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The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.
The State Children's Health Insurance Program (SCHIP) offers federal matching funds for states and territories to provide health insurance to uninsured, low-income children in families whose annual incomes are too high to qualify for Medicaid. Unlike Medicaid, which operates as an individual entitlement, SCHIP operates as a capped grant program. Allotment of funds among states is determined by a formula set in law. Once a state depletes a given year's original allotment, other than funds from prior years made available through redistribution, no additional federal funds will be made available to that state for that year. States have the flexibility to design their programs to operate within these funding constraints. The allotment and redistribution methods under current law have been incompatible with state spending patterns to date.
The State Children's Health Insurance Program (SCHIP) was established by Congress to provide health insurance to uninsured children whose family income was too high for Medicaid coverage but too low to allow the family to obtain private health insurance coverage. The enabling legislation for SCHIP, included in the Balanced Budget Act of 1997, made available to states (and the District of Columbia) almost $40 billion over a 10-year period for this program. Like Medicaid, SCHIP is a joint federal-state program, with funding from both sources, but it is implemented by the states. Thus, there are SCHIP programs in all of the states and the District of Columbia. The National Research Council, through the Committee on National Statistics, was asked to explore some of the ways in which data analysis could be used to promote achievement of the SCHIP goal of expanding health insurance coverage for uninsured children from low-income families. To inform its work, the panel for this project held a workshop to bring together state SCHIP officials and researchers to share findings and methods that would inform the design, implementation, and evaluation of SCHIP at the state and national levels. In keeping with this charge, this report is limited to discussions at the workshop. It does not attempt to provide a summary of all the state programs nor a comprehensive review of the literature. Data Needs for the State Children's Health Insurance Program concludes that data are insufficient in the individual states to provide a clear picture of the impact of SCHIP on the number of children who are eligible for the program, the rate at which eligible children are enrolled in the program, and the rate at which they are retained in the program once enrolled. This situation is due, in part, to the fact that sample sizes in national surveys are too small to provide detailed data for individual states. In addition, the great amount of movement of children among health insurance categories-Medicaid, SCHIP, private insurance, or no insurance at all-makes it difficult for states to count the number of children in specific categories at a particular point in time. The panel specifies a number of practices that could be implemented to improve the overall functioning of SCHIP and the ability of policy makers to evaluate the program. Foremost among these are: (1) developing more uniform ways of estimating eligibility and health insurance coverage among the states; (2) sharing among the states effective methods for outreach; (3) taking qualitative information into account, in addition to quantitative information, in assessing variation among states in enrollment and disenrollment; and (4) implementing longitudinal studies to track the movement of children among the various insurance statuses.
The federal government operates six major health care programs that serve nearly 100 million Americans. Collectively, these programs significantly influence how health care is provided by the private sector. Leadership by Example explores how the federal government can leverage its unique position as regulator, purchaser, provider, and research sponsor to improve care - not only in these six programs but also throughout the nation's health care system. The book describes the federal programs and the populations they serve: Medicare (elderly), Medicaid (low income), SCHIP (children), VHA (veterans), TRICARE (individuals in the military and their dependents), and IHS (native Americans). It then examines the steps each program takes to assure and improve safety and quality of care. The Institute of Medicine proposes a national quality enhancement strategy focused on performance measurement of clinical quality and patient perceptions of care. The discussion on which this book focuses includes recommendations for developing and pilot-testing performance measures, creating an information infrastructure for comparing performance and disseminating results, and more. Leadership by Example also includes a proposed research agenda to support quality enhancement. The third in the series of books from the Quality of Health Care in America project, this well-targeted volume will be important to all readers of To Err Is Human and Crossing the Quality Chasm - as well as new readers interested in the federal government's role in health care.