Science.gov

Sample records for affordable child care

  1. Affordable Care?

    PubMed

    Goldstein, Adam O

    2015-01-01

    Once a year, Stuart, a long-haul truck driver, visited a physician to get a signature on the forms that allowed him to continue driving his 18-wheeler. Over 8 years, he had never seen the same physician twice, in large part because of a lack of health insurance. Upon seeing him for the first time, I assured him that we could make financial arrangements, and he subsequently became my continuity patient. Two years later, we both looked forward to his impending 65th birthday, allowing Medicare to ease his fiscal health care burdens. His unexpected death made me ponder how a lack of access to affordable health care profoundly affects patients and their clinicians.

  2. Moving Forward: Southern States Take Action To Improve Access to Quality, Affordable Child Care.

    ERIC Educational Resources Information Center

    Southern Inst. on Children and Families, Columbia, SC.

    The Southern Regional Initiative on Child Care (established by the Southern Institute on Children and Families) is guided by the Southern Regional Task Force on Child Care including representatives from 16 southern states and the District of Columbia. The initial charge from the Task Force was to develop a southern regional action plan to improve…

  3. Affordable Care Act.

    PubMed

    Rak, Sofija; Coffin, Janis

    2013-01-01

    The Patient Protection and Affordable Care Act of 2010 (PPACA), although a subject of much debate in the Unites States, was enacted on March 23, 2010, and upheld by the Supreme Court on June 28, 2012. This act advocates that "healthcare is a right, not a privilege." The main goals of PPACA are to minimize the number of uninsured Americans and make healthcare available to everyone at an affordable price. The Congressional Budget Office has determined that 94% of Americans will have healthcare coverage while staying under the $900 billion limit that President Barack Obama established by bending the healthcare cost curve and reducing the deficit over the next 10 years.

  4. Office of Child Care

    MedlinePlus

    ... Early Head Start-Child Care Partnerships. Review the profiles. > What is the Office of Child Care (OCC)? The Office of Child Care supports low-income working families through child care financial assistance and ...

  5. Child Care Aware

    MedlinePlus

    ... Aware of America Symposium 2016 Looking for child care? Need resources for your child care business? There are more than 500 local Child Care Resource & Referral (CCR&R) agencies across the United ...

  6. Affordable Care Act and Women

    MedlinePlus

    ... care for older women, and ends the gender discrimination that requires women to pay more for the ... Preventive Health Services Improved Medicare Coverage Ending Gender Discrimination in Premiums Expanded Insurance Coverage Endnotes Download "rb. ...

  7. Employer Child Care Organizations Eye Changing Economics: Employer Child Care Status Report #16

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2008-01-01

    In the intervening years, the question of whether corporations should be in the child care business has been answered. Employers no longer question whether providing child care support for employees is a good idea; the key question now is whether they can afford it. This article reports that research for the employer child care status report finds…

  8. Child Care and Child Nutrition

    ERIC Educational Resources Information Center

    Karolak, Eric

    2009-01-01

    The weak economy is challenging the child care program budget. Fluctuations in enrollment come up against rising costs making every penny count. So for many reasons a federal program that helps defray the costs of snacks and meals in child care programs is particularly important and timely. In this article, the author pushes for the…

  9. Diabetes and the Affordable Care Act

    PubMed Central

    Schade, David S.

    2014-01-01

    Abstract The Affordable Care Act—“Obamacare”—is the most important federal medical legislation to be enacted since Medicare. Although the goal of the Affordable Care Act is to improve healthcare coverage, access, and quality for all Americans, people with diabetes are especially poised to benefit from the comprehensive reforms included in the act. Signed into law in 2010, this massive legislation will slowly be enacted over the next 10 years. In the making for at least a decade, it will affect every person in the United States, either directly or indirectly. In this review, we discuss the major changes in healthcare that will take place in the next several years, including (1) who needs to purchase insurance on the Web-based exchange, (2) the cost to individuals and the rebates that they may expect, (3) the rules and regulations for purchasing insurance, (4) the characteristics of the different “metallic” insurance plans that are available, and (5) the states that have agreed to participate. With both tables and figures, we have tried to make the Affordable Care Act both understandable and appreciated. The goal of this comprehensive review is to highlight aspects of the Affordable Care Act that are of importance to practitioners who care for people with diabetes by discussing both the positive and the potentially negative aspects of the program as they relate to diabetes care. PMID:24927108

  10. Child Care in Texas: A Report.

    ERIC Educational Resources Information Center

    Larson, Erik

    This report examines a basic child care challenge confronting the state of Texas: the shortage of affordable, accessible, quality early care and education for Texas families with children, particularly those with limited incomes. The report notes that these three factors--affordability, accessibility, and good quality--are integral to a successful…

  11. Access To Care And Affordability Have Improved Following Affordable Care Act Implementation; Problems Remain.

    PubMed

    Shartzer, Adele; Long, Sharon K; Anderson, Nathaniel

    2016-01-01

    There is growing evidence that millions of adults have gained insurance coverage under the Affordable Care Act, but less is known about how access to and affordability of care may be changing. This study used data from the Health Reform Monitoring Survey to describe changes in access and affordability for nonelderly adults from September 2013, just prior to the first open enrollment period in the Marketplace, to March 2015, after the end of the second open enrollment period. Overall, we found strong improvements in access to care for all nonelderly adults and across income and state Medicaid expansion groups. We also found improvements in the affordability of care for all adults and for low- and moderate-income adults. Despite this progress, there were still large gaps in access and affordability in March 2015, particularly for low-income adults.

  12. Patient Protection and Affordable Care Act

    THOMAS, 111th Congress

    Rep. Rangel, Charles B. [D-NY-15

    2009-09-17

    03/23/2010 Became Public Law No: 111-148. (TXT | PDF) (All Actions) Notes: H.R.4872 makes a number of health-related financing and revenue changes to this bill. Read together, this bill and the health care-related provisions of H.R.4872 are commonly referred to as the Affordable Care Act (ACA). Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  13. Patient Protection and Affordable Care Act

    THOMAS, 111th Congress

    Rep. Rangel, Charles B. [D-NY-15

    2009-09-17

    03/23/2010 Became Public Law No: 111-148. (PDF) (All Actions) Notes: H.R.4872 makes a number of health-related financing and revenue changes to this bill. Read together, this bill and the health care-related provisions of H.R.4872 are commonly referred to as the Affordable Care Act (ACA). Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  14. Patient Protection and Affordable Care Act

    THOMAS, 111th Congress

    Rep. Rangel, Charles B. [D-NY-15

    2009-09-17

    03/23/2010 Became Public Law No: 111-148. (TXT | PDF) (All Actions) Notes: H.R.4872 makes a number of health-related financing and revenue changes to this bill. Read together, this bill and the health care-related provisions of H.R.4872 are commonly referred to as the Affordable Care Act (ACA). Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  15. Affordable Care Act and Diabetes Mellitus.

    PubMed

    Shi, Qian; Nellans, Frank P; Shi, Lizheng

    2015-12-01

    The Affordable Care Act (ACA) has the potential for great impact on U.S. health care, especially for chronic disease patients requiring long-term care and management. The act was designed to improve insurance coverage, health care access, and quality of care for all Americans, which will assist patients with diabetes mellitus in acquiring routine monitoring and diabetes-related complication screening for better health management and outcomes. There is great potential for patients with diabetes to benefit from the new policy mandating health insurance coverage and plan improvement, Medicaid expansion, minimum coverage guarantees, and free preventative care. However, policy variability among states and ACA implementation present challenges to people with diabetes in understanding and optimizing ACA impact. This paper aims to select the most influential components of the ACA as relates to people with diabetes and discuss how the ACA may improve health care for this vulnerable population.

  16. Child Care Services Handbook.

    ERIC Educational Resources Information Center

    Duval County School Board, Jacksonville, FL.

    A companion document to the curriculum guide for a secondary level child care services curriculum, this handbook contains a variety of administrative and program resources for the teacher: The vocational curriculum outline for child care services; a calendar of suggested public relations activities; procedures for building child care services…

  17. Child Care Design Guide.

    ERIC Educational Resources Information Center

    Olds, Anita Rui

    This book provides architects, interior designers, developers, and child-care professionals with detailed information on the planning and design of child care centers. Part 1 examines the current state of child care in the United States and offers an overall philosophical concert--the spirit of place--as the framework for all center design. Part 2…

  18. Child Care Bulletin, 1997.

    ERIC Educational Resources Information Center

    McGhee, Marilyn, Ed.

    1997-01-01

    This document is comprised of six issues of the Child Care Bulletin, a bimonthly publication of the National Child Care Information Center. The January-February issue focuses on involving communities in child care planning. Topics discussed in this issue include: community mobilization strategies, assessing needs and establishing goals, and…

  19. Affordable access to care for the undocumented.

    PubMed

    Rosen, Dennis

    2014-09-01

    How do you tell a sick kid that nobody cares if he gets better? That's an exaggeration, of course, but it is the fundamental message our society sends when we tell him that, because he and his family are undocumented immigrants, we are unwilling to extend them access to affordable and reliable health insurance. One major shortcoming of the Affordable Care Act is its specific exclusion of the almost twelve million undocumented immigrants-including millions of children-in this country from access to the state and federal insurance exchanges where coverage can be purchased. It is true that providing undocumented immigrants access to the exchanges and subsidies mandated by the ACA would require additional funding. However, a recent analysis in California has found that the costs of expanding state-supported care to include undocumented immigrants would largely be offset by the increased state sales tax revenue paid by managed care organizations and by reduced spending at the county level on emergency-room and hospital care of the uninsured.

  20. Child Care Resource Materials.

    ERIC Educational Resources Information Center

    Webb, Jeanne, Comp.; Pennington, Marnee, Comp.

    "Child Care Resource Materials" is an annotated bibliography of books, films, and filmstrips on various topics related to the education and development of young children. Categories include: learning activities for children; caring for children - infants through adolescents and children with special needs; parent-child relationships; day care -…

  1. Quality Health Care for Children and the Affordable Care Act: A Voltage Drop Checklist

    PubMed Central

    Wise, Paul H.; Halfon, Neal

    2014-01-01

    The Affordable Care Act (ACA) introduces enormous policy changes to the health care system with several anticipated benefits and a growing number of unanticipated challenges for child and adolescent health. Because the ACA gives each state and their payers substantial autonomy and discretion on implementation, understanding potential effects will require state-by-state monitoring of policies and their impact on children. The “voltage drop” framework is a useful interpretive guide for assessing the impact of insurance market change on the quality of care received. Using this framework we suggest a state-level checklist to examine ACA statewide implementation, assess its impact on health care delivery, and frame policy correctives to improve child health system performance. Although children’s health care is a small part of US health care spending, child health provides the foundation for adult health and must be protected in ACA implementation. PMID:25225140

  2. Breastfeeding and the Affordable Care Act.

    PubMed

    Hawkins, Summer Sherburne; Dow-Fleisner, Sarah; Noble, Alice

    2015-10-01

    Mothers who receive or qualify for the Women, Infants, and Children (WIC) program or have lower income are less likely to start and continue breastfeeding than their more advantaged counterparts. The Patient Protection and Affordable Care Act (ACA) requires employers to provide break time and space to express breast milk and requires insurance companies to cover breastfeeding support, supplies, and counseling at no cost to mothers. This ACA benefit does not extend to all Medicaid recipients or women in the WIC program. Legislative and regulatory efforts are needed to provide comprehensive coverage for all women and reduce disparities in breastfeeding.

  3. Clinton's Child Care Plan: Helping Families to Secure and Pay for Child Care. Family Review.

    ERIC Educational Resources Information Center

    Lindjord, Denise

    1998-01-01

    Reviews features of President Bill Clinton's proposed $22 billion child care plan, a set of spending measures and tax credits designed to make child care more affordable, available, and safe for low- and middle-income families. Features noted include Head Start and after-school programs, and business tax credits. (HTH)

  4. America's Child Care Crisis: A Crime Prevention Tragedy.

    ERIC Educational Resources Information Center

    Newman, Sanford; Brazelton, T. Berry; Zigler, Edward; Sherman, Lawrence W.; Bratton, William; Sanders, Jerry; Christeson, William

    This report presents findings relating the reduction of crime and violence with access to good educational child care programs. The report discusses the affordability of such programs, suggests that federal and state governments are not adequately funding educational child care programs, and argues that investing in high-quality child care and…

  5. Child Care Use in Minnesota: 2009 Statewide Survey Summary

    ERIC Educational Resources Information Center

    Chase, Richard; Valorose, Jennifer

    2010-01-01

    Nearly 500,000 households in Minnesota include a parent or parents with at least one child age 12 and under. About three-quarters use some type of child care. The strength of the economy depends on families having high-quality, affordable child care, so parents can work and children have the early learning opportunities they need to perform better…

  6. Child Care in Canada

    ERIC Educational Resources Information Center

    Graham, Kathy

    2005-01-01

    In this article, the author describes early learning and care arrangements in Canada and how the country faced the challenges in the development of a National Child Care System. While the provincial/territorial governments are responsible for early learning and care, the federal government has formed health and social programs including some child…

  7. Child Care and the Family.

    ERIC Educational Resources Information Center

    Friedman, David B.; And Others

    The booklet examines child care as a major resource for the prevention of child abuse, and is intended to bring child care and child abuse workers together. An introductory section on child abuse is followed by an update on the family, including historical perspectives and a case study illustrating cooperation of parents and day care staff. A…

  8. Beginning Child Care Fact Sheets.

    ERIC Educational Resources Information Center

    Tweedie, Pat

    These six fact sheets from Child Care Aware are designed to help parents ease their children's transition to child care. The first fact sheet, "Before Your Child's First Day," discusses tips such as: (1) "prepare your child"; (2) read and look at picture books about child care; and (3) "prepare yourself." The second fact sheet, "First Day Tips,"…

  9. Navy Child Care, 1980.

    DTIC Science & Technology

    1982-12-01

    34 1. Reenlistment or Retention Intentions and Career Satisfaction --------------------------- 34 2. Number ( Present ...about how best to support those families arise. One family support system is the base child-care center. Does the Navy’s present child-care system...problems and experiences of Navy active-duty women. The results of this survey are presented in Chapter II. The second survey was of primary Navy

  10. Trends in Family Child Care

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2011-01-01

    The author presents insights from various readers of "ExchangeEveryDay" regarding trends in the world of family child care. Kathleen Reticker of Acre Family Child Care in Lowell, Massachusetts thinks an increasing trend in Family Child Care is the pressure to emulate a Center, instead of seeing family child care as a different model. Over the…

  11. Stability of Subsidy Participation and Continuity of Care in the Child Care Assistance Program in Minnesota. Minnesota Child Care Choices Research Brief Series. Publication #2014-55

    ERIC Educational Resources Information Center

    Davis, Elizabeth E.; Krafft, Caroline; Tout, Kathryn

    2014-01-01

    The Minnesota Child Care Assistance Program (CCAP) provides subsidies to help low-income families pay for child care while parents are working, looking for work, or attending school. The program can help make quality child care affordable and is intended both to support employment for low-income families and to support the development and…

  12. Louisiana KIDS COUNT Special Report on Child Care, 2006

    ERIC Educational Resources Information Center

    Agenda for Children, 2006

    2006-01-01

    The "2006 Agenda for Children Louisiana Kids Count Special Report on Child Care" documents and describes the supply and affordability of child care and early education in each of Louisiana's 64 parishes. Seventy-eight percent (78%) of Louisiana's children under the age of five are cared for by someone other than a parent or guardian on a…

  13. Child Care Center Regulations.

    ERIC Educational Resources Information Center

    Nebraska State Dept. of Health and Human Services, Lincoln.

    This guide enumerates regulations for anyone caring for four or more children, from families other than their own, for compensation and on a regular basis, in the state of Nebraska. The purpose of the regulations is to protect and promote the health and safety of children in child care facilities. The first section of the guide lists specific…

  14. Critical Care Implications of the Affordable Care Act

    PubMed Central

    Dogra, Anjali P.; Dorman, Todd

    2015-01-01

    Objectives To provide an overview of key elements of the Affordable Care Act (ACA). To evaluate ways in which the ACA will likely impact the practice of critical care medicine. To describe strategies that may help health systems and providers effectively adapt to changes brought about by the ACA. Data Sources and Synthesis Data sources for this concise review include search results from the PubMed and Embase databases, as well as sources relevant to public policy such as the text of the Patient Protection and Affordable Care Act and reports of the Congressional Budget Office (CBO). As all of the ACA's provisions will not be fully implemented until 2019, we also drew upon cost, population and utilization projections as well as the experience of existing state-based healthcare reforms. Conclusion The ACA represents the furthest reaching regulatory changes in the US healthcare system since the 1965 Medicare and Medicaid provisions of the Social Security Act. The ACA aims to expand health insurance coverage to millions of Americans and place an emphasis on quality and cost-effectiveness of care. From models which link pay and performance to those which center on episodic care, the ACA outlines sweeping changes to health systems, reimbursement structures, and the delivery of critical care. Staffing models that include daily rounding by an intensivist, palliative care integration, and expansion of the role of telemedicine in areas where intensivists are inaccessible are potential strategies that may improve quality and profitability of ICU care in the post-ACA era. PMID:26565630

  15. Dateline Child Care: President Unveils Child Care Plan.

    ERIC Educational Resources Information Center

    Child Care Information Exchange, 1989

    1989-01-01

    Discusses such topics as President Bush's proposed low-income tax credits for child care; the Act for Better Child Care Services; the coming Americanization of child care in Great Britain; and state courts' upholding of church day care licensing exemptions. (BB)

  16. Child Care and Development Block Grant (CCDBG) Participation Continues to Fall

    ERIC Educational Resources Information Center

    Matthews, Hannah; Schmit, Stephanie

    2014-01-01

    Child care subsidies help make quality child care affordable for low-income parents, allowing them to attend work or school to support their families while ensuring their children's healthy development. The Child Care and Development Block Grant (CCDBG) is the primary source of federal funding for child care subsidies for low-income working…

  17. Child Care Assistance Spending and Participation in 2012: A Record Low

    ERIC Educational Resources Information Center

    Matthews, Hannah; Schmit, Stephanie

    2014-01-01

    Child care subsidies help make quality child care affordable for low-income parents, allowing them to attend work or school to support their families while ensuring their children's healthy development. Access to quality child care is also proven to strengthen families' economic security. The Child Care and Development Block Grant (CCDBG) is the…

  18. Harris Poll on Child Care. The Harris Poll #5.

    ERIC Educational Resources Information Center

    Taylor, Humphrey

    Recent proposals by President Clinton to increase the availability and affordability of child care address a major issue of concern for many parents. This Harris Poll on child care surveyed 1,000 adults between January 14 and 18, 1998. The findings indicate that: (1) about half of all adults were aware of the president's recent proposal; (2) most…

  19. The Economic Impact of Vermont's Child Care Industry.

    ERIC Educational Resources Information Center

    2002

    This report documents the relationship between the supply of reliable, affordable, accessible child care and the health of Vermont's economy. The child care industry is a growing part of the Vermont economy, pumping money into local communities by supporting working families, creating jobs, and generating taxes through employment and the purchase…

  20. Why the affordable care act needs a better name: 'Americare'.

    PubMed

    Sage, William M

    2010-08-01

    The culmination of a century's effort to enact universal coverage in the United States is a law with an uninspiring title, the Patient Protection and Affordable Care Act, and an even more awkward acronym, PPACA. The Obama administration has decided to call the legislation the Affordable Care Act, but the expansion of health coverage that the law sets in motion has no name, and therefore no identity. It badly needs one.

  1. Child Care Subsidies and Child Development

    ERIC Educational Resources Information Center

    Herbst, Chris M.; Tekin, Erdal

    2010-01-01

    Child care subsidies are an important part of federal and state efforts to move welfare recipients into employment. One of the criticisms of the current subsidy system, however, is that it overemphasizes work and does little to encourage parents to purchase high-quality child care. Consequently, there are reasons to be concerned about the…

  2. Child Care Health Connections, 2002.

    ERIC Educational Resources Information Center

    Guralnick, Eva, Ed.; Zamani, Rahman, Ed.; Evinger, Sara, Ed.; Dailey, Lyn, Ed.; Sherman, Marsha, Ed.; Oku, Cheryl, Ed.; Kunitz, Judith, Ed.

    2002-01-01

    This document is comprised of the six 2002 issues of a bimonthly newsletter on children's health for California's child care professionals. The newsletter provides information on current and emerging health and safety issues relevant to child care providers and links the health, safety, and child care communities. Regular features include columns…

  3. Child Care and the Economy

    ERIC Educational Resources Information Center

    Karolak, Eric

    2009-01-01

    Unemployment has topped 7% nationally and economists predict it will approach 10% by 2010. Child care programs experience a trickle-down effect: when businesses cut back hours or lay people off, parents cut back child care hours or pull children from programs. "We're seeing more and more families lose their child care assistance and have nowhere…

  4. Campus Child Care News, 1998.

    ERIC Educational Resources Information Center

    Newton, Marion F., Ed.

    1998-01-01

    This document is comprised of the three 1998 issues of a newsletter disseminating information on the National Coalition for Campus Child Care Centers (NCCCC) and providing a forum for news, research, and information concerning campus child care centers. The February issue contains stories on the White House Conference on Child Care, registration…

  5. The Affordable Care Act: a primer for plastic surgeons.

    PubMed

    Chen, Jenny T; Israel, Jacqueline S; Poore, Samuel O; Rao, Venkat K

    2014-11-01

    The Patient Protection and Affordable Care Act, sometimes referred to as Obamacare, was signed into law on March 23, 2010. It represents the most extensive overhaul of the country's health care system since the passage of Medicare and Medicaid in 1965. The Affordable Care Act has two goals. The first goal is to reduce the uninsured population in the United States. Key elements to covering the uninsured include the following: (1) expanding Medicaid coverage for low-income individuals and (2) establishing health insurance marketplaces for moderate-income individuals with subsidies and tax cuts in an effort to make health insurance more affordable. The second goal of the Affordable Care Act is to address concerns about quality and the overall cost of U.S. health care. It is imperative that plastic surgeons thoroughly understand the impact that the Affordable Care Act will undoubtedly have on the country, on our patients, and on our clinical practices. Plastic surgery will see many changes in the future. This will include an overall increase in the number of insured patients, a push toward joining accountable care organizations, and a shift in payment systems to bundled reimbursement for episodes of care. In this article, the authors describe how these changes are likely to occur and what plastic surgeons must do to be part of the change.

  6. 78 FR 13575 - Coverage of Certain Preventive Services Under the Affordable Care Act; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... Affordable Care Act; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Correction to... Health Service Act, as added by the Patient Protection and Affordable Care Act, as amended,...

  7. Early Child Care in Hungary.

    ERIC Educational Resources Information Center

    Hermann, Alice; Komlosi, Sandor

    The theoretical conceptions of the child and the socialization processes involved in a socialist pedagogical theory are described in this monograph on early child care in Hungary. In emphasizing the partnership between family and state in the care of the young child, this book traces the central role played by government planning in the midst of…

  8. Caring for Children: Case Studies of Local Government Child Care Initiatives.

    ERIC Educational Resources Information Center

    Marx, Fern

    This book of case studies highlights 26 municipalities involved in activities related to child care. Cities selected were of different sizes; were located in different parts of the country; and used diverse approaches for developing ways to improve access to affordable, high-quality child care. Each case study was developed through a telephone…

  9. Time To Care: Redesigning Child Care To Promote Education, Support Families, and Build Communities.

    ERIC Educational Resources Information Center

    Lombardi, Joan

    Refuting the widely held belief that the child care crisis in America is irresolvableor that it can be resolved by simply relying on market forcesthis book presents an alternative vision for ensuring that American families with children will have access to high-quality, affordable child care, shifting the perception of the issue as primarily one…

  10. Subsidizing Success with Child Care.

    ERIC Educational Resources Information Center

    Groginsky, Scott; McConnell, Laurie

    1998-01-01

    Examines how states are responding to the increased need for quality child care and the funding issues raised by the costs of such care. Includes sidebars discussing federal child-care proposals, differential reimbursement rates, and programs for families with a stay-at-home parent. (HTH)

  11. Illinois: Child Care Collaboration Program

    ERIC Educational Resources Information Center

    Center for Law and Social Policy, Inc. (CLASP), 2012

    2012-01-01

    The Illinois Child Care Collaboration Program promotes collaboration between child care and other early care and education providers, including Early Head Start (EHS), by creating policies to ease blending of funds to extend the day or year of existing services. While no funding is provided through the initiative, participating programs may take…

  12. New Forces Shaping Child Care.

    ERIC Educational Resources Information Center

    1972

    In an address to local, state, regional, and national groups involved with child care, characteristics of some of the programs are explained in an effort to develop a broad based national coalition for a system of universally available child care. Head Start, Title IV-A of the Social Security Act (amended) day care, and church-related day care…

  13. Multicultural Issues in Child Care.

    ERIC Educational Resources Information Center

    Gonzalez-Mena, Janet

    This volume focuses on cultural differences relevant to all child-care-giving settings, including day care, nursery, and preschool programs. Based on respect for cultural pluralism, this concise supplementary text is designed to increase caregiver sensitivity to different cultural child-care practices and values and to improve communication and…

  14. What does the Affordable Care Act mean for nursing?

    PubMed

    Luther, Brenda; Hart, Sara

    2014-01-01

    Nurses are ethically bound to engage in efforts of improving health and healthcare delivery and, even more important, nurses recently have been called out as key leaders in the reform of healthcare delivery, including many components of the Patient Protection and Affordable Care Act. The Patient Protection and Affordable Care Act, its history, and what healthcare will look like during and after implementation are addressed in this article. A discussion of the role and value of nurses in healthcare reform accompanies knowledge-building and action-oriented resources available to nurses and clients.

  15. 76 FR 20354 - Notice of Intent To Award Supplemental Affordable Care Act Funding

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... Affordable Care Act Funding Notice of Intent to award supplemental Affordable Care Act funding to support...: Notice. SUMMARY: This notice provides public announcement of CDC's intent to use Affordable Care Act (ACA....'' Funding is appropriated under the Affordable Care Act (Pub. L. 111-148), Title IV, Section...

  16. Child Care: A Level III Review.

    ERIC Educational Resources Information Center

    Florida State Board of Community Colleges, Tallahassee.

    This report describes the state-mandated review of Florida's child care programs. Florida's community colleges offer a total of six different degree or certificate programs in child care: Child Development and Education; Child Care Center Management; Child Development Early Intervention; Child Care Provider (discontinued in 98-99); Early Childhood…

  17. The Economic Impact of Child Care Subsidies for Kentucky. Policy Insights. Occasional Policy Brief #3

    ERIC Educational Resources Information Center

    Hardy, Bradley; Hokayem, Charles; Ziliak, James P.

    2011-01-01

    For parents of young children the decision to work strongly depends on the availability of affordable child care. Child care costs can take up a large portion of a family budget and may serve as an obstacle to work. In 2008 the National Association of Child Care Resource and Referral Agencies (NACCRRA) estimated that Kentucky families recently…

  18. Investing in the Future: Child Care Financing Options for the Public and Private Sectors.

    ERIC Educational Resources Information Center

    Eichman, Caroline; And Others

    Sweeping changes in the economy, the makeup of the labor force, and family structure have altered both the family and the workplace, and have changed the way society must respond to family needs. The supply of child care is inadequate to meet families' child care needs, and many parents cannot afford to pay the full fees for child care. Public…

  19. Child Care-Who Needs It?

    ERIC Educational Resources Information Center

    Clyde, Margaret

    "Child care" is a phrase which has become inextricably linked with the political, economic, and social policies of Australian society. Antagonists and protagonists of child care have put forth arguments against and for child care, respectively, over the past two decades. Supporters of child care have variously viewed child care as a…

  20. The Affordable Care Act: A Prescription for Homeland Security Preparedness?

    DTIC Science & Technology

    2014-09-01

    purchase health insurance  Correct the inequity of Medicaid preventive coverage for new beneficiaries vs. existing beneficiaries  Design and...might incentivize choosing health insurance over penalties. D. ADDRESS MEDICAID PREVENTIVE COVERAGE INEQUITY As noted in Chapter V, § 1001 of the...Affordable Care Act (ACA), tens of millions of U.S. citizens were without health insurance coverage. Without health insurance, health care can be

  1. Infant Child Care. ERIC Digest.

    ERIC Educational Resources Information Center

    Howes, Carollee

    This ERIC Digest briefly reviews studies of maternal employment, child care settings, and links between children's development and family and child care influences. Studies of maternal employment suggest that infants' positive relationships with caregivers may compensate for insecure attachments with mothers. If future research supports this…

  2. Selecting Child Care Administrative Software.

    ERIC Educational Resources Information Center

    Kalinowski, Michael

    1998-01-01

    Offers advice on the selection of child care administrative software. Directors should consider needs, computer experience, budget, time, and temperament, and should also ask lots of questions and test demo versions. Choices range from custom programs and existing business products to child care administrative software packages. Includes directory…

  3. Valuing Your Child Care Business.

    ERIC Educational Resources Information Center

    Linsmeier, Dave; Richards, Dick; Routzong, Ed

    2003-01-01

    Offers guidelines for putting a monetary value on a child care business. Discusses reasons for valuing the business, types of valuations (book, liquidation, and fair market), fair market valuation formulas, the corporate valuation, valuing assets included in a sale, and using experts. Also offers several tips for selling a child care business. (EV)

  4. Model Child Care Health Policies.

    ERIC Educational Resources Information Center

    Aronson, Susan; Smith, Herberta

    Drawn from a review of policies at over 100 child care programs nationwide, the model health policies presented in this report are intended for adaptation and selective use by out-of-home child care facilities. Following an introduction, the report presents model policy forms with blanks for adding individualized information for the following…

  5. 77 FR 28790 - Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-16

    ... Protection and Affordable Care Act AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Final... Care Act (Pub. L. 111-148) was enacted on March 23, 2010; the Health Care and Education Reconciliation... collectively as the Affordable Care Act. The Affordable Care Act reorganizes, amends, and adds to...

  6. Foster Care and Child Health.

    PubMed

    McDavid, Lolita M

    2015-10-01

    Children in foster care need more from health providers than routine well-child care. The changes in legislation that were designed to prevent children from languishing in foster care also necessitate a plan that works with the child, the biological family, and the foster family in ensuring the best outcome for the child. This approach acknowledges that most foster children will return to the biological family. Recent research on the effect of adverse childhood experiences across all socioeconomic categories points to the need for specifically designed, focused, and coordinated health and mental health services for children in foster care.

  7. Child Care in 1976: Goals and Reflections.

    ERIC Educational Resources Information Center

    Provence, Sally

    Goals for future child care services are discussed in this address. It is stressed that social service agencies should consider the family as a unit in providing flexible child care services. Other goals include: (1) tailoring child care programs to parent development as well as child development, (2) insuring that child care workers are motivated…

  8. International examples of undocumented immigration and the affordable care act.

    PubMed

    Stutz, Matthew; Baig, Arshiya

    2014-08-01

    As it stands there is no viable health care option for undocumented immigrants of low socioeconomic status. Even more worrisome is that Affordable Care Act simply does not address this issue with any direct plan. The US is in a very influential time period in terms of undocumented immigration and its relationship with health care. The purpose of this paper is to examine international examples of undocumented immigrant health care and their implications for the United States' undocumented immigrant health care. This study found that physicians in the US must work to prevent the initiation of policies which exclude undocumented immigrants from accessing health care. Exclusionary policies implemented in European nations have had disastrous effects on physicians and patients. This paper examines the implications which similar policies would have if implemented in the US.

  9. Promoting Prevention Through the Affordable Care Act: Workplace Wellness

    PubMed Central

    Roffenbender, Jason S.; Goetzel, Ron Z.; Millard, Francois; Wildenhaus, Kevin; DeSantis, Charles; Novelli, William

    2012-01-01

    Public health in the United States can be improved by building workplace “cultures of health” that support healthy lifestyles. The Affordable Care Act (ACA), which includes the Prevention and Public Health Fund, will support a new focus on prevention and wellness, offering opportunities to strengthen the public’s health through workplace wellness initiatives. This article describes the opportunity the ACA provides to improve worker wellness. PMID:23237245

  10. 78 FR 15553 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-11

    ... 45 CFR Parts 155 and 156 RIN 0938-AR76 Patient Protection and Affordable Care Act; Establishment of... of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act) related to the Small Business...

  11. 77 FR 17143 - Medicaid Program; Eligiblity Changes Under the Affordable Care Act of 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    ...This final rule implements several provisions of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). The Affordable Care Act expands access to health insurance coverage through improvements to the Medicaid and Children's Health Insurance (CHIP) programs, the establishment of......

  12. Child Care Aware: A Guide to Promoting Professional Development in Family Child Care. Lessons Learned from Child Care Aware Sites.

    ERIC Educational Resources Information Center

    Dombro, Amy Laura

    This guide is designed to help educators and community leaders plan and implement professional development initiatives for family child care providers at the community level, and is based on Dayton Hudson Corporation's 1992 Child Care Aware (CCA) campaign to educate child care consumers about quality family child care. Part 1 provides an overview…

  13. Early Child Care in Switzerland

    ERIC Educational Resources Information Center

    Luscher, Kurt K.; And Others

    1973-01-01

    This monograph provides a comprehensive description of the multiple, diverse, and complex systems of child care in Switzerland today. The following topics are discussed: prevailing conceptions of the child-rearing process, the relationship between family and society, socialization, training of personnel, information dissemination, mass media and…

  14. Family Child Care Licensing Study, 2003.

    ERIC Educational Resources Information Center

    Hollestelle, Kay; Koch, Pauline D.

    This report presents the findings of the 2003 national survey of state child care regulatory agencies to update and expand family child care regulatory information published in the 2002 study. Data on small family child care homes and group or large family child care homes are organized into the following 23 categories: (1) number of regulated…

  15. Family Child Care Licensing Study, 2001.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    This report presents the findings of the 2001 national survey of state child care regulatory agencies to update and expand family child care regulatory information published in the 2000 study. Data on small family child care homes and group or large family child care homes are organized into the following 23 categories: (1) number of regulated…

  16. The Family Child Care Licensing Study, 1999.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    This report presents the findings of the 1999 national survey of state child care regulatory agencies to update and expand family child care regulatory information published in the 1998 study. Data on small family child care homes and group or large family child care homes are organized in 22 categories: (1) number of regulated homes; (2)…

  17. Family Child Care Licensing Study, 2000.

    ERIC Educational Resources Information Center

    Kelly, Nia, Comp.

    This report presents the findings of the 2000 national survey of state child care regulatory agencies to update and expand family child care regulatory information published in the 1999 study. Data on small family child care homes and group or large family child care homes are organized in 23 categories: (1) number of regulated homes; (2)…

  18. Family Child Care Licensing Study, 2002.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    This report presents the findings of the 2002 national survey of state child care regulatory agencies to update and expand family child care regulatory information published in the 2001 study. Data on small family child care homes and group or large family child care homes are organized into the following 23 categories: (1) number of regulated…

  19. Pathways and Partnerships for Child Care Excellence

    ERIC Educational Resources Information Center

    Office of Child Care, 2011

    2011-01-01

    More than 12 million American children regularly rely on child care to support their healthy development and school success. Of these, over 1.6 million children receive a child care subsidy from the Child Care and Development Fund (CCDF) program each month. In addition, CCDF helps leverage child care investments from the Temporary Assistance for…

  20. Small businesses and the Affordable Care Act of 2010.

    PubMed

    Collins, Sara R; Davis, Karen; Nicholson, Jennifer L; Stremikis, Kristof

    2010-09-01

    The Patient Protection and Affordable Care Act (ACA) includes several short- and long-term provisions designed to help small businesses pay for and maintain health insurance for their workers, and to allow workers without employer coverage to gain access to affordable, comprehensive health insurance. Provisions include a small business tax credit to offset premium costs for firms that offer coverage starting this taxable year, establishment of state-based insurance exchanges that promise to lower administrative costs and pool risk more broadly, and creation of new market rules and an essential benefit standard to protect small firms and their workers. Analysis shows that up to 16.6 million workers are in firms that would be eligible for the tax credit in 2010 to 2013. Over the next 10 years, small businesses and organizations could receive an estimated $40 billion in federal support through the premium credit program.

  1. Balancing adequacy and affordability?: Essential Health Benefits under the Affordable Care Act.

    PubMed

    Haeder, Simon F

    2014-12-01

    The Essential Health Benefits provisions under the Affordable Care Act require that eligible plans provide coverage for certain broadly defined service categories, limit consumer cost-sharing, and meet certain actuarial value requirements. Although the Department of Health and Human Services (HHS) was tasked with the regulatory development of these EHB under the ACA, the department quickly devolved this task to the states. Not surprisingly, states fully exploited the leeway provided by HHS, and state decision processes and outcomes differed widely. However, none of the states took advantage of the opportunity to restructure fundamentally their health insurance markets, and only a very limited number of states actually included sophisticated policy expertise in their decisionmaking processes. As a result, and despite a major expansion of coverage, the status quo ex ante in state insurance markets was largely perpetuated. Decisionmaking for the 2016 revisions should be transparent, included a wide variety of stakeholders and policy experts, and focus on balancing adequacy and affordability. However, the 2016 revisions provide an opportunity to address these previous shortcomings.

  2. Child effects and child care: Implications for risk and adjustment.

    PubMed

    Snell, Emily K; Hindman, Annemarie H; Belsky, Jay

    2015-11-01

    Evocative effects of child characteristics on the quality and quantity of child care were assessed in two studies using longitudinal data from the NICHD Study of Early Child Care. We focus on the influence of child characteristics on two important aspects of the child care experience: language stimulation provided by caregivers and quantity of care. In Study 1, associations between the developmental status of children aged 15 to 54 months and the language stimulation provided by their caregivers were examined using path models, and longitudinal child effects were detected across the earliest time points of the study. In Study 2, the associations among child behavior, temperament, development, and time in care were examined. Little evidence was found for such child effects on time in care. The results are discussed in terms of the effects of child care on child development and implications for developmental processes, particularly for children at greatest risk for developmental delay or psychopathology.

  3. Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture

    PubMed Central

    Johnson, Eric J.; Hassin, Ran; Baker, Tom; Bajger, Allison T.; Treuer, Galen

    2013-01-01

    Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a “smart” default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year. PMID:24367484

  4. 77 FR 18309 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ...This final rule will implement the new Affordable Insurance Exchanges (``Exchanges''), consistent with title I of the Patient Protection and Affordable Care Act of 2010 as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for individuals and small employers to directly......

  5. 76 FR 41865 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ...This proposed rule would implement the new Affordable Insurance Exchanges (``Exchanges''), consistent with title I of the Patient Protection and Affordable Care Act of 2010 (Pub. L. 111-148) as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152), referred to collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for......

  6. 78 FR 20581 - Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-05

    ... HUMAN SERVICES 45 CFR Part 155 RIN 0938-AR75 Patient Protection and Affordable Care Act; Exchange... state or Exchange must not prevent the application of the provisions of title I of the Affordable Care.... Introduction The Patient Protection and Affordable Care Act (Pub. L. 111-148) was enacted on March 23,...

  7. 76 FR 59702 - Notice of Intent To Award Affordable Care Act (ACA) Funding

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act... Services (HHS). ACTION: Notice. Overview Information Notice of Intent to Award Affordable Care Act (ACA...: This notice provides public announcement of CDC's intent to award Affordable Care Act...

  8. 77 FR 16501 - Certain Preventive Services Under the Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ...-AR42 Certain Preventive Services Under the Affordable Care Act AGENCIES: Internal Revenue Service... regarding certain preventive health services under provisions of the Patient Protection and Affordable Care Act (Affordable Care Act). The proposed amendments would establish alternative ways to fulfill...

  9. 78 FR 65045 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, Premium Stabilization...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ...This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines financial integrity and oversight standards with respect to Affordable Insurance Exchanges, qualified health plan (QHP) issuers in Federally-facilitated......

  10. Dental care - child

    MedlinePlus

    ... hygiene. In: Dean JA, ed. McDonald and Avery's Dentistry for the Child and Adolescent . 10th ed. St. ... Updated by: Michael Kapner, DDS, general and aesthetic dentistry, Norwalk Medical Center, Norwalk, CT. Review provided by ...

  11. Guaranteeing Quality in Child Care.

    ERIC Educational Resources Information Center

    Morgan, Gwen G.

    This paper presents a discussion of state and federal licensing and regulation of child care services. A hierarchy of the kinds of regulation is defined: (1) basic preventive/protective requirements (related to zoning, fire and safety, sanitation, and basic day care licensing); (2) administrative standards for publicly operated programs (equal to…

  12. Family Child Care Home Standards.

    ERIC Educational Resources Information Center

    Nebraska State Dept. of Health and Human Services, Lincoln.

    This guide enumerates regulations for anyone caring for four or more children at any one time in their home, from families other than their own, in the state of Nebraska. The purpose of the regulations is to protect and promote the health and safety of children in home based child care. The first section of the guide lists specific regulations for…

  13. Health Care Disparities in the Post–Affordable Care Act Era

    PubMed Central

    Preston, Michael A.; Gonzales, Gilbert

    2015-01-01

    Disparities in health care have been targeted for elimination by federal agencies and professional organizations, including the American Public Health Association. Although the Affordable Care Act (ACA) provides a valuable first step in reducing the disparities gap, progress is contingent upon whether opportunities in the ACA help or hinder populations at risk for impaired health and limited access to medical care. PMID:25879149

  14. Women and the Affordable Care Act of 2010.

    PubMed

    Collins, Sara R; Rustgi, Sheila D; Doty, Michelle M

    2010-07-01

    This issue brief analyzes how, over the next decade, the Affordable Care Act (ACA) is likely to stabilize and reverse women's growing exposure to health care costs. Up to 15 million women who now are uninsured could gain subsidized coverage under the law. In addition, 14.5 million insured women will benefit from provisions that improve coverage or reduce premiums. Women who have coverage through the individual insurance market and are charged higher premiums than men, who have been unable to secure coverage for the cost of pregnancy, or who have a preexisting health condition excluded from their benefits will ultimately find themselves on a level playing field with men, enjoying a full range of comprehensive benefits.

  15. The Future of the Affordable Care Act and Insurance Coverage.

    PubMed

    Glied, Sherry; Jackson, Adlan

    2017-04-01

    We describe the patterns of coverage gains associated with the Affordable Care Act (ACA) expansions and use these patterns to assess the potential impact of alternative repeal or repeal and replace strategies because Congress and the president are weighing options to repeal or replace the ACA. We find that specific provisions of the ACA, including the Medicaid expansion and the structure of premium subsidies, have been associated with large and robust gains in insurance coverage. We evaluate the impact of retaining dependent coverage and high-risk pool provisions and show, on the basis of the ACA experience, that these provisions would have little effect on coverage. We find that many replacement proposal components, including flat tax credits and maintaining cost savings provisions, could jeopardize the ability of many of the ACA's primary beneficiaries, as well as other Americans, to access coverage and care. By leading to a deterioration of the safety net, these strategies could also imperil population health activities.

  16. Delivery of affordable and equitable cancer care in India.

    PubMed

    Pramesh, C S; Badwe, Rajendra A; Borthakur, Bibhuti B; Chandra, Madhu; Raj, Elluswami Hemanth; Kannan, T; Kalwar, Ashok; Kapoor, Sanjay; Malhotra, Hemant; Nayak, Sukdev; Rath, Goura K; Sagar, T G; Sebastian, Paul; Sarin, Rajiv; Shanta, V; Sharma, Suresh C; Shukla, Shilin; Vijayakumar, Manavalan; Vijaykumar, D K; Aggarwal, Ajay; Purushotham, Arnie; Sullivan, Richard

    2014-05-01

    The delivery of affordable and equitable cancer care is one of India's greatest public health challenges. Public expenditure on cancer in India remains below US$10 per person (compared with more than US$100 per person in high-income countries), and overall public expenditure on health care is still only slightly above 1% of gross domestic product. Out-of-pocket payments, which account for more than three-quarters of cancer expenditures in India, are one of the greatest threats to patients and families, and a cancer diagnosis is increasingly responsible for catastrophic expenditures that negatively affect not only the patient but also the welfare and education of several generations of their family. We explore the complex nature of cancer care systems across India, from state to government levels, and address the crucial issues of infrastructure, manpower shortages, and the pressing need to develop cross-state solutions to prevention and early detection of cancer, in addition to governance of the largely unregulated private sector and the cost of new technologies and drugs. We discuss the role of public insurance schemes, the need to develop new political mandates and authority to set priorities, the necessity to greatly improve the quality of care, and the drive to understand and deliver cost-effective cancer care programmes.

  17. Employer Child Care Languishes--Awaiting Economic Upturn--Status Report #13 on Employer Child Care.

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2003-01-01

    Considers economic factors in the development of employer child care, noting the expansion of two large child care provision corporations despite slow economic growth and changes for smaller child care providers. Quotes program administrators on trends in employer child care services and provides a list of the 14 largest employer child care…

  18. [Music therapy and child care].

    PubMed

    Chang, Shu-Min; Sung, Huei-Chuan

    2005-12-01

    Music therapy was shown many years ago to have positive effects in various age groups of patients in the Western world. Music can produce physiological and psychological effects, including changes in the vital signs, reductions in anxiety, improvements in the immune system, decreases in cortisol levels, the reduction of stress and the promotion of well-being. Music therapy is an inexpensive and effective intervention for nurses to apply to patients. The application of such therapy to children, however, is different from that to adults due to their limited cognitive and language development. In Taiwan, nurses' knowledge of music therapy is limited, and it is rarely used in child care. This article introduces music therapy and its effects in child care, such as in premature infants, children in emergency care, handicapped children, and children receiving surgery. Music therapy is often used as an assisted intervention for patient care in clinical settings. Health care professionals can perform some of the music therapy activities for patients appropriately even if they have not been trained in music. This article aims to improve nurses' knowledge of music therapy and to provide a useful reference for those involved in child care.

  19. The Affordable Care Act, remedy, and litigation reform.

    PubMed

    Maher, Brendan S

    2014-01-01

    The Patient Protection and Affordable Care Act of 2010 (ACA) rewrote the law of private health insurance. How the ACA rewrote the law of civil remedies, however, is a question largely unexamined by scholars. Courts everywhere, including the U.S. Supreme Court, will soon confront this important issue. This Article offers a foundational treatment of the ACA on remedy. It predicts a series of flashpoints over which litigation reform battles will be fought. It identifies several themes that will animate those conflicts and trigger others. It explains how judicial construction of the statute's functional predecessor, the Employee Retirement Income Security Act of 1974 (ERISA), converted a protective statute into a uniquely effective piece of federal litigation reform. Ultimately, it considers whether the ACA--which incorporates, modifies, and rejects ERISA in several notable ways--will experience a similar fate.

  20. Child Development, Care, and Guidance.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin. Dept. of Occupational Education and Technology.

    This teacher's guide on child development, care, and guidance is one of seven subject area guides developed for use in consumer and homemaking education in secondary schools in Texas. The guide is correlated with the "Conceptual Framework for Consumer and Homemaking Education in Texas." Content is based on the competencies needed by…

  1. Innovating affordable neonatal care equipment for use at scale

    PubMed Central

    Sashi Kumar, V; Paul, V K; Sathasivam, K

    2016-01-01

    The care of small and sick neonates requires biomedical technologies, such as devices that can keep babies warm (radiant warmers and incubators), resuscitate (self-inflating bags), track growth (weighing scales), treat jaundice (phototherapy units) and provide oxygen or respiratory support (hoods, continuous positive airway pressure (CPAP) devices and ventilators). Until the 1990s, most of these products were procured through import at a high cost and with little maintenance support. Emerging demand and an informal collaboration of neonatologists, engineers and entrepreneurs has led to the production of good quality equipment of several high-volume categories at affordable cost in India. Radiant warmers, resuscitation bags, phototherapy units, weighing scales and other devices manufactured by Indian small-scale companies have enabled an expansion of neonatal care in the country, particularly in district hospitals, medical college hospitals and subdistrict facilities in the public sector as a part of the National Rural Health Mission. Indian products have acquired international quality standards and are even exported to developed nations. This paper captures this story of innovation and entrepreneurship in neonatal care. PMID:27924105

  2. On Medicaid and the Affordable Care Act in Connecticut

    PubMed Central

    Manthous, Constantine A.; Sofair, Andre N.

    2014-01-01

    Background: Medicaid is the federal program, administered by states, for health care for the poor. The Affordable Care Act (ACA) has added a large number of new recipients to this program. Hypothesis: Medicaid programs in some, if not many, states do not provide patients uniform access to subspecialty care guaranteed by the federal statutes. Insofar as the ACA does not address this pre-existing “sub-specialty gap” and more patients are now covered by Medicaid under the ACA, the gap is likely to increase and may contribute to disparities of health care access and outcomes. Methods: A brief description of previous studies demonstrating or suggesting a subspecialty gap in Medicaid services is accompanied by perspectives of the authors, using published literature — most notably the Denver, Colorado health care system — to propose various solutions that may be deployed to address gaps in subspecialty coverage. Results: All published studies describing the Medicaid subspecialty gap are qualitative, survey designs. There are no authoritative objective data regarding the exact prevalence of gaps for each subspecialty in each state. However, surveys of caregivers suggest that gaps were prevalent in the United States prior to initiation of the ACA. Even fewer papers have addressed solutions (in light of the paucity of data describing the magnitude of the problem), and proposed solutions remain speculative and not grounded in objective data. Conclusions: There is reason to believe that a substantial proportion of U.S. citizens — those who are guaranteed a full complement of health services through Medicaid — have difficult or no access to some subspecialty services, many of which other citizens take for granted. This problem deserves greater attention to verify its existence, quantify its magnitude, and develop solutions. PMID:25506291

  3. Kindergarten Child Care Experiences and Child Achievement and Socioemotional Skills

    ERIC Educational Resources Information Center

    Claessens, Amy

    2012-01-01

    Young children's experiences outside of both home and school are important for their development. As women have entered the labor force, child care has become an increasingly important context for child development. Child care experiences prior to school entry have been well-documented as important influences on children's academic and…

  4. Home Child Care: A Caregiver's Guide.

    ERIC Educational Resources Information Center

    Dunster, Lee

    Intended for those already providing home child care or those considering becoming a caregiver in Canada, this book provides practical ideas and advice covering the many areas involved in home child care, from organization of the home to resources available to the provider. Chapter 1 describes how home child care can be provided, how to adapt to…

  5. Shared Heritage: An Intergenerational Child Care Program.

    ERIC Educational Resources Information Center

    Hawkeye Area Community Action Program, Cedar Rapids, IA.

    This report describes ways in which older persons may become involved in the field of home child care. It is intended to provide (1) detailed information on an intergenerational child care (IGCC) program; (2) general information relating to intergenerational contacts and home child care; and (3) "how-to" information for agencies planning…

  6. Family Child Care Licensing Study, 1998.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    This report details a survey of state child care regulatory agencies. Data on both small family child care homes (FCCH) and group or large family child care homes (LCCH or GCCH) are included and organized into 22 categories: (1) number of regulated homes; (2) definitions and regulatory requirements; (3) unannounced inspection procedure; (4)…

  7. Family Child Care Licensing Study, 1997.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    This report details the findings of an annual survey of state child care regulatory agencies. The survey gathered data on both small family child care homes and group or large family child care homes in each of the 50 states, the District of Columbia, Puerto Rico and the Virgin Islands. The report's introduction lists the survey categories and…

  8. Professional Child and Youth Care. Second Edition.

    ERIC Educational Resources Information Center

    Ferguson, Roy, Ed.; And Others

    This book provides a comprehensive analysis of the child and youth care field in Canada. It covers a spectrum of key concerns within the field of child and youth care, and presents an analysis that spans a variety of program areas. The 12 chapters in the book are: (1) "The Scope of Child and Youth Care in Canada" (Roy Ferguson and…

  9. Child Care Lead Poisoning Prevention. Training Curriculum.

    ERIC Educational Resources Information Center

    California Dept. of Health Services, Oakland. Childhood Lead Poisoning Prevention Branch.

    In an effort to address young children's substantial risk for exposure to lead in out-of-home child care programs, outreach and training were developed for child care providers. This workshop curriculum consists of training activities and materials appropriate for child care providers in centers or homes for the purpose of educating them about the…

  10. Child Care by Design: Resource Guide.

    ERIC Educational Resources Information Center

    Schmidt, Lori, Ed.

    In Canada today, more than a million children spend a large portion of their preschool years in child care outside the immediate family. The design of a child care center's physical facility has a major impact on the quality of interactions that take place within it. Intended to assist design and child care professionals who are building a new…

  11. Child Care Bulletin. Issue 33, Summer 2007

    ERIC Educational Resources Information Center

    Shillady, Amy, Ed.

    2007-01-01

    The "Child Care Bulletin" is published quarterly and includes practical, informative articles based on current literature regarding topics important to policy-makers, child care providers, and parents. The Bulletin includes short articles, tips sheets, policy updates, interviews with leaders in the child care field, information from child…

  12. Employer Child Care Growth Slows with the Economy--Status Report #12 on Employer Child Care.

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2002-01-01

    Examines reasons for slowed growth in employer child care over the past two years. Discusses the impact of the economic recession, organizational changes in the largest employer child care management organizations, international acquisitions of the Bright Horizons child care organization, flexible options for the child care benefit, and the…

  13. The Affordable Care Act, health care reform, prescription drug formularies and utilization management tools.

    PubMed

    Ung, Brian L; Mullins, C Daniel

    2015-01-01

    The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability.

  14. Small firm self-insurance under the Affordable Care Act.

    PubMed

    Buettgens, Matthew; Blumberg, Linda J

    2012-11-01

    The Affordable Care Act changes the small-group insurance market substan­tially beginning in 2014, but most changes do not apply to self-insured plans. This exemp­tion provides an opening for small employers with healthier workers to avoid broader sharing of health care risk, isolating higher-cost groups in the fully insured market. Private stop-loss or reinsurance plans can mediate the risk of self-insurance for small employ­ers, facilitating the decision to self-insure. We simulate small-employer coverage decisions under the law and find that low-risk stop-loss policies lead to higher premiums in the fully insured small-group market. Average single premiums would be up to 25 percent higher, if stop-loss insurance with no additional risk to employers than fully insuring is allowed--an option available in most states absent further government action. Regulation of stop-loss at the federal or state level can, however, prevent such adverse selection and increase stabil­ity in small-group insurance coverage.

  15. The Future of the Affordable Care Act and Insurance Coverage

    PubMed Central

    Jackson, Adlan

    2017-01-01

    We describe the patterns of coverage gains associated with the Affordable Care Act (ACA) expansions and use these patterns to assess the potential impact of alternative repeal or repeal and replace strategies because Congress and the president are weighing options to repeal or replace the ACA. We find that specific provisions of the ACA, including the Medicaid expansion and the structure of premium subsidies, have been associated with large and robust gains in insurance coverage. We evaluate the impact of retaining dependent coverage and high-risk pool provisions and show, on the basis of the ACA experience, that these provisions would have little effect on coverage. We find that many replacement proposal components, including flat tax credits and maintaining cost savings provisions, could jeopardize the ability of many of the ACA’s primary beneficiaries, as well as other Americans, to access coverage and care. By leading to a deterioration of the safety net, these strategies could also imperil population health activities. PMID:28207344

  16. 78 FR 13405 - Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-27

    ...This final rule implements provisions related to fair health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and catastrophic plans, consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The final rule......

  17. 76 FR 52663 - Notice of Intent To Award Affordable Care Act Funding, DP-09-001

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... Care Act Funding, DP-09-001 AGENCY: Centers for Disease Control and Prevention (CDC), Department of... Centers (U48).'' It is the intent of CDC to fund the applications with Patient Protection Affordable Care... 4002 of the Patient Protection and Affordable Care Act (Pub. L. 111-148.). DATES: The effective...

  18. 76 FR 20352 - Notice of Intent To Award Affordable Care Act (ACA) Funding

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act (ACA) Funding Notice of Intent to award Affordable Care Act (ACA) funding to two Emerging Infections... Care Act (ACA) appropriations to the Connecticut Department of Public Health and the Georgia...

  19. Child and family safety device affordability by country income level: an 18 country comparison

    PubMed Central

    Hendrie, D; Miller, T; Orlando, M; Spicer, R; Taft, C; Consunji, R; Zaloshnja, E

    2004-01-01

    Objective: To compare availability, urban price, and affordability of child/family safety devices between 18 economically diverse countries. Design: Descriptive: urban price surveys by local safety organisations or shoppers. Setting: Retail stores and internet vendors. Main outcome measures: Prices expressed in US dollars, and affordability measured by hours of factory work needed to buy a child safety seat, a belt-positioning booster seat, a child bicycle helmet, and a smoke alarm. Results: Prices of child and family safety devices varied widely between countries but the variation for child safety seats and bicycle helmets did not relate strongly to country income. Safety devices were expensive, often prohibitively so, in lower income countries. Far more hours of factory work were required to earn a child safety device in lower income than middle income, and middle income than higher income, countries. A bicycle helmet, for example, cost 10 hours of factory work in lower income countries but less than an hour in higher income countries. Smoke alarms and booster seats were not available in many lower income countries. Conclusions: Bicycles and two-axle motor vehicles were numerous in lower and middle income countries, but corresponding child safety devices were often unaffordable and sometimes not readily available. The apparent market distortions and their causes merit investigation. Advocacy, social marketing, local device production, lowering of tariffs, and mandatory use legislation might stimulate market growth. Arguably, a moral obligation exists to offer subsidies that give all children a fair chance of surviving to adulthood. PMID:15583254

  20. Who Cares for Kids? A Report on Child Care Providers.

    ERIC Educational Resources Information Center

    Benson, Carolyn

    This study offers a profile of child care workers in family day care homes and child care centers, reporting general statistics and examining their wages, benefits, training, working conditions, and turnover rates. In addition, it looks at government regulation and licensing, employer-sponsored programs, child abuse, insurance rates, and federal…

  1. Quality or Affordability: Trade-Offs for Early Childhood Programs? ERIC Digest.

    ERIC Educational Resources Information Center

    Willer, Barbara

    The demand for child care services in the United States continues to grow, stretching the levels of program quality to the limit. In fact, the country is facing a crisis in child care. Affordable child care continues to be a major issue for many families. Solutions to the current crisis in child care must, in addition to insuring affordability,…

  2. The Relevance of the Affordable Care Act for Improving Mental Health Care.

    PubMed

    Mechanic, David; Olfson, Mark

    2016-01-01

    Provisions of the Affordable Care Act provide unprecedented opportunities for expanded access to behavioral health care and for redesigning the provision of services. Key to these reforms is establishing mental and substance abuse care as essential coverage, extending Medicaid eligibility and insurance parity, and protecting insurance coverage for persons with preexisting conditions and disabilities. Many provisions, including Accountable Care Organizations, health homes, and other structures, provide incentives for integrating primary care and behavioral health services and coordinating the range of services often required by persons with severe and persistent mental health conditions. Careful research and experience are required to establish the services most appropriate for primary care and effective linkage to specialty mental health services. Research providing guidance on present evidence and uncertainties is reviewed. Success in redesign will follow progress building on collaborative care and other evidence-based practices, reshaping professional incentives and practices, and reinvigorating the behavioral health workforce.

  3. Commercial pressures on professionalism in american medical care: from Medicare to the Affordable Care Act.

    PubMed

    Marmor, Theodore R; Gordon, Robert W

    2014-01-01

    Since the passage of Medicare, the self-regulation characteristic of professionalism in health care has come under steady assault. While Canadian physicians chose to relinquish financial autonomy, they have enjoyed far greater professional autonomy over their medical judgments than their U.S. counterparts who increasingly have their practices micromanaged. The Affordable Care Act illustrates the ways that managerial strategies and a market model of health care have shaped the financing and delivery of health care in the U.S., often with little or no evidence of their effectiveness.

  4. Twitter Sentiment Predicts Affordable Care Act Marketplace Enrollment

    PubMed Central

    Sap, Maarten; Schwartz, Andrew; Town, Robert; Baker, Tom; Ungar, Lyle; Merchant, Raina M

    2015-01-01

    Background Traditional metrics of the impact of the Affordable Care Act (ACA) and health insurance marketplaces in the United States include public opinion polls and marketplace enrollment, which are published with a lag of weeks to months. In this rapidly changing environment, a real-time barometer of public opinion with a mechanism to identify emerging issues would be valuable. Objective We sought to evaluate Twitter’s role as a real-time barometer of public sentiment on the ACA and to determine if Twitter sentiment (the positivity or negativity of tweets) could be predictive of state-level marketplace enrollment. Methods We retrospectively collected 977,303 ACA-related tweets in March 2014 and then tested a correlation of Twitter sentiment with marketplace enrollment by state. Results A 0.10 increase in the sentiment score was associated with an 8.7% increase in enrollment at the state level (95% CI 1.32-16.13; P=.02), a correlation that remained significant when adjusting for state Medicaid expansion (P=.02) or use of a state-based marketplace (P=.03). Conclusions This correlation indicates Twitter’s potential as a real-time monitoring strategy for future marketplace enrollment periods; marketplaces could systematically track Twitter sentiment to more rapidly identify enrollment changes and potentially emerging issues. As a repository of free and accessible consumer-generated opinions, this study reveals a novel role for Twitter in the health policy landscape. PMID:25707038

  5. The Creative Curriculum for Family Child Care.

    ERIC Educational Resources Information Center

    Dodge, Diane Trister; Colker, Laura J.

    Designed to provide practical and comprehensive assistance to family child care providers in a range of settings, this curriculum consists of two parts. Part 1, Setting the Stage, helps caregivers formulate a philosophy of child care, understand child development, prepare their homes, and plan their programs. It includes many ideas for making the…

  6. 77 FR 29235 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-17

    ... HUMAN SERVICES 45 CFR Part 153 RIN 0938-AR07 Patient Protection and Affordable Care Act; Standards... ] entitled, ``Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors... section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we can waive...

  7. Child Care Subsidy Use and Child Development: Potential Causal Mechanisms

    ERIC Educational Resources Information Center

    Hawkinson, Laura E.

    2011-01-01

    Research using an experimental design is needed to provide firm causal evidence on the impacts of child care subsidy use on child development, and on underlying causal mechanisms since subsidies can affect child development only indirectly via changes they cause in children's early experiences. However, before costly experimental research is…

  8. Employer Child Care Growth and Consolidation Continues: Status Report #11 on Employer Child Care.

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2001-01-01

    Delineates significant developments in the employer- sponsored child care arena. Highlights predictions from chief executive officers of the largest employer child care organizations for the most significant trends in employer child care: slowing growth, consolidation, increasing demands for back-up care, globalization, and multi-site strategies.…

  9. Affordable Care Act risk adjustment: overview, context, and challenges.

    PubMed

    Kautter, John; Pope, Gregory C; Keenan, Patricia

    2014-01-01

    Beginning in 2014, individuals and small businesses will be able to purchase private health insurance through competitive marketplaces. The Affordable Care Act (ACA) provides for a program of risk adjustment in the individual and small group markets in 2014 as Marketplaces are implemented and new market reforms take effect. The purpose of risk adjustment is to lessen or eliminate the influence of risk selection on the premiums that plans charge and the incentive for plans to avoid sicker enrollees. This article--the first of three in the Medicare & Medicaid Research Review--describes the key program goal and issues in the Department of Health and Human Services (HHS) developed risk adjustment methodology, and identifies key choices in how the methodology responds to these issues. The goal of the HHS risk adjustment methodology is to compensate health insurance plans for differences in enrollee health mix so that plan premiums reflect differences in scope of coverage and other plan factors, but not differences in health status. The methodology includes a risk adjustment model and a risk transfer formula that together address this program goal as well as three issues specific to ACA risk adjustment: 1) new population; 2) cost and rating factors; and 3) balanced transfers within state/market. The risk adjustment model, described in the second article, estimates differences in health risks taking into account the new population and scope of coverage (actuarial value level). The transfer formula, described in the third article, calculates balanced transfers that are intended to account for health risk differences while preserving permissible premium differences.

  10. Health Update: Care of Ill Children in Child Care Programs.

    ERIC Educational Resources Information Center

    Aronson, Susan S.

    1987-01-01

    Discusses differing opinions about (1) exclusion of ill children from child care; (2) the meaning of fever; (3) appropriate care for ill children; (4) transfer of information about ill children in child care; and (5) written policies and procedures for care of ill children. (NH)

  11. Are Marketplace Plans Affordable? Consumer Perspectives from the Commonwealth Fund Affordable Care Act Tracking Survey, March-May 2015.

    PubMed

    Collins, Sara R; Gunja, Munira; Rasmussen, Petra W; Doty, Michelle M; Beutel, Sophie

    2015-09-01

    Most employers who provide health insurance to employees subsidize their premiums and provide a comprehensive benefit package. Before the Affordable Care Act, people who lacked health insurance through a job and purchased it on their own paid the full cost of their plans, which often came with skimpy benefit packages and high deductibles. Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, March--May 2015, indicate that the law's tax credits have made premium costs in health plans sold through the marketplaces roughly comparable to employer plans, at least for people with low and moderate incomes. At higher incomes, the phase-out of the subsidies means that adults in marketplace plans have higher premium costs than those in employer plans. Overall, larger shares of adults in marketplace plans reported deductibles of $1,000 or more, compared with those in employer plans, though these differences were narrower among low-and moderate-income adults.

  12. 5 CFR 792.200 - What are the benefits of the child care subsidy program law?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... subsidy program law? 792.200 Section 792.200 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... subsidy program law? Sec. 630 of Public Law 107-67 permits executive agencies to use appropriated funds to improve the affordability of child care for lower income Federal employees. The law applies to child...

  13. The Patient Protection and Affordable Care Act: what every provider of gynecologic oncology care should know.

    PubMed

    Duska, Linda R; Engelhard, Carolyn L

    2013-06-01

    The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama in 2010. While initial implementation of the law began shortly thereafter, the full implementation will take place over the next few years. With respect to cancer care, the act was intended to make care more accessible, affordable, and comprehensive across different parts of the country. For our cancer patients and our practices, the ACA has implications that are both positive and negative. The Medicaid expansion and access to insurance exchanges are intended to increase the number of insured patients and thus improve access to care, but many states have decided to opt out of the Medicaid program and in these states access problems will persist. Screening programs will be put in place for insured patients but may supplant federally funded programs that are currently in place for uninsured patients and may not follow current screening guidelines. Both hospice and home health providers will be asked to provide more services with less funding, and quality measures, including readmission rates, will factor into reimbursement. Insured patients will have access to all phases of clinical trial research. There is a need for us as providers of Gynecologic Oncology care to be active in the implementation of the ACA in order to ensure that our patients and our practices can survive and benefit from the changes in health care reimbursement, with the ultimate goals of improving access to care and quality while reducing unsustainable costs.

  14. Leveraging the Affordable Care Act to improve the health of mothers and newborns.

    PubMed

    Grande, David; Srinivas, Sindhu K

    2013-06-01

    Health insurance in the United States is a patchwork system whereby opportunities for coverage are strongly associated with life circumstances (ie, age, income, pregnancy, parental status). For pregnant women, this situation contributes to unstable coverage before, between, and after pregnancies. The Affordable Care Act has the potential to make coverage for women of reproductive age more stable and create new opportunities to intervene on conditions associated with maternal and neonatal morbidity. In this article, we discuss the health economics of the Affordable Care Act, its implications for maternal and neonatal health, specific challenges associated with implementation, and opportunities for obstetricians to leverage the Affordable Care Act to improve the care of women.

  15. Child Care and Other Support Programs

    ERIC Educational Resources Information Center

    Floyd, Latosha; Phillips, Deborah A.

    2013-01-01

    The U.S. military has come to realize that providing reliable, high-quality child care for service members' children is a key component of combat readiness. As a result, the Department of Defense (DoD) has invested heavily in child care. The DoD now runs what is by far the nation's largest employer-sponsored child-care system, a sprawling network…

  16. What Health Care Reform Means for Immigrants: Comparing the Affordable Care Act and Massachusetts Health Reforms.

    PubMed

    Joseph, Tiffany D

    2016-02-01

    The 2010 Patient Protection and Affordable Care Act (ACA) was passed to provide more affordable health coverage to Americans beginning in 2014. Modeled after the 2006 Massachusetts health care reform, the ACA includes an individual mandate, Medicaid expansion, and health exchanges through which middle-income individuals can purchase coverage from private insurance companies. However, while the ACA provisions exclude all undocumented and some documented immigrants, Massachusetts uses state and hospital funds to extend coverage to these groups. This article examines the ACA reform using the Massachusetts reform as a comparative case study to outline how citizenship status influences individuals' coverage options under both policies. The article then briefly discusses other states that provide coverage to ACA-ineligible immigrants and the implications of uneven ACA implementation for immigrants and citizens nationwide.

  17. Multiple Child Care Arrangements and Child Well Being: Early Care Experiences in Australia

    ERIC Educational Resources Information Center

    Claessens, Amy; Chen, Jen-Hao

    2013-01-01

    Nearly one quarter of Australian children under the age of 5 experience multiple non-parental child care arrangements. Research focused on the relationship between multiple child care arrangements and child socioemotional development is limited, particularly in Australia. Evidence from the United States and Europe has linked multiple child care…

  18. Implementing the Affordable Care Act: The Promise and Limits of Health Care Reform.

    PubMed

    Oberlander, Jonathan

    2016-08-01

    The Obama administration has confronted a formidable array of obstacles in implementing the Affordable Care Act (ACA). The ACA has overcome those obstacles to substantially expand access to health insurance, though significant problems with its approach have emerged. What does the ACA's performance to date tell us about the possibilities and limits of health care reform in the United States? I identify key challenges in ACA implementation-the inherently disruptive nature of reform, partisan polarization, the limits of "near universal" coverage, complexity, and divided public opinion-and analyze how these issues have shaped its evolution. The article concludes by exploring the political and policy challenges that lie ahead for the ACA.

  19. Infant Child Care and Attachment Security: Results of the NICHD Study of Early Child Care.

    ERIC Educational Resources Information Center

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD. Early Child Care Network.

    A longitudinal study explored the effects of different aspects of child care on infants' attachment security. Child care variables examined included age of entry; the quality, amount, stability, and type of care; and mother's sensitivity to the child's needs. When the validity of the Strange Situation was tested by comparing children with low and…

  20. Family Child Care Licensing Study, 1996. National Child Care Advocacy Project.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    This report presents the results of a nationwide survey of state agencies charged with regulating or licensing family child care. An introduction contains information on survey methodology, a summary of regulatory requirements for family child care homes and group (large) child care homes, and a survey question and answer summary. The body of the…

  1. Family Child Care Licensing Study, 1995: National Child Care Advocacy Project.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    This report presents the results of a nationwide survey of state agencies charged with regulating or licensing family child care. An introduction contains information on survey methodology, a summary of regulatory requirements for family child care homes and group (large) child care homes, and a survey question and answer summary. The body of the…

  2. Financing Child Care: Current Arrangements. Report of the Task Force on Child Care: Series 1.

    ERIC Educational Resources Information Center

    Townson, Monica; And Others

    The five research studies in this volume focus on the financing of child care, and constitute part of a detailed analysis of issues relevant to child care and parental leave policies and the effects of such issues on the Canadian family. Paper 1 describes how child care is funded through the Canada Assistance Plan (CAP); points out the problems…

  3. The Impact of Child Care Subsidy Use on Child Care Quality

    ERIC Educational Resources Information Center

    Ryan, Rebecca M.; Johnson, Anna; Rigby, Elizabeth; Brooks-Gunn, Jeanne

    2011-01-01

    In 2008, the federal government allotted $7 billion in child care subsidies to low-income families through the state-administered Child Care and Development Fund (CCDF), now the government's largest child care program (US DHHS, 2008). Although subsidies reduce costs for families and facilitate parental employment, it is unclear how they impact the…

  4. Child Care Reacts to Hugo and the Quake. Dateline Child Care.

    ERIC Educational Resources Information Center

    Child Care Information Exchange, 1990

    1990-01-01

    Describes the effects of Hurricane Hugo and the San Francisco earthquake on child care and child care centers and the responses of the centers to the disasters. Announces the openings of new child care centers and an expansion of Head Start.(RJC)

  5. Iowa Child Care Quality Rating System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    ERIC Educational Resources Information Center

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Iowa's Child Care Quality Rating System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile is divided into the following categories: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for Family Child Care Programs;…

  6. The Journey from Babysitter to Child Care Professional: Military Family Child Care Providers.

    ERIC Educational Resources Information Center

    Nielsen, Dianne Miller

    2002-01-01

    Describes the transformation of women from babysitters to child care professionals as a result of becoming a family child care provider in the U.S. military Family Child Care (FCC) program. Discusses application process, orientation training, the use of peer mentors, initial setup, inspections, enrollment, caregiver training, and accreditation.…

  7. Do Child Care Regulations Affect the Child Care and Labor Markets?

    ERIC Educational Resources Information Center

    Blau, David M.

    2003-01-01

    The effect of child care regulations on outcomes in the child care market and the labor market for mothers of young children is examined. The analysis uses a time series of cross sections and examines the robustness of previous cross-section findings to controls for state-level heterogeneity. Child care regulations as a group have statistically…

  8. The Politics of Native American Health Care and the Affordable Care Act.

    PubMed

    Skinner, Daniel

    2016-02-01

    This article examines an important but largely overlooked dimension of the Patient Protection and Affordable Care Act (ACA), namely, its significance for Native American health care. The author maintains that reading the ACA against the politics of Native American health care policy shows that, depending on their regional needs and particular contexts, many Native Americans are well-placed to benefit from recent Obama-era reforms. At the same time, the kinds of options made available by the ACA constitute a departure from the service-based (as opposed to insurance-based) Indian Health Service (IHS). Accordingly, the author argues that ACA reforms--private marketplaces, Medicaid expansion, and accommodations for Native Americans--are best read as potential "supplements" to an underfunded IHS. Whether or not Native Americans opt to explore options under the ACA will depend in the long run on the quality of the IHS in the post-ACA era. Beyond understanding the ACA in relation to IHS funding, the author explores how Native American politics interacts with the key tenets of Obama-era health care reform--especially "affordability"--which is critical for understanding what is required from and appropriate to future Native American health care policy making.

  9. Financial Health of Child Care Facilities Affects Quality of Care.

    ERIC Educational Resources Information Center

    Brower, Mary R.; Sull, Theresa M.

    2003-01-01

    Contends that child care facility owners, boards of directors, staff, and parents need to focus on financial management, as poor financial health compromises the quality of care for children. Specifically addresses the issues of: (1) concern for providing high quality child care; (2) the connection between quality and money; and (3) strengthening…

  10. The Child Care Connection: Reaching Children in Day Care.

    ERIC Educational Resources Information Center

    Dworkin, Judith Daniels

    1993-01-01

    Describes the Child Care Connection, a public library project serving preschool children by providing hard-to-reach home day-care providers with bags of children's materials. Details of planning, funding, delivery of materials, and evaluation are provided. A sample of the thematic book list for Child Care Connection Kits is appended. (KRN)

  11. Child Care Quality in Different State Policy Contexts

    ERIC Educational Resources Information Center

    Rigby, Elizabeth; Ryan, Rebecca M.; Brooks-Gunn, Jeanne

    2007-01-01

    Using data from the Child Care Supplement to the Fragile Families and Child Wellbeing Study, we test associations between the quality of child care and state child care policies. These data, which include observations of child care and interviews with care providers and mothers for 777 children across 14 states, allow for comparisons across a…

  12. Child Care Is Good Business: An Agenda for Fort Wayne.

    ERIC Educational Resources Information Center

    Van Leuven, Patricia O'Brien

    Background information and recommendations related to the support of child care services in Fort Wayne, Indiana is presented in six chapters. Chapter I discusses the feminization of the workforce and demographic data bearing on the need for child care, the child care workforce, and child care arrangements. Chapter II reviews child care services in…

  13. Child Care: State Requirements for Background Checks.

    ERIC Educational Resources Information Center

    Fagnoni, Cynthia

    Background checks involve gathering information from state and federal databases to determine if child care providers have a history of child abuse or other criminal convictions that would make them unacceptable for working with children. Background checks include state criminal history checks, state child abuse registry checks, and Federal Bureau…

  14. Expansion of Coverage under the Patient Protection and Affordable Care Act and Primary Care Utilization

    PubMed Central

    Hofer, Adam N; Abraham, Jean Marie; Moscovice, Ira

    2011-01-01

    Context: Provisions of the Patient Protection and Affordable Care Act of 2010 (PPACA) expand Medicaid to all individuals in families earning less than 133 percent of the federal poverty level (FPL) and make available subsidies to uninsured lower-income Americans (133 to 400 percent of FPL) without access to employer-based coverage to purchase insurance in new exchanges. Since primary care physicians typically serve as the point of entry into the health care delivery system, an adequate supply of them is critical to meeting the anticipated increase in demand for medical care resulting from the expansion of coverage. This article provides state-level estimates of the anticipated increases in primary care utilization given the PPACA's provisions for expanded coverage. Methods: Using the Medical Expenditure Panel Survey, this article estimates a multivariate regression model of annual primary care utilization. Using the model estimates and state-level information regarding the number of uninsured, it predicts, by state, the change in primary care visits expected from the expanded coverage. Finally, the article predicts the number of primary care physicians needed to accommodate this change in utilization. Findings: This expanded coverage is predicted to increase by 2019 the number of annual primary care visits between 15.07 million and 24.26 million. Assuming stable levels of physicians’ productivity, between 4,307 and 6,940 additional primary care physicians would be needed to accommodate this increase. Conclusions: The PPACA's health insurance expansion parameters are expected to significantly increase the use of primary care. Two strategies that policymakers may consider are creating stronger financial incentives to attract medical school students to primary care and changing the delivery of care in ways that lead to operational improvements, higher throughput, and better quality of care. PMID:21418313

  15. Unionizing: A Guide for Child Care Workers.

    ERIC Educational Resources Information Center

    Whitebook, Marcy; And Others

    Including excerpts from contracts protecting unionized child care workers, this booklet explains basic terminology and facts about unionizing and addresses child care workers' concerns. Section 1 answers commonly asked questions about unions and offers advice about how to answer parents' questions about workers' attempts to organize. Section 2…

  16. Child Care in Sweden: A Comparative Perspective.

    ERIC Educational Resources Information Center

    Jaffe, Kenneth

    This paper describes child care delivery in Sweden, compares aspects of the American and Swedish systems of child care, and identifies what each country can learn from the other. Focusing mainly on the Swedish system, the first section addresses such topics as (1) the role of the State and local districts in program planning and administration,…

  17. Assistant Child Care Teacher: A Teacher's Guide.

    ERIC Educational Resources Information Center

    Staaland, Elaine; Lader, Catherine

    This publication is a guide to Wisconsin's 40-hour high school course for assistant child care teachers. A total of 11 units describe: (1) the child care industry and the services it provides; (2) the arrangement of space and provision of equipment; (3) children's development from birth through 8 years of age; (4) techniques for interacting…

  18. Putting the Spotlight on Child Care.

    ERIC Educational Resources Information Center

    Bancroft, John

    1998-01-01

    Describes the October 1997 White House Conference on Child Care, including points made by major speakers such as President Clinton, the First Lady, Treasury Secretary Robert Rubin, and Health and Human Services Secretary Donna Shalala. Discusses the sobering information about child care quality/availability presented at the conference and the…

  19. Child and Youth Care To-Come

    ERIC Educational Resources Information Center

    Kouri, Scott

    2012-01-01

    The intent of this article is to follow deconstruction as a way to think about the questions that are currently being asked in Child and Youth Care (CYC). As a graduate student in the School of Child and Youth Care at the University of Victoria (SCYC), I am challenged to think my position and identity in terms of my location within, or on the…

  20. Model Child Care Health Policies. Fourth Edition.

    ERIC Educational Resources Information Center

    Aronson, Susan S.

    Drawn from a review of policies at over 100 child care programs nationwide, this document compiles model health policies intended for adaptation and selective use by out-of-home child care facilities. Following an introduction, the document presents model policy forms with blanks for adding individualized information for the following areas: (1)…

  1. The Child's Start in Day Care Centre.

    ERIC Educational Resources Information Center

    Thyssen, Sven

    2000-01-01

    Examined the transition of 10 children to day care. Found that separation from parent was difficult for one child and that a caring teacher, opportunities for exploration, and support in those activities assisted in overcoming separation difficulties. Identified the caregiver-child relationship as important for supporting children in their…

  2. Reconceptualising Child Care in Rural Areas.

    ERIC Educational Resources Information Center

    Morda, Romana; Kapsalakis, Anthoula; Clyde, Margaret

    A study examining child care services in rural and remote areas conducted focus group interviews and distributed questionnaires to parents living in 15 towns in the Mallee region of Western Victoria (Australia). Barriers to accessing child care in rural areas included limited availability of formal services, costs, stereotypes associated with life…

  3. Child Care in the Year 2000.

    ERIC Educational Resources Information Center

    Blank, Helen

    This paper envisions child care problems in the year 2000 and explores their relationship to policies of today. The population entering parenting age in the year 2000 will bear the scars of the inadequate child care policies of the 1980's. New poor and black parents--many of them born to adolescent mothers in the early 1980's--will have been…

  4. Licensed Child Care in Washington State: 1996.

    ERIC Educational Resources Information Center

    Miller, Marna Geyer; Hu, James S.; Mayfield, Jim

    This study was the fifth survey of the Washington State licensed child care market, completed in 1996 by the Washington State Department of Social and Health Services (DSHS). Data were obtained through telephone interviews of approximately 2,700 child care providers. The major findings indicate that between 1994 and 1996, the monthly rate at…

  5. Licensed Child Care in Washington State: 1998.

    ERIC Educational Resources Information Center

    Miller, Marna Geyer; Schrager, Laura

    This study is one of an ongoing series of biennial surveys of all child care centers and some licensed family home providers by Washington State's Department of Social and Health Services (DSHS). A total of 1,137 child care centers and 1,527 family home providers were interviewed in spring 1998. Major findings include: (1) Over the period 1990 to…

  6. Managerial Succession in Child Care Centers.

    ERIC Educational Resources Information Center

    Lindeman, Toni D.

    Because a change in child care center directors is potentially so disruptive to both staff and children, factors which inhibit a smooth transition of leadership should be identified and, where possible, solutions proposed. Therefore, this paper (1) briefly describes (through five case studies) different managerial successions in child care centers…

  7. Literacy Instruction in Canadian Child Care Centers

    ERIC Educational Resources Information Center

    Perlman, Michal; Fletcher, Brooke A.

    2008-01-01

    The purpose of this study was to describe literacy instruction in child care centers, examine aspects of child care center quality that may predict such instruction, and provide a limited analysis of whether literacy instruction impacts children's concurrent pre-academic functioning. Staff and children in 103 classrooms serving preschool-age…

  8. Focus on Preschool Aquatics: Child Care Regulations.

    ERIC Educational Resources Information Center

    Sayre, Nancy E.

    This paper proposes state regulations for the training of child care staff members in developmentally appropriate safe aquatic practices, outlines required features of any pools that children visit, and suggests safe practices for water-related activities at child care centers and swimming pools. The staff training regulation suggestions include…

  9. The Affordable Care Act and Diabetes Diagnosis and Care: Exploring the Potential Impacts

    PubMed Central

    Laiteerapong, Neda

    2016-01-01

    This article reviews available data on the implications of the Affordable Care Act (ACA) for the diagnosis and care of type 2 diabetes. We provide a general overview of the major issues for diabetes diagnosis and care, and describe the policies in the ACA that affect diabetes diagnosis and care. We also estimate that approximately 2.3 million of the 4.6 million people in the USA with undiagnosed diabetes aged 18–64 in 2009–2010 may have gained access to free preventive care under the ACA, which could increase diabetes detection. In addition, we note two factors that may limit the success of the ACA for improving access to diabetes care. First, many states with the highest diabetes prevalence have not expanded Medicaid eligibility, and second, primary care providers may not adequately meet the increase in Medicaid patients because federal funding to increase provider reimbursement for Medicaid visits recently expired. We close by discussing current gaps in the literature and future directions for research on the ACA’s impact on diabetes diagnosis, care, and health outcomes. PMID:26892908

  10. Investing in Our Children: A Plan to Expand Access to Preschool and Child Care

    ERIC Educational Resources Information Center

    Brown, Cynthia G.; Cooper, Donna; Herman, Juliana; Lazarín, Melissa; Linden, Michael; Post, Sasha; Tanden, Neera

    2013-01-01

    This issue brief presents a plan to expand educational opportunities and care for children ages 0-5 years old by investing significant federal dollars to: (1) Make high-quality preschool universally accessible to all 3- and 4-year-old children; and (2) Enable more lower-income families to afford child care for children ages 0-3 years old. These…

  11. Policy Dilemmas in Latino Health Care and Implementation of the Affordable Care Act

    PubMed Central

    Ortega, Alexander N.; Rodriguez, Hector P.; Bustamante, Arturo Vargas

    2016-01-01

    The changing Latino demographic in the United States presents a number of challenges to health care policy makers, clinicians, organizations, and other stakeholders. Studies have demonstrated that Latinos tend to have worse patterns of access to, and utilization of, health care than other ethnic and racial groups. The implementation of the Affordable Care Act (ACA) of 2010 may ameliorate some of these disparities. However, even with the ACA, it is expected that Latinos will continue to have problems accessing and using high-quality health care, especially in states that are not expanding Medicaid eligibility as provided by the ACA. We identify four current policy dilemmas relevant to Latinos’ health and ACA implementation: (a) the need to extend coverage to the undocumented; (b) the growth of Latino populations in states with limited insurance expansion; (c) demands on public and private systems of care; and (d) the need to increase the number of Latino physicians while increasing the direct patient-care responsibilities of nonphysician Latino health care workers. PMID:25581154

  12. Interrelation of preventive care benefits and shared costs under the Affordable Care Act (ACA).

    PubMed

    Dixon, Robert Brent; Hertelendy, Attila J

    2014-08-01

    With the implementation of the Affordable Care Act (ACA), access to insurance and coverage of preventive care services has been expanded. By removing the barrier of shared costs for preventive care, it is expected that an increase in utilization of preventive care services will reduce the cost of chronic diseases. Early detection and treatment is anticipated to be less costly than treatment at full onset of chronic conditions. One concern of early detection of disease is the cost to treat. In reality, the confluence of early detection may result in greater overall expenditures. Even with improved access to preventive care benefits, cost-sharing of other health services remains a major component of insurance plans. In order to treat identified conditions or diseases, cost-sharing comes into play. With the greater adoption of cost-sharing insurance plans, expenditures on the part of enrollee are anticipated to rise. Once the healthcare recipients realize the implication of early identification and resultant treatment costs, enrollment in preventive care may decline. Healthcare legislation and regulation should consider the full spectrum of care and the microeconomic costs associated with preventive treatment. Although the system at large may not realize the immediate impact, behavioral shifts on the part of healthcare consumers may alter healthcare. Rather than the current status quo of treating presenting conditions, preventive treatment is largely anticipated to require more resources and may impact the consumer's financial capacity. This report will explore how these two concepts are co-dependent, and highlight the need for continued reform.

  13. 7 CFR 226.17 - Child care center provisions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 4 2014-01-01 2014-01-01 false Child care center provisions. 226.17 Section 226.17... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.17 Child care center provisions. (a) Child care centers may participate in the Program either as...

  14. 7 CFR 226.17 - Child care center provisions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 4 2013-01-01 2013-01-01 false Child care center provisions. 226.17 Section 226.17... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.17 Child care center provisions. (a) Child care centers may participate in the Program either as...

  15. 7 CFR 226.17 - Child care center provisions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 4 2011-01-01 2011-01-01 false Child care center provisions. 226.17 Section 226.17... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.17 Child care center provisions. (a) Child care centers may participate in the Program either as...

  16. 7 CFR 226.17 - Child care center provisions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 4 2012-01-01 2012-01-01 false Child care center provisions. 226.17 Section 226.17... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.17 Child care center provisions. (a) Child care centers may participate in the Program either as...

  17. American Child Care: Lessons from the First 100 Years.

    ERIC Educational Resources Information Center

    Anderson, Susan D.

    Child care has been part of American culture for nearly a century. This paper takes a backward glance at the history of child care in the United States. During the industrial revolution, child care was disguised as child labor. As child labor laws were enacted, schooling became the focus of ideas about caring for groups of children. The idea of a…

  18. The ABCs of Safe and Healthy Child Care: A Handbook for Child Care Providers.

    ERIC Educational Resources Information Center

    Hale, Cynthia M.; Polder, Jacquelyn A.

    Recognizing the importance of maintaining a safe and healthy child care setting, this manual for home or center child care providers contains information and guidelines to help providers maintain child health and reduce sickness and injuries. Part 1, "Introduction," describes how diseases are spread and how to prevent and prepare for unintentional…

  19. When Child Care Breaks down: Mothers' Experiences with Child Care Problems and Resulting Missed Work

    ERIC Educational Resources Information Center

    Usdansky, Margaret L.; Wolf, Douglas A.

    2008-01-01

    Qualitative research suggests that day-to-day problems with child care produce significant costs for low-income mothers. But the relevance of daily child care problems for mothers of all socioeconomic backgrounds has been largely overlooked. This article asks two interrelated questions: What factors shape how often mothers experience child care…

  20. Who Cares? State Commitment to Child Care and Early Education.

    ERIC Educational Resources Information Center

    Adams, Gina; Poersch, Nicole Oxendine

    This report analyzes data gathered through surveys of state administrators of child care and early childhood programs. The report is in three sections: (1) the state of child care and early education in the mid-1990s; (2) the relative level of commitment of each state in 1994; and (3) the likely impact of 1996 U.S. welfare reform legislation. The…

  1. The Affordable Care Act and the future of clinical medicine: the opportunities and challenges.

    PubMed

    Kocher, Robert; Emanuel, Ezekiel J; DeParle, Nancy-Ann M

    2010-10-19

    The Affordable Care Act is a once-in-a-generation change to the U.S. health system. It guarantees access to health care for all Americans, creates new incentives to change clinical practice to foster better coordination and quality, gives physicians more information to make them better clinicians and patients more information to make them more value-conscious consumers, and changes the payment system to reward value. The Act and the health information technology provisions in the American Recovery and Reinvestment Act remove many barriers to delivering high-quality care, such as unnecessary administrative complexity, inaccessible clinical data, and insufficient access to primary care and allied health providers. We hope that physicians will embrace the opportunities created by the Affordable Care Act that will enable them to provide better care for their patients and lead the U.S. health system in a more positive direction. To fully realize the benefits of the Affordable Care Act for their practices and their patients, physicians will design their offices for seamless care, employing new practice models and using technology to integrate patient information with professional society guidelines to keep patients with chronic conditions healthy and out of the hospital. Under the Affordable Care Act, physicians who effectively collaborate with other providers to improve patient outcomes, the value of medical services, and patient experiences will thrive and be the leaders of the health care system.

  2. Faith-based organizations and the Affordable Care Act: Reducing Latino mental health care disparities.

    PubMed

    Villatoro, Alice P; Dixon, Elizabeth; Mays, Vickie M

    2016-02-01

    The Patient Protection and Affordable Care Act (ACA; 2010) is expected to increase access to mental health care through provisions aimed at increasing health coverage among the nation's uninsured, including 10.2 million eligible Latino adults. The ACA will increase health coverage by expanding Medicaid eligibility to individuals living below 138% of the federal poverty level, subsidizing the purchase of private insurance among individuals not eligible for Medicaid, and requiring employers with 50 or more employees to offer health insurance. An anticipated result of this landmark legislation is improvement in the screening, diagnosis, and treatment of mental disorders in racial/ethnic minorities, particularly for Latinos, who traditionally have had less access to these services. However, these efforts alone may not sufficiently ameliorate mental health care disparities for Latinos. Faith-based organizations (FBOs) could play an integral role in the mental health care of Latinos by increasing help seeking, providing religion-based mental health services, and delivering supportive services that address common access barriers among Latinos. Thus, in determining ways to eliminate Latino mental health care disparities under the ACA, examining pathways into care through the faith-based sector offers unique opportunities to address some of the cultural barriers confronted by this population. We examine how partnerships between FBOs and primary care patient-centered health homes may help reduce the gap of unmet mental health needs among Latinos in this era of health reform. We also describe the challenges FBOs and primary care providers need to overcome to be partners in integrated care efforts.

  3. Child Care and Development Fund (CCDF) Program. Final rule.

    PubMed

    2016-09-30

    This final rule makes regulatory changes to the Child Care and Development Fund (CCDF) based on the Child Care and Development Block Grant Act of 2014. These changes strengthen requirements to protect the health and safety of children in child care; help parents make informed consumer choices and access information to support child development; provide equal access to stable, high-quality child care for low-income children; and enhance the quality of child care and the early childhood workforce.

  4. How Might the Affordable Care Act's Coverage Expansion Provisions Influence Demand for Medical Care?

    PubMed Central

    ABRAHAM, JEAN MARIE

    2014-01-01

    Context: The Affordable Care Act (ACA) is predicted to expand health insurance to 25 million individuals. Since insurance reduces the price of medical care, the quantity of services demanded by these newly covered individuals is expected to rise. In this article I provide a comprehensive picture of the demographics, health status, and medical care utilization of the population targeted for the ACA's expansion of coverage, contrasted with that of other nonelderly, insured populations. In addition, I synthesize the current evidence regarding the causal impact of insurance on medical care demand, drawing heavily on recent evidence from Massachusetts and Oregon. Methods: Using the 2008 to 2010 Medical Expenditure Panel Survey, I conducted bivariate and multivariate analyses to examine differences between the ACA target population and other insured groups. I used the results from the descriptive analysis and quasi-experimental literature to generate “back of the envelope” estimates of the potential impact of the coverage expansion on total medical care utilization by the noninstitutionalized US population. Findings: Comparisons of the potential ACA target population with the privately and publicly insured reveal that the former is younger and more likely to be male. The ACA target population, and particularly the uninsured with incomes under 200% of the federal poverty line, reports lower rates of several medical conditions relative to those of the privately and publicly insured. Future changes in rates of inpatient hospitalization and ED use among the newly insured could vary widely, based on descriptive findings and inferences from the quasi-experimental literature. Results also suggest moderate increases in ambulatory care. Total increases in overall demand for medical care by the newly insured comprise a modest proportion of the aggregate utilization. Conclusions: With the expected increases in utilization resulting from the coverage expansion

  5. Informing Parents about Child Care Subsidies. Child Care Action Campaign Issue Brief #10.

    ERIC Educational Resources Information Center

    Child Care Action Campaign, New York, NY.

    On December 11, 1997, the Child Care Action Campaign (CCAC) hosted an audioconference to explore the issue of how parents seeking to get off welfare can learn about subsidies available for child care in the transition from welfare to work. Presenters were Doug Baird, president of Associated Day Care Services in Boston, who discussed lessons of a…

  6. Who's Vulnerable in Infant Child Care Centers?

    ERIC Educational Resources Information Center

    Kendall, Earline D.; Moukaddem, Virginia E.

    1992-01-01

    Maintains that infants and toddlers, parents, and child caregivers are vulnerable to a variety of infectious diseases from infant-toddler child care centers. These diseases include infectious diarrhea; rubella; cytomeglovirus; hepatitis A, and haemophilus influenza type B. Suggests ways to prevent the spread of such diseases. (BB)

  7. School-Based Child Care. Research Brief

    ERIC Educational Resources Information Center

    Muir, Mike

    2004-01-01

    Each year, half a million teenagers become mothers in the United States. School-based child care programs are a positive way for educational institutions to encourage young mothers to return to or stay in school, prepare for employment, and acquire accurate information about child development and appropriate parenting practices. Nationwide,…

  8. The affordable care act and treatment for "substance use disorders:" implications of ending segregated behavioral healthcare.

    PubMed

    McLellan, A Thomas; Woodworth, Abigail Mason

    2014-01-01

    The Affordable Care Act (2010) and the Mental Health Parity and Addiction Equity Act (2008) are expected to transform substance abuse prevention and treatment in the United States. In this paper, we outline the potential disruption to the existing specialty care delivery system, and describe the opportunities for treatment providers and health services researchers.

  9. The Patient Protection and Affordable Care Act: The Role of the School Nurse. Position Statement

    ERIC Educational Resources Information Center

    Combe, Laurie G.; Sharpe, Susan; Feeser, Cynthia Jo; Ondeck, Lynnette; Fekaris, Nina

    2015-01-01

    It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) serves a vital role in the delivery of health care to our nation's students within the healthcare system reshaped by the Patient Protection and Affordable Care Act of 2010, commonly known as…

  10. Insurers' policies on coverage for behavior management services and the impact of the Affordable Care Act.

    PubMed

    Edelstein, Burton L

    2014-01-01

    The impact of the Affordable Care Act (ACA) on dental insurance coverage for behavior management services depends upon the child's source of insurance (Medicaid, CHIP, private commercial) and the policies that govern each such source. This contribution describes historical and projected sources of pediatric dental coverage, catalogues the seven behavior codes used by dentists, compares how often they are billed by pediatric and general dentists, assesses payment policies and practices for behavioral services across coverage sources, and describes how ACA coverage policies may impact each source. Differences between Congressional intent to ensure comprehensive oral health services with meaningful consumer protections for all legal-resident children and regulatory action by the Departments of Treasury and Health and Human Services are explored to explain how regulations fail to meet Congressional intent as of 2014. The ACA may additionally impact pediatric dentistry practice, including dentists' behavior management services, by expanding pediatric dental training and safety net delivery sites and by stimulating the evolution of novel payment and delivery systems designed to move provider incentives away from procedure-based payments and toward health outcome-based payments.

  11. Health Update: Chemical Hazards in Child Care.

    ERIC Educational Resources Information Center

    Aronson, Susan S.

    1988-01-01

    Points out that children are uniquely susceptible to toxic substances. Describes the hazards that asbestos, pesticides, and art materials pose to children. Offers practical advice for dealing with common problems encountered in child care programs. (RJC)

  12. Take Care of Your Child's Teeth

    MedlinePlus

    ... This Topic En español Take Care of Your Child’s Teeth Browse Sections The Basics Overview Tooth Decay ... can cause cavities (holes) in teeth. Is my child at risk for tooth decay? Tooth decay is ...

  13. Preventing the Spread of Illness in Child Care or School

    MedlinePlus

    ... Print Share Reducing the Spread of Illness in Child Care Page Content ​​Whenever children are together, there is ... each dose. Measures to Promote Good Hygiene in Child Care: To reduce the risk of disease in child ...

  14. Child Care Teaching as Women's Work: Reflections on Experiences

    ERIC Educational Resources Information Center

    Kim, Miai; Reifel, Stuart

    2010-01-01

    Child care teachers' experiences and their gendered understandings of their work were explored in this study. Two female child care teachers were interviewed individually and asked to describe their work as women's work. Analysis showed that teachers essentialized child care teaching, recognized the paradoxes of being a child care teacher,…

  15. 45 CFR 98.50 - Child care services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Child care services. 98.50 Section 98.50 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Use of Child Care and Development Funds § 98.50 Child care services. (a) Of the funds remaining...

  16. 45 CFR 98.50 - Child care services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Child care services. 98.50 Section 98.50 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Use of Child Care and Development Funds § 98.50 Child care services. (a) Of the funds remaining...

  17. 45 CFR 98.50 - Child care services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Child care services. 98.50 Section 98.50 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Use of Child Care and Development Funds § 98.50 Child care services. (a) Of the funds remaining...

  18. Child Care and Development Block Grant Participation in 2012

    ERIC Educational Resources Information Center

    Matthews, Hannah; Reeves, Rhiannon

    2014-01-01

    The Child Care and Development Block Grant (CCDBG) is the primary funding source for federal child care subsidies to low-income working families, as well as improving child care quality. Based on preliminary state-reported data from the federal Office of Child Care, this fact sheet provides a snapshot of CCDBG program participation in 2012, noting…

  19. 45 CFR 98.50 - Child care services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Child care services. 98.50 Section 98.50 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Use of Child Care and Development Funds § 98.50 Child care services. (a) Of the funds remaining...

  20. 45 CFR 98.50 - Child care services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Child care services. 98.50 Section 98.50 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Use of Child Care and Development Funds § 98.50 Child care services. (a) Of the funds remaining...

  1. State Child Care Policies for Limited English Proficient Families

    ERIC Educational Resources Information Center

    Firgens, Emily; Matthews, Hannah

    2012-01-01

    The Child Care and Development Block Grant (CCDBG), the largest source of federal funding for child care assistance available to states, provides low-income families with help paying for child care. Studies have shown that low-income LEP (limited English proficient), as well as immigrant families, are less likely to receive child care assistance.…

  2. Parents and the High Cost of Child Care: 2015 Report

    ERIC Educational Resources Information Center

    Fraga, Lynette; Dobbins, Dionne; McCready, Michelle

    2015-01-01

    Eleven million children younger than age five are in some form of child care in the United States. The "Parents and the High Cost of Child Care: 2015 Report" summarizes the cost of child care across the country, examines the importance of child care as a workforce support and as an early learning program, and explores the effect of high…

  3. Parents and the High Cost of Child Care: 2014 Report

    ERIC Educational Resources Information Center

    Wood, Stephen; Fraga, Lynette; McCready, Michelle

    2014-01-01

    Eleven million children younger than age five are in some form of child care in the United States. The "Parents and the High Cost of Child Care: 2014 Report" summarizes the cost of child care across the country, examines the importance of child care as a workforce support and as an early learning program, and explores the effect of high…

  4. Parents and the High Cost of Child Care: 2012 Report

    ERIC Educational Resources Information Center

    Child Care Aware of America, 2012

    2012-01-01

    "Parents and the High Cost of Child Care: 2012 Report" presents 2011 data reflecting what parents pay for full-time child care in America. It includes average fees for both child care centers and family child care homes. Information was collected through a survey conducted in January 2012 that asked for the average costs charged for…

  5. Child Care during Nonstandard Work Hours: Research to Policy Resources

    ERIC Educational Resources Information Center

    Ferguson, Daniel

    2016-01-01

    In November 2014, the Child Care and Development Block Grant (CCDBG) Act of 2014 was signed into law, reauthorizing the Child Care and Development Fund (CCDF)--the federal child care subsidy program--for the first time since 1996. In December 2015, the U.S. Office of Child Care issued a Notice of Proposed Rulemaking, which updated CCDF regulations…

  6. 5 CFR 792.203 - Child care subsidy programs; eligibility.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Child care subsidy programs; eligibility... of Appropriated Funds for Child Care Costs for Lower Income Employees § 792.203 Child care subsidy programs; eligibility. (a)(1) An Executive agency may establish a child care subsidy program in which...

  7. 5 CFR 792.203 - Child care subsidy programs; eligibility.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Child care subsidy programs; eligibility... of Appropriated Funds for Child Care Costs for Lower Income Employees § 792.203 Child care subsidy programs; eligibility. (a)(1) An Executive agency may establish a child care subsidy program in which...

  8. Support for Government Provision of Health Care and the Patient Protection and Affordable Care Act

    PubMed Central

    Corman, Juliane; Levin, David

    2016-01-01

    Since the 1930s, US politicians have argued about whether healthcare should be the responsibility of the federal government. Both major political parties have cited public opinion concerning Americans’ support for or rejection of government provision of healthcare to support their position. With the passage of the Patient Protection and Affordable Care Act (ACA) in 2010, however, the political debate has changed. Where it had been about the government provision of healthcare as an abstract principle, it became a debate imbued with evaluations of the implementation of the ACA itself. This spawned a new line of research examining the consequences of the ACA’s implementation on public attitudes toward government provision of healthcare. The change in support for government provision of healthcare and the new post-ACA research highlight a need for a long-term examination of trends in support over the past two decades that will provide context for the new studies. This study provides that examination. PMID:27257309

  9. The Affordable Care Act: the ethical call to transform the organizational culture.

    PubMed

    Piper, Llewellyn E

    2014-01-01

    The Patient Protection and Affordable Care Act will require health care leaders and managers to develop strategies and implement organizational tactics for their organization to survive and thrive under the federal mandates of this new health care law. Successful health care organizations and health care systems will be defined by their adaptability in the new value-based marketplace created by the Affordable Care Act. The most critical underlining challenge for this success will be the effective transformation of the organizational culture. Transformational value-based leadership is now needed to answer the ethical call for transforming the organizational culture. This article provides a model and recommendations to influence change in the most difficult leadership duty-transforming the organizational culture.

  10. The Affordable Care Act: the ethical call for value-based leadership to transform quality.

    PubMed

    Piper, Llewellyn E

    2013-01-01

    Hospitals in America face a daunting and historical challenge starting in 2013 as leadership navigates their organizations toward a new port of call-the Patient Protection and Affordable Care Act. Known as the Affordable Care Act (ACA) was signed into law in March 2010 and held in abeyance waiting on 2 pivotal points-the Supreme Court's June 2012 ruling upholding the constitutionality of the ACA and the 2012 presidential election of Barack Obama bringing to reality to health care organizations that leadership now must implement the mandates of health care delivery under the ACA. This article addresses the need for value-based leadership to transform the culture of health care organizations in order to be successful in navigating uncharted waters under the unprecedented challenges for change in the delivery of quality health care.

  11. The Affordable Care Act, Accountable Care Organizations, and Mental Health Care for Older Adults: Implications and Opportunities.

    PubMed

    Bartels, Stephen J; Gill, Lydia; Naslund, John A

    2015-01-01

    The Patient Protection and Affordable Care Act (ACA) represents the most significant legislative change in the United States health care system in nearly half a century. Key elements of the ACA include reforms aimed at addressing high-cost, complex, vulnerable patient populations. Older adults with mental health disorders are a rapidly growing segment of the population and are among the most challenging subgroups within health care, and they account for a disproportionate amount of costs. What does the ACA mean for geriatric mental health? We address this question by highlighting opportunities for reaching older adults with mental health disorders by leveraging the diverse elements of the ACA. We describe nine relevant initiatives: (1) accountable care organizations, (2) patient-centered medical homes, (3) Medicaid-financed specialty health homes, (4) hospital readmission and health care transitions initiatives, (5) Medicare annual wellness visit, (6) quality standards and associated incentives, (7) support for health information technology and telehealth, (8) Independence at Home and 1915(i) State Plan Home and Community-Based Services program, and (9) Medicare-Medicaid Coordination Office, Center for Medicare and Medicaid Innovation, and the Patient-Centered Outcomes Research Institute. We also consider potential challenges to full implementation of the ACA and discuss novel solutions for advancing geriatric mental health in the context of projected workforce shortages and the opportunities afforded by the ACA.

  12. Small Child Care Facilities in Residential Areas.

    ERIC Educational Resources Information Center

    Giegerich & Associates, Inc., Rockville, MD.

    One part of a three-part investigation prepared for the Montgomery County Planning Board in Silver Spring, Maryland, this study addresses planning and site planning issues arising from the location of child care facilities in residential settings. The study, which emphasizes homes and centers which care for 7 to 20 children, provides a detailed…

  13. How To Start a Child Care Center.

    ERIC Educational Resources Information Center

    Benner, Phylis M., Comp.; Hollestelle, Kay, Comp.

    This paper is addressed to those who want to start their own child care center, and provides guidelines for doing so. It identifies the first things to be considered--planning and conducting a community needs assessment to analyze the competition in the area and make the decision of opening a day care center, and gathering information from a…

  14. Child Care Insurance Crisis: Strategies for Survival.

    ERIC Educational Resources Information Center

    Koppelman, Jane

    Designed to help child care centers in their search for liability insurance, this report explores the controversy about insurance provision, and offers advice on how to combat high rates and locate policies offering the most protection. Chapter 1 reports on how insurers justify their treatment of day care centers as high risk enterprises.…

  15. Family Child Care Health and Safety Checklist: A Packet for Family Child Care Providers [with Videotape].

    ERIC Educational Resources Information Center

    Kendrick, Abby Shapiro; Gravell, Joanne

    This checklist and accompanying video are designed to help family child care providers assess the health and safety of the child care home. The checklist includes suggestions for conducting the self-evaluation and for creating a safer, healthier home environment. The areas of the checklist are: your home, out of bounds areas, gates and guards,…

  16. Child Care Teachers' Perspectives on Including Children with Challenging Behavior in Child Care Settings

    ERIC Educational Resources Information Center

    Quesenberry, Amanda C.; Hemmeter, Mary Louise; Ostrosky, Michaelene M.; Hamann, Kira

    2014-01-01

    In this study, 9 teachers from 5 child care centers were interviewed to examine their perceptions on including children with challenging behavior in their classrooms. The findings provide a firsthand view into how child care teachers support children's social and emotional development and address challenging behavior. Results confirm previous…

  17. Maintaining Work: The Influence of Child Care Subsidies on Child Care-Related Work Disruptions

    ERIC Educational Resources Information Center

    Forry, Nicole D.; Hofferth, Sandra L.

    2011-01-01

    With the passage of welfare reform, support for low-income parents to not only obtain but also maintain work has become imperative. The role of child care subsidies in supporting parents' job tenure has received little attention in the literature. This article examines the association between receiving a child care subsidy and experiencing a child…

  18. Evaluation of Child Care Subsidy Strategies: Massachusetts Family Child Care Study

    ERIC Educational Resources Information Center

    Collins, Ann; Goodson, Barbara; Luallen, Jeremy; Fountain, Alyssa Rulf; Checkoway, Amy

    2010-01-01

    This report presents findings from the Massachusetts Family Child Care study, a two-year evaluation of the impacts of an early childhood education program on providers and children in family child care. The program--"LearningGames"--is designed to train caregivers to stimulate children's cognitive, language, and social-emotional…

  19. Quality Child Care in Virginia. Critical Issues in Child Care. White Paper 1.

    ERIC Educational Resources Information Center

    Johnson, Suzanne Clark; Baratka, Talley V.; Wood, Lisa

    This paper on child care is one of four to be published by the Action Alliance for Virginia's Children. The papers are based on the most comprehensive data available on child care in Virginia, recent scholarly research from both social science and neuroscience, and the best judgment of leading professionals in the fields of education and child…

  20. Employer Child Care Providers Stalled, but Optimistic: Fourteenth Annual Status Report on Employer Child Care

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2005-01-01

    The ten largest employer child care management organizations, as a group, reported a zero growth rate in 2004. This year of no growth follows two years in which the sector grew by only 4% per year. This contrasts dramatically with the fast expansion period for employer child care, 1996 through 2000, when the sector grew at an annual rate of 10%.…

  1. Making the Case for Public-Private Child Care Partnerships: Child Care Partnership Project. [Videotape].

    ERIC Educational Resources Information Center

    Finance Project, Washington, DC.

    The quality of child care in the United States has important implications for school preparedness, welfare reform, economic vitality, and the quality of family life. In this 8-minute videotape, business leaders describe why child care makes good business sense. Visuals explain the importance of early childhood for school and life success, and the…

  2. Fact Sheets of Public-Private Partnerships for Child Care. The Child Care Partnership Project.

    ERIC Educational Resources Information Center

    Finance Project, Washington, DC.

    These fact sheets were developed as part of the Child Care Partnership Project, a multi-year technical assistance effort. The Partnership Project provides a series of technical assistance resources and materials to support the development and strengthening of public-private partnerships to improve the quality and supply of child care. The fact…

  3. Winning at Child Caring: Easier Ways with Young Children in Child Care Centers, Homes and Malls.

    ERIC Educational Resources Information Center

    Simons, Bette

    This booklet is a compilation of articles from a column in the "Warner Center News" written by an experienced early childhood educator on various topics related to child care. The brief articles describe the problems and pleasures that preschool children bring to child care centers, homes, markets, and malls. The articles are grouped…

  4. Oregon Child Care Quality Indicators Program: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    ERIC Educational Resources Information Center

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Oregon's Child Care Quality Indicators Program prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  5. Not-for-profit hospitals and Affordable Care Act: Navigating the new health care landscape.

    PubMed

    Nakra, Prema; Nakra, Sushma

    2016-08-01

    On a sunny Thursday morning, June 25, 2015, President Obama strode into the Rose Garden and declared a victory for the Affordable Care Act (ACA) by stating that the act was working exactly the way it was supposed to work. He further reinforced that ACA has enabled young Americans up to the age of 26 to remain on their parents' health plans. It disallows the insurance companies from denying coverage based on preexisting conditions. Above all, an expansion of Medicaid has also brought an additional 16 million Americans under health coverage in a span of less than 2 years. The ACA went into full effect on January 1, 2014, ushering in health insurance reforms and new health coverage options across the country. As the states expand Medicaid and provide new coverage options through the federal health insurance marketplace, they are busy streamlining application and enrollment processes for coverage programs. This article highlights the positive impact of the ACA on uninsured and the challenges that not-for-profit and public hospitals are facing as they navigate the new health care landscape.

  6. Making Child Care Centers SAFER: A Non-Regulatory Approach to Improving Child Care Center Siting

    PubMed Central

    Somers, Tarah S; Harvey, Margaret L.; Rusnak, Sharee Major

    2011-01-01

    Licensed child care centers are generally considered to be safe because they are required to meet state licensing regulations. As part of their licensing requirements, many states inspect child care centers and include an assessment of the health and safety of the facility to look for hazardous conditions or practices that may harm children. However, most states do not require an environmental assessment of the child care center building or land to prevent a center from being placed on, next to, or inside contaminated buildings. Having worked on several sites where child care centers were affected by environmental contaminants, the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry (ATSDR) endeavor to raise awareness of this issue. One of ATSDR's partner states, Connecticut, took a proactive, non-regulatory approach to the issue with the development its Child Day Care Screening Assessment for Environmental Risk Program. PMID:21563710

  7. Child Care Gifts to Bolster Astronomy

    NASA Astrophysics Data System (ADS)

    Nemiroff, Robert J.; Allen, Alice

    2016-01-01

    Caring for children should not derail potentially excellent future astronomers. It is therefore suggested that a mechanism be created for established astronomers to voluntarily will 10 percent of their estate to a fund that helps aspiring astronomers reduce child care costs. Statistics indicate that many scientists delay child rearing until they have secure jobs. This delay appears to be based on the early relative cost of child care and the perception that time spent raising children negatively impacts job performance and future employability. Having even a portion of child care expenses covered may increase the efficiency of early-career education and productivity of early-career scientific research. It is hoped that some established astronomers may be inspired to contribute by remembering their own lives as aspiring astronomers, while also wishing to add to their legacy. Only an expression of interest is requested here, both from established astronomers who might be interested in taking such a donation pledge, and from aspiring astronomers who feel their careers would be helped by child care assistance.

  8. Child Care You Can Count On: Model Programs and Policies.

    ERIC Educational Resources Information Center

    Annie E. Casey Foundation, Baltimore, MD.

    This document is composed of an overview of the 1998 Kids Count data book, a pocket guide summarizing findings, and information sheets on various aspects of child care. The overview discusses the need for child care, examines its cost, presents information on the quality of available child care, describes potential solutions to make child care…

  9. The Relationship between Child Care Subsidies and Children's Cognitive Development

    ERIC Educational Resources Information Center

    Hawkinson, Laura E.; Griffen, Andrew S.; Dong, Nianbo; Maynard, Rebecca A.

    2013-01-01

    Child care subsidies help low-income families pay for child care while parents work or study. Few studies have examined the effects of child care subsidy use on child development, and no studies have done so controlling for prior cognitive skills. We use rich, longitudinal data from the ECLS-B data set to estimate the relationship between child…

  10. Child Care Assistance: Helping Parents Work and Children Succeed

    ERIC Educational Resources Information Center

    Matthews, Hannah; Walker, Christina

    2014-01-01

    Quality child care enables parents to work or go to school while also providing young children with the early childhood education experiences needed for healthy development. The Child Care and Development Block Grant (CCDBG) is the primary federal program that provides funding for child care assistance for low-income working parents. Child care…

  11. Reducing Health Care Disparities for Minority Women in the Era of the Affordable Care Act: Opportunities within Primary Care.

    PubMed

    Karliner, Leah; Marks, Angela; Mutha, Sunita

    2016-01-01

    Despite improvements in overall health of the American population, disparities persist, particularly for minority women. The Affordable Care Act (ACA) offers the potential to reduce disparities through expanded insurance coverage, greater access to high-quality care, and bolstered prevention efforts in the context of new models of care such as the patient-centered medical home (PCMH). We use case studies representing three clinical conditions (breast cancer, HIV, and coronary heart disease) to present strategies for how a PCMH could reduce disparities for minority women. The case studies highlight the opportunity that further implementation of the ACA provides to improve screening, risk assessment, and prevention for a range of conditions that impact the health of minority women, as well as areas ripe for future investigation.

  12. Repeal and Replace of Affordable Care: A Complex, but Not an Impossible Task.

    PubMed

    Manchikanti, Laxmaiah; Hirsch, Joshua A

    2016-01-01

    The Affordable Care Act (ACA), signature legislation of President Obama, was arguably the most consequential and comprehensive health care reform since Medicare was introduced as part of President Lyndon B. Johnson's great society. It has been claimed that many of the law's reforms are now so integrated in the health system that full repeal would be impractical, while others including President Elect Trump have rejected that idea and called for full repeal and replacement claiming ACA law cannot be fixed. A tsunami of increasing regulatory burden over the past 8 years, the current health care milieu has moved independent practitioners towards hospital employment in great numbers. In addition, public opinion has been slowly climbing against ObamaCare with 54% of Americans now opposing the law.President Obama has indicated that the law has accomplished many of its goals, including increasing accessibility, affordability, and quality of health care. However, others have contradicted these assertions and described the ACA as "insurance for many with coverage for few." Some believe that the ACA might be more appropriately labeled the "Medicaid Expansion Act."There are multiple plans developed over the years by republican members of the congress; however, of significant consequence and importance are President-elect Trump's proposals and the plan developed by Speaker Paul Ryan to repeal and replace the ACA. The President-elect has described the problems he perceives with the ACA; rapidly rising premiums and deductibles, narrow networks, and limits of coverage imposed by health insurance companies. The President-elect has indicated that his goal will be to create a patient-centered health care system that promotes choice, quality, and affordability with health insurance and health care, and take any needed action to alleviate the burdens imposed on American families and businesses by law.Key words: Affordable Care Act, ObamaCare, Medicaid, exchanges, Trump plan, repeal

  13. 76 FR 41929 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... July 15, 2011 Part III Department of Health and Human Services 45 CFR Part 153 Patient Protection and... OF HEALTH AND HUMAN SERVICES 45 CFR Part 153 RIN 0938-AR07 Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and Risk Adjustment AGENCY: Department of Health and...

  14. 78 FR 39493 - Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-01

    ... requested translation of the requisite materials in non-English languages, and suggested that HHS refer to... applicable language in the Affordable Care Act. Upon publication of the Treasury final rule, we intend to... proposed to amend Sec. 155.200(a) to add a reference to indicate that, consistent with existing language...

  15. 78 FR 8456 - Coverage of Certain Preventive Services Under the Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    ...This document proposes amendments to rules regarding coverage for certain preventive services under section 2713 of the Public Health Service Act, as added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. Section 2713 of the Public Health Service Act requires coverage without......

  16. Awareness, Perceptions, and Communication Needs about the Affordable Care Act across the Life Span

    ERIC Educational Resources Information Center

    Bergeron, Caroline D.; Friedman, Daniela B.; Sisson, Diana C.; Tanner, Andrea; Kornegay, Vance L.; Owens, Otis L.; Weis, Megan A.; Patterson, Lee L.

    2016-01-01

    Background: By March 2014, all U.S. citizens were required to have health insurance according to the Affordable Care Act (ACA). Purpose: Study objectives were to explore individuals' opinions, perceptions, and communication sources and needs about the ACA and to assess differences by age group. Methods: In November 2013, 10 1-hour focus groups (5…

  17. 77 FR 4564 - Request for Information Regarding the Reinsurance Program Under the Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-30

    ... responses to this RFI are not offers, and cannot be accepted by the Government to form a binding contract or... contract for services required to fulfill the statutory and regulatory requirements of the reinsurance..., 2011 (76 FR 41930). The Affordable Care Act instructs each State to establish or contract with...

  18. 76 FR 77392 - Patient Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-13

    ... and other business cooperatives provide possible models for the successful development of CO-OPs... to promote integrated models of care and enhance competition in the Affordable Insurance Exchanges... met. Starting in 2014, individuals and small businesses will be able to purchase private...

  19. 76 FR 51201 - Patient Protection and Affordable Care Act; Exchange Functions in the Individual Market...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ... From the Federal Register Online via the Government Publishing Office ] Vol. 76 Wednesday, No. 159 August 17, 2011 Part III Department of Health and Human Services 45 CFR Parts 155 and 157 Patient Protection and Affordable Care Act; Exchange Functions in the Individual Market: Eligibility...

  20. California Early Care and Education Workforce Study: Licensed Child Care Centers and Family Child Care Providers. Statewide Highlights

    ERIC Educational Resources Information Center

    Center for the Study of Child Care Employment, University of California at Berkeley, 2006

    2006-01-01

    Recognizing the critical role that early childhood educators play in the lives of California's children and families, First 5 California commissioned in 2004 a statewide and regional study of the early care and education (ECE) workforce in licensed child care centers and licensed family child care homes. The overall goal of the study was to…

  1. 45 CFR 98.20 - A child's eligibility for child care services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false A child's eligibility for child care services. 98.20 Section 98.20 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Eligibility for Services § 98.20 A child's eligibility for child...

  2. 45 CFR 98.20 - A child's eligibility for child care services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false A child's eligibility for child care services. 98.20 Section 98.20 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Eligibility for Services § 98.20 A child's eligibility for child...

  3. 45 CFR 98.20 - A child's eligibility for child care services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false A child's eligibility for child care services. 98.20 Section 98.20 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Eligibility for Services § 98.20 A child's eligibility for child...

  4. 45 CFR 98.20 - A child's eligibility for child care services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false A child's eligibility for child care services. 98.20 Section 98.20 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Eligibility for Services § 98.20 A child's eligibility for child...

  5. 45 CFR 98.20 - A child's eligibility for child care services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false A child's eligibility for child care services. 98.20 Section 98.20 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Eligibility for Services § 98.20 A child's eligibility for child...

  6. Child Care and Work Absences: Trade-Offs by Type of Care

    ERIC Educational Resources Information Center

    Gordon, Rachel A.; Kaestner, Robert; Korenman, Sanders

    2008-01-01

    Parents face a trade-off in the effect of child-care problems on employment. Whereas large settings may increase problems because of child illness, small group care may relate to provider unavailability. Analyzing the NICHD Study of Early Child Care, we find that child-care centers and large family day care lead to mothers' greater work absences…

  7. Family factors in child care research.

    PubMed

    Hungerford, Anne; Cox, Martha J

    2006-10-01

    The purpose of this article is to review evidence concerning the joint impact of family characteristics and child care experiences in understanding children's development. Although child care experiences are related to children's development across a variety of domains, family characteristics, particularly socioeconomic status and parenting quality, are typically stronger predictors of children's outcomes. An important implication of these findings is that high-quality child care experiences are likely to have stronger effects on children who are at risk of poorer outcomes because of less optimal family environments; evidence from experimental and nonexperimental studies generally supports this conclusion. From a policy perspective, an important goal for future research is to identify subgroups of families within the heterogeneous low-income population that are in particular need of relatively more intensive services and to develop effective interventions that are tailored to their needs.

  8. Which moral hazard? Health care reform under the Affordable Care Act of 2010.

    PubMed

    Mendoza, Roger Lee

    2016-06-20

    Purpose - Moral hazard is a concept that is central to risk and insurance management. It refers to change in economic behavior when individuals are protected or insured against certain risks and losses whose costs are borne by another party. It asserts that the presence of an insurance contract increases the probability of a claim and the size of a claim. Through the US Affordable Care Act (ACA) of 2010, this study seeks to examine the validity and relevance of moral hazard in health care reform and determine how welfare losses or inefficiencies could be mitigated. Design/methodology/approach - This study is divided into three sections. The first contrasts conventional moral hazard from an emerging or alternative theory. The second analyzes moral hazard in terms of the evolution, organization, management, and marketing of health insurance in the USA. The third explains why and how salient reform measures under the ACA might induce health care consumption and production in ways that could either promote or restrict personal health and safety as well as social welfare maximization. Findings - Insurance generally induces health care (over) consumption. However, not every additional consumption, with or without adverse selection, can be considered wasteful or risky, even if it might cost insurers more in the short run. Moral hazard can generate welfare and equity gains. These gains might vary depending on which ACA provisions, insured population, covered illnesses, treatments, and services, as well as health outcomes are taken into account, and because of the relative ambiguities surrounding definitions of "health." Actuarial risk models can nonetheless benefit from incorporating welfare and equity gains into their basic assumptions and estimations. Originality/value - This is the first study which examines the ACA in the context of the new or alternative theory of moral hazard. It suggests that containing inefficient moral hazard, and encouraging its desirable

  9. A Profile Approach to Child Care Quality, Quantity, and Type of Setting: Parent Selection of Infant Child Care Arrangements

    ERIC Educational Resources Information Center

    Sosinsky, Laura Stout; Kim, Se-Kang

    2013-01-01

    Building on prior variable-oriented research which demonstrates the independence of the associations of child care quality, quantity, and type of setting with family factors and child outcomes, the current study identifies four profiles of child care dimensions from the NICHD Study of Early Child Care and Youth Development. Profiles accounted for…

  10. The Patient Protection and Affordable Care Act: opportunities for prevention and public health.

    PubMed

    Shaw, Frederic E; Asomugha, Chisara N; Conway, Patrick H; Rein, Andrew S

    2014-07-05

    The Patient Protection and Affordable Care Act, which was enacted by the US Congress in 2010, marks the greatest change in US health policy since the 1960s. The law is intended to address fundamental problems within the US health system, including the high and rising cost of care, inadequate access to health insurance and health services for many Americans, and low health-care efficiency and quality. By 2019, the law will bring health coverage--and the health benefits of insurance--to an estimated 25 million more Americans. It has already restrained discriminatory insurance practices, made coverage more affordable, and realised new provisions to curb costs (including tests of new health-care delivery models). The new law establishes the first National Prevention Strategy, adds substantial new funding for prevention and public health programmes, and promotes the use of recommended clinical preventive services and other measures, and thus represents a major opportunity for prevention and public health. The law also provides impetus for greater collaboration between the US health-care and public health systems, which have traditionally operated separately with little interaction. Taken together, the various effects of the Patient Protection and Affordable Care Act can advance the health of the US population.

  11. Americans' Experiences with ACA Marketplace Coverage: Affordability and Provider Network Satisfaction: Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016.

    PubMed

    Gunja, Munira Z; Collins, Sara R; Doty, Michelle M; Beutel, Sophie

    2016-07-01

    For people with low and moderate incomes, the Affordable Care Act's tax credits have made premium costs roughly comparable to those paid by people with job-based health insurance. For those with higher incomes, the tax credits phase out, meaning that adults in marketplace plans on average have higher premium costs than those in employer plans. The law's cost-sharing reductions are reducing deductibles. Lower-income adults in marketplace plans were less likely than higher-income adults to report having deductibles of $1,000 or more. Majorities of new marketplace enrollees and those who have changed plans since they initially obtained marketplace coverage are satisfied with the doctors participating in their plans. Overall, the majority of marketplace enrollees expressed confidence in their ability to afford care if they were to become seriously ill. This issue brief explores these and other findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016.

  12. Medicaid Expansion under the Affordable Care Act. Implications for Insurance-related Disparities in Pulmonary, Critical Care, and Sleep

    PubMed Central

    Douglas, Ivor S.; Cooke, Colin R.

    2014-01-01

    The Affordable Care Act was intended to address systematic health inequalities for millions of Americans who lacked health insurance. Expansion of Medicaid was a key component of the legislation, as it was expected to provide coverage to low-income individuals, a population at greater risk for disparities in access to the health care system and in health outcomes. Several studies suggest that expansion of Medicaid can reduce insurance-related disparities, creating optimism surrounding the potential impact of the Affordable Care Act on the health of the poor. However, several impediments to the implementation of Medicaid’s expansion and inadequacies within the Medicaid program itself will lessen its initial impact. In particular, the Supreme Court’s decision to void the Affordable Care Act’s mandate requiring all states to accept the Medicaid expansion allowed half of the states to forego coverage expansion, leaving millions of low-income individuals without insurance. Moreover, relative to many private plans, Medicaid is an imperfect program suffering from lower reimbursement rates, fewer covered services, and incomplete acceptance by preventive and specialty care providers. These constraints will reduce the potential impact of the expansion for patients with respiratory and sleep conditions or critical illness. Despite its imperfections, the more than 10 million low-income individuals who gain insurance as a result of Medicaid expansion will likely have increased access to health care, reduced out-of-pocket health care spending, and ultimately improvements in their overall health. PMID:24708065

  13. 76 FR 59703 - Notice of Intent To Award Affordable Care Act (ACA) Funding, RFA-TP-08-001

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... (ACA) Funding, RFA- TP-08-001 AGENCY: Centers for Disease Control and Prevention (CDC), Department of... Affordable Care Act (ACA) funding to Preparedness and Emergency Response Research Centers (PERRCs). This... award Affordable Care Act (ACA) appropriations to the following 4 Preparedness and Emergency...

  14. Evaluation of Child Care Subsidy Strategies: Massachusetts Family Child Care Study. Executive Summary

    ERIC Educational Resources Information Center

    Collins, Ann; Goodson, Barbara

    2010-01-01

    This report presents findings from the Massachusetts Family Child Care study, a two-year evaluation designed to examine the impacts on providers and children of an early childhood education program aimed at improving the development and learning opportunities in the care settings and, as a consequence, the outcomes for children in care. The early…

  15. Creditable Foods Guide for Child Care Centers on the Child Care Food Program.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Health, Denver.

    This manual provides information on creditable and noncreditable foods in child care centers, before-and-after-school centers, family day care homes, and adult day care centers. Creditable foods are foods that may be counted toward meeting the requirements for a reimbursable meal. Foods are determined to be creditable according to guidelines…

  16. Mothers' Search for Infant Child Care: The Dynamic Relationship between Availability and Desirability in a Continental European Welfare State

    ERIC Educational Resources Information Center

    Vandenbroeck, M.; De Visscher, S.; Van Nuffel, K.; Ferla, J.

    2008-01-01

    The availability, affordability, and desirability of quality child care are matters of concern, especially for children raised in poverty, given the literature showing that young children raised in poverty can benefit from early access to quality care. The unique features of the Brussels context enable us to look at the connection between…

  17. How the Patient Protection and Affordable Care Act affects Texas dentists.

    PubMed

    Oneacre, Lee P

    2012-10-01

    President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law March 23, 2010 (P.L. 111-148), as arguably the most significant legislative health reform since the creation of Medicare and Medicaid in 1965 (1). Several PPACA provisions will impact dentists as both health care providers and small business owners and employers (2). Overall, the law significantly changes health care financing and facilitates competition in the health insurance market place through the creation of health insurance exchanges (HIX).

  18. The Patient Protection and Affordable Care Act and the regulation of the health insurance industry.

    PubMed

    Jha, Saurabh; Baker, Tom

    2012-12-01

    The Patient Protection and Affordable Care Act is a comprehensive and multipronged reform of the US health care system. The legislation makes incremental changes to Medicare, Medicaid, and the market for employer-sponsored health insurance. However, it makes substantial changes to the market for individual and small-group health insurance. The purpose of this article is to introduce the key regulatory reforms in the market for individual and small-group health insurance and explain how these reforms tackle adverse selection and risk classification and improve access to health care for the hitherto uninsured or underinsured population.

  19. Employers Roundtable: Employer Supported Child Care.

    ERIC Educational Resources Information Center

    Delaware Valley Child Care Council, Philadelphia, PA.

    This booklet outlines a number of options available to employers to enable them to better cope with child care issues that they and their employees face. Major options include: (1) flexible work policies, such as flexible scheduling, alternate work places, shorter work weeks, and the consolidating of sick leave, holidays, and vacation time into…

  20. Health Instruction Packages: Consumer--Child Care.

    ERIC Educational Resources Information Center

    Wojcik, Bonnie; And Others

    Text, illustrations, and exercises are utilized in these four learning modules to instruct parents and nursing students in topics related to child care and development. The first module, "Growth and Development: Let's Test Your Baby's Reflexes" by Bonnie Wojcik, describes the behavioral signs that are indicative of eight normal primitive…

  1. Child Care in the United States.

    ERIC Educational Resources Information Center

    Lazar, Irving

    This paper discusses present child care provision for children of preschool age in the United States. After a brief historical preface that points out deficits and needed improvements in public school and infant programs, the discussion focuses on several aspects of established programs for 3- to 5-year-old children. In particular, research…

  2. Child Day Care Center Licensing Study, 1997.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    The 1997 Child Care Center Licensing Study contains an update of information compiled in 1991 by the Children's Foundation. The data was obtained from the central regulatory office of each of the 50 states, the District of Columbia, Puerto Rico, and the Virgin Islands. The study is organized in alphabetical order by states and territories. The…

  3. Playground Hazards in Atlanta Child Care Centers.

    ERIC Educational Resources Information Center

    Sacks, Jeffrey J.; And Others

    1990-01-01

    Examines 71 of the 605 licensed child care centers in Atlanta for playground hazards and school accidents. Finds 684 hazards in 66 centers, including climbing equipment over 6 feet high with inadequate impact-absorbing undersurfacing that had over twice the rate of fall injuries as climbing equipment under 6 feet high. (FMW)

  4. Teaching Your Child Healthy Nail Care

    MedlinePlus

    ... aad", "size=300x250", "vpos=t", "hpos=r", "zone=public", "mcat1=de12", ]; for (var c = 0; c Teaching your child healthy nail care Nails take a ... by wearing flip-flops or shower sandals in public places, such as beaches, ... nails are usually healthy, but teaching them to check their nails at a young ...

  5. Child and Youth Care Approaches to Management

    ERIC Educational Resources Information Center

    Gharabaghi, Kiaras

    2008-01-01

    This article explores the themes and issues related to child and youth care approaches to management. The profession is significantly underrepresented at the management level. To some extent, this reflects the challenges of being recognized in the broader human services sector as a profession, but perhaps more so, it reflects an underdevelopment…

  6. Child Care Center Licensing Study, 2000.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    This report is an update of information initially compiled in 1991 through a survey of the child care regulatory offices of the 50 United States, the District of Columbia, Puerto Rico, and the Virgin Islands. The report begins with an introduction, definition of terms, and a question and answer summary. The bulk of the report is organized in…

  7. Child Care Center Licensing Study, 2003.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    This report is a yearly update of information initially compiled in 1991 through a survey of the child care regulatory offices of the 50 U.S. states, the District of Columbia, Puerto Rico, and the Virgin Islands. The report begins with an introduction, definition of terms, and a question and answer summary. The bulk of the report is organized in…

  8. Child Care Center Licensing Study, 2002.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    This report is an update of information initially compiled in 1991 through a survey of the child care regulatory offices of the 50 U.S. states, the District of Columbia, Puerto Rico, and the Virgin Islands. The report begins with an introduction, definition of terms, and a question and answer summary. The bulk of the report is organized in…

  9. Child Care Center Licensing Study, 2001.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    This report is an update of information initially compiled in 1991 through a survey of the child care regulatory offices of the 50 U.S. states, the District of Columbia, Puerto Rico, and the Virgin Islands. The report begins with an introduction, definition of terms, and a question and answer summary. The bulk of the report is organized in…

  10. The Child Care Center Licensing Study, 1999.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    This report compiles findings of a survey of the child care regulatory offices of the 50 United States, the District of Columbia, Puerto Rico, and the Virgin Islands. The report begins with an introduction, definition of terms, and a question and answer summary. The bulk of the report is organized in alphabetical order by state or territory, and…

  11. 33 CFR 55.13 - Family child care providers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PERSONNEL CHILD DEVELOPMENT SERVICES General § 55.13 Family child care providers. When appropriated funds... Guard child development centers. 33 CFR Ch. I (7-1-13 Edition) Coast Guard, DHS ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Family child care providers....

  12. 33 CFR 55.13 - Family child care providers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... PERSONNEL CHILD DEVELOPMENT SERVICES General § 55.13 Family child care providers. When appropriated funds... Guard child development centers. 33 CFR Ch. I (7-1-14 Edition) Coast Guard, DHS ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Family child care providers....

  13. 33 CFR 55.13 - Family child care providers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PERSONNEL CHILD DEVELOPMENT SERVICES General § 55.13 Family child care providers. When appropriated funds... Guard child development centers. 33 CFR Ch. I (7-1-12 Edition) Coast Guard, DHS ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Family child care providers....

  14. 33 CFR 55.13 - Family child care providers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PERSONNEL CHILD DEVELOPMENT SERVICES General § 55.13 Family child care providers. When appropriated funds... Guard child development centers. 33 CFR Ch. I (7-1-10 Edition) Coast Guard, DHS ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Family child care providers....

  15. 33 CFR 55.13 - Family child care providers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... PERSONNEL CHILD DEVELOPMENT SERVICES General § 55.13 Family child care providers. When appropriated funds... Guard child development centers. 33 CFR Ch. I (7-1-11 Edition) Coast Guard, DHS ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Family child care providers....

  16. Patient Protection and Affordable Care Act of 2010 and Children and Youth With Special Health Care Needs

    PubMed Central

    Buysse, Christina A.; Hubner, Lauren M.; Huffman, Lynne C.; Loe, Irene M.

    2015-01-01

    ABSTRACT: The Patient Protection and Affordable Care Act (ACA) was designed to (1) decrease the number of uninsured Americans, (2) make health insurance and health care affordable, and (3) improve health outcomes and performance of the health care system. During the design of ACA, children in general and children and youth with special health care needs and disabilities (CYSHCN) were not a priority because before ACA, a higher proportion of children than adults had insurance coverage through private family plans, Medicaid, or the State Children's Health Insurance Programs (CHIP). ACA benefits CYSHCN through provisions designed to make health insurance coverage universal and continuous, affordable, and adequate. Among the limitations of ACA for CYSHCN are the exemption of plans that had been in existence before ACA, lack of national standards for insurance benefits, possible elimination or reductions in funding for CHIP, and limited experience with new delivery models for improving care while reducing costs. Advocacy efforts on behalf of CYSHCN must track implementation of ACA at the federal and the state levels. Systems and payment reforms must emphasize access and quality improvements for CYSHCN over cost savings. Developmental-behavioral pediatrics must be represented at the policy level and in the design of new delivery models to assure high quality and cost-effective care for CYSHCN. PMID:25793891

  17. Patient Protection and Affordable Care Act of 2010 and children and youth with special health care needs.

    PubMed

    Feldman, Heidi M; Buysse, Christina A; Hubner, Lauren M; Huffman, Lynne C; Loe, Irene M

    2015-04-01

    The Patient Protection and Affordable Care Act (ACA) was designed to (1) decrease the number of uninsured Americans, (2) make health insurance and health care affordable, and (3) improve health outcomes and performance of the health care system. During the design of ACA, children in general and children and youth with special health care needs and disabilities (CYSHCN) were not a priority because before ACA, a higher proportion of children than adults had insurance coverage through private family plans, Medicaid, or the State Children's Health Insurance Programs (CHIP). ACA benefits CYSHCN through provisions designed to make health insurance coverage universal and continuous, affordable, and adequate. Among the limitations of ACA for CYSHCN are the exemption of plans that had been in existence before ACA, lack of national standards for insurance benefits, possible elimination or reductions in funding for CHIP, and limited experience with new delivery models for improving care while reducing costs. Advocacy efforts on behalf of CYSHCN must track implementation of ACA at the federal and the state levels. Systems and payment reforms must emphasize access and quality improvements for CYSHCN over cost savings. Developmental-behavioral pediatrics must be represented at the policy level and in the design of new delivery models to assure high quality and cost-effective care for CYSHCN.

  18. Health Education in Child Care: Opportunities and Challenges.

    ERIC Educational Resources Information Center

    Nalle, Maureen A.

    1996-01-01

    This article addresses the health and safety risks associated with child care facilities, including injuries and infectious diseases. Related health education needs for child care providers, parents, and children are examined, and recommendations for health educators are provided. (SM)

  19. DAP in the 'Hood: Perceptions of Child Care Practices by African American Child Care Directors Caring for Children of Color

    ERIC Educational Resources Information Center

    Sanders, Kay E.; Deihl, Amy; Kyler, Amy

    2007-01-01

    This paper presents a qualitative analysis concerning child care practices by six African American directors of subsidized child care centers located in a low-income, racial ethnic minority area of Los Angeles, California. These programs are traditionally African American programs that experienced an influx of Latino immigrant enrollment. Using…

  20. Child Care Helps America Work and Learn. Issue No. 1

    ERIC Educational Resources Information Center

    Child Care Bureau, 2010

    2010-01-01

    "Child Care Helps America Work and Learn" is a new publication produced by the Child Care Bureau. This new series will highlight some of the many Recovery Act-funded child care success stories from communities across the country that illustrate how the Bureau is working toward the shared goal of supporting children and families. This…

  1. Inter Association Child Care Conference. Conference Proceedings 1979.

    ERIC Educational Resources Information Center

    Austin, David, Ed.

    This publication of the proceedings of the Inter Association Child Care Conference includes a debate for and against professionalization in the field of child care. A section on meeting the treatment needs of children through educational preparation of child care practitioners discusses background factors, levels of education for practitioners,…

  2. Toward Better Child Care Worker Compensation: Advocacy in Three States.

    ERIC Educational Resources Information Center

    De Vita, Carol J.; Twombly, Eric C.; Montilla, Maria D.

    Although the demand for child care in the United States has risen over the past 40 years, the supply of good quality child care remains both limited and costly, and the supply of well-trained and adequately compensated workers remains low. This study reviewed how advocates have moved the issue of child care worker compensation forward in the…

  3. Employer-Supported Child Care: Investing in Human Resources.

    ERIC Educational Resources Information Center

    Burud, Sandra L.; And Others

    This book for employers interested in establishing child care programs is organized into five major topic areas. Part One provides an overview of employer-supported child care. Part Two discusses the processes of identifying and estimating benefits of child care to companies, and tax considerations. Part Three presents practical guidelines and a…

  4. An Effective Training Approach for Child Day Care Providers.

    ERIC Educational Resources Information Center

    Kaplan, Melissa G.; Smock, Sue Marx

    Controversy exists in the field of child day care concerning the training of child care workers. Becker (1979) states that trainers should be child care professionals who help to engage workers in an educational/developmental process, as opposed to "outside" trainers from other professions who view training as a mechanism to "add…

  5. How To Start a Licensed Child Care Home.

    ERIC Educational Resources Information Center

    Henry, Jeanie

    This booklet was designed as a resource for people applying for a license as a family child care home or a family child care group home under Alaska state licensing requirements. Following an introduction that explains the difference between the two types of child care homes, the booklet considers the following topics: (1) choosing family child…

  6. Texas Subsidized Child Care Utilization Patterns and Outcomes.

    ERIC Educational Resources Information Center

    Schexnayder, Deanna T.; Schroeder, Daniel G.; Faliski, Katherine; McCoy, Jody

    To learn more about families and children who have been served by the Texas Child Care Management Services (CCMS) system, this study investigated four primary questions: (1) What are the demographic characteristics of Texas families and children who have received subsidized child care services? (2) What are the subsidized child care utilization…

  7. Conceptual Frameworks for Child Care Decision-Making. White Paper

    ERIC Educational Resources Information Center

    Chaudry, Ajay; Henly, Julia; Meyers, Marcia

    2010-01-01

    This working paper is one in a series of projects initiated by the Administration for Children and Families (ACF) to improve knowledge for child care researchers and policy makers about parental child care decision making. In this paper, the authors identify three distinct conceptual frameworks for understanding child care decisions--a rational…

  8. Money, Accreditation, and Child Care Center Quality. Working Paper Series.

    ERIC Educational Resources Information Center

    Gormley, William T., Jr.; Lucas, Jessica K.

    In recent years, several states have offered financial incentives to encourage child care centers and homes to become accredited by a reputable national organization to improve child care quality. This report examines whether it is good policy to offer higher reimbursement rates to accredited child care facilities and assesses the relative merits…

  9. 45 CFR 98.44 - Priority for child care services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Priority for child care services. 98.44 Section 98.44 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements §...

  10. 45 CFR 98.44 - Priority for child care services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Priority for child care services. 98.44 Section 98.44 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements §...

  11. 45 CFR 98.44 - Priority for child care services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Priority for child care services. 98.44 Section 98.44 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements §...

  12. 45 CFR 98.44 - Priority for child care services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Priority for child care services. 98.44 Section 98.44 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements §...

  13. 45 CFR 98.44 - Priority for child care services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Priority for child care services. 98.44 Section 98.44 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements §...

  14. State Developments in Child Care and Early Education, 1999.

    ERIC Educational Resources Information Center

    Blank, Helen; Poersch, Nicole Oxendine

    This report provides highlights and updates regarding state actions on child care and early education issues during 1999. It is intended to serve as a supplement to "State Child Care and Early Education Development: Highlights and Updates for 1998" and "State Developments in Child Care and Early Education 1997." The information…

  15. Employer Support for Families with Child Care Needs.

    ERIC Educational Resources Information Center

    Fischer, Jan Lockwood

    Present and past employer support for child care is reviewed in this paper. The first half of the discussion is devoted to a general and brief historical survey describing employer support for families needing child care and detailing working mothers' increasing demand for child care services. Also briefly mentioned are government programs…

  16. Parents and the High Cost of Child Care: 2013 Report

    ERIC Educational Resources Information Center

    Wood, Stephen; Kendall, Rosemary

    2013-01-01

    Every week in the United States, nearly 11 million children younger than age 5 are in some type of child care arrangement. On average, these children spend 36 hours a week in child care. While parents are children's first and most important teachers, child care programs provide early learning for millions of young children daily, having a profound…

  17. Rights in the Workplace: A Guide for Child Care Teachers.

    ERIC Educational Resources Information Center

    Owens, Christine; Stoken, Amy; Fritts, Jonathan; Magar, Michele; Bellm, Dan; Shukla, Renu; Vardell, Rosemarie; Wayne, Claudia; Whitebook, Marcy

    Research on child care quality and experience in the field shows that the quality of working conditions are linked to a caregiver's ability to provide quality care. Noting that legal rights that generally apply to most child care teachers are not upheld in every workplace, this guide provides information on federal legal rights of child care…

  18. Employer-Sponsored Child Care Models and Related Issues.

    ERIC Educational Resources Information Center

    Renfroe, Martha Lou

    This study was designed to describe the different models of Employer-Sponsored Child Care (ESCC) available to employers and child care professionals. Examples of specific child care programs sponsored by employers are described, and five ESCC models are identified: on-site and off-site centers for a single employer, off-site centers for multiple…

  19. 20 CFR 638.542 - Child care services.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Child care services. 638.542 Section 638.542... TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.542 Child care services. (a) Job Corps centers shall, where practicable, arrange for the provision of child care for students...

  20. 20 CFR 638.542 - Child care services.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Child care services. 638.542 Section 638.542... TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.542 Child care services. (a) Job Corps centers shall, where practicable, arrange for the provision of child care for students...

  1. 20 CFR 638.542 - Child care services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Child care services. 638.542 Section 638.542... TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.542 Child care services. (a) Job Corps centers shall, where practicable, arrange for the provision of child care for students...

  2. Hospitals as Child Care Providers. An Interview with Diane Schulz.

    ERIC Educational Resources Information Center

    Child Care Information Exchange, 1999

    1999-01-01

    Interviews Diane Schulz, president of Child Care in Health Care, discussing the status of on-site or near-site child care for hospital employees. Considers the trend in hospital-based care, organization, support, customers, and challenges faced by these day care centers. (JPB)

  3. The Business of Child Care; Management and Financial Strategies

    ERIC Educational Resources Information Center

    Jack, Gail

    2004-01-01

    Unpleasant as it sounds, how providers care for the business aspects of child care can be as vital as how children are cared for. When your business runs smoothly it allows staff to focus on the most important task of all -- providing the best care for children. "The Business of Child Care" supplies guidance for successfully completing the…

  4. Child Care and Child Safety for Farm Children in Manitoba. RDI Report Series 1994-7.

    ERIC Educational Resources Information Center

    Brockman, Lois M.

    A Manitoba survey examined child care use, child safety concerns, and parents' on-farm and off-farm work to determine the needs of farm families for child care services. Of 972 questionnaires mailed to Manitoba farm residences, 121 were returned by respondents who were actively farming and living on a farm with at least one child younger than 16…

  5. The Patient Protection and Affordable Care Act: A Primer for Hand Surgeons

    PubMed Central

    Adkinson, Joshua M.; Chung, Kevin C.

    2014-01-01

    The Affordable Care Act is the largest and most comprehensive overhaul of the United States healthcare industry since the inception of the Medicare and Medicaid. Contained within the 10 Titles are a multitude of provisions that will change how hand surgeons practice medicine and how they are reimbursed. It is imperative that surgeons are equipped with the knowledge of how this law will affect all physician practices and hospitals. PMID:25066853

  6. Seizing opportunities under the Affordable Care Act for transforming the mental and behavioral health system.

    PubMed

    Mechanic, David

    2012-02-01

    The Affordable Care Act, along with Medicaid expansions, offers the opportunity to redesign the nation's highly flawed mental health system. It promotes new programs and tools, such as health homes, interdisciplinary care teams, the broadening of the Medicaid Home and Community-Based Services option, co-location of physical health and behavioral services, and collaborative care. Provisions of the act offer extraordinary opportunities, for instance, to insure many more people, reimburse previously unreimbursed services, integrate care using new information technology tools and treatment teams, confront complex chronic comorbidities, and adopt underused evidence-based interventions. The Centers for Medicare and Medicaid Services and its Center for Medicare and Medicaid Innovation should work intensively with the states to implement these new programs and other arrangements and begin to fulfill the many unmet promises of community mental health care.

  7. The Affordable Care Act and Implications for Health Care Services for American Indian and Alaska Native Individuals

    PubMed Central

    Ross, Raven E.; Garfield, Lauren D.; Brown, Derek S.; Raghavan, Ramesh

    2016-01-01

    American Indian and Alaska Native (AI/AN) populations report poor physical and mental health outcomes while tribal health providers and the Indian Health Service (IHS) operate in a climate of significant under funding. Understanding how the Patient Protection and Affordable Care Act (ACA) affects Native American tribes and the IHS is critical to addressing the improvement of the overall access, quality, and cost of health care within AI/AN communities. This paper summarizes the ACA provisions that directly and/or indirectly affect the service delivery of health care provided by tribes and the IHS. PMID:26548665

  8. Child Health and Access to Medical Care

    PubMed Central

    Leininger, Lindsey; Levy, Helen

    2016-01-01

    It might seem strange to ask whether increasing access to medical care can improve children’s health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children’s health. Nonetheless, they find that, on the whole, policies to improve access indeed improve children’s health, with the caveat that context plays a big role—medical care “matters more at some times, or for some children, than others.” Focusing on studies that can plausibly show a causal effect between policies to increase access and better health for children, and starting from an economic framework, they consider both the demand for and the supply of health care. On the demand side, they examine what happens when the government expands public insurance programs (such as Medicaid), or when parents are offered financial incentives to take their children to preventive appointments. On the supply side, they look at what happens when public insurance programs increase the payments that they offer to health-care providers, or when health-care providers are placed directly in schools where children spend their days. They also examine how the Affordable Care Act is likely to affect children’s access to medical care. Leininger and Levy reach three main conclusions. First, despite tremendous progress in recent decades, not all children have insurance coverage, and immigrant children are especially vulnerable. Second, insurance coverage alone doesn’t guarantee access to care, and insured children may still face barriers to getting the care they need. Finally, as this issue of Future of Children demonstrates, access to care is only one of the factors that policy makers should consider as they seek to make the nation’s children healthier. PMID:27516723

  9. Child Health and Access to Medical Care.

    PubMed

    Leininger, Lindsey; Levy, Helen

    2015-01-01

    It might seem strange to ask whether increasing access to medical care can improve children's health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children's health. Nonetheless, they find that, on the whole, policies to improve access indeed improve children's health, with the caveat that context plays a big role-medical care "matters more at some times, or for some children, than others." Focusing on studies that can plausibly show a causal effect between policies to increase access and better health for children, and starting from an economic framework, they consider both the demand for and the supply of health care. On the demand side, they examine what happens when the government expands public insurance programs (such as Medicaid), or when parents are offered financial incentives to take their children to preventive appointments. On the supply side, they look at what happens when public insurance programs increase the payments that they offer to health-care providers, or when health-care providers are placed directly in schools where children spend their days. They also examine how the Affordable Care Act is likely to affect children's access to medical care. Leininger and Levy reach three main conclusions. First, despite tremendous progress in recent decades, not all children have insurance coverage, and immigrant children are especially vulnerable. Second, insurance coverage alone doesn't guarantee access to care, and insured children may still face barriers to getting the care they need. Finally, as this issue of Future of Children demonstrates, access to care is only one of the factors that policy makers should consider as they seek to make the nation's children healthier.

  10. Family Child Care Programs within the Military System of Care

    ERIC Educational Resources Information Center

    Stevens, Carolyn S.

    2011-01-01

    Military families face challenges not found in other work environments. Shifting work schedules that are often longer than the typical 8-hour day, as well as the ever-present possibility of being deployed anywhere in the world on a moment's notice, require a child care system that is flexible but maintains high-quality standards. The U.S.…

  11. From Child Care to Family Care: The Parent Services Handbook.

    ERIC Educational Resources Information Center

    San Francisco Foundation, CA.

    This handbook for child care centers that are expanding their support to parents of children in their programs begins by describing the Parent Services Project (PSP). The next section explains the many services available to parents and the variety of ways these services are provided at the PSP centers. Services include fun family events; parenting…

  12. I Am Your Child. Quality Child Care: Making the Right Choice for You and Your Child. [Videotape].

    ERIC Educational Resources Information Center

    I Am Your Child Foundation, Beverly Hills, CA.

    Finding the right child care is often challenging for parents, but it is one of the most important decisions a parent will ever make. This videotape is intended to help parents with the process of evaluating child care options. The 30-minute video is presented in seven parts. Part 1, "Choosing Child Care," discusses why quality child…

  13. Patient Protection and Affordable Care Act; establishment of exchanges and qualified health plans; Small Business Health Options Program. Final rule.

    PubMed

    2013-06-04

    This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act) related to the Small Business Health Options Program (SHOP). Specifically, this final rule amends existing regulations regarding triggering events and special enrollment periods for qualified employees and their dependents and implements a transitional policy regarding employees' choice of qualified health plans (QHPs) in the SHOP.

  14. 77 FR 72581 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-05

    ...The U.S. Office of Personnel Management (OPM) is issuing a proposed rule to implement the Multi-State Plan Program (MSPP). OPM is establishing the MSPP pursuant to the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Through contracts with OPM, health insurance issuers will......

  15. Implementing the Patient Protection and Affordable Care Act: the time is now.

    PubMed

    Wojcik, Steven E

    2013-01-01

    Employers all across the country should be in full swing as they prepare to implement the tougher parts of the Patient Protection and Affordable Care Act's (ACA) employer provisions, which are about to come online and take effect in 2014. This article reviews these more challenging requirements and their complications, including how employer calculations over whether to continue to offer coverage might vary by industry characteristics. The author then looks further ahead to the "Cadillac" tax and discusses how this liability may affect every employer's decision about its health care strategy leading up to 2018.

  16. Medical Device Innovation in the Era of the Affordable Care Act

    PubMed Central

    Mattke, Soeren; Liu, Hangsheng; Orr, Patrick

    2016-01-01

    Abstract In this article, the authors explore why medical device innovation has traditionally been geared so thoroughly toward improving performance, with little regard to cost. They argue that the changing incentives in the health care sector and the move to value-based payment models, accelerated by the implementation of the Affordable Care Act, will force device manufacturers to redirect investments from the spectacular toward the prudent, which they dub “the end of sexy.” The authors explore consequences for manufacturers, investors, and policymakers. PMID:28083437

  17. 5 CFR 792.224 - Are child care subsidies paid to the Federal employee using the child care?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... administer its program (see § 792.223), the organization pays the child care provider; (b) For overseas... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Are child care subsidies paid to the Federal employee using the child care? 792.224 Section 792.224 Administrative Personnel OFFICE...

  18. Creating New Child Care Slots in Mini Child Care Centers: Big Bang for the Buck in New Jersey.

    ERIC Educational Resources Information Center

    Frankel, Arthur J.; And Others

    1992-01-01

    Small grants of $7,500 with technical assistance were offered to the child care community of New Jersey to either start or increase licensed capacity in mini-child care centers. Results of a subsequent analysis showed that 26 grantees created 481 new child care slots at an average cost of $561 per slot. (Author/SM)

  19. Our Families, Our Children: The Lesbian and Gay Child Care Task Force Report on Quality Child Care.

    ERIC Educational Resources Information Center

    Dispenza, Mary

    The Lesbian and Gay Child Care Task Force documented anecdotal evidence of homophobia in child care and school age communities, including: (1) refusal to accept children from lesbian, gay, bisexual, and transgender (LGBT) families into child care; (2) biased attitudes expressed to children when they speak about their families; and (3) demonstrated…

  20. Affordability of emergency obstetric and neonatal care at public hospitals in Madagascar.

    PubMed

    Honda, Ayako; Randaoharison, Pierana Gabriel; Matsui, Mitsuaki

    2011-05-01

    Timely access to emergency obstetric care is necessary to save the lives of women experiencing complications at delivery, and for newborn babies. Out-of-pocket costs are one of the critical factors hindering access to such services in low- and middle-income countries. This study measured out-of-pocket costs for caesarean section and neonatal care at an urban tertiary public hospital in Madagascar, assessed affordability in relation to household expenditure and investigated where families found the money to cover these costs. Data were collected for 103 women and 73 newborns at the Centre Hospitalier Universitaire de Mahajanga in the Boeny region of Madagascar between September 2007 and January 2008. Out-of-pocket costs for caesarean section were catastrophic for middle and lower socio-economic households, and treatment for neonatal complications also created a big financial burden, with geographical and other financial barriers further limiting access to hospital care. This study identified 12 possible cases where the mother required an emergency caesarean section and her newborn required emergency care, placing a double burden on the household. In an effort to make emergency obstetric and neonatal care affordable and available to all, including those living in rural areas and those of medium and lower socio-economic status, well-designed financial risk protection mechanisms and a strong commitment by the government to mobilise resources to finance the country's health system are necessary.

  1. Active Play Opportunities at Child Care

    PubMed Central

    Saelens, Brian E.; Christakis, Dimitri A.

    2015-01-01

    BACKGROUND AND OBJECTIVES: Physical activity (PA) is important for children’s health and development, yet preschoolers are not meeting PA recommendations. The objective of this study was to examine different PA opportunities at child care and how variation in indoor versus outdoor and free versus teacher-led opportunities relate to children’s PA. METHODS: An observational study of 98 children (mean age 4.5 years, 49% girls) from 10 child care centers. Classrooms were observed for at least 4 full days per center (total 50 days) to categorize time into (1) not an active play opportunity (APO); (2) naptime; (3) APO, outdoor free play; (4) APO, outdoor teacher-led; (5) APO, indoor free play; and (6) APO, indoor teacher-led. Children wore accelerometers during observations. Linear regression models examined the influence of APO categories on moderate-vigorous physical activity (MVPA) and sedentary time. RESULTS: Children’s activity was 73% sedentary, 13% light, and 14% MVPA. For 88% of time children did not have APOs, including 26% time as naptime. On average, 48 minutes per day were APOs (41% sedentary, 18% light, and 41% MVPA), 33 minutes per day were outdoors. The most frequent APO was outdoor free play (8% of time); outdoor teacher-led time was <1%. Children were more active and less sedentary outdoors versus indoors and during the child-initiated APOs (indoors and outdoors) versus teacher-led APOs. CONCLUSIONS: Preschoolers were presented with significantly fewer than recommended opportunities for PA at child care. More APOs are needed for children to meet recommendations, particularly those that encourage more outdoor time, more teacher-led and child-initiated active play, and flexibility in naptime for preschoolers. PMID:25986016

  2. Diarrhea & Child Care: Controlling Diarrhea in Out-of-Home Child Care. NCEDL Spotlights, No. 4.

    ERIC Educational Resources Information Center

    Churchill, Robin B.; Pickering, Larry K.

    This report, the fourth in the National Center for Early Development and Learning's (NCEDL) "Spotlights" series, is based on excerpts from a paper presented during a "Research into Practice in Infant/Toddler Care" synthesis conference in fall 1997. The report addresses controlling diarrhea in out-of-home child care. The report…

  3. The Affordable Care Act's payment and delivery system reforms: a progress report at five years.

    PubMed

    Abrams, Melinda; Nuzum, Rachel; Zezza, Mark; Ryan, Jamie; Kiszla, Jordan; Guterman, Stuart

    2015-05-01

    In addition to its expansion and reform of health insurance coverage, the Affordable Care Act (ACA) contains numerous provisions intended to resolve underlying problems in how health care is delivered and paid for in the United States. These provisions focus on three broad areas: testing new delivery models and spreading successful ones, encouraging the shift toward payment based on the value of care provided, and developing resources for systemwide improvement. This brief describes these reforms and, where possible, documents their initial impact at the ACA's five-year mark. While it is still far too early to offer any kind of definitive assessment of the law's transformation-seeking reforms, it is clear that the ACA has spurred activity in both the public and private sectors, and is contributing to momentum in states and localities across the U.S. to improve the value obtained for our health care dollars.

  4. Child Poverty and the Health Care System.

    PubMed

    Racine, Andrew D

    2016-04-01

    The persistence of child poverty in the United States and the pervasive health consequences it engenders present unique challenges to the health care system. Human capital theory and empirical observation suggest that the increased disease burden experienced by poor children originates from social conditions that provide suboptimal educational, nutritional, environmental, and parental inputs to good health. Faced with the resultant excess rates of pediatric morbidity, the US health care system has developed a variety of compensatory strategies. In the first instance, Medicaid, the federal-state governmental finance system designed to assure health insurance coverage for poor children, has increased its eligibility thresholds and expanded its benefits to allow greater access to health services for this vulnerable population. A second arm of response involves a gradual reengineering of health care delivery at the practice level, including the dissemination of patient-centered medical homes, the use of team-based approaches to care, and the expansion of care management beyond the practice to reach deep into the community. Third is a series of recent experiments involving the federal government and state Medicaid programs that includes payment reforms of various kinds, enhanced reporting, concentration on high-risk populations, and intensive case management. Fourth, pediatric practices have begun to make use of specific tools that permit the identification and referral of children facing social stresses arising from poverty. Finally, constituencies within the health care system participate in enhanced advocacy efforts to raise awareness of poverty as a distinct threat to child health and to press for public policy responses such as minimum wage increases, expansion of tax credits, paid family leave, universal preschool education, and other priorities focused on child poverty.

  5. Integrating Community Health Workers Within Patient Protection and Affordable Care Act Implementation

    PubMed Central

    Islam, Nadia; Nadkarni, Smiti Kapadia; Zahn, Deborah; Skillman, Megan; Kwon, Simona C.; Trinh-Shevrin, Chau

    2015-01-01

    Context The Patient Protection and Affordable Care Act’s (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs. Objective This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration. Results Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers’ role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers’ unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs. Conclusion Community health workers can support the effective implementation of PPACA if the capacity

  6. [Health advocacy in child care: literature review].

    PubMed

    Andrade, Raquel Dully; Mello, Débora Falleiros; Silva, Marta Angélica Iossi; Ventura, Carla Aparecida Arena

    2011-01-01

    This narrative literature review aimed to identify the publications about health law, in the ambit of child health care. The databases LILACS and MEDLINE were searched, between 2004 and 2009. Thirteen articles were analyzed, and three themes were identified: Emphasis on knowledge, abilities and attitudes for the development of competencies; Partnerships as an imperative; Health and Law: intersectorial relationship. The studies about the practice of health law are relevant to our reality, especially in primary health care, pointing out for the possibilities of its applicability in the role of the nurses acting in the family health strategy, with families and children.

  7. The Affordable Care Act's Impacts on Access to Insurance and Health Care for Low-Income Populations.

    PubMed

    Kominski, Gerald F; Nonzee, Narissa J; Sorensen, Andrea

    2017-03-20

    The Patient Protection and Affordable Care Act (ACA) expands access to health insurance in the United States, and, to date, an estimated 20 million previously uninsured individuals have gained coverage. Understanding the law's impact on coverage, access, utilization, and health outcomes, especially among low-income populations, is critical to informing ongoing debates about its effectiveness and implementation. Early findings indicate that there have been significant reductions in the rate of uninsurance among the poor and among those who live in Medicaid expansion states. In addition, the law has been associated with increased health care access, affordability, and use of preventive and outpatient services among low-income populations, though impacts on inpatient utilization and health outcomes have been less conclusive. Although these early findings are generally consistent with past coverage expansions, continued monitoring of these domains is essential to understand the long-term impact of the law for underserved populations.

  8. The Russian Child Health Care System.

    PubMed

    Baranov, Alexander; Namazova-Baranova, Leyla; Albitskiy, Valeriy; Ustinova, Natalia; Terletskaya, Rimma; Komarova, Olga

    2016-10-01

    We present a historical and analytical overview of the Russian child health care system describing strengths and challenges of the system. Main indicators of social environment and children's health, general demographics, and socioeconomic factors of Russia are described. The Russian health care system has preserved positive elements of the former Soviet model of pediatric care. However, beginning in 1991, it has been altered greatly in its funding and management. The child health care system is composed of a special network of outpatient and inpatient facilities. The key element of pediatric community care is the pediatric polyclinic, staffed by district pediatricians and nurses. Undergraduate pediatric training is separate from adult medical training. From day one onward, future pediatricians are trained at separate pediatric faculties of universities. Thus, they qualify as general pediatricians after only 2 years of postgraduate training. It should be emphasized that the gap between the health status of children in developed countries and the Russian Federation is largely due to the influence of socioeconomic determinants, such as traffic accidents, poverty, pollution, and hazardous life styles, including binge drinking. Further improvements of children's health require protective measures by the state to address the underlying socioeconomic determinants.

  9. Meeting the Needs of the Youngest Infants in Child Care

    ERIC Educational Resources Information Center

    Perez, Amanda; Petersen, Sandy

    2009-01-01

    Children may enter group care at very young ages. Developmentally, newborns (from birth to 4 months old) offer unique opportunities and challenges for child care providers. Are child care programs ready? Little information is available on providing group care to children at this critical developmental stage. This article explores the challenges of…

  10. 78 FR 75581 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-12

    ...This document announces the effective date of a regulatory provision published in the Federal Register by OPM on March 11, 2013 (78 FR 15559), entitled ``Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the Affordable Insurance...

  11. Implementing the Affordable Care Act: State Action to Establish SHOP Marketplaces.

    PubMed

    Dash, Sarah J; Lucia, Kevin W; Thomas, Amy

    2014-03-01

    The Affordable Care Act seeks to help small employers offer coverage by reforming the small-group market and establishing Small Business Health Options Program (SHOP) marketplaces. Seventeen states and the District of Columbia chose to operate their own SHOP marketplaces in 2014, with the federal government operating the SHOP marketplace in 33 states. This brief examines state decisions to enhance the value of SHOP marketplaces for small employers and finds that most have set predictable participation and eligibility requirements and will offer a competitive choice of insurers and plans. States also are seeking to facilitate small employers' shopping experience through online tools and access to personalized assistance. While not all SHOP marketplaces are yet functioning as intended, their establishment offers an opportunity to identify successful strategies for improving the affordability and accessibility of coverage for small employers.

  12. Enrollment in Health Insurance Through the Marketplace After Implementation of the Affordable Care Act in Texas.

    PubMed

    Gong, Gordon; Huey, Cassandra C; Johnson, Coleman; Curti, Debra; Philips, Billy U

    2016-10-01

    One of the goals of the Affordable Care Act aims to provide affordable health insurance through the health insurance exchange marketplace (the Marketplace). This study explores enrollments in the Marketplace in Texas and in rural vs urban areas in the East, South, and West regions of the state. Data are derived from the US Census Bureau and the Department of Health and Human Services. A total of 92.7% of eligible non-elderly adult Texans (NEATs) had enrolled in Marketplace insurance as of February 2015. Rural residents were less likely than urban residents to use the Marketplace. Most enrollees (85%) had received tax credits, and 58.6% had received cost-sharing reductions. The number of uninsured NEATs was reduced by 710,000 by 2014, which is equivalent to two-thirds of the enrollees in the Marketplace. One-third of the enrollees previously had private or employer-based insurance before enrollment into the Marketplace.

  13. A Critical Analysis of Obamacare: Affordable Care or Insurance for Many and Coverage for Few?

    PubMed

    Manchikanti, Laxmaiah; Helm Ii, Standiford; Benyamin, Ramsin M; Hirsch, Joshua A

    2017-03-01

    The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access. Health insurance is a financial mechanism for paying for health care, while access refers to the process of actually obtaining that health care. The ACA has widened the gap between providing patients the mechanism of paying for healthcare and actually receiving it. The ACA is applauded for increasing the number of insured, quite appropriately as that has occurred for over 20 million people. Less frequently mentioned are the 6 million who have lost their insurance. Further, in terms of how health insurance is been provided, the majority the expansion was based on Medicaid expansion, with an increase of 13 million. Consequently, the ACA hasn't worked well for the working and middle class who receive much less support, particularly those who earn more than 400% of the federal poverty level, who constitute 40% of the population and don't receive any help. As a result, exchange enrollment has been a disappointment and the percentage of workers obtaining their health benefits from their employer has decreased steadily. Access to health care has been uneven, with those on Medicaid hampered by narrow networks, while those on the exchanges or getting employer benefits have faced high out-of-pocket costs.The second category relates to cost containment. President Obama claimed that the ACA provided significant cost containment, in that costs would have been even much higher if the ACA was not enacted. Further, he attributed

  14. Implementing the Affordable Care Act in North Carolina: the rubber hits the road.

    PubMed

    Silberman, Pam

    2013-01-01

    The health insurance mandate, perhaps the best-known provision of the Patient Protection and Affordable Care Act of 2010 (ACA), is slated to go into effect on January 1, 2014. Yet most people do not know how the ACA will affect them. More than one-third of people in a recent national poll were unaware that new health insurance marketplaces will make it easier to purchase coverage or that some people will qualify for subsidies to help them purchase coverage. The ACA includes many other provisions that will have a profound impact on our health care delivery system. Some changes are already helping to break down silos in the delivery of care. Groups of health care professionals are working together to manage the health of populations. The ACA places a much greater emphasis on measuring quality and on paying health professionals and health care institutions based on the value of the services they provide. In addition, the ACA makes greater investments in prevention and in population health management. This issue brief highlights some of the health system changes that have taken place over the past 3 years, as well as some of the potential changes that are yet to come relating to insurance coverage, access to care, quality of care, rising health care costs, and overall population health.

  15. Caring and Learning Environments: Quality in Regulated Family Child Care across Canada. You Bet I Care!

    ERIC Educational Resources Information Center

    Doherty, Gillian; Lero, Donna S.; Goelman, Hillel; Tougas, Jocelyne; LaGrange, Annette

    Canadian experts in diverse fields as well as people concerned about social justice and cohesion have identified quality child care as a crucial component in addressing a variety of broad societal goals. This study explored the relationships between quality in Canadian family child care homes and: provider characteristics and attitudes about…

  16. Child Care in Rhode Island: Caring for Infants and Pre-School Children. Issue Brief.

    ERIC Educational Resources Information Center

    Harrington, Ann-Marie, Ed.; Walsh, Catherine Boisvert, Ed.; Bryant, Elizabeth Burke, Ed.

    1997-01-01

    This report of the Rhode Island Kids Count organization details the state's infant and preschool child care, components of quality care, and state policies to increase the supply of quality care. The report begins with a discussion of the importance of providing good quality child care to enhance healthy child development, especially brain…

  17. Classroom Level Effects of Children's Prior Participation in Child Care

    ERIC Educational Resources Information Center

    Clarke-Stewart, K. Alison; Lucas-Thompson, Rachel; Weaver, Jennifer M.; Karsh, Andrea

    2013-01-01

    Previous research indicates that children who spend many hours in early child care exhibit more externalizing behavior problems than children who spend less time in child care. Concern has been expressed regarding the cumulative effect of these problem behaviors on elementary school classes. We collected information about children's child-care…

  18. Child Care Choices, Consumer Education, and Low-Income Families.

    ERIC Educational Resources Information Center

    Mitchell, Anne; And Others

    In 1991, the National Center for Children in Poverty undertook a study of low-income parents as child care consumers. The study involved a review of current research findings, interviews with staff of child resource and referral agencies, and an examination of child care consumer education provided in the Job Opportunities and Basic Skills (JOBS)…

  19. Boys, Girls, and "Two Cultures" of Child Care

    ERIC Educational Resources Information Center

    Winer, Abby C.; Phillips, Deborah A.

    2012-01-01

    This study examined differences in the quality of child care experienced by toddler boys and girls. Boys were more likely to be in lower-quality child care than girls, assessed with both setting-level measures and observations of caregiver-child interaction. A possible explanatory mechanism for the gender differences is suggested by evidence that…

  20. Evaluating a Hygiene Education Program for Child Care Workers.

    ERIC Educational Resources Information Center

    Petri, Cynthia J.; Winnail, Scott D.; Geiger, Brian F.; Artz, Lynn M.; Mason, J. W.

    Children, parents, and child caregivers are vulnerable to several infectious diseases as a result of contact with child care centers. This pilot program, implemented in a rural county in a southeastern state, was designed to enhance knowledge and skills related to improved hygiene practices in a child care setting. The target audience for the…

  1. 76 FR 3143 - Office of Child Care; Delegation of Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-19

    ... HUMAN SERVICES Administration for Children and Families Office of Child Care; Delegation of Authority Notice is hereby given that I have delegated to the Director, Office of Child Care, Administration for..., Pub. L. 104-193), as amended, as they pertain to the functions assigned to the Office of Child...

  2. The Child Welfare Profession's Perception of Residential Care for Children

    ERIC Educational Resources Information Center

    Owens, Larry W.

    2008-01-01

    This research study explored the Child Welfare League of America's (CWLA) perception of residential care for children, as a reflection of the child welfare profession as a whole. A content analysis of CWLA's national conference programs and the journal "Child Welfare" from 1997 to 2006 found that the profession emphasizes family foster care and…

  3. Child Care and Welfare Reform: More Painful Choices.

    ERIC Educational Resources Information Center

    Ebb, Nancy

    This report discusses the impact of child care and welfare reform legislation under consideration by the Senate Republican leadership in the United States 104th Congress, based in part on a national survey of how states are coping, or not coping, with current child care needs and how prepared they are to cope with new demands for child care…

  4. The Affordable Care Act: new opportunities for cardiac rehabilitation in the workplace?

    PubMed

    Pinkstaff, Sherry O; Arena, Ross; Myers, Jonathan; Kaminsky, Leonard; Briggs, Paige; Forman, Daniel E; Patel, Mahesh J; Cahalin, Lawrence P

    2014-08-01

    Many people affected by cardiovascular disease (CVD) are working age. Employers bear a large percentage of the costs associated with CVD. Employers pay 80 times more in diagnosis and treatment than in prevention, although there is evidence that 50% to 70% of all diseases are associated with preventable health risks. As a result, the worksite is an appealing location to deliver health care.Cardiac rehabilitation has developed a track record of delivering improved outcomes for patients with CVD. Partnerships between cardiac rehabilitation providers and worksite health programs have the potential to improve referral and participation rates of employees with CVD. The current era of health reform in the United States that has been stimulated by the Affordable Care Act provides an ideal opportunity to reconsider worksite health programs as an essential partner in the health care team.

  5. Mitigating the effects of churning under the Affordable Care Act: lessons from Medicaid.

    PubMed

    Rosenbaum, Sara; Lopez, Nancy; Dorley, Mark; Teitelbaum, Joel; Burke, Taylor; Miller, Jacqueline

    2014-06-01

    Through a combination of three needs-based public programs--Medicaid, the Children's Health Insurance Program, and tax credits for purchasing private plans in the new marketplaces--the Affordable Care Act can potentially ensure continuous coverage for many low- and moderate-income Americans. At the same time, half of individuals with incomes at less than twice the poverty level will experience a form of "churning" in their coverage; as changes occur in their life or work circumstances, they will need to switch among these three coverage sources. For many, churning will entail not only changes in covered benefits and cost-sharing, but also in care, owing to differences in provider networks. Strategies for mitigating churning's effects are complex and require time to implement. For the short term, however, the experiences of 17 states with policies aimed at smoothing transitions between health plans offer lessons for ensuring care continuity.

  6. Rethinking the Affordable Care Act's "Cadillac tax": A More Equitable Way to Encourage "Chevy" Consumption.

    PubMed

    Nowak, Sarah; Eibner, Christine

    2015-12-01

    The Affordable Care Act's "Cadillac tax" will apply a 40 percent excise tax on total employer health insurance premiums in excess of $10,200 for single coverage and $27,500 for family coverage, starting in 2018. Employer spending on premiums is currently excluded from income and payroll taxes. Economists argue that this encourages overconsumption of health care, favors high-income workers, and reduces federal revenue. This issue brief suggests that the Cadillac tax is a "blunt instrument" for addressing these concerns because it will affect workers on a rolling timetable, does relatively little to address the regressive nature of the current exclusion, and may penalize firms and workers for cost variation that is outside their control. Replacing the current exclusion with tax credits for employer coverage that scale inversely with income might allow for regional adjustments in health care costs and eliminate aspects of the tax exclusion that favor high-income over low-income workers.

  7. Achieving a deeper understanding of the implemented provisions of the Affordable Care Act.

    PubMed

    Zhang, Shuang Qin; Polite, Blase N

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama on March 23, 2010. Since that time, numerous regulations have been promulgated, legal battles continue to be fought and the major provisions of the law are being implemented. In the following article, we outline components of the ACA that are relevant to cancer health care, review current implementation of the new health care reform law, and identify challenges that may lie ahead in the post-ACA era. Specifically, among the things we explore are Medicaid expansion, health insurance exchanges, essential health benefits and preventive services, subsidies, access to clinical trials, the Medicare Part D donut hole, and physician quality payment reform.

  8. "I can't afford that!": dilemmas in the care of the uninsured and underinsured.

    PubMed

    Weiner, S

    2001-06-01

    When patients lack sufficient health care insurance, financial matters become integrally intertwined with biomedical considerations in the process of clinical decision making. With a growing medically indigent population, clinicians may be compelled to bend billing or reimbursement rules, lower standards, or turn patients away when they cannot afford the costs of care. This article focuses on 3 types of dilemmas that clinicians face when patients cannot pay for needed medical services: (1) whether to refer the individual to a safety net provider, such as a public clinic; (2) whether to forgo indicated tests and therapies because of cost; and (3) whether to reduce fees by fee waivers or other adjustments in billing. Clinicians' responses to these dilemmas impact on quality of care, continuity, safety net providers, and the liability risk of committing billing violations or offering nonstandard care. Caring for the underinsured in the current health care climate requires an understanding of billing regulations, a commitment to informed consent, and a beneficent approach to finding individualized solutions to each patient care/financial dilemma. To effect change, however, physicians must address issues of social justice outside of the office through political and social activism.

  9. Evil, Child Abuse and the Caring Professions.

    PubMed

    Humphrey, Caroline

    2015-10-01

    The aim of this paper is to explore the ways in which the concept of evil has been invoked in relation to child abuse. First, the scene is set by juxtaposing professional discourses which have eschewed the concept of evil and public opinion which is affronted by the evil of child abuse. Second, I will discuss the work of some therapists in the USA whose work with perpetrators and survivors has led them to frame the causes and consequences of child abuse in terms of moral evil. Third, I will draw upon case studies of Satanic abuse and spirit possession in the UK to illustrate that some social workers and religious communities have interpreted child abuse as an outcome of or as an antidote to metaphysical evil. Finally, there is a critical appraisal of the merits of referencing moral and metaphysical evil in the discourses of caring professionals, with a suggestion that a mythical-metaphorical conception of evil could be a more flexible and fruitful resource for therapeutic work.

  10. Right-wing conspiracy? Socialist plot? The origins of the Patient Protection and Affordable Care Act.

    PubMed

    Quadagno, Jill

    2014-02-01

    On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA). Did the ACA signify a government takeover of the health care system, a first step on the road to socialism, as conservative critics charged? Or was it, rather, a sellout to the right wing, as liberal single-payer advocates proclaimed? The ACA's key provisions, the employer mandate and the individual mandate, were Republican policy ideas, and its fundamental principles were nearly identical to the Health Equity and Access Reform Today Act of 1993 (HEART), a bill promoted by Republican senators to deflect support for President Bill Clinton's Health Security plan. Yet the ACA was also a policy legacy of the Clinton administration in important ways that rarely are acknowledged, notably Medicaid expansion and insurance company regulation. Although the ACA departed from the liberal vision of a single-payer plan and adhered closely to the objectives of those who believed that the health care system should encourage the free market, it included provisions that will make coverage more affordable, reliable, and accessible.

  11. Meeting the Need for Child Care: Problems and Progress. Hearing before a Subcommittee of the Committee on Government Operations. House of Representatives, One Hundredth Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U. S., Washington, DC. House Committee on Government Operations.

    A hearing was held to identify problems and assess progress in the provision of affordable, high quality child care. Testimony concerned: (1) problems working parents have had in providing care for their young children; (2) day care initiatives and needs in California; (3) ways in which San Mateo County used its housing and community development…

  12. Public health law: the constitutionality of the Patient Protection and Affordable Care Act.

    PubMed

    De Ville, Kenneth

    2011-01-01

    Congress of the Patient Protection and Affordable Care Act (PPACA) was immediately challenged by lawsuits attacking the constitutionality of the legislation. The lawsuits, joined by over 2 dozen state's attorney generals, contend that PPACA is an unconstitutional exercise of federal power. Specifically, the suits argue that the individual insurance mandate portion of the law is justified by neither the "Commerce Power" nor Congress' authority to "tax" and provide for "the general welfare." This essay outlines and analyzes the constitutional arguments for, and against, PPACA forecasting the likely resolution of the debate if the suits reach the US Supreme Court.

  13. Women’s Health and the Affordable Care Act: High Hopes Versus Harsh Realities?

    PubMed Central

    Fendrick, A. Mark; Zochowski, Melissa; Dalton, Vanessa K.

    2014-01-01

    Our population-based survey of 1078 randomly sampled US women, aged 18 to 55 years, sought to characterize their understanding of and attitudes toward the Affordable Care Act (ACA). Most women, especially socially disadvantaged groups, had negative or uncertain attitudes toward the ACA and limited understanding of its health benefits, including its relevance for their own health service coverage and utilization. Our findings are important for continued research, policy, and practice, with implications for whether, when, and how improved coverage will translate to improved access and outcomes for US women. PMID:24922171

  14. Reform of the Individual Insurance Market in New Jersey: Lessons for the Affordable Care Act.

    PubMed

    Cantor, Joel C; Monheit, Alan C

    2016-08-01

    The individual health insurance market has played a small but important role in providing coverage to those without access to group insurance or public programs. With implementation of the Affordable Care Act (ACA), the individual market has attained a more prominent role. However, achieving accessible and affordable coverage in this market is a long-standing challenge, in large part due to the threat of adverse risk selection. New Jersey pursued comprehensive reforms beginning in the 1990s to achieve a stable, accessible, and affordable individual market. We review how adverse risk selection can pose a challenge to achieving such objectives in the individual health insurance market. We follow this discussion by describing the experience of New Jersey through three rounds of legislative reform and through the first year of the implementation of the ACA coverage provisions. While the New Jersey reforms did not require individuals to purchase coverage, its experiences with direct and indirect market subsidies and regulations guiding plan design, issuance, and rating have important implications for how the ACA may achieve its coverage goals in the absence of the controversial individual purchase mandate.

  15. Maryland Child Care Choices Study: Changes in Child Care Arrangements of Young Children in Maryland. Publication #2014-57

    ERIC Educational Resources Information Center

    Krafft, Caroline; Davis, Elizabeth E.; Tout, Kathryn

    2014-01-01

    The purpose of this series is to summarize key findings and implications from the Maryland Child Care Choices study, a longitudinal survey of parents who were applying for Temporary Assistance for Needy Families (TANF) in 2011. Families in the Maryland Child Care Choices study had at least one child age six or younger and lived in one of the…

  16. Caregiver-Child Relationships as a Context for Continuity in Child Care

    ERIC Educational Resources Information Center

    Recchia, Susan L.

    2012-01-01

    This paper focuses on one aspect of continuity--the caregiver-child relationship--within a larger global study of continuity in child care based at a university-affiliated child care center. Case studies are presented of two toddler boys, followed as they transitioned from their infant classroom to the preschool classroom at the age of…

  17. Modelling the affordability and distributional implications of future health care financing options in South Africa.

    PubMed

    McIntyre, Di; Ataguba, John E

    2012-03-01

    South Africa is considering introducing a universal health care system. A key concern for policy-makers and the general public is whether or not this reform is affordable. Modelling the resource and revenue generation requirements of alternative reform options is critical to inform decision-making. This paper considers three reform scenarios: universal coverage funded by increased allocations to health from general tax and additional dedicated taxes; an alternative reform option of extending private health insurance coverage to all formal sector workers and their dependents with the remainder using tax-funded services; and maintaining the status quo. Each scenario was modelled over a 15-year period using a spreadsheet model. Statistical analyses were also undertaken to evaluate the impact of options on the distribution of health care financing burden and benefits from using health services across socio-economic groups. Universal coverage would result in total health care spending levels equivalent to 8.6% of gross domestic product (GDP), which is comparable to current spending levels. It is lower than the status quo option (9.5% of GDP) and far lower than the option of expanding private insurance cover (over 13% of GDP). However, public funding of health services would have to increase substantially. Despite this, universal coverage would result in the most progressive financing system if the additional public funding requirements are generated through a surcharge on taxable income (but not if VAT is increased). The extended private insurance scheme option would be the least progressive and would impose a very high payment burden; total health care payments on average would be 10.7% of household consumption expenditure compared with the universal coverage (6.7%) and status quo (7.5%) options. The least pro-rich distribution of service benefits would be achieved under universal coverage. Universal coverage is affordable and would promote health system equity, but

  18. The Effects of Smart Start Child Care on Kindergarten Entry Skills. FPG-UNC Smart Start Evaluation Report.

    ERIC Educational Resources Information Center

    Bryant, Donna; Bernier, Kathleen; Taylor, Karen; Maxwell, Kelly

    Helping families access affordable, quality child care has been the primary focus for the Orange County, North Carolina Smart Start Partnership for Young Children. This study investigated the effects of Smart Start efforts on children's skills at kindergarten entry. Kindergarten teachers rated the cognitive, language and social skills of 39…

  19. Child Care: Volume II. Vocational Home Economics Education. Revised.

    ERIC Educational Resources Information Center

    Benson, Ann; Kates, Donna

    Intended for use in a four-semester occupational child care program for 11th- or 12th-grade and adult students, this curriculum guide provides instructional materials covering basic information and skills for operating a child care center or a family day care home. It includes 4 sections and 23 instructional units. Each unit of instruction…

  20. Differential Susceptibility to Parenting and Quality Child Care

    ERIC Educational Resources Information Center

    Pluess, Michael; Belsky, Jay

    2010-01-01

    Research on differential susceptibility to rearing suggests that infants with difficult temperaments are disproportionately affected by parenting and child care quality, but a major U.S. child care study raises questions as to whether quality of care influences social adjustment. One thousand three hundred sixty-four American children from…

  1. Crediting Foods in the Child Care Food Program. [Revised].

    ERIC Educational Resources Information Center

    Food and Nutrition Service (USDA), Robbinsville, NJ. Mid-Atlantic Regional Office.

    This modified version of a previously published title provides additional information on foods for which reimbursement may be obtained from the United States Department of Agriculture (USDA) by child care centers and family day care homes participating in the Child Care Food Program. Such foods, called creditable foods, are those that may be…

  2. The essential health benefits provisions of the Affordable Care Act: implications for people with disabilities.

    PubMed

    Rosenbaum, Sara; Teitelbaum, Joel; Hayes, Katherine

    2011-03-01

    In establishing minimum coverage standards for health insurance plans, the Affordable Care Act includes an "essential health benefits" statute that directs the U.S. Secretary of Health and Human Services not to make coverage decisions, determine reimbursement rates, establish incentive programs, or design benefits in ways that discriminate against individuals because of their age, disability, or expected length of life. This issue brief examines how this statute will help Americans with disabilities, who currently are subject to discrimination by insurers based on health status and health care need. The authors also discuss the complex issues involved in implementing the essential benefits provision and offer recommendations to federal policymakers for ensuring that people with disabilities receive the full insurance benefits to which they are entitled.

  3. How health navigators legitimize the Affordable Care Act to the uninsured poor.

    PubMed

    Vargas, Robert

    2016-09-01

    Health navigators are a new health care workforce created by the Affordable Care Act (ACA) to assist low-income minority populations with acquiring health insurance. Given the high levels of distrust among the poor toward government and the medical profession, this article asks: How do health navigators build the legitimacy necessary to persuade low-income uninsured clients to enroll in health insurance? Through ethnography of face-to-face interaction between navigators and the uninsured poor in Chicago, this study shows that successful navigators deployed a combination of cultural repertoires for building trust and legitimacy. These repertoires included ceding control of the conversation, creating ethnic solidarity, and disassociating themselves from government bureaucrats or self-serving insurance employees. These findings demonstrate the usefulness of cultural sociology for understanding health insurance provision to the poor, ACA outreach efforts, and the more general study of how occupations legitimize themselves to clients.

  4. Comparing Individual Health Coverage On and Off the Affordable Care Act's Insurance Exchanges.

    PubMed

    McCue, Michael J; Hall, Mark A

    2015-08-01

    The new health insurance exchanges are the core of the Affordable Care Act's (ACA) reforms, but how the law improves the nonsubsidized portion of the individual market is also important. This issue brief compares products sold on and off the exchanges to gain insight into how the ACA's market reforms are functioning. Initial concerns that insurers might seek to enroll lower-risk customers outside the exchanges have not been realized. Instead, more-generous benefit plans, which appeal to people with health problems, constitute a greater portion of plans sold off-exchange than those sold on-exchange. Although insur­ers that sell mostly on the exchanges incur an additional fee, they still devote a greater portion of their premium dollars to medical care. Their projected admin­istrative costs and profit margins are lower than are those of insurers selling only off the exchanges.

  5. Opportunities for social work under the Affordable Care Act: A call for action.

    PubMed

    Lynch, Sean; Greeno, Catherine; Teich, Judith; Delany, Peter

    2016-10-01

    The Affordable Care Act (ACA) has profoundly restructured American health care. Numerous social work authors have commented on the importance of the ACA's reforms to social work practice, education, and research. This article summarizes the literature, adds relevant information, and makes recommendations for future actions. The policy, opinion, and peer-reviewed literatures were systematically reviewed. Sixty-three publications appeared between 2010 and 2015 are included. Five themes emerged, as follows: 1) the crucial provisions of the ACA, 2) the natural affinity of social work and the ACA reforms, 3) curricular adaptations needed to address changing workforce needs, 4) areas for continued social work advocacy, and 5) opportunities for high-impact social work research. This article provides a comprehensive introduction to the ACA, its reforms, and opportunities for social work to assume a high visibility leadership role in implementing the reforms, with particular emphasis on needed curricular changes and opportunities for research.

  6. Profiles of Public-Private Partnerships for Child Care. The Child Care Partnership Project.

    ERIC Educational Resources Information Center

    Finance Project, Washington, DC.

    The profiles of programs collected in this report were developed as part of the Child Care Partnership Project, a multi-year technical assistance effort. The Partnership Project provides a series of technical assistance resources and materials to support the development and strengthening of public-private partnerships to improve the quality and…

  7. Child Care: Almost Ours. An AFL-CIO Guide to Implementing Child Care Laws.

    ERIC Educational Resources Information Center

    American Federation of Labor and Congress of Industrial Organizations, Washington, DC.

    On October 27, 1990, Congress enacted comprehensive federal child care legislation targeted toward low-income workers and a broad expansion of assistance to parents through the earned income tax credit. This guide alerts union members to the benefits that are now available under the new law: the Omnibus Budget Reconciliation Act of 1990. The guide…

  8. Child Care Health Connections, 1999: A Health and Safety Newsletter for California Child Care Professionals.

    ERIC Educational Resources Information Center

    Walery, Nancy, Ed.; Evinger, Sara, Ed.; Dailey, Lyn, Ed.; Sherman, Marsha, Ed.; Zamani, Rahman, Ed.

    1999-01-01

    This document is comprised of the six 1999 issues of a bimonthly newsletter providing information on young children's health and safety for California's child care professionals. Regular features include a column on infant/toddler concerns, a question-answer column regarding medical and health issues, a nutrition column, and resources for child…

  9. Staying Healthy in Child Care: Preventing Infectious Diseases in Child Care.

    ERIC Educational Resources Information Center

    Thomson, Beth, Ed.

    This guide provides explanations of control methods for infection and diseases in child care with an emphasis on prevention and health. The guide consists of two parts. The first part covers the following topics on preventing illness in children: how infections spread; handwashing; separation into age groups; nappy changing and toileting; cleaning…

  10. At the Heart of Child Care: Predictors of Teacher Sensitivity in Center-Based Child Care

    ERIC Educational Resources Information Center

    Gerber, Emily B.; Whitebook, Marcy; Weinstein, Rhona S.

    2007-01-01

    This study examined the extent to which characteristics of early childhood teachers and settings predicted observed teacher sensitivity. Participants included 41 head teachers at child care centers located in Northern California. Accreditation status, center size, and program quality were uniquely associated with teacher sensitivity. Accreditation…

  11. A systems thinking approach to analysis of the Patient Protection and Affordable Care Act.

    PubMed

    Williams, John C

    2015-01-01

    The public health community is challenged with understanding the many complexities presented by systems thinking and its applications in systems modeling. The model presented encompasses multiple variables needed (eg, model building) for the construction of a conceptual system model of the Patient Protection and Affordable Care Act (ACA). The model tracks the ACA from inception, through passage, March 2010, to its current state. Justification for the need to reform the current health care system rests, in part, on the heels of social justice. Proponents of the ACA have long argued that health reform was needed by the millions of uninsured person who suffered from health disparities, took little advantage of health prevention advice, and faced issues of access to providers as well as insurers. In addition the ACA seeks to address our uncontrollable spending on health care delivery. This article highlights the ACA from a systems perspective. The conceptual model presented encompasses both health reform variables (eg, health care provisions, key legislative components, system environment) and system variables (eg, inputs, outputs, feedback, and throughput) needed to understand current health care reform efforts from a systems perspective. The model presented shows how the interrelationships and interconnections of elements of a system come together to achieve its purpose or goal.

  12. The Patient Protection and Affordable Care Act: impact on mental health services demand and provider availability.

    PubMed

    Pearlman, Shoshannah A

    2013-01-01

    The Patient Protection and Affordable Care Act (ACA) will greatly increase the demand for mental health (MH) services, as 62.5 million Americans from relatively high-need populations will be newly eligible for MH benefits. Consequently, the supply of MH care provider services is expected to proportionately decrease by 18% to 21% in 2014. ACA funding does not demonstrate the ability to increase turnout of psychiatrists sufficiently to meet the need. Available data indicate that the numbers of advanced practice psychiatric nurses (APPNs) continue to increase at a much greater rate, but information from either a clinical perspective or a market perspective is complicated by the weak distinctions that are made between nurse practitioners (NPs) and other nonphysician care professionals. The following recommendations are made: (a) some of the ACA funding for research into efficient and effective care delivery systems should be allocated to acquiring data on APPNs in leadership roles or clinical settings in which they are ultimately responsible for management of MH care, as differentiated from settings in which they provide support for psychiatrists; and (b) since the available data indicate nurse practitioners achieve good outcomes and are more economically viable than psychiatrists, placement of psychiatric-mental health nurse practitioners in community settings should be recognized as a realistic solution to the shortfall of MH services.

  13. The Patient Protection and Affordable Care Act: the victory of unorthodox lawmaking.

    PubMed

    Beaussier, Anne-Laure

    2012-10-01

    The 2010 Patient Protection and Affordable Care Act was a major legislative achievement of the 111th Congress. This law structurally reforms the US health care system by encouraging universal health care coverage through regulated competition among private insurance companies. When looking at the process for reform, what strikes an observer of US health care policy in the first place is that the Democratic majority was able to enact something in a political field characterized by strong resistance to change. This article builds on that observation. Arguments concentrate on the legislative process of the reform and support the idea that it may be partly explained by considering an evolution of US legislative institutions, mostly in the sense of a more centralized legislative process. Based on approximately one hundred semidirected interviews, I argue that the Democratic majority, building on lessons from both President Bill Clinton's health care reform attempt and the Republicans' strategy of using strong congressional leadership to pass social reforms, was able to overcome institutional constraints that have long prevented comprehensive change. A more centralized legislative process, which has been described as "unorthodox lawmaking," enabled the Democratic leadership to overcome multiple institutional and political veto players.

  14. Determinants of Receipt of Recommended Preventive Services: Implications for the Affordable Care Act

    PubMed Central

    Kenney, Genevieve M.; Goin, Dana

    2014-01-01

    Objectives. We examined preventive care use by nonelderly adults (aged 18–64 years) before the Affordable Care Act (ACA) and considered the contributions of insurance coverage and other factors to service use patterns. Methods. We used data from the 2005–2010 Medical Expenditure Panel Survey to measure the receipt of 8 recommended preventive services. We examined gaps in receipt of services for adults with incomes below 400% of the federal poverty level compared with higher incomes. We then used a regression-based decomposition analysis to consider factors that explain the gaps in service use by income. Results. There were large income-related disparities in preventive care receipt for nonelderly adults. Differences in insurance coverage explain 25% to 40% of the disparities in preventive service use by income, but education, age, and health status are also important drivers. Conclusions. Expanding coverage to lower-income adults through the ACA is expected to increase their preventive care use. However, the importance of education, age, and health status in explaining income-related gaps in service use indicates that the ACA cannot address all barriers to preventive care and additional interventions may be necessary. PMID:24432932

  15. Child Care and Mothers' Mental Health: Is High-Quality Care Associated with Fewer Depressive Symptoms?

    ERIC Educational Resources Information Center

    Gordon, Rachel A.; Usdansky, Margaret L.; Wang, Xue; Gluzman, Anna

    2011-01-01

    Finding high-quality child care may pose financial and logistical challenges and create ongoing emotional strains for some mothers. We use the Study of Early Child Care and Youth Development to ask (a) are child-care settings that mothers select on the basis of their own perceptions of quality rated more highly by independent observers (and more…

  16. Supporting Nutrition in Early Care and Education Settings: The Child and Adult Care Food Program (CACFP)

    ERIC Educational Resources Information Center

    Stephens, Samuel A.

    2016-01-01

    Child care centers, Head Start programs, and family child care providers serving young children--as well as after school programs and homeless shelters that reach older children, adults, and families--are supported in providing healthy meals and snacks by reimbursements through the Child and Adult Care Food Program (CACFP). Administered by the…

  17. Gaining ground: Americans' health insurance coverage and access to care after the Affordable Care Act's first open enrollment period.

    PubMed

    Collins, Sara R; Rasmussen, Petra W; Doty, Michelle M

    2014-07-01

    A new Commonwealth Fund survey finds that in the wake of the Affordable Care Act's first open enrollment period, significantly fewer working-age adults are uninsured than just before the sign-up period began, and many have used their new coverage to obtain needed care. The uninsured rate for people ages 19 to 64 declined from 20 percent in the July-to-September 2013 period to 15 percent in the April-to-June 2014 period. An estimated 9.5 million fewer adults were uninsured. Young men and women drove a large part of the decline: the uninsured rate for 19-to-34-year-olds declined from 28 percent to 18 percent, with an estimated 5.7 million fewer young adults uninsured. By June, 60 percent of adults with new coverage through the marketplaces or Medicaid reported they had visited a doctor or hospital or filled a prescription; of these, 62 percent said they could not have accessed or afforded this care previously.

  18. Family Child Care Providers' Perspectives regarding Effective Professional Development and Their Role in the Child Care System: A Qualitative Study

    ERIC Educational Resources Information Center

    Lanigan, Jane D.

    2011-01-01

    This study examines family child care providers' perspectives regarding effective professional development and their role in the early learning and care system. Four focus groups were conducted annually for 3 years involving a total of 54 licensed family child care providers. Supportive social relationships emerged as an important dimension of…

  19. Creating Better Child Care Jobs: Model Work Standards for Teaching Staff in Center-Based Child Care.

    ERIC Educational Resources Information Center

    Center for the Child Care Workforce, Washington, DC.

    This document presents model work standards articulating components of the child care center-based work environment that enable teachers to do their jobs well. These standards establish criteria to assess child care work environments and identify areas to improve in order to assure good jobs for adults and good care for children. The standards are…

  20. Effects of the Affordable Care Act on Consumer Health Care Spending and Risk of Catastrophic Health Costs.

    PubMed

    Nowak, Sarah A; Eibner, Christine; Adamson, David M; Saltzman, Evan

    2014-01-01

    This study examines the likely effects of the Affordable Care Act (ACA) on average annual consumer health care spending and the risk of catastrophic medical costs for the United States overall and in two large states that have decided not to expand their Medicaid programs (Texas and Florida). The ACA will have varied impacts on individuals' and families' spending on health care, depending on income level and on estimated 2016 insurance status without the ACA. The authors find that average out-of-pocket spending is expected to decrease for all groups considered in the analysis, although decreases in out-of-pocket spending will be largest for those who would otherwise be uninsured. People who would otherwise be uninsured who transition to the individual market under the ACA will have higher total health care spending on average after implementation of the ACA because they will now incur the cost of health insurance premiums. The authors also find that risk of catastrophic health care spending will decrease for individuals of all income levels for the insurance transitions considered; decreases will be greatest for those at the lowest income levels. Case studies found that in Texas and Florida, Medicaid expansion would substantially reduce out-of-pocket and total health care spending for those with incomes below 100 percent of the federal poverty level, compared with a scenario in which the ACA is implemented without Medicaid expansion. Expansion would reduce the risk of high medical spending for those covered under Medicaid who would remain uninsured without expansion.

  1. Health literacy and the Affordable Care Act: a policy analysis for children with special health care needs in the USA

    PubMed Central

    Keim-Malpass, Jessica; Letzkus, Lisa C; Kennedy, Christine

    2015-01-01

    Children with special health care needs (CSHCN) represent populations with chronic health conditions that are often high utilizers of health care. Limited health literacy has emerged as a key indicator of adverse health outcomes, and CSHCN from limited health literacy families are particularly vulnerable. The purpose of this policy analysis is to outline key provisions in the Affordable Care Act (ACA) that incorporate health literacy approaches for implementation and have implications for CSHCN in the USA. Several key provisions are incorporated in the ACA that involve health literacy and have implications for CSHCN. These include: expansion of public insurance coverage and simplifying the enrollment process, provisions assuring equity in health care and communication among all populations, improving access to patient-centered medical homes that can offer care coordination, ensuring enhanced medication safety by changing liquid medication labeling requirements, and provisions to train health care providers on literacy issues. More research is needed to determine how provisions pertaining to health literacy in the ACA are implemented in various states. PMID:25897270

  2. Neurosurgery value and quality in the context of the Affordable Care Act: a policy perspective.

    PubMed

    Menger, Richard P; Guthikonda, Bharat; Storey, Christopher M; Nanda, Anil; McGirt, Matthew; Asher, Anthony

    2015-12-01

    Neurosurgeons provide direct individualized care to patients. However, the majority of regulations affecting the relative value of patient-related care are drafted by policy experts whose focus is typically system- and population-based. A central, prospectively gathered, national outcomes-related database serves as neurosurgery's best opportunity to bring patient-centered outcomes to the policy arena. In this study the authors analyze the impact of the Affordable Care Act (ACA) on the determination of quality and value in neurosurgery care through the scope, language, and terminology of policy experts. The methods by which the ACA came into law and the subsequent quality implications this legislation has for neurosurgery will be discussed. The necessity of neurosurgical patient-oriented clinical registries will be discussed in the context of imminent and dramatic reforms related to medical cost containment. In the policy debate moving forward, the strength of neurosurgery's argument will rest on data, unity, and proactiveness. The National Neurosurgery Quality and Outcomes Database (N(2)QOD) allows neurosurgeons to generate objective data on specialty-specific value and quality determinations; it allows neurosurgeons to bring the patient-physician interaction to the policy debate.

  3. Racial and Ethnic Disparities in Services and the Patient Protection and Affordable Care Act

    PubMed Central

    Abdus, Salam; Mistry, Kamila B.

    2015-01-01

    Objectives. We examined prereform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). Methods. We used pre-ACA household data from the Medical Expenditure Panel Survey to identify groups targeted by the coverage provisions of the Act (Medicaid expansions and subsidized Marketplace coverage). We examined racial/ethnic differences in coverage, access to care, and preventive service use, across and within ACA relevant subgroups from 2005 to 2010. The study took place at the Agency for Healthcare Research and Quality in Rockville, Maryland. Results. Minorities were disproportionately represented among those targeted by the coverage provisions of the ACA. Targeted groups had lower rates of coverage, access to care, and preventive services use, and racial/ethnic disparities were, in some cases, widest within these targeted groups. Conclusions. Our findings highlighted the opportunity of the ACA to not only to improve coverage, access, and use for all racial/ethnic groups, but also to narrow racial/ethnic disparities in these outcomes. Our results might have particular importance for states that are deciding whether to implement the ACA Medicaid expansions. PMID:26447920

  4. Patient Protection and Affordable Care Act; standards related to essential health benefits, actuarial value and accreditation. Final rule.

    PubMed

    2013-02-25

    This final rule sets forth standards for health insurance issuers consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Specifically, this final rule outlines Exchange and issuer standards related to coverage of essential health benefits and actuarial value. This rule also finalizes a timeline for qualified health plans to be accredited in Federally-facilitated Exchanges and amends regulations providing an application process for the recognition of additional accrediting entities for purposes of certification of qualified health plans.

  5. Parent Experiences with State Child Care Subsidy Systems and Their Perceptions of Choice and Quality in Care Selected

    ERIC Educational Resources Information Center

    Raikes, Helen; Torquati, Julia; Wang, Cixin; Shjegstad, Brinn

    2012-01-01

    Research Findings: This study investigated parents' experiences using Child Care and Development Fund and other state-dispersed child care subsidies, reasons for choosing their current child care program, and perceptions of the quality of child care received from their current program. A telephone survey of 659 parents receiving child care…

  6. A Qualitative Study of Caregivers' Attitudes about Child Care.

    ERIC Educational Resources Information Center

    Innes, Robert B; Innes, Sharon M.

    1984-01-01

    Interviews of 31 caregivers and directors of day care centers assessed role identity constructs and attitudes toward parents and the child care profession. Results concluded that conflict over attachment issues contributed to problems between parents and caregivers. (Author/CI)

  7. Attachment and Child Care: Relationships With Mother and Caregiver.

    ERIC Educational Resources Information Center

    Howes, Carolee; And Others

    1988-01-01

    Two studies examined the influences of concordant and nonconcordant attachment relationships to mothers and to child caregivers on children's behavior in child care. In both studies, the child's level of competence in play with the caregiver and engagement with peers was a function of attachment security with both mother and caregiver. (NH)

  8. Health and Safety Resources for Child Care Workers.

    ERIC Educational Resources Information Center

    Child Care Employee Project, Berkeley, CA.

    Organized into three sections, these resource materials provide basic information for child caregivers about occupational hazards associated with child care work; personnel policies, staff burnout and environmental stressors; and employee rights. Contents of the first section include a general discussion of health and safety hazards in child care…

  9. Military Child Care Programs: Progress Made, More Needed.

    DTIC Science & Technology

    1982-06-01

    program areas such as nutri- tion, health, child growth and development, educational guidance, and remedial techniques. None of the existing service...activities weakens their programs. The child care staff should know about such things as nutri- tion, health, child growth and development

  10. The Vulnerable Child. Caring for Children, Number Five.

    ERIC Educational Resources Information Center

    Murphy, Lois B.; Leeper, Ethel M.

    The booklet addresses the problems of vulnerable children with suggestions child care center workers may use both for recognizing signs of handicaps in children and helping children overcome existing handicaps. The vulnerable child is defined as a child who may be overwhelmed by physical and/or emotional handicaps and thus is at risk of later…

  11. The Individual Child. Caring for Children No. 7.

    ERIC Educational Resources Information Center

    Murphy, Lois B.; Leeper, Ethel M.

    Discussed are ways to meet the needs of the individual preschool child within the child care center. Ways in which each child is unique are given to include type of personality rate of development, attitude toward the world, and coping method. Discussed are causes of individual differences including heredity and environment, prenatal and postnatal…

  12. Improving The Affordable Care Act: An Assessment Of Policy Options For Providing Subsidies.

    PubMed

    Saltzman, Evan A; Eibner, Christine; Enthoven, Alain C

    2015-12-01

    A key challenge of health reform efforts is to make health insurance affordable for individuals and families who lack coverage without harming those with coverage or increasing federal spending. The Affordable Care Act (ACA) addresses this challenge in part by providing tax subsidies to qualified individuals for purchasing individual insurance and retaining tax exemptions for employer and employee contributions to the cost of premiums of employer-sponsored insurance. These tax exemptions cost approximately $250 billion annually in lost tax revenue and have been criticized for favoring higher earners and conferring preferential treatment of employer-sponsored over individual insurance. We analyzed three options for leveling the financial playing field between the two insurance markets by reallocating the value of tax benefits of employer coverage. We found that one option that uses the subsidy formula employed in the insurance Marketplaces under the ACA for both the individual and employer-sponsored insurance markets, and additionally requires the subsidy to be at least $1,250 without an upper income limit on subsidy eligibility imposed, could expand insurance coverage and reduce individual market premiums relative to the ACA with no additional federal spending.

  13. Small employer perspectives on the Affordable Care Act's premiums, SHOP exchanges, and self-insurance.

    PubMed

    Gabel, Jon R; Whitmore, Heidi; Pickreign, Jeremy; Satorius, Jennifer L; Stromberg, Sam

    2013-11-01

    Beginning January 1, 2014, small businesses having no more than fifty full-time-equivalent workers will be able to obtain health insurance for their employees through Small Business Health Options Program (SHOP) exchanges in every state. Although the Affordable Care Act intended the exchanges to make the purchasing of insurance more attractive and affordable to small businesses, it is not yet known how they will respond to the exchanges. Based on a telephone survey of 604 randomly selected private firms having 3-50 employees, we found that both firms that offered health coverage and those that did not rated most features of SHOP exchanges highly but were also very price sensitive. More than 92 percent of nonoffering small firms said that if they were to offer coverage, it would be "very" or "somewhat" important to them that premium costs be less than they are today. Eighty percent of offering firms use brokers who commonly perform functions of benefit managers--functions that the SHOP exchanges may assume. Twenty-six percent of firms using brokers reported discussing self-insuring with their brokers. An increase in the number of self-insured small employers could pose a threat to SHOP exchanges and other small-group insurance reforms.

  14. Coverage of certain preventive services under the Affordable Care Act. Final rules.

    PubMed

    2013-07-02

    This document contains final regulations regarding coverage of certain preventive services under section 2713 of the Public Health Service Act (PHS Act), added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. Section 2713 of the PHS Act requires coverage without cost sharing of certain preventive health services by non-grandfathered group health plans and health insurance coverage. Among these services are women's preventive health services, as specified in guidelines supported by the Health Resources and Services Administration (HRSA). As authorized by the current regulations, and consistent with the HRSA guidelines, group health plans established or maintained by certain religious employers (and group health insurance coverage provided in connection with such plans) are exempt from the otherwise applicable requirement to cover certain contraceptive services. These final regulations simplify and clarify the religious employer exemption. These final regulations also establish accommodations with respect to the contraceptive coverage requirement for group health plans established or maintained by eligible organizations (and group health insurance coverage provided in connection with such plans), as well as student health insurance coverage arranged by eligible organizations that are institutions of higher education. These regulations also finalize related amendments to regulations concerning Affordable Insurance Exchanges.

  15. How the affordable care act and mental health parity and addiction equity act greatly expand coverage of behavioral health care.

    PubMed

    Beronio, Kirsten; Glied, Sherry; Frank, Richard

    2014-10-01

    The Patient Protection and Affordable Care Act (ACA) will expand coverage of mental health and substance use disorder benefits and federal parity protections to over 60 million Americans. The key to this expansion is the essential health benefit provision in the ACA that requires coverage of mental health and substance use disorder services at parity with general medical benefits. Other ACA provisions that should improve access to treatment include requirements on network adequacy, dependent coverage up to age 26, preventive services, and prohibitions on annual and lifetime limits and preexisting exclusions. The ACA offers states flexibility in expanding Medicaid (primarily to childless adults, not generally eligible previously) to cover supportive services needed by those with significant behavioral health conditions in addition to basic benefits at parity. Through these various new requirements, the ACA in conjunction with Mental Health Parity and Addiction Equity Act (MHPAEA) will expand coverage of behavioral health care by historic proportions.

  16. Young Adults' Health Care Utilization and Expenditures Prior to the Affordable Care Act

    PubMed Central

    Lau, Josephine S.; Adams, Sally H.; Boscardin, W. John; Irwin, Charles E.

    2014-01-01

    Purpose Examine young adults' health care utilization and expenditures prior to the ACA. Methods We used 2009 Medical Expenditure Panel Survey (MEPS) to 1) compare young adults' health care utilization and expenditures of a full-spectrum of health services to children and adolescents and 2) identify disparities in young adults' utilization and expenditures, based on access (insurance and usual source of care) and other socio-demographic factors, including race/ethnicity and income. Results Young adults had: 1) significantly lower rates of overall utilization (72%) than other age groups (83-88%, P<.001) and 2), the lowest rate of office-based utilization (55% vs. 67-77%, P<.001) and higher rate of ER visits compared to adolescents (15% v. 12%, P<.01). Uninsured young adults had high out-of-pocket expenses. Compared to the young adults with private insurance, the uninsured spent less than half on health care ($1,040 vs. $2,150/ person, P<.001), but essentially the same out-of-pocket expenses ($403 vs. $380/person, p =.57). Among young adults, we identified significant disparities in utilization and expenditures based on the presence/absence of a usual source of care, race/ethnicity, home language and sex. Conclusions Young adults may not be utilizing the health care system optimally by having low rates of office-based visits and high rates of ER visits. The ACA provision of insurance for those previously uninsured or under-insured will likely increase their utilization and expenditures and lower their out-of-pocket expenses. Further effort is needed to address non-insurance barriers and ensure equal access to health services. PMID:24702839

  17. Coverage of Certain Preventive Services Under the Affordable Care Act. Final rules.

    PubMed

    2015-07-14

    This document contains final regulations regarding coverage of certain preventive services under section 2713 of the Public Health Service Act (PHS Act), added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. Section 2713 of the PHS Act requires coverage without cost sharing of certain preventive health services by non-grandfathered group health plans and health insurance coverage. These regulations finalize provisions from three rulemaking actions: Interim final regulations issued in July 2010 related to coverage of preventive services, interim final regulations issued in August 2014 related to the process an eligible organization uses to provide notice of its religious objection to the coverage of contraceptive services, and proposed regulations issued in August 2014 related to the definition of "eligible organization,'' which would expand the set of entities that may avail themselves of an accommodation with respect to the coverage of contraceptive services.

  18. The Effect of the Affordable Care Act Medicaid Expansion on Migration.

    PubMed

    Goodman, Lucas

    2017-01-01

    The expansion of Medicaid to low-income nondisabled adults is a key component of the Affordable Care Act's strategy to increase health insurance coverage, but many states have chosen not to take up the expansion. As a result, for many low-income adults, there has been stark variation across states in access to Medicaid since the expansions took effect in 2014. This study investigates whether individuals migrate in order to gain access to these benefits. Using an empirical model in the spirit of a difference-in-differences, this study finds that migration from non-expansion states to expansion states did not increase in 2014 relative to migration in the reverse direction. The estimates are sufficiently precise to rule out a migration effect that would meaningfully affect the number of enrollees in expansion states, which suggests that Medicaid expansion decisions do not impose a meaningful fiscal externality on other states.

  19. Knowledge and perceptions of the Affordable Care Act by uninsured patients at a free clinic.

    PubMed

    Petrany, Stephen M; Christiansen, Matthew

    2014-05-01

    The Affordable Care Act (ACA) has as one of its main objectives to reduce the number of uninsured Americans. The understanding of the ACA reforms by uninsured patients will likely influence the degree of success in achieving this objective. This study assessed the basic knowledge and opinions regarding the ACA of patients at a free clinic and the impact of a brief educational intervention on respondents' knowledge and opinions. One hundred uninsured adult patients completed a brief survey about the ACA before and after viewing a video outlining the major features of the act. The study cohort initially performed worse than national polls on all knowledge questions. Significant improvement was observed after the educational video. Our study suggests a need for educational efforts directed at those individuals most likely to benefit from the ACA. We demonstrated that a brief intervention during a routine office visit may improve knowledge of the ACA.

  20. Implementing the Affordable Care Act: Revisiting the ACA's Essential Health Benefits Requirements.

    PubMed

    Giovannelli, Justin; Lucia, Kevin W; Corlette, Sabrina

    2014-10-01

    The Affordable Care Act broadens and strengthens the health insurance benefits available to consumers by requiring insurers to provide coverage of a minimum set of medical services known as "essential health benefits." Federal officials implemented this reform using transitional policies that left many important decisions to the states, while pledging to reassess that approach in time for the 2016 coverage year. This issue brief examines how states have exercised their options under the initial federal essential health benefits framework. We find significant variation in how states have developed their essential health benefits packages, including their approaches to benefit substitution and coverage of habilitative services. Federal regulators should use insurance company data describing enrollees' experiences with their coverage--information called for under the law's delayed transparency requirements--to determine whether states' differing strategies are producing the coverage improvements promised by reform.

  1. The Affordable Care Act and Abortion Comparing the U.S. and Western Europe.

    PubMed

    McFarlane, Deborah R

    2015-01-01

    The 2010 Affordable Health Care Act (ACA) treats abortion differently than any other health service, precluding public funding for abortion and imposing other restrictions on American states. To determine whether the ACA's abortion restrictions are uniquely American or have counterparts in other national health systems, this study employs a cross-sectional design comparing abortion restrictions in the ACA with those in 17 Western European countries. Using a six-item scale, the intensity of abortion restrictions is compared across Western European nations. A similar scale is employed for a five-state sample of state-level abortion restrictions. Although the United States is not alone in having abortion restrictions, how abortion is proscribed in the ACA has no counterpart in Western Europe. Unlike many Western European countries, the ACA's restrictions focus on abortion funding, not the length of gestation or the health of the pregnant woman.

  2. How Has the Affordable Care Act Affected Health Insurers' Financial Performance?

    PubMed

    Hall, Mark A; McCue, Michael J

    2016-07-01

    Starting in 2014, the Affordable Care Act transformed the market for individual health insurance by changing how insurance is sold and by subsidizing coverage for millions of new purchasers. Insurers, who had no previous experience under these market conditions, competed actively but faced uncertainty in how to price their products. This issue brief uses newly available data to understand how health insurers fared financially during the ACA's first year of full reforms. Overall, health insurers' financial performance began to show some strain in 2014, but the ACA's reinsurance program substantially buffered the negative effects for most insurers. Although a quarter of insurers did substantially worse than others, experience under the new market rules could improve the accuracy of pricing decisions in subsequent years.

  3. The Health Insurance Gap After Implementation of the Affordable Care Act in Texas.

    PubMed

    Gong, Gordon; Huey, Cassandra C; Johnson, Coleman; Curti, Debra; Philips, Billy U

    2017-03-01

    Households with incomes between 18% and 99% of the federal poverty level (FPL) are ineligible for Medicaid or enrollment in the health insurance exchange marketplace in Texas, resulting in the health insurance gap. We sought to determine the number of non-elderly adult Texans (NEATs) aged between 18 and 64 years in the insurance gap in rural vs urban areas in East Texas, West Texas, and South Texas. Data were obtained from the US Census Bureau website. In 2014, there were 1,101,000 NEATs in the insurance gap, accounting for 24.5% of all uninsured persons in Texas. The gap was significantly higher in rural vs urban areas in East and South Texas and in Texas as a whole. Large coverage gaps in states like Texas not expanding Medicaid under the Affordable Care Act pose major hurdles to reducing the number of uninsured individuals in these states.

  4. Health insurers' financial performance and quality improvement expenditures in the Affordable Care Act's second year.

    PubMed

    McCue, Michael J; Hall, Mark

    2015-02-01

    The Affordable Care Act requires health insurers to rebate any amounts less than 80%-85% of their premiums that they fail to spend on medical claims or quality improvement. This study uses the new comprehensive reporting under this law to examine changes in insurers' financial performance and differences in their quality improvement expenditures. In the ACA's second year (2012), insurers' median medical loss ratios continued to increase and their median administrative cost ratios dropped, producing moderate operating margins in the group markets but a small operating loss in the individual market, at the median. For-profit insurers showed larger changes, in general, than did nonprofits. For quality improvement, insurers reported spending a significantly greater amount per member in their government plans than they did on their self-insured members, with spending on commercial insurance being in between these two extremes. The magnitude and source of these differences varied by corporate ownership.

  5. Infant and Toddler Child Care Quality Measures: Bibliography

    ERIC Educational Resources Information Center

    Ferguson, Daniel

    2016-01-01

    The Research Connections collection contains records for more than 1,300 instruments that have been used to conduct studies in the child care and early education field. This bibliography provides records for instruments in the collection that can be used to observe child care quality in center-based settings serving infants and toddlers. In…

  6. Teachers' Discussions of Emotion in Child Care Centers

    ERIC Educational Resources Information Center

    Ahn, Hey Jun

    2005-01-01

    Teachers have the opportunity to discuss the emotions of children as they occur in the context of the classroom. As such, teachers play an important role in the socialization of emotions of young children. This observational study examines teachers' discussions of emotions in three child care centers. The findings suggest that child care centers…

  7. Tribal Child Care Facilities: A Guide to Construction and Renovation

    ERIC Educational Resources Information Center

    US Department of Health and Human Services, 2006

    2006-01-01

    The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 allowed Tribes to use Child Care and Development Fund (CCDF) monies for the construction or renovation of child care facilities. As procedures have been implemented over the years, Tribes and Administration for Children and Families (ACF) Regional Offices have identified a…

  8. Tribal Child Care Facilities: A Guide to Construction and Renovation.

    ERIC Educational Resources Information Center

    National Child Care Information Center, Vienna, VA.

    This document provides technical assistance in addressing major areas of the child care facility construction and renovation process, including conducting a child care community needs assessment, identifying a site, financing costs, developing a business plan, conducting an environmental assessment, building and designing a facility, and hiring…

  9. The Effects of Infant Day Care on Child Development.

    ERIC Educational Resources Information Center

    Avgar, Amy

    Studies on the effects of early day care can be characterized according to two distinct research trends. In the first, which occurred during the 1960s and 1970s, the principal issue was whether day care had any inevitable and negative consequences for the child and, particularly, the mother-child attachment. The second, more recent, trend has been…

  10. Pregnancy, Birth, Infant and Child Care: Midwifery Skill and Knowledge.

    ERIC Educational Resources Information Center

    Negussie, Birgit

    This presentation, which is based in part on a cross-cultural survey of East Africans and also on research conducted in Ethiopia, highlights the importance of traditional knowledge of midwifery. Examples of traditional skills in pregancy and birth care, and of child care and child rearing in several East African countries, are offered. It is…

  11. State Initiatives To Increase Compensation for Child Care Workers.

    ERIC Educational Resources Information Center

    Twombly, Eric C.; Montilla, Maria D.; De Vita, Carol J.

    Noting that wages for child care workers are among the lowest in the U.S. labor force and that generally caregivers are offered few employee benefits, this paper summarizes proposals and programs in the 50 states and the District of Columbia to raise child care worker compensation. The paper classifies state-level initiatives into two categories:…

  12. Business Administration Scale for Family Child Care, BAS

    ERIC Educational Resources Information Center

    Talan, Teri N.; Bloom, Paula Jorde

    2009-01-01

    The "BAS for Family Child Care" is the first valid and reliable tool for measuring and improving the overall quality of business and professional practices in family child care settings. It is applicable for multiple uses, including program self-improvement, technical assistance and monitoring, training, research and evaluation, and public…

  13. Growing Your Business by Adapting Employer Child Care Practices

    ERIC Educational Resources Information Center

    Spencer, Becky

    2012-01-01

    As an early childhood professional for 30 years operating both traditional and employer child care programs, the author believes that traditional center owners and operators have an opportunity to grow their business, serve more children and families, and stay relevant for future workforce needs by integrating employer child care practices into…

  14. 7 CFR 226.17 - Child care center provisions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... requirements (1) Child care centers must have Federal, State, or local licensing or approval to provide day... licensing or approval, may participate in the Program during the renewal process, unless the State agency... standards or any applicable State or local child care standards to the State agency. (2) Except for...

  15. The Role of Child Care Settings in Obesity Prevention

    ERIC Educational Resources Information Center

    Story, Mary; Kaphingst, Karen M.; French, Simone

    2006-01-01

    Mary Story, Karen Kaphingst, and Simone French argue that researchers and policymakers focused on childhood obesity have paid insufficient attention to child care. Although child care settings can be a major force in shaping children's dietary intake, physical activity, and energy balance--and thus in combating the childhood obesity…

  16. Journal of Child-Care Administration, 1997-1998.

    ERIC Educational Resources Information Center

    Kalbaugh, Christine, Ed.

    1998-01-01

    This document is comprised of the four 1997-1998 issues of the Journal of Child-Care Administration, which addresses the concerns of child care centers, learning centers, preschools, nursery schools, kindergartens, and intergenerational centers. Issue 214 includes the following articles: (1) "Turning Your Staff into a Team: The Basics";…

  17. Maternal Education, Early Child Care and the Reproduction of Advantage

    ERIC Educational Resources Information Center

    Augustine, Jennifer March; Cavanagh, Shannon E.; Crosnoe, Robert

    2009-01-01

    The social and human capital that educational attainment provides women enables them to better navigate their children's passages through school. In this study, we examine a key mechanism in this intergenerational process: mothers' selection of early child care. Analyses of the NICHD Study of Early Child Care and Youth Development revealed that…

  18. Industry and Child Care Resource Bank. Alphabetical Title Bibliography.

    ERIC Educational Resources Information Center

    Boulder Child Care Support Center, CO.

    This bibliography contains every listing available, as of the summer of 1982, in the Industry and Child Care Resource Bank located at the Boulder Child Care Support Center at 2160 Spruce Street, Boulder, Colorado. Each entry is annotated. References thought to be excellent sources of information are indicated by a star placed in the left hand…

  19. Study of Early Child Care and Youth Development (SECCYD)

    MedlinePlus

    ... Supported Research Networks & Programs NICHD Study of Early Child Care and Youth Development (SECCYD) Sunsetted/For Reference Only Skip sharing on ... is not being updated . The Study of Early Child Care and Youth Development (SECCYD), now complete, began as the Study of ...

  20. Child Care and Cortisol across Early Childhood: Context Matters

    ERIC Educational Resources Information Center

    Berry, Daniel; Blair, Clancy; Ursache, Alexandra; Wiloughy, Michael; Garrett-Peters, Patricia; Veron-Feagans, Lynne; Bratsch-Hines, Mary; Mills-Koonce, W. Roger; Granger, Douglas A.

    2014-01-01

    A considerable body of literature suggests that children's child-care experiences may impact adrenocortical functioning in early childhood. Yet emerging findings also suggest that the magnitude and sometimes the direction of child-care effects on development may be markedly different for children from higher risk contexts. Using data from a large…

  1. Towards a Research Agenda on Child Care in Alberta.

    ERIC Educational Resources Information Center

    LaGrange, Annette; Read, Malcolm

    In this study, a Delphi Method was used to collect and collate opinions of 24 Alberta child care professionals regarding the creation of a research agenda on child care. Findings indicated that the 25 research questions (out of an original list of 80 questions) considered important or very important by at least three-quarters of the participants…

  2. Examining Child Care Need among Military Families. Technical Report

    ERIC Educational Resources Information Center

    Gates, Susan M.; Zellman, Gail L.; Moini, Joy S.

    2006-01-01

    This report documents the results of a survey of 1,137 active-duty military families, including activated Reservists, regarding child care use. These survey data were analyzed to estimate the relationship between individual family characteristics and installation characteristics and the probability that the family uses any nonparental child care,…

  3. Child Care Services Guide. Performance Objectives. Criterion Measures. Home Economics.

    ERIC Educational Resources Information Center

    Duval County School Board, Jacksonville, FL.

    Several intermediate performance objectives and corresponding criterion measures are listed for each of 14 terminal objectives for a high school child care services course. This course is designed to provide opportunities for exploring a broad range of child care, guidance, and service occupations. Major concepts include characteristics of…

  4. Quality Child Care for All: A Guide to Integration.

    ERIC Educational Resources Information Center

    Panitch, Melanie

    This manual is intended to facilitate the integration of children with mental handicaps into child care centers in Canada and elsewhere. The first chapter looks at the background of integration in early childhood child care programs in Canada and identifies concerns of parents. The second chapter explores the practice of labelling children with…

  5. Child Care in Canada: Provinces and Territories 1995.

    ERIC Educational Resources Information Center

    Toronto Univ. (Ontario). Centre for Urban and Community Studies.

    This report presents provincial/territorial and national data on child care in Canada. Data collection methods included document examination for nation-wide statistics, and questionnaires sent to each provincial/territorial child care office, followed by telephone interviews with an official from each jurisdiction to update or clarify data. The…

  6. Epistemological Beliefs in Child Care: Implications for Vocational Education

    ERIC Educational Resources Information Center

    Brownlee, J.; Boulton-Lewis, G.; Berthelsen, D.

    2008-01-01

    Background: The quality of child care is of social and economic significance worldwide. The beliefs that child care workers hold about knowing and knowledge (epistemological beliefs) influence the quality of their professional work. However, attention to epistemological beliefs is rarely a focus in vocational education programmes. Aim: The aim of…

  7. How Early Child Care Affects Later Development. Science Briefs

    ERIC Educational Resources Information Center

    National Scientific Council on the Developing Child, 2007

    2007-01-01

    "Science Briefs" summarize the findings and implications of a recent study in basic science or clinical research. This brief reports on the study "Are there Long-Term Effects of Early Child Care?" (J. Belsky, D. L. Vandell, M. Burchinal, K. A. Clarke-Stewart, K. McCartney, M. T. Owen, M. T., and The NICHD Early Child Care Research Network).…

  8. Values and Values Education in Estonian Preschool Child Care Institutions

    ERIC Educational Resources Information Center

    Ülavere, Pärje; Veisson, Marika

    2015-01-01

    The objective of the study was to provide an outline of the values that principals, teachers and parents of preschool child care institutions consider important to be taught to children, and which activities, in their estimation, should be used to implement values education in child care institutions. A total of 978 respondents from all 15…

  9. Parents' Child Care Experience: Effects of Sex and Parity.

    ERIC Educational Resources Information Center

    Gilpin, Andrew R.; Glanville, Bradley B.

    1985-01-01

    Surveyed 94 couples to determine effects on child care experience associated with gender, parity, and various other demographic variables. As expected, women had higher scores than men. Experience was a linear function of parity for men, but not for women, and was unrelated to attitudes toward women. Implications for child care responsibility are…

  10. Resource Guide for Family-Centered Child Care. Families Matter.

    ERIC Educational Resources Information Center

    Eyre, Saren

    For child care to become more supportive of families, programs and providers need to learn about the guiding principles of working with families and the concrete steps they can take in that direction. This resource guide offers ideas and resources for implementing family support principles in child care. The guide offers practitioners ideas and…

  11. Child Care as Script: Children's Descriptions of Daily Experiences.

    ERIC Educational Resources Information Center

    Reifel, Stuart; Garza, Margaret

    Children's knowledge of daily events in full-day child care was assessed. Interviews with 14 children produced spontaneous narratives that revealed script-like knowledge of the child care day, including events such as indoor play, outdoor play, breakfast, lunch, nap, and snack. Younger children reported a smaller number of events in their…

  12. After-School Child Care: Dilemma in a Rural Community.

    ERIC Educational Resources Information Center

    Warnock, Mary M.

    1992-01-01

    A rural community established an after-school child care program by forming a community coalition, acquiring funding, obtaining space, and arranging for children's transportation. The program enriched the quality of life for children, parents, and staff. Children's grades improved and the number of mothers satisfied with child care services…

  13. Enhancing the Quality of Child Care: Lessons from Research.

    ERIC Educational Resources Information Center

    Chambliss, Catherine

    Drawing on current research, this paper advocates the optimization and enhancement of quality in group day care. Child development researchers offer many suggestions for improving the quality of child care. Recent research has indicated the importance peers play in children's development. Researchers have also indicated the importance of…

  14. Child Care Teachers' Strategies in Children's Socialization of Emotion

    ERIC Educational Resources Information Center

    Ahn, Hey Jun

    2005-01-01

    An observational study was conducted to examine teachers' emotional socialization strategies in three child care centers. Qualitative analysis of the data suggests that teachers in child care centers respond to children's emotional expressions with various strategies. Teachers clearly expressed a preference for positive emotion through verbal…

  15. 45 CFR 1306.35 - Family child care program option.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... cognitive, socio-emotional, and physical development, including both gross and fine motor. Family child care... 45 Public Welfare 4 2014-10-01 2014-10-01 false Family child care program option. 1306.35 Section 1306.35 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN...

  16. 45 CFR 1306.35 - Family child care program option.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... cognitive, socio-emotional, and physical development, including both gross and fine motor. Family child care... 45 Public Welfare 4 2012-10-01 2012-10-01 false Family child care program option. 1306.35 Section 1306.35 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN...

  17. Effects of Quality Improvement System for Child Care Centers

    ERIC Educational Resources Information Center

    Ma, Xin; Shen, Jianping; Kavanaugh, Amy; Lu, Xuejin; Brandi, Karen; Goodman, Jeff; Till, Lance; Watson, Grace

    2011-01-01

    Using multiple years of data collected from about 100 child care centers in Palm Beach County, Florida, the authors studied whether the Quality Improvement System (QIS) made a significant impact on quality of child care centers. Based on a pre- and postresearch design spanning a period of 13 months, QIS appeared to be effective in improving…

  18. 45 CFR 1306.35 - Family child care program option.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Family child care program option. 1306.35 Section... SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD... Family child care program option. (a) Grantee and delegate agency implementation. Grantee and...

  19. Child Care in the American South: Poverty, Costs, and Quality

    ERIC Educational Resources Information Center

    Collins, Vikki K.

    2012-01-01

    High-quality child care has been shown to improve the academic success and life adjustments of children living in poverty. During the past decade, many American states have adopted voluntary Quality Rating and Improvement (QRI) systems in an attempt to increase the level of quality in child care. Using data compiled by the National Association of…

  20. Children's Use of Retreats in Family Child Care Homes

    ERIC Educational Resources Information Center

    Weinberger, Nanci

    2006-01-01

    The use of retreat spaces by 65 children in 9 family child care homes was assessed in this study. Family child care providers used daily diaries to collect information about children's retreat frequency and associated behavior. The findings revealed that nearly half of the children used informal, readily available retreats during the research…

  1. Overcoming Obstacles To Create Retreats in Family Child Care.

    ERIC Educational Resources Information Center

    Weinberger, Nanci

    2000-01-01

    Discusses the importance of creating retreat spaces for young children in child care settings. Identifies special challenges and opportunities for creating such spaces in family child care homes. Outlines research findings detailing the benefits of retreats for children, and discusses the contributions of location, form, and materials in creating…

  2. Investing in Our Children's Future: The Path to Quality Child Care through the Pennsylvania Child Care/Early Childhood Development Training System.

    ERIC Educational Resources Information Center

    Iutcovich, Joyce; Fiene, Richard; Johnson, James; Koppel, Ross; Langan, Francine

    This study identified training needs for Pennsylvania child care providers and assessed the impact of training, classroom/caregiver dynamics, and staff characteristics on child care quality. Participating were 29 family child care providers, 30 group homes, and 60 child care centers, stratified by type of site and geographic region. Quality of…

  3. We Can Do Better: Child Care Aware® of America's Ranking of State Child Care Center Regulations and Oversight. 2013 Update

    ERIC Educational Resources Information Center

    Child Care Aware of America, 2013

    2013-01-01

    Each week, nearly 11 million children under age 5 are in some type of child care setting for an average of 35 hours. Parents, as consumers of child care, equate a child care license with state approval--a gold seal for those businesses to which a state grants a license. Child Care Aware® of America reviews state licensing policies, which include…

  4. Identifying Child-Staff Ratios That Promote Peer Skills in Child Care

    ERIC Educational Resources Information Center

    Iluz, Reli; Adi-Japha, Esther; Klein, Pnina S.

    2016-01-01

    Research Findings: Early child care policy and practice are grounded in a growing understanding of the importance of the first years of life. In earlier studies, associations between child-staff ratios and peer skills yielded inconsistent findings. The current study used data from the National Institute of Child Health and Human Development Study…

  5. Children's Cortisol and the Quality of Teacher-Child Relationships in Child Care

    ERIC Educational Resources Information Center

    Lisonbee, Jared A.; Mize, Jacquelyn; Payne, Amie Lapp; Granger, Douglas A.

    2008-01-01

    Teacher-child relationships were examined as predictors of cortisol change in preschool children. Saliva for assays was collected from one hundred and ninety-one 4-year-olds (101 boys) in the mornings and afternoons on 2 days at child care, and before and after a series of challenging tasks and a teacher-child interaction session outside the…

  6. Child Care Use in Minnesota: Report of the 2009 Statewide Household Child Care Survey

    ERIC Educational Resources Information Center

    Chase, Richard; Valorose, Jennifer

    2010-01-01

    This report on a statewide telephone survey describes child care use in Minnesota among households with children 12 and younger. Minnesota has an estimated 908,000 children ages 12 and younger; 24 percent are ages 0 to 2, 24 percent ages 3 to 5, 30 percent ages 6 to 9 and 23 percent ages 10 to 12. Of the nearly 500,000 households with one or more…

  7. We Are Not Babysitters: Family Child Care Providers Redefine Work and Care.

    ERIC Educational Resources Information Center

    Tuominen, Mary C.

    Drawing on in-depth interviews with 20 family child care providers of diverse race, ethnicity, immigrant status, and social class, this book explores the social, political, and economic forces and processes that draw women into the work of family child care. The articles dispel not only myths about why women choose to be family child care…

  8. Act for Better Child Care Services of 1988. Report from the Committee on Labor and Human Resources Together with Additional Views (To Accompany S. 1885). 100th Congress, 2nd Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

    The Act for Better Child Care Services of 1988, additional views of members of the United States Senate, and related materials are reported. The purpose of the Act is to increase the availability, affordability, and quality of child care throughout the nation. The legislation provides direct financial assistance to low-income and working families…

  9. Information for Government Agencies about Specific Environmental Health Issues in Child-Care Settings

    EPA Pesticide Factsheets

    research on child care environmental health issues, identify key state and regional healthy child care organizations for partnerships, and see how other states are addressing child care environmental health issues.

  10. Children's cortisol and the quality of teacher--child relationships in child care.

    PubMed

    Lisonbee, Jared A; Mize, Jacquelyn; Payne, Amie Lapp; Granger, Douglas A

    2008-01-01

    Teacher-child relationships were examined as predictors of cortisol change in preschool children. Saliva for assays was collected from one hundred and ninety-one 4-year-olds (101 boys) in the mornings and afternoons on 2 days at child care, and before and after a series of challenging tasks and a teacher-child interaction session outside the classroom. Parents reported on children's temperament, teachers and children reported on teacher-child relationship quality, and observers rated group-level teacher insensitivity. Teacher-reported relationship conflict predicted cortisol increases during teacher-child interaction and teacher-reported overdependence predicted cortisol increases from morning to afternoon, even after controlling for individual teacher, child, and classroom characteristics. The findings extend earlier work by suggesting that cortisol change across the child-care day is influenced by teacher-child relationship characteristics.

  11. Model Child Care Standards Act--Guidance to States to Prevent Child Abuse in Day Care Facilities.

    ERIC Educational Resources Information Center

    Department of Health and Human Services, Washington, DC.

    The document offers guidelines to states regarding review and revision of child care statutes, standards, and policies to address the prevention of child sexual abuse in day care facilities. General information is also provided on changes in state standards in recent years. Each of six sections examines findings of the 1981 Comparative Licensing…

  12. The Economic Impact of Subsidized Child Care: An Economic Analysis of Valley Child Care from November 1976 to June 1979.

    ERIC Educational Resources Information Center

    Freis, Ruth; Miller, Miriam

    This study examines the specific economic impact on the cost to government of subsidized child care and development services. Data were collected from all 295 families who used Valley Child Care services for more than six months, over a period of two and a half years. The data and results indicated significant economic effects of providing…

  13. Creating and Maintaining a Wellness Environment in Child Care Centers Participating in the Child and Adult Care Food Program

    ERIC Educational Resources Information Center

    Lofton, Kristi L.; Carr, Deborah H.

    2010-01-01

    Purpose/Objectives: This study identifies issues associated with creating and maintaining a wellness environment in child care centers (CCCs) participating in the Child and Adult Care Food Program (CACFP). Methods: Structured interviews and focus groups were conducted with CCC professionals and state agency personnel to develop a survey to assess…

  14. Tennessee Star-Quality Child Care Program: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    ERIC Educational Resources Information Center

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Tennessee's Star-Quality Child Care Program prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  15. Louisiana Quality Start Child Care Rating System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    ERIC Educational Resources Information Center

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Louisiana's Quality Start Child Care Rating System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs;…

  16. The Relationship between Practices and Child Care Providers' Beliefs Related to Child Feeding and Obesity Prevention

    ERIC Educational Resources Information Center

    Lanigan, Jane D.

    2012-01-01

    Objective: To examine the association between child care practices and child care provider knowledge and beliefs about their role in supporting children's healthful eating. Design: Longitudinal design using survey and observation data from baseline and year 1 of the Encouraging Healthy Activity and Eating in Childcare Environments (ENHANCE) pilot…

  17. Relationship of Affordable Care Act Implementation to Emergency Department Utilization Among Young Adults

    PubMed Central

    Hernandez-Boussard, Tina; Morrison, Doug; Goldstein, Ben A.; Hsia, Renee Y.

    2016-01-01

    Study objective The 2010 provision of the Patient Protection and Affordable Care Act (ACA) extended eligibility for health insurance for young adults aged 19 to 25 years. It is unclear, however, how expanded coverage changes health care behavior and promotes efficient use of emergency department (ED) services. Our objective was to use population-level emergency department data to characterize any changes in diagnoses seen in ED among young adults since the implementation of the ACA dependent coverage expansion. Methods We performed a difference-in-differences analysis of 2009 to 2011 ED visits from California, Florida, and New York, using all-capture administrative data to determine how the use of ED services changed for clinical categories after the ACA provision among young adults aged 19 to 25 years compared with slightly older adults unaffected by the provision, aged 26 to 31 years. Results We analyzed a total of 10,158,254 ED visits made by 4,734,409 patients. After the implementation of the 2010 ACA provision, young adults had a relative decrease of 0.5% ED visits per 1,000 people compared with the older group. For the majority of diagnostic categories, young adults’ rates and risk of visit did not change relative to that of slightly older adults after the implementation of the ACA. However, although young adults’ ED visits significantly increased for mental illnesses (2.6%) and diseases of the circulatory system (eg, nonspecific chest pain) (4.8%), visits decreased for pregnancy-related diagnoses and diseases of the skin (eg, cellulitis, abscess) compared with that of the older group (3.7% and 3.1%, respectively). Conclusion Our results indicate that increased coverage has kept young adults out of the ED for specific conditions that can be cared for through access to other channels. As EDs face capacity challenges, these results are encouraging and offer insight into what could be expected under further insurance expansions from health care reform. PMID

  18. Faith-Based Organizations and the Affordable Care Act: Reducing Latino Mental Healthcare Disparities

    PubMed Central

    Villatoro, Alice P.; Dixon, Elizabeth; Mays, Vickie M.

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) is expected to increase access to mental healthcare through provisions aimed at increasing health coverage among the nation's uninsured, including 10.2 million eligible Latino non-elderly adults. The ACA will increase health coverage by expanding Medicaid eligibility to individuals living below 138% of the federal poverty level, subsidizing the purchase of private insurance among individuals not eligible for Medicaid, and requiring employers with 50 or more employees to offer health insurance. An anticipated result of this landmark legislation is improvement in the screening, diagnosis, and treatment of mental disorders in racial/ethnic minorities, particularly for Latinos, who traditionally have had less access to these services. However, these efforts alone may not sufficiently ameliorate mental healthcare disparities for Latinos. Faith-based organizations (FBOs) could play an integral role in the mental healthcare of Latinos by increasing help-seeking, providing religion-based mental health services, and delivering supportive services that address common access barriers among Latinos. Thus, in determining ways to eliminate Latino mental healthcare disparities under the ACA, examining pathways into care through the faith-based sector offers unique opportunities to address some of the cultural barriers confronted by this population. We examine how partnerships between FBOs and primary care patient-centered medical homes (PCMH) may help reduce the gap of unmet mental health needs among Latinos in this era of health reform. We also describe the challenges FBOs and PCMH providers need to overcome in order to be partners in integrated care efforts. PMID:26845492

  19. A cross-jurisdictional evaluation of insurance coverage among HIV care patients following the Affordable Care Act.

    PubMed

    Hood, Julia E; Buskin, Susan E; Anderson, Bridget J; Gagner, Alexandra; Kienzle, Jennifer; Maggio, David; Markey, Katie; Reuer, Jennifer; Benbow, Nanette; Wortley, Pascale

    2017-04-01

    The impact of the Affordable Care Act (ACA) on HIV care patients, aged 18-64, was evaluated in three jurisdictions with Medicaid expansion (Chicago, New York State, and Washington) and three jurisdictions without Medicaid expansion (Georgia, Texas, and Virginia) using data from the Medical Monitoring Project. Multivariate regression models were used to evaluate insurance status that was reported pre- and post-ACA; self-reported impact of ACA on HIV care was explored with descriptive statistics. The likelihood of having insurance was significantly greater post-ACA compared to pre-ACA in Chicago (aRR = 1.33, 95%CI = 1.20, 1.47), Washington (aRR = 1.15, 95%CI = 1.08, 1.22), and Virginia (aRR = 1.14, 95%CI = 1.00, 1.29). In Washington and Chicago, the likelihood of being Medicaid-insured was greater post-ACA compared to pre-ACA implementation (Chicago: aRR = 1.25, 95%CI = 1.03,1.53; Washington: aRR = 1.66 95% CI = 1.30, 2.13). No other significant differences were observed. Only a subset of HIV care patients (range: 15-35%) reported a change in insurance that would have coincided with the implementation of ACA; and within this subset, a change in medical care costs was the most commonly noted issue. In conclusion, the influence of ACA on insurance coverage and other factors affecting HIV care likely varies by jurisdiction.

  20. Mapping the literature: palliative care within adult and child neurology.

    PubMed

    Dallara, Alexis; Meret, Anca; Saroyan, John

    2014-12-01

    Objectives of this review were to examine definitions and background of palliative care, as well as address whether there is an increased need for palliative care education among neurologists. The review also explores what literature exists regarding palliative care within general neurology and child neurology. A literature review was conducted examining use of palliative care within child neurology. More than 100 articles and textbooks were retrieved and reviewed. Expert guidelines stress the importance of expertise in palliative care among neurologists. Subspecialties written about in child neurology include that of peripheral nervous system disorders, neurodegenerative diseases, and metabolic disorders. Adult and child neurology patients have a great need for improved palliative care services, as they frequently develop cumulative physical and cognitive disabilities over time and cope with decreasing quality of life before reaching the terminal stage of their illness.

  1. International policies toward parental leave and child care.

    PubMed

    Waldfogel, J

    2001-01-01

    The pleasures and pressures of parenting a newborn are universal, but the supports surrounding parents vary widely from country to country. In many nations, decades of attention to benefits and services for new parents offer lessons worthy of attention in this country. This article describes policies regarding parental leave, child care, and early childhood benefits here and in 10 industrial nations in North America and Europe. The sharpest contrast separates the United States from the other countries, although differences among the others also are instructive: The right to parental leave is new to American workers; it covers one-half of the private-sector workforce and is relatively short and unpaid. By contrast, other nations offer universal, paid leaves of 10 months or more. Child care assistance in Europe is usually provided through publicly funded programs, whereas the United States relies more on subsidies and tax credits to reimburse parents for part of their child care expenses. Nations vary in the emphasis they place on parental leave versus child care supports for families with children under age three. Each approach creates incentives that influence parents' decisions about employment and child care. Several European nations, seeking flexible solutions for parents, are testing "early childhood benefits" that can be used to supplement income or pay for private child care. Based on this review, the author urges that the United States adopt universal, paid parental leave of at least 10 months; help parents cover more child care costs; and improve the quality of child care. She finds policy packages that support different parental choices promising, because the right mix of leave and care will vary from family to family, and child to child.

  2. The Affordable Care Act reduces emergency department use by young adults: evidence from three States.

    PubMed

    Hernandez-Boussard, Tina; Burns, Carson S; Wang, N Ewen; Baker, Laurence C; Goldstein, Benjamin A

    2014-09-01

    The Affordable Care Act (ACA) extended eligibility for health insurance for young adults ages 19-25. This extension may have affected how young adults use emergency department (ED) care and other health services. To test the impact of the ACA on how young adults used ED services, we used 2009-11 state administrative records from California, Florida, and New York to compare changes in ED use in young adults ages 19-25 before and after the ACA provision was implemented with changes in the same period for people ages 26-31 (the control group). Following implementation of the ACA provision, the younger group had a decrease of 2.7 ED visits per 1,000 people compared to the older group--a relative change of -2.1 percent. The largest relative decreases were found in women (-3.0 percent) and blacks (-3.4 percent). This relative decrease in ED use implies a total reduction of more than 60,000 visits from young adults ages 19-25 across the three states in 2011. When we compared the probability of ever using the ED before and after implementation of the ACA provision, we found a minimal decrease (-0.4 percent) among the younger group compared to the older group. This suggests that the change in the number of visits was driven by fewer visits among ED users, not by changes in the number of people who ever visited the ED.

  3. The problem of choice: From the voluntary way to Affordable Care Act health insurance exchanges.

    PubMed

    Mulligan, Jessica

    2017-03-28

    This article takes a genealogical and ethnographic approach to the problem of choice, arguing that what choice means has been reworked several times since health insurance first figured prominently in national debates about health reform. Whereas voluntary choice of doctor and hospital used to be framed as an American right, contemporary choice rhetoric includes consumer choice of insurance plan. Understanding who has deployed choice rhetoric and to what ends helps explain how offering choices has become the common sense justification for defending and preserving the exclusionary health care system in the United States. Four case studies derived from 180 enrollment observations at the Rhode Island health insurance exchange conducted from March 2014-January 2017 and interviews with enrollees show how choice is experienced in this latest iteration of health reform. The Affordable Care Act (ACA) of 2010 created new pathways to insurance coverage in the United States. Insurance exchanges were supposed to unleash the power of consumer decision-making through marketplaces where health plans compete on quality, coverage, and price. Consumers, however, contended with confusing insurance terminology and difficult to navigate websites. The ethnography shows that consumers experienced choice as confusing and overwhelming and did not feel "in charge" of their decisions. Instead, unstable employment, changes in income, existing health needs, and bureaucratic barriers shaped their "choices."

  4. Making a Quality Child Care Choice: Finding and Keeping Quality Child Care Can Be Challenging. Where Do You Start? = Choisir des services de garde de qualite: Trouver et garder des services de garde de qualite peut etre difficile. Du commencer?

    ERIC Educational Resources Information Center

    Canadian Child Care Federation, Ottawa (Ontario).

    This booklet offers Canadian parents guidance on finding high-quality child care. The booklet begins by defining quality child care, indicating that child care should support a child's emotional, social, intellectual well-being and that child caregivers are the key to quality child care. The characteristics of quality child care settings are also…

  5. Caring for a Seriously Ill Child

    MedlinePlus

    ... some discomfort, pain, pressure, or stinging. But then reassure your child that it will be temporary and ... on by something they thought, said, or did. Reassure your child that this is not the case, ...

  6. Child-Care Subsidies: Do They Impact the Quality of Care Children Experience?

    ERIC Educational Resources Information Center

    Johnson, Anna D.; Ryan, Rebecca M.; Brooks-Gunn, Jeanne

    2012-01-01

    The federal child-care subsidy program represents one of the government's largest investments in early care and education, but little is known about whether it increases low-income children's access to higher quality child care. This study used newly available nationally representative data on 4-year-old children (N = 750) to investigate whether…

  7. The Child Care Food Program and Family Day Care: A How-To Manual.

    ERIC Educational Resources Information Center

    Brock, Estelle; Travis, Nancy

    This manual explains what is involved in sponsoring a Child Care Food Program (CCFP) for family day care providers. It draws on the experience of Save the Children's Southern States Office in sponsoring the "Child Care Food Umbrella," a CCFP program serving over 1,000 providers, which Save the Children has operated for 6 years. Chapter 1…

  8. Smoke-Free Child Care = Proyecto de Cuidado Diurno Para Ninos Donde "No se Fuma."

    ERIC Educational Resources Information Center

    Massachusetts State Dept. of Public Health, Boston.

    This packet of materials on smoke-free child care contains: (1) "Smoke Free Child Care," a booklet warning child care providers about the dangers of second-hand smoke and the fact that children often imitate adult behaviors, such as smoking; (2) "Smoke-Free Child Care: A Booklet for Family Day Care Providers," warning about the…

  9. 77 FR 35981 - Notice of Intent To Award Affordable Care Act (ACA) Funding, HM10-1001

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-15

    ... Tracking Network. This network builds on ongoing efforts within the public health and environmental sectors... Public Tracking Network as a potential data tool for laboratories. This award was proposed in the grantee... Network. Funding is appropriated under the Affordable Care Act (Pub. L. 111-148), Section...

  10. AIDS Drug Assistance Programs: managers confront uncertainty and need to adapt as the Affordable Care Act kicks in.

    PubMed

    Martin, Erika G; Meehan, Terence; Schackman, Bruce R

    2013-06-01

    With the Affordable Care Act set to expand insurance coverage to millions more Americans next year, existing discretionary health programs that receive federal support might find themselves competing for funds as the health reform law is fully implemented. To assess the implications the Affordable Care Act might have for discretionary health programs, we focused on state AIDS Drug Assistance Programs, which provide free medications to low-income HIV patients. We conducted semistructured interviews with program managers from twenty-two states. Many of the managers predicted that their programs will change focus to provide "wrap-around services," such as helping newly insured clients finance out-of-pocket expenses, including copayments, deductibles, and premiums. Although program managers acknowledged that they must adapt to a changing environment, many said that they were overwhelmed by the complexity of the Affordable Care Act, and some expressed fear that state AIDS Drug Assistance Programs would be eliminated entirely. To remain viable, such programs must identify and justify the need for services in the context of the Affordable Care Act and receive sufficient political support and funding.

  11. Effects of prenatal care on child health at age 5.

    PubMed

    Noonan, Kelly; Corman, Hope; Schwartz-Soicher, Ofira; Reichman, Nancy E

    2013-02-01

    The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child's development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Using data from a national urban birth cohort study in the US, we estimate the effects of prenatal care on four markers of child health at age 5-maternal-reported health status, asthma diagnosis, overweight, and height. Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children's health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime healthcare on child health.

  12. The HHS-HCC Risk Adjustment Model for Individual and Small Group Markets under the Affordable Care Act

    PubMed Central

    Kautter, John; Pope, Gregory C; Ingber, Melvin; Freeman, Sara; Patterson, Lindsey; Cohen, Michael; Keenan, Patricia

    2014-01-01

    Beginning in 2014, individuals and small businesses are able to purchase private health insurance through competitive Marketplaces. The Affordable Care Act (ACA) provides for a program of risk adjustment in the individual and small group markets in 2014 as Marketplaces are implemented and new market reforms take effect. The purpose of risk adjustment is to lessen or eliminate the influence of risk selection on the premiums that plans charge. The risk adjustment methodology includes the risk adjustment model and the risk transfer formula. This article is the second of three in this issue of the Review that describe the Department of Health and Human Services (HHS) risk adjustment methodology and focuses on the risk adjustment model. In our first companion article, we discuss the key issues and choices in developing the methodology. In this article, we present the risk adjustment model, which is named the HHS-Hierarchical Condition Categories (HHS-HCC) risk adjustment model. We first summarize the HHS-HCC diagnostic classification, which is the key element of the risk adjustment model. Then the data and methods, results, and evaluation of the risk adjustment model are presented. Fifteen separate models are developed. For each age group (adult, child, and infant), a model is developed for each cost sharing level (platinum, gold, silver, and bronze metal levels, as well as catastrophic plans). Evaluation of the risk adjustment models shows good predictive accuracy, both for individuals and for groups. Lastly, this article provides examples of how the model output is used to calculate risk scores, which are an input into the risk transfer formula. Our third companion paper describes the risk transfer formula. PMID:25360387

  13. Child Care Quality: An Overview for Parents. ERIC Digest.

    ERIC Educational Resources Information Center

    Patten, Peggy; Ricks, Omar Benton

    Many parents want to know how important the quality of care is to children's social, emotional, and academic development. This digest synthesizes some major recent research on child care quality. First, the digest explains what features contribute to quality of care. The digest also explains the differences between studies of how quality is…

  14. The Heroic Beginnings of Child Care: Looking Back Two Centuries

    ERIC Educational Resources Information Center

    Neugebauer, Roger; Hartzell, Debra

    2010-01-01

    The field of early care and education has a long, proud history. In conducting research on the oldest child care centers in the United States, the authors discovered 75 organizations that have been in operation research more than 90 years; the oldest of which, Newark Day Care Center, has been in operation for 207 years! Rather than summarizing…

  15. Food Safety Training Needs of Child Care Providers.

    ERIC Educational Resources Information Center

    Murphy, Anne S.; And Others

    1995-01-01

    A sample of child-care centers and family day-care homes in Michigan was used to identify what care providers need to know about safe food handling. Their primary concern was to become informed about what causes food to become unsafe and how to prevent foodborne illnesses. Providers preferred printed materials to tapes or workshops. (AA)

  16. Difficult Children and Difficult Parents: Constructions by Child Care Providers

    ERIC Educational Resources Information Center

    Owens, Erica; Ring, Gail

    2007-01-01

    As more mothers of young children work, concerns about child care have gained prominence. Analyses of this topic typically address availability, safety, and costs of care, or the impact of care on children's "outcomes." When providers' input is included, it is generally used as an assessment tool to reinforce the researcher's conceptual framework.…

  17. Guidebook to Collaborating with the Illinois Child Care Subsidy System.

    ERIC Educational Resources Information Center

    Illinois State Dept. of Human Services, East St. Louis. Head Start State Collaboration Office.

    This guide provides information on using the Illinois Child Care Subsidy System in order to assist Illinois early childhood education and care programs in collaborating with other agencies and programs to plan and provide quality, consistent early care and education services for low-income families and their children. The guide also discusses…

  18. Convergent innovation for sustainable economic growth and affordable universal health care: innovating the way we innovate.

    PubMed

    Dubé, Laurette; Jha, Srivardhini; Faber, Aida; Struben, Jeroen; London, Ted; Mohapatra, Archisman; Drager, Nick; Lannon, Chris; Joshi, P K; McDermott, John

    2014-12-01

    This paper introduces convergent innovation (CI) as a form of meta-innovation-an innovation in the way we innovate. CI integrates human and economic development outcomes, through behavioral and ecosystem transformation at scale, for sustainable prosperity and affordable universal health care within a whole-of-society paradigm. To this end, CI combines technological and social innovation (including organizational, social process, financial, and institutional), with a special focus on the most underserved populations. CI takes a modular approach that convenes around roadmaps for real world change-a portfolio of loosely coupled complementary partners from the business community, civil society, and the public sector. Roadmaps serve as collaborative platforms for focused, achievable, and time-bound projects to provide scalable, sustainable, and resilient solutions to complex challenges, with benefits both to participating partners and to society. In this paper, we first briefly review the literature on technological innovation that sets the foundations of CI and motivates its feasibility. We then describe CI, its building blocks, and enabling conditions for deployment and scaling up, illustrating its operational forms through examples of existing CI-sensitive innovation.

  19. Obamacare: what the Affordable Care Act means for patients and physicians.

    PubMed

    Hall, Mark A; Lord, Richard

    2014-10-22

    The Affordable Care Act's core achievement is to make all Americans insurable, by requiring insurers to accept all applicants at rates based on population averages regardless of health status. The act also increases coverage by allowing states to expand Medicaid (the social healthcare program for families and people with low income and resources) to cover everyone near the poverty line, and by subsidizing private insurance for people who are not poor but who do not have workplace coverage. The act allows most people to keep the same kind of insurance that they currently have, and it does not change how private insurance pays physicians and hospitals. Although the act falls short of achieving truly universal coverage, nine million uninsured people have received coverage so far. Market reforms have not hurt the insurance industry's profitability, prices for individual insurance have been lower than expected, and government costs so far have been less than initially projected. The act expands several ongoing pilot programs in Medicare that reform how doctors and hospitals are paid, but it does not directly change how private insurers pay healthcare providers. Nevertheless, it has set into motion market dynamics that are affecting medical practice, such as limiting insurance networks to fewer providers and requiring patients to pay for more treatment costs out of pocket. In response, many hospitals and physicians are forming closer and larger affiliations. Further time and study are needed to learn whether these evolutionary changes will achieve their goals without harming the doctor-patient relationship.

  20. Patient Protection and Affordable Care Act of 2010: a primer for neurointerventionalists.

    PubMed

    Manchikanti, Laxmaiah; Hirsch, Joshua A

    2012-03-01

    The Patient Protection and Affordable Care Act (the ACA, for short) became law on 23 March 2010. It represents the most significant transformation of the American healthcare system since Medicare and Medicaid. Essentials of ACA include: (1) a mandate for individuals and businesses requiring as a matter of law that nearly every American has an approved level of health insurance or pay a penalty; (2) a system of federal subsidies to completely or partially pay for the now required health insurance for ∼34 million Americans who are currently uninsured-subsidized through Medicaid and Exchanges; (3) extensive new requirements on the health insurance industry and (4) changes in the practice of medicine. The Act is divided into 10 titles. It contains provisions that went into effect starting on 21 June 2010 with many of the provisions going into effect in 2014 and later. The ACA goes well beyond insurance and payment reform. Practicing physicians will potentially be impacted by the Independent Payment Advisory Board and the Patient Centered Outcomes Research Institute.

  1. Media Messages and Perceptions of the Affordable Care Act during the Early Phase of Implementation.

    PubMed

    Fowler, Erika Franklin; Baum, Laura M; Barry, Colleen L; Niederdeppe, Jeff; Gollust, Sarah E

    2017-02-01

    Public opinion about the Affordable Care Act (ACA) has been polarized since the law's passage. Past research suggests these conditions would make any media influence on the public limited at best. However, during the early phase of implementation, locally broadcast ACA-related media messages-in the form of paid health insurance and political advertisements and news media stories-abounded as advocates, insurance marketers, and politicians sought to shape the public's perceptions of the law. To what extent did message exposure affect ACA perceptions during the first open enrollment period? We merge data on volumes of messaging at the media market level with nationally representative survey data to examine the relationship between estimated exposure to media messaging and the public's perceptions of how informed they were about and favorable toward the ACA in October 2013. We find that higher volumes of insurance advertising and local news coverage are associated with participants' perceptions of being informed about the law. Volumes of insurance advertising and of local news coverage are also associated with participants' favorability toward the law, but the relationship varies with partisanship, supporting the growing body of research describing partisan perceptual bias.

  2. Early Impact Of The Affordable Care Act On Oral Contraceptive Cost Sharing, Discontinuation, And Nonadherence.

    PubMed

    Pace, Lydia E; Dusetzina, Stacie B; Keating, Nancy L

    2016-09-01

    The oral contraceptive pill is the contraceptive method most commonly used by US women, but inconsistent use of the pill is a contributor to high rates of unintended pregnancy. The relationship between consumer cost sharing and consistent use of the pill is not well understood, and the impact of the elimination of cost sharing for oral contraceptive pills in a mandate in the Affordable Care Act (ACA) is not yet known. We analyzed insurance claims for 635,075 women with employer-sponsored insurance who were initiating use of the pill, to examine rates of discontinuation and nonadherence, their relationship with cost sharing, and trends before and during the first year after implementation of the ACA mandate. We found that cost sharing for oral contraceptives decreased markedly following implementation, more significantly for generic than for brand-name versions. Higher copays were associated with greater discontinuation of and nonadherence to generic pills than was the case with zero copayments. Discontinuation of the use of generic or brand-name pills decreased slightly but significantly following ACA implementation, as did nonadherence to brand-name pills. Our findings suggest a modest early impact of the ACA on improving consistent use of oral contraceptives among women initiating their use.

  3. Gain in Insurance Coverage and Residual Uninsurance Under the Affordable Care Act: Texas, 2013–2016

    PubMed Central

    Pickett, Stephen; Marks, Elena

    2017-01-01

    Objectives. To examine the effects of the Affordable Care Act’s (ACA’s) Marketplace on Texas residents and determine which population subgroups benefited the most and which the least. Methods. We analyzed insurance coverage rates among nonelderly Texas adults using the Health Reform Monitoring Survey-Texas from September 2013, just before the first open enrollment period in the Marketplace, through March 2016. Results. Texas has experienced a roughly 6–percentage-point increase in insurance coverage (from 74.7% to 80.6%; P = .012) after implementation of the major insurance provisions of the ACA. The 4 subgroups with the largest increases in adjusted insurance coverage between 2013 and 2016 were persons aged 50 to 64 years (12.1 percentage points; P = .002), Hispanics (10.9 percentage points; P = .002), persons reporting fair or poor health status (10.2 percentage points; P = .038), and those with a high school diploma as their highest educational attainment (9.2 percentage points; P = .023). Conclusions. Many population subgroups have benefited from the ACA’s Marketplace, but approximately 3 million Texas residents still lack health coverage. Adopting the ACA’s Medicaid expansion is a means to address the lack of coverage. PMID:27854535

  4. An early look at changes in employer-sponsored insurance under the Affordable Care Act.

    PubMed

    Blavin, Fredric; Shartzer, Adele; Long, Sharon K; Holahan, John

    2015-01-01

    Critics frequently characterize the Affordable Care Act (ACA) as a threat to the survival of employer-sponsored insurance. The Medicaid expansion and Marketplace subsidies could adversely affect employers' incentives to offer health insurance and workers' incentives to take up such offers. This article takes advantage of timely data from the Health Reform Monitoring Survey for June 2013 through September 2014 to examine, from the perspective of workers, early changes in offer, take-up, and coverage rates for employer-sponsored insurance under the ACA. We found no evidence that any of these rates have declined under the ACA. They have, in fact, remained constant: around 82 percent, 86 percent, and 71 percent, respectively, for all workers and around 63 percent, 71 percent, and 45 percent, respectively, for low-income workers. To date, the ACA has had no effect on employer coverage. Economic incentives for workers to obtain coverage from employers remain strong.

  5. Plastic Surgeons’ Perceptions of the Affordable Care Act: Results of a National Survey

    PubMed Central

    Israel, Jacqueline S.; Chen, Jenny T.; Rao, Venkat K.

    2015-01-01

    Background: The Affordable Care Act (ACA) aims to expand coverage to the uninsured, improve quality, and contain costs. The goal of this study was to ascertain how plastic surgeons perceive the ACA. Methods: An electronic questionnaire was e-mailed to members of the American Society of Plastic Surgeons between May and June 2014. The survey was anonymous and voluntary and included questions to assess understanding and opinions of the ACA. Results: The survey was sent to 3070 members of the American Society of Plastic Surgeons, and the response rate was 17%. Sixty-eight percent agree or strongly agree that they understand the basic concepts of the ACA. The majority of respondents disagree (38% strongly disagree, 31% disagree) with the notion that the ACA will positively affect their practice, and 51% agree with the statement, “I do not support the ACA, and I believe it did too much.” Two thirds (66%) believe that the ACA deserves a grade of D or F. When answers were analyzed across demographics, 42% of respondents with “Academic” practice background identify with the statement, “I support the ACA but I think it needs more work,” compared to 15% of those who selected “Solo Practice” (p <0.001). Conclusions: The ACA will affect all specialties, including plastic surgery. The results of this survey suggest that many plastic surgeons believe that they have a baseline understanding of current health-care reform. The majority of surveyed surgeons do not support the Act. It is imperative that plastic surgeons possess the knowledge of the ACA; its changes, both current and impending, will likely affect patient mix, coverage of procedures, and reimbursement. PMID:25674374

  6. Hospital and Health Plan Partnerships: The Affordable Care Act's Impact on Promoting Health and Wellness

    PubMed Central

    Vu, Michelle; White, Annesha; Kelley, Virginia P.; Hopper, Jennifer Kuca; Liu, Cathy

    2016-01-01

    Background The Affordable Care Act (ACA) healthcare reforms, centered on achieving the Centers for Medicare & Medicaid Services (CMS) Triple Aim goals of improving patient care quality and satisfaction, improving population health, and reducing costs, have led to increasing partnerships between hospitals and insurance companies and the implementation of employee wellness programs. Hospitals and insurance companies have opted to partner to distribute the risk and resources and increase coordination of care. Objective To examine the ACA's impact on the health and wellness programs that have resulted from the joint ventures of hospitals and health plans based on the published literature. Method We conducted a review of the literature to identify successful mergers and best practices of health and wellness programs. Articles published between January 2007 and January 2015 were compiled from various search engines, using the search terms “corporate,” “health and wellness program,” “health plan,” “insurance plan,” “hospital,” “joint venture,” and “vertical merger.” Publications that described consolidations or wellness programs not tied to health insurance plans were excluded. Noteworthy characteristics of these programs were summarized and tabulated. Results A total of 44 eligible articles were included in the analysis. The findings showed that despite rising healthcare costs, joint ventures prevent hospitals from trading-off quality and services for cost reductions. Administrators believed that partnering would allow the companies to meet ACA standards for improving clinical outcomes at reduced costs. Before the implementation of the ACA, some employers had wellness programs, but these were not standardized and did not need to produce measurable results. The ACA encouraged improvement of employee wellness programs by providing funding for expanded health services and by mandating quality care. Successful workplace health and wellness

  7. Components of Quality Community College Child Care Programs.

    ERIC Educational Resources Information Center

    Campion, William J.; Kyle, Marybeth

    Community colleges are uniquely positioned and well suited to assist in meeting the increasing demand for child care programs. Although a number of colleges have been reluctant to institute these programs due to the problems of liability, operating expenses, and allegations of child abuse, there are a number of advantages to having on-campus child…

  8. Preschool Child Care and Parents' Use of Physical Discipline

    ERIC Educational Resources Information Center

    Magnuson, Katherine A.; Waldfogel, Jane

    2005-01-01

    Parenting practices, including the use of physical discipline, are shaped by multiple influences. Although much research focuses on how parent, child, and dyadic characteristics shape parenting practices, extra-familial resources may also play a role. This paper focuses on how children's experiences of child care during the preschool years may…

  9. Intra-Cultural Variation in Child Care Practices in Japan

    ERIC Educational Resources Information Center

    Toyama, Noriko

    2016-01-01

    This study, comprising three sub-studies, aims to examine how child-rearing practices vary according to different social circumstances in Japan. By comparing teacher-child interaction at mealtimes in day care centres both on an isolated small island located in Okinawa prefecture, Tarama, and in a large industrialised city, Tokyo, the following was…

  10. Meals without Squeals: Child Care Feeding Guide and Cookbook.

    ERIC Educational Resources Information Center

    Berman, Christine; Fromer, Jacki

    Simple, straightforward information on child nutrition and growth is offered in this child care feeding guide and cookbook. The book contains clear, easy-to-read menus and recipes, provides solutions to common feeding problems, and shows ways to offer children positive learning experiences with food. Chapter 1 gives an overview to important issues…

  11. Once Attained, Can Quality Child Care Be Maintained?

    ERIC Educational Resources Information Center

    Roach, Mary A.; Kim, YaeBin; Riley, David A.

    2006-01-01

    Research Findings: This study was designed to assess whether investments in child care quality were maintained 3 years after public funding for these centers was significantly reduced. An earlier evaluation documented significant improvements in classroom environments, teachers' sensitivity, and teachers' child-centered beliefs following a…

  12. Administration of Child Care Programs: Business Management. Instructor's Guide.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    Designed for use by postsecondary child development instructors, this guide is organized into four units that expose students to the general competencies and business management aspects of child care program administration. Introductory materials discuss the use of the materials and provide guidelines for evaluating students. The four units cover…

  13. When Your Child's in the Pediatric Intensive Care Unit

    MedlinePlus

    ... parts of the hospital. Some of these more intensive therapies include ventilators (breathing machines) and certain medicines that ... that a child no longer needs such an intensive level of monitoring, therapy, and/or nursing care. But leaving the PICU ...

  14. Procedures for the Handling of Retaliation Complaints Under Section 1558 of the Affordable Care Act. Final rule.

    PubMed

    2016-10-13

    This document provides the final text of regulations governing employee protection (retaliation or whistleblower) claims under section 1558 of the Affordable Care Act, which added section 18C to the Fair Labor Standards Act to provide protections to employees who may have been subject to retaliation for seeking assistance under certain affordability assistance provisions (for example, health insurance premium tax credits) or for reporting potential violations of the Affordable Care Act's consumer protections (for example, the prohibition on rescissions). An interim final rule (IFR) governing these provisions and request for comments was published in the Federal Register on February 27, 2013. Thirteen comments were received; eleven were responsive to the IFR. This rule responds to those comments and establishes the final procedures and time frames for the handling of retaliation complaints under section 18C, including procedures and time frames for employee complaints to the Occupational Safety and Health Administration (OSHA), investigations by OSHA, appeals of OSHA determinations to an administrative law judge (ALJ) for a hearing de novo, hearings by ALJs, review of ALJ decisions by the Administrative Review Board (ARB) (acting on behalf of the Secretary of Labor), and judicial review of the Secretary of Labor's (Secretary's) final decision. It also sets forth the Secretary's interpretations of the Affordable Care Act whistleblower provision on certain matters.

  15. Relating Child Care during Infancy to Externalizing and Internalizing Behaviors in Toddlerhood: How Specific Features of Child Care Quality Matter Depending on a Child's Gender and Temperament

    ERIC Educational Resources Information Center

    Lemay, Lise; Bigras, Nathalie; Bouchard, Caroline

    2014-01-01

    This study explored whether the relationships between specific features of child care quality and externalizing and internalizing behaviors in 24-month-old children are moderated by gender and temperament. Questionnaires were used to record children's gender and measure their temperament. Child care quality was observed with the "Échelles…

  16. The health reform monitoring survey: addressing data gaps to provide timely insights into the affordable care act.

    PubMed

    Long, Sharon K; Kenney, Genevieve M; Zuckerman, Stephen; Goin, Dana E; Wissoker, Douglas; Blavin, Fredric; Blumberg, Linda J; Clemans-Cope, Lisa; Holahan, John; Hempstead, Katherine

    2014-01-01

    The Health Reform Monitoring Survey (HRMS) was launched in 2013 as a mechanism to obtain timely information on the Affordable Care Act (ACA) during the period before federal government survey data for 2013 and 2014 will be available. Based on a nationally representative, probability-based Internet panel, the HRMS provides quarterly data for approximately 7,400 nonelderly adults and 2,400 children on insurance coverage, access to health care, and health care affordability, along with special topics of relevance to current policy and program issues in each quarter. For example, HRMS data from summer 2013 show that more than 60 percent of those targeted by the health insurance exchanges struggle with understanding key health insurance concepts. This raises concerns about some people's ability to evaluate trade-offs when choosing health insurance plans. Assisting people as they attempt to enroll in health coverage will require targeted education efforts and staff to support those with low health insurance literacy.

  17. Effects of Prenatal Care on Child Health at Age 5

    PubMed Central

    Noonan, Kelly; Corman, Hope; Schwartz-Soicher, Ofira; Reichman, Nancy E.

    2012-01-01

    Objectives The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child’s development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Methods Using data from a national urban birth cohort study in the U.S., we estimate the effects of prenatal care on four markers of child health at age 5—maternal-reported health status, asthma diagnosis, overweight, and height. We implement a number of different strategies to address the issue of potential omitted variables bias as well as a large number of specification checks to validate the findings. Results and Conclusions Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children’s health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime helathcare on child health. PMID:22374319

  18. Prevention of Child Abuse and Neglect in Child Care Settings

    DTIC Science & Technology

    1988-08-01

    34to make her listen to me." Abuse also may be a pattern of behavior such as incest between parent and child extending over many years or parents...when his or her parents leave. "Today, I heard Jerry telling Sandy, ’Don’t cry, your mom will come back soon!’ I think that’s his way of assuring

  19. Trends in Child Protection and Out-of-Home Care

    PubMed Central

    Szilagyi, Moira A.; Franke, Todd M.; Albertin, Christina S.; Blumkin, Aaron K.; Szilagyi, Peter G.

    2013-01-01

    BACKGROUND: Over the past decades, increased knowledge about childhood abuse and trauma have prompted changes in child welfare policy, and practice that may have affected the out-of-home (OOH) care population. However, little is known about recent national trends in child maltreatment, OOH placement, or characteristics of children in OOH care. The objective of this study was to examine trends in child maltreatment and characteristics of children in OOH care. METHODS: We analyzed 2 federal administrative databases to identify and characterize US children who were maltreated (National Child Abuse and Neglect Data System) or in OOH care (Adoption and Foster Care Analysis and Reporting System). We assessed trends between 2000 and 2010. RESULTS: The number of suspected maltreatment cases increased 17% from 2000 to 2010, yet the number of substantiated cases decreased 7% and the number of children in OOH care decreased 25%. Despite the decrease in OOH placements, we found a 19% increase in the number of children who entered OOH care because of maltreatment (vs other causes), a 36% increase in the number of children with multiple (vs single) types of maltreatment, and a 60% increase in the number of children in OOH care identified as emotionally disturbed. CONCLUSIONS: From 2000 to 2010, fewer suspected cases of maltreatment were substantiated, despite increased investigations, and fewer maltreated children were placed in OOH care. These changes may have led to a smaller but more complex OOH care population with substantial previous trauma and emotional problems. PMID:24062369

  20. The Relationship between Women's Working Arrangements and Their Child Care Arrangements.

    ERIC Educational Resources Information Center

    VandenHeuvel, Audrey

    1996-01-01

    An Australian survey examined the child care and working arrangements (part time, shift work, overtime) of 2,890 mothers. Differences in use of formal child care or unmet child care needs depended on children's ages and full-time/overtime status. Those working in nontraditional arrangements may be more likely to use informal child care. (SK)