Adoption of the National CLAS Standards by State Mental Health Agencies: A Nationwide Policy Analysis.

PubMed

Aggarwal, Neil Krishan; Cedeno, Kryst; John, Dolly; Lewis-Fernandez, Roberto

2017-08-01

This study reports the extent to which states have adopted the national culturally and linguistically appropriate services (CLAS) standards. Officials from public mental health agencies in the 50 states, Washington, D.C., and Puerto Rico were contacted between January and June 2016 to obtain information about adoption of CLAS standards in current policies. Each policy was coded through thematic analysis to determine its correspondence with any of the 14 national CLAS standards, which are grouped into three domains. Officials from 47 states and territories (90%) responded. Eight states (17%) reported adopting all national CLAS standards. Ten (23%) had adopted no CLAS policies, five (12%) had adopted policies under one domain, three (7%) under two domains, and 25 (58%) under all three domains. Most states do not have policies that meet all CLAS standards, raising questions about how CLAS standards should be adopted.

32 CFR 644.432 - Assignment to Department of Health, Education, and Welfare (HEW) or successor agencies for health...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 4 2012-07-01 2011-07-01 true Assignment to Department of Health, Education, and Welfare (HEW) or successor agencies for health or educational purposes. 644.432 Section 644.432... to Department of Health, Education, and Welfare (HEW) or successor agencies for health or educational...

32 CFR 644.432 - Assignment to Department of Health, Education, and Welfare (HEW) or successor agencies for health...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 4 2013-07-01 2013-07-01 false Assignment to Department of Health, Education, and Welfare (HEW) or successor agencies for health or educational purposes. 644.432 Section 644.432... to Department of Health, Education, and Welfare (HEW) or successor agencies for health or educational...

32 CFR 644.432 - Assignment to Department of Health, Education, and Welfare (HEW) or successor agencies for health...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 4 2014-07-01 2013-07-01 true Assignment to Department of Health, Education, and Welfare (HEW) or successor agencies for health or educational purposes. 644.432 Section 644.432... to Department of Health, Education, and Welfare (HEW) or successor agencies for health or educational...

For-profit medicare home health agencies' costs appear higher and quality appears lower compared to nonprofit agencies.

PubMed

Cabin, William; Himmelstein, David U; Siman, Michael L; Woolhandler, Steffie

2014-08-01

For-profit, or proprietary, home health agencies were banned from Medicare until 1980 but now account for a majority of the agencies that provide such services. Medicare home health costs have grown rapidly since the implementation of a risk-based prospective payment system in 2000. We analyzed recent national cost and case-mix-adjusted quality outcomes to assess the performance of for-profit and nonprofit home health agencies. For-profit agencies scored slightly but significantly worse on overall quality indicators compared to nonprofits (77.18 percent and 78.71 percent, respectively). Notably, for-profit agencies scored lower than nonprofits on the clinically important outcome "avoidance of hospitalization" (71.64 percent versus 73.53 percent). Scores on quality measures were lowest in the South, where for-profits predominate. Compared to nonprofits, proprietary agencies also had higher costs per patient ($4,827 versus $4,075), were more profitable, and had higher administrative costs. Our findings raise concerns about whether for-profit agencies should continue to be eligible for Medicare payments and about the efficiency of Medicare's market-oriented, risk-based home care payment system. Project HOPE—The People-to-People Health Foundation, Inc.

Towards National eHealth Implementation--a comparative study on WHO/ITU National eHealth Strategy Toolkit in Iran.

PubMed

Riazi, Hossein; Jafarpour, Maryam; Bitaraf, Ehsan

2014-01-01

Experiences has shown that utilization of ICT in health sector requires national commitment and planned efforts to make the best use of existing capacity. Establishing the main directions as well as planning the detailed steps needed are key to achieving longer-term goals such as health sector efficiency, reform or more fundamental transformation. Collaboration between the health and ICT sectors, both public and private, is central to this effort. As the major United Nations agencies for health and telecommunications respectively, the World Health Organization (WHO) and the International Telecommunication Union (ITU) have recognized the importance of collaboration for eHealth in their global resolutions, which encourage countries to develop national eHealth strategies; the National eHealth Strategy Toolkit is the proof of these recommendations. In this study a mapping of eHealth components in WHO/ITU National eHealth Strategy Toolkit and our national eHealth vision is presented.

[Regional health agencies: only sham autonomy two years later].

PubMed

Rolland, Christine; Pierru, Frédéric

2013-01-01

From the outset, reform of regional health agencies in France, has been torn between two conflicting approaches: traditional state planning and the more recent New Public Management. In fact, the "Hôpital Patients Santá Territoires" (Hospital Patients Health Territories) bill juxtaposes rather than supplants these conflicting approaches. Based on a sociological and qualitative survey conducted nationwide and in three regional health agencies, this article highlights the contradictions in which regional health agency management is entangled and how it tries to accommodate them in its everyday professional activity. Officially, and paradoxically, regional agencies are required to be "autonomous" and "innovative" to ensure more "territorialized" health policies, but in fact, they are caught in a meshwork of somewhat arbitrary national regulatory and budgetary controls that are very similar to the traditional French model of administration. In the light of the example of three different schemes of regional/territorial delegation regulations, this article shows how the various stakeholders are nevertheless trying to innovate even if, ultimately, they are faced with a more traditional, centralised healthcare system with decreased participation at the more local levels.

Use of health information technology in home health and hospice agencies: United States, 2007.

PubMed

Resnick, Helaine E; Alwan, Majd

2010-01-01

This report provides updated estimates on use of electronic medical records (EMRs) in US home health and hospice (HHH) agencies, describes utilization of EMR functionalities, and presents novel data on telemedicine and point of care documentation (PoCD) in this setting. Nationally representative, cross-sectional survey of US HHH agencies conducted in 2007. Data on agency characteristics, current use of EMR systems as well as use of telemedicine and PoCD were collected. In 2007, 43% of US HHH agencies reported use of an EMR system. Patient demographics (40%) and clinical notes (34%) were the most commonly used EMR functions among US HHH agencies. Only 20% of agencies with EMR systems had health information sharing functionality and about half of them used it. Telemedicine was used by 21% of all HHH agencies, with most (87%) of these offering home health services. Among home health agencies using telemedicine, greater than 90% used telephone monitoring and about two-thirds used non-video monitoring. Nearly 29% of HHH agencies reported using electronic PoCD systems, most often for Outcome and Assessment Information Set (OASIS) data capture (79%). Relative to for-profit HHH agencies, non-profit agencies used considerably more EMR (70% vs 28%, p<0.001) and PoCD (63% vs 9%, p<0.001). Between 2000 and 2007, there was a 33% increase in use of EMR among HHH agencies in the US. In 2007, use of EMR and PoCD technologies in non-profit agencies was significantly higher than for-profit ones. Finally, HHH agencies generally tended to use available EMR functionalities, including health information sharing.

[Health education in the French Regional Health Agencies in 2012: observations and analysis].

PubMed

Baudier, François; Destaing, Lara; Michaud, Claude

2013-01-01

This paper examines the role of health education in the French Agences régionales de santé (ARS, Regional Health Agencies) in 2012. A survey was conducted among public health managers working in the ARS. Most of the participants reported that health education plays an important role in their agency, notably through their regional health plan and the activities of the organizations responsible for promoting democracy in health care. This is also true of the links with the Institut national de prévention et d'education pour la santé (INPES, the National Institute for Health Prevention and Education) and the network of Instances régionales d'éducation et de promotion de la santé (IREPS, the Regional Authorities for Health Education and Promotion). However, the answers to the open-ended questions and the results of the interviews suggest that these results must be interpreted with caution. The study focuses on a number of factors that must be taken into account when considering the results of the quantitative analysis. These factors include: the subjective (or interpretive) dimension of the term "health education" emphasized by many of the participants (a term involving an emphasis on either health promotion or preventive medicine); the limited emphasis on health education in the ARS (beyond therapeutic patient education) compared to other issues such as health monitoring and security, health care and medico-social problems; the limited resources allocated to health education and the bleak budget outlook; the relationships with the main operators; and the need to develop, promote and apply knowledge of good practice. Finally, the study shows that the role of health education is dependent on individuals' willingness to promote it and, in particular, on the commitment of ARS managers.

Comparison of home health and hospice care agencies by organizational characteristics and services provided: United States, 2007.

PubMed

Park-Lee, Eunice Y; Decker, Frederic H

2010-11-09

This report presents national estimates of the organizational characteristics of home health and hospice care agencies in 2007. Comparisons of organizational characteristics and provision of selected services are made by agency type. A comparison of selected characteristics between 1996 and 2007 is also provided to highlight changes that have occurred leading to the current composition of the home health and hospice care sector. Estimates are based on data collected on agencies from the 1996, 2000, and 2007 National Home and Hospice Care Survey, conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. Estimates are derived from data collected during interviews with administrators and staff designated by the administrators. In 2007, there were 14,500 home health and hospice care agencies in the United States, an increase from 11,400 in 2000. Three-quarters of these agencies provided home health care only, 15% provided hospice care only, and 10% provided both home health and hospice care (mixed). The percentage of proprietary home health care only and hospice care only agencies increased during 1996-2007, whereas the percentage of proprietary mixed agencies remained relatively stable. The average number of home health care patients that home health care only and mixed agencies served decreased, while the average number of hospice care patients that hospice care only agencies served increased across years. Among mixed agencies, no significant changes were observed in the average number of hospice care patients being served. The percentage of home health care only agencies offering certain therapeutic and nonmedical services declined over the years. There was an increase in the proportion of hospice care only agencies' providing many core and noncore hospice care services during 1996-2007. Also during this time, the proportion of mixed agencies providing selected nonmedical services decreased.

Earth Science and Public Health: Proceedings of the Second National Conference on USGS Health-Related Research

USGS Publications Warehouse

Buxton, Herbert T.; Griffin, Dale W.; Pierce, Brenda S.

2007-01-01

The mission of the U.S. Geological Survey (USGS) is to serve the Nation by providing reliable scientific information to describe and understand the earth; minimize loss of life and property from natural disasters; manage water, biological, energy, and mineral resources; and enhance and protect our quality of life. As the Nation?s largest water, earth, and biological science and civilian mapping agency, the USGS can play a significant role in providing scientific knowledge and information that will improve our understanding of the relations of environment and wildlife to human health and disease. USGS human health-related research is unique in the Federal government because it brings together a broad spectrum of natural science expertise and information, including extensive data collection and monitoring on varied landscapes and ecosystems across the Nation. USGS can provide a great service to the public health community by synthesizing the scientific information and knowledge on our natural and living resources that influence human health, and by bringing this science to the public health community in a manner that is most useful. Partnerships with health scientists and managers are essential to the success of these efforts. USGS scientists already are working closely with the public health community to pursue rigorous inquiries into the connections between natural science and public health. Partnering agencies include the Armed Forces Institute of Pathology, Agency for Toxic Substances Disease Registry, Centers for Disease Control and Prevention, U.S. Environmental Protection Agency, Food and Drug Administration, Mine Safety and Health Administration, National Cancer Institute, National Institute of Allergy and Infectious Disease, National Institute of Environmental Health Sciences, National Institute for Occupational Safety and Health, U.S. Public Health Service, and the U.S. Army Medical Research Institute of Infectious Diseases. Collaborations between public

Emergency medicine public health research funded by federal agencies: progress and priorities.

PubMed

D'Onofrio, Gail; Goldstein, Amy B; Denisco, Richard A; Hingson, Ralph; Heffelfinger, James D; Post, Lori A

2009-11-01

The emergency department (ED) visit provides an opportunity to impact the health of the public throughout the entire spectrum of care, from prevention to treatment. As the federal government has a vested interest in funding research and providing programmatic opportunities that promote the health of the public, emergency medicine (EM) is prime to develop a research agenda to advance the field. EM researchers need to be aware of federal funding opportunities, which entails an understanding of the organizational structure of the federal agencies that fund medical research, and the rules and regulations governing applications for grants. Additionally, there are numerous funding streams outside of the National Institutes of Health (NIH; the primary federal health research agency). EM researchers should seek funding from agencies according to each agency's mission and aims. Finally, while funds from the Department of Health and Human Services (HHS) are an important source of support for EM research, we need to look beyond traditional sources and appeal to other agencies with a vested interest in promoting public health in EDs. EM requires a broad skill set from a multitude of medical disciplines, and conducting research in the field will require looking for funding opportunities in a variety of traditional and not so traditional places within and without the federal government. The following is the discussion of a moderated session at the 2009 Academic Emergency Medicine consensus conference that included panel discussants from the National Institutes of Mental Health, Drug Abuse, and Alcoholism and Alcohol Abuse and the Centers for Disease Control and Prevention (CDC). Further information is also provided to discuss those agencies and centers not represented. (c) 2009 by the Society for Academic Emergency Medicine.

Bringing central line-associated bloodstream infection prevention home: CLABSI definitions and prevention policies in home health care agencies.

PubMed

Rinke, Michael L; Bundy, David G; Milstone, Aaron M; Deuber, Kristin; Chen, Allen R; Colantuoni, Elizabeth; Miller, Marlene R

2013-08-01

A study was conducted to investigate health care agency central line-associated bloodstream infection (CLABSI) definitions and prevention policies and pare them to the Joint Commission National Patient Safety Goal (NPSG.07.04.01), the Centers for Disease Control and Prevention (CDC) CLABSI prevention recommendations, and a best-practice central line care bundle for inpatients. A telephone-based survey was conducted in 2011 of a convenience sample of home health care agencies associated with children's hematology/oncology centers. Of the 97 eligible home health care agencies, 57 (59%) completed the survey. No agency reported using all five aspects of the National Healthcare and Safety Network/Association for Professionals in Infection Control and Epidemiology CLABSI definition and adjudication process, and of the 50 agencies that reported tracking CLABSI rates, 20 (40%) reported using none. Only 10 agencies (18%) had policies consistent with all elements of the inpatient-focused NPSG.07.04.01, 10 agencies (18%) were consistent with all elements of the home care targeted CDC CLABSI prevention recommendations, and no agencies were consistent with all elements of the central line care bundle. Only 14 agencies (25%) knew their overall CLABSI rate: mean 0.40 CLABSIs per 1,000 central line days (95% confidence interval [CI], 0.18 to 0.61). Six agencies (11%) knew their agency's pediatric CLABSI rate: mean 0.54 CLABSIs per 1,000 central line days (95% CI, 0.06 to 1.01). The policies of a national sample of home health care agencies varied significantly from national inpatient and home health care agency targeted standards for CLABSI definitions and prevention. Future research should assess strategies for standardizing home health care practices consistent with evidence-based recommendations.

[The senses of sanitary safety in the discourse of the National Health Surveillance Agency].

PubMed

Barbosa, Ana de Oliveira; Costa, Ediná Alves

2010-11-01

The term sanitary safety (SS) appeared in the international debate mainly due to the emerging sanitary crisis, although its meaning has remained obscure. This paper aims to analyze the concept of SS brought into the Brazilian sanitary surveillance upon the creation of the National Health Surveillance Agency. An exploratory case study was undertaken with technical data analysis and semi-structured interviews with informants who had taken part in the process of formulating the body's institutional design. The following categories were analyzed: incorporation of the SS term into the institutional mission, the SS concept and SS mechanisms. The SS concept was analyzed in both institutional and technical discursive dimensions. The former elicits the sense of strategy, a reliable relationship and legitimacy whereas the latter shows the sense of an acceptable risk-benefit relationship from the perspective of individual and collective health protection and promotion. The SS concept was found to encompass health-related products, technologies and services, especially those designed for medical diagnosis and treatment, but environmental issues received little mention. The scope of the SS concept was shown to be widening to include the surveillance of hospital infection, drugs and blood.

Veterinarians in Environmental Health: Opportunities for Veterinarians at the Environmental Protection Agency

EPA Science Inventory

The United States Environmental Protection Agency (EPA) was created in 1970 partially in response to widespread public concern about environmental degradation. The EPA mission is to protect human health and the environment and the Agency is tasked with enforcing our nation's envi...

Predictors of Intent to Leave the Job Among Home Health Workers: Analysis of the National Home Health Aide Survey.

PubMed

Stone, Robyn; Wilhelm, Jess; Bishop, Christine E; Bryant, Natasha S; Hermer, Linda; Squillace, Marie R

2017-10-01

To identify agency policies and workplace characteristics that are associated with intent to leave the job among home health workers employed by certified agencies. Data are from the 2007 National Home and Hospice Care Survey/National Home Health Aide Survey, a nationally representative, linked data set of home health and hospice agencies and their workers. Logistic regression with survey weights was conducted to identify agency and workplace factors associated with intent to leave the job, controlling for worker, agency, and labor market characteristics. Job satisfaction, consistent patient assignment, and provision of health insurance were associated with lower intent to leave the job. By contrast, being assigned insufficient work hours and on-the-job injuries were associated with greater intent to leave the job after controlling for fixed worker, agency, and labor market characteristics. African American workers and workers with a higher household income also expressed greater intent to leave the job. This is the first analysis to use a weighted, nationally representative sample of home health workers linked with agency-level data. The findings suggest that intention to leave the job may be reduced through policies that prevent injuries, improve consistency of client assignment, improve experiences among African American workers, and offer sufficient hours to workers who want them. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

78 FR 57463 - National Farm Safety and Health Week, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-18

... National Farm Safety and Health Week, 2013 By the President of the United States of America A Proclamation... to generation--is central to the American story. During National Farm Safety and Health Week, we... Safety and Health Week. I call upon the agencies, organizations, businesses, and extension services that...

Quality improvement and accreditation readiness in state public health agencies.

PubMed

Madamala, Kusuma; Sellers, Katie; Beitsch, Leslie M; Pearsol, Jim; Jarris, Paul

2012-01-01

There were 3 specific objectives of this study. The first objective was to examine the progress of state/territorial health assessment, health improvement planning, performance management, and quality improvement (QI) activities at state/territorial health agencies and compare findings to the 2007 findings when available. A second objective was to examine respondent interest and readiness for national voluntary accreditation. A final objective was to explore organizational factors (eg, leadership and capacity) that may influence QI or accreditation readiness. Cross-sectional study. State and Territorial Public Health Agencies. Survey respondents were organizational leaders at State and Territorial Public Health Agencies. Sixty-seven percent of respondents reported having a formal performance management process in place. Approximately 77% of respondents reported a QI process in place. Seventy-three percent of respondents agreed or strongly agreed that they would seek accreditation and 36% agreed or strongly agreed that they would seek accreditation in the first 2 years of the program. In terms of accreditation prerequisites, a strategic plan was most frequently developed, followed by a state/territorial health assessment and health improvement plan, respectively. Advancements in the practice and applied research of QI in state public health agencies are necessary steps for improving performance. In particular, strengthening the measurement of the QI construct is essential for meaningfully assessing current practice patterns and informing future programming and policy decisions. Continued QI training and technical assistance to agency staff and leadership is also critical. Accreditation may be the pivotal factor to strengthen both QI practice and research. Respondent interest in seeking accreditation may indicate the perceived value of accreditation to the agency.

76 FR 54001 - Agency Information Collection (National Practitioner Data Bank (NPDB) Regulations) Activity Under...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-30

... the Health Care Quality Improvement Act of 1986 and administered by the Department of Health and Human... Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0621] Agency Information Collection (National...

Design and operation of the national home health aide survey: 2007-2008.

PubMed

Bercovitz, Anita; Moss, Abigail J; Sengupta, Manisha; Harris-Kojetin, Lauren D; Squillace, Marie R; Emily, Rosenoff; Branden, Laura

2010-03-01

This report provides an overview of the National Home Health Aide Survey (NHHAS), the first national probability survey of home health aides. NHHAS was designed to provide national estimates of home health aides who provided assistance in activities of daily living (ADLs) and were directly employed by agencies that provide home health and/or hospice care. This report discusses the need for and objectives of the survey, the design process, the survey methods, and data availability. METHODS NHHAS, a multistage probability sample survey, was conducted as a supplement to the 2007 National Home and Hospice Care Survey (NHHCS). Agencies providing home health and/or hospice care were sampled, and then aides employed by these agencies were sampled and interviewed by telephone. Survey topics included recruitment, training, job history, family life, client relations, work-related injuries, and demographics. NHHAS was virtually identical to the 2004 National Nursing Assistant Survey of certified nursing assistants employed in sampled nursing homes with minor changes to account for differences in workplace environment and responsibilities. RESULTS From September 2007 to April 2008, interviews were completed with 3,416 aides. A public-use data file that contains the interview responses, sampling weights, and design variables is available. The NHHAS overall response rate weighted by the inverse of the probability of selection was 41 percent. This rate is the product of the weighted first-stage agency response rate of 57 percent (i.e., weighted response rate of 59 percent for agency participation in NHHCS times the weighted response rate of 97 percent for agencies participating in NHHCS that also participated in NHHAS) and the weighted second-stage aide response rate of 72 percent to NHHAS.

Health-related biotechnology transfer to Africa: principal-agency relationship issues.

PubMed

Kirigia, J M; Muthuri, L K; Kirigia, D G

2007-01-01

The aim of this paper is to stimulate debate on the agency (principal-agent) in health-related biotechnology research. It attempts to answer the following questions: What is health-related biotechnology and biotechnology research? What is an agency? What factors are likely to undermine the principal's capacity to exercise informed consent? When might the principal-agency problem arise? How could the agency in biotechnology transfer be strengthened in Sub-Saharan Africa (SSA)? The transfer of health-related biotechnology to SSA ought to be preceded by research to ascertain the effectiveness of such technologies on population health. In that process, the national ethical review committee (REC), as an agent of every human research subject (principal), ought to ensure that international principles (e.g. beneficence, non-malfeasance, autonomy, justice, dignity, truthfulness and honesty) for human experimentation are observed by biotechnology researchers in order to satisfy moral, ethical and legal requirements. The key factors that undermine principals' sovereignty in exercising their right to informed consent to participate in biotechnology trials are discussed. The paper ends with a list of activities that can strengthen the agency, e.g. legislative requirement that all health-related biotechnology transfer should be preceded by rigorous evaluation; continuous update of the agents knowledge of the contents of the international ethical guidelines; and education of potential and actual principals on their human rights; among others.

Integration of site-specific health information: Agency for Toxic Substances and Disease Registry health assessments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lesperance, A.M.; Siegel, M.R.

The Agency for Toxic Substances and Disease Registry is required to conduct a health assessment of any site that is listed on or proposed for the US Environmental Protection Agency's National Priorities List. Sixteen US Department of Energy (DOE) sites currently fall into this category. Health assessments contain a qualitative description of impacts to public health and the environment from hazardous waste sites, as well as recommendations for actions to mitigate or eliminate risk. Because these recommendations may have major impacts on compliance activities at DOE facilities, the health assessments are an important source of information for the monitoring activitiesmore » of DOE's Office of Environmental Compliance (OEC). This report provides an overview of the activities involved in preparing the health assessment, its role in environmental management, and its key elements.« less

76 FR 32374 - National Advisory Committee on Occupational Safety and Health (NACOSH)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-06

... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2011-0065] National Advisory Committee on Occupational Safety and Health (NACOSH) AGENCY: Occupational Safety and... on Occupational Safety and Health (NACOSH) and NACOSH subgroups. SUMMARY: The National Advisory...

75 FR 78775 - National Advisory Committee on Occupational Safety and Health (NACOSH)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-16

... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2010-0012] National Advisory Committee on Occupational Safety and Health (NACOSH) AGENCY: Occupational Safety and... on Occupational Safety and Health (NACOSH) and NACOSH subgroup meetings. SUMMARY: The National...

75 FR 28659 - National Advisory Committee on Occupational Safety and Health (NACOSH)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-21

... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2010-0012] National Advisory Committee on Occupational Safety and Health (NACOSH) AGENCY: Occupational Safety and... on Occupational Safety and Health (NACOSH). SUMMARY: The National Advisory Committee on Occupational...

The United Nations and One Health: the International Health Regulations (2005) and global health security.

PubMed

Nuttall, I; Miyagishima, K; Roth, C; de La Rocque, S

2014-08-01

The One Health approach encompasses multiple themes and can be understood from many different perspectives. This paper expresses the viewpoint of those in charge of responding to public health events of international concern and, in particular, to outbreaks of zoonotic disease. Several international organisations are involved in responding to such outbreaks, including the United Nations (UN) and its technical agencies; principally, the Food and Agriculture Organization of the UN (FAO) and the World Health Organization (WHO); UN funds and programmes, such as the United Nations Development Programme, the World Food Programme, the United Nations Environment Programme, the United Nations Children's Fund; the UN-linked multilateral banking system (the World Bank and regional development banks); and partner organisations, such as the World Organisation for Animal Health (OIE). All of these organisations have benefited from the experiences gained during zoonotic disease outbreaks over the last decade, developing common approaches and mechanisms to foster good governance, promote policies that cut across different sectors, target investment more effectively and strengthen global and national capacities for dealing with emerging crises. Coordination among the various UN agencies and creating partnerships with related organisations have helped to improve disease surveillance in all countries, enabling more efficient detection of disease outbreaks and a faster response, greater transparency and stakeholder engagement and improved public health. The need to build more robust national public human and animal health systems, which are based on good governance and comply with the International Health Regulations (2005) and the international standards set by the OIE, prompted FAO, WHO and the OIE to join forces with the World Bank, to provide practical tools to help countries manage their zoonotic disease risks and develop adequate resources to prevent and control disease

Small Business Grants at the National Cancer Institute and National Institutes of Health

NASA Astrophysics Data System (ADS)

Baker, Houston

2002-10-01

Ten Federal Agencies set aside 2.5% of their external research budget for US small businesses—mainly for technology research and development, including radiation sensor system developments. Five agencies also set aside another 0.15% for the Small Business Technology Transfer Program, which is intended to facilitate technology transfers from research laboratories to public use through small businesses. The second largest of these agencies is the Department of Health and Human Services, and almost all of its extramural research funds flow through the 28 Institutes and Centers of the National Institutes of Health. For information, instructions, and application forms, visit the NIH website's Omnibus Solicitation for SBIR and STTR applications. The National Cancer Institute is the largest NIH research unit and SBIR/STTR participant. NCI also issues SBIR and STTR Program Announcements of its own that feature details modified to better support its initiatives and objectives in cancer prevention, detection, diagnosis, treatment, and monitoring.

Collaboration between local health and local government agencies for health improvement.

PubMed

Hayes, Sara L; Mann, Mala K; Morgan, Fiona M; Kitcher, Hilary; Kelly, Mark J; Weightman, Alison L

2011-06-15

In many countries, national, regional and local inter- and intra-agency collaborations have been introduced in order to improve health outcomes. Evidence is needed on the effectiveness of locally-developed partnerships which target changes in individual health outcomes and behaviours. To evaluate the effects of interagency collaboration between local health and local government agencies on health outcomes. Twenty-five databases were searched using a highly sensitive search strategy. 'Snowballing' methods were also used, including expert contact, website searching and reference list follow up. Randomized controlled trials (RCTs), controlled clinical trials (CCTs), controlled before-and-after studies (CBAs) and interrupted time series (ITS) where the study reported on interagency collaboration between health and local government agencies. Studies were selected independently in duplicate by two of five authors. From the team of five review authors, two authors independently conducted data extraction and assessed risk of bias for each study. Eleven studies were identified, presenting information on a total of 26,686 participants. Owing to the heterogeneity between studies a narrative synthesis was undertaken. The included studies covered a range of topics. Six studies examined mental health initiatives, of which one study showed health benefit; four showed modest improvement in one or more of the outcomes measured, but no clear overall health gain; and one study showed no evidence of health gain. Two studies were related to lifestyle improvements of which one failed to show health gains for the intervention population, while the other showed more unhealthy lifestyle behaviours persisting in the intervention population. Three studies were related to chronic disease management and all three failed to demonstrate health gains. Collaboration between local health and local government is commonly considered best practice. However, the review did not identify any reliable

[Social determinants of health and convergence in health agendas of regional agencies in South America].

PubMed

Díaz-Bermúdez, Ximena Pamela; Bueno, Flavia; Otero, Luis Francisco Sánchez; Auer, Annela Jean

2016-11-01

Characterize areas of interinstitutional cooperation and converging health agendas of the Pan American Health Organization/World Health Organization (PAHO/WHO), the Health Council of the Union of South American Nations (UNASUR), and the Amazon Cooperation Treaty Organization (ACTO) in South America based on social determinants of health. A qualitative study based on official documentary sources from the three organizations, using a comparative analysis of the health agendas of these agencies and the Rio Political Declaration on Social Determinants of Health (2011). Information was systematized using an analytical matrix that identifies convergences in the respective agendas. Development of the health agendas of these agencies is influenced by various international forces such as Member States' foreign policy, international cooperation strategies and models, and the institutions' political and strategic guidelines. These agendas reveal efforts to strengthen blocs, cooperation mechanisms, and coordinated programmatic actions. The agendas of PAHO/WHO, the UNASUR Health Council, and ACTO point towards opportunities for convergence in various programmatic areas, emphasizing social determinants of health. Based on the overall agreements of the Rio Declaration as an analytical framework with recommendations in five decision-making spheres, structural cooperation actions can be carried out in the region's countries, jointly mediated by these agencies.

The policy implications of the cost structure of home health agencies.

PubMed

Mukamel, Dana B; Fortinsky, Richard H; White, Alan; Harrington, Charlene; White, Laura M; Ngo-Metzger, Quyen

2014-01-01

To examine the cost structure of home health agencies by estimating an empirical cost function for those that are Medicare-certified, ten years following the implementation of prospective payment. 2010 national Medicare cost report data for certified home health agencies were merged with case-mix information from the Outcome and Assessment Information Set (OASIS). We estimated a fully interacted (by tax status) hybrid cost function for 7,064 agencies and calculated marginal costs as percent of total costs for all variables. The home health industry is dominated by for-profit agencies, which tend to be newer than the non-profit agencies and to have higher average costs per patient but lower costs per visit. For-profit agencies tend to have smaller scale operations and different cost structures, and are less likely to be affiliated with chains. Our estimates suggest diseconomies of scale, zero marginal cost for contracting with therapy workers, and a positive marginal cost for contracting with nurses, when controlling for quality. Our findings suggest that efficiencies may be achieved by promoting non-profit, smaller agencies, with fewer contract nursing staff. This conclusion should be tested further in future studies that address some of the limitations of our study.

The Policy Implications of the Cost Structure of Home Health Agencies

PubMed Central

Mukamel, Dana B; Fortinsky, Richard H; White, Alan; Harrington, Charlene; White, Laura M; Ngo-Metzger, Quyen

2014-01-01

Purpose To examine the cost structure of home health agencies by estimating an empirical cost function for those that are Medicare-certified, ten years following the implementation of prospective payment. Design and Methods 2010 national Medicare cost report data for certified home health agencies were merged with case-mix information from the Outcome and Assessment Information Set (OASIS). We estimated a fully interacted (by tax status) hybrid cost function for 7,064 agencies and calculated marginal costs as percent of total costs for all variables. Results The home health industry is dominated by for-profit agencies, which tend to be newer than the non-profit agencies and to have higher average costs per patient but lower costs per visit. For-profit agencies tend to have smaller scale operations and different cost structures, and are less likely to be affiliated with chains. Our estimates suggest diseconomies of scale, zero marginal cost for contracting with therapy workers, and a positive marginal cost for contracting with nurses, when controlling for quality. Implications Our findings suggest that efficiencies may be achieved by promoting non-profit, smaller agencies, with fewer contract nursing staff. This conclusion should be tested further in future studies that address some of the limitations of our study. PMID:24949224

Characterizing the Quality Workforce in Private U.S. Child and Family Behavioral Health Agencies.

PubMed

McMillen, J Curtis; Raffol, Matthew

2016-09-01

Behavioral health agencies have been encouraged to monitor performance and improve service quality. This paper characterizes the workforce charged with these tasks through a national survey of 238 behavioral health quality professionals. A latent class analysis suggests only 30 % of these workers report skills in both basic research and quality-specific skills. Respondents wanted to learn a variety of research and data analytic skills. The results call into question the quality of data collected in behavioral health agencies and the conclusions agencies are drawing from their data. Professional school and continuing education programs are needed to prepare this workforce.

U.S. Public Health Service Commissioned Corps pharmacists: making a difference in advancing the nation's health.

PubMed

Flowers, Louis; Wick, Jeannette; Figg, William Douglas; McClelland, Robert H; Shiber, Michael; Britton, James E; Ngo, Diem-Kieu H; Borders-Hemphill, Vicky; Mead, Christina; Zee, Jerry; Huntzinger, Paul

2009-01-01

To describe how U.S. Public Health Service (PHS) pharmacists serving in jobs that are normal for them, but considerably different than those found in the private sector, are making a difference in advancing the nation's health. Pharmacists who serve in the Commissioned Corps of PHS fill roles that are considerably different than their counterparts in the private sector. Their work takes them out from behind the counter and into the world. Pharmacy officers advance the health and safety of the nation by their involvement in the delivery of direct patient care to medically underserved people, national security, drug vigilance, research, and policy-making endeavors. PHS pharmacists fill essential public health leadership and service roles throughout the U.S. Department of Health and Human Services (HHS) and certain non-HHS federal agencies and programs. The Health Resources and Services Administration, National Institutes of Health, Federal Bureau of Prisons, Indian Health Service, Food and Drug Administration, and U.S. Coast Guard are among the many federal agencies in which pharmacy officers are assigned. In each setting, PHS pharmacists find traditional roles augmented with assignments and challenges that broaden the scope of their practice.

Lessons learned for the National Children's Study from the National Institute of Environmental Health Sciences/U.S. Environmental Protection Agency Centers for Children's Environmental Health and Disease Prevention Research.

PubMed

Kimmel, Carole A; Collman, Gwen W; Fields, Nigel; Eskenazi, Brenda

2005-10-01

This mini-monograph was developed to highlight the experiences of the National Institute of Environmental Health Sciences (NIEHS)/U.S. Environmental Protection Agency (EPA) Centers for Children's Environmental Health and Disease Prevention Research, focusing particularly on several areas of interest for the National Children's Study. These include general methodologic issues for conducting longitudinal birth cohort studies and community-based participatory research and for measuring air pollution exposures, pesticide exposures, asthma, and neurobehavioral toxicity. Rather than a detailed description of the studies in each of the centers, this series of articles is intended to provide information on the practicalities of conducting such intensive studies and the lessons learned. This explication of lessons learned provides an outstanding opportunity for the planners of the National Children's Study to draw on past experiences that provide information on what has and has not worked when studying diverse multiracial and multiethnic groups of children with unique urban and rural exposures. The Children's Centers have addressed and overcome many hurdles in their efforts to understand the link between environmental exposures and health outcomes as well as interactions between exposures and a variety of social and cultural factors. Some of the major lessons learned include the critical importance of long-term studies for assessing the full range of developmental consequences of environmental exposures, recognition of the unique challenges presented at different life stages for both outcome and exposure measurement, and the importance of ethical issues that must be dealt with in a changing medical and legal environment. It is hoped that these articles will be of value to others who are embarking on studies of children's environmental health.

Home Health Agency Work Environments and Hospitalizations

PubMed Central

Flynn, Linda; Lake, Eileen T.; Aiken, Linda H.

2014-01-01

Background: An important goal of home health care is to assist patients to remain in community living arrangements. Yet home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional health challenges and increasing care costs. Objectives: To determine the relationship between home health agency work environments and agency-level rates of acute hospitalization and discharges to community living. Methods and Design: Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 home health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-agency variation in rates of acute hospitalization and community discharge. Results: Home health agencies with good work environments had lower rates of acute hospitalizations and higher rates of patient discharges to community living arrangements compared with home health agencies with poor work environments. Conclusion: Improved work environments in home health agencies hold promise for optimizing patient outcomes and reducing use of expensive hospital and institutional care. PMID:25215647

Home health agency work environments and hospitalizations.

PubMed

Jarrín, Olga; Flynn, Linda; Lake, Eileen T; Aiken, Linda H

2014-10-01

An important goal of home health care is to assist patients to remain in community living arrangements. Yet home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional health challenges and increasing care costs. To determine the relationship between home health agency work environments and agency-level rates of acute hospitalization and discharges to community living. Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 home health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-agency variation in rates of acute hospitalization and community discharge. Home health agencies with good work environments had lower rates of acute hospitalizations and higher rates of patient discharges to community living arrangements compared with home health agencies with poor work environments. Improved work environments in home health agencies hold promise for optimizing patient outcomes and reducing use of expensive hospital and institutional care.

Medicare-certified home health services: national and regional supply in the 1980s.

PubMed Central

Scalzi, C C; Zinn, J S; Guilfoyle, M J; Perdue, S T

1994-01-01

The number of Medicare-certified home health agencies nearly doubled from 1980 to 1990. Using Health Care Financing Administration data, this study documented national and regional patterns of entry and exist by Medicare home health providers from 1980 to 1990. Nationally, agency origination rates accelerated during the early 1980s and then dropped abruptly in the second half of the decade. The proprietary sector, accounting for approximately 42% of agencies in existence during the period of the study, exhibited the greatest volatility. Regional differences are also evident. Both expansion and contraction in Medicare home health services appear to be a response to the incentives of legislation implemented during this period. PMID:7943487

When nurses are also patients: Intimate partner violence and the health system as an enabler of women's health and agency in Johannesburg.

PubMed

Sprague, Courtenay; Woollett, Nataly; Parpart, Jane; Hatcher, Abigail M; Sommers, Theresa; Brown, Shelley; Black, Vivian

2016-01-01

While violence against women is a recognised global health problem, women's agency in marginalised settings is poorly understood, particularly in relation to health systems. We explored agency as a practical and theoretical construct through qualitative research among 20 nurses with direct or indirect experiences of intimate partner violence (IPV) in Johannesburg. Interviews conducted from August 2013 to March 2014 generated rich descriptions from respondents in five health facilities. Nurses' self-reported IPV matched national prevalence of 24-31%. Findings revealed the way in which agency is enacted by nurses, allowing them the economic means to leave abusive partnerships, yet disabling them from agency and health promotion in their workplace. At the same time, nurses expanded agentic possibilities for patients by enabling a national response to IPV within South African health clinics - one that is largely undocumented. We posit that nurses can serve as important agentic actors in public health systems in low- and middle-income country settings by assisting patients to address IPV, even in the absence of targeted training and guidelines. To ensure the health and well-being of women experiencing IPV, nurses should be supported by the health sector to respond skilfully to patients and to safely process their own experiences of violence.

Facilitating the implementation of clinical technology in healthcare: what role does a national agency play?

PubMed

Harvey, Gill; Llewellyn, Sue; Maniatopoulos, Greg; Boyd, Alan; Procter, Rob

2018-05-10

Accelerating the implementation of new technology in healthcare is typically complex and multi-faceted. One strategy is to charge a national agency with the responsibility for facilitating implementation. This study examines the role of such an agency in the English National Health Service. In particular, it compares two different facilitation strategies employed by the agency to support the implementation of insulin pump therapy. The research involved an empirical case study of four healthcare organisations receiving different levels of facilitation from the national agency: two received active hands-on facilitation; one was the intended recipient of a more passive, web-based facilitation strategy; the other implemented the technology without any external facilitation. The primary method of data collection was semi-structured qualitative interviews with key individuals involved in implementation. The integrated-PARIHS framework was applied as a conceptual lens to analyse the data. The two sites that received active facilitation from an Implementation Manager in the national agency made positive progress in implementing the technology. In both sites there was a high level of initial receptiveness to implementation. This was similar to a site that had successfully introduced insulin pump therapy without facilitation support from the national agency. By contrast, a site that did not have direct contact with the national agency made little progress with implementation, despite the availability of a web-based implementation resource. Clinicians expressed differences of opinion around the value and effectiveness of the technology and contextual barriers related to funding for implementation persisted. The national agency's intended roll out strategy using passive web-based facilitation appeared to have little impact. When favourable conditions exist, in terms of agreement around the value of the technology, clinician receptiveness and motivation to change, active

Forest health monitoring in the United States: focus on national reports

Treesearch

Kurt Riitters; Kevin Potter

2013-01-01

The health and sustainability of United States forests have been monitored for many years from several different perspectives. The national Forest Health Monitoring (FHM) Program was established in 1990 by Federal and State agencies to develop a national system for monitoring and reporting on the status and trends of forest ecosystem health. We describe and illustrate...

Succession Planning and Management Practice in Washington State Local Public Health Agencies.

PubMed

Wiesman, John M; Babich, Suzanne M; Umble, Karl; Baker, Edward L

2016-01-01

Turnover of top local public health officials is expected to be great, with 23% being 60 years of age or older, and another 42% being 50 to 59 years of age. Yet, we know little about the use of succession planning in public health agencies. Describe succession planning practices in local public health agencies. We conducted a Web-based, cross-sectional survey of succession planning practices and followed the career paths of public health officials for 40 months. The top local public health officials from Washington State's 35 local governmental public health agencies. Twenty-five succession planning best practices. All 35 agencies responded, resulting in a 100% response rate. Our study found evidence of succession planning practices in Washington State local public health agencies: 85% of agencies selected high-performing high potential employees for development, 76% sent them to formal technical and management/leadership training, 70% used cross-functional team projects, and 67% used stretch assignments to develop their employees. Impetuses to implement succession planning were discovering that large percentages of employees were able to retire soon and that national accreditation requires workforce development plans. Barriers to implementing succession planning included other competing demands for time, belief that the agency's workforce was too small for a formal program, and concerns that there would be union barriers. In 2012, 50% of the officials surveyed said that it would be at least possible that they would leave their current jobs within 5 years. Forty months later, 12 (34%) had left their positions. We were encouraged by the level of succession planning in Washington State and recommend creating a greater sense of urgency by focusing on agency retirement profiles and emphasizing the need for workforce development plans for accreditation. Developing the public health leaders of tomorrow is too important to be left to chance.

76 FR 9319 - Notice of Request for Reinstatement of an Information Collection; National Animal Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-17

... Collection; National Animal Health Monitoring System; Feedlot 2011 Study AGENCY: Animal and Plant Health... National Animal Health Monitoring Feedlot 2011 Study. DATES: We will consider all comments that we receive.... SUPPLEMENTARY INFORMATION: Title: National Animal Health Monitoring System; Feedlot 2011 Study. OMB Number: 0579...

About the Associate Director for Health of EPA's National Health and Environmental Effects Research Laboratory (NHEERL)

EPA Pesticide Factsheets

Dr. Ronald Hines serves as Associate Director for Health for the National Health and Environmental Effects Research Laboratory (NHEERL) within the U.S. Environmental Protection Agency's Office of Research and Development (ORD).

75 FR 48973 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; National...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration on Aging Agency Information Collection Activities; Submission for OMB Review; Comment Request; National Survey of Older Americans Act Title III... of Older Americans Act Title III Service Recipients information collection, which builds on earlier...

Use of quality measures for Medicaid behavioral health services by state agencies: implications for health care reform.

PubMed

Seibert, Julie; Fields, Suzanne; Fullerton, Catherine Anne; Mark, Tami L; Malkani, Sabrina; Walsh, Christine; Ehrlich, Emily; Imshaug, Melina; Tabrizi, Maryam

2015-06-01

The structure-process-outcome quality framework espoused by Donabedian provides a conceptual way to examine and prioritize behavioral health quality measures used by states. This report presents an environmental scan of the quality measures and satisfaction surveys that state Medicaid managed care and behavioral health agencies used prior to Medicaid expansion in 2014. Data were collected by reviewing online documents related to Medicaid managed care contracts for behavioral health, quality strategies, quality improvement plans, quality and performance indicators data, annual outcomes reports, performance measure specification manuals, legislative reports, and Medicaid waiver requests for proposals. Information was publicly available for 29 states. Most states relied on process measures, along with some structure and outcome measures. Although all states reported on at least one process measure of behavioral health quality, 52% of states did not use any outcomes measures and 48% of states had no structure measures. A majority of the states (69%) used behavioral health measures from the National Committee for Quality Assurance's Healthcare Effectiveness Data and Information Set, and all but one state in the sample (97%) used consumer experience-of-care surveys. Many states supplemented these data with locally developed behavioral health indicators that rely on administrative and nonadministrative data. State Medicaid agencies are using nationally recognized as well as local measures to assess quality of behavioral health care. Findings indicate a need for additional nationally endorsed measures in the area of substance use disorders and treatment outcomes.

HUMAN HEALTH RESEARCH IMPLEMENTATION PLAN, NATIONAL HEALTH AND ENVIRONMENTAL EFFECTS RESEARCH LABORATORY

EPA Science Inventory

The National Health and Environmental Effects Research Laboratory (NHEERL), as part of the Environmental Protection Agency's (EPA's) Office of Research and Development (ORD), is responsible for conducting research to improve the risk assessment of chemicals for potential effects ...

75 FR 52988 - National Advisory Committee on Occupational Safety and Health

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-30

... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2010-0012] National Advisory Committee on Occupational Safety and Health AGENCY: Occupational Safety and Health... Occupational Safety and Health (NACOSH) will meet September 14 and 15, 2010, in Washington, DC. In conjunction...

Agency and market area factors affecting home health agency supply changes.

PubMed

Porell, Frank W; Liu, Korbin; Brungo, David P

2006-10-01

To use the natural experiment created by the Medicare interim payment system (IPS) to study supply change behavior of home health agencies (HHAs) in local market areas. One hundred percent Medicare home health claims for 1996 and 1999, linked with Medicare Provider of Service and Denominator files, and the Area Resource File. Medicare home health care (HHC) claims data were used to distinguish HHAs that changed the local market supply of Medicare HHC by their market exit or by significant expansion or contraction of their geographic service area between 1996 and 1999 from other HHAs. Multinomial logit models were estimated to analyze how characteristics of agencies and the market areas in which they served were associated with these different agency-level supply changes. Changes in local HHA supply stemming from geographic service area expansions and contractions rivaled those owing to agency closures and market entries. Agencies at greater risk of closure and service area contraction tended to be smaller, newer, freestanding agencies, operating with more visit-intensive practice styles in markets with more competitor agencies. Except for having much less visit-intensive practice styles, similar attributes characterized agencies that increased local supply through service area expansion. Supply changes by HHAs largely reflected rational market responses by agencies to significant changes in financial incentives associated with the Medicare IPS. Recently certified agencies were among the most dynamic providers. Supply changes were more likely among agencies operating in more competitive market environments.

Private Health Care Coverage in the Brazilian population, according to the 2013 Brazilian National Health Survey.

PubMed

Malta, Deborah Carvalho; Stopa, Sheila Rizzato; Pereira, Cimar Azeredo; Szwarcwald, Célia Landmann; Oliveira, Martha; Reis, Arthur Chioro Dos

2017-01-01

This study aims to present the percentages of the Brazilian population holding health insurance plans, itemized by social-demographic characteristics, based on the data of the National Health Survey carried out in 2013, and to compare this information with the administrative data of the National Supplementary Health Agency for the same year. Data from the National Health Survey, and from the Beneficiaries Information System of the National Health Agency for the year 2013, were used. The percentage of people having a health plan was described according to stratification for: all of Brazil, urban/rural, Brazilian official Regions, Brazilian States and state capitals, gender, age group, level of schooling, position in the workforce, ethnic classification, and self-assessed state of health. Results include the following: The percentage of people saying they had some health plan in Brazil was 27.9% (CI 95%: 27.1-28.8). A significant difference was found relating to level of schooling - the percentage being highest for those who stated they had complete secondary education (68.8% CI 95%: 67.2-70.4) and for those who said they were currently in work (32.5% CI 95%: 31.5-33.5). The increase in health plan coverage in the Brazilian population reflects the improvement of the suply of employment and the growth in the country's economy.

The health systems agency: a new bureaucracy.

PubMed

Meredith, S; Meredith, G

1977-07-01

A Federal law signed by President Ford in 1975 (PL 93-641) mandates the establishment of Health Systems Agencies across the country. The major intent of the law is to provide local direction and control of health care planning. Each Agency shall have a professional staff under the aegis of a board of directors composed of a majority of consumers and a minority of providers. Data identifying health care needs shall be translated into a Health Systems Plan, which is a statement of goals for each Agency; an Annual Implementation Plan shall be developed as a statement of objectives, projects, and strategies requisite to achieving the Health Systems Plan. The concept of the Health Systems Agency has correlate state and federal bureaucratic strata to facilitate health care planning coordination.

"1970" Inter-Agency Health Meeting (Navajo).

ERIC Educational Resources Information Center

Arizona Commission of Indian Affairs, Phoenix.

An inter-agency health meeting regarding health services for Navajo Indians is reported on in this document. The meeting, sponsored by the Arizona Commission of Indian Affairs, involved agencies such as the U.S. Public Health Service, Bureau of Indian Affairs, and the Navajo Tribe. Included in the proceedings are reports and remarks by…

Agency and Market Area Factors Affecting Home Health Agency Supply Changes

PubMed Central

Porell, Frank W; Liu, Korbin; Brungo, David P

2006-01-01

Objective To use the natural experiment created by the Medicare interim payment system (IPS) to study supply change behavior of home health agencies (HHAs) in local market areas. Data Sources One hundred percent Medicare home health claims for 1996 and 1999, linked with Medicare Provider of Service and Denominator files, and the Area Resource File. Study Design Medicare home health care (HHC) claims data were used to distinguish HHAs that changed the local market supply of Medicare HHC by their market exit or by significant expansion or contraction of their geographic service area between 1996 and 1999 from other HHAs. Multinomial logit models were estimated to analyze how characteristics of agencies and the market areas in which they served were associated with these different agency-level supply changes. Principal Findings Changes in local HHA supply stemming from geographic service area expansions and contractions rivaled those owing to agency closures and market entries. Agencies at greater risk of closure and service area contraction tended to be smaller, newer, freestanding agencies, operating with more visit-intensive practice styles in markets with more competitor agencies. Except for having much less visit-intensive practice styles, similar attributes characterized agencies that increased local supply through service area expansion. Conclusions Supply changes by HHAs largely reflected rational market responses by agencies to significant changes in financial incentives associated with the Medicare IPS. Recently certified agencies were among the most dynamic providers. Supply changes were more likely among agencies operating in more competitive market environments. PMID:16987305

78 FR 19710 - Call for Collaborating Partners for National Women's Health Week

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Call for Collaborating Partners for National Women's Health Week AGENCY: Office on Women's Health, Office of the Assistant Secretary for Health, Office of the... Human Services (HHS), Office on Women's Health (OWH) invites public and private-sector health-related...

National health care reform and the 103rd Congress: the activities and influence of public health advocates.

PubMed Central

Schauffler, H; Wilkerson, J

1997-01-01

OBJECTIVES: This study examined the activities and influence of public health interest groups and coalitions on the national health care reform debates in the 103rd Congress. METHODS: Congressional staff and representatives of public health interest groups, coalitions, and government health agencies were interviewed. Content analysis of eight leading national health care reform bills was performed. RESULTS: The public health community coalesced around public health in health care reform; nearly all the major interest groups and government health agencies joined two or more public health or prevention coalitions, and half joined three or more. The most effective influence on health care reform legislation was early, sustained personal contact with Congress members and their staffs, accompanied by succinct written materials summarizing key points. Media campaigns and grassroots mobilization were less effective. Seven of the eight leading health care reform bills included one or more of the priorities supported by public health advocates. CONCLUSIONS: The public health community played an important role in increasing awareness and support for public health programs in the health care reform bills of the 103rd Congress. PMID:9240098

75 FR 43528 - Seeking Public Comment on Draft National Health Security Strategy Biennial Implementation Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Seeking Public Comment on Draft National Health Security Strategy Biennial Implementation Plan AGENCY: Department of Health and Human... Interim Implementation Guide for the National Health Security Strategy of the United States of America...

Coordination between child welfare agencies and mental health providers, children's service use, and outcomes

PubMed Central

Bai, Yu; Wells, Rebecca; Hillemeier, Marianne M.

2009-01-01

Objective Interorganizational relationships (IORs) between child welfare agencies and mental health service providers may facilitate mental health treatment access for vulnerable children. This study investigates whether IORs are associated with greater use of mental health services and improvement in mental health status for children served by the child welfare system. Methods This was a longitudinal analysis of data from a 36 month period in the National Survey of Child and Adolescent Well-Being (NSCAW). The sample consisted of 1,613 children within 75 child welfare agencies who were 2 years or older and had mental health problems at baseline. IOR intensity was measured as the number of coordination approaches between each child welfare agency and mental health service providers. Separate weighted multilevel logistic regression models tested associations between IORs and service use and outcomes, respectively. Results Agency level factors accounted for 9% of the variance in the probability of service use and 12% of mental health improvement. Greater intensity of IORs was associated with higher likelihood of both service use and mental health improvement. Conclusions Having greater numbers of ties with mental health providers may help child welfare agencies improve children's mental health service access and outcomes. Practice Implications Policymakers should develop policies and initiatives to encourage a combination of different types of organizational ties between child welfare and mental health systems. For instance, information sharing at the agency level in addition to coordination at the case level may improve the coordination necessary to serve these vulnerable children. PMID:19473702

Health information exchange: national and international approaches.

PubMed

Vest, Joshua R

2012-01-01

Health information exchange (HIE), the process of electronically moving patient-level information between different organizations, is viewed as a solution to the fragmentation of data in health care. This review provides a description of the current state of HIE in seven nations, as well was three international HIE efforts, with a particular focus on the relation of exchange efforts to national health care systems, common challenges, and the implications of cross-border information sharing. National and international efforts highlighted in English language informatics journals, professional associations, and government reports are described. Fully functioning HIE is not yet a common phenomenon worldwide. However, multiple nations see the potential benefits of HIE and that has led to national and international efforts of varying scope, scale, and purview. National efforts continue to work to overcome the challenges of interoperability, record linking, insufficient infrastructures, governance, and interorganizational relationships, but have created architectural strategies, oversight agencies, and incentives to foster exchange. The three international HIE efforts reviewed represent very different approaches to the same problem of ensuring the availability of health information across borders. The potential of HIE to address many cost and quality issues will ensure HIE remains on many national agendas. In many instances, health care executives and leaders have opportunities to work within national programs to help shape local exchange governance and decide technology partners. Furthermore, HIE raises policy questions concerning the role of centralized planning, national identifiers, standards, and types of information exchanged, each of which are vital issues to individual health organizations and worthy of their attention.

Health information given by Swiss travel agencies.

PubMed

Schwitz, Fabienne M; Haley, Timothy J L; Stat, C; Hatz, Christoph F R

2006-01-01

Many of the 1 million Swiss traveling to tropical or subtropical countries book their trip through travel agencies every year. These agencies are thus an important source of information about malaria and other important health risks and little is known about the appropriate health information provided by these. A study was conducted to assess health-related information in members of the Swiss Federation of Travel Agencies in the metropolitan area of Zurich, Switzerland. A covert investigator (F.M.S.) visited these agencies and requested information on a package holiday for 2 or 3 weeks to Kenya. Following an in-person interview, the investigator recorded any health-related information provided on a pretested form. If none was mentioned, the agent was prompted using a standardized procedure. A total of 88 agencies were visited. Spontaneous health advice was given in 44% of all visits. After prompting, 99% of all travel agents mentioned preventive measures against malaria, but only 69% indicated the need for vaccinations against other diseases. Spontaneous advice on malaria risk and vaccinations was better than advice given upon prompting. One fifth of all travel agents neither mentioned malaria prevention measures spontaneously nor recommended seeing a health specialist. Overall, travel medicine knowledge of travel agents in the Zurich area needs improvement as many tended to draw attention to health risks only when prompted. Attitude, personal knowledge, and experience of individual travel agents were key to the health information given. Up-to-date and readily available information on health risks should be provided to travel agencies and structured training given in collaboration with health professionals.

75 FR 70365 - Agency Information Collection (Follow-Up Study of a National Cohort of Gulf War and Gulf Era...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-17

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-New (10-0488)] Agency Information Collection (Follow-Up Study of a National Cohort of Gulf War and Gulf Era Veterans) Activity Under OMB Review AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: In compliance with...

Assessing Advanced Airway Management Performance in a National Cohort of Emergency Medical Services Agencies.

PubMed

Wang, Henry E; Donnelly, John P; Barton, Dustin; Jarvis, Jeffrey L

2018-05-01

Although often the focus of quality improvement efforts, emergency medical services (EMS) advanced airway management performance has few national comparisons, nor are there many assessments with benchmarks accounting for differences in agency volume or patient mix. We seek to assess variations in advanced airway management and conventional intubation performance in a national cohort of EMS agencies. We used EMS data from ESO Solutions, a national EMS electronic health record system. We identified EMS emergency responses with attempted advanced airway management (conventional intubation, rapid sequence intubation, sedation-assisted intubation, supraglottic airway insertion, and cricothyroidotomy). We also separately examined cases with initial conventional intubation. We determined EMS agency risk-standardized advanced airway management and initial conventional intubation success rates by using mixed-effects regression models, fitting agency as a random intercept, adjusting for patient age, sex, race, cardiac arrest, or trauma status, and use of rapid sequence or sedation-assisted intubation, and accounting for reliability variations from EMS agency airway volume. We assessed changes in agency advanced airway management and initial conventional intubation performance rank after risk and reliability adjustment. We also identified high and low performers (reliability-adjusted and risk-standardized success confidence intervals falling outside the mean). During 2011 to 2015, 550 EMS agencies performed 57,209 advanced airway management procedures. Among 401 EMS agencies with greater than or equal to 10 advanced airway management procedures, there were a total of 56,636 procedures. Median reliability-adjusted and risk-standardized EMS agency advanced airway management success was 92.9% (interquartile range 90.1% to 94.8%; minimum 58.2%; maximum 99.0%). There were 56 advanced airway management low-performing and 38 high-performing EMS agencies. Among 342 agencies with

77 FR 43616 - National Advisory Committee on Occupational Safety and Health (NACOSH)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-25

... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2012-0019] National Advisory Committee on Occupational Safety and Health (NACOSH) AGENCY: Occupational Safety and... Assistant Secretary of Labor for Occupational Safety and Health requests nominations for membership on...

76 FR 60085 - National Advisory Committee on Occupational Safety and Health (NACOSH)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-28

... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2011-0065] National Advisory Committee on Occupational Safety and Health (NACOSH) AGENCY: Occupational Safety and... Assistant Secretary of Labor for Occupational Safety and Health requests nominations for membership on...

75 FR 28661 - National Advisory Committee on Occupational Safety and Health (NACOSH)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-21

... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2010-0012] National Advisory Committee on Occupational Safety and Health (NACOSH) AGENCY: Occupational Safety and... Committee on Occupational Safety and Health (NACOSH). SUMMARY: The Assistant Secretary of Labor for...

Telehealth Utilization for Chronic Illness and Depression Among Home Health Agencies: A Pilot Survey.

PubMed

Kim, Eunhae; Gellis, Zvi D; Hoak, Vicki

2015-01-01

This pilot survey study explores current telehealth use among home health care agencies for chronic illness and depression care, and identifies factors associated with agencies' perception and intention to use telehealth. Between June and August 2014, 73 directors and 13 staff nurses (N = 86) from the Pennsylvania Homecare Association member agencies participated in an online survey. Eighty-five percent of telehealth provider agencies reported utilizing telehealth for monitoring health status while only 7.7% reported use for depression care. Telehealth technology was more positively perceived for chronic illness care (90.7%) than for depression care (53%) services. Factors associated with positive perceptions of telehealth were identified, including: (a) intention to use or continuing to use telehealth, (b) the size of the agency, (c) the participant's agency role, and (d) existence of depression services. These pilot findings have been used to inform the theoretical framework and the survey instrument for our U.S. national survey.

Comparing maternal child health problems and outcomes across public health nursing agencies.

PubMed

Monsen, Karen A; Fulkerson, Jayne A; Lytton, Amy B; Taft, Lila L; Schwichtenberg, Linda D; Martin, Karen S

2010-05-01

To use aggregated data from health informatics systems to identify needs of maternal and child health (MCH) clients served by county public health agencies and to demonstrate outcomes of services provided. Participating agencies developed and implemented a formal standardized classification data comparison process using structured Omaha System data. An exploratory descriptive analysis of the data was performed. Summary reports of aggregated and analyzed data from records of clients served and discharged in 2005 were compared. Client problems and outcomes were found to be similar across agencies, with behavioral, psychosocial, environmental and physiological problems identified and addressed. Differential improvement was noted by problem, outcome measure, and agency; and areas for enhancing intervention strategies were prioritized. Problems with greatest improvement across agencies were Antepartum/postpartum and Family planning, and least improvement across agencies were Neglect and Substance use. Findings demonstrated that public health nurses address many serious health-related problems with low-income high-risk MCH clients. MCH client needs were found to be similar across agencies. Public health nurse home visiting services addressed important health issues with MCH clients, and statistically significant improvement in client health problems occurred consistently across agencies. The data comparison processes developed in this project were useful for MCH programs, and may be applicable to other program areas using structured client data for evaluation purposes. Using informatics tools and data facilitated needs assessment, program evaluation, and outcomes management processes for the agencies, and will continue to play an integral role in directing practice and improving client outcomes.

Mental health status of women in Jordan: a comparative study between attendees of governmental and UN relief and works agency's health care centers.

PubMed

Al-Modallal, Hanan; Hamaideh, Shaher; Mudallal, Rula

2014-05-01

This study aimed at investigating differences in mental health problems between attendees of governmental and United Nations Relief and Works Agency for Palestine Refugees health care centers in Jordan. Further, predictors of mental health problems based on women's demographic profile were investigated. A convenience sample of 620 women attending governmental and United Nations Relief and Works Agency for Palestine Refugees health care centers in Jordan was recruited for this purpose. Independent samples t-tests were used to identify differences in mental health, and multiple linear regression was implemented to identify significant predictors of women's mental health problems. Results indicated an absence of significant differences in mental health problems between attendees of the two types of health care centers. Further, among the demographic indicators that were tested, income, spousal violence, and general health were the predictors of at least three different mental health problems in women. This study highlights opportunities for health professionals to decrease women's propensity for mental health problems by addressing these factors when treating women attending primary care centers in different Jordanian towns, villages, and refugee camps.

32 CFR 147.24 - The national agency check.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false The national agency check. 147.24 Section 147.24 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN... reinvestigations. It consists of a review of; (a) Investigative and criminal history files of the FBI, including a...

32 CFR 147.24 - The national agency check.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false The national agency check. 147.24 Section 147.24 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN... reinvestigations. It consists of a review of; (a) Investigative and criminal history files of the FBI, including a...

32 CFR 147.24 - The national agency check.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false The national agency check. 147.24 Section 147.24 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN... reinvestigations. It consists of a review of; (a) Investigative and criminal history files of the FBI, including a...

32 CFR 147.24 - The national agency check.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 1 2014-07-01 2014-07-01 false The national agency check. 147.24 Section 147.24 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN... reinvestigations. It consists of a review of; (a) Investigative and criminal history files of the FBI, including a...

32 CFR 147.24 - The national agency check.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 1 2012-07-01 2012-07-01 false The national agency check. 147.24 Section 147.24 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN... reinvestigations. It consists of a review of; (a) Investigative and criminal history files of the FBI, including a...

77 FR 31398 - National Advisory Committee on Occupational Safety and Health (NACOSH)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-25

... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2012-0019] National Advisory Committee on Occupational Safety and Health (NACOSH) AGENCY: Occupational Safety and... on Occupational Safety and Health (NACOSH) and NACOSH Work Groups. SUMMARY: NACOSH will meet June 20...

78 FR 24154 - Notice of Availability of a National Animal Health Laboratory Network Reorganization Concept Paper

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-24

...] Notice of Availability of a National Animal Health Laboratory Network Reorganization Concept Paper AGENCY... Network (NAHLN) for public review and comment. The NAHLN is a nationally coordinated network and... Coordinator, National Animal Health Laboratory Network, Veterinary Services, APHIS, 2140 Centre Avenue...

Vulnerability, Health Agency and Capability to Health.

PubMed

Straehle, Christine

2016-01-01

One of the defining features of the capability approach (CA) to health, as developed in Venkatapuram's book Health Justice, is its aim to enable individual health agency. Furthermore, the CA to health hopes to provide a strong guideline for assessing the health-enabling content of social and political conditions. In this article, I employ the recent literature on the liberal concept of vulnerability to assess the CA. I distinguish two kinds of vulnerability. Considering circumstantial vulnerability, I argue that liberal accounts of vulnerability concerned with individual autonomy, align with the CA to health. Individuals should, as far as possible, be able to make health-enabling decisions about their lives, and their capability to do so should certainly not be hindered by public policy. The CA to health and a vulnerability-based analysis then work alongside to define moral responsibilities and designate those who hold them. Both approaches demand social policy to address circumstances that hinder individuals from taking health-enabling decisions. A background condition of vulnerability, on the other hand, even though it hampers the capability for health, does not warrant the strong moral claim proposed by the CA to health to define health as a meta-capability that should guide social policy. Nothing in our designing social policy could change the challenge to health agency when we deal with background conditions of vulnerability. © 2016 John Wiley & Sons Ltd.

State health agencies and the legislative policy process.

PubMed

Williams-Crowe, S M; Aultman, T V

1994-01-01

A new era of health care reform places increasing pressure on public health leaders and agencies to participate in the public policy arena. Public health professionals have long been comfortable in providing the scientific knowledge base required in policy development. What has been more recent in its evolution, however, is recognition that they must also play an active role in leading and shaping the debate over policy. A profile of effective State legislative policy "entrepreneurs" and their strategies has been developed to assist health agencies in developing such a leadership position. Based on the experiences of State legislative liaison officers, specific strategies for dealing with State legislatures have been identified and are organized into five key areas--agency organization, staff skills, communications, negotiation, and active ongoing involvement. A public health agency must be organized effectively to participate in the legislative policy process. Typically, effective agencies centralize responsibility for policy activities and promote broad and coordinated participation throughout the organization. Playing a key role in the agency's political interventions, the legislative liaison office should be staffed with persons possessing excellent interpersonal skills and a high degree of technical competence. Of central importance to effective legislative policy entrepreneurship is the ability to communicate the agency's position clearly. This includes setting forward a focused policy agenda, documenting policy issues in a meaningful manner, and reaching legislators with the proper information. Once a matter is on the legislative agenda, the agency must be prepared to negotiate and build broad support for the measure. Finally, public health agencies must be active policy players. To take advantage of new opportunities for action, the public health (policy) leader must monitor the political environment continually.By working to anticipate and formulate

National Health Accounts development: lessons from Thailand.

PubMed

Tangcharoensathien, V; Laixuthai, A; Vasavit, J; Tantigate, N A; Prajuabmoh-Ruffolo, W; Vimolkit, D; Lertiendumrong, J

1999-12-01

National Health Accounts (NHA) are an important tool to demonstrate how a country's health resources are spent, on what services, and who pays for them. NHA are used by policy-makers for monitoring health expenditure patterns; policy instruments to re-orientate the pattern can then be further introduced. The National Economic and Social Development Board (NESDB) of Thailand produces aggregate health expenditure data but its estimation methods have several limitations. This has led to the research and development of an NHA prototype in 1994, through an agreed definition of health expenditure and methodology, in consultation with peer and other stakeholders. This is an initiative by local researchers without external support, with an emphasis on putting the system into place. It involves two steps: firstly, the flow of funds from ultimate sources of finance to financing agencies; and secondly, the use of funds by financing agencies. Five ultimate sources and 12 financing agencies (seven public and five private) were identified. Use of consumption expenditures was listed under four main categories and 32 sub-categories. Using 1994 figures, we estimated a total health expenditure of 128,305.11 million Baht; 84.07% consumption and 15.93% capital formation. Of total consumption expenditure, 36.14% was spent on purchasing care from public providers, with 32.35% on private providers, 5.93% on administration and 9.65% on all other public health programmes. Public sources of finance were responsible for 48.79% and private 51.21% of the total 1994 health expenditure. Total health expenditure accounted for 3.56% of GDP (consumption expenditure at 3.00% of GDP and capital formation at 0.57% of GDP). The NESDB consumption expenditure estimate in 1994 was 180,516 million Baht or 5.01% of GDP, of which private sources were dominant (82.17%) and public sources played a minor role (17.83%). The discrepancy of consumption expenditure between the two estimates is 2.01% of GDP. There

75 FR 41505 - National Center for Environmental Health/Agency for Toxic Substances and Disease Registry (NCEH...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-16

...; Notice of National Conversation on Public Health and Chemical Exposures Leadership Council Meeting Time... is the fifth meeting of the National Conversation on Public Health and Chemical Exposures Leadership... Leadership Council provides overall guidance to the National Conversation project and is responsible for...

77 FR 42255 - Notice of Request for Approval of a New Information Collection; National Animal Health Monitoring...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-18

... Collection; National Animal Health Monitoring System; Layers 2013 Study AGENCY: Animal and Plant Health... Health Inspection Service's intention to initiate the Layers 2013 Study, an information collection to... INFORMATION: Title: National Animal Health Monitoring System; Layers 2013 Study. OMB Number: 0579-XXXX. Type...

76 FR 9578 - National Center for Environmental Health/Agency for Toxic Substances and Disease Registry (NCEH...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-18

... National Conversation on Public Health and Chemical Exposures Leadership Council Meeting Time and Date: 8... Conversation on Public Health and Chemical Exposures Leadership Council. The National Conversation on Public... public's health from harmful chemical exposures. The Leadership Council provides overall guidance to the...

77 FR 62536 - National Advisory Committee on Occupational Safety and Health (NACOSH)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-15

... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2012-0019] National Advisory Committee on Occupational Safety and Health (NACOSH) AGENCY: Occupational Safety and... Section 7(a) of the Occupational Safety and Health Act of 1970 (OSH Act) (29 U.S.C. 651, 656) to advise...

ASSESSING BIOACCUMULATION FOR DERIVING NATIONAL HUMAN HEALTH WATER QUALITY CRITERIA

EPA Science Inventory

The United States Environmental Protection Agency is revising its methodology for deriving national ambient water quality criteria (AWQC) to protect human health. A component of this guidance involves assessing the potential for chemical bioaccumulation in commonly consumed fish ...

Local public health agency funding: money begets money.

PubMed

Bernet, Patrick Michael

2007-01-01

Local public health agencies are funded federal, state, and local revenue sources. There is a common belief that increases from one source will be offset by decreases in others, as when a local agency might decide it must increase taxes in response to lowered federal or state funding. This study tests this belief through a cross-sectional study using data from Missouri local public health agencies, and finds, instead, that money begets money. Local agencies that receive more from federal and state sources also raise more at the local level. Given the particular effectiveness of local funding in improving agency performance, these findings that nonlocal revenues are amplified at the local level, help make the case for higher public health funding from federal and state levels.

Payment reform will shift home health agency valuation parameters.

PubMed

Hahn, A D

1998-12-01

Changes authorized by the Balanced Budget Act of 1997 have removed many of the payment benefits that motivated past home health agency acquisition activity and temporarily have slowed the rapid pace of acquisitions of home health agencies. The act required that Medicare's cost-based payment system be replaced with a prospective payment system (PPS) and established an interim payment system to provide a framework for home health agencies to make the transition to the PPS. As a consequence, realistic valuations of home health agencies will be determined primarily by cash flows, with consideration given to operational factors, such as quality of patient care, service territory, and information systems capabilities. The limitations imposed by the change in payment mechanism will cause acquisition interest to shift away from home health agencies with higher utilization and revenue expansion to agencies able to control costs and achieve operating leverage.

78 FR 38287 - Bitterroot National Forest, Darby Ranger District, Como Forest Health Project

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... DEPARTMENT OF AGRICULTURE Forest Service Bitterroot National Forest, Darby Ranger District, Como Forest Health Project AGENCY: Forest Service. ACTION: Notice; Correction. SUMMARY: The Department of Agriculture (USDA), Forest Service, Bitterroot National Forest, Darby Ranger District published a document in...

42 CFR 484.245 - Accelerated payments for home health agencies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Accelerated payments for home health agencies. 484... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Prospective Payment System for Home Health Agencies § 484.245 Accelerated payments for home health agencies. (a) General rule...

42 CFR 484.245 - Accelerated payments for home health agencies.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Accelerated payments for home health agencies. 484... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Prospective Payment System for Home Health Agencies § 484.245 Accelerated payments for home health agencies. (a) General rule...

42 CFR 484.245 - Accelerated payments for home health agencies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Accelerated payments for home health agencies. 484... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Prospective Payment System for Home Health Agencies § 484.245 Accelerated payments for home health agencies. (a) General rule...

Factors That Influence the Recruitment and Retention of Nurses in Public Health Agencies.

PubMed

Yeager, Valerie A; Wisniewski, Janna M

Given challenges to recruiting nurses to public health and the growth in national policies focused on population health, it is crucial that public health agencies develop strategies to sustain this important group of employees. The objective of this study was to examine factors that influence nurses' decisions to work in public health agencies. This cross-sectional study examined perspectives of nurses who worked in state and local public health departments and responded to the 2010 Council on Linkages Between Academia and Public Health Practice's survey of public health workers. We calculated the mean rating of each recruitment and retention factor for nurses and non-nurses separately and compared differences by using t tests. We then used multivariate regression analysis to examine differences in ratings by role (ie, nurse or non-nurse). After controlling for personal and organizational characteristics, the influence of 5 recruitment factors was significantly stronger among nurses than among non-nurses: flexibility of work schedule ( P < .001), autonomy/employee empowerment ( P < .001), ability to innovate ( P = .002), specific duties and responsibilities ( P = .005), and identifying with the mission of the organization ( P = .02). The influence of 5 retention factors was stronger among nurses than among non-nurses : autonomy/employee empowerment ( P < .001), flexibility of work schedule ( P < .001), specific duties and responsibilities ( P < .001), opportunities for training/continuing education ( P = .03), and ability to innovate ( P = .008). Some factors that influence nurses to begin and remain working in local governmental public health agencies, such as flexible schedules and employee autonomy, are factors that governmental public health agencies can design into positions and highlight when recruiting from health care organizations, private industry, and academia.

Mental health services for homebound elders from home health nursing agencies and home care agencies.

PubMed

Zeltzer, Barry B; Kohn, Robert

2006-04-01

This study examined the practices of home care agencies and home health nursing agencies in the management and treatment of homebound clients with behavioral problems, dementia, and undiagnosed mental illnesses. A survey was mailed to all 54 directors of agencies in Rhode Island in 2003; 53 responded, either by mail or telephone. Data indicated a lack of psychiatric services, a reluctance to address behavioral problems, and a failure to identify undiagnosed disorders. There was also a bias against accepting individuals with primary psychiatric disorders. Although the population of homebound elders with mental illness is increasing, their needs are not being met by these agencies.

Utilisation and costs of nursing agencies in the South African public health sector, 2005-2010.

PubMed

Rispel, Laetitia C; Angelides, George

2014-01-01

Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals. The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6-2009/10) from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ∼ R7, 2010 prices). Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million) was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million) in Mpumalanga Province (mixed urban-rural) to a high of R356.43 million (US$50.92 million) in the Eastern Cape Province (mixed urban-rural). Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural) to 11.96% in the Northern Cape Province (rural). In that financial year

77 FR 1945 - Agency Information Collection Activities: Proposed Collection; Comment Request, National Fire...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-12

..., National Fire Department Census AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice. SUMMARY... the development and continuation of the National Fire Department Census. DATES: Comments must be..., Statistician, United States Fire Administration, National Fire Data Center, (301) 447-1154 for additional...

[Vinyl chloride and 1,2-dichloroethane: classification and assessment of carcinogenicity, guidelines, threshold values, and standards developed by national and international entities, organizations, and agencies].

PubMed

Binetti, R; Costamagna, F M; Marcello, I

2001-01-01

International, national and regulatory classification, evaluation, guidelines and occupational exposure values regarding vinyl chloride and 1,2-dichloroethane, carried out by European Union (EU). Environmental Protection Agency (US EPA), International Agency for Research on Cancer (IARC), Italian National Advisory Toxicological Committee (CCTN), Occupational Safety and Health Administration (OSHA), World Health Organization (WHO), National Institute for Occupational Safety and Health (NIOSH), American Conference of Governmental Industrial Hygienists (ACGIH) and other institutions, have been considered with particular reference to the carcinogenic effects. Moreover information is reported in support of classification and evaluation and a short historical review since early 1970s, when first evidence that occupational exposure to VC could lead to angiosarcoma was published.

75 FR 66797 - National Advisory Committee on Occupational Safety and Health (NACOSH), Charter Renewal

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2010-0012] National Advisory Committee on Occupational Safety and Health (NACOSH), Charter Renewal AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Notice of renewal of the NACOSH charter...

The structure of state health agencies: a strategic analysis.

PubMed

Ford, Eric W; Duncan, W Jack; Ginter, Peter M

2003-03-01

Leaders in public organizations are adopting many private sector management practices to control costs and increase efficiency. Nowhere is this more evident than among state health agencies. State health agencies were encouraged to change the way they operate by the 1988 Institute of Medicine (IOM) report on The Future of Public Health. This report portrayed public health as being in disarray. To address major deficiencies identified by the IOM study, some public health leaders have reevaluated their environments, reconfigured their organizations, and adopted a strategic mindset. The purpose of this research is to explore the various organizational configurations of state health agencies. Replicating methods used in studies of private sector organizations, five distinct strategic configurations or archetypes were identified. This comprehensive public health agency taxonomy will assist future researchers in analyzing public health organizations' environments, structures, and strategies.

Exploring National Environmental Policy Act processes across federal land management agencies

Treesearch

Marc J. Stern; Michael J. Mortimer

2009-01-01

Broad discretion is granted at all levels throughout federal land management agencies regarding compliance with the National Environmental Policy Act (NEPA). We explored the diversity of procedures employed in NEPA processes across four agencies, the USDA Forest Service, The USDI National Park Service and Bureau of Land Management, and the U.S. Army Corps of Engineers...

42 CFR 484.245 - Accelerated payments for home health agencies.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Recovery of payment. Recovery of the accelerated payment is made by recoupment as HHA bills are processed... 42 Public Health 5 2013-10-01 2013-10-01 false Accelerated payments for home health agencies. 484... for Home Health Agencies § 484.245 Accelerated payments for home health agencies. (a) General rule...

42 CFR 484.245 - Accelerated payments for home health agencies.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Recovery of payment. Recovery of the accelerated payment is made by recoupment as HHA bills are processed... 42 Public Health 5 2014-10-01 2014-10-01 false Accelerated payments for home health agencies. 484... for Home Health Agencies § 484.245 Accelerated payments for home health agencies. (a) General rule...

Mental Health Need and Access to Mental Health Services by Youths Involved with Child Welfare: A National Survey.

ERIC Educational Resources Information Center

Burns, Barbara J.; Phillips, Susan D.; Wagner, H. Ryan; Barth, Richard P.; Kolko, David J.; Campbell, Yvonne; Landsverk, John

2004-01-01

Objective: This study assessed the relationship between the need for and use of mental health services among a nationally representative sample of children who were investigated by child welfare agencies after reported maltreatment. Method: Data were collected at study entry into the National Survey of Child and Adolescent Well-Being and were…

Refining estimates of public health spending as measured in national health expenditures accounts: the United States experience.

PubMed

Sensenig, Arthur L

2007-01-01

Providing for the delivery of public health services and understanding the funding mechanisms for these services are topics of great currency in the United States. In 2002, the Department of Homeland Security was created and the responsibility for providing public health services was realigned among federal agencies. State and local public health agencies are under increased financial pressures even as they shoulder more responsibilities as the vital first link in the provision of public health services. Recent events, such as hurricanes Katrina and Rita, served to highlight the need to accurately access the public health delivery system at all levels of government. The National Health Expenditure Accounts (NHEA), prepared by the National Health Statistics Group, measure expenditures on healthcare goods and services in the United States. Government public health activity constitutes an important service category in the NHEA. In the most recent set of estimates, Government Public Health Activity expenditures totaled $56.1 billion in 2004, or 3.0 percent of total US health spending. Accurately measuring expenditures for public health services in the United States presents many challenges. Among these challenges is the difficult task of defining what types of government activity constitute public health services. There is no clear-cut, universally accepted definition of government public health care services, and the definitions in the proposed International Classification for Health Accounts are difficult to apply to an individual country's unique delivery systems. Other challenges include the definitional issues associated with the boundaries of healthcare as well as the requirement that census and survey data collected from government(s) be compliant with the Classification of Functions of Government (COFOG), an internationally recognized classification system developed by the United Nations.

77 FR 32952 - Defense Intelligence Agency National Intelligence University Board of Visitors Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-04

... DEPARTMENT OF DEFENSE Office of the Secretary Defense Intelligence Agency National Intelligence University Board of Visitors Closed Meeting AGENCY: Department of Defense, Defense Intelligence Agency, National Intelligence University. ACTION: Notice of closed meeting. SUMMARY: Pursuant to the provisions of...

77 FR 58557 - Board of Scientific Counselors, National Center for Environmental Health/Agency for Toxic...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-21

..., will include NCEH/ATSDR Office of the Director updates: ATSDR Reorganization, Asthma, Lead and Healthy... activities at the National Institute for Occupational Safety and Health, U.S. Department of Energy, National...

Employment-Related Health Insurance: Federal Agencies' Roles in Meeting Data Needs

PubMed Central

Wiatrowski, William; Harvey, Holly; Levit, Katharine R.

2002-01-01

Employer-sponsored health insurance accounts for almost one-third of all health care spending. As health care cost growth accelerates affecting the availability of employer-sponsored insurance and depth of coverage, the importance of timely and accurate information for measuring and monitoring these changes and formulating policy options increases. Identifying a growing gap between the need for and availability of data to inform policy on employment-related health insurance issues, the Office of Management and Budget (OMB) established a committee of Federal agency representatives to evaluate and advise data collection efforts. This article reports on the committee's current efforts, focusing on evaluation of results from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) and the National Compensation Survey (NCS). PMID:12500352

Employment-related health insurance: federal agencies' roles in meeting data needs.

PubMed

Wiatrowski, William; Harvey, Holly; Levit, Katharine R

2002-01-01

Employer-sponsored health insurance accounts for almost one-third of all health care spending. As health care cost growth accelerates affecting the availability of employer-sponsored insurance and depth of coverage, the importance of timely and accurate information for measuring and monitoring these changes and formulating policy options increases. Identifying a growing gap between the need for and availability of data to inform policy on employment-related health insurance issues, the Office of Management and Budget (OMB) established a committee of Federal agency representatives to evaluate and advise data collection efforts. This article reports on the committee's current efforts, focusing on evaluation of results from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) and the National Compensation Survey (NCS).

42 CFR 413.125 - Payment for home health agency services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Payment for home health agency services. 413.125... Categories of Costs § 413.125 Payment for home health agency services. (a) For additional rules on the allowability of certain costs incurred by home health agencies, see §§ 409.46 and 409.49(b) of this chapter. (b...

42 CFR 413.125 - Payment for home health agency services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Payment for home health agency services. 413.125... Categories of Costs § 413.125 Payment for home health agency services. (a) For additional rules on the allowability of certain costs incurred by home health agencies, see §§ 409.46 and 409.49(b) of this chapter. (b...

42 CFR 413.125 - Payment for home health agency services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Payment for home health agency services. 413.125... Categories of Costs § 413.125 Payment for home health agency services. (a) For additional rules on the allowability of certain costs incurred by home health agencies, see §§ 409.46 and 409.49(b) of this chapter. (b...

International involvement and national health governance: the basic benefit package in Tajikistan.

PubMed

Rechel, Bernd; Khodjamurodov, Ghafur

2010-06-01

Tajikistan, a Central Asian state of 7.4 million inhabitants, is facing particular health policy challenges: not only is the country the poorest of the former Soviet republics, but its capacity to deal with post-communist transition and economic crisis has been further undermined through civil war and large-scale migration. This paper, examining the introduction of the basic benefit package and formal co-payments, elucidates how international involvement in Tajikistan's health sector has impacted on national health governance. Based on documentary sources and information provided by key informants, we find that external agencies have both strengthened and weakened national health governance. Although they have played a major part in supporting Tajikistan's health sector, these efforts have often been fragmented, as donor coordination was at times less than optimal. A key challenge for national health governance is the limited technical and institutional capacity of the Ministry of Health and further efforts are needed to build national capacity. Copyright 2010 Elsevier Ltd. All rights reserved.

The Life and Death of Two National Agencies.

ERIC Educational Resources Information Center

Haywood, Roy

1986-01-01

The history and demise of the following two educational agencies are discussed: the Schools Council for Curriculum and Examinations of England and Wales and the National Council for Innovation in Education of Norway. (RM)

National Institutes of Health Presentation at IPE Conference Program

NASA Technical Reports Server (NTRS)

Holloway, Caroline

1992-01-01

The conference objective was to set up a working dialogue among representatives from industry and various Federal agencies. Discussed here are present National Institutes of Health (NIH) support in the area of intelligent processing equipment (IPE) and how researchers can work together on future research objectives. Information is given in viewgraph form with accompanying comments.

Utilisation and costs of nursing agencies in the South African public health sector, 2005–2010

PubMed Central

Rispel, Laetitia C.; Angelides, George

2014-01-01

Background Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals. Objective The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. Design A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6–2009/10) from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ∼ R7, 2010 prices). Results Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million) was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million) in Mpumalanga Province (mixed urban-rural) to a high of R356.43 million (US$50.92 million) in the Eastern Cape Province (mixed urban-rural). Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural) to 11.96% in the Northern Cape

Policies for Use of Real-World Data in Health Technology Assessment (HTA): A Comparative Study of Six HTA Agencies.

PubMed

Makady, Amr; Ham, Renske Ten; de Boer, Anthonius; Hillege, Hans; Klungel, Olaf; Goettsch, Wim

2017-04-01

Randomized controlled trials provide robust data on the efficacy of interventions rather than on effectiveness. Health technology assessment (HTA) agencies worldwide are thus exploring whether real-world data (RWD) may provide alternative sources of data on effectiveness of interventions. Presently, an overview of HTA agencies' policies for RWD use in relative effectiveness assessments (REA) is lacking. To review policies of six European HTA agencies on RWD use in REA of drugs. A literature review and stakeholder interviews were conducted to collect information on RWD policies for six agencies: the Dental and Pharmaceutical Benefits Agency (Sweden), the National Institute for Health and Care Excellence (United Kingdom), the Institute for Quality and Efficiency in Healthcare (Germany), the High Authority for Health (France), the Italian Medicines Agency (Italy), and the National Healthcare Institute (The Netherlands). The following contexts for RWD use in REA of drugs were reviewed: initial reimbursement discussions, pharmacoeconomic analyses, and conditional reimbursement schemes. We identified 13 policy documents and 9 academic publications, and conducted 6 interviews. Policies for RWD use in REA of drugs notably differed across contexts. Moreover, policies differed between HTA agencies. Such variations might discourage the use of RWD for HTA. To facilitate the use of RWD for HTA across Europe, more alignment of policies seems necessary. Recent articles and project proposals of the European network of HTA may provide a starting point to achieve this. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Chile's National Center for Health Information Systems: A Public-Private Partnership to Foster Health Care Information Interoperability.

PubMed

Capurro, Daniel; Echeverry, Aisen; Figueroa, Rosa; Guiñez, Sergio; Taramasco, Carla; Galindo, César; Avendaño, Angélica; García, Alejandra; Härtel, Steffen

2017-01-01

Despite the continuous technical advancements around health information standards, a critical component to their widespread adoption involves political agreement between a diverse set of stakeholders. Countries that have addressed this issue have used diverse strategies. In this vision paper we present the path that Chile is taking to establish a national program to implement health information standards and achieve interoperability. The Chilean government established an inter-agency program to define the current interoperability situation, existing gaps, barriers, and facilitators for interoperable health information systems. As an answer to the identified issues, the government decided to fund a consortium of Chilean universities to create the National Center for Health Information Systems. This consortium should encourage the interaction between all health care stakeholders, both public and private, to advance the selection of national standards and define certification procedures for software and human resources in health information technologies.

76 FR 52633 - Notice of Request for Reinstatement of an Information Collection; National Animal Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-23

... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service [Docket No. APHIS-2011-0084] Notice of Request for Reinstatement of an Information Collection; National Animal Health Monitoring System; Swine 2012 Study AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Reinstatement...

National health financing policy in Eritrea: a survey of preliminary considerations

PubMed Central

2012-01-01

Background The 58th World Health Assembly and 56th WHO Regional Committee for Africa adopted resolutions urging Member States to ensure that health financing systems included a method for prepayment to foster financial risk sharing among the population and avoid catastrophic health-care expenditure. The Regional Committee asked countries to strengthen or develop comprehensive health financing policies. This paper presents the findings of a survey conducted among senior staff of selected Eritrean ministries and agencies to elicit views on some of the elements likely to be part of a national health financing policy. Methods This is a descriptive study. A questionnaire was prepared and sent to 19 senior staff (Directors) in the Ministry of Health, Labour Department, Civil Service Administration, Eritrean Confederation of Workers, National Insurance Corporation of Eritrea and Ministry of Local Government. The respondents were selected by the Ministry of Health as key informants. Results The key findings were as follows: the response rate was 84.2% (16/19); 37.5% (6/16) and 18.8% said that the vision of Eritrean National Health Financing Policy (NHFP) should include the phrases ‘equitable and accessible quality health services’ and ‘improve efficiency or reduce waste’ respectively; over 68% indicated that NHFP should include securing adequate funding, ensuring efficiency, ensuring equitable financial access, protection from financial catastrophe, and ensuring provider payment mechanisms create positive incentives to service providers; over 80% mentioned community participation, efficiency, transparency, country ownership, equity in access, and evidence-based decision making as core values of NHFP; over 62.5% confirmed that NHFP components should consist of stewardship (oversight), revenue collection, revenue pooling and risk management, resource allocation and purchasing of health services, health economics research, and development of human resources for health

National health financing policy in Eritrea: a survey of preliminary considerations.

PubMed

Kirigia, Joses Muthuri; Zere, Eyob; Akazili, James

2012-08-28

The 58th World Health Assembly and 56th WHO Regional Committee for Africa adopted resolutions urging Member States to ensure that health financing systems included a method for prepayment to foster financial risk sharing among the population and avoid catastrophic health-care expenditure. The Regional Committee asked countries to strengthen or develop comprehensive health financing policies. This paper presents the findings of a survey conducted among senior staff of selected Eritrean ministries and agencies to elicit views on some of the elements likely to be part of a national health financing policy. This is a descriptive study. A questionnaire was prepared and sent to 19 senior staff (Directors) in the Ministry of Health, Labour Department, Civil Service Administration, Eritrean Confederation of Workers, National Insurance Corporation of Eritrea and Ministry of Local Government. The respondents were selected by the Ministry of Health as key informants. The key findings were as follows: the response rate was 84.2% (16/19); 37.5% (6/16) and 18.8% said that the vision of Eritrean National Health Financing Policy (NHFP) should include the phrases 'equitable and accessible quality health services' and 'improve efficiency or reduce waste' respectively; over 68% indicated that NHFP should include securing adequate funding, ensuring efficiency, ensuring equitable financial access, protection from financial catastrophe, and ensuring provider payment mechanisms create positive incentives to service providers; over 80% mentioned community participation, efficiency, transparency, country ownership, equity in access, and evidence-based decision making as core values of NHFP; over 62.5% confirmed that NHFP components should consist of stewardship (oversight), revenue collection, revenue pooling and risk management, resource allocation and purchasing of health services, health economics research, and development of human resources for health; over 68.8% indicated cost

78 FR 90 - Defense Intelligence Agency National Intelligence University Board of Visitors Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-02

... DEPARTMENT OF DEFENSE Office of the Secretary Defense Intelligence Agency National Intelligence University Board of Visitors Closed Meeting AGENCY: National Intelligence University, Defense Intelligence... hereby given that a closed meeting of the National Intelligence University Board of Visitors has been...

About the Director of EPA's National Health and Environmental Effects Research Laboratory (NHEERL)

EPA Pesticide Factsheets

Dr. Wayne Cascio serves as Acting Director for the National Health and Environmental Effects Research Laboratory (NHEERL) within the U.S. Environmental Protection Agency's Office of Research and Development (ORD).

75 FR 32191 - National Health and Nutrition Examination Survey (NHANES) DNA Samples: Guidelines for Proposals...

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2010-06-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Health... Cost Schedule AGENCY: Centers for Disease Control and Prevention, Department of Health and Human... for Disease Control and Prevention (CDC). Examination surveys conducted since 1960 by NCHS have...

75 FR 45154 - National Security Division; Agency Information Collection Activities:

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2010-08-02

... DEPARTMENT OF JUSTICE [OMB Number 1124-0003] National Security Division; Agency Information Collection Activities: Proposed Collection; Comments Requested ACTION: 60-Day Notice of Information...), National Security Division (NSD), will be submitting the following information collection request to the...

Developing Multi-Agency Teams: Implications of a National Programme Evaluation

ERIC Educational Resources Information Center

Simkins, Tim; Garrick, Ros

2012-01-01

This paper explores the factors which influence the effectiveness of formal development programmes targeted at multi-agency teams in children's services. It draws on two studies of the National College for School Leadership's Multi-Agency Teams Development programme, reporting key characteristics of the programme, short-term outcomes in terms of…

76 FR 70745 - Agency Information Collection Activities: Proposed Collection; Comment Request; National Flood...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-15

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID: FEMA-2011-0034...; National Flood Insurance Program--Mortgage Portfolio Protection Program AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice. SUMMARY: The Federal Emergency Management Agency, as part of its...

Does Money Matter: Earnings Patterns Among a National Sample of the US State Governmental Public Health Agency Workforce

PubMed Central

Castrucci, Brian C.; Leider, Jonathon P.; Liss-Levinson, Rivka; Sellers, Katie

2015-01-01

Context: Earnings have been shown to be a critical point in workforce recruitment and retention. However, little is known about how much governmental public health staff are paid across the United States. Objective: To characterize earnings among state health agency central office employees. Design: A cross-sectional survey was conducted of state health agency central office employees in late 2014. The sampling approach was stratified by 5 (paired HHS) regions. Balanced repeated replication weights were used to correctly calculate variance estimates, given the complex sampling design. Descriptive and bivariate statistical comparisons were conducted. A linear regression model was used to examine correlates of earnings among full-time employees. Setting and Participants: A total of 9300 permanently employed, full-time state health agency central office staff who reported earnings information. Main Outcome Measure: Earnings are the main outcomes examined in this article. Results: Central office staff earn between $55 000 and $65 000 on average annually. Ascending supervisory status, educational attainment, and tenure are all associated with greater earnings. Those employed in clinical and laboratory positions and public health science positions earn more than their colleagues in administrative positions. Disparities exist between men and women, with men earning more, all else being equal (P < .001). Racial/ethnic disparities also exist, after accounting for other factors. Conclusions: This study provides baseline information to characterize the workforce and key challenges that result from earnings levels, including disparities in earnings that persist after accounting for education and experience. Data from the survey can inform strategies to address earnings issues and help reduce disparities. PMID:26422496

Does Money Matter: Earnings Patterns Among a National Sample of the US State Governmental Public Health Agency Workforce.

PubMed

Castrucci, Brian C; Leider, Jonathon P; Liss-Levinson, Rivka; Sellers, Katie

2015-01-01

Earnings have been shown to be a critical point in workforce recruitment and retention. However, little is known about how much governmental public health staff are paid across the United States. To characterize earnings among state health agency central office employees. A cross-sectional survey was conducted of state health agency central office employees in late 2014. The sampling approach was stratified by 5 (paired HHS) regions. Balanced repeated replication weights were used to correctly calculate variance estimates, given the complex sampling design. Descriptive and bivariate statistical comparisons were conducted. A linear regression model was used to examine correlates of earnings among full-time employees. A total of 9300 permanently employed, full-time state health agency central office staff who reported earnings information. Earnings are the main outcomes examined in this article. Central office staff earn between $55,000 and $65,000 on average annually. Ascending supervisory status, educational attainment, and tenure are all associated with greater earnings. Those employed in clinical and laboratory positions and public health science positions earn more than their colleagues in administrative positions. Disparities exist between men and women, with men earning more, all else being equal (P < .001). Racial/ethnic disparities also exist, after accounting for other factors. This study provides baseline information to characterize the workforce and key challenges that result from earnings levels, including disparities in earnings that persist after accounting for education and experience. Data from the survey can inform strategies to address earnings issues and help reduce disparities.

77 FR 44647 - Agency Information Collection Activities: Proposed Collection; Comment Request, National...

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2012-07-30

... individuals to search for displaced friends, family, and household members. Affected Public: Individuals and..., National Emergency Family Registry and Locator System (NEFRLS) AGENCY: Federal Emergency Management Agency... effort to reduce paperwork and respondent burden, invites the general public and other Federal agencies...

Origins and Elaboration of the National Health Accounts, 1926-2006

PubMed Central

Fetter, Bruce

2006-01-01

The National Health Statistics Group (NHSG) has managed to keep the national health accounts (NHA) apolitical and highly respected. NHSG strategies have included the careful acquisition and presentation of statistics relating to health costs and payers; the use of scholarly journals to disseminate ideas to other government offices and, beyond them, to industry, labor, the professions, and universities; and the promotion of cooperation with related U.S., statistical agencies, provider groups, contractors, and international organizations. Responding to an increasingly complex system of third-party payers in the U.S. health system and controversies over methods, the NHA has continually evolved to meet the demands of health care decisionmakers. Historically, these dialogues have forced health accountants to refine their methods to ensure that their portrayal of spending and financing trends presents information that can inform the decisionmaking process in a non-partisan way. PMID:17290668

76 FR 64361 - Agency Information Collection Activities: Proposed Collection; Comment Request; National Flood...

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2011-10-18

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID: FEMA-2011-0029...; National Flood Insurance Program Claims Appeals Process AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice. SUMMARY: The Federal Emergency Management Agency, as part of its continuing effort to...

A concept analysis of children's agency within the health literature.

PubMed

Montreuil, Marjorie; Carnevale, Franco A

2015-12-14

The capacity of children to act as agents is being increasingly recognized and has important implications for health research and practice. However, there are various discrepancies in how children's agency is defined in the literature. The aim of this analysis was to examine the concept of children's agency within the health-related literature, using Rodgers evolutionary method. The following questions were addressed: How did the concept of agency become associated with children in the health-related literature? What are the sociocultural and legal contexts that surround the concept of children's agency? What is the meaning of children's agency? Forty-five articles were included in the analysis. An inductive approach was used to identify the attributes of children's agency as well as the temporal, disciplinary, and paradigmatic trends in its conceptualization. The concept of children's agency first appeared in the health literature in the 1980s and was defined as an ability children could gradually develop. Later on, children's agency was used to refer to the capacity of all children to influence their own and others' health-care needs and is now increasingly used to refer to children as active agents who reflect on and construct their social worlds. © The Author(s) 2015.

75 FR 16488 - National Center for Environmental Health/Agency for Toxic Substances and Disease Registry (NCEH...

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... National Conversation on Public Health and Chemical Exposures Leadership Council Conference Call Time and... Leadership Council, which is convened by RESOLVE, a non-profit independent facilitator. The National... Leadership Council provides overall guidance to the National Conversation project and will be responsible for...

75 FR 76423 - Defense Intelligence Agency National Defense Intelligence College Board of Visitors Closed Meeting

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2010-12-08

... DEPARTMENT OF DEFENSE Office of the Secretary Defense Intelligence Agency National Defense Intelligence College Board of Visitors Closed Meeting AGENCY: National Defense Intelligence College, Defense Intelligence Agency, Department of Defense. ACTION: Notice of Closed Meeting. SUMMARY: Pursuant to the...

78 FR 32241 - Defense Intelligence Agency National Intelligence University Board of Visitors; Notice of Closed...

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2013-05-29

... DEPARTMENT OF DEFENSE Office of the Secretary Defense Intelligence Agency National Intelligence University Board of Visitors; Notice of Closed Meeting AGENCY: National Intelligence University, Defense Intelligence Agency, Department of Defense. ACTION: Notice of closed meeting. SUMMARY: Pursuant to the...

76 FR 28960 - Defense Intelligence Agency National Defense Intelligence College Board of Visitors Closed Meeting

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2011-05-19

... DEPARTMENT OF DEFENSE Office of the Secretary Defense Intelligence Agency National Defense Intelligence College Board of Visitors Closed Meeting AGENCY: National Defense Intelligence College, Defense Intelligence Agency, Department of Defense. ACTION: Notice of Closed Meeting. SUMMARY: Pursuant to the...

[Health technology assessment agencies in the xxi century].

PubMed

Argimon, Josep Maria

2015-11-01

The origins of the health technology assessment (HTA) agencies date back to the 70s in the United States; in the European context, the current Agency for Quality and Health Assessment of Catalonia was among the pioneers in 1991. Epidemiological, social, technological and economic changes of recent years have led to the incorporation, by the agencies, of new functions, activities and projects that can offer better services (information and knowledge) to the various players in the healthcare system (patients, professionals, providers, insurers and policy-makers) in order to increase healthcare quality and preserve the sustainability of the health system. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

75 FR 75474 - National Center for Environmental Health/Agency for Toxic Substances and Disease Registry (NCEH...

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2010-12-03

... National Conversation on Public Health and Chemical Exposures Leadership Council Meeting Time and Date: 9 a... Leadership Council, which is convened by RESOLVE, a non-profit independent facilitator. The National... Leadership Council provides overall guidance to the National Conversation project and is responsible for...

77 FR 7171 - Agency Information Collection Activities: Proposed Collection; Comment Request, National Fire...

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2012-02-10

..., National Fire Incident Reporting System (NFIRS) v5.0 AGENCY: Federal Emergency Management Agency, DHS... accordance with the Paperwork Reduction Act of 1995, this notice seeks comments concerning National Fire... standardized reporting methods, to collect and analyze fire incident data at the Federal, State, and local...

75 FR 6398 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

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2010-02-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the National Coordinator for Health Information Technology; HIT Policy Committee's Adoption/Certification Workgroup Meeting; Notice of Meeting AGENCY: Office... of Committee: HIT Policy Committee's Adoption/Certification Workgroup. General Function of the...

Primary healthcare reform in the United Nations Relief and Works Agency for Palestine Refugees in the Near East.

PubMed

Santoro, A; Abu-Rmeileh, N; Khader, A; Seita, A; McKee, M

2016-09-25

Palestinian refugees served by the United Nation Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) are experiencing increasing rates of diagnosis of non-communicable diseases. In response, in 2011 UNRWA initiated an Agency-wide programme of primary healthcare reform, informed by the Chronic Care Model framework. Health services were reorganized following a family-centred approach, with delivery by multidisciplinary family health teams supported by updated technical advice. An inclusive clinical information system, termed e-Health, was implemented to collect a wide range of health information, with a focus on continuity of treatment. UNRWA was able to bring about these wide-ranging changes within its existing resources, reallocating finances, reforming its payment mechanisms, and modernizing its drug-procurement policies. While specific components of UNRWA's primary healthcare reform are showing promising results, additional efforts are needed to empower patients further and to strengthen involvement of the community.

National health spending trends in 1996. National Health Accounts Team.

PubMed

Levit, K R; Lazenby, H C; Braden, B R

1998-01-01

The National Health Accounts, produced annually by the Health Care Financing Administration's Office of the Actuary, present estimates for 1960-1996 of nationwide spending for health care and the sources funding that care. This year's estimates set two records: Spending topped $1 trillion for the first time, and expenditure growth slowed to the lowest rate seen in thirty-seven years of measuring health care spending--4.4 percent. The combination of decelerating health spending and a growing economy has kept national health spending as a share of the nation's gross domestic product unchanged for the fourth consecutive year.

78 FR 21607 - National Institute for Occupational Safety and Health Partnership Opportunity on a Research...

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... Performance of Isolation Gowns AGENCY: National Institute for Occupational Safety and Health (NIOSH) of the...) International standards development to establish minimum performance requirements for isolation gowns for health... will be recognized as contributing to the establishment of the performance standard. Manufacturers...

5 CFR 5501.111 - Awards tendered to employees of the National Institutes of Health.

Code of Federal Regulations, 2013 CFR

2013-01-01

... HUMAN SERVICES SUPPLEMENTAL STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES § 5501.111 Awards tendered to employees of the National Institutes of Health. (a... approved in writing in advance in accordance with procedures specified by the designated agency ethics...

5 CFR 5501.111 - Awards tendered to employees of the National Institutes of Health.

Code of Federal Regulations, 2011 CFR

2011-01-01

... HUMAN SERVICES SUPPLEMENTAL STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES § 5501.111 Awards tendered to employees of the National Institutes of Health. (a... approved in writing in advance in accordance with procedures specified by the designated agency ethics...

5 CFR 5501.111 - Awards tendered to employees of the National Institutes of Health.

Code of Federal Regulations, 2012 CFR

2012-01-01

... HUMAN SERVICES SUPPLEMENTAL STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES § 5501.111 Awards tendered to employees of the National Institutes of Health. (a... approved in writing in advance in accordance with procedures specified by the designated agency ethics...

Forging University-Community Collaboration: The Agency Perspective on National Service.

ERIC Educational Resources Information Center

Tice, Carol H.

1994-01-01

With passage of the National and Community Service Trust Act of 1993, national service volunteers will be joining forces with community-based organizations to work with underserved populations, creating many challenges. The community agency perspective on some anticipated challenges, possible responses, and application of principles of good…

Collaboration between local health and local government agencies for health improvement.

PubMed

Hayes, Sara L; Mann, Mala K; Morgan, Fiona M; Kelly, Mark J; Weightman, Alison L

2012-10-17

In many countries, national, regional and local inter- and intra-agency collaborations have been introduced to improve health outcomes. Evidence is needed on the effectiveness of locally developed partnerships which target changes in health outcomes and behaviours. To evaluate the effects of interagency collaboration between local health and local government agencies on health outcomes in any population or age group. We searched the Cochrane Public Health Group Specialised Register, AMED, ASSIA, CENTRAL, CINAHL, DoPHER, EMBASE, ERIC, HMIC, IBSS, MEDLINE, MEDLINE In-Process, OpenGrey, PsycINFO, Rehabdata, Social Care Online, Social Services Abstracts, Sociological Abstracts, TRoPHI and Web of Science from 1966 through to January 2012. 'Snowballing' methods were used, including expert contact, citation tracking, website searching and reference list follow-up. Randomized controlled trials (RCTs), controlled clinical trials (CCTs), controlled before-and-after studies (CBAs) and interrupted time series (ITS) where the study reported individual health outcomes arising from interagency collaboration between health and local government agencies compared to standard care. Studies were selected independently in duplicate, with no restriction on population subgroup or disease. Two authors independently conducted data extraction and assessed risk of bias for each study. Sixteen studies were identified (28,212 participants). Only two were considered to be at low risk of bias. Eleven studies contributed data to the meta-analyses but a narrative synthesis was undertaken for all 16 studies. Six studies examined mental health initiatives, of which one showed health benefit, four showed modest improvement in one or more of the outcomes measured but no clear overall health gain, and one showed no evidence of health gain. Four studies considered lifestyle improvements, of which one showed some limited short-term improvements, two failed to show health gains for the intervention

National Health Information Center

MedlinePlus

... About ODPHP National Health Information Center National Health Information Center The National Health Information Center (NHIC) is ... of interest View the NHO calendar . Federal Health Information Centers and Clearinghouses Federal Health Information Centers and ...

Public health financial management needs: report of a national survey.

PubMed

Costich, Julia F; Honoré, Peggy A; Scutchfield, F Douglas

2009-01-01

The work reported here builds on the identification of public health financial management practice competencies by a national expert panel. The next logical step was to provide a validity check for the competencies and identify priority areas for educational programming. We developed a survey for local public health finance officers based on the public health finance competencies and field tested it with a convenience sample of officials. We asked respondents to indicate the importance of each competency area and the need for training to improve performance; we also requested information regarding respondent education, jurisdiction size, and additional comments. Our local agency survey sample drew on the respondent list from the National Association of County and City Health Officials 2005 local health department survey, stratified by agency size and limited to jurisdiction populations of 25,000 to 1,000,000. Identifying appropriate respondents was a major challenge. The survey was fielded electronically, yielding 112 responses from 30 states. The areas identified as most important and needing most additional training were knowledge of budget activities, financial data interpretation and communication, and ability to assess and correct the organization's financial status. The majority of respondents had some postbaccalaureate education. Many provided additional comments and recommendations. Health department finance officers demonstrated a high level of general agreement regarding the importance of finance competencies in public health and the need for training. The findings point to a critical need for additional training opportunities that are accessible, cost-effective, and targeted to individual needs.

A Consensus Action Agenda for Achieving the National Health Information Infrastructure

PubMed Central

Yasnoff, William A.; Humphreys, Betsy L.; Overhage, J. Marc; Detmer, Don E.; Brennan, Patricia Flatley; Morris, Richard W.; Middleton, Blackford; Bates, David W.; Fanning, John P.

2004-01-01

Background: Improving the safety, quality, and efficiency of health care will require immediate and ubiquitous access to complete patient information and decision support provided through a National Health Information Infrastructure (NHII). Methods: To help define the action steps needed to achieve an NHII, the U.S. Department of Health and Human Services sponsored a national consensus conference in July 2003. Results: Attendees favored a public–private coordination group to guide NHII activities, provide education, share resources, and monitor relevant metrics to mark progress. They identified financial incentives, health information standards, and overcoming a few important legal obstacles as key NHII enablers. Community and regional implementation projects, including consumer access to a personal health record, were seen as necessary to demonstrate comprehensive functional systems that can serve as models for the entire nation. Finally, the participants identified the need for increased funding for research on the impact of health information technology on patient safety and quality of care. Individuals, organizations, and federal agencies are using these consensus recommendations to guide NHII efforts. PMID:15187075

A consensus action agenda for achieving the national health information infrastructure.

PubMed

Yasnoff, William A; Humphreys, Betsy L; Overhage, J Marc; Detmer, Don E; Brennan, Patricia Flatley; Morris, Richard W; Middleton, Blackford; Bates, David W; Fanning, John P

2004-01-01

Improving the safety, quality, and efficiency of health care will require immediate and ubiquitous access to complete patient information and decision support provided through a National Health Information Infrastructure (NHII). To help define the action steps needed to achieve an NHII, the U.S. Department of Health and Human Services sponsored a national consensus conference in July 2003. Attendees favored a public-private coordination group to guide NHII activities, provide education, share resources, and monitor relevant metrics to mark progress. They identified financial incentives, health information standards, and overcoming a few important legal obstacles as key NHII enablers. Community and regional implementation projects, including consumer access to a personal health record, were seen as necessary to demonstrate comprehensive functional systems that can serve as models for the entire nation. Finally, the participants identified the need for increased funding for research on the impact of health information technology on patient safety and quality of care. Individuals, organizations, and federal agencies are using these consensus recommendations to guide NHII efforts.

75 FR 33811 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the National Coordinator for Health Information Technology; HIT Policy Committee's Privacy & Security Tiger Team Meeting; Notice of Meeting AGENCY: Office of... of Committee: HIT Policy Committee's Privacy & Security Tiger Team. General Function of the Committee...

Home Health Agency Performance in the United States: 2011–15

PubMed Central

Wang, Yun; Spatz, Erica S.; Tariq, Maliha; Angraal, Suveen; Krumholz, Harlan M.

2017-01-01

OBJECTIVES To evaluate home health agency quality performance. DESIGN Observational study. SETTING Home health agencies PARTICIPANTS All Medicare-certified agencies with at least 6 months of data from 2011 to 2015. MEASUREMENTS Twenty-two quality indicators, five patient survey indicators, and their composite scores. RESULTS The study included 11,462 Medicare-certified home health agencies that served 92.4% of all ZIP codes nationwide, accounting for 315.2 million people. The mean composite scores were 409.1 ± 22.7 out of 500 with the patient survey indicators and 492.3 ± 21.7 out of 600 without the patient survey indicators. Home health agency performance on 27 quality indicators varied, with the coefficients of dispersion ranging from 4.9 to 62.8. Categorization of agencies into performance quartiles revealed that 3,179 (27.7%) were in the low-performing group (below 25th percentile) at least one time during the period from 2011–12 to 2014–15 and that 493 were in the low-performing group throughout the study period. Geographic variation in agency performance was observed. Agencies with longer Medicare-certified years were more likely to have high-performing scores; agencies providing partial services, with proprietary ownership, and those with long travel distances to reach patients had lower performance. Agencies serving low-income counties and counties with lower proportions of women and senior residences and greater proportions of Hispanic residents were more likely to attain lower performance scores. CONCLUSION Home health agency performance on several quality indicators varied, and many agencies were persistently in the lowest quartile of performance. Still, there is a need to improve the quality of care of all agencies. Many parts of the United States, particularly lower-income areas and areas with more Hispanic residents, are more likely to receive lower quality home health care. PMID:28960228

Recognizing Excellence in Maternal and Child Health (MCH) Epidemiology: The 2014 National MCH Epidemiology Awards

PubMed Central

Vladutiu, Catherine J.; Jones, Jessica R.

2016-01-01

Purpose The impact of programs, policies, and practices developed by professionals in the field of maternal and child health (MCH) epidemiology is highlighted biennially by 16 national MCH agencies and organizations, or the Coalition for Excellence in MCH Epidemiology. Description In September 2014, multiple leading agencies in the field of MCH partnered to host the national CityMatCH Leadership and MCH Epidemiology Conference in Phoenix, Arizona. The conference offered opportunities for peer exchange; presentation of new scientific methodologies, programs, and policies; dialogue on changes in the MCH field; and discussion of emerging MCH issues relevant to the work of local, state, and national MCH professionals. During the conference, the National MCH Epidemiology Awards were presented to individuals, teams, institutions, and leaders for significantly contributing to the improved health of women, children, and families. Assessment During the conference, the Coalition presented seven deserving health researchers and research groups with national awards in the areas of advancing knowledge, effective practice, outstanding leadership, young professional achievement, and lifetime achievement. The article highlights the accomplishments of these national-level awardees. Conclusion Recognition of deserving professionals strengthens the field of MCH epidemiology, and sets the standard for exceptional research, mentoring, and practice. PMID:26723200

Public Health Agency Accreditation Among Rural Local Health Departments: Influencers and Barriers.

PubMed

Beatty, Kate E; Erwin, Paul Campbell; Brownson, Ross C; Meit, Michael; Fey, James

Health department accreditation is a crucial strategy for strengthening public health infrastructure. The purpose of this study was to investigate local health department (LHD) characteristics that are associated with accreditation-seeking behavior. This study sought to ascertain the effects of rurality on the likelihood of seeking accreditation through the Public Health Accreditation Board (PHAB). Cross-sectional study using secondary data from the 2013 National Association of County & City Health Officials (NACCHO) National Profile of Local Health Departments Study (Profile Study). United States. LHDs (n = 490) that responded to the 2013 NACCHO Profile Survey. LHDs decision to seek PHAB accreditation. Significantly more accreditation-seeking LHDs were located in urban areas (87.0%) than in micropolition (8.9%) or rural areas (4.1%) (P < .001). LHDs residing in urban communities were 16.6 times (95% confidence interval [CI], 5.3-52.3) and micropolitan LHDs were 3.4 times (95% CI, 1.1-11.3) more likely to seek PHAB accreditation than rural LHDs (RLHDs). LHDs that had completed an agency-wide strategic plan were 8.5 times (95% CI, 4.0-17.9), LHDs with a local board of health were 3.3 times (95% CI, 1.5-7.0), and LHDs governed by their state health department were 12.9 times (95% CI, 3.3-50.0) more likely to seek accreditation. The most commonly cited barrier was time and effort required for accreditation application exceeded benefits (73.5%). The strongest predictor for seeking PHAB accreditation was serving an urban jurisdiction. Micropolitan LHDs were more likely to seek accreditation than smaller RLHDs, which are typically understaffed and underfunded. Major barriers identified by the RLHDs included fees being too high and the time and effort needed for accreditation exceeded their perceived benefits. RLHDs will need additional financial and technical support to achieve accreditation. Even with additional funds, clear messaging of the benefits of accreditation

National support to public health research: a survey of European ministries.

PubMed

Conceição, Cláudia; Leandro, Alexandra; McCarthy, Mark

2009-06-25

organisation and funding. Health ministries and national agencies value exchange between researchers and policy-makers, civil society organizations, and academic and public authorities, and the application of public-health research results. There would be benefits from better processes of priority setting and improved coordination for research, at regional, national and European levels.

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Bacteria as bullies: effects of linguistic agency assignment in health message.

PubMed

Bell, Robert A; McGlone, Matthew S; Dragojevic, Marko

2014-01-01

When describing health threats, communicators can assign agency to the threat (e.g., "Hepatitis C has infected 4 million Americans") or to humans (e.g., "Four million Americans have contracted hepatitis C"). In an online experiment, the authors explored how assignment of agency affects perceptions of susceptibility and severity of a health threat, response efficacy, self-efficacy, fear arousal, and intentions to adopt health-protective recommendations. Participants were 719 individuals recruited through Mechanical Turk ( www.mturk.com ), a crowdsource labor market run by Amazon ( www.amazon.com ). The participants were assigned randomly to read 1 of 8 flyers defined by a 2×4 (Agency Assignment×Topic) factorial design. Each flyer examined 1 health threat (E. coli, necrotizing fasciitis, salmonella, or Carbapenem-resistant Klebsiella pneumoniae) and was written in language that emphasized bacterial or human agency. Perceived susceptibility and severity were highest when bacterial agency language was used. Response efficacy, self-efficacy, and fear arousal were not significantly affected by agency assignment. Participants reported stronger intentions to adopt recommendations when bacteria agency language was used, but this effect did not reach conventional standards of significance (p < .051). The authors concluded that health communicators can increase target audiences' perceptions of susceptibility and severity by assigning agency to the threat in question when devising health messages.

Does caregiver participation in decision making within child welfare agencies influence children's primary and mental health care service use?

PubMed

Jolles, M P; Wells, R

2017-03-01

Many children in contact with child welfare agencies do not receive needed health services. These agencies have used participatory decision making (PDM) practices as a way to increase families' use of recommended services. However, we lack evidence of whether caregiver participation in PDM increases children's use of health services. This study uses a national sample of children involved with child welfare to compare their health service use between those children serve through a PDM practice and those who did not experience it. Cross-sectional analyses using the 2009-2010 National Survey of Child and Adolescent Well-Being. Propensity score analysis accounted for observed selection bias. PDM practice was measured as whether the caregiver was included in decision-making during service planning meetings. Health service use was measured as child's receipt of any primary or mental health care services in the past year. Primary health care need was measured using standardized measures and caseworker report. The sample was comprised of children ages 2-17 with primary or mental health needs in contact with a child welfare agency. In the unmatched sample of 1,358 children, 14% were served through a PDM service practice, and 12% had a primary health care and 37% a mental health need. Families served through PDM were also reported by caseworkers as more cooperative during the child welfare investigation, and with fewer reports of domestic violence and agency re-referrals (P < 0.05). Analyses using matched samples showed that for primary health care, 59% of PDM children received services compared with 40% for non-PDM children (P = 0.004). Group differences were not significant for mental health services. Lower-risk families were more likely to be served through PDM which was positively associated with child use of primary health services. Inclusion of caregivers in decision making may not be sufficient to overcome barriers to children's mental health service use. �

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National Trends and Geographic Variation in Availability of Home Health Care: 2002-2015.

PubMed

Wang, Yun; Leifheit-Limson, Erica C; Fine, Jonathan; Pandolfi, Michelle M; Gao, Yan; Liu, Fanglin; Eckenrode, Sheila; Lichtman, Judith H

2017-07-01

To evaluate national trends and geographic variation in the availability of home health care from 2002 to 2015 and identify county-specific characteristics associated with home health care. Observational study. All counties in the United States. All Medicare-certified home health agencies included in the Centers for Medicare & Medicaid Services Home Health Compare system. County-specific availability of home health care, defined as the number of available home health agencies that provided services to a given county per 100,000 population aged ≥18 years. The study included 15,184 Medicare-certified home health agencies that served 97% of U.S. ZIP codes. Between 2002-2003 and 2014-2015, the county-specific number of available home health agencies per 100,000 population aged ≥18 years increased from 14.7 to 21.8 and the median (inter-quartile range) population that was serviced by at least one home health agency increased from 403,605 (890,329) to 455,488 (1,039,328). Considerable geographic variation in the availability of home health care was observed. The West, North East, and South Atlantic regions had lower home health care availability than the Central regions, and this pattern persisted over the study period. Counties with higher median income, a larger senior population, higher rates of households without a car and low access to stores, more obesity, greater inactivity, and higher proportions of non-Hispanic white, non-Hispanic black, and Hispanic populations were more likely to have higher availability of home health care. The availability of home health care increased nationwide during the study period, but there was much geographic variation. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

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Impacts of psychological science on national security agencies post-9/11.

PubMed

Brandon, Susan E

2011-09-01

Psychologists have been an integral part of national security agencies since World War I, when psychological science helped in personnel selection. A robust infrastructure supporting wider applications of psychology to military and intelligence problems developed further during World War II and the years following, primarily in the areas of testing, human factors, perception, and the decision sciences. Although the nature of the attacks on 9/11 raised the level of perceived need for increased human-based intelligence, the impacts of psychologists on the policies and practices of national security agencies in the decade since have not increased significantly. © 2011 American Psychological Association

Confined to a tokenistic status: Social scientists in leadership roles in a national health research funding agency.

PubMed

Albert, Mathieu; Laberge, Suzanne

2017-07-01

The idea of interdisciplinarity has been taken up by academic and governmental organisations around the world and enacted through science policies, funding programs and higher education institutions. In Canada, interdisciplinarity led to a major transformation in health research funding. In 2000, the federal government closed the Medical Research Council (MRC) and created the Canadian Institutes of Health Research (CIHR). From the outset, CIHR's vision and goals were innovative, as it sought to include the social sciences within its purview alongside more traditional health research sectors. The extent to which it has been successful in this endeavour, however, remains unknown. The aim of our study was to examine how CIHR's intentions to foster inclusiveness and cooperation across disciplines were implemented in the agency's own organisational structure. We focused on social scientists' representation on committees and among decision-makers between 2000 and 2015, one of the key mandates of CIHR being to include the social sciences within its remit and support research in this area. We examined the composition of the Governing Council, the Institute Scientific Directors, the Chairs of the College of Reviewers, and two International Review Panels invited by CIHR. We targeted these committees and decision-makers since they hold the power to influence the field of Canadian health research through the decisions they make. Our findings show that, while CIHR was created with the mandate to support the entire spectrum of health-related research-including the social sciences-this call for inclusiveness has not yet been materialized in the agency's organisational structure. Social scientists, as well as researchers from neighbouring disciplines such as social epidemiology, health promotion and the humanities, are still confined to low levels of representation within CIHR's highest echelons. This imbalance limits social scientists' input into health research in Canada and

The Role of State Library Agencies in National Plans for Library and Information Services.

ERIC Educational Resources Information Center

Trezza, Alphonse F.

1978-01-01

A full-service national network of library and information services can only become a reality if there is careful articulation among local, state, multistate, and national planning and implementation activities. The role of the state library agency as coordinator, catalyst, initiator, and even-handed funding agency is essential, difficult, and…

Funding of Medical Research in Australia by the National Health & Medical Research Council.

ERIC Educational Resources Information Center

McCloskey, Ian

1994-01-01

The role of Australia's National Health and Medical Research Council, an independent statutory body, in distribution of funds for research projects, programs, units, and major institutes. The agency's evaluation system, resource allocation practices, and training and career support system are described briefly. (MSE)

National Trends and Geographic Variation in Availability of Home Health Care: 2002–2015

PubMed Central

Wang, Yun; Leifheit-Limson, Erica C; Fine, Jonathan; Pandolfi, Michelle M; Gao, Yan; Liu, Fanglin; Eckenrode, Sheila; Lichtman, Judith H

2017-01-01

Objectives To evaluate national trends and geographic variation in the availability of home health care from 2002–2015 and identify county-specific characteristics associated with home health care. Design Observational study Setting All counties in the United States Participants All Medicare-certified home health agencies included in the Centers for Medicare & Medicaid Services Home Health Compare system. Measurements County-specific availability of home health care, defined as the number of available home health agencies that provided services to a given county per 100,000 population aged ≥18 years. Results The study included 15,184 Medicare-certified home health agencies that served 97% of U.S. ZIP codes. Between 2002–2003 and 2014–2015, the county-specific number of available home health agencies per 100,000 population aged ≥18 years increased from 14.7 to 21.8 and the median (inter-quartile range) population that was serviced by at least one home health agency increased from 403,605 (890,329) to 455,488 (1,039,328). Considerable geographic variation in the availability of home health care was observed. The West, North-East, and South Atlantic regions had lower home health care availability than the Central regions, and this pattern persisted over the study period. Counties with higher median income, a larger senior population, higher rates of households without a car and low access to stores, more obesity, greater inactivity, and higher proportions of non-Hispanic white, non-Hispanic black, and Hispanic populations were more likely to have higher availability of home health care. Conclusion The availability of home health care increased nationwide during the study period, but there was much geographic variation. PMID:28322441

Health lifestyle theory and the convergence of agency and structure.

PubMed

Cockerham, William C

2005-03-01

This article utilizes the agency-structure debate as a framework for constructing a health lifestyle theory. No such theory currently exists, yet the need for one is underscored by the fact that many daily lifestyle practices involve considerations of health outcomes. An individualist paradigm has influenced concepts of health lifestyles in several disciplines, but this approach neglects the structural dimensions of such lifestyles and has limited applicability to the empirical world. The direction of this article is to present a theory of health lifestyles that includes considerations of both agency and structure, with an emphasis upon restoring structure to its appropriate position. The article begins by defining agency and structure, followed by presentation of a health lifestyle model and the theoretical and empirical studies that support it.

National health expenditures, 1990

PubMed Central

Levit, Katharine R.; Lazenby, Helen C.; Cowan, Cathy A.; Letsch, Suzanne W.

1991-01-01

During 1990, health expenditures as a share of gross national product rose to 12.2 percent, up from 11.6 percent in 1989. This dramatic increase is the second largest increase in the past three decades. The national health expenditure estimates presented in this article document rapidly rising health care costs and provide a context for understanding the health care financing crisis facing the Nation today. The 1990 national health expenditures incorporate the most recently available data. They differ from historical estimates presented in the preceding article. The length of time and complicated process of producing projections required use of 1989 national health expenditures—data available prior to the completion of the 1990 estimates presented here. PMID:10114934

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Preparedness and Emergency Response Learning Centers: supporting the workforce for national health security.

PubMed

Richmond, Alyson L; Sobelson, Robyn K; Cioffi, Joan P

2014-01-01

The importance of a competent and prepared national public health workforce, ready to respond to threats to the public's health, has been acknowledged in numerous publications since the 1980s. The Preparedness and Emergency Response Learning Centers (PERLCs) were funded by the Centers for Disease Control and Prevention in 2010 to continue to build upon a decade of focused activities in public health workforce preparedness development initiated under the Centers for Public Health Preparedness program (http://www.cdc.gov/phpr/cphp/). All 14 PERLCs were located within Council on Education for Public Health (CEPH) accredited schools of public health. These centers aimed to improve workforce readiness and competence through the development, delivery, and evaluation of targeted learning programs designed to meet specific requirements of state, local, and tribal partners. The PERLCs supported organizational and community readiness locally, regionally, or nationally through the provision of technical consultation and dissemination of specific, practical tools aligned with national preparedness competency frameworks and public health preparedness capabilities. Public health agencies strive to address growing public needs and a continuous stream of current and emerging public health threats. The PERLC network represented a flexible, scalable, and experienced national learning system linking academia with practice. This system improved national health security by enhancing individual, organizational, and community performance through the application of public health science and learning technologies to frontline practice.

Thinking Beyond the Silos: Emerging Priorities in Workforce Development for State and Local Government Public Health Agencies

PubMed Central

Kaufman, Nancy J.; Castrucci, Brian C.; Pearsol, Jim; Leider, Jonathon P.; Sellers, Katie; Kaufman, Ira R.; Fehrenbach, Lacy M.; Liss-Levinson, Rivka; Lewis, Melissa; Jarris, Paul E.; Sprague, James B.

2014-01-01

Context: Discipline-specific workforce development initiatives have been a focus in recent years. This is due, in part, to competency-based training standards and funding sources that reinforce programmatic silos within state and local health departments. Objective: National leadership groups representing the specific disciplines within public health were asked to look beyond their discipline-specific priorities and collectively assess the priorities, needs, and characteristics of the governmental public health workforce. Design: The challenges and opportunities facing the public health workforce and crosscutting priority training needs of the public health workforce as a whole were evaluated. Key informant interviews were conducted with 31 representatives from public health member organizations and federal agencies. Interviews were coded and analyzed for major themes. Next, 10 content briefs were created on the basis of priority areas within workforce development. Finally, an in-person priority setting meeting was held to identify top workforce development needs and priorities across all disciplines within public health. Participants: Representatives from 31 of 37 invited public health organizations participated, including representatives from discipline-specific member organizations, from national organizations and from federal agencies. Results: Systems thinking, communicating persuasively, change management, information and analytics, problem solving, and working with diverse populations were the major crosscutting areas prioritized. Conclusions: Decades of categorical funding created a highly specialized and knowledgeable workforce that lacks many of the foundational skills now most in demand. The balance between core and specialty training should be reconsidered. PMID:24667228

Thinking beyond the silos: emerging priorities in workforce development for state and local government public health agencies.

PubMed

Kaufman, Nancy J; Castrucci, Brian C; Pearsol, Jim; Leider, Jonathon P; Sellers, Katie; Kaufman, Ira R; Fehrenbach, Lacy M; Liss-Levinson, Rivka; Lewis, Melissa; Jarris, Paul E; Sprague, James B

2014-01-01

Discipline-specific workforce development initiatives have been a focus in recent years. This is due, in part, to competency-based training standards and funding sources that reinforce programmatic silos within state and local health departments. National leadership groups representing the specific disciplines within public health were asked to look beyond their discipline-specific priorities and collectively assess the priorities, needs, and characteristics of the governmental public health workforce. The challenges and opportunities facing the public health workforce and crosscutting priority training needs of the public health workforce as a whole were evaluated. Key informant interviews were conducted with 31 representatives from public health member organizations and federal agencies. Interviews were coded and analyzed for major themes. Next, 10 content briefs were created on the basis of priority areas within workforce development. Finally, an in-person priority setting meeting was held to identify top workforce development needs and priorities across all disciplines within public health. Representatives from 31 of 37 invited public health organizations participated, including representatives from discipline-specific member organizations, from national organizations and from federal agencies. Systems thinking, communicating persuasively, change management, information and analytics, problem solving, and working with diverse populations were the major crosscutting areas prioritized. Decades of categorical funding created a highly specialized and knowledgeable workforce that lacks many of the foundational skills now most in demand. The balance between core and specialty training should be reconsidered.

Examining national trends in worker health with the National Health Interview Survey.

PubMed

Luckhaupt, Sara E; Sestito, John P

2013-12-01

To describe data from the National Health Interview Survey (NHIS), both the annual core survey and periodic occupational health supplements (OHSs), available for examining national trends in worker health. The NHIS is an annual in-person household survey with a cross-sectional multistage clustered sample design to produce nationally representative health data. The 2010 NHIS included an OHS. Prevalence rates of various health conditions and health behaviors among workers based on multiple years of NHIS core data are available. In addition, the 2010 NHIS-OHS data provide prevalence rates of selected health conditions, work organization factors, and occupational exposures among US workers by industry and occupation. The publicly available NHIS data can be used to identify areas of concern for various industries and for benchmarking data from specific worker groups against national averages.

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2013-02-19

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[An analysis of eligibility for occupational health inspection agencies in eight provinces of China].

PubMed

Qi, Fang; Wang, Huanqiang; Li, Tao; Lyu, Xiangpei; Zhu, Qiuhong; Yu, Chen

2015-06-01

To investigate the eligibility and main problems for occupational health inspection agencies in China, and to provide technical references for improvement of occupational health inspection. A survey was performed in occupational health inspection agencies that obtained eligibility before June 2011 in eight provinces: Zhejiang, Jiangsu, Shandong, Hubei, Guangxi, Shanghai, Chongqing, and Shenzhen. The survey used the General Information Questionnaire for Occupational Health Inspection Agency made by the project of Occupational Health Surveillance and Diagnosis and Identification of Occupational Diseases in China and Australia. A total of 650 agencies obtained eligibility for occupational health inspection in the eight provinces. These agencies contained 343 centers of disease control and prevention (CDC) or health and epidemic prevention stations (52.8%), 219 hospitals (33.7%), 25 institutes or centers for occupational disease prevention and control (3.8%), 29 community health service centers (4.5%), and 34 other agencies (5.2%) including departments of preventive and health care and preventive medicine outpatient departments. Four hundred and fifty-three agencies completed the questionnaire survey with a response rate of 69.7%. The main types of eligible agencies were different among various regions. A majority of occupational health inspection agencies were hospitals in Shanghai and Zhejiang (67.1%, 62.3%), departments of preventive and health care in Shenzhen (70.0%), and CDCs in Chongqing, Jiangsu, Hubei, and Guangxi. Each agency obtained 3.5 occupational health inspection eligibilities on average. Most of agencies could perform eligible health inspection for dust, harmful physical factors, or harmful chemical factors (84.8%, 87.9%, 87.2%). Moreover, 72.8% of agencies were eligible for all the three types of inspections. A few agencies were able to perform eligible health inspection for harmful biological factors or radiation work (22.5%, 23.0%). An occupational

Basic Research in the Mission Agencies: Agency Perspectives on the Conduct and Support of Basic Research. Report of the National Science Board, 1978.

ERIC Educational Resources Information Center

National Science Foundation, Washington, DC. National Science Board.

A survey was conducted by the National Science Board of the basic research supported by executive branch agencies of the federal government. Most of the data came from information solicited by the Board from federal agencies involved in science. Fourteen mission agencies and two agencies not so classified and 20 subunits of these responded.…

Exploring bi-directional and SMS messaging for communications between Public Health Agencies and their stakeholders: a qualitative study.

PubMed

Revere, Debra; Calhoun, Rebecca; Baseman, Janet; Oberle, Mark

2015-07-08

Communication technologies that enable bi-directional/two-way communications and cell phone texting (SMS) between public health agencies and their stakeholders may improve public health surveillance, ensure targeted distribution of alerts to hard-to-reach populations, reduce mortality and morbidity in an emergency, and enable a crucial feedback loop between public health agencies and the communities they serve. Building on prior work regarding health care provider preferences for receiving one-way public health communications by email, fax or SMS, we conducted a formative, exploratory study to understand how a bi-directional system and the incorporation of SMS in that system might be used as a strategy to send and receive messages between public health agencies and community-based organizations which serve vulnerable populations, health care providers, and public health workers. Our research question: Under what conditions and/or situations might public health agencies utilize bi-directional and/or SMS messaging for disseminating time-sensitive public health information (alerts, advisories, updates, etc.) to their stakeholders? A mixed methods (qualitative and quantitative) study was conducted between April and July 2014. Data collection included a survey distributed to health care providers and semi-structured interviews with providers, community- and government-based organization leaders and directors, and public health agency internal workforce staff. Survey respondents and interviewees were asked about their exposure to public health messages, how these messages are received and how the information in these messages are handled, and in what situations (for example, a local vs. a national event, a pandemic or emergency vs. a health update) a bi-directional and/or SMS messaging system might improve communications between public health agencies and their stakeholder group. Interview and survey data were qualitatively analyzed. Thematic codes were quantitized into

Information sharing between the National Health Service and criminal justice system in the United Kingdom.

PubMed

Lennox, Charlotte; Mason, Julie; McDonnell, Sharon; Shaw, Jenny; Senior, Jane

2012-09-01

Offenders with mental health problems often have complex and interrelated needs which separately challenge the criminal justice system (CJS) and National Health Service (NHS) in the United Kingdom (U.K.). Consequently, interagency collaboration and timely information sharing are essential. This study focused on the sharing of information about people with mental health problems in contact with the CJS. Questionnaires were distributed to a range of health and criminal justice personnel. The results showed that there was a mismatch between what service user information criminal justice agencies felt they needed and what was routinely received. Prison Service staff received more information (between 15% and 37%) from health agencies than the police (between 6% and 22%). Health professionals received most of the information they needed from criminal justice agencies (between 55% and 85%). Sharing service user information was impeded by incompatible computer systems and restrictions due to data protection/confidentiality requirements. In the U.K., recent governmental publications have highlighted the importance of information sharing; however there remains a clear mismatch between what health related information about service users criminal justice agencies need, and what is actually received. Better guidance is required to encourage and empower people to share. © 2012 International Association of Forensic Nurses.

Assessing overall, technical, and scale efficiency among home health care agencies.

PubMed

Valdmanis, Vivian G; Rosko, Michael D; Leleu, Hervé; Mukamel, Dana B

2017-06-01

While home health care agencies (HHAs) play a vital role in the production of health, little research has been performed gauging their efficiency. Employing a robust approach to data envelopment analysis (DEA) we assessed overall, technical, and scale efficiency on a nationwide sample of HHAs. After deriving the three efficiency measures, we regressed these scores on a variety of environmental factors. We found that HHAs, on average, could proportionally reduce inputs by 28 % (overall efficiency), 23 % (technical efficiency) and 6 % (scale efficiency). For-profit ownership was positively associated with improvements in overall efficiency and technical efficiency and chain ownership was positively associated with global efficiency. There were also state-by-state variations on all the efficiency measures. As home health becomes an increasingly important player in the health care system, and its share of national health expenditures increases, it has become important to understand the cost structure of the industry and the potential for efficiencies. Therefore, further research is recommended as this sector continues to grow.

Kent County Health Department: Using an Agency Strategic Plan to Drive Improvement.

PubMed

Saari, Chelsey K

The Kent County Health Department (KCHD) was accredited by the Public Health Accreditation Board (PHAB) in September 2014. Although Michigan has had a state-level accreditation process for local health departments since the late 1990s, the PHAB accreditation process presented a unique opportunity for KCHD to build on successes achieved through state accreditation and enhance performance in all areas of KCHD programs, services, and operations. PHAB's standards, measures, and peer-review process provided a standardized and structured way to identify meaningful opportunities for improvement and to plan and implement strategies for enhanced performance and established a platform for being recognized nationally as a high-performing local health department. The current case report highlights the way in which KCHD has developed and implemented its strategic plan to guide efforts aimed at addressing gaps identified through the accreditation process and to drive overall improvement within our agency.

Health technology assessment agencies: an international overview of organizational aspects.

PubMed

Martelli, Francesco; La Torre, Giuseppe; Di Ghionno, Elena; Staniscia, Tommaso; Neroni, Massimo; Cicchetti, Americo; Von Bremen, Konrade; Ricciardi, Walter

2007-01-01

The aim of the study is to make an international comparison of Health Technology Assessment (HTA) Agencies, to show their similarities and differences. An e-mail questionnaire was sent to thirty HTA agencies internationally. Questions related to the structure of the agency, the relationship with health-related institutions, the prescriptiveness of the decisions taken, the main core and the modalities to spread the assessment, and the type of funding. Twenty-four HTA Agencies answered the questionnaire: 25 percent in America, 4.2 percent in Australia, and 70.8 percent in Europe. Fifty-four percent of HTA Agencies are governmental institutions (83.3 percent have central government funding), while 62.5 percent have relationships with health-related governmental institutions. Of the agencies, 87 percent reported that their decisions are not prescriptive, while for 20.8 percent and 8.3 percent of them stated that this was the case totally or partially, respectively, especially for the governmental and American Agencies. Seventeen agencies (70.8 percent) declared their work on multiannual programs (77 percent of the governmental HTA Agencies and 100 percent of the American ones). The assessments mainly addressed diagnostic procedures (85.7 percent) and pharmaceuticals (25 percent). The most common way to disseminate results is by means of paper report (91.7 percent), followed by the Internet (16.7 percent), and seminars to expert audiences (12.5 percent). The comparative analysis of HTA Agencies showed that governmental and American Agencies have a profound impact on the prescriptiveness of their assessment, and this could be linked to the fact that these types of Agencies work on multiannual programs. European and American HTA Agencies have many similarities in terms of type of assessment, funding, and dissemination of results.

National nutrition surveys in Asian countries: surveillance and monitoring efforts to improve global health.

PubMed

Song, SuJin; Song, Won O

2014-01-01

Asian regions have been suffering from growing double burden of nutritional health problems, such as undernutrition and chronic diseases. National nutrition survey plays an essential role in helping to improve both national and global health and reduce health disparities. The aim of this review was to compile and present the information on current national nutrition surveys conducted in Asian countries and suggest relevant issues in implementation of national nutrition surveys. Fifteen countries in Asia have conducted national nutrition surveys to collect data on nutrition and health status of the population. The information on national nutrition survey of each country was obtained from government documents, international organizations, survey website of governmental agencies, and publications, including journal articles, books, reports, and brochures. The national nutrition survey of each country has different variables and procedures. Variables of the surveys include sociodemographic and lifestyle variables; foods and beverages intake, dietary habits, and food security of individual or household; and health indicators, such as anthropometric and biochemical variables. The surveys have focused on collecting data about nutritional health status in children aged under five years and women of reproductive ages, nutrition intake adequacy and prevalence of obesity and chronic diseases for all individuals. To measure nutrition and health status of Asian populations accurately, improvement of current dietary assessment methods with various diet evaluation tools is necessary. The information organized in this review is important for researchers, policy makers, public health program developers, educators, and consumers in improving national and global health.

National health expenditures, 1989

PubMed Central

Lazenby, Helen C.; Letsch, Suzanne W.

1990-01-01

Spending for health care in the United States grew to $604.1 billion in 1989, an increase of 11.1 percent from the 1988 level. Growth in national health expenditures has been edging upward since 1986, when the annual growth in the health care bill was 7.7 percent. Health care spending continues to command a larger and larger proportion of the resources of the Nation: In 1989, 11.6 percent of the Nation's output, as measured by the gross national product, was consumed by health care, up from 11.2 percent in 1988. PMID:10113559

75 FR 49946 - National Drug Intelligence Center: Agency Information Collection Activities: Proposed Extension...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-16

... DEPARTMENT OF JUSTICE [OMB Number 1105-0087] National Drug Intelligence Center: Agency Information...), National Drug Intelligence Center (NDIC), will be submitting the following information collection request... Kevin M. Walker, General Counsel, National Drug Intelligence Center, Fifth Floor, 319 Washington Street...

77 FR 63341 - Agency Information Collection Activities; Proposed Collection; Comments Requested: National...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-16

... DEPARTMENT OF JUSTICE Office of Justice Programs [OMB Number 1121-0321] Agency Information Collection Activities; Proposed Collection; Comments Requested: National Institute of Justice Compliance Testing Program ACTION: 30-Day Notice. The Department of Justice, Office of Justice Programs, National...

76 FR 13673 - National Endowment for the Arts; Agency Information Collection Activities: Proposed Collection...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-14

... generalized to the overall population. This type of generic clearance for qualitative information will not be... of Qualitative Feedback on Agency Service Delivery AGENCY: The National Endowment for the Arts, NFAH... Qualitative Feedback on Agency Service Delivery'' to OMB for approval under the Paperwork Reduction Act (PRA...

Privacy, confidentiality, and security in information systems of state health agencies.

PubMed

O'Brien, D G; Yasnoff, W A

1999-05-01

To assess the employment and status of privacy, confidentiality, security and fair information practices in electronic information systems of U.S. state health agencies. A survey instrument was developed and administered to key contacts within the state health agencies of each of the 50 U.S. states, Puerto Rico and the District of Columbia. About a third of U.S. state health agencies have no written policies in place regarding privacy and confidentiality in electronic information systems. The doctrines of fair information practice often seemed to be ignored. One quarter of the agencies reported at least one security breach during the past two years, and 16% experienced a privacy and confidentiality related transgression. Most of the breaches were committed by personnel from within the agencies. These results raise questions about the integrity of existing privacy, confidentiality and security measures in the information systems of U.S. state health agencies. Recommendations include the development and vigorous enforcement of written privacy and confidentiality policies, increased personnel training, and expanded implementation of security measures such as encryption and system firewalls. A discussion of the current status of U.S. privacy, confidentiality and security issues is offered.

78 FR 29731 - Agency Information Collection Activities; Proposed Collection; Comment Request; CPSC National...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-21

... communications efforts to achieve a greater impact on consumer behavior. The CPSC's activities aim to serve a... CONSUMER PRODUCT SAFETY COMMISSION [Docket No. CPSC-2013-0020] Agency Information Collection Activities; Proposed Collection; Comment Request; CPSC National Awareness Survey AGENCY: Consumer Product...

[Quality of health care, accreditation, and health technology assessment in Croatia: role of agency for quality and accreditation in health].

PubMed

Mittermayer, Renato; Huić, Mirjana; Mestrović, Josipa

2010-12-01

standards, and providing other services in the field of healthcare quality assurance, improvement, promotion and monitoring, according to the Act. Formal activities of the Agency in the field of HTA actually began in summer 2009. In the field of quality and accreditation, the plan and program of healthcare quality assurance, improvement, promotion and monitoring was finished and published in October 2010; preparation of the healthcare quality standards as well as the accreditation standards is still in process, with the aim to start accreditation process at 10 hospitals in 2011. Education in the field of healthcare quality assurance, improvement and promotion has been established as a continuous process from the beginning. The Agency is member of the International Society for Quality in Health Care (ISQua) and participates in the work of the European Accreditation Network (EAN). In the field of HTA, the Agency has established international collaboration and support, which resulted in its appointment and participation in the European network for Health Technology Assessment (EUnetHTA) Joint Action Project as a EUnetHTA Partner, as well as its membership in the international society, HTAi. TAIEX project has been approved as a two-day workshop in December 2010. The Croatian HTA Guidelines have been issued with the aim to start the HTA process and reports that should serve as recommendations, as a support to policy-makers at the national level, in particular the Croatian Ministry of Health and Social Welfare, and Croatian Institute of Health Insurance, in making evidence-informed decisions on the strategic planning, investment, management and implementation of technologies in health care, on funding (reimbursement) and coverage of health technologies, and at hospital level on the request from hospital directors and policy teams. In conclusion, establishment of all these measures in Croatia is by no means an easy and quick process, however, we do believe that it is feasible

[The strategic purchasing of health services: a big opportunity for the National Universal Health System].

PubMed

González-Block, Miguel Ángel; Alarcón Irigoyen, José; Figueroa Lara, Alejandro; Ibarra Espinosa, Ignacio; Cortés Llamas, Noemí

2015-01-01

proposed to establish a service packages, whether through a single obligatory list or through the definition of a flexible, high priority set to be offered to specific populations according to their economic possibilities. For the strategic purchasing of services, two alternatives are proposed: to assign the fund either to a single national manager or to each of the existing public provider institutions, with the expectation that they would contract across each other and with private providers to fulfill their complementary needs.The proposal does not consider the risks and alternatives to a single tax contribution fund, which could have been suggested given that it is not an essential part of a National Universal Health System. However, it is necessary to discuss in more detail the roles and strategies for a national single-payer, especially for the strategic purchasing of high-cost and specialized interventions in the context of public and private providers. The alternative of allocating funds directly to providers would undermine the incentives for competition and collaboration and the capacity to steer providers towards the provision of high quality health services.It is proposed to focus the discussion of the reform of the national health system around strategic purchasing and the functions and structure of a single-payer as well as of agencies to articulate integrated health service networks as tools to promote quality and efficiency of the National Universal Health System. The inclusion of economic incentives to providers will be vital for competition, but also for the cooperation of providers within integrated, multi-institutional health service networks.Health professionals and sector policy specialists coordinated by the Centro de Estudios Espinosa Yglesi as in Mexico propose a policy to anchor the health system in primary care centered on the individual. The vision includes effective stewardship,solid financing, and the provision of services by a

77 FR 44266 - Agency Information Collection Activities: National Geological and Geophysical Data Preservation...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-27

... DEPARTMENT OF THE INTERIOR U.S. Geological Survey [USGS-GX12GL00DT70500] Agency Information Collection Activities: National Geological and Geophysical Data Preservation Program (NGGDPP) AGENCY: U.S. Geological Survey (USGS), Interior. ACTION: Notice of an extension of an existing information collection...

New partnership for health? Business groups on health and health systems agencies.

PubMed Central

Bradbury, R C

1983-01-01

The experience of the Central Massachusetts Health Systems Agency (CMHSA) and the Central Massachusetts Business Group on Health (CMBGH) demonstrates the feasibility of cooperation between HSAs and BGHs. Objectives and strategies of the two groups in carrying out community health planning and working for health systems change are compared. Nearly two decades of government-sponsored community health planning programs, first through comprehensive health planning agencies and then through HSAs, have had less impact than many had anticipated because neither the technical nor political basis for such planning was sufficiently established. The CMHSA experience is typical, although it is credited with developing a hospital systems plan that is based on sound planning methods and statistical data. It is in the implementation of plans that the CMHSA has made slow progress, reflecting its inadequate community power base. The CMBGH, 1 of more than 90 groups that have developed recently across the country to attack high health care costs, was formed in 1981 by business leaders to address these rising costs. The principal strategy adopted by the CMBGH involves fostering a competitive health care market by creating a critical number of competing health plans. The providers in each plan will then have incentives to provide effective care in an efficient manner to keep the premium competitive and attract enrollees. Cooperation between the CMBGH and CMHSA is based on each organization's emphasizing its strengths. The CMHSA's data base and analyses have been the primary resources used by the CMBGH to identify problems. Each organization has developed its own set of goals and objectives, while keeping in mind those of the other organization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6419277

Regulatory Enforcement and Fiscal Impact in Local Health Agencies

PubMed Central

Rabarison, Kristina M.; Rabarison, Monika K.

2015-01-01

Objectives. We used a cross-sectional, retrospective study design to analyze the association between local health agency regulatory activities and revenues from nonclinical fees and fines (NFF). Methods. We extracted data from the 2010 National Association of County and City Health Officials (NACCHO) Profile Survey, the most recent report including NFF information, and used 2-part multivariable regression models to identify relationships between regulatory activities and revenue. We also interviewed LHD directors on access to revenue from fines. Results. NFFs generated substantial revenue for most LHDs, increasing in scope and amount with jurisdiction size for all but the largest municipalities. The greatest proportion of net revenue came from public pools, campgrounds and recreational vehicles, and solid waste disposal. For small and mid-sized LHDs, enforcement activities generated revenue in a dose–response pattern, with higher returns for increased activities. LHDs in decentralized governance states collected more NFF revenue than those in centralized states. States vary regarding LHD access to revenue from sanctions. Conclusions. The fiscal impact of changes in regulatory activity needs careful assessment to avoid unanticipated consequences of applicable law. PMID:25689178

The case of national health promotion policy in Australia: where to now?

PubMed

Smith, James A; Crawford, Gemma; Signal, Louise

2016-04-01

Issue addressed Over the last three decades there has been an incremental investment in health promotion and prevention across Australia; yet, the Commonwealth Government and some state/territory governments have more recently instigated funding cuts in health promotion and prevention. This paper argues that the role of health promotion is critical in contemporary Australia and discusses strategies needed to move forward within the context of recent disinvestments. Discussion Key areas of concern relating to recent health promotion and prevention disinvestment in Australia include the abolishment of the Australian National Preventive Health Agency, the cessation of the National Partnership Agreement on Preventive Health and significant cuts to Indigenous programs. These changes pose a significant threat to the health, economic and social well being of Australians and the region, particularly those that are most vulnerable. Conclusions Future health promotion and prevention efforts will require strategic leadership and action to enhance the promotion of health equity in Australia over the coming decades. We call on governments to (re)invest in health promotion and prevention both in and outside the health sector so that health promotion professionals can continue their advocacy efforts aimed at articulating their professional place in improving population health. So what? Recent changes to national health promotion and prevention policy are detrimental to the health and well being of the Australian population, particularly those most vulnerable. Sound planning to revitalise and refocus health promotion action in Australia is urgently required.

National health expenditures, 1983

PubMed Central

Gibson, Robert M.; Levit, Katharine R.; Lazenby, Helen; Waldo, Daniel R.

1984-01-01

Although growing more slowly than in recent years, spending for health continued to account for an increasing share of the Nation's gross national product. In 1983, spending for health amounted to 10.8 percent of the gross national product, or $1,459 per person. Public programs financed 40 percent of all personal health care spending. Medicare and Medicaid expended $91 billion in benefits, 29 percent of all spending for personal health. New estimates of spending in calendar year 1983, along with revised measures of the benefits paid by private health insurers, are presented here. PMID:10310949

A relational approach to health practices: towards transcending the agency-structure divide.

PubMed

Veenstra, Gerry; Burnett, Patrick John

2014-02-01

Many health scholars find that Pierre Bourdieu's theory of practice leaves too little room for individual agency. We contend that, by virtue of its relational, field-theoretic underpinnings, the idea of leaving room for agency in Bourdieu's theory of practice is misguided. With agency manifested in interactions and social structures consisting of relations built upon relations, the stark distinction between agency and structure inherent to substantialist thinking is undermined, even dissolved, in a relational field-theoretic context. We also contend that, when treated as relationally bound phenomena, Bourdieu's notions of habitus, doxa, capital and field illuminate creative, adaptive and future-looking practices. We conclude by discussing difficulties inherent to implementing a relational theory of practice in health promotion and public health. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

National Health Expenditures, 1979

PubMed Central

Gibson, Robert M

1980-01-01

Outlays for health care in the nation reached $212.2 billion in calendar year 1979—12.5 percent higher than in 1978, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $943 per person in the United States and was equal to 9.0 percent of the Gross National Product. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing. PMID:10309255

29 CFR 1960.80 - Secretary's evaluations of agency occupational safety and health programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Evaluation of Federal Occupational Safety and Health Programs § 1960.80 Secretary's evaluations of agency occupational safety and health... evaluating an agency's occupational safety and health program. To accomplish this, the Secretary shall...

29 CFR 1960.80 - Secretary's evaluations of agency occupational safety and health programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Evaluation of Federal Occupational Safety and Health Programs § 1960.80 Secretary's evaluations of agency occupational safety and health... evaluating an agency's occupational safety and health program. To accomplish this, the Secretary shall...

29 CFR 1960.80 - Secretary's evaluations of agency occupational safety and health programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Evaluation of Federal Occupational Safety and Health Programs § 1960.80 Secretary's evaluations of agency occupational safety and health... evaluating an agency's occupational safety and health program. To accomplish this, the Secretary shall...

29 CFR 1960.80 - Secretary's evaluations of agency occupational safety and health programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Evaluation of Federal Occupational Safety and Health Programs § 1960.80 Secretary's evaluations of agency occupational safety and health... evaluating an agency's occupational safety and health program. To accomplish this, the Secretary shall...

29 CFR 1960.80 - Secretary's evaluations of agency occupational safety and health programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Evaluation of Federal Occupational Safety and Health Programs § 1960.80 Secretary's evaluations of agency occupational safety and health... evaluating an agency's occupational safety and health program. To accomplish this, the Secretary shall...

[Health agencies and the every day management of bioethics].

PubMed

Byk, Christian

2014-06-01

Taking into account their acquired experience, would not health agencies become the place where biomedical practices will be managed on an every day basis? Would in a near future these agencies have the role to interprete the principles of the bioethics law to adapt them to concrete issues?

A Needs-Assessment of Agencies Serving Individuals with Deaf-Blindness: A National Profile of Transitional Services.

ERIC Educational Resources Information Center

Seiler, Lauren H.; And Others

A national needs assessment of 719 educational and adult service agencies providing or proposing to provide transitional services to individuals with deaf-blindness was conducted to determine national and regional technical assistance needs. On average, each agency expressed a need for technical assistance in 20 separate areas. In the area of…

A life course perspective on migration and mental health among Asian immigrants: the role of human agency.

PubMed

Gong, Fang; Xu, Jun; Fujishiro, Kaori; Takeuchi, David T

2011-12-01

The relationship between human agency and health is an important yet under-researched topic. This study uses a life course perspective to examine how human agency (measured by voluntariness, migratory reasons, and planning) and timing (measured by age at immigration) affect mental health outcomes among Asian immigrants in the United States. Data from the National Latino and Asian American Study showed that Asian immigrants (n=1491) with multiple strong reasons to migrate were less likely to suffer from mental health problems (i.e., psychological distress and psychiatric disorders in the past 12 months) than those without clear goals. Moreover, Asian immigrants with adequate migratory planning had lower levels of distress and lower rates of 12-month psychiatric disorders than those with poorly planned migration. Compared with migrants of the youngest age category (six or younger), those who migrated during preteen and adolescent years without clear goals had higher levels of psychological distress, and those who migrated during adulthood (25 years or older) were less likely to suffer from recent depressive disorders (with the exception of those migrating for life-improving goals). Furthermore, we found that well-planned migration lowered acculturative stress, and multiple strong reasons for migration buffered the negative effect of acculturative stress upon mental health. Findings from this study advance research on immigrant health from the life course perspective by highlighting the effects of exercising human agency during the pre-migration stage upon post-migration mental health. Copyright © 2011 Elsevier Ltd. All rights reserved.

76 FR 28244 - Agency Information Collection Activities: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-16

... of Health. Use of the Information: Analysis of the Facilities Survey data will provide updated... NATIONAL SCIENCE FOUNDATION Agency Information Collection Activities: Comment Request AGENCY... public comment on this information collection. Comments are invited on: (a) Whether the proposed...

Sport for Development and Global Public Health Issues: A Case Study of National Sports Associations

PubMed Central

Banda, Davies

2017-01-01

Sport is widely recognised for the contribution it can make to international development goals. More specifically, the value of sport as a tool for development gained its impetus through the HIV/AIDS pandemic in sub-Saharan Africa. The institutionalized relationship between sport and development has mainly focussed on sport-for-development (SfD) non-governmental organisations (NGOs). This study proposed to examine the response of National Sports Associations (NSAs) towards the multisectoral approach for HIV/AIDS prevention in Zambia. The study draws on lessons learnt from how NSAs within a resource-scarce or low-income country responded to a health pandemic. While public health was previously a state and health sector preserve, the impact of HIV/AIDS pandemic influenced not only the way that a pandemic is managed but also other public health issues. A case study approach was adopted comprising of three National Sports Associations (NSAs) as units of analysis. The study utilised semi-structured interviews, documentary analysis and field observations to gain perspectives on how each NSA mainstreamed and implemented work-based health programmes. Using governance and policy network theories, the paper discusses each NSAs' role in the governance and implementation of a multisectoral approach to a health pandemic. The findings identified lack of engagement of sports agencies at strategic decision-making level, marginalisation of sport by other sectors, and variations in implementation patterns among sports agencies. Further findings indicate that lack of resources among government sport agencies or departments limited their involvement with other state or non-state actors in strategic level meetings or health policy networks. Resource-scarce conditions placed limitations on the political steer of state actors while non-state actors with foreign resources attracted collaboration from other public health policy networks. PMID:29546215

Sport for Development and Global Public Health Issues: A Case Study of National Sports Associations.

PubMed

Banda, Davies

2017-01-01

Sport is widely recognised for the contribution it can make to international development goals. More specifically, the value of sport as a tool for development gained its impetus through the HIV/AIDS pandemic in sub-Saharan Africa. The institutionalized relationship between sport and development has mainly focussed on sport-for-development (SfD) non-governmental organisations (NGOs). This study proposed to examine the response of National Sports Associations (NSAs) towards the multisectoral approach for HIV/AIDS prevention in Zambia. The study draws on lessons learnt from how NSAs within a resource-scarce or low-income country responded to a health pandemic. While public health was previously a state and health sector preserve, the impact of HIV/AIDS pandemic influenced not only the way that a pandemic is managed but also other public health issues. A case study approach was adopted comprising of three National Sports Associations (NSAs) as units of analysis. The study utilised semi-structured interviews, documentary analysis and field observations to gain perspectives on how each NSA mainstreamed and implemented work-based health programmes. Using governance and policy network theories, the paper discusses each NSAs' role in the governance and implementation of a multisectoral approach to a health pandemic. The findings identified lack of engagement of sports agencies at strategic decision-making level, marginalisation of sport by other sectors, and variations in implementation patterns among sports agencies. Further findings indicate that lack of resources among government sport agencies or departments limited their involvement with other state or non-state actors in strategic level meetings or health policy networks. Resource-scarce conditions placed limitations on the political steer of state actors while non-state actors with foreign resources attracted collaboration from other public health policy networks.

76 FR 41243 - Agency Information Collection Activities: Proposed Collection; Comment Request; National Water...

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2011-07-13

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2012-01-24

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76 FR 37371 - Agency Information Collection: Comment Request for National Gap Analysis Program Evaluation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

... Gap Analysis Program (GAP). The information collected will provide information for the Program's... DEPARTMENT OF THE INTERIOR U.S. Geological Survey [USGS--GX10RB0000SDP00] Agency Information Collection: Comment Request for National Gap Analysis Program Evaluation AGENCY: United States Geological...

The theory of agency and breastfeeding.

PubMed

Ryan, Kath; Team, Victoria; Alexander, Jo

2017-03-01

In this paper, we apply psychological agency theory to women's interviews of their breastfeeding experiences to understand the role of agency in relation to breastfeeding initiation, maintenance and duration. Qualitative, video interviews were collected from 49 women in the UK from a wide range of ethnic, religious, educational and employment backgrounds about their breastfeeding experiences. We undertook secondary analysis of the data focusing on their accounts of vulnerability and agency. Women's agency was impacted by a variety of factors including their own vulnerability, knowledge, expectations and experience, the feeding environment and the support of health professionals in sharing decision-making and dealing with uncertainty. Health professionals as co-agents with women are well positioned to maintain, enhance or restore women's sense of agency. Breastfeeding goals should be included in women's birth plans. Training related to agency, continuity of care, and staffing and workload management supported by national breastfeeding policies could improve breastfeeding rates and experiences.

Gender in health technology assessment: pilot study on agency approaches.

PubMed

Panteli, Dimitra; Zentner, Annette; Storz-Pfennig, Philipp; Busse, Reinhard

2011-07-01

Gender as a social construct is a recognized health determinant. Because best practice in reporting health technology assessment (HTA) clearly specifies the need to appraise a technology's social impact within the target population, the extent to which gender issues are taken into account in HTA production is of interest, not only in light of equitable practices but also for reasons of effectiveness. The aim of this study is to provide a first assessment of the degree of gender sensitivity shown by HTA agencies around the world today. The Web sites of sixty HTA agencies were analyzed. The consideration of gender aspects was specifically looked for in each agency's general mission statement, its priority setting process, and its methodological approach. Additionally, specific gender-oriented initiatives not belonging to any of the aforementioned categories were identified. Of the sixty agencies, less than half mention a commitment to addressing the social implication of health technologies. Only fifteen institutions make information on their priority setting principles available on their Web sites and gender was an issue in two of those cases. Data on methodology were obtainable online from 18 agencies, two of which mentioned gender issues explicitly. Finally, gender-oriented initiatives were identified by thirteen agencies. A gender-sensitive approach is apparently rarely adopted in current HTA production. Exceptional practices and relevant tools do exist and could serve as examples to be promoted by international collaborative networks.

Integrating Local Public Health Agencies into the Homeland Security Community

DTIC Science & Technology

2007-03-01

public health needs that require attention (such as poor prenatal health, teen pregnancy , and sexually transmitted diseases) it is not difficult to...11 2. Education ... relationships and improved planning and response capabilities. Public health agencies are diverse organizations administrating multiple health programs

29 CFR 1960.19 - Other Federal agency standards affecting occupational safety and health.

Code of Federal Regulations, 2014 CFR

2014-07-01

... safety and health. 1960.19 Section 1960.19 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Standards § 1960.19 Other Federal agency standards affecting occupational safety and health. (a) Where employees of different agencies...

29 CFR 1960.19 - Other Federal agency standards affecting occupational safety and health.

Code of Federal Regulations, 2013 CFR

2013-07-01

... safety and health. 1960.19 Section 1960.19 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Standards § 1960.19 Other Federal agency standards affecting occupational safety and health. (a) Where employees of different agencies...

29 CFR 1960.19 - Other Federal agency standards affecting occupational safety and health.

Code of Federal Regulations, 2012 CFR

2012-07-01

... safety and health. 1960.19 Section 1960.19 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Standards § 1960.19 Other Federal agency standards affecting occupational safety and health. (a) Where employees of different agencies...

Transitioning to a national health system in Cyprus: a stakeholder analysis of pharmaceutical policy reform.

PubMed

Wouters, Olivier J; Kanavos, Panos G

2015-09-01

To review the pharmaceutical sector in Cyprus in terms of the availability and affordability of medicines and to explore pharmaceutical policy options for the national health system finance reform expected to be introduced in 2016. We conducted semi-structured interviews in April 2014 with senior representatives from seven key national organizations involved in pharmaceutical care. The captured data were coded and analysed using the predetermined themes of pricing, reimbursement, prescribing, dispensing and cost sharing. We also examined secondary data provided by the Cypriot Ministry of Health; these data included the prices and volumes of prescription medicines in 2013. We identified several key issues, including high medicine prices, underuse of generic medicines and high out-of-pocket drug spending. Most stakeholders recommended that the national government review existing pricing policies to ensure medicines within the forthcoming national health system are affordable and available, introduce a national reimbursement system and incentivize the prescribing and dispensing of generic medicines. There were disagreements over how to (i) allocate responsibilities to governmental agencies in the national health system, (ii) reconcile differences in opinion between stakeholders and (iii) raise awareness among patients, physicians and pharmacists about the benefits of greater generic drug use. In Cyprus, if the national health system is going to provide universal health coverage in a sustainable fashion, then the national government must address the current issues in the pharmaceutical sector. Importantly, the country will need to increase the market share of generic medicines to contain drug spending.

77 FR 6128 - Agency Information Collection Activities: Proposed Collection; Comment Request; Generic Clearance...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-07

... Qualitative Feedback on Agency Service Delivery ACTION: 30-Day notice of submission of information collection... delivery, the National Institute of Nursing Research (NINR), National Institutes of Health (NIH), has... Qualitative Feedback on Agency Service Delivery'' to OMB for approval under the Paperwork Reduction Act (PRA...

Tracking Success: Outputs Versus Outcomes-A Comparison of Accredited and Non-Accredited Public Health Agencies' Community Health Improvement Plan objectives.

PubMed

Perrault, Evan K; Inderstrodt-Stephens, Jill; Hintz, Elizabeth A

2018-06-01

With funding for public health initiatives declining, creating measurable objectives that are focused on tracking and changing population outcomes (i.e., knowledge, attitudes, or behaviors), instead of those that are focused on health agencies' own outputs (e.g., promoting services, developing communication messages) have seen a renewed focus. This study analyzed 4094 objectives from the Community Health Improvement Plans (CHIPs) of 280 local PHAB-accredited and non-accredited public health agencies across the United States. Results revealed that accredited agencies were no more successful at creating outcomes-focused objectives (35% of those coded) compared to non-accredited agencies (33% of those coded; Z = 1.35, p = .18). The majority of objectives were focused on outputs (accredited: 61.2%; non-accredited: 63.3%; Z = 0.72, p = .47). Outcomes-focused objectives primarily sought to change behaviors (accredited: 85.43%; non-accredited: 80.6%), followed by changes in knowledge (accredited: 9.75%; non-accredited: 10.8%) and attitudes (accredited: 1.6%; non-accredited: 5.1%). Non-accredited agencies had more double-barreled objectives (49.9%) compared to accredited agencies (32%; Z = 11.43, p < .001). The authors recommend that accreditation procedures place a renewed focus on ensuring that public health agencies strive to achieve outcomes. It is also advocated that public health agencies work with interdisciplinary teams of Health Communicators who can help them develop procedures to effectively and efficiently measure outcomes of knowledge and attitudes that are influential drivers of behavioral changes.

The Economic Cost of Communicable Disease Surveillance in Local Public Health Agencies.

PubMed

Atherly, Adam; Whittington, Melanie; VanRaemdonck, Lisa; Lampe, Sarah

2017-12-01

We identify economic costs associated with communicable disease (CD) monitoring/surveillance in Colorado local public health agencies and identify possible economies of scale. Data were collected via a survey of local public health employees engaged in CD work. Survey respondents logged time spent on CD surveillance for 2-week periods in the spring of 2014 and fall of 2014. Forty-three of the 54 local public health agencies in Colorado participated. We used a microcosting approach. We estimated a statistical cost function using cost as a function of the number of reported investigable diseases during the matched 2-week period. We also controlled for other independent variables, including case mix, characteristics of the agency, the community, and services provided. Data were collected from a microcosting survey using time logs. Costs increased at a decreasing rate as cases increased, with both cases (β = 431.5, p < .001) and cases squared (β = -3.62, p = .05) statistically significant. The results of the model suggest economies of scale. Cost per unit is estimated to be one-third lower for high-volume agencies as compared to low-volume agencies. Cost savings could potentially be achieved if smaller agencies shared services. © Health Research and Educational Trust.

Bringing the National Security Agency into the Classroom: Ethical Reflections on Academia-Intelligence Agency Partnerships.

PubMed

Kampe, Christopher; Reid, Gwendolynne; Jones, Paul; S, Colleen; S, Sean; Vogel, Kathleen M

2018-01-09

Academia-intelligence agency collaborations are on the rise for a variety of reasons. These can take many forms, one of which is in the classroom, using students to stand in for intelligence analysts. Classrooms, however, are ethically complex spaces, with students considered vulnerable populations, and become even more complex when layering multiple goals, activities, tools, and stakeholders over those traditionally present. This does not necessarily mean one must shy away from academia-intelligence agency partnerships in classrooms, but that these must be conducted carefully and reflexively. This paper hopes to contribute to this conversation by describing one purposeful classroom encounter that occurred between a professor, students, and intelligence practitioners in the fall of 2015 at North Carolina State University: an experiment conducted as part of a graduate-level political science class that involved students working with a prototype analytic technology, a type of participatory sensing/self-tracking device, developed by the National Security Agency. This experiment opened up the following questions that this paper will explore: What social, ethical, and pedagogical considerations arise with the deployment of a prototype intelligence technology in the college classroom, and how can they be addressed? How can academia-intelligence agency collaboration in the classroom be conducted in ways that provide benefits to all parties, while minimizing disruptions and negative consequences? This paper will discuss the experimental findings in the context of ethical perspectives involved in values in design and participatory/self-tracking data practices, and discuss lessons learned for the ethics of future academia-intelligence agency partnerships in the classroom.

Population Activities Fund Agency (PAFA): the journey so far.

PubMed

1993-01-01

Mechanisms are needed funding Nigerian Federal efforts to implement the National Policy on Population for Development, which was approved by the Armed Forces Ruling Council in February, 1988. Subprojects of the Population Activities Fund Agency (PAFA) which were approves are: the integration of family planning (FP) into maternal and child health (MCH) the promotion of Fp through health education, tertiary centers for reproductive health, public enlightenment on population, population/family life education in primary schools, monitoring of National Population Project impact, and integration of population into planning and budgeting. The last obstacle to implementation of PAFA's activities is the signing into law the decree establishing PAFA as a parastatal. The passage is required for continued operations. The national Population for Development policy is unique in providing for quantitative targets, which has attracted the needed financial support of agencies such as the World Bank. As part of the National Population Policy, the National Population Program (NPP) is developing an effective strategy for securing funding and evaluation of subprojects that are designed and implemented b Collaborating Agencies (CAs), both private and public. NPP aims 1) to provide funds for qualified CAs through the Population Activities Fund (PAF) and Agency (PAFA); 2) to monitor PAFA, which manages PAf with the Department of Population Activities, and 3) to stimulate analysis of sociocultural constraints to fertility reduction and international comparisons, and to design innovative interventions through the Population Research Fund (PRF). PAFA funds implementing agencies at all government and nongovernment levels with approaches to population information and services. The goal of PAFA is to realize NPP objectives. The motto is "Towards an improved quality of life for every Nigerian." The mandate is to provide funding for the PAF and NPP, to monitor CAs, to provide assistance to CAs

Implementation of stress assessments by occupational health nurses working in occupational health agencies and their confidence in conducting such assessments.

PubMed

Ikeda, Chiseko; Saeki, Kazuko; Hirano, Michiyo

2016-06-21

Stress assessments are due to be conducted in December 2015. It is expected that there will be an increase in the number of private health agencies that provide stress assessment services and mental health care. This study aimed to clarify the current situation of and the factors related to stress assessments conducted by nurses in occupational health agencies. Nurses working full time were randomly selected from 60 organizations that were members of the National Federation of Industrial Health Organization. Self-administered questionnaires were sent out between November 2013 and January 2014. The questionnaire included the personal attributes of the participants, training programs, job contents, and how practical mental health care, including stress assessment, is. The study was approved by the ethics committees in the respective organizations. Out of the 162 questionnaires that were distributed, 89 (54.9%) were returned and 85 (53.1%) were valid for analysis. Stress assessments were conducted by 38.8% of the participants. With reference to their confidence in conducting stress assessments, "confidence and" 70.6%, respectively. The groups that conducted and did not conduct the stress assessments did not show any differences in the findings or other attributes. Further, the implementation of stress assessment was not associated with occupational health nurse (OHN) training, education, position, age, years of experience, attendance of lectures on mental health, etc. However, the confidence in conducting the assessment was related to age when dealing with cases on confidence stress assessment consultation in follow-up to the implementation of screening, such as stress, persons at high risk, and so on. Approximately 40% of the nurses were already conducting stress assessments, but most of them conducted such assessments about once a year and were not deeply involved in them. Approximately 70% of the nurses were confident in implementing stress assessments. Further

Funding agencies in low- and middle-income countries: support for knowledge translation.

PubMed

Cordero, Cynthia; Delino, Rachel; Jeyaseelan, L; Lansang, Mary Ann; Lozano, Juan M; Kumar, Shuba; Moreno, Socorro; Pietersen, Merle; Quirino, Jose; Thamlikitkul, Visanu; Welch, Vivian A; Tetroe, Jacqueline; Ter Kuile, Aleida; Graham, Ian D; Grimshaw, Jeremy; Neufeld, Vic; Wells, George; Tugwell, Peter

2008-07-01

The aim was to describe how selected health research funding agencies active in low- and middle-income countries promote the translation of their funded research into policy and practice. We conducted inductive analysis of semi-structured interviews with key informants from a purposive sample of 23 national and international funding agencies that fund health research in Brazil, Colombia, India, the Philippines, South Africa and Thailand. We also surveyed web sites. We found a commitment to knowledge translation in the mandate of 18 of 23 agencies. However, there was a lack of common terminology. Most of the activities were traditional efforts to disseminate to a broad audience, for example using web sites and publications. In addition, more than half (13 of 23) of the agencies encouraged linkage/exchange between researchers and potential users, and 6 of 23 agencies described "pull" activities to generate interest in research from decision-makers. One-third (9 of 23) of funding agencies described a mandate to enhance health equity through improving knowledge translation. Only 3 of 23 agencies were able to describe evaluation of knowledge translation activities. Furthermore, we found national funding agencies made greater knowledge translation efforts when compared to international agencies. Funding agencies are engaged in a wide range of creative knowledge translation activities. They might consider their role as knowledge brokers, with an ability to promote research syntheses and a focus on health equity. There is an urgent need to evaluate the knowledge translation activities of funding agencies.

Health Status of Homeless and Marginally Housed Users of Mental Health Self-Help Agencies.

ERIC Educational Resources Information Center

Segal, Steven P.; Gomory, Tomi; Silverman, Carol J.

1998-01-01

Investigates the health status of 310 homeless and marginally housed people to determine the usefulness of mental health self-help agencies (SHAs) in addressing their physical health needs. Findings indicated that frequencies of health problems among respondents were similar to those of other homeless or marginally housed groups and that the study…

75 FR 52768 - National Protection and Programs Directorate; Agency Information Collection Activities: Office of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-27

... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2010-0071] National Protection and Programs Directorate; Agency Information Collection Activities: Office of Infrastructure Protection; Chemical Security.... SUMMARY: The Department of Homeland Security, National Protection and Programs Directorate, Office of...

Strategic philanthropy: an opportunity for partnership between corporations and health/human service agencies.

PubMed

Marx, J D

1996-01-01

The study is a national survey of corporate philanthropy programs. The original problem underlying the study is the long-term decline in the percentage of total corporate contributions to health and human services. A questionnaire, mailed in May of 1993, was used to investigate the impact of strategic philanthropy on the relationship between corporations and health/human service organizations. Corporations strategically prioritizing their philanthropic support were expected to create new opportunities for partnerships between business and health/human service agencies. The survey resulted in a sample of 226 corporations. The results showed statistically significant support for the hypothesis that highly strategic philanthropy programs will be more likely to enter into a health/human service partnership than less strategic programs. The multiple regression analysis method was used to control for the effects of corporate size, industry type, the (corporate) contributions management organization, and United Way credibility. Based upon the results of the study, United Way is recommended to consider new roles for itself as a facilitator of partnerships between business and health/human service organizations.

[Priority setting of health interventions. Review of criteria, approaches and role of assessment agencies].

PubMed

Varela-Lema, Leonor; Atienza-Merino, Gerardo; López-García, Marisa

This study was carried out to develop an explicit health priority setting methodology to support decision-making regarding the technologies to be assessed for inclusion in the National Health Service service portfolio. The primary objective is to identify and analyse the criteria, approaches and conceptual frameworks used for national/international priority setting. An exhaustive review of the literature was carried out. For this purpose, a search of the main biomedical databases was performed and assessment agency websites were reviewed, among other sources. In general terms, it was found that there are no standardised criteria for priority setting, although some consensus and common trends have been identified regarding key elements (criteria, models and strategies, key actors, etc.). Globally, 8 key domains were identified: 1) need for intervention; 2) health outcomes; 3) type of benefit of the intervention; 4) economic consequences; 5) existing knowledge on the intervention/quality of and uncertainties regarding the evidence; 6) implementation and complexity of the intervention/feasibility; 7) priority, justice and ethics; and 8) overall context. The review provides a thorough analysis of the relevant issues and offers key recommendations regarding considerations for developing a national prioritisation framework. Findings are envisioned to be useful for different public organisations that are aiming to establish healthcare priorities. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Public health emergencies and responses: what are they, how long do they last, and how many staff does your agency need?

PubMed

Posid, Joseph M; Bruce, Sherrie M; Guarnizo, Julie T; O'Connor, Ralph C; Papagiotas, Stephen S; Taylor, Melissa L

2013-12-01

Responding to outbreaks is one of the most routine yet most important functions of a public health agency. However, some outbreaks are bigger, more visible, or more complex than others, prompting discussion about when an "outbreak" becomes a "public health emergency." When a public health emergency is identified, resources (eg, funding, staff, space) may need to be redirected from core public health programs to contribute to the public health emergency response. The need to sustain critical public health functions while preparing for public health emergency responses raises a series of operational and resource management questions, including when a public health emergency begins and ends, why additional resources are needed, how long an organization should expect staff to be redirected, and how many staff (or what proportion of the agency's staff ) an organization should anticipate will be needed to conduct a public health emergency response. This article addresses these questions from a national perspective by reviewing events for which the Centers for Disease Control and Prevention redirected staff from core public health functions to respond to a series of public health emergencies. We defined "public health emergency" in both operational and public health terms and found that on average each emergency response lasted approximately 4 months and used approximately 9.5% of our workforce. We also provide reasons why public health agencies should consider the impact of redirecting resources when preparing for public health emergencies.

National Institutes of Health Pathways to Prevention Workshop: Advancing Research to Prevent Youth Suicide.

PubMed

Little, Todd D; Roche, Kathleen M; Chow, Sy-Miin; Schenck, Anna P; Byam, Leslie-Ann

2016-12-06

The National Institutes of Health (NIH) Pathways to Prevention Workshop "Advancing Research to Prevent Youth Suicide" was cosponsored by the NIH Office of Disease Prevention, National Institute of Mental Health, National Institute on Drug Abuse, and National Center for Complementary and Integrative Health. A multidisciplinary working group developed the agenda, and an evidence-based practice center prepared an evidence report that addressed data systems relevant to suicide prevention efforts through a contract with the Agency for Healthcare Research and Quality. During the workshop, experts discussed the evidence and participants commented during open forums. After considering the data from the evidence report, expert presentations, and public comments, an independent panel prepared a draft report that was posted on the NIH Office of Disease Prevention Web site for 5 weeks for public comment. This abridged version of the final report provides a road map for optimizing youth suicide prevention efforts by highlighting strategies for guiding the next decade of research in this area. These strategies include recommendations for improving data systems, enhancing data collection and analysis methods, and strengthening the research and practice community.

42 CFR 413.125 - Payment for home health agency services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for home health agency services. 413.125 Section 413.125 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE...

75 FR 17920 - Agency Information Collection Activities: Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency... Services Administration (HRSA) publishes periodic summaries of proposed projects being developed for...: National Health Service Corps Alumni Initiative--New The Health Resources and Services Administration's...

Invasive bacterial diseases: national surveillance in Italy and vaccination coverage in the Local Health Agency 4 "Chiavarese", Liguria region (Italy).

PubMed

Trucchi, C; Zoppi, G

2012-06-01

In 2007 in Italy, the National Institute of Health published a new protocol for the National Surveillance of Invasive Bacterial Diseases, in order to enhance the notification system of these diseases and to improve immunization strategies. Available vaccines to prevent these diseases were introduced for the first time into the 1999-2000 National Immunization Plan (NIP) (vaccination against Haemophilus influenzae type b) and the 2005-2007 NIP (vaccination against Streptococcus pneumoniae and Neisseria meningitidis serogroup C). We evaluated the frequency of invasive diseases, on the basis of the number of notifications, the different immunization strategies in the Italian Regions and the vaccination coverage in Local Health Agency 4 "Chiavarese" (LHA) in the Liguria Region (Italy). We evaluated the number of notifications of invasive diseases collected by the national databank coordinated by the ISS (Informative System of Infectious Diseases, SIMI) from 1994 to 2011. We also examined regional regulations concerning immunization policies. Immunization coverage was calculated by means of the "OASIS" software (version 9.0.0) used in our LHA. Available data indicate that the large-scale vaccination policy begun in 1999 in Italy has led to a great reduction in Haemophilus influenzae-related diseases in the pediatric age. Meningococcal diseases have declined to a lesser degree; this is due to the more recent introduction of vaccination against serogroup C (in 2005), the variability of the immunization strategies adopted in the different Italian Regions and the availability of the vaccination against serogroup C only in the pediatric age. The diseases caused by Streptococcus pneumoniae seem to have increased since 2007 because of the implementation of the Surveillance of Invasive Diseases Program and the subsequent notification of all invasive diseases (not only meningitis). Furthermore, the various Italian Regions have adopted different immunization strategies against

Health professionals working with First Nations, Inuit, and Métis consensus guideline.

PubMed

Wilson, Don; de la Ronde, Sandra; Brascoupé, Simon; Apale, Alisha Nicole; Barney, Lucy; Guthrie, Bing; Harrold, Elizabeth; Horn, Ojistoh; Johnson, Robin; Rattray, Darrien; Robinson, Nicole; Alainga-Kango, Natsiq; Becker, Gisela; Senikas, Vyta; Aningmiuq, Annie; Bailey, Geri; Birch, Darlene; Cook, Katsi; Danforth, Jessica; Daoust, Mary; Kitty, Darlene; Koebel, Jaime; Kornelsen, Judith; Tsatsa Kotwas, Ndakaitedzva; Lawrence, Audrey; Mudry, Amanda; Senikas, Vyta; Turner, Gail Theresa; Van Wagner, Vicki; Vides, Eduardo; Wasekeesikaw, Fjola Hart; Wolfe, Sara

2013-06-01

Our aim is to provide health care professionals in Canada with the knowledge and tools to provide culturally safe care to First Nations, Inuit, and Métis women and through them, to their families, in order to improve the health of First Nations, Inuit, and Métis. Published literature was retrieved through searches of PubMed, CINAHL, Sociological Abstracts, and The Cochrane Library in 2011 using appropriate controlled vocabulary (e.g.,cultural competency, health services, indigenous, transcultural nursing) and key words (e.g., indigenous health services, transcultural health care, cultural safety). Targeted searches on subtopics (e.g., ceremonial rites and sexual coming of age) were also performed. The PubMed search was restricted to the years 2005 and later because of the large number of records retrieved on this topic. Searches were updated on a regular basis and incorporated in the guideline to May 2012. Grey (unpublished) literature was identified through searching the websites of selected related agencies (e.g., Campbell Collaboration, Social Care Online, Institute for Healthcare Improvement). The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task force on Preventive Health Care (Table).

National health expenditures, 1985

PubMed Central

Waldo, Daniel R.; Levit, Katharine R.; Lazenby, Helen

1986-01-01

Slower price inflation in 1985 translated into slower growth of national health expenditures, but underlying growth in the use of goods and services continued along historic trends. Coupled with somewhat sluggish growth of the gross national product, this adherence to trends pushed the share of our Nation's output accounted for by health spending to 10.7 percent. Some aspects of health spending changed: Falling use of hospital services was offset by rising hospital profits and increased use of other health care services. Other aspects remained the same: Both the public sector and the private sector continued efforts to contain costs, efforts that have affected and will continue to affect not only the providers of care but the users of care as well. PMID:10311775

77 FR 8273 - Agency Information Collection Activities: Submission for OMB Review; Comment Request, National...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

..., National Flood Insurance Program-Mortgage Portfolio Protection Program AGENCY: Federal Emergency Management... Title: National Flood Insurance Program-Mortgage Portfolio Protection Program. OMB Number: 1660-0086... Write Your Own (WYO) company that wishes to participate in the Mortgage Portfolio Protection Program...

Health Research Funding Agencies' Support and Promotion of Knowledge Translation: An International Study

PubMed Central

Tetroe, Jacqueline M; Graham, Ian D; Foy, Robbie; Robinson, Nicole; Eccles, Martin P; Wensing, Michel; Durieux, Pierre; Légaré, France; Nielson, Camilla Palmhøj; Adily, Armita; Ward, Jeanette E; Porter, Cassandra; Shea, Beverley; Grimshaw, Jeremy M

2008-01-01

Context The process of knowledge translation (KT) in health research depends on the activities of a wide range of actors, including health professionals, researchers, the public, policymakers, and research funders. Little is known, however, about health research funding agencies' support and promotion of KT. Our team asked thirty-three agencies from Australia, Canada, France, the Netherlands, Scandinavia, the United Kingdom, and the United States about their role in promoting the results of the research they fund. Methods Semistructured interviews were conducted with a sample of key informants from applied health funding agencies identified by the investigators. The interviews were supplemented with information from the agencies' websites. The final coding was derived from an iterative thematic analysis. Findings There was a lack of clarity between agencies as to what is meant by KT and how it is operationalized. Agencies also varied in their degree of engagement in this process. The agencies' abilities to create a pull for research findings; to engage in linkage and exchange between agencies, researchers, and decision makers; and to push results to various audiences differed as well. Finally, the evaluation of the effectiveness of KT strategies remains a methodological challenge. Conclusions Funding agencies need to think about both their conceptual framework and their operational definition of KT, so that it is clear what is and what is not considered to be KT, and adjust their funding opportunities and activities accordingly. While we have cataloged the range of knowledge translation activities conducted across these agencies, little is known about their effectiveness and so a greater emphasis on evaluation is needed. It would appear that “best practice” for funding agencies is an elusive concept depending on the particular agency's size, context, mandate, financial considerations, and governance structure. PMID:18307479

U.S. Environmental Protection Agency, Region 6 National Priorities List (NPL) Boundaries - 05/12/2014

EPA Pesticide Factsheets

Boundaries of sites in U.S. Environmental Protection Agency, Region 6 which are documented as being part of the National Priorities List as of May 12, 2014. The locations were determined by U.S. Environmental Protection Agency, Region 6 Superfund RPMs.

HEALTH AND EXPOSURE RESEARCH FOR THE AGRICULTURAL COMMUNITY: THE AGRICULTURAL HEALTH STUDY

EPA Science Inventory

The Agricultural Health Study (AHS) is a collaborative effort between the National Cancer Institute, the National Institute of Environmental Health Sciences, the U.S. Environmental Protection Agency, and the National Institute for Occupational Safety and Health. The AHS is the...

Involvement of consumers in health technology assessment activities by Inahta agencies.

PubMed

Hailey, David; Werkö, Sophie; Bakri, Rugayah; Cameron, Alun; Göhlen, Britta; Myles, Susan; Pwu, Jasmine; Yothasamut, Jomkwan

2013-01-01

To obtain further information from members of the International Network of Agencies for Health Technology Assessment (INAHTA) on the involvement of consumers in their programs. A questionnaire for a survey was developed and sent to member agencies in November 2010. Survey responses were compared with those from an earlier survey conducted in 2005. Of the thirty-three agencies that provided responses, 67 percent involve consumers in some aspects of their health technology assessment (HTA) programs, compared with 57 percent in 2005. As in the earlier survey, most agencies reporting involvement have contact with consumer or patient organizations and a large minority also involve individual consumers. Summaries of HTA reports that are intended to be easily understood by consumers are prepared by 84 percent of the agencies, and 42 percent involve consumers in dissemination of HTA material. In both areas, there was some increase from the levels previously reported. The survey results suggest that there is a trend to increased involvement of consumers by the INAHTA agencies in their programs but that the level of involvement remains relatively limited. The manner of consumer participation varies between agencies.

Notifiable condition reporting practices: implications for public health agency participation in a health information exchange.

PubMed

Revere, Debra; Hills, Rebecca H; Dixon, Brian E; Gibson, P Joseph; Grannis, Shaun J

2017-03-11

The future of notifiable condition reporting in the United States is undergoing a transformation with the increasing development of Health Information Exchanges which support electronic data-sharing and -transfer networks and the wider adoption of electronic laboratory reporting. Communicable disease report forms originating in clinics are an important source of surveillance data for public health agencies. However, problems of poor data quality and delayed submission of reports to public health agencies are common. In addition, studies of barriers and facilitators to reporting have assumed that the primary reporter is the treating physician, although the extent to which a provider is involved in the reporting workflow is unclear. We sought to better understand the barriers to and burden of notifiable condition reporting from the perspectives of the three primary groups involved in reporting workflow: providers, clinic staff who bear the principal responsibility for reporting, and the public health workers who receive and process reports from clinics. In addition, we sought to situate these findings within the context of the future of notifiable disease reporting and the potential impacts of electronic lab and medical records on the surveillance system. Seven ambulatory care clinics and 3 public health agencies that are part of a Health Information Exchange in the state of Indiana, USA, participated in the study. Data were obtained from a survey of clinic physicians (N = 29), interviews with clinic reporters (N = 11), and interviews with public health workers (N = 9). Survey data were summarized descriptively and interview transcripts underwent qualitative analysis. In both clinics and public health agencies, the laboratory report initiates reporting workflow. Provider involvement with reporting primarily revolves around ordering medications to treat a condition confirmed by the lab result. In clinics, reporting is typically the responsibility of clinic

Health policy evolution in Lao People's Democratic Republic: context, processes and agency.

PubMed

Jönsson, Kristina; Phoummalaysith, Bounfeng; Wahlström, Rolf; Tomson, Göran

2015-05-01

During the last 20 years Lao People's Democratic Republic has successfully developed and adopted some 30 health policies, strategies, decrees and laws in the field of health. Still, the implementation process remains arduous. This article aims at discussing challenges of health policy development and effective implementation by contextualizing the policy evolution over time and by focusing particularly on the National Drug Policy and the Health Care Law. Special attention is given to the role of research in policymaking. The analysis was guided by the conceptual framework of policy context, process, content and actors, combined with an institutional perspective, and showed that effective implementation of a health policy is highly dependent on both structures and agency of those involved in the policy process. The National Drug Policy was formulated and adopted in a short period of time in a resource-scarce setting, but with dedicated policy entrepreneurs and support of concerned international collaborators. Timely introduction of operational health systems research played a crucial role to support the implementation, as well as the subsequent revision of the policy. The development of the Health Care Law took several years and once adopted, the implementation was delayed by institutional legacies and issues concerning the choice of institutional design and financing, despite strong support of the law among the policymakers. Among many factors, timing of the implementation appeared to be of crucial importance, in combination with strong leadership. These two examples show that more research, that problematizes the complex policy environment in combination with improved communication between researchers and policymakers, is necessary to inform about measures for effective implementation. A way forward can be to strengthen the domestic research capacity and the international research collaboration regionally as well as globally. Published by Oxford University Press

Disaster preparedness in home health and personal-care agencies: are they ready?

PubMed

Daugherty, Jill D; Eiring, Hilary; Blake, Sarah; Howard, David

2012-01-01

The use of home health care and personal-care agencies in the United States has increased by nearly 1,000% in less than 20 years. Despite the numerous advantages of keeping older and disabled people at home and fairly independent, new concerns have emerged about how to keep home health care and personal-care clients safe during emergencies and large-scale disasters. To date, little is known about the disaster preparedness activities of home health and personal-care agencies, including what oversight they have for their patients and what capabilities they sustain for preparing their clients for disasters. The purpose of this study was to explore the disaster preparedness policies and practices of these agencies and to identify opportunities for coordination with disaster preparedness officials. Semi-structured interviews were conducted by phone and in person with 21 home health and personal-care administrators across Georgia and Southern California. Transcripts from the interviews were analyzed for disaster preparedness themes. We found that most agencies have very limited disaster plans and capabilities. Despite this, most stated either their intentions or outlined past experience which demonstrated their commitment to provide services to clients on a case-by-case basis throughout a large-scale emergency or disaster. The findings from our study help to contribute to the growing interest in disaster preparedness among home health and personal-care agencies and point to the fact that these agencies need assistance to properly lay out their disaster preparedness plans. Copyright © 2012 S. Karger AG, Basel.

Building a Stronger Network: Developing the Role of National Training Organisations. The Agency Responds.

ERIC Educational Resources Information Center

Learning and Skills Development Agency, London (England).

The Learning and Skills Development Agency agrees that national training organizations (NTOs) have a vital role to play in delivering the United Kingdom's skills agenda and that doing so will require strengthening their role. The agency particularly welcomes the fact that the NTO framework will do the following things: include clear statements of…

Transitioning to a national health system in Cyprus: a stakeholder analysis of pharmaceutical policy reform

PubMed Central

Kanavos, Panos G

2015-01-01

Abstract Objective To review the pharmaceutical sector in Cyprus in terms of the availability and affordability of medicines and to explore pharmaceutical policy options for the national health system finance reform expected to be introduced in 2016. Methods We conducted semi-structured interviews in April 2014 with senior representatives from seven key national organizations involved in pharmaceutical care. The captured data were coded and analysed using the predetermined themes of pricing, reimbursement, prescribing, dispensing and cost sharing. We also examined secondary data provided by the Cypriot Ministry of Health; these data included the prices and volumes of prescription medicines in 2013. Findings We identified several key issues, including high medicine prices, underuse of generic medicines and high out-of-pocket drug spending. Most stakeholders recommended that the national government review existing pricing policies to ensure medicines within the forthcoming national health system are affordable and available, introduce a national reimbursement system and incentivize the prescribing and dispensing of generic medicines. There were disagreements over how to (i) allocate responsibilities to governmental agencies in the national health system, (ii) reconcile differences in opinion between stakeholders and (iii) raise awareness among patients, physicians and pharmacists about the benefits of greater generic drug use. Conclusion In Cyprus, if the national health system is going to provide universal health coverage in a sustainable fashion, then the national government must address the current issues in the pharmaceutical sector. Importantly, the country will need to increase the market share of generic medicines to contain drug spending. PMID:26478624

Building Public Health Ontario: experience in developing a new public health agency.

PubMed

Goel, Vivek

2012-06-05

The history and development of Ontario's new public health agency, Public Health Ontario, is explored. The governance model and organizational structure are identified along with an overview of the relationship with the Ontario Ministry of Health and Long-Term Care. The strategic mission and vision are described as are the key functions. The building of the organization through new investments and divestments is explained. The paper concludes with an overview of the challenges encountered and the opportunities ahead.

U.S. Environmental Protection Agency, Region 6 National Priorities List (NPL) Sites - 05/12/2014

EPA Pesticide Factsheets

Point locations for sites in U.S. Environmental Protection Agency, Region 6 which are documented as being part of the National Priorities List as of May 12, 2014. The locations were determined by U.S. Environmental Protection Agency, Region 6 Superfund RPMs.

New partnership for health? Business groups on health and health systems agencies.

PubMed

Bradbury, R C

1983-01-01

The experience of the Central Massachusetts Health Systems Agency (CMHSA) and the Central Massachusetts Business Group on Health (CMBGH) demonstrates the feasibility of cooperation between HSAs and BGHs. Objectives and strategies of the two groups in carrying out community health planning and working for health systems change are compared. Nearly two decades of government-sponsored community health planning programs, first through comprehensive health planning agencies and then through HSAs, have had less impact than many had anticipated because neither the technical nor political basis for such planning was sufficiently established. The CMHSA experience is typical, although it is credited with developing a hospital systems plan that is based on sound planning methods and statistical data. It is in the implementation of plans that the CMHSA has made slow progress, reflecting its inadequate community power base. The CMBGH, 1 of more than 90 groups that have developed recently across the country to attack high health care costs, was formed in 1981 by business leaders to address these rising costs. The principal strategy adopted by the CMBGH involves fostering a competitive health care market by creating a critical number of competing health plans. The providers in each plan will then have incentives to provide effective care in an efficient manner to keep the premium competitive and attract enrollees. Cooperation between the CMBGH and CMHSA is based on each organization's emphasizing its strengths. The CMHSA's data base and analyses have been the primary resources used by the CMBGH to identify problems. Each organization has developed its own set of goals and objectives, while keeping in mind those of the other organization. The CMBGH adopted a subset of theCMHSA's goals-those that focus on hospital capacity and utilization. Although the CMHSA's regulatory strategies differ greatly from the CMBGH's competition strategies, they do not necessarily conflict

National Health Expenditures, 1982

PubMed Central

Gibson, Robert M.; Waldo, Daniel R.; Levit, Katharine R.

1983-01-01

Rapid growth in the share of the nation's gross national product devoted to health expenditure has heightened concern over the survival of government entitlement programs and has led to debate of the desirability of current methods of financing health care. In this article, the authors present the data at the heart of the issue, quantifying spending for various types of health care in 1982 and discussing the sources of funds for that spending. PMID:10310273

Loving and Leaving Public Health: Predictors of Intentions to Quit Among State Health Agency Workers

PubMed Central

Liss-Levinson, Rivka; Bharthapudi, Kiran; Leider, Jonathon P.; Sellers, Katie

2015-01-01

Context: State health agencies play a critical role in protecting and promoting the health and well-being of the people they serve. To be effective, they must maintain a highly skilled, diverse workforce of sufficient size and with proper training. Objective: The goal of this study was to examine demographics, job and workplace environment characteristics, job satisfaction, and reasons for initially joining the public health workforce as predictors of an employee's intentions to leave an organization within the next year. Design: This study used a cross-sectional design. Respondents were selected on the basis of a stratified sampling approach, with 5 geographic (paired Health and Human Services [HHS] regions) as the primary strata. Balanced repeated replication was used as a resampling method for variance estimation. A logistic regression model was used to examine the correlates of intentions to leave one's organization within the next year. The independent variables included several measures of satisfaction, perceptions about the workplace environment, initial reasons for joining public health, gender, age, education, salary, supervisory status, program area, and paired HHS region. Setting and Participants: The sample for this study consisted of 10 246 permanently employed state health agency central office employees who responded to the Public Health Workforce Interests and Needs Survey (PH WINS). Main Outcome Measure: Considering leaving one's organization within the next year. Results: Being a person of color, living in the West (HHS regions 9 and 10), and shorter tenure in one's current position were all associated with higher odds of intentions to leave an organization within the next year. Conversely, greater employee engagement, organizational support, job satisfaction, organization satisfaction, and pay satisfaction were all significant predictors of lower intentions to leave one's organization within the next year. Conclusions: Results from this study

Loving and Leaving Public Health: Predictors of Intentions to Quit Among State Health Agency Workers.

PubMed

Liss-Levinson, Rivka; Bharthapudi, Kiran; Leider, Jonathon P; Sellers, Katie

2015-01-01

State health agencies play a critical role in protecting and promoting the health and well-being of the people they serve. To be effective, they must maintain a highly skilled, diverse workforce of sufficient size and with proper training. The goal of this study was to examine demographics, job and workplace environment characteristics, job satisfaction, and reasons for initially joining the public health workforce as predictors of an employee's intentions to leave an organization within the next year. This study used a cross-sectional design. Respondents were selected on the basis of a stratified sampling approach, with 5 geographic (paired Health and Human Services [HHS] regions) as the primary strata. Balanced repeated replication was used as a resampling method for variance estimation. A logistic regression model was used to examine the correlates of intentions to leave one's organization within the next year. The independent variables included several measures of satisfaction, perceptions about the workplace environment, initial reasons for joining public health, gender, age, education, salary, supervisory status, program area, and paired HHS region. The sample for this study consisted of 10,246 permanently employed state health agency central office employees who responded to the Public Health Workforce Interests and Needs Survey (PH WINS). Considering leaving one's organization within the next year. Being a person of color, living in the West (HHS regions 9 and 10), and shorter tenure in one's current position were all associated with higher odds of intentions to leave an organization within the next year. Conversely, greater employee engagement, organizational support, job satisfaction, organization satisfaction, and pay satisfaction were all significant predictors of lower intentions to leave one's organization within the next year. Results from this study suggest several variables related to demographics, job characteristics, workplace environment, and

The health system consequences of agency nursing and moonlighting in South Africa

PubMed Central

Rispel, Laetitia C.; Blaauw, Duane

2015-01-01

Background Worldwide, there is an increased reliance on casual staff in the health sector. Recent policy attention in South Africa has focused on the interrelated challenges of agency nursing and moonlighting in the health sector. Objective This paper examines the potential health system consequences of agency nursing and moonlighting among South African nurses. Methods During 2010, a cluster random sample of 80 hospitals was selected in four South African provinces. On the survey day, all nurses providing clinical care completed a self-administered questionnaire after giving informed consent. The questionnaire obtained information on socio-demographics, involvement in agency nursing and moonlighting, and self-reported indicators of potential health system consequences of agency nursing and moonlighting. A weighted analysis was done using STATA® 13. Results In the survey, 40.7% of nurses reported moonlighting or working for an agency in the preceding year. Of all participants, 51.5% reported feeling too tired to work, 11.5% paid less attention to nursing work on duty, and 10.9% took sick leave when not actually sick in the preceding year. Among the moonlighters, 11.9% had taken vacation leave to do agency work or moonlighting, and 9.8% reported conflicting schedules between their primary and secondary jobs. In the bivariate analysis, moonlighting nurses were significantly more likely than non-moonlighters to take sick leave when not sick (p=0.011) and to pay less attention to nursing work on duty (p=0.035). However, in a multiple logistic regression analysis, the differences between moonlighters and non-moonlighters did not remain statistically significant after adjusting for other socio-demographic variables. Conclusion Although moonlighting did not emerge as a statistically significant predictor, the reported health system consequences are serious. A combination of strong nursing leadership, effective management, and consultation with and buy-in from front

National Health Expenditures, 1978

PubMed Central

Gibson, Robert M.

1979-01-01

Outlays for health care in the Nation reached $192.4 billion in calendar year 1978--13 percent higher than in 1977, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $863 per person in the United States and was equal to 9.1 percent of the GNP. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing. Revised estimates are presented extending back to 1965. PMID:10309049

78 FR 55751 - National Institutes of Health

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute...: National Institutes of Health, Neuroscience Building, Conference Room D, 6001 Executive Boulevard...: National Institutes of Health, Neuroscience Building, Conference Room D, 6001 Executive Boulevard...

National poverty reduction strategies and HIV/AIDS governance in Malawi: a preliminary study of shared health governance.

PubMed

Wachira, Catherine; Ruger, Jennifer Prah

2011-06-01

The public health and development communities understand clearly the need to integrate anti-poverty efforts with HIV/AIDS programs. This article reports findings about the impact of the Poverty Reduction Strategy Paper (PRSP) process on Malawi's National HIV/AIDS Strategic Framework (NSF). In this article we ask, how does the PRSP process support NSF accountability, participation, access to information, funding, resource planning and allocation, monitoring, and evaluation? In 2007, we developed and conducted a survey of Malawian government ministries, United Nations agencies, members of the Country Coordination Mechanism, the Malawi National AIDS Commission (NAC), and NAC grantees (N = 125, 90% response rate), seeking survey respondents' retrospective perceptions of NSF resource levels, participation, inclusion, and governance before, during, and after Malawi's PRSP process (2000-2004). We also assessed principle health sector and economic indicators and budget allocations for HIV/AIDS. These indicators are part of a new conceptual framework called shared health governance (SHG), which seeks congruence among the values and goals of different groups and actors to reflect a common purpose. Under this framework, global health policy should encompass: (i) consensus among global, national, and sub-national actors on goals and measurable outcomes; (ii) mutual collective accountability; and (iii) enhancement of individual and group health agency. Indicators to assess these elements included: (i) goal alignment; (ii) adequate resource levels; (iii) agreement on key outcomes and indicators for evaluating those outcomes; (iv) meaningful inclusion and participation of groups and institutions; (v) special efforts to ensure participation of vulnerable groups; and (vi) effectiveness and efficiency measures. Results suggest that the PRSP process supported accountability for NSF resources. However, the process may have marginalized key stakeholders, potentially undercutting the

Impacts of Psychological Science on National Security Agencies Post-9/11

ERIC Educational Resources Information Center

Brandon, Susan E.

2011-01-01

Psychologists have been an integral part of national security agencies since World War I, when psychological science helped in personnel selection. A robust infrastructure supporting wider applications of psychology to military and intelligence problems developed further during World War II and the years following, primarily in the areas of…

The 2009 National Environmental Public Health Conference: one model for planning green and healthy conferences.

PubMed

Ruckart, Perri Zeitz; Moore, Cory; Burgin, Deborah; Byrne, Maggie Kelly

2011-01-01

The Centers for Disease Control and Prevention's National Center for Environmental Health and the Agency for Toxic Substances and Disease Registry committed to making their 2009 National Environmental Public Health Conference a model for green and healthy conferences. The conference included increased opportunities for physical activity, both as part of conference events and for transportation to the conference. In addition, conference meals were healthy and sustainably sourced. The conference also implemented intuitive, accessible recycling; online scheduling and evaluation to minimize hard-copy materials; and the purchase of carbon offsets to reduce the unwanted environmental impact of the conference. Public health professionals have an opportunity and obligation to support healthy behaviors at their events and to serve as leaders in this area. Facilitating healthy and sustainable choices is in alignment with goals for both public health and broader social issues-such as environmental quality-that have a direct bearing on public health.

Deliberately casual? Workers' agency, health, and nonstandard employment relations in Australia.

PubMed

Keuskamp, Dominic; Mackenzie, Catherine R M; Ziersch, Anna M; Baum, Fran E

2013-06-01

We explored Australian workers' experiences of nonstandard employment, how it related to health and well-being, and the role that Bourdieu's forms of capital (cultural, economic, and social resources) played in underpinning workers' agency. Qualitative data from semistructured interviews with 32 causal workers were analyzed on the basis of framework analysis. Most participants were "deliberate casuals" who had chosen casual over permanent employment, with half of that group naming improved health and well-being as motivation. Those with greater access to capital felt more able to exercise choice, whereas those with fewer capital resources felt constrained to be casual. Gendered structures and labor market dynamics were also significant in shaping agency. Access to capital and a buoyant labor market underpinned workers' agency in Australia, enabling some to gain health and well-being benefits from nonstandard employment.

76 FR 71047 - National Institutes of Health

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on...., Chief, Extramural Project Review Branch EPRB, NIAAA, National Institutes of Health, 5365 Fishers Lane... Awards., National Institutes of Health, HHS) Dated: November 8, 2011. Jennifer S. Spaeth, Director...

78 FR 24427 - National Institutes of Health

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; 60-Day..., the National Human Genome Research Institute (NHGRI), National Institutes of Health (NIH), will... Genome Research Institute (NHGRI), National Institutes of Health (NIH). Need and Use of Information...

Implementing Health Impact Assessment at National Level: An Experience in Iran.

PubMed

Damari, Behzad; Vosoogh-Moghaddam, Abbas; Riazi-Isfahani, Sahand

2018-02-01

According to the general health policies issued in 2014, Health Impact Assessment (HIA) or Health Annex should be implemented in Iran. The present study provided a model for executing HIA in the Iranian context as a developing country. This is a system design study with the qualitative approach. The data on the system components were gathered via reviews of the literature, in-depth interviews and focused group discussions (FGDs) with experts. The information were contently analyzed in order to draft the model and a consensus was reached on by the steering committee. Fifteen in-depth interviews and six FGD meeting were conducted. The equity-based approach in assessing the health impacts of policies, programs and projects were chosen as the most practical tool. Experts believe that for the next five years, HIA should be used just for the "national projects" so that the ministries and national agencies could be empowered. Components of the model including structure, procedures, and standards, management style, mission and resources were prepared. The national regulations and protocols were sent to the SCHFS Secretariat for final revision and the council approval. The hasty implementation of HIA will face serious resistances as the health-oriented attitude and behavior in both government and non-governmental sectors will gradually form. Also, the overlapping of the contents of HIA with other tools such as Environmental, Cultural and Social Impact Assessments, currently used by other sectors, causes difficulties in implementing the HIA by the Ministry of Health and Medical Education.

78 FR 76412 - Agency Information Collection (Application for Reimbursement of National Test Fee) Activity Under...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-17

... (Application for Reimbursement of National Test Fee) Activity Under OMB Review AGENCY: Veterans Benefits... National Test Fee, VA Form 22-0810. OMB Control Number: 2900-0706. Type of Review: Revision of a currently... to request reimbursement of national test fees. VA will use the data collected to determine the...

76 FR 79702 - Agency Information Collection Activities: Proposed Collection; Comment Request; Generic Clearance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-22

... calculations that justify the proposed sample size, the expected response rate, methods for assessing potential... Qualitative Feedback on Agency Service Delivery AGENCY: National Institute of Mental Health (NIMH), HHS... Collection Request (Generic ICR): ``Generic Clearance for the Collection of Qualitative Feedback on Agency...

76 FR 55398 - Agency Information Collection Activities: Proposed Collection; Comment Request; Generic Clearance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-07

... precision requirements or power calculations that justify the proposed sample size, the expected response... Qualitative Feedback on Agency Service Delivery AGENCY: National Institutes of Health, Eunice Kennedy Shriver...): ``Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery '' to OMB for...

Hypertension and treatment outcomes in Palestine refugees in United Nations Relief and Works Agency primary health care clinics in Jordan.

PubMed

Khader, A; Farajallah, L; Shahin, Y; Hababeh, M; Abu-Zayed, I; Zachariah, R; Kochi, A; Kapur, A; Harries, A D; Shaikh, I; Seita, A

2014-10-01

In six United Nations Relief and Works Agency (UNRWA) primary health care clinics in Jordan serving Palestine refugees diagnosed with hypertension, to determine the number, characteristics, programme outcomes and measures of disease control for those registered up to 30 June, 2013, and in those who attended clinic in the second quarter of 2013, the prevalence of disease-related complications between those with hypertension only and hypertension combined with diabetes mellitus. Retrospective cohort study with programme and outcome data collected and analysed using E-Health. There were 18 881 patients registered with hypertension with females (64%) and persons aged ≥ 40 years (87%) predominating. At baseline, cigarette smoking was recorded in 17%, physical inactivity in 48% and obesity in 71% of patients. 77% of all registered patients attended clinic in the second quarter of 2013; of these, 50% had hypertension and diabetes and 50% had hypertension alone; 9% did not attend the clinics and 10% were lost to follow-up. Amongst those attending clinic, 92% had their blood pressure measured, of whom 83% had blood pressure <140/90 mm Hg. There were significantly more patients with hypertension and diabetes (N = 966, 13%) who had disease-related complications than patients who had hypertension alone (N = 472, 6%) [OR 2.2, 95% CI 2.0-2.5], and these differences were found for both males [18% vs. 10%, OR 1.9, 95% CI 1.6-2.2] and females [11% vs. 5%, OR 2.4, 95% CI 2.1-2.9]. Large numbers of Palestine refugees are being registered and treated for hypertension in UNRWA primary health care clinics in Jordan. Cohort analysis and E-Health can be used to regularly assess caseload, programme outcomes, clinic performance, blood pressure control and cumulative prevalence of disease-related complications. Current challenges include the need to increase clinic attendance and attain better control of blood pressure. © 2014 John Wiley & Sons Ltd.

Building the national health information infrastructure for personal health, health care services, public health, and research

PubMed Central

Detmer, Don E

2003-01-01

Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII) offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries). The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security) framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin PMID:12525262

45 CFR 1155.645 - Federal agency or agency.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Federal agency or agency. 1155.645 Section 1155.645 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS... (FINANCIAL ASSISTANCE) Definitions § 1155.645 Federal agency or agency. Federal agency or agency means any...

Health Lifestyle Theory and the Convergence of Agency and Structure

ERIC Educational Resources Information Center

Cockerham, William C.

2005-01-01

This article utilizes the agency-structure debate as a framework for constructing a health lifestyle theory. No such theory currently exists, yet the need for one is underscored by the fact that many daily lifestyle practices involve considerations of health outcomes. An individualist paradigm has influenced concepts of health lifestyles in…

Evaluating healthcare information technology outside of academia: observations from the national resource center for healthcare information technology at the Agency for Healthcare Research and Quality.

PubMed

Poon, Eric G; Cusack, Caitlin M; McGowan, Julie J

2009-01-01

The National Resource Center for Health Information Technology (NRC) was formed in the fall of 2004 as part of the Agency for Healthcare Research and Quality (AHRQ) health IT portfolio to support its grantees. One of the core functions of the NRC was to assist grantees in their evaluation efforts of Health IT. This manuscript highlights some common challenges experienced by health IT project teams at nonacademic institutions, including inappropriately scoped and resourced evaluation efforts, inappropriate choice of metrics, inadequate planning for data collection and analysis, and lack of consideration of qualitative methodologies. Many of these challenges can be avoided or overcome. The strategies adopted by various AHRQ grantees and the lessons learned from their projects should become part of the toolset for current and future implementers of health IT as the nation moves rapidly towards its widespread adoption.

77 FR 37919 - Agency Information Collection Activities: Proposed Collection; Comments Requested: National...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-25

... Customer Satisfaction Survey ACTION: 60-Day Notice of Information Collection Under Review. The Department.../Collection: National Response Team Customer Satisfaction Survey. (3) Agency form number, if any, and the...- specific customer satisfaction survey to more effectively capture customer perception/satisfaction of...

Medicare program; home health prospective payment system rate update for calendar year 2011; changes in certification requirements for home health agencies and hospices. Final rule.

PubMed

2010-11-17

This final rule sets forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: the national standardized 60-day episode rates, the national per-visit rates, the nonroutine medical supply (NRS) conversion factors, and the low utilization payment amount (LUPA) add-on payment amounts, under the Medicare prospective payment system for HHAs effective January 1, 2011. This rule also updates the wage index used under the HH PPS and, in accordance with the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), updates the HH PPS outlier policy. In addition, this rule revises the home health agency (HHA) capitalization requirements. This rule further adds clarifying language to the "skilled services" section. The rule finalizes a 3.79 percent reduction to rates for CY 2011 to account for changes in case-mix, which are unrelated to real changes in patient acuity. Finally, this rule incorporates new legislative requirements regarding face-to-face encounters with providers related to home health and hospice care.

Measurement of Women's Agency in Egypt: A National Validation Study.

PubMed

Yount, Kathryn M; VanderEnde, Kristin E; Dodell, Sylvie; Cheong, Yuk Fai

2016-09-01

Despite widespread assumptions about women's empowerment and agency in the Arab Middle East, psychometric research of these constructs is limited. Using national data from 6214 married women ages 16-49 who took part in the 2006 Egypt Labor Market Panel Survey, we applied factor analysis to explore and then to test the factor structure of women's agency. We then used multiple indicator multiple cause structural equations models to test for differential item functioning (DIF) by women's age at first marriage, a potential resource for women's agency. Our results confirm that women's agency in Egypt is multi-dimensional and comprised of their (1) influence in family decisions, including those reserved for men, (2) freedom of movement in public spaces, and (3) attitudes about gender, specifically violence against wives. These dimensions confirm those explored previously in selected rural areas of Egypt and South Asia. Yet, three items showed significant uniform DIF by women's categorical age at first marriage, with and without a control for women's age in years. Models adjusting for DIF and women's age in years showed that women's older age at first marriage was positively associated with the factor means for family decision-making and gender-violence attitudes, but not freedom of movement. Our findings reveal the value of our analytical strategy for research on the dimensions and determinants of women's agency. Our approach offers a promising model to discern "hierarchies of evidence" for social policies and programs to enhance women's empowerment.

21 CFR 1405.645 - Federal agency or agency.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Federal agency or agency. 1405.645 Section 1405.645 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Definitions § 1405.645 Federal agency or agency. Federal agency or agency...

National Health Care Skill Standards.

ERIC Educational Resources Information Center

National Consortium on Health Science and Technology Education, Okemos, MI.

This document presents the National Health Care Skill Standards, which were developed by the National Consortium on Health Science and Technology and West Ed Regional Research Laboratory, in partnership with educators and health care employers. The document begins with an overview of the purpose and benefits of skill standards. Presented next are…

National health expenditures, 1991

PubMed Central

Letsch, Suzanne W.; Lazenby, Helen C.; Levit, Katharine R.; Cowan, Cathy A.

1992-01-01

Spending for health care rose to $751.8 billion in 1991, an increase of 11.4 percent from the 1990 level. National health expenditures as a share of gross domestic product increased to 13.2 percent, up from 12.2 percent in 1990. The health care sector exhibited strong growth, despite slow growth in the overall economy. This combination resulted in the largest increase in the share of the Nation's output consumed by health care in the past three decades. In this article, the authors present estimates of health spending in the United States for 1991. The authors also examine reasons for the unusually large growth in Medicaid expenditures and highlight recent trends in the hospital sector. PMID:10127445

The use of memoranda of understanding in fostering inter-agency collaboration: a qualitative study of health services agencies serving vulnerable populations in Baltimore, USA.

PubMed

Khosla, Nidhi; Marsteller, Jill A; Holtgrave, David R

2013-11-01

We examined whether mandated collaboration reflected in memoranda of understanding (MOUs) developed by health agencies to meet funder expectations is effective in fostering inter-agency collaboration. We conducted 22 semi-structured interviews from late 2010 to early 2012 in Baltimore, USA, with representatives of 17 HIV service agencies, three local health department units, and one agency that closed in 2008 (two interviews). While there was no consensus, most respondents perceived MOUs negatively, mainly because the process of obtaining signed MOUs was time consuming; frontline staff was mostly unaware of MOUs, agencies did not necessarily work with agencies they signed MOUs with and MOUs were rarely evaluated after being signed. A few agencies reported that MOUs could keep agencies focused and set mutual expectations. The local health department acknowledged shortcomings in MOUs but emphasized that MOUs could help agencies plan for referring clients when their own capacity was full. Although many agencies acknowledged the importance of collaboration, most respondents found that MOUs lacked practical utility. Grant-makers should consult sub-grantees to develop alternative means of fostering collaboration that would be perceived as relevant by both parties. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Correlates of consumer trust in online health information: findings from the health information national trends survey.

PubMed

Ye, Yinjiao

2011-01-01

The past few decades have witnessed a dramatic increase in consumers seeking health information online. However, the quality of such information remains questionable, and the trustworthiness of online health information has become a hot topic, whereas little attention has been paid to how consumers evaluate online health information credibility. This study builds on theoretical perspectives of trust such as personal-capital-based, social-capital-based, and transfer-based, and it examines various correlates of consumer trust in online health information. The author analyzed the 2007 Health Information National Trends Survey data (N = 7,674). Results showed that consumer trust in online health information did not correlate with personal capital such as income, education, and health status. Social capital indicated by visiting social networking Web sites was not associated with trust in online health information either. Nevertheless, trust in online health information transferred from traditional mass media and government health agencies to the Internet, and it varied by such information features as easiness to locate and to understand. Age appeared to be a key factor in understanding the correlates of trust in online health information. Theoretical and empirical implications of the results are discussed.

75 FR 78807 - Agency Information Collection (Application for Reimbursement of National Test Fee) Activity Under...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-16

... (Application for Reimbursement of National Test Fee) Activity Under OMB Review AGENCY: Veterans Benefits... Reimbursement of National Test Fee, VA Form 22-0810. OMB Control Number: 2900-0706. Type of Review: Extension of... complete VA Form 22-0810 to request reimbursement of national test fees. VA will use the data collected to...

Making the Case for Using Financial Indicators in Local Public Health Agencies

PubMed Central

Suarez, Virginia; Denison, Dwight

2011-01-01

The strength of the public health infrastructure determines the ability of local public health agencies to respond to emergencies and provide essential services. Organizational and systems capacity measures and assessments are important components of the public health infrastructure. Hospitals and governments have a long tradition of using financial indicators to assess fiscal and operational activities. We reviewed the literature on how hospitals use financial indicators to monitor financial risk, promote organizational sustainability, and improve organizational capacity. Given that financial indicators have not generally been employed by public health practitioners, we discuss how these measures can be applied to local public health agencies to improve their organizational capacity. PMID:21233438

An evaluation of the National Public Health Leadership Institute--1991-2006: part I. Developing individual leaders.

PubMed

Umble, Karl E; Baker, Edward L; Woltring, Carol

2011-01-01

Public health leadership development programs are widely employed to strengthen leaders and leadership networks and ultimately agencies and systems. The year-long National Public Health Leadership Institute's (PHLI) goals are to develop the capacity of individual leaders and networks of leaders so that both can lead improvement in public health systems, infrastructure, and population health. To evaluate the impact of PHLI on individual graduates using data collected from the first 15 cohorts. Between 1992 and 2006, PHLI graduated 806 senior leaders from governmental agencies, academia, health care, associations, nonprofit organizations, foundations, and other organizations. Of 646 graduates located, 393 (61%) responded to a survey, for an overall response rate of 49% (393/806). PHLI has included retreats; readings, conference calls, and webinars; assessments, feedback, and coaching; and action learning projects, in which graduates apply concepts to a work challenge aided by peers and a coach. A survey of all graduates and interviews of 34 graduates and one other key informant. PHLI improved graduates' understanding, skills, and self-awareness, strengthened many graduates' connections to a network of leaders, and significantly increased graduates' voluntary leadership activities at local, state, and national levels (P < .001). Deeper and wider network connections shaped graduates' sense of "belonging" to the national cadre of public health leaders, provided access to supportive peers and ideas, and bolstered confidence and interest in taking on leadership work. Nearly all graduates remained in public health. Some partially attributed to PHLI their promotions into more senior positions. Leadership development programs can strengthen and sustain their impact by cultivating sustained "communities of practice" that provide ongoing support for skill development and innovative practice. Sponsors can fruitfully view leadership development as a long-term investment in

National Health Care Skill Standards.

ERIC Educational Resources Information Center

Far West Lab. for Educational Research and Development, San Francisco, CA.

This booklet contains draft national health care skill standards that were proposed during the National Health Care Skill Standards Project on the basis of input from more than 1,000 representatives of key constituencies of the health care field. The project objectives and structure are summarized in the introduction. Part 1 examines the need for…

Social media engagement analysis of U.S. Federal health agencies on Facebook.

PubMed

Bhattacharya, Sanmitra; Srinivasan, Padmini; Polgreen, Philip

2017-04-21

It is becoming increasingly common for individuals and organizations to use social media platforms such as Facebook. These are being used for a wide variety of purposes including disseminating, discussing and seeking health related information. U.S. Federal health agencies are leveraging these platforms to 'engage' social media users to read, spread, promote and encourage health related discussions. However, different agencies and their communications get varying levels of engagement. In this study we use statistical models to identify factors that associate with engagement. We analyze over 45,000 Facebook posts from 72 Facebook accounts belonging to 24 health agencies. Account usage, user activity, sentiment and content of these posts are studied. We use the hurdle regression model to identify factors associated with the level of engagement and Cox proportional hazards model to identify factors associated with duration of engagement. In our analysis we find that agencies and accounts vary widely in their usage of social media and activity they generate. Statistical analysis shows, for instance, that Facebook posts with more visual cues such as photos or videos or those which express positive sentiment generate more engagement. We further find that posts on certain topics such as occupation or organizations negatively affect the duration of engagement. We present the first comprehensive analyses of engagement with U.S. Federal health agencies on Facebook. In addition, we briefly compare and contrast findings from this study to our earlier study with similar focus but on Twitter to show the robustness of our methods.

44 CFR 352.21 - Participating Federal agencies.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Department of Defense; (3) Department of Energy; (4) Department of Health and Human Services; (5) Department...; (8) Environmental Protection Agency; (9) Federal Communications Commission; (10) General Services Administration; (11) National Communications System; (12) Nuclear Regulatory Commission; (13) United States...

Health policy evolution in Lao People’s Democratic Republic: context, processes and agency

PubMed Central

Jönsson, Kristina; Phoummalaysith, Bounfeng; Wahlström, Rolf; Tomson, Göran

2015-01-01

During the last 20 years Lao People’s Democratic Republic has successfully developed and adopted some 30 health policies, strategies, decrees and laws in the field of health. Still, the implementation process remains arduous. This article aims at discussing challenges of health policy development and effective implementation by contextualizing the policy evolution over time and by focusing particularly on the National Drug Policy and the Health Care Law. Special attention is given to the role of research in policymaking. The analysis was guided by the conceptual framework of policy context, process, content and actors, combined with an institutional perspective, and showed that effective implementation of a health policy is highly dependent on both structures and agency of those involved in the policy process. The National Drug Policy was formulated and adopted in a short period of time in a resource-scarce setting, but with dedicated policy entrepreneurs and support of concerned international collaborators. Timely introduction of operational health systems research played a crucial role to support the implementation, as well as the subsequent revision of the policy. The development of the Health Care Law took several years and once adopted, the implementation was delayed by institutional legacies and issues concerning the choice of institutional design and financing, despite strong support of the law among the policymakers. Among many factors, timing of the implementation appeared to be of crucial importance, in combination with strong leadership. These two examples show that more research, that problematizes the complex policy environment in combination with improved communication between researchers and policymakers, is necessary to inform about measures for effective implementation. A way forward can be to strengthen the domestic research capacity and the international research collaboration regionally as well as globally. PMID:24740710

Workplace violence prevention policies in home health and hospice care agencies.

PubMed

Gross, Nathan; Peek-Asa, Corinne; Nocera, Maryalice; Casteel, Carri

2013-01-31

Workplace violence in the home health industry is a growing concern, but little is known about the content of existing workplace violence prevention programs. The authors present the methods for this study that examined workplace violence prevention programs in a sample of 40 California home health and hospice agencies. Data was collected through surveys that were completed by the branch managers of participating facilities. Programs were scored in six different areas, including general workplace violence prevention components; management commitment and employee involvement; worksite analysis; hazard prevention and control; safety and health training; and recordkeeping and program evaluation. The results and discussion sections consider these six areas and the important gaps that were found in existing programs. For example, although most agencies offered workplace violence training, not every worker performing patient care was required to receive the training. Similarly, not all programs were written or reviewed and updated regularly. Few program differences were observed between agency characteristics, but nonetheless several striking gaps were found.

76 FR 16798 - National Institutes of Health

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center for Scientific Review.... Place: National Institutes of Health, 6701 Rockledge Drive, Bethesda, MD 20892 (Telephone Conference..., National Institutes of Health, 6701 Rockledge Drive, Room 4136, MSC 7850, Bethesda, MD 20892, (301) 435...

75 FR 6044 - National Institutes of Health

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2010-02-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... individual intramural programs and projects conducted by the National Institute of Environmental Health...

78 FR 54661 - Agency Information Collection Activities; Proposed Collection; Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency... Reduction Act of 1995), the Health Resources and Services Administration (HRSA) announces plans to submit an.... Information Collection Request Title: The National Health Service Corps Loan Repayment Program OMB No. 0915...

Comparing types of local public health agencies in North Carolina.

PubMed

Markiewicz, Milissa; Moore, Jill; Foster, Johanna H; Berner, Maureen; Matthews, Gene; Wall, Aimee

2013-01-01

Some states are considering restructuring local public health agencies (LPHAs) in hopes of achieving long-term efficiencies. North Carolina's experience operating different types of LPHAs, such as county health departments, district health departments, public health authorities, and consolidated human services agencies, can provide valuable information to policy makers in other states who are examining how best to organize their local public health system. To identify stakeholders' perceptions of the benefits and challenges associated with different types of LPHAs in North Carolina and to compare LPHA types on selected financial, workforce, and service delivery measures. Focus groups and key informant interviews were conducted to identify stakeholders' perceptions of different LPHA types. To compare LPHA types on finance, workforce, and service delivery measures, descriptive statistical analyses were performed on publicly available quantitative data. North Carolina. Current and former state and local public health practitioners, county commissioners, county managers, assistant managers, state legislators, and others. In addition to identifying stakeholders' perceptions of LPHA types, proportion of total expenditures by funding source, expenditures per capita by funding source, full-time equivalents per 1000 population, and percentage of 127 tracked services offered were calculated. Stakeholders reported benefits and challenges of all LPHA types. LPHA types differ with regard to source of funding, with county health departments and consolidated human services agencies receiving a greater percentage of their funding from county appropriations than districts and authorities, which receive a comparatively larger percentage from other revenues. Types of LPHAs are not entirely distinct from one another, and LPHAs of the same type can vary greatly from one another. However, stakeholders noted differences between LPHA types-particularly with regard to district health

76 FR 2910 - Meeting of the National Vaccine Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Meeting of the National Vaccine Advisory Committee AGENCY... Department of Health and Human Services (DHHS) is hereby giving notice that the National Vaccine Advisory...., Washington, DC 20201. FOR FURTHER INFORMATION CONTACT: National Vaccine Program Office, Department of Health...

Interorganizational relationships among family support organizations and child mental health agencies.

PubMed

Acri, Mary C; Palinkas, Larry; Hoagwood, Kimberly E; Shen, Sa; Schoonover, Diana; Reutz, Jennifer Rolls; Landsverk, John

2014-07-01

This study examined: (1) qualitative aspects of close working relationships between family support organizations and child mental health agencies, including effective and ineffective characteristics of the relationship and aspects that they would change, and (2) the impact of the working relationship upon the family support organization. Semi-structured interviews were conducted with 40 directors of family support organizations characterized as having a close working relationship with a child mental health agency. Three main themes emerged regarding the quality of the working relationship: (a) interactional factors, including shared trust, communication, collaboration and service coordination; (b) aspects of the inner context of the family support organization, mental health agency, or both, including alignment of goals and values and perceptions of mental health services; and (c) outer contextual factors external to the organizations, such as financial and county regulations. Responses to the perceived impact of the relationship was divided into two themes: positive impacts (e.g. gained respect, influence and visibility), and negative impacts (e.g. lack of trust). This study lays the foundation for future research to better understand the mechanisms underlying interorganizational relationships in communities among different types of providers to create a more seamless continuum of services for families of children with mental health conditions.

National health expenditures, 1988

PubMed Central

1990-01-01

Every year, analysts in the Health Care Financing Administration present figures on what our Nation spends for health. As the result of a comprehensive re-examination of the definitions, concepts, methods, and data sources used to prepare those figures, this year's report contains new estimates of national health expenditures for calendar years 1960 through 1988. Significant changes have been made to estimates of spending for professional services and to estimates of what consumers pay out of pocket for health care. In the first article, trends in use of and expenditure for various types of goods and services are discussed, as well as trends in the sources of funds used to finance health care. In a companion article, the benchmark process is described in more detail, as are the data sources and methods used to prepare annual estimates of health expenditures. PMID:10113395

76 FR 53685 - National Institutes of Health

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Submission for OMB Review... data collection projects, the Center for Scientific Review (CSR), National Institutes of Health (NIH... for public comment. The National Institutes of Health may not conduct or sponsor and the respondent is...

The National Aeronautics and Space Administration's Earth Science Applications Program: Exploring Partnerships to Enhance Decision Making in Public Health Practice

NASA Technical Reports Server (NTRS)

Vann, Timi S.; Venezia, Robert A.

2002-01-01

The National Aeronautics and Space Administration (NASA), Earth Science Enterprise is engaged in applications of NASA Earth science and remote sensing technologies for public health. Efforts are focused on establishing partnerships with those agencies and organizations that have responsibility for protecting the Nation's Health. The program's goal is the integration of NASA's advanced data and technology for enhanced decision support in the areas of disease surveillance and environmental health. A focused applications program, based on understanding partner issues and requirements, has the potential to significantly contribute to more informed decision making in public health practice. This paper intends to provide background information on NASA's investment in public health and is a call for partnership with the larger practice community.

The effect of health payment reforms on cost containment in Taiwan hospitals: the agency theory perspective.

PubMed

Chang, Li

2011-01-01

This study aims to determine whether the Taiwanese government's implementation of new health care payment reforms (the National Health Insurance with fee-for-service (NHI-FFS) and global budget (NHI-GB)) has resulted in better cost containment. Also, the question arises under the agency theory whether the monitoring system is effective in reducing the risk of information asymmetry. This study uses panel data analysis with fixed effects model to investigate changes in cost containment at Taipei municipal hospitals before and after adopting reforms from 1989 to 2004. The results show that the monitoring system does not reduce information asymmetry to improve cost containment under the NHI-FFS. In addition, after adopting the NHI-GB system, health care costs are controlled based on an improved monitoring system in the policymaker's point of view. This may suggest that the NHI's fee-for-services system actually causes health care resource waste. The GB may solve the problems of controlling health care costs only on the macro side.

Experiences from regional public funding agencies

PubMed Central

Alonso-Trujillo, Federico

2009-01-01

Introduction There is an increasing demand of social and health services by persons with long-term care (LTC) needs. On the other hand the devolution process has shifted governance and funding to regional agencies in many EU countries. Regional agencies are getting an increasing role in funding LTC. Knowledge transfer (KT) plays a key role in the development of regional funding agencies, as they should cooperate with both local and national agencies as well as several European organisations and companies operating in their regions. The communication barriers between social and health services play a particular role at regional level. Description of care or policy practice In Spain the 17 regions have full government autonomy in health and social care. These regions have developed different approaches to coordination of care and KT. Andalusia is the larger region in Spain. In order to coordinate provision and planning, the regional government has developed a network of cross-sectional agencies in specific areas such as Mental Health (FAISEM), Social Services in Ageing, Disabilities, Poverty and TICs (FASS), Emergency care (EPES), care related to gender (Instituto Andaluz de la Mujer), Health Care for the Elderly in the community (Living Lab and IAVANTE Foundation) or innovation in new technologies applied to social care (I2BC); among several others. A number of these public organisations are privately run. Discussion Coordination and links across these organisations as well as funding issues are discussed here. The relationship or coordination agencies with citizens and other stakeholders deserve special attention as well. Andalusia provides an interesting case of cross-sectorial coordination within the European context.

Innovation within a national health care system.

PubMed

Young, Antony

2017-05-01

Tony is a practicing frontline National Health Service surgeon and director of medical innovation at Anglia Ruskin University and has founded 4 medical-technology start-ups. He has also cofounded the £500 million Anglia Ruskin MedTech Campus, which will become one of the world's largest health innovation spaces. In 2014, he was appointed as national clinical director for innovation at National Health Service England and in February 2016 became the first national clinical lead for innovation. In this role, he provides clinical leadership and support in delivering improved health outcomes in England, drives the uptake of proven innovations across the National Health Service, promotes economic growth through innovation, and helps make the National Health Service the go-to place on the planet for medical innovation. Copyright © 2016 Elsevier Inc. All rights reserved.

Health financing in Malawi: Evidence from National Health Accounts

PubMed Central

2010-01-01

Background National health accounts provide useful information to understand the functioning of a health financing system. This article attempts to present a profile of the health system financing in Malawi using data from NHA. It specifically attempts to document the health financing situation in the country and proposes recommendations relevant for developing a comprehensive health financing policy and strategic plan. Methods Data from three rounds of national health accounts covering the Financial Years 1998/1999 to 2005/2006 was used to describe the flow of funds and their uses in the health system. Analysis was performed in line with the various NHA entities and health system financing functions. Results The total health expenditure per capita increased from US$ 12 in 1998/1999 to US$25 in 2005/2006. In 2005/2006 public, external and private contributions to the total health expenditure were 21.6%, 60.7% and 18.2% respectively. The country had not met the Abuja of allocating at least 15% of national budget on health. The percentage of total health expenditure from households' direct out-of-pocket payments decreased from 26% in 1998/99 to 12.1% in 2005/2006. Conclusion There is a need to increase government contribution to the total health expenditure to at least the levels of the Abuja Declaration of 15% of the national budget. In addition, the country urgently needs to develop and implement a prepaid health financing system within a comprehensive health financing policy and strategy with a view to assuring universal access to essential health services for all citizens. PMID:21062503

77 FR 51536 - Meeting of the National Vaccine Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Meeting of the National Vaccine Advisory Committee AGENCY... Department of Health and Human Services (HHS) is hereby giving notice that the National Vaccine Advisory... INFORMATION CONTACT: National Vaccine Program Office, U.S. Department of Health and Human Services, Room 715-H...

78 FR 4147 - Meeting of the National Vaccine Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Meeting of the National Vaccine Advisory Committee AGENCY... Department of Health and Human Services (HHS) is hereby giving notice that the National Vaccine Advisory... INFORMATION CONTACT: National Vaccine Program Office, U.S. Department of Health and Human Services, Room 715-H...

78 FR 31553 - Meeting of the National Vaccine Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Meeting of the National Vaccine Advisory Committee AGENCY... Department of Health and Human Services (HHS) is hereby giving notice that the National Vaccine Advisory...: National Vaccine Program Office, U.S. Department of Health and Human Services,, 200 Independence Avenue SW...

Characteristics and trends of clinical trials funded by the National Institutes of Health between 2005 and 2015.

PubMed

Gresham, Gillian K; Ehrhardt, Stephan; Meinert, Jill L; Appel, Lawrence J; Meinert, Curtis L

2018-02-01

Background The National Institutes of Health is one of the largest biomedical research agencies in the world. Clinical trials are an important component of National Institutes of Health research efforts. Given the recent updates in National Institutes of Health trial reporting requirements, more information regarding the current state of National Institutes of Health-funded clinical trials is warranted. The objective of this analysis was to describe characteristics and trends of clinical trials funded by the National Institutes of Health over time and by Institutes and Centers of the National Institutes of Health. Methods Interventional studies funded by the National Institutes of Health and registered in ClinicalTrials.gov between 2005 and 2015 were included in the analysis. Trials were identified from the 27 March 2016 Clinical Trials Transformation Initiative Aggregate Analysis of ClinicalTrials.gov database. A descriptive analysis of trials by year and National Institutes of Health Institute/Center was performed. Results There were 12,987 National Institutes of Health-funded clinical trials registered between 2005 and 2015. There were 1,580, 1,116, and 930 trials registered in 2005, 2010, and 2015, respectively. The majority were early-development trials (phases 0, 1, or 2; 53%), randomized (61%), and single-center (63%). Trial demographics have remained unchanged over time. Median trial sample size was 64 (interquartile range 29-192) with 10% of trials enrolling ≥500 participants. Most trials were completed within 5 years of enrollment start (69%). Trial characteristics varied considerably across National Institutes of Health Institutes and Centers. Results were reported under the assumptions that most National Institutes of Health-funded trials are registered in ClinicalTrials.gov and that trials are being registered completely and accurately. Conclusion In conclusion, there has been a decline in the number of trials being funded over time, explained in

78 FR 77167 - Agency Information Collection Activities; Proposed Collection; Comments Requested: National...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-20

... (NFA)--Special Occupation Taxes (SOT) ACTION: 60-day notice. The Department of Justice (DOJ), Bureau of...)-- Special Occupation Taxes (SOT). (3) Agency form number, if any, and the applicable component of the... Collection ATF F 5630.7, NFA Special Tax Registration and Return National Firearms Act is completed and...

32 CFR 621.1 - Loan of Army/Defense Logistics Agency (DLA) owned property for use at national and State...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Loan of Army/Defense Logistics Agency (DLA) owned... of Army/Defense Logistics Agency (DLA) owned property for use at national and State conventions. (a... will be submitted to the appropriate CONUS Army Commander of the area in which the convention will be...

32 CFR 621.1 - Loan of Army/Defense Logistics Agency (DLA) owned property for use at national and State...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 3 2012-07-01 2009-07-01 true Loan of Army/Defense Logistics Agency (DLA) owned... of Army/Defense Logistics Agency (DLA) owned property for use at national and State conventions. (a... will be submitted to the appropriate CONUS Army Commander of the area in which the convention will be...

32 CFR 621.1 - Loan of Army/Defense Logistics Agency (DLA) owned property for use at national and State...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Loan of Army/Defense Logistics Agency (DLA) owned... of Army/Defense Logistics Agency (DLA) owned property for use at national and State conventions. (a... will be submitted to the appropriate CONUS Army Commander of the area in which the convention will be...

77 FR 508 - Agency Forms Undergoing Paperwork Reduction Act Review

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2012-01-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [30-Day-12-12CO] Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention... Evaluation of the National Tobacco Prevention and Control Public Education Campaign--New--National Center for...

[The external quality assessment schemes for lead in blood organized by the French national agency for medicine and health product safety: a synthesis of 15 years of activity].

PubMed

Pineau, Alain; Otz, Jocelyne; Guillard, Olivier; Fauconneau, Bernard; Dumont, Gilles; François-Burg, Elisabeth

2014-01-01

In 1992, at the request of the French labor ministry following questions on the ability of medical biology laboratories to satisfactorily measure blood lead level (PbB), a national PbB quality control came into being. Only in 1996 did this external quality control include a number of laboratories sufficient to allow for a significant retrospective evaluation. After fifteen years (1996-2011), The French National Agency for Medicines and Health Products Safety wished to exploit the database collected. The number of participating laboratories went down from 73 to 41. On the other hand, the key finding pertained to the highly improved performance of the laboratories, which was associated with a spread decrease of the results over the entire range of tested PbBs (9 to 700 μg/L). Since 2006, we have observed increasing use of the inductively coupled plasma with mass spectrometry and decreasing use of electrothermal atomic absorption spectrometry. Provided that they rely on identical metrology expertise, the two analytical techniques lead to results on all the tested concentrations that are not statistically different.

32 CFR 621.1 - Loan of Army/Defense Logistics Agency (DLA) owned property for use at national and State...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 3 2014-07-01 2014-07-01 false Loan of Army/Defense Logistics Agency (DLA... § 621.1 Loan of Army/Defense Logistics Agency (DLA) owned property for use at national and State... will be submitted to the appropriate CONUS Army Commander of the area in which the convention will be...

32 CFR 621.1 - Loan of Army/Defense Logistics Agency (DLA) owned property for use at national and State...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 3 2013-07-01 2013-07-01 false Loan of Army/Defense Logistics Agency (DLA... § 621.1 Loan of Army/Defense Logistics Agency (DLA) owned property for use at national and State... will be submitted to the appropriate CONUS Army Commander of the area in which the convention will be...

Mental health need and access to mental health services by youths involved with child welfare: a national survey.

PubMed

Burns, Barbara J; Phillips, Susan D; Wagner, H Ryan; Barth, Richard P; Kolko, David J; Campbell, Yvonne; Landsverk, John

2004-08-01

This study assessed the relationship between the need for and use of mental health services among a nationally representative sample of children who were investigated by child welfare agencies after reported maltreatment. Data were collected at study entry into the National Survey of Child and Adolescent Well-Being and were weighted to provide population estimates. Nearly half (47.9%) of the youths aged 2 to 14 years (N = 3,803) with completed child welfare investigations had clinically significant emotional or behavioral problems. Youths with mental health need (defined by a clinical range score on the Child Behavior Checklist) were much more likely to receive mental health services than lower scoring youth; still, only one fourth of such youths received any specialty mental health care during the previous 12 months. Clinical need was related to receipt of mental health care across all age groups (odds ratio = 2.7-3.5). In addition, for young children (2-5 years), sexual abuse (versus neglect) increased access to mental health services. For latency-age youths, African-American race and living at home significantly reduced the likelihood of care. Adolescents living at home were also less likely to receive services, whereas having a parent with severe mental illness increased (odds ratio = 2.4) the likelihood of service use. Routine screening for mental health need and increasing access to mental health professionals for further evaluation and treatment should be a priority for children early in their contact with the child welfare system.

77 FR 61409 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [30-Day-13-12SF] Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention...--Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health...

78 FR 42967 - National Institutes of Health

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Heart, Lung, and Blood Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee... Resources Research, National Institutes of Health, HHS) Dated: July 12, 2013. Michelle Trout, Program...

Key Informant Perspectives on Federal Research Agency Policy and Systems and Scientific Workforce Diversity Development: A Companion Study

ERIC Educational Resources Information Center

Moore, Corey L.; Wang, Ningning; Davis, Dytisha; Aref, Fariborz; Manyibe, Edward O.; Washington, Andre L.; Johnson, Jean; Eugene-Cross, Kenyotta; Muhammad, Atashia; Jennings-Jones, Desiree

2017-01-01

Purpose: In the previous analysis of key informant perspectives on minority research leaders' career development factors, we identified individual and sociocultural, institutional, and federal research agency (i.e., National Institute on Disability, Independent Living, and Rehabilitation Research; National Institutes of Health; Agency for…

75 FR 71134 - National Institutes of Health

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U....398, Cancer Research Manpower; 93.399, Cancer Control, National Institutes of Health, HHS) Dated...

77 FR 38398 - Agency Information Collection (National Acquisition Center Customer Response Survey) Activities...

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2012-06-27

... Acquisition Center Customer Response Survey) Activities Under OMB Review AGENCY: Office of Acquisition and... INFORMATION: Title: Department of Veterans Affairs (VA) National Acquisition Center Customer Response Survey... collection. Abstract: VA Form 0863 will be used to collect customer's feedback and suggestions on delivered...

National Health Interview Survey (NHIS)

EPA Pesticide Factsheets

The NHIS collects data on a broad range of health topics through personal household interviews. The results of NHIS provide data to track health status, health care access, and progress toward achieving national health objectives.

Model of health? Distributed preparedness and multi-agency interventions surrounding UK regional airports.

PubMed

Warren, Adam; Bell, Morag; Budd, Lucy

2012-01-01

The liberalisation of the European aviation sector has multiplied paths of entry into the United Kingdom (UK) for the international traveller. These changing mobilities necessitate a reconceptualisation of the border as a series of potentially vulnerable nodes occurring within, and extending beyond, national boundaries. In this paper, we consider the border through the lens of port health, the collective term for various sanitary operations enacted at international transport terminals. In the UK, a critical player in the oversight of port health is the Health Protection Agency (HPA), which became a non-Departmental public body in 2005. A major part of port health is preparedness, a set of techniques aimed at managing, and responding to, emergencies of public health concern. More recently, certain jurisdictions have embarked on public health preparedness work across a number of different geographical scales. Using methods pioneered by the military, this form of 'distributed preparedness' is of increased interest to social science and medical scholars. With reference to case studies conducted in localities surrounding two UK regional airports following the 2009-10 H1N1 influenza pandemic, we consider the extent to which distributed preparedness as a concept and a set of practices can inform current debates - in the UK, and beyond - concerning interventions at the border 'within'. Copyright © 2011 Elsevier Ltd. All rights reserved.

76 FR 28986 - Agency Information Collection Request. 30-Day Public Comment Request

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2011-05-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES [Document Identifier: OS-0990-Ne30-day notice] Agency... of the Secretary (OS), Department of Health and Human Services, is publishing the following summary... Communication Campaign for HITECH Act-- OMB No. 0990-NEW-Office National Coordinator for Health Information...

Project TEACH: A Capacity-Building Training Program for Community-Based Organizations and Public Health Agencies.

PubMed

Sauaia, Angela; Tuitt, Nicole R; Kaufman, Carol E; Hunt, Cerise; Ledezma-Amorosi, Mariana; Byers, Tim

2016-01-01

Project TEACH (Teaching Equity to Advance Community Health) is a capacity-building training program to empower community-based organizations and regional public health agencies to develop data-driven, evidence-based, outcomes-focused public health interventions. TEACH delivers training modules on topics such as logic models, health data, social determinants of health, evidence-based interventions, and program evaluation. Cohorts of 7 to 12 community-based organizations and regional public health agencies in each of the 6 Colorado Area Health Education Centers service areas participate in a 2-day training program tailored to their specific needs. From July 2008 to December 2011, TEACH trained 94 organizations and agencies across Colorado. Training modules were well received and resulted in significant improvement in knowledge in core content areas, as well as accomplishment of self-proposed organizational goals, grant applications/awards, and several community-academic partnerships.

Charges Made by the National Federation of the Blind Against the National Accreditation Council for Agencies Serving the Blind and Visually Handicapped.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

Presented is a report submitted by the General Accounting Office (GAO) concerning its investigation of charges made by the National Federation of the Blind (NFB) against the National Accreditation Council for Agencies Serving the Blind and Visually Handicapped (NAC). It is explained that the GAO reviewed NFB allegations that the NAC does not act…

April Spotlight: National Minority Health Month

Cancer.gov

Each April, we recognize National Minority Health Month and National Minority Cancer Awareness Week. Dr. Peter Ogunbiyi shares how CRCHD’s work is related to the 2017 theme: Bridging Health Equity Across Communities.

76 FR 56503 - Agency Information Collection Activity (VSO Access to VHA Electronic Health Records) Under OMB...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-13

... power of attorney by veterans who have medical information recorded in VHA electronic health records... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0710] Agency Information Collection Activity (VSO Access to VHA Electronic Health Records) Under OMB Review AGENCY: Veterans Health Administration...

Home Health Agency Characteristics and Quality Outcomes for Medicare Beneficiaries With Rehabilitation-Sensitive Conditions.

PubMed

Mroz, Tracy M; Meadow, Ann; Colantuoni, Elizabeth; Leff, Bruce; Wolff, Jennifer L

2018-06-01

To examine associations between organizational characteristics of home health agencies (eg, profit status, rehabilitation therapy staffing model, size, and rurality) and quality outcomes in Medicare beneficiaries with rehabilitation-sensitive conditions, conditions for which occupational, physical, and/or speech therapy have the potential to improve functioning, prevent or slow substantial decline in functioning, or increase ability to remain at home safely. Retrospective analysis. Home health agencies. Fee-for-service beneficiaries (N=1,006,562) admitted to 9250 Medicare-certified home health agencies in 2009. Not applicable. Institutional admission during home health care, community discharge, and institutional admission within 30 days of discharge. Nonprofit (vs for-profit) home health agencies were more likely to discharge beneficiaries to the community (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.13-1.33) and less likely to have beneficiaries incur institutional admissions within 30 days of discharge (OR, .93; 95% CI, .88-.97). Agencies in rural (vs urban) counties were less likely to discharge patients to the community (OR, .83; 95% CI, .77-.90) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.24; 95% CI, 1.18-1.30) and within 30 days of discharge (OR, 1.15; 95% CI, 1.10-1.22). Agencies with contract (vs in-house) therapy staff were less likely to discharge beneficiaries to the community (OR, .79, 95% CI, .70-.91) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.09; 95% CI, 1.03-1.15) and within 30 days of discharge (OR, 1.17; 95% CI, 1.07-1.28). As payers continue to test and implement reimbursement mechanisms that seek to reward value over volume of services, greater attention should be paid to organizational factors that facilitate better coordinated, higher quality home health care for beneficiaries who may benefit from rehabilitation. Copyright © 2017

[Social inequalities in health, missions of a regional healthcare agency].

PubMed

Ginot, Luc

The presence of social inequalities in health requires a multi-faceted intervention, focusing on the social determinants as well as the provision of care and prevention strategies. Regional health agencies have important levers at their disposal, as illustrated by the example of the Île-de-France region. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Australia's national men's health policy: masculinity matters.

PubMed

Saunders, Margo; Peerson, Anita

2009-08-01

The development of Australia's first national men's health policy provides an important opportunity for informed discussions of health and gender. It is therefore a concern that the stated policy appears to deliberately exclude hegemonic masculinity and other masculinities, despite evidence of their major influence on men's health-related values, beliefs, perspectives, attitudes, motivations and behaviour. We provide an evidence-based critique of the proposed approach to a national men's health policy which raises important questions about whether the new policy can achieve its aims if it fails to acknowledge 'masculinity' as a key factor in Australian men's health. The national men's health policy should be a means to encourage gender analysis in health. This will require recognition of the influence of hegemonic masculinity, and other masculinities, on men's health. Recognising the influence of 'masculinity' on men's health is not about 'blaming' men for 'behaving badly', but is crucial to the development of a robust, meaningful and comprehensive national men's health policy.

45 CFR 630.645 - Federal agency or agency.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Federal agency or agency. 630.645 Section 630.645 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Definitions § 630.645 Federal agency...

78 FR 37817 - Meeting of the National Vaccine Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Meeting of the National Vaccine Advisory Committee AGENCY: National Vaccine Program Office, Office of the Assistant Secretary for Health, Office of the Secretary... giving notice that the National Vaccine Advisory Committee (NVAC) will be holding a special meeting. This...

75 FR 25259 - Meeting of the National Vaccine Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Meeting of the National Vaccine Advisory Committee AGENCY... Services (HHS) is hereby giving notice that the National Vaccine Advisory Committee (NVAC) will hold a...., Washington, DC 20201. FOR FURTHER INFORMATION CONTACT: National Vaccine Program Office, Department of Health...

77 FR 3268 - Meeting of the National Vaccine Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Meeting of the National Vaccine Advisory Committee AGENCY... Department of Health and Human Services (HHS) is hereby giving notice that the National Vaccine Advisory...., Washington, DC 20201. FOR FURTHER INFORMATION CONTACT: The National Vaccine Program Office, U.S. Department...

Exploring the effect of organizational culture on consumer perceptions of agency support for mental health recovery.

PubMed

Clossey, Laurene; Rheinheimer, David

2014-05-01

This research explores the impact of mental health agency culture on consumers' perceptions of agency support for their recovery. This study hypothesized that a constructive organizational culture must be present for consumers to perceive agency support for recovery. A sample of 12 mental health agencies in rural Pennsylvania participated in the research. Agency administrators completed an instrument called the recovery oriented service environment, which measured the number of recovery model program components offered by the agency. Consumers completed the recovery oriented services indicators, which taps into their perception of agency support for recovery. Direct service staff completed the organizational social context, which measured their agency's culture. Results showed that in this sample stronger consumer perceptions of agency support for recovery were correlated with higher ratings of agency constructive culture. The results suggest that agency culture is an important variable to target when implementing recovery model programming.

[Investigation of the allocation of equipment among the major research agencies for occupational health and medicine].

PubMed

Zhang, Lin; Wu, Zhi-Jun; Zhang, Shuang; Qin, Jian; Zhang, Xing

2011-08-01

To understand the allocation of instruments and equipment in major research institutions for occupational health and medicine in China. Questionnaire was designed for collecting the information of the equipment used in occupational health and medicine research. Questionnaires were distributed to 78 research agencies to investigate the situation of allocation of instrument and equipment. There was a great diversity of allocation in investigated agencies. The features in three kinds of agencies are different. The occupational health agencies in universities fit out the biological equipment in laboratories. The occupational health laboratories in CDCs were equipped with the chemical analytical devices. The institutes of occupational medicine were equipped with the clinical inspection instruments. The protocol of sharing resource and predominance complementation should be established among research institutions for occupational health and medicine in the same region or neighboring provinces.

Application of situational leadership to the national voluntary public health accreditation process.

PubMed

Rabarison, Kristina; Ingram, Richard C; Holsinger, James W

2013-08-12

Successful navigation through the accreditation process developed by the Public Health Accreditation Board (PHAB) requires strong and effective leadership. Situational leadership, a contingency theory of leadership, frequently taught in the public health classroom, has utility for leading a public health agency through this process. As a public health agency pursues accreditation, staff members progress from being uncertain and unfamiliar with the process to being knowledgeable and confident in their ability to fulfill the accreditation requirements. Situational leadership provides a framework that allows leaders to match their leadership styles to the needs of agency personnel. In this paper, the application of situational leadership to accreditation is demonstrated by tracking the process at a progressive Kentucky county public health agency that served as a PHAB beta test site.

Vocational Instructional Materials for Health Occupations Education Available from Federal Agencies.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

This annotated bibliography lists curriculum materials for health occupations education which were produced by Federal agencies and are appropriate for these subject matter areas: (1) dentistry, (2) medical laboratory technology, (3) nursing, (4) rehabilitation, (5) radiology, (6) opthalmology, (7) environmental health, and (8) mental health…

78 FR 18619 - Extension of Agency Information Collection Activity Under OMB Review: National Explosives...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-27

... DEPARTMENT OF HOMELAND SECURITY Transportation Security Administration Extension of Agency Information Collection Activity Under OMB Review: National Explosives Detection Canine Team Program (NEDCTP... Explosives Detection Canine Team Program (NEDCTP) canine handlers. Abstract: The FAMS/CTES Explosives...

The health-related, social, and economic consequences of parkinsonism: a controlled national study.

PubMed

Jennum, Poul; Zoetmulder, Marielle; Korbo, Lise; Kjellberg, Jakob

2011-08-01

Parkinson's disease (PD) and atypical parkinsonism (AP) cause a significant socioeconomic burden, but there is insufficient information about the total disease burden at a national level. Thus, the goal of this study was to estimate the excess direct and indirect costs of PD and AP in a national sample. Using records from the Danish National Patient Registry (1997-2007), 13,400 PD and 647 AP patients were identified and compared with, respectively, 53,600 and 2,588 control cases randomly selected with respect to age, gender, civil status, and geographic location. Direct costs including frequencies of primary and sector contacts and procedures, and medication from primary and secondary sectors were obtained from the Danish Ministry of Health, the Danish Medicines Agency, and the National Health Security. Indirect costs, which included labor supply and social transfer payments, were based on income data derived from the Coherent Social Statistics. Patients with PD and AP had significantly higher rates of health-related contact and medication use and a higher socioeconomic cost. Furthermore, they had very low employment rates, and those in employment had a lower income level than employed control subjects. The annual mean excess health-related cost was 6,500 ($8,975/£5,543) and 9,771 ($13,491/£8,332) for each patient with PD and AP, respectively. In addition, the patients with PD and AP received an annual mean excess social transfer income of 324 (£276/$447) and 844 (£719/$1,165), respectively. The employment- and health-related consequences could be identified up to 8 years before the first diagnosis and increased with disease advancement. PD and AP have major socioeconomic consequences for patients and society. The health effects are present for up to more than 8 years before a diagnosis of PD/AP.

Factors associated with local public health agency participation in obesity prevention in southern States.

PubMed

Hatala, Jeffrey J; Fields, Tina T

2015-05-01

Obesity rates in the southern US states are higher than in other states. Historically, large-scale community-based interventions in the United States have not proven successful. With local public health agencies (LPHAs) tasked with prevention, their role in obesity prevention is important, yet little research exists regarding what predicts the participation of LPHAs. Cross-sectional data from the 2008 National Association of City and County Health Officials profile study and two public health conceptual frameworks were used to assess structural and environmental predictors of LPHA participation in obesity prevention. The predictors were compared between southern and nonsouthern states. Univariate and weighted logistic regressions were performed. Analysis revealed that more LPHAs in southern states were engaged in nearly all of the 10 essential public health functions related to obesity prevention compared with nonsouthern states. Presence of community-based organizations and staffing levels were the only significant variables in two of the six logistic regression models. This study provides insights into the success rates of the obesity prevention efforts of LPHAs in southern and nonsouthern states. Future research is needed to understand why and how certain structural elements and any additional factors influence LPHA participation in obesity prevention.

Sharing Overdose Data Across State Agencies to Inform Public Health Strategies: A Case Study.

PubMed

Cherico-Hsii, Sara; Bankoski, Andrea; Singal, Pooja; Horon, Isabelle; Beane, Eric; Casey, Meghan; Rebbert-Franklin, Kathleen; Sharfstein, Joshua

2016-01-01

Data sharing and analysis are important components of coordinated and cost-effective public health strategies. However, legal and policy barriers have made data from different agencies difficult to share and analyze for policy development. To address a rise in overdose deaths, Maryland used an innovative and focused approach to bring together data on overdose decedents across multiple agencies. The effort was focused on developing discrete intervention points based on information yielded on decedents' lives, such as vulnerability upon release from incarceration. Key aspects of this approach included gubernatorial leadership, a unified commitment to data sharing across agencies with memoranda of understanding, and designation of a data management team. Preliminary results have yielded valuable insights and have helped inform policy. This process of navigating legal and privacy concerns in data sharing across multiple agencies may be applied to a variety of public health problems challenging health departments across the country.

Quality Assurance and Improvement Practice in Mental Health Agencies: Roles, Activities, Targets and Contributions

PubMed Central

McMillen, Curtis; Zayas, Luis E.; Books, Samantha; Lee, Madeline

2009-01-01

Accompanying the rise in the number of mental health agency personnel tasked with quality assurance and improvement (QA/I) responsibilities is an increased need to understand the nature of the work these professionals undertake. Four aspects of the work of quality assurance and improvement (QA/I) professionals in mental health were explored in this qualitative study: their perceived roles, their major activities, their QA/I targets, and their contributions. In-person interviews were conducted with QA/I professionals at 16 mental health agencies. Respondents perceived their roles at varying levels of complexity, focused on different targets, and used different methods to conduct their work. Few targets of QA/I work served as indicators of high quality care. Most QA/I professionals provided concrete descriptions of how they had improved agency services, while others could describe none. Accreditation framed much of agency QA/I work, perhaps to its detriment. PMID:18688707

Using Real-World Data in Health Technology Assessment (HTA) Practice: A Comparative Study of Five HTA Agencies.

PubMed

Makady, Amr; van Veelen, Ard; Jonsson, Páll; Moseley, Owen; D'Andon, Anne; de Boer, Anthonius; Hillege, Hans; Klungel, Olaf; Goettsch, Wim

2018-03-01

Reimbursement decisions are conventionally based on evidence from randomised controlled trials (RCTs), which often have high internal validity but low external validity. Real-world data (RWD) may provide complimentary evidence for relative effectiveness assessments (REAs) and cost-effectiveness assessments (CEAs). This study examines whether RWD is incorporated in health technology assessment (HTA) of melanoma drugs by European HTA agencies, as well as differences in RWD use between agencies and across time. HTA reports published between 1 January 2011 and 31 December 2016 were retrieved from websites of agencies representing five jurisdictions: England [National Institute for Health and Care Excellence (NICE)], Scotland [Scottish Medicines Consortium (SMC)], France [Haute Autorité de santé (HAS)], Germany [Institute for Quality and Efficacy in Healthcare (IQWiG)] and The Netherlands [Zorginstituut Nederland (ZIN)]. A standardized data extraction form was used to extract information on RWD inclusion for both REAs and CEAs. Overall, 52 reports were retrieved, all of which contained REAs; CEAs were present in 25 of the reports. RWD was included in 28 of the 52 REAs (54%), mainly to estimate melanoma prevalence, and in 22 of the 25 (88%) CEAs, mainly to extrapolate long-term effectiveness and/or identify drug-related costs. Differences emerged between agencies regarding RWD use in REAs; the ZIN and IQWiG cited RWD for evidence on prevalence, whereas the NICE, SMC and HAS additionally cited RWD use for drug effectiveness. No visible trend for RWD use in REAs and CEAs over time was observed. In general, RWD inclusion was higher in CEAs than REAs, and was mostly used to estimate melanoma prevalence in REAs or to predict long-term effectiveness in CEAs. Differences emerged between agencies' use of RWD; however, no visible trends for RWD use over time were observed.

Public reporting and market area exit decisions by home health agencies.

PubMed

Jung, Kyoungrae; Feldman, Roger

2012-01-01

To examine whether home health agencies selectively discontinue services to areas with socio-economically disadvantaged people after the introduction of Home Health Compare (HHC), a public reporting program initiated by Medicare in 2003. We focused on agencies' initial responses to HHC and examined selective market-area exits by agencies between 2002 and 2004. We measured HHC effects by the percentage of quality indicators reported in public HHC data in 2003. Socio-economic status was measured by per capita income and percent college-educated at the market-area level. 2002 and 2004 Outcome and Assessment Information Set (OASIS); 2000 US Census file; 2004 Area Resource File; and 2002 Provider of Service File. WE FOUND A SMALL AND WEAK EFFECT OF PUBLIC REPORTING ON SELECTIVE EXITS: a 10-percent increase in reporting (reporting one more indicator) increased the probability of leaving an area with less-educated people by 0.3 percentage points, compared with leaving an area with high education. The small level of market-area exits under public reporting is unlikely to be practically meaningful, suggesting that HHC did not lead to a disruption in access to home health care through selective exits during the initial year of the program.

Organizational capacity and implementation change: a comparative case study of heart health promotion in Ontario public health agencies.

PubMed

Riley, Barbara L; Taylor, S Martin; Elliott, Susan J

2003-12-01

This paper reports the results of a comparative case study that examines factors influencing changes in implementation of heart health promotion activities in Ontario public health units. The study compared two cases that experienced large changes in implementation from 1994 to 1996, but in opposite directions. Multiple data sources were used, with an emphasis on secondary analyses of quantitative surveys of health units and other community agencies, and in-depth interviews of public health staff, collected as part of the Canadian Heart Health Initiative Ontario Project. Guided by social ecological and organizational theories, changes in implementation were explained by examining changes in (1) organizational predisposition to undertake heart health promotion activities, (2) organizational practices to undertake these activities, (3) other internal organizational factors and (4) external system factors. Findings show that in communities with diverse characteristics, implementation change was most strongly influenced by an interplay of changes in internal features of public health agencies; notably, leadership, structure and staff skills. Findings support a social ecological approach to health promotion by demonstrating the importance of the institutional context in the implementation change process, the interaction of individual (skills) and organizational (structure) levels in explaining implementation change, and community context in shaping the change process. Findings also reinforce the value of strengthening capacity within public health agencies and suggest further research on the implementation change process, especially in different systems and over longer periods of time.

78 FR 64228 - National Institutes of Health

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Health Sciences Special Emphasis Panel Assessment of Toxic and Carcinogenic Effects from Exposure to...

76 FR 78738 - Agency Information Collection (Locality Pay System for Nurses and Other Health Care Personnel...