state-almost 60 percent of whom lack health insurance. In particular, they are removing immigration status requirements from Medicaid eligibility. They are also considering whether to provide state-funded subsidies to undocumented immigrants enrolled in individual market plans. A key challenge for this analysis was determining what share of undocumented immigrants would be likely to take up insurance coverage if it were available to them. Because few states have expanded coverage to their undocumented populations and because the denominator is uncertain, estimates of take-up rates are highly uncertain. There is similar uncertainty in estimating how much health care undocumented populations will use once they become insured. To address these uncertainties, the authors conducted sensitivity analyses that varied both the take-up and utilization rates. Using the RAND Corporation's COMPARE microsimulation model, the authors estimate the impacts of each policy scenario on enrollment, premiums, state spending, and hospital spending on uncompensated care. Their analysis suggests that removing immigration status requirements for Medicaid and individual market subsidy eligibility would decrease uninsurance among the undocumented and legally present recent immigrant populations by 32 to 37 percent and could improve insurance coverage and affordability in Connecticut for these populations while not substantially impacting other Connecticut residents.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Immigrant Families aims to capture the richness, complexity, and diversity that characterize contemporary immigrant families in the United States. In doing so, it reaffirms that the vast majority of people do not migrate as isolated individuals, but are members of families. There is no quintessential immigrant experience, as immigrants and their families arrive with different levels of economic, social, and cultural resources, and must navigate various social structures that shape how they fare. Immigrant Families highlights the hierarchies and inequities between and within immigrant families created by key axes of inequality such as legal status, social class, gender, and generation. Drawing on ethnographic, demographic, and historical scholarship, the authors highlight the transnational context in which many contemporary immigrant families live, exploring how families navigate care, resources, expectations, and aspirations across borders. Ultimately, the book analyzes how dynamics at the individual, family, and community levels shape the life chances and wellbeing of immigrants and their families. As the United States turns its attention to immigration as a critical social issue, Immigrant Families encourages students, scholars, and policy makers to center family in their discussions, thereby prioritizing the human and relational element of human mobility.
"Pressing Onward narrates the lives of mothers who migrated from Latin America and settled in New Haven, Connecticut, overcoming trauma and ongoing adversity to build futures for their children. By enacting imperative resilience, migrant mothers engage cognitive and social strategies to resist racial, economic, and gender-based oppression to seguir adelante, or push onward. Both a contemporary view of the impacts of the COVID-19 pandemic on racially minoritized populations and a timeless account of the ways immigration enforcement and healthcare inequality affect migrant mothers, Pressing Onward uses ethnography to tell a greater story of persistence amid longstanding structural violence"--
This guide has been developed jointly by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, and is designed for use by all personnel involved in the care of pregnant women, their foetuses, and their neonates.
The definitive story of American health care today -- its causes, consequences, and confusions. In March 2010, the Affordable Care Act was signed into law. It was the most extensive reform of America's health care system since at least the creation of Medicare in 1965, and maybe ever. The ACA was controversial and highly political, and the law faced legal challenges reaching all the way to the Supreme Court; it even precipitated a government shutdown. It was a signature piece of legislation for President Obama's first term, and also a ball and chain for his second. Ezekiel J. Emanuel, a professor of medical ethics and health policy at the University of Pennsylvania who also served as a special adviser to the White House on health care reform, has written a brilliant diagnostic explanation of why health care in America has become such a divisive social issue, how money and medicine have their own -- quite distinct -- American story, and why reform has bedeviled presidents of the left and right for more than one hundred years. Emanuel also explains exactly how the ACA reforms are reshaping the health care system now. He forecasts the future, identifying six mega trends in health that will determine the market for health care to 2020 and beyond. His predictions are bold, provocative, and uniquely well-informed. Health care -- one of America's largest employment sectors, with an economy the size of the GDP of France -- has never had a more comprehensive or authoritative interpreter.
Cultural Competency/Vulnerable Populations
The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.
Comprehensive skills in management, administration, and leadership are essential for occupational therapy assistants (OTA) in their daily interactions with their clients in various health care environments. Inside Management and Administration for the OTA: Leadership and Application Skills, Dr. Karen Jacobs has gathered an expert team of 11 contributors of clinicians, academicians, administrators, managers, and graduate students to address each of the ACOTE Standards with a focus on evidence-based literature and examples of the leadership and management skills needed as an OTA. What you will learn from Management and Administration for the OTA: Contexts and Health Care—the potential impact of policy issues as they relate to the practice of occupational therapy Leadership and Advocacy—two important roles that OTAs need to assume to be agents of change Credentialing—introduces the national requirements for credentialing and for licensure, certification or registration under state laws Reimbursement—the various reimbursement systems requirements that affect the practice of occupational therapy Marketing and Promoting—The role of the OTA to promote the distinct value of occupational therapy to the public, as well as other professionals, service providers, consumers, third-party payers, and regulatory bodies Documentation and Quality Improvement—to ensure the OTA provides the highest quality of occupational therapy services Supervision—to understand the important relationship between the OTA, the OT, and nonprofessional personnel Fieldwork—to understand the role, criteria, and components of the OTA in fieldwork education Communication Skills—define health literacy and discuss how to use this concept to better understand the client, the client’s health environment, and the client’s occupations and health activities Ethics—explore the components of ethics that impact the delivery of occupational therapy and the foundational skills and knowledge needed by the OTA to maintain high standards of responsible, ethical practice Scholarship and Scholarly Practice—assists the OTA with how to articulate the importance of how scholarly activities and the evidence-based literature contribute to the distinct value and advancement of occupational therapy The chapters of Management and Administration for the OTA: Leadership and Application Skills also includes 5 key vocabulary terms and their definitions, case examples relevant to the content, website resources, and multiple choice review questions. Included with the text are online supplemental materials for faculty use in the classroom. Straightforward, comprehensive, and user-friendly, Management and Administration for the OTA: Leadership and Application Skills will provide OTA students and clinicians with an essential resource for their future success.