Final Deliverable: 2008 Florida Conference on Medicaid ...fcmu.phhp.ufl.edu/publications/reports/pdf/MED054 Deliverable 7 2... · Final Deliverable: 2008 Florida Conference on

Contract MED054, Deliverable 7:2

Contains: • List of Conference Attendees • Conference Program with Agenda • Conference Evaluation Summary Results • Conference Evaluation Forms (Overall and Breakout

Session)

Final Deliverable: 2008 Florida Conference on Medicaid & the Uninsured

2008 Florida Conference on Medicaid & the UninsuredPost-conference List of Attendees and Registrants

Count Lname FName MI Title Company/Agency Attended?Pre-

registered?

1 Adams Margo S Executive Director Florida Psychiatric Society Y Y

2 Alsiro Pilar Program Administrator Florida Agency for Health Care Administration N Y

3 Armstrong Mary I Assistant Professor USF Louis de la Parte Florida Mental Health Institute Y Y

4 Arnedos Thomas Asst. County Health Director Palm Beach County Health Department Y Y

5 Arnold Thomas Deputy State Health Officer Florida Department of Health Y Y

6 Ashford Jerome Florida Comprehensive Health Association Y N

7 Atkins Danni D. Government Analyst II Florida Agency for Health Care Administration Y Y

8 Austin Lorraine Y Director Alachua County CHOICES Health Services Y Y

9 Awadzi Kezia D University of Florida N Y

10 Bailey Marie FL PRAMS Coordinator Florida Department of Health Y Y

11 Barnes Linda G. Pharmacy Program Manager for Operations Florida Agency for Health Care Administration Y Y

12 Barr Platt Carol Acting AHCA Administrator Florida Agency for Health Care Administration Y Y

13 Becker Marion A Professor University of South Florida Y Y

14 Behmke Stanley J Inspector General Florida Department of Elder Affairs Y Y

15 Belcher Paul E. Senior Vice President Florida Hospital Association Y Y

16 Bell Amber J Health Policy Analyst Florida Agency for Health Care Administration N Y

17 Bell Lilly L Research Project Coordinator University of Florida PHHP HSRMP Y Y

18 Benda Andrea V COO Project Health N Y

19 Benson Holly Secretary Florida Agency for Health Care Administration Y Y

20 Berger Sandra Senior Consultant Health Management Associates Y Y

21 Bigos Yvonne M Chief Legislative Analyst OPPAGA Y Y

22 Biles Brian Professor, Department of Health Policy, School of Public Health George Washington University Y Y

23 Blades Laurie An Chief, Children's Mental Health Florida Department of Children & Families Y Y

24 Blount Whitney Florida Agency for Health Care Administration Y Y

25 Boatwright Karin B Government Operations Consultant I Florida Agency for Health Care Administration Y Y

26 Boothroyd Roger USF Louis de la Parte Florida Mental Health Institute Y Y

27 Boston Jeannie Director of Programs Suwannee Valley 4Cs Y Y

28 Bowls John R Clinic Manager The Sulzbacher Center N Y

29 Boyce Philip Sr. Vice President Baptist Health - Jacksonville Y Y

Page 1 of 10



registered?

30 Bracher James J Executive Vice President Florida Association of Health Plans Y Y

31 Bradley Stephen Florida Agency for Health Care Administration N Y

32 Bradley Terrye S Bureau Chief Florida Department of Health Y Y

33 Brady Carol M. NEF Healthy Start Coalition N Y

34 Brennan Margaret J Health Services Manager Orange County Government N Y

35 Brewer Earnest Field Office Manager Florida Agency for Health Care Administration N Y

36 Brickman Andrew Executive Director,Health Connect The Children's Trust Y Y

37 Bridges Matt Florida Agency for Health Care Administration Y N

38 Brown-Woofter Melanie AHC Administrator Florida Agency for Health Care Administration Y Y

39 Burg Mary Ann Associate Professor University of Florida Y Y

40 Butler Robert C MEDICAID POLICY AND ANALYTICS Wellcare N Y

41 Butler-Moore Barbara E. Operations & Management Consultant Manager Florida Agency for Health Care Administration Y Y

42 Campbell Benjamin F. Grantwriter Shands Jacksonville N Y

43 Campbell John CFO Palm Beach County Health Department N Y

44 Cantwell Laura Program Coordinator AARP Y Y

45 Carmon Terry National Acct. Executive OAPI N Y

46 Carotenuto Bernardo J VP of Political Affairs Genoa Healthcare N Y

47 Cavendish Margaret Medical Health Care Program Analyst Florida Agency for Health Care Administration Y Y

48 Cawthon Sarah Program Analyst Florida Department of Health Y Y

49 Chadee Hannah University of Florida, College of Pharmacy Y N

50 Chang Karen Florida Agency for Health Care Administration Y Y

51 Chang Mel Senior Policy Advisor Office of Planning, Evaluation and Data Analysis Y Y

52 Chisholm Latarsha R University of Florida N Y

53 Chorba Lorna P Statistician University of Florida HSRMP FCMU Y Y

54 Ciccone Lucy C Staff Director, Committee on Healthy Seniors Florida House of Representatives Y Y

55 Clarke Stephanie L MEDICAL/HEALTH CARE PROGRAM ANALYST Florida Agency for Health Care Administration Y Y

56 Cober Amy Asst. Director, Div. of Family Health Florida Department of Health Y Y

57 Cochran Micheal VP of Health Services The Sulzbacher Center N Y

58 Commedore Emile Director Office of Minoirty Health Y Y

59 Congleton Bruce A Government Analyst Florida Agency for Health Care Administration Y Y

Page 2 of 10



registered?

60 Consolo Cathy A Mental Health Liaison Bristol-Myers Squibb Y Y

61 Cook Robert Assoc. Prof/Assoc. Director University of Florida College of Medicine, FCMU Y Y

62 Cooper Matt APS Healthcare Y Y

63 Cowart Jalanna A Intern FCMU Y Y

64 Croissant Dorie Regional Manager Florida Hospital Y Y

65 Cruz Cesar Project Manager Florida Agency for Health Care Administration Y Y

66 Culbertson Patricia M PMC LLC Y Y

67 Dahlem William E Economic Analyst Florida Agency for Health Care Administration Y Y

68 Daniels Larry Mgr, Regulatory Affairs WellCare Y Y

69 Das Rajeeb University of Florida Y Y

70 Davis Glen C Program Administrator Florida Department of Health Y Y

71 Davis Josh "JD" Project Manager Florida Agency for Health Care Administration Y Y

72 Dean Amy Y N

73 Delaney Rose Consumer Advocate NAMI Florida Y Y

74 Detman Linda A. Research Associate USF Lawton & Rhea Chiles Center Y Y

75 Diaz Robert VP, Reg'l Affairs & QA WellCare Y Y

76 Dichio Frank Program Analyst Florida Agency for Health Care Administration Y Y

77 Dilmore Susan Bureau Chief of Quality Management Y Y

78 Dimperio Diane Director Of Program Development Alachua CHD Y Y

79 Duarte Charles C Y N

80 DuBose Derenda Health Services Manager Suwannee Valley 4Cs Y Y

81 Duncan R. Paul Professor, Director, and Chair University of Florida HSRMP FCMU Y Y

82 Durden Schlisha Y N

83 Eastman Beth Interim Bureau Chief Florida Agency for Health Care Administration Y Y

84 Eddleton Katherine Institute for Child Health Policy Y Y

85 Elliott Kimberly S PhD Student University of Florida PHHP HSRMP Y Y

86 Emerick Dawn Executive Director Health Planning Council of Northeast Florida, Inc. Y Y

87 Evans Judi Executive Director NAMI Florida Y Y

88 Ewigman Nate PhD Student University of Florida Y Y

89 Feller Jeff A. Chief Operating Officer WellFlorida Council Y Y

Page 3 of 10



registered?

90 Fields Robert CIO Florida Agency for Health Care Administration N Y

91 Fitzgerald Kathleen Health Planning Council of NE Florida Y N

92 Foley Barbara MAXIMUS Y Y

93 Fox Claude Earl Executive Director Florida Public Health Institute Y Y

94 Fox Heidi Administrator Florida Agency for Health Care Administration Y Y

95 Foy David Policy Director State of Floirda Office of the Governor Y Y

96 Foy Leslie D Governmental Consultant Greenberg Traurig Y Y

97 Frier Lindsay E Student University of Florida PHHP HSRMP Y Y

98 Frisby George Florida Agency for Health Care Administration Y Y

99 Frost Beth Anne MCHERDC Y Y

100 Fuhrman Clint Deputy Secretary for Communications and Legislative Affairs Florida Agency for Health Care Administration Y Y

101 Garcia-Quevedo Ana J Florida Department of Health Y Y

102 Garner Michael W President and CEO Florida Association of Health Plans Y Y

103 Gay Rebecca J Vice President, New Markets Blue Cross Blue Shield of Florida Y Y

104 Gill Lisa T. AHC Administrator, HSD Florida Agency for Health Care Administration N Y

105 Glassner Kathleen M Health Science Advisor Merck & Co., Inc Y Y

106 Goodhue Laura Executive Director Florida CHAIN Y Y

107 Goodman Tobi L Managed Care Unit Director Florida Department of Health Y Y

108 Goodworth Gary Information Systems Management Y Y

109 Graham Justin OPPAGA Y Y

110 Graham Justin OPPAGA Y N

111 Graham Mimi Y Y

112 Guinan Amy K. Florida Legal Services, Inc. Y Y

113 Hagler Wesley D Regulatory Analyst Supervisor Florida Agency for Health Care Administration Y Y

114 HAHN R.H. Director Government Relations Vista HealthPlan Y Y

115 Hahn Roger Director Government Relations Vista/A Coventry Health Care Plan Y Y

116 Hajdukiewicz Marcy Florida Department of Elder Affairs Y Y

117 Hall Allyson Assoc. Prof/Assoc. Director University of Florida HSRMP FCMU Y Y

118 Halperin Karen State of Floirda Office of the Governor Y Y

119 Hamrick Leah Legislative Analyst Florida House of Representatives Healthcare Council Y Y

Page 4 of 10



registered?

120 Hansen Craig M Associate Director, Government Affairs Merck & Co., Inc. Y Y

121 Hardy Talisa Clinical Program Manager Florida Agency for Health Care Administration Y Y

122 Harman Jeffrey Associate Professor University of Florida PHHP HSRMP Y Y

123 Haynes Louvenia B. Human Scvs Prog Spec Florida Agency for Health Care Administration N Y

124 Helvey Nikole Network Development and Program Planning Health Planning Council of Northeast Florida, Inc. Y Y

125 Henderson Joel G Healthy Seminole Project Manager Health Council of E Central FL Y Y

126 Hendlin Rae A OPPAGA Y Y

127 Hernandez Leticia E Training and Researh Consultant Florida Department of Health Y Y

128 Hernandez Tony Director of Internal Audit Department of Elder Affairs Office of the Inspector General Y Y

129 Herndon Jill Research Associate Professor University of Florida Y Y

130 Hervey Shani Analyst USF Lawton & Rhea Chiles Center Y Y

131 Hill Mike Florida Association of Health Planning Agencies Y Y

132 Holt Gregory Tallahassee Sleep Diagnostic Center Y N

133 Holton Annette Program Operations Manager Florida Agency for Health Care Administration N Y

134 Houck Edward W Executive Director Administrator Y Y

135 Huntley Abby J Medical Health Care Analyst Florida Agency for Health Care Administration N Y

136 Hurd Tracy L AHCA Administrator Florida Agency for Health Care Administration Y Y

137 Hutchens-Gueth Cindy Program Analyst Florida Department of Children & Families Y Y

138 Hutton Patrick Florida Medical Association Y Y

139 Hyer Kathryn Associate Professor University of South Florida Y Y

140 Jackson Catherine M State Alliance Manager AstraZeneca Y Y

141 Jacobs Shannon L Administrator Santa Rosa County Health Department Y Y

142 Jamoom Eric W PhD Student University of Florida PHHP HSRMP Y Y

143 Jensen Sandra API Healthcare Y N

144 Jensen Sandra Florida Agency for Health Care Administration Y N

145 Johnson Tammie M Chronic Disease Epidemiologist Florida Department of Health Y Y

146 Johnson Tevieca A Senior Pharmacist/Investigator Florida Agency for Health Care Administration Y Y

147 Jones-Garrett Brenda D. Medical Health Care Program Analyst Florida Agency for Health Care Administration Y Y

148 Kane John C Consultant APS Healthcare Y Y

149 Karns Michael Florida Agency for Health Care Administration Y N

Page 5 of 10



registered?

150 Kearley Melanie Y N

151 Kellum Kim Medicaid Chief Counsel Florida Agency for Health Care Administration Y Y

152 Kenney Genevieve Principal Research Associate and Health Economist The Urban Institute Y Y

153 Kersmarki Maureen S Y N

154 Kim Ester Florida Agency for Health Care Administration N Y

155 Kokol Doc Director of Communications Florida Agency for Health Care Administration Y Y

156 La Croix Rachel M Program Administrator Florida Agency for Health Care Administration Y Y

157 Laberge Alex University of Florida PHHP HSRMP Y Y

158 Lawrence Simonne Assistant General Counsel Florida Agency for Health Care Administration N Y

159 Lee Kenyatta Associate Professor Shands Jacksonville Y Y

160 Lee Keon Florida State University Y N

161 Littles Alma Florida Medical Association Y Y

162 Lloyd Linda M State Director - FL Ortho-McNeil-Janssen Y Y

163 Lowry Amy Legislative Analyst OPPAGA Y Y

164 Lucas Mary L. R.N.;B.S.N. Leon CHD Y Y

165 Madden Steve Southern Strategy Group Y Y

166 Magnuson Michael P Project Manager Florida Agency for Health Care Administration Y Y

167 Mallison Chris Coordinator, Statistical Programs AHCA and University of Florida FCMU Y Y

168 Mankodi Shachi Special Counsel to the Chief of Staff Florida Agency for Health Care Administration Y Y

169 Markiewicz Bobbi Associate in Research USF Lawton & Rhea Chiles Center Y Y

170 Marshall Kimberly L Uninsured Research Analyst Florida Agency for Health Care Administration Y Y

171 Marshall Tony Sr. Vice President & COO Florida Health Care Association Y Y

172 Mather Charlotte C. VP, Government Relations & Community/Public Affairs Broward Health Y Y

173 Matthews John J vp UnitedHealth Group Y Y

174 McCarty Chris Associate Professor University of Florida BEBR/PHHP Y Y

175 McGhee Darrick D. Director of Legislative Affairs Florida Department of Elder Affairs Y Y

176 McKenzie Kathleen Dr. Jacksonville Community Council Inc. Y Y

177 McLeod Sylvia Florida Agency for Health Care Administration Y Y

178 McNamara Deborah N Quality Coordinator Florida Agency for Health Care Administration Y Y

179 McNamara Susan R. Government Analyst II Florida Agency for Health Care Administration Y Y

Page 6 of 10



registered?

180 Meadows-Keefe Julie A. Chief Legal Counsel Florida Department of Health Y Y

181 Means Elizabeth Y N

182 Medina Ralph Director Custumer Service-PR Access Health Solutions Y Y

183 Mellowe Greg Policy Director Florida CHAIN Y Y

184 Merrell Linda F President Florida Child Health Care Coalition Y Y

185 Mertz Briant Medicaid Healthcare Analyst Florida Agency for Health Care Administration N Y

186 Mesler Michael P Program Analyst Florida Agency for Health Care Administration Y Y

187 Metts Paul E deputy secretary Florida Department of Health Y Y

188 Miller Erica N Medical Health Care Program Analyst Florida Agency for Health Care Administration N Y

189 Miller Pamela T. Vice President - Market Strategy & Development Medco Health Solutions, Inc. Y Y

190 Morris Michael PhD Student University of Florida PHHP HSRMP Y Y

191 Mosley John Director of Primary Care Division Duval County Health Department Y Y

192 Murray Nichole Senior Management Analyst Florida Department of Children & Families Y Y

193 Mwenene Mukweso Senior Management Analyst Supervisor Florida Department of Children & Families Y Y

194 Myers Susan D Alachua County Community Support Services Y Y

195 Naff Rose M President Government Policy Solutions Y Y

196 Neu Edward W Chief Information Officer Florida Department of Elder Affairs Y Y

197 Nixon Candie T Director Alachua County Division of Social Services Y Y

198 Nogle June M Research Associate Scientist Institute for Child Health Policy, Univ. of Florida Y Y

199 Norris Patricia E Government Analyst II Florida Agency for Health Care Administration Y Y

200 Nunez Jeanette Jackson Health System Y Y

201 Oliva Steven J. Chief Executive Officer WellFlorida Council Y Y

202 Olsen Ellen Florida Agency for Health Care Administration Y N

203 Orender Heather OPPAGA Y Y

204 Orender Heather OPPAGA Y N

205 Ottinger Jason R Government Analyst II Florida Agency for Health Care Administration Y Y

206 Owens Mary Kay Y N

207 Pannell Robert E Acting Director FL Office of Rural Health Y Y

208 Papadopoulos Airia Assistant in Research USF Louis de la Parte Florida Mental Health Institute Y Y

209 Perkins Janet Executive Director Office of Countywide Healthcare Planning Y Y

Page 7 of 10



registered?

210 Perri Michael G Professor and Interim Dean University of Florida PHHP Y Y

211 Petrie Geoffrey Dir, Regulatory Affairs WellCare Y Y

212 Piekalkiewicz Ellen Z. Executive Director Florida Substance Abuse and Mental Health Corp Y Y

213 Pilkenton Kathy Special Projects Coordinator Florida Agency for Health Care Administration Y Y

214 Platt Frank Florida Department of Children & Families Y Y

215 Putnam Celeste J Florida State University Y Y

216 Quinn Joe Senior Director Health Care Policy, Benefits Communications Walmart Y Y

217 Ragbeer Diana Director of Public Policy & Communications The Children's Trust Y Y

218 Rayner Clint Chief, Office of Consumer and Family Affairs Florida Department of Children & Families Y Y

219 Reich Debbie Health Planner Florida Department of Health Y Y

220 Reinhardt Peggy C Acting DON Leon CHD Y Y

221 Richards Scott Coordinator, Programming & Research University of Florida Survey Research Center Y Y

222 Roberts Mike Florida Agency for Health Care Administration Y Y

223 Robinson Patricia A Assistant Dean USF Louis de la Parte Florida Mental Health Institute Y Y

224 Rodrigues Jessica Medicaid Healthcare Analyst Florida Agency for Health Care Administration Y Y

225 Rodriguez Monica L Attorney/Lobbyist Akerman Senterfitt Y Y

226 Rogers Joseph Senior Vice President Broward Health Y Y

227 Roth Jeffrey Research Associate Professor University of Florida Y Y

228 Rugg Elizabeth M Executive Director The Health Councils, Inc. Y Y

229 Sacher Lesley Florida State University Y Y

230 Salman Zaynab Senior Attorney Florida Agency for Health Care Administration N Y

231 Sanchez Robert The James Madison Institute Y Y

232 Sanders Billy Florida Agency for Health Care Administration Y N

233 Sandvoss Mark T. Medical/ Health Care Program Analyst Florida Agency for Health Care Administration Y Y

234 Sappenfield William M. State MCH Epidemiologist Florida Department of Health Y Y

235 Scheffers Marten Associate Consultant APS Healthcare Y Y

236 Schlaich Monica Planning Analyst Shands HealthCare Y Y

237 Schmidt Clifford D. AHC Administrator Florida Agency for Health Care Administration Y Y

238 Schmidt Diana M Sr. Region Director, State Government Operations Bristol-Myers Squibb Y Y

239 Schoolfied Kerry Florida House of Representatives Y N

Page 8 of 10



registered?

240 Segal Richard Professor and Chair University of Florida College of Pharmacy Y Y

241 Senior Justin M Chief Appellate Counsel Florida Agency for Health Care Administration Y Y

242 Senra Fernando Florida Agency for Health Care Administration Y N

243 Sexton Christine Florida Health News Y N

244 Shafer Kim Sr. Legislative Analyst OPPAGA Y Y

245 Shah Tanvi Y Y

246 Shah Tejas Y Y

247 Sharrock Patty Assistant in Research USF Louis de la Parte FMHI Y Y

248 Sheedy Michael B Associate Director for Health Florida Catholic Conference Y Y

249 Shenkman Betsy University of Florida College of Medicine Y Y

250 Smith Betty L. Management Analyst Florida Department of Health Y Y

251 Smith Craig Deputy General Counsel Florida Agency for Health Care Administration Y Y

252 Smith Doris Family Services Coordinator Suwannee Valley 4Cs Y Y

253 Smith Sylvia W. Public Policy Coordinator Advocacy Center for Persons with Disabilities, Inc. Y Y

254 Snipes Dyke Medicaid Director Florida Agency for Health Care Administration Y Y

255 Snow Alisa Executive Director Alliance for Pediatric Therapies Y Y

256 Spencer Leslie A Associate State Director for Advocacy AARP Y Y

257 St. Petery Louis Executive Vice President Florida Pediatric Society Y Y

258 Steingraber Heather G Research Program Manager University of Florida HSRMP FCMU Y Y

259 Stewart Eric Y N

260 Stilwell Donna L. Office Manager University of Florida HSRMP Y Y

261 Street Philip E Research Manager Florida Department of Health Y Y

262 Streit Jane B Senior Psychologist Florida Department of Children & Families Y Y

263 Stringer Lucille D Registered Nurse Consultant Children's Medical Services Y Y

264 Sullivan Michael "Mick" HIV Access & Reimbursment Director Tibotec Therapeutics Y Y

265 Swink Kathryn A Graduate Research Assistant UF Maternal Child Health& Education Research Y Y

266 Thibodaux Beth Assistant Director, Government Affairs Florida Hospital Y Y

267 Thomas Brenda Y N

268 Thomas Mark S Chief of Staff Florida Agency for Health Care Administration Y Y

269 Thompson Keva PhD Student University of Florida PHHP HSRMP Y Y

Page 9 of 10



registered?

270 Thompson Trina K Program Administrator, Diabetes Prevention and Control Program Florida Department of Health Y Y

271 Tiam-Fook Penelope State Public Affairs Director March of Dimes Florida Chapter Y Y

272 Treharne Vivienne Florida Department of Health Y Y

273 Tribley Lloyd J Government Analyst II Florida Agency for Health Care Administration N Y

274 Tutwiler Marianna D Program Director USF Lawton & Rhea Chiles Center Y Y

275 Vargo Amy C faculty USF Louis de la Parte FMHI Y Y

276 Vergeson Melissa Program Administrator Florida Agency for Health Care Administration Y Y

277 Vergon Keren S Assistant Professor University of South Florida Y Y

278 Waddell Lisa D Medical Representative AstraZeneca Y Y

279 Walker Arlene C. Medical Health Care Program Analyst Florida Agency for Health Care Administration Y Y

280 Wan Thomas T. Professor & Associate Dean for Research University of Central Florida Health & Public Affairs Y Y

281 Ward Scott C IT Business Consultant Manager Florida Agency for Health Care Administration Y Y

282 WebsterMrs. Freddie

L. WE CARE Manager WE CARE Jacksonville, Inc. Y Y

283Weech-Maldonado

Robert Associate Professor University of Florida HSRMP Y Y

284 Weiner Lynne G Senior Advocate Advocacy Center Y Y

285 Weissert William Professor & Director, MPH Florida State University Y Y

286 Whitesell Mary J. Health Educator Consultant Healthy Communities Healthy Families, DOH Y Y

287 Wiggins Regina Government Analyst II Florida Agency for Health Care Administration Y Y

288 Wilcox Randy Bureau Chief Children's Medical Services Y Y

289 Wilhelmy Felicia Medical health care Program Analyst Florida Agency for Health Care Administration Y Y

290 Winn William H. Director of Government Programs JMH Health Plan Y Y

291 Zhang Jackie Assistant Professor, Doctoral Program in Public Affairs, College University of Central Florida Y Y

292 Zhang Jianyi Coordinator, Statistical Programs University of Florida HSRMP FCMU N Y

293 Zheng Hao W MCHERDC Y Y

294 Zingale Jim Safety Net Hospital Alliance of Florida Y N

Page 10 of 10

2008 Florida Conference onMedicaid and The Uninsured

State & National Level Reforms: Research & Policy

Tallahassee-Leon County Civic CenterSeptember 11-12, 2008

Program

NamePlenary Titles

Morning PlenaryTitle

Thursday, September 11Welcome

Dear Colleague:

It is my pleasure to welcome you to the 7th Annual Medicaid Research and Policy Conference, “State and National Reform: Research and Policy.”

This year’s conference seeks to explore health care reforms at the local, state, and federal level, with our usual attention to the effects on vulnerable populations. During the next two days we will discuss both state and local health care reforms, health disparities and cultural competency, and health care for especially vulnerable groups such as children on Medicaid and SCHIP, women, the disabled, and elders.

By hosting an annual conference, The Florida Center for Medicaid and the Uninsured seeks to foster an environment for open dialogue among leaders in research, practice, and policy. Last year, conference attendance grew dramatically and this year we are delighted to host a full audience and a terrific lineup of speakers. We are particularly pleased to have the participation of the Secretary of Florida’s Agency for Health Care Administration, Holly Benson, and David Foy from the Office of the Governor. Dr. Genevieve Kenney from the Urban Insitutue and Dr. Brian Biles from George Washington University are joining us with some perspective from Washington D.C.

We are grateful to the Agency for Health Care Administration for its ongoing financial support, without which these annual meetings would not be possible. Thanks also to all those who have given of their time, energy, and resources to make this conference a success.

Thank you for being a part of our 7th Annual Medicaid Research and Policy Conference. We recognize your participation and feedback as an essential factor in the ongoing improvement of this meeting and the fulfillment of our mission to promote research, policy analysis, and education on issues related to access, quality, and cost of health care for underserved populations.

Sincerely,

R. Paul Duncan, PhDDirectorFlorida Center for Medicaid and the UninsuredCollege of Public Health and Health ProfessionsUniversity of Florida

R. Paul Duncan, PhD

Table of Contents

WelcomeR. Paul Duncan, PhDRobert L. Cook, MD, MPH ...................................................................................................................................................................5

ScheduleThursday, September 11........................................................................................................................................................................6Friday, September 12 ...............................................................................................................................................................................7

Panel SeSSionS overvieW State Children’s Health Insurance Plan (SCHIP) .............................................................................................................8The Elderly and Long Term Care ....................................................................................................................................................9Local Health Reform Initiatives ....................................................................................................................................................10Mental Health .............................................................................................................................................................................................11Private Sector Innovations ..............................................................................................................................................................12Maternal and Child Health ...............................................................................................................................................................13

BioSPlenary Speaker: Holly Benson, Secretary of AHCA ..........................................................................................15

State children’s health insurance Plan (SchiP) PanelBetsy Shenkman, PhD (Moderator) .........................................................................................................................................16Jill Herndon, PhD .....................................................................................................................................................................................16Rose Naff, President, Government Policy Solutions...................................................................................................17June Nogle, PhD ....................................................................................................................................................................................17

The elderly and long Term care PanelRobert Weech-Maldonado, PhD, MBA (Moderator) ...................................................................................................18Kathryn Hyer, PhD, MPP ...................................................................................................................................................................18Alex Laberge, PT, MBA .......................................................................................................................................................................18Thomas Wan, PhD, MHS ...................................................................................................................................................................19Jackie Zhang, MD, MPH, PhD ......................................................................................................................................................19

Plenary Speaker: Genevieve Kenney, PhD ..................................................................................................................20

Plenary Speaker: Brian Biles, MD, MPH ......................................................................................................................21

Plenary Speaker: David Foy, Governor’s Office ......................................................................................................23

Town Hall Panel Moderator: Cliff Schmidt, MPA.................................................................................................25

Table of Contents continued

local health reform initiatives Panel Allyson Hall, PhD (Moderator) ......................................................................................................................................................26Diane Dimperio, MA ...............................................................................................................................................................................26Kenyatta Lee, MD ..................................................................................................................................................................................27Janet Perkins, MPP ..............................................................................................................................................................................27

mental health PanelRoger Boothroyd, PhD (Moderator) ........................................................................................................................................28Mary Armstrong, PhD ...........................................................................................................................................................................28Laurie Blades, MA, BCBA ..............................................................................................................................................................29Barbara Butler-Moore, MSW, LCSW ......................................................................................................................................29Keren Vergon, PhD ................................................................................................................................................................................29

Private Sector innovations PanelJeff Feller, MS (Moderator) ............................................................................................................................................................30Joe Quinn, Wal-Mart Stores, Inc. .................................................................................................................................................30Blue Cross and Blue Shield of Florida .................................................................................................................................31

maternal and child health PanelBill Sappenfield, MD, MPH (Moderator) ...............................................................................................................................32Linda Detman, PhD ................................................................................................................................................................................32Kathleen Mackenzie, PhD, MS .....................................................................................................................................................33Beth Anne Frost, BS ...........................................................................................................................................................................33Kathryn Swink, BS ................................................................................................................................................................................33

Plenary Speaker: R. Paul Duncan, PhD ..........................................................................................................................35

reSearch aBSTracTSIdentifying Barriers to Screening and Treatment of Cervical Cancer .........................................................36Predictors and Outcomes of Evidence-Based Practice for Medicaid Recipients with

Major Depressive Disorder .........................................................................................................................................................37 The Distribution of Diabetes, Obesity, and Current Cigarette Use by Income Group .....................38Do For-Profit Chain Affiliated Nursing Homes Cost Less? ..................................................................................39MEDNET©: A Collaborative Approach to Prescription Drug Access .........................................................40Stage of Cancer Diagnosis among Medicaid Patients for Breast, Cervical, and

Colorectal Cancers ...........................................................................................................................................................................41

conference reSourceSHotel Amenities.........................................................................................................................................................................................42Tallahassee Attractions .......................................................................................................................................................................43

5

A Note from the Conference Chair

Greetings! As Chair of this year’s conference, I am pleased to welcome everyone to the 7th Annual Medicaid Research and

Policy Conference. The planning committee has worked diligently to bring you a diverse mix of researchers, policy-makers, and advocates interested in improving the health care for persons on Medicaid and those who lack adequate health insurance coverage.

I would like to extend a special invitation to join us for an “Evening at the Brogan” on Thursday from 6-8pm. This reception will be held at the Mary Brogan Museum of Art and Science, one of Tallahassee’s special gems. As our conference attendees, you and your guest will be able to enjoy exclusive access to the museum while viewing an array of exhibits and mingling with others. Complimentary beverages and hors d’oeuvres will be served. The museum is currently displaying some special exhibits provided by the world famous Smithsonian that you won’t want to miss. Transportation is provided from the Residence Inn and Civic Center to and from the museum.

Again, welcome to the conference!

Robert L. Cook, MD, MPH

Trolley ServiceThere will be a free trolley that will be circulating from the Residence Inn to the Civic Center and then on to the Brogan Museum. The trolley will run from 5:45pm to 8:30pm.

Evening at The BroganThursday, September 116:00-8:00pm

Mary Brogan Museum of Art and Science350 S. Duval St.Tallahassee, FL 32301

Robert L. Cook, MD, MPH

6

Agenda: Thursday, September 11

Exhibition Hall 11:00-12:30 RegistRation

~Buffet lunch~

Exhibition Hall12:30-1:30 opening plenaRy

“Florida Medicaid: Overview and Status”

holly Benson, Secretary of Florida’s Agency for Health Care Administration

Arena Access

1:30-1:45 BReak

Room A3 Room A1/A21:45-3:00 BReakout sessions

Panel A: SchiP

Panel B: The elderly & long Term care

Arena Access3:00-3:15 BReak

Exhibition Hall3:15-4:15 afteRnoon plenaRy

“Health Care Reform Initiatives at the National Level: The SCHIP Example”

Genevieve m. Kenney, PhdPrincipal Research Associate, Health Policy Center, The Urban Institute

Brian Biles, md, mPhProfessor, Department of Health Policy, The George Washington University


Exhibition Hall4:30-5:00 policy update

“Cover Florida: Health Care Options for the Uninsured”

david foy, Policy Director, State of Florida, Office of the Governor

Brogan Museum6:00-8:00 evening Reception

Mary Brogan Museum of Art and Science350 South Duval Street

OR

7

Agenda: Friday, September 12

*Agenda is subject to change.

Meeting Room D7:30-8:30 diRectoR’s BReakfast (by invitation only)

Exhibition Hall8:00-8:30 continental BReakfast

Exhibition Hall8:30-10:00 MoRning plenaRy

Town Hall Meeting: Ask the Stakeholders about UninsurancePanelists to include representatives from the state legislative and executive branches, Congress, medical provider groups, insurers, private sector, and consumer groups.



Panel A: local health reform initiatives

Panel B: mental health

Exhibition Hall11:30-12:30 lunch


Panel A: Private Sector innovations

Panel B: maternal & child health


Exhibition Hall2:00-3:15 closing plenaRy

“Florida Research Initiatives: Medicaid Reform Evaluation and the Florida Health Insurance Study”

r. Paul duncan, Phd and the UF Evaluation Team

OR

OR

8

Panel Session Overview

State Children’s Health Insurance Program (SCHIP)

Thursday September 11th 1:45-3:00room a3

The purpose of this session is to present and discuss policy changes to the State Children’s

Health Insurance Program (SCHIP) and their implications for continuity of insurance

coverage. Specific subgroups of children most affected by the policy changes, including those

with special health care needs will be discussed. State-specific and national trends will be

presented.

“national Trends in State children health insurance”Rose Naff

“impact of Policy changes on disenrollment”Jill Herndon

“analysis of cmSn Title 21 disenrollment for non-Payment”June Nogle

9


Despite recent improvements in nursing home quality, major quality problems are still

prevalent (GAO, 2003). As a result, federal and state governments are increasingly using

regulatory and market-based approaches to promote quality of care in nursing homes.

This session explores the impact of Florida policy initiatives aimed at increasing nursing

home staffing on quality of care. In addition, it provides an overview of a nursing home pay-

for-performance methodology that incorporates both quality and efficiency criteria, which

policymakers can use to reimburse and reward better performing nursing homes.

“impact of florida nurse Staffing legislation on nursing home Quality of care”Kathryn Hyer

“does State medicaid Policy to increase nursing home Staffing result in Better care?”Alex Laberge

“a Pay for Quality-efficiency System: a Skilled nursing home Balanced Scorecard approach”Thomas Wan and Jackie Zhang

The Elderly and Long Term Careimproving Quality of care in nursing homes: regulatory and market-Based approaches

Thursday September 11th 1:45-3:00

room a1/a2

10


Local Health Reform Initiatives

friday, September 12th 10:15-11:30

room a3

This panel will explore approaches to improving health care at a local level. Panelists from

rural and urban public sector organizations will present new and ongoing strategies to expand

insurance coverage, manage chronic disease, and improve primary care access.

“creating Portals of access to medical homes”Janet Perkins

“disparities, now You See Them, Soon You Won’t”Kenyatta Lee

“diabetic disease management in a rural area”Diane Dimperio

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Mental Healthflorida’s at-risk children:

cross System movement and financial and Policy implications

friday, September 12th 10:15-11:30room a1/a2

This panel presentation will begin with a summary of findings from the Trajectory Study which

was designed to understand how and why youth move through the publicly funded mental health

system and across multiple systems (e.g., child welfare, juvenile justice) in Florida. Secondary

data analyses of administrative data, interviews, and case file reviews were performed. Specialized

visualization software was created to assist in data interpretation and the sharing of findings.

Findings from Markov models show that while youth move through the system in generally

appropriate pathways, there are unusual movements showing that some youth move in less

desirable ways. Jumps from high to low levels of restrictiveness, or vice versa, do appear at times,

and sometimes youth become involved with the justice system during placement. There are also

gender differences in how youth move.

Inappropriate movements have financial implications: youth placed into higher levels of care

may not need this more expensive level of services, and youth without appropriate step-down

placements and community-based services may re-enter higher levels of care needlessly.

Examination of facilitators and barriers to inappropriate youth movements provide a window into

ways to address the financial and policy implications of inappropriate youth movements. Policy

and practice recommendations from the study will be presented followed by a discussion of the

findings and recommendations by panel representatives from AHCA and DCF.

Roger Boothroyd, Mary Armstrong, Laurie Blades, Barbara Butler-Moore and Keren S. Vergon

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Private Sector Innovations

friday, September 12th 12:30-1:45room a3

Innovations in health care often begin in the private sector, and public-private partnerships

provide an opportunity to bring cutting edge innovation to populations served by the public

sector. This panel will showcase two private sector health care programs/public-private

partnerships to show how private sector innovations can make their way into the public sector.

Wal-Mart Stores, Inc. is uniquely positioned to provide access to affordable health care

products and services to millions of Americans, including both consumers and employees.

Blue Cross and Blue Shield of Florida has partnered with Miami-Dade County government to

provide a health insurance plan to the uninsured.

Joe Quinn, Wal-Mart Stores, Inc.

Becky Gay, Blue Cross and Blue Shield of Florida

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Maternal & Child Healthfrom research to Practice:

access/utilization of health care and Pregnancy outcomes

friday, September 12th 12:30-1:45

room a1/a2

The session will cover from data to action on pregnancy outcomes. New quantitative

and qualitative tools and information are available to assist Florida and its communities in

improving pregnancy outcomes. Communities in Florida are currently using this and other

information to improve the outcomes of their women. Session discussions will focus on use of

these new tools and information, the need for further tools and information, and the essentials

to effectively using this information to improve outcomes at a community and state level.

“using Web Technology to Plan intervention Strategies to reduce adverse Birth outcomes in florida”Kathryn Swink and Beth Anne Frost

“voices from the Gaps—listening to florida’s african american Women”Linda Detman

“from data to action: a community-Based infant mortality Prevention Strategy”Kathleen McKenzie

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Thursday, September 11

Florida Medicaid: Overview and StatusOpening Plenary

Holly BensonSecretary of Florida’s Agency for Health Care Administration

Governor Charlie Crist appointed Holly Benson Secretary of the Agency for Health Care Administrant on February 25, 2008. He asked her to lead the Agency charged with working for affordable, quality health care for all Floridians and outlined a bold agenda of finding more affordable insurance for uninsured Floridians and of reducing the regulatory burden placed on health care providers.

Prior to her appointment as Secretary of the Agency, Secretary Benson served as Secretary of the Department of Business and Professional Regulation where she and her team worked to improve customer service and to reduce the regulatory burden placed on Florida’s businesses and professionals. The Department is responsible for licensing over 1 million Floridians.

Prior to joining Governor Crist’s administration, Secretary Benson served the people of Pensacola and Gulf Breeze for six years as their representative in the Florida House. During her tenure in the House, Secretary Benson earned a reputation for successfully tackling tough issues. As Chair of the Select Committee on Article V, she led the successful reorganization of the state procurement system. As Chair of the Committee on State Administration, she updated the state’s procurement code. In addition, as Chair of the Health and Families Council she addressed the tough health care access issues that touch the lives of all Floridians.

Secretary Benson is a graduate of Dartmouth College and the University of Florida College of Law. She practiced municipal bond law with Miller, Canfield, Paddock and Stone, P.L.C. from 1996 to her appointment as Secretary of the Department of Business and Professional Regulation in 2007.

In addition to her service as Secretary of the Agency for Health Care Administration, she serves on the Council on Efficient Government, the Florida Council of 100, the Board of Directors for the Mary Brogan Museum of Art and Science and the Board of Directors of the Tallahassee Chamber of Commerce.

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Panel Speakers Thursday, September 11

MOderaTOrJill Boylston Herndon, PhD

Jill Boylston Herndon, PhD is a Research Associate Professor in the Department of Epidemiology and Health Policy Research at the Institute for Child

Health Policy, University of Florida College of Medicine. Dr. Herndon is an economist and health services researcher whose interests include health insurance coverage and access to care; the relationship between health care utilization, expenditure patterns and health outcomes; and health care antitrust. Her current research analyzes the effect of public policy changes on health care coverage and access among low-income children with a focus on Medicaid and the State Children’s Health Insurance Program (SCHIP). She has served as co-principal investigator on a statewide evaluation of Florida’s SCHIP program and on the 2007 Florida Children’s Health Insurance Study. She has a contract with RAND to study asthma drug adherence, utilization, and costs in public insurance programs and is the evaluation expert on a HRSA-funded project to reduce early childhood caries among Medicaid enrollees. Her earlier research examined the structure and competitiveness of provider and payer markets with a focus on the role of payer monopsony power.

Dr. Herndon’s research has been published in such journals as the Journal of Health Economics, Health Services Research, Review of Industrial Organization, Antitrust Law Journal, and the Journal of Law, Medicine & Ethics. The recipient of teaching awards, she has taught courses in health care economics, public economics, and microeconomic theory. She currently serves on the Advisory Board for the Academy Health Economics Interest Group and on the Scientific Committees of the American Society of Health Economists and the International Health Economics Association.

Elizabeth A. Shenkman, PhD

Elizabeth A. Shenkman, PhD, is a Professor in the Department of Epidemiology and Health Policy Research and the Department of Pediatrics at the University of Florida College of Medicine. She also serves as the Director of the Institute for Child

Health Policy and the Chair of Epidemiology and Health Policy Research.

Dr. Shenkman is a health services researcher whose areas of specialization include examining the quality and outcomes of care for children, adolescents and young adults; particularly those with chronic conditions including cancer. In addition, she is an expert in program evaluation, particularly for public insurance programs such as Medicaid, the State Children’s Health Insurance Program and special waiver projects. She is the Principal Investigator on four large scale state projects including the evaluation of the Texas Medicaid and Children’s Health Insurance Program, the Florida KidCare Program, the Florida Title V Program, and a special waiver project designed to provide palliative care for children with life-limiting conditions. Dr. Shenkman also was the Principal Investigator on two awards from the Agency for Health Care Research and Quality and a project funded by the Maternal and Child Health Bureau to establish a National Center on Financing for Children with Special Health Care Needs. Under the auspices of this project, Dr. Shenkman worked with economists and health care providers to develop reimbursement strategies for health plans and providers caring for chronically ill children. She has publications in journals such as Pediatrics, Health Care Financing Review, Health Services Research, and the American Journal of Public Health.

State Children’s Health Insurance Plan (SCHIP)

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Thursday, September 11Panel Speakers

June Marie Nogle (PhD, Demography, Cornell University) is an Associate Research Scientist with the University of Florida, College of Medicine, Institute for Child Health Policy. She holds Graduate Faculty status in the College of

Medicine’s Department of Epidemiology and Health Policy Research. She is currently evaluating state and federally funded health insurance programs for low-income children. Her particular interest is in service utilization and unmet health care needs for minority and immigrant children.

Ms. Naff is President and CEO of Government Policy Solutions, a Tallahassee-based consulting firm specializing in health policy, health care coverage and the uninsured.

Prior to establishing GPS, Ms. Naff served as the Executive Director of the Florida Healthy Kids Corporation, a position which she held for 18 years, overseeing the provision of health services to previously uninsured children.

During 1996-2000, in addition to her duties in Florida, Ms. Naff was the National Program Director of the Robert Wood Johnson Foundation’s Healthy Kids Replication Program, expanding the Healthy Kids experience to other states.

A recipient of the Innovations in American Government Award from Harvard University, Ms. Naff is also a graduate of the school’s Senior Executives in State and Local Government. In 2002, the program was again recognized by the University – this time, as a sustaining model of public-sector innovation of national significance.

More recently, for her efforts during the January 2005 Open Enrollment campaign, Ms. Naff was awarded the Florida Hospital Association’s 2005 Jack Hardy Healthcare Communicator of the Year Award, and is a Golden Image Award regional winner for the One Month, One Chance and Project Pathfinder efforts to find eligible uninsured families and keeping them enrolled.

A graduate of Florida State University, Ms. Naff resides in Tallahassee with her son Chaney, age 16. Brenna, age 20, attends the University of North Florida in Jacksonville.

June Nogle, PhDRose M. Naff

State Children’s Health Insurance Plan (SCHIP)

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MOderaTOr

The elderly and Long Term Care

Kathryn Hyer, PhD, MPP

Alex Laberge PT, MBA

Kathryn Hyer is an Associate Professor in the School of Aging Studies and Director of the University of South Florida’s Training Academy on Aging. She received her masters in public policy from the Kennedy School of Government at Harvard

and her PhD in Public Administration from Arizona State University. She was the lead author of the nursing home sections for the Task Force on Availability and Affordability of Long term Care that resulted in Senate Bill 1202, the legislative reforms enacted in Florida in 2001. Dr. Hyer has received grants from the Commonwealth Fund and the US Administration on Aging to investigate the impact of staffing changes in Florida’s nursing homes on quality of resident care.

Alex Laberge is a PhD candidate in the Department of Health Services Research, Management and Policy at the University of Florida. His research interest includes processes of care in nursing homes (e.g. rehabilitation, restorative

and skin care) and how they relate to costs and quality outcomes. Mr. Laberge has worked as a physical therapist and rehab manager for 12 years in acute, sub-acute and home health settings. His dissertation topic is “An examination of strategic group membership and technology in nursing homes.”

Robert Weech-Maldonado, PhD, MBA

Robert Weech-Maldonado joined the College of Public Health and Health Professions in 2004 as an Associate Professor in the Department of Health Sciences Research, Management and Policy at the University of Florida.

Prior to this he was a faculty member at Penn State University. He currently teaches in both the MHA and PhD programs at UF, and has taught courses in health care management, strategic management, finance, and quality and outcomes. Dr. Weech-Maldonado’s research examines the impact of organizational and market factors on access, quality, and costs of care for vulnerable populations, particularly the elderly and racial/ethnic minorities. His work has been published in journals such as Health Services Research, Medical Care, Medical Care Research and Review, Health Care Management Review, and Social Science and Medicine.

He is currently funded by the Administration on Aging/University of South Florida to examine the relationship of staffing, quality and financial performance of nursing homes. In addition, he is a member of RAND’s Consumer Assessments of Healthcare Providers and Systems (CAHPS III) research team, where he is analyzing racial/ethnic differences in patient experiences with care and evaluating the cultural adaptation of the CAHPS surveys and reports of care. He is currently the principal investigator in a project funded by the Commonwealth Fund to examine the relationship between hospitals’ cultural competency activities and diverse patient experiences with care. In another Commonwealth Fund project, Dr. Weech-Maldonado is testing, validating, and disseminating a new survey—the Patient Assessments of Cultural Competency (PACC)—that addresses issues of cultural competency.

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The elderly and Long Term Care

Jackie N. Zhang, MD, MPH, PhD

Jackie N. Zhang, MD, MPH, PhD is an assistant professor of public affairs and health services administration at the College of Health and Public Affairs, University of Central Florida. His expertise includes healthcare informatics, nursing home research,

and quantitative methods. He received his MD and MPH in biostatistics in San Dong University, China. He earned his PhD in Health Services Organization and Research from the Medical College of Virginia, Virginia Commonwealth University in 2003. He has published extensively in Journal of Medical Systems, Nursing Economics, Health Services Research, etc.

Thomas T.H. Wan, PhD, MHS

Thomas T.H. Wan, PhD, MHS, is Professor of Public Affairs, Health Services Administration, and Medicine at the College of Health and Public Affairs, University of Central Florida. He directs an interdisciplinary doctoral program in public affairs

and serves as an associate dean for research at the College of Health and Public Affairs. Before joining UCF, he was Professor of the Department of Health Administration, Medical College of Virginia, Virginia Commonwealth University. He held the Arthur Graham Glasgow Chair (1991-1999) at VCU. He was a member of the National Committee on Vital and Health Statistics (1993-1996), appointed by the Secretary of the Department of Health and Human Services. He is a member of the Health Services Organization and Delivery Study Section, NIH. His research interests are centered in managerial epidemiology, health services evaluation, health informatics, and clinical outcome studies. His published work includes 10 books [Analysis and Evaluation of Health Care Systems: An Integrated Managerial Decision Making Approach; Evidence-Based Health Care Management: Multivariate Modeling Approaches; Monitoring the Quality of Health Care: Issues and Scientific Approaches, Healing Environments, Creating Values for Health Services Organization, Healing Environments, etc.] and 130+ scientific articles and book chapters. His project, entitled “Nurse Staffing & Nursing Home Quality,” was funded by NINR/NIH (2003-2008).

Thursday, September 11Afternoon PlenaryHealth Care reform Initiatives at the National Level

Genevieve M. Kenney, PhD Principal Research Associate and Health Economist The Urban Institute

Genevieve M. Kenney, PhD, is a principal research associate and health economist at The Urban Institute. She is a nationally renowned expert

on The State Children’s Health Insurance Program (SCHIP), Medicaid, and the broader health insurance coverage and access issues facing low-income children and families.

Dr. Kenney was a lead researcher on two major evaluations of SCHIP: a congressionally-mandated evaluation for the United States Department of Health and Human Services and an evaluation supported by a number of private foundations. She has published over 50 articles and briefs on insurance coverage and access for low-income children, pregnant women, and other adults. Dr. Kenney is a graduate of Smith College and received a PhD in Economics and an MA in Statistics from the University of Michigan.

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Thursday, September 11Afternoon PlenaryHealth Care reform Initiatives at the National Level

Brian Biles, MD, MPHProfessor in the Department of Health PolicySchool of Public Health and Health ServicesGeorge Washington University

From his first professional job as a legislative assistant to a Kansas Congressman, to his position as Senior Vice President of the Commonwealth

Foundation, Professor Biles has been helping to analyze and shape the nation’s health care policy for more than three decades. He spent much of that time in government service.

During his seven years as staff director of the House Ways and Means Subcommittee on Health, Dr. Biles helped to guide debate on Medicare and health financing legislation. Later, as Deputy Assistant Secretary for Health at the Department of Health and Human Services in the Clinton Administration, he led policy development on health reform and public health issues. Dr. Biles also served as Deputy Secretary for Maryland’s Department of Health and Mental Hygiene, where he was responsible for state programs in public health, Medicaid, health regulation and more. He joined the faculty of the School in 2000.

Among other professional activities, Dr. Biles served as Director of the National Commission on Nursing Workforce for Long-Term Care, which issued its final report on worker retention and recruitment in April 2005. He also chairs the Medical Administrators Conference, and is a member of Delta Omega, a Fellow of the New York Academy of Medicine and an Invited Lecturer at the Kennedy School of Government at Harvard University.

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Thursday, September 11

Cover Florida: Health Care Options for the UninsuredPolicy Update

David Keith Foy, MPAPolicy DirectorOffice of the Governor

David Foy began his professional career in 1993. In his current position, Mr. Foy is the Policy Director for Governor Charlie Crist and is responsible for

designing the Governor’s statewide policy agenda. In addition, David provides the Governor, Lt. Governor and senior staff with policy guidance on all issues affecting the State of Florida.

Prior to joining the Governor’s Office, Mr. Foy was the Chief of Staff for Florida’s Insurance Commissioner and served as the Office of Insurance Regulation’s chief governmental relations representative overseeing the agency budget and policy matters. Mr. Foy represented the Office at the National Conference of Insurance Legislators (NCOIL), the National Conference of State Legislatures (NCSL), and served on National Association of Insurance Commissioners (NAIC) committees and task forces related to property and casualty insurance, technology, health care, and life and health insurance policy.

In addition, Mr. Foy has worked in the public sector for more than a decade, holding executive and legislative positions at the Florida Department of Education. Florida Parole Commission, the Florida Board of Regents, the Florida Student Association, and the former Department of Insurance.

He received both a bachelor’s degree in Political Science and a Master in Public Administration from Florida State University.

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Morning Plenary Friday, September 12

Town Hall Meeting: ask the Stakeholders about Uninsurance

Cliff Schmidt, MPAAHC AdministratorOffice of Medicaid Research Contracts and EvaluationsBureau of Medicaid Quality ManagementFlorida Division of Medicaid

Cliff Schmidt has worked in the Florida Medicaid Program since 2004. He is currently the Administrator for the Office of Research Contracts and Evaluations, in the Bureau of Quality Management. His office is responsible for guiding Medicaid policy and research, as well as managing independent evaluations for Medicaid Waiver Programs. Mr. Schmidt has worked for the State of Florida for approximately 15 years, where he has served as a research and policy analyst for several health related programs and offices. During his tenure, he has worked on a wide range of critical health related issues including worker’s compensation reform, health care access, pharmacy benefits, health data applications, Medicaid Reform, and addressing Florida’s uninsured population. Mr. Schmidt continues to work with various other bureaus in order to help improve existing Medicaid Programs and projects. He holds a BS degree in Economics and Political Science, and a Master’s in Public Administration from Florida State University. Currently, he is also completing his doctorate degree with a focus on institutions and governance, and local health care reform.

Research Conference – Town Hall Panel/Representatives

moderator: Cliff Schmidt, Agency for Health Care Administration

agency for health care administration: Holly Benson, Secretary

children’s medical Services: TBA

consumer representative: TBA

department of health: Thomas W. Arnold, Deputy Secretary for Public Health

florida association of health Plans: Michael W. Garner, Ph.D.

florida legislature: TBA

florida medical association: TBA

Governor’s office: Karen Halperin, Deputy Policy Chief, Health and Human Services Policy Unit

office of insurance regulation: TBA

Private Sector: Government Innovation Solutions: Rose Naff, President and CEO, and Former Executive Director, Florida Healthy Kids Corporation

The James madison institute: Robert Sanchez, Director of Public Policy

university of florida: R. Paul Duncan, PhD, Professor and Chair, Department of Health Services Research, Management and Policy and Director, Florida Center for Medicaid & the Uninsured

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Panel Speakers

MOderaTOr

Friday, September 12

Local Health reform Initiatives

Diane Dimperio is the Director of Program Development for the Alachua County Health Department. She has more than 25 years experience in the provision of health care services for low income families. She has been involved in managing

and developing and financing programs for Medicaid and the uninsured. Ms Dimperio was instrumental in obtaining funding for and developing one of the first community based programs resulting from the Low Income Pool.

Diane Dimperio, MAAllyson G. Hall, PhD

Dr. Allyson Hall joined the University of Florida in 2003 and serves as Associate Director for the University of Florida Center for Medicaid and the Uninsured. She is also an Associate Professor in the Department of Health Services Research,

Management, and Policy. Currently she serves as one of the investigators on a project to evaluate Medicaid reforms in Florida. Prior to joining the University of Florida, Dr. Hall worked for the United Hospital Fund, the Commonwealth Fund, and served as an adjunct assistant professor at New York University. At the United Hospital Fund she served as the principal investigator on a qualitative research project that examined the quality of primary care in New York City. She has also worked as a health care consultant in Guyana and in Jamaica. Dr. Hall is interested in issues related to access to care for vulnerable populations including Medicaid, the health care safety net, and primary care delivery systems. Dr. Hall holds a PhD in Health Policy from the Johns Hopkins University School of Hygiene and Public Health.

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Panel Speakers Friday, September 12

Dr. Kenyatta Lee is currently an Assistant Professor in Family Medicine for the University of Florida College of Medicine. Dr. Lee was born in Richmond, Virginia and received his undergraduate education at Cornell University in

Ithaca, New York. He attended medical school at Mayo Graduate School of Medicine in Rochester, MN. While at Mayo he spent his research trimester in Jacksonville, Florida, assessing the factors responsible for the infant mortality rate in Jacksonville’s urban core. Dr. Lee also served as a Family Practice resident at the University of Pennsylvania, in Philadelphia.

Dr. Lee currently works as the Assistant Medical Director for both the Commonwealth Family Practice Group, and Soutel Plaza Family Practice and Pediatrics. He is also the Medical Director of the Community Affairs Department, where his responsibilities include oversight of the disease management programs via the registry programs. Dr. Lee is actively involved in the enhancement of quality of care for the Commonwealth Family Practice Group and the clinics that are operated by the Community Affairs Department.

Dr Kenyatta Lee currently lives in Jacksonville, Florida with his lovely wife of 10 years and their 4 children. In his spare time he enjoys fishing and spending quality time with his family.

Local Health reform Initiatives

Janet Perkins, MPP

As a Public Health Planner and Program Director, with more than 20 years in the field, Ms. Perkins’ most rewarding experiences have involved the contribution of her analytical skills and knowledge of program and services to the support of

collaborative efforts that improve healthcare service delivery systems. Her work has focused on aiding organizations and their clients in the establishment of best-practice approaches and in the implementation of evidence-based methodologies that help provide solutions for the health crises facing communities across the United States. Currently, as Executive Director of Miami-Dade County’s Office of Countywide Healthcare Planning, Ms. Perkins and her team of highly skilled health planners, which includes experts in Health Statistics and Epidemiology, Health Promotion and Disease Management, Health Legislation and Policy, and Community Health Planning, assist Miami-Dade County through the design and implementation of health improvement strategies. Together this team has successfully developed 4 core product lines: 1) Low Cost Health Insurance Product Pilot; 2) Methodology for Achieving an Integrated Network of Primary Care Medical Homes in Conjunction with the Counties’ 7 FQHCs; 3) Clearinghouse and Training Program on Best Practices for Health Promotion including, pilot implementation of Commit-2B-Fit; and 4) the Construction of 35 GIS e-maps and health statistical databases for baselines, monitoring and evaluation. Throughout her career, Ms. Perkins has served as a health planner and designer both internationally and in the US working for United Nations, Congressional, federal, state and local health agencies.

Kenyatta Lee, MD

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Mary I. Armstrong, PhD has over twenty-five years experience in children’s behavioral health, public sector managed care, children’s health insurance, child welfare services, specializing in state and local government organizational structures,

program development and evaluation, policy analysis, and consultation.

She currently is the Director of the Division of State and Local Support, Department of Child and Family Studies at the Louis de la Parte Florida Mental Health Institute, University of South Florida. She is responsible for the administration of the Division of State and Local Support including the direction of evaluation and research activities, and specialized consultation, training, and technical assistance to public sector entities nationally and in Florida.

Current activities include a national study of financing strategies and structures that support effective systems of care, evaluation of child welfare privatization and IV-E waiver in Florida, out-of-home treatment alternatives, and the role of informal supports for parents with children with serious mental health problems. For the past 5 years, she has been a member of the Advisory Committee and a faculty member for the Policy Academy on Developing Systems of Care for Children with Mental Health Needs and Their Families, sponsored by the National Technical Assistance Center for Children’s Mental Health at Georgetown University. She is co-chair of the national Outcomes Roundtable for Children and Families and a member of the National Advisory Board of the Quality Improvement Center for the Privatization of Child Welfare Services. She is an active member of the National Association of Social Workers and has many publications in both professional journals and textbooks.

Roger Boothroyd, PhD

Roger A. Boothroyd is a Professor and the Associate Chair in the Department of Mental Health Law & Policy and also holds a faculty appointment in the College of Public Health at the University of South Florida. He has been conducting mental

health services research for the past 20 years. He received his PhD in Educational Psychology, specializing in measurement, evaluation, and research design. He teaches courses in research methodology, program evaluation, and statistics. Dr. Boothroyd was formerly a Research Scientist with the New York State Office of Mental Health where he directed various federally-funded research and demonstration projects.

He is currently the PI of a $1.5 million contract with the Florida Agency for Health Care Administration examining, among other issues, how Medicaid mental health managed care impact beneficiaries’ access to, quality of, and outcome of care. He also is the PI on a project funded by the NIH to study of the maximum individualized change (MIC) analytic procedure developed by Boothroyd, Banks, Evans, Greenbaum, and Brown (2000). He is also a Co-PI on an NSF-funded Research Experience for Undergraduates. His other research interests include issue associated with social/behavioral research ethics and welfare reform.

MOderaTOrMary I. Armstrong, PhD

Mental Health

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Keren S. Vergon, PhD

Keren S. Vergon is Assistant Professor in the Department of Child and Family Studies at the Louis de la Parte Florida Mental Health Institute of the University of South Florida. Her current research activities include Principal Investigator

for the evaluation of the Trauma Recovery for Youth Initiative (TRI) Center, a partnership with the Children’s Home Society of Florida as part of the National Child Traumatic Stress Network (NCTSN); Principal Investigator for the Successful Kids System of Care Practice Review (SOCPR) Project; and Evaluation Team Member for a SAMHSA Center for Substance Abuse Treatment (CSAT) Family Treatment Dependency Court grant. Dr. Vergon has 13 years of research experience in the areas of older adults’ and children’s mental health. She received her PhD in Aging Studies from the University of South Florida.

Laurie Blades, MA, BCBA

Barbara Butler-Moore, MSW, LCSW

Laurie Blades is the Chief of Children’s Mental Health for the State of Florida Department of Children and Families. Ms. Blades has worked with children and youth with mental health needs

and developmental disabilities in a variety of settings in the private and public sector and has been with the Department of Children and Families for approximately six years. Ms. Blades received her Bachelor’s degree in Psychology and Master Degree in Mental Health Counseling from the University of Central Florida.

Barbara is a Licensed Clinical Social Worker who has worked with children and families with mental health and developmental disorders for 18 years. She received her Bachelor’s of Art’s degree from the State University of New York College at Buffalo

and Master of Social Work from the University of Nebraska. Additionally, she has obtained post graduate training in Marriage and Family Therapy through the Menninger Center in Topeka, Kansas and training in Infant Mental Health through the Center for Prevention and Early Intervention at Florida State University. She is currently employed by the Agency for Health Care Administration, which administers Florida’s Medicaid, as the Contract Manager for 16 residential treatment centers under the Statewide Inpatient Psychiatric Program. She also serves as Coordinator for Medicaid funded Children’s Mental Health Services.

Mental Health

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Joe Quinn

Joe Quinn is Senior Director, State Healthcare Policy for Wal-Mart Stores, Inc. Wal-Mart is the largest employer in the United States with more than one million people covered on its health plans. As a director at Wal-Mart, Quinn is involved in the national effort to make

health benefits as affordable and accessible as possible to the company’s 1.4 million associates in the United States. Quinn works jointly with the Wal-Mart benefits communication team and the public affairs group.

Quinn was part of the Wal-Mart team that rolled out the innovative $4 generic drug program that is changing the healthcare landscape in America. For this work he was one of the 2007 co-winners of the companies Sam M. Walton Entrepreneur Award.

Prior to joining Wal-Mart in 2006 Quinn was Director of Policy for former Arkansas Governor Mike Huckabee. Quinn was responsible for the development of the Healthy Arkansas Initiative that became Healthy America when Huckabee was elected Chairman of the National Governors Association, and was instrumental in the development of the nationally acclaimed ARKids First program that reduced the number of uninsured Arkansas children by half.

In 2002 Quinn was Director of Communications for the successful Huckabee reelection campaign. Prior to that Quinn was Director of Communications for the Arkansas Department of Human Services. Before entering public service Quinn was an award winning television journalist with the CBS TV affiliate in Little Rock, Arkansas.

Quinn holds a Bachelor of Arts Degree in Communications from Marietta College in Marietta, Ohio and is a past President of the Board of Directors of The Children’s Museum of Arkansas.

Jeff Feller, MS

Jeff Feller is the Chief Operating Officer of WellFlorida Council, one of Florida’s 11 private, non-profit local health councils as designated by Florida Statute 408.033. Jeff has been with WellFlorida for more than 12 years during which most of his tenure has

been dedicated to WellFlorida’s Community Initiatives section. The Community Initiatives section provides health planning services to 16 counties in north central Florida encompassing more than 11,000 square miles and 1.6 million residents.

WellFlorida’s mission is to foster greater health throughout North Central Florida by providing communities the insights, tools, programs and services necessary to meet their healthcare needs and to improve health outcomes. Jeff has been involved with hundreds of public and private sector projects taking them from issues; to actions; to implementation. He specializes in community health needs assessment and program evaluation activities. Jeff received both his BS and MS degrees from the University of Florida in Industrial and Systems Engineering, with a focus on management systems engineering within hospitals.

MOderaTOr


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the Executive Masters of Business Administration Alumni Association at Jacksonville University and is currently Board Secretary. In 2006 she was honored by Community Connections “Celebration of Leadership” for her outstanding involvement in the community.

Gay holds a Bachelor of Arts in Communication from Florida Atlantic University and a Master of Business Administration from Jacksonville University.

Becky Gay

Becky Gay is Vice President of New Markets for Blue Cross and Blue Shield of Florida. In this role she is responsible for developing new products to meet the needs of the uninsured, and over and under served customers.

Gay has been with BCBSF for more than 30 years during which time she has worked on a variety of assignments in both the corporate and regional offices across the state. Throughout her tenure, she has been involved in leading work efforts focused on establishing provider networks to support new products, medical and administrative cost savings initiatives, and most recently served as the Vice President of Shared Services for the Service Organization, creating a framework for continuous improvement. She served as co-chair for the company’s Women’s Interactive Network employee resource group from 2004-2006, co-chair of its 2005 United Way campaign and is currently the Executive Sponsor of the company’s employee resource group – Hispanic Organization for Learning and Advancement (HOLA). Becky is also a Board Member of The Blue Foundation for a Healthy Florida and a member of the Grant Making, Finance, and Nominating Committees. She also holds a seat on the Board of the Florida Health Political Action Committee (FHPAC).

During her career, Gay has been active in community and civic organizations. She has participated in United Way through its resource management committee for health education, served as the liaison to the American Lung Association and currently is a member of United Way’s Life Act II Partnership Council and Chairperson for the Bridging Elder Care Networks initiative. She’s on the planning committee for the Speaking of Women’s Health symposium, and is a former commissioner of the Mayor’s Commission on the Status of Women. She is a founding member of


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Linda A. Detman, PhD

Linda A. Detman, PhD is a research associate at the Lawton and Rhea Chiles Center for Healthy Mothers and Babies, College of Public Health, University of South Florida, Tampa, where she serves as the PI of the AHCA Perinatal Research and Systems

Design Project (a.k.a., Healthy Futures). Her areas of interest include health services and policy research, qualitative methodologies, and the study of women’s portrayal in the media.

William M. Sappenfield, MD, MPH

William M. Sappenfield, MD, MPH is the State MCH Epidemiologist and Chief of the Office of Surveillance, Evaluation and Epidemiology, Division of Family Health Services, Florida Department of Health. As both a pediatrician and an epidemiologist, Dr.

Bill Sappenfield has more than 23 years of experience in epidemiological research and practice at a local, state, and national level in maternal and child health. As a nationally recognized leader in the field of maternal and child health epidemiology, Dr. Sappenfield has spent most of his career as a CDC epidemiologist working with state and local public health agencies to enhance their capacity to use epidemiology to improve the health of the women and children they serve. In August of 2005, Dr. Sappenfield retired from CDC and joined the Florida Department of Health. In his current position with the Florida Department of Health, his responsibilities are now to lead the Department’s MCH epidemiology efforts including directing an office of six epidemiologists, working with programs across the Department, collaborating with state agencies, organizations, and universities; and assisting County Health Departments and community coalitions.

MOderaTOr

Maternal and Child Health

33


Beth Anne Frost, BS

Kathryn Swink, BS

Ms. Beth Anne Frost received her Bachelor of Science in Food Science and Human Nutrition degree from the University of Florida in 2007. She is pursuing her Masters of Public Health, with a major in Epidemiology from the University of Florida,

with an expected graduation in the spring of 2009. She is currently working as a graduate research assistant at the Maternal Child Health and Education Research and Data Center, Department of Pediatrics, College of Medicine, University of Florida, Gainesville.

Ms. Kathryn Swink is a second year graduate student in the Master of Public Health program with a concentration in epidemiology at the University of Florida. She currently works as a graduate research assistant where she analyzes statewide

birth certificate data at the Maternal Child Health and Education Research and Data Center. As a student in the MPH program, she has also done research analyzing the protective factors of physical activity in people with disabilities. Katie received her BS degree in Chemistry from the University of Florida in 2007.

Kathleen McKenzie, PhD, MS

Dr. Kathleen B. McKenzie joined Jacksonville Community Council Inc (JCCI) staff in January 2007 as the Program Director for Research and Studies. In this position, Kathleen manages and facilitates the annual community study, the most recent of which

was the Infant Mortality Study, as well as researching indicators for the annual Quality of Life Progress Report for Jacksonville and Northeast Florida. Kathleen has previously worked in social service areas as a grant-writer and consultant to non-profit organizations and as the Director of Education for Refugees, in which she created and lead several different direct-service programs and a staff of about 20. Prior to that experience Kathleen was the Executive Director of a state-wide Department of Education advisory panel on gender equity in education and employment. In this position she planned, organized, and facilitated state-wide meetings and hearings and researched and wrote annual studies on educational issues. Kathleen also created, organized, and facilitated staff development workshops for community college and high school administrators, teachers, and guidance counselors. Kathleen has a doctorate in Educational Leadership and a Master’s degree in Counseling.

Maternal and Child Health

Friday, September 12

Florida research Initiatives: Medicaid reform evaluation and the Florida Health Insurance StudyClosing Plenary

R. PAuL DuNCAN, PhDProfessor and ChairmanDepartment of Health Services Research, Management and Policy

Interim Director, Florida Center for Medicaid and the UninsuredCollege of Public Health and Health Professions University of Florida

Paul Duncan has been a faculty member at the University of Florida since 1979. He currently serves as the Director of the Florida Center for Medicaid

and the Uninsured, and is Professor and Chair of the Department of Health Services Research, Management and Policy in the College of Public Health and Health Professions. His teaching assignments are targeted to the training of health services administration professionals focused on the challenges of administrative leadership in health care organizations, as well as doctoral level trainees focused on studying and understanding how the health care system works.

Dr. Duncan is a nationally prominent health services researcher, best known for his studies of access to various forms of medical and dental care. In recent years, much of his work has focused on health insurance and the uninsured. Between 1999 and 2001, he served as Principal Investigator for three major surveys examining health insurance circumstances in Florida, Indiana, and Kansas. In 2004, Florida completed a replication of the Florida Health Insurance Study under Dr. Duncan’s leadership. His current research includes a five-year contract with the Florida Agency for Health Care Administration to conduct an independent evaluation of the implementation of, and outcomes related to, Florida’s Medicaid reform initiative.

Dr. Duncan has published widely, including articles in such prominent journals as Medical Care, and Health Affairs.

In 1996, 1997, and 1998, Dr. Duncan was selected Teacher of the Year by the department’s graduate students. In 2008 he was named a University of Florida Research Foundation Professor.

When not teaching or doing research, Duncan takes his interests into the community. He has been a member and chair of the Health Care Board of Alachua County, Florida. For almost ten years, he served on the Board of Directors, and has twice been elected President of the ACORN Clinic, an award winning medical and dental care clinic that serves poor and uninsured rural residents in the areas north of his home in Gainesville, Florida.

35

36

RESEARCH ABSTRACTS

Identifying Barriers to Screening and Treatment of Cervical Cancer among Florida’s Uninsured Women

BackgroundIn Florida there were 826 new cases of cervical cancer in 2004 and 303 deaths attributable to cervical cancer in 2006. Among Florida women, 93.5% have had a Pap smear test in their lifetime, while 82.2% have had a Pap smear test in the past 2 years. This study examines the barriers to cervical cancer screening and treatment that are unique to Florida. Understanding these barriers from the individual level to the policy level is critical to reducing cervical cancer morbidity and mortality.

MethodsData obtained from an earlier phase of the study were used to identify counties in Florida with higher incidence rates and five-year cervical cancer and mortality rates (n=13). Nine of these counties are designated as rural by the state. Key informants from the fields of public health and medicine were identified through public health and rural health networks and subsequently interviewed. A semi-structured interview guide was used to conduct qualitative telephone interviews with key informants. Interviews were transcribed, coded and analyzed by the project investigators. The USF IRB approved the project.

ResultsBarriers to cervical cancer prevention and treatment in Florida were found to be extensive and unique to the state. Utilizing a multi-level analytical approach, investigators identified various layers of barriers ranging from individual to policy levels. Barriers are wide-ranging and include not only lack of access to care (poverty, lack of health insurance, lack of transportation, etc.), but also institutional and structural barriers, cultural differences in conceptions of illness and the health care system, and fear of deportation among undocumented populations. Regulatory and funding barriers seemed particularly significant at the policy level where there is a systemic disconnect between federal, state, and local level providers.

ConclusionsInterviews have provided important insights on the specific circumstances affecting low-income rural and urban communities in Florida. While Florida has admirable screening and treatment programs, there exists a consider-able disconnect between national and state level protocol that impacts the ability of the individual to receive treatment services. Program success is often due to the persistence of practitioners and program coordinators to identify ways to access services on an individual basis, and is far from ideal. The barriers to cervical cancer prevention efforts are formidable, but identifying the complexity of issues from individual and socioecological perspectives will allow future actions to be drawn at education, service and policy levels.

Erica Hesch Anstey, MA1; Ellen Daley, PhD1; Amina Alio, PhD1; Rasheeta Chandler, PhD1; Karen Dyer, MPH1; Hannah Helmy, MPH1.

1. Department of Community and Family Health, College of Public Health, University of South Florida

Contact: Erica AnsteyPhone: (813) 335-6611

Fax: (813) 974-5172E-mail: [email protected]

37

RESEARCH ABSTRACTS

Predictors and Outcomes of Evidence-Based Practice for Medicaid Recipients with Major Depressive Disorder

BackgroundResearch indicates 80-90% of persons with major depressive disorder (MDD) can be successfully treated, yet depression often goes unrecognized or improperly treated. In response, evidence-based practice guidelines (EBPGs) have been developed to achieve greater consistency and quality in clinical care. Although EBPGs are recommended, they have not been widely adopted. The objective of this study was to investigate the extent to which community dwelling Medicaid enrolled Floridians with a diagnosis of major depressive disorder (MDD) receive treatment that adheres to the American Psychiatric Association (APA) approved guidelines. The study examined predictors of APA guideline adherence and the relationship between adherence, outcomes, service use, and costs for Medicaid enrolled Floridians.

MethodsThis study used two and a half years of Medicaid enrollment and claims data, and involuntary psychiatric commit-ment data. Regression analyses were conducted to determine predictive factors for adherence to EBPGs and the relationship of adherence to service utilization and cost. Subjects included all Florida Medicaid enrollees who were18 years or older at entry into the study; had at least one inpatient or two outpatient claims containing ICD-9-CM codes for MDD; and had continuous Medicaid enrollment for at least 33 of 36 months after the claim that identified their diagnosis for MDD.

Results Data show that 4.3% of enrollees aged 18 years and above (N = 42,009) had a diagnosis of MDD. Of these individuals, 15,950 met study inclusion criteria. Only 33% received mental health treatment that conformed to the APA guidelines. Adults over age 65, and individuals with dual Medicaid and Medicare enrollment were least likely to receive treatment consistent with the APA guidelines. Reasons for nonadherence included receiving insufficient psychotherapy, inadequate medication follow-up, antidepressant dosing above or below suggested therapeutic range, and receiving non-approved antidepressant combinations. Compared with those receiving treatment conforming to EBP guidelines, persons with treatment that did not conform to the guidelines used fewer services and had lower healthcare cost during the18 months following their diagnosis.

Conclusions Findings are consistent with other studies and show that nonadherence to APA guidelines for MDD was the norm. Study analyses provide a basis for future research and clinical training initiatives. They challenge support-ers of EBPs to more effectively market evidence-based guidelines to clinicians, consumers, and other medical decision makers. The challenge is to bridge the gap between the availability of EBP guidelines and their use in medical decision-making.

Presenter: Marion Becker RN, PhD,Co-Authors: Timothy Boaz PhD, Amber Gum PhD, Airia Papadopoulos MPH

38

RESEARCH ABSTRACTS

The Distribution of Diabetes, Obesity, and Current Cigarette Use by Income Group

BackgroundTobacco use, diabetes, and obesity are among the leading causes of death in the nation and in Florida. Each of these disproportionately affects specific sub-populations, especially the poor and underserved, which results in disproportionate morbidity and mortality. This study examines the prevalence rate patterns of tobacco use, diabetes, and obesity stratified by income.

MethodsThis study uses 2007 Florida Behavioral Risk Factor Surveillance System (BRFSS) data. BRFSS is a cross-sectional telephone survey developed by the Centers for Disease Control and Prevention and administered by state health departments. Monthly interviews are conducted among non-institutionalized adults. The BRFSS has been conducted in Florida since 1986. The BRFSS survey contains questions related to chronic diseases, behaviors that are associated with preventable chronic diseases, infectious diseases, and injuries. The 2007 Florida BRFSS had nearly 40,000 participants.

ResultsChi-square tests were used to compare rates between income groups for diagnosed diabetes, obesity, and current cigarette use. Overall, the prevalence of diagnosed diabetes declines steadily with increasing income group. The prevalence of diabetes among those who earn less than $10,000 per year is nearly fourfold the rate observed among those earning $75,000 or more per year. A different distribution pattern was observed for both obesity and current smoking rates. Although the overall rates declined comparing the lowest income group to the highest income group, the slope was not a continuous downward trend. For both of these outcomes, rates were clustered among those in the lowest two income groups, then declined and clustered for the next five income groups, then declined again for the eight and final income group.

ConclusionsDiabetes, tobacco use, and obesity are important public health concerns in Florida and the nation. Socioeco-nomic status is associated with prevalence rates among those in different income brackets. Understanding the patterns of these important disease and behavior indicators is important when implementing interventions among specific sub-populations.

Tammie M. Johnson, MPHFlorida Department of Health

Division of Disease Control, Bureau of Epidemiology4052 Bald Cypress Way Bin A-12

Tallahassee, FL 32399-1720Phone: 850-245-4405

Fax: 850-922-9299Email: [email protected]

39

RESEARCH ABSTRACTS

Do For Profit Chain Affiliated Nursing Homes Cost Less?

BackgroundFor profit and chain affiliated health care organizations have been credited with being more efficient and being better able to control the cost of providing care in nursing homes. With nearly 60% of nursing homes revenue coming from govern-ment programs like Medicaid and Medicare, the question of whether these costs savings are passed on to the payers is of significant importance. The purpose of this study is to examine whether For Profit and Chain Affiliated nursing homes can provide care at lower cost and to determine who benefits from these cost savings: The nursing homes or the payers.

MethodsThe study is a retrospective observational cohort study that used facility level data from the Medicare Cost Reports, Online Survey Certification and Reporting (OSCAR) and the Area Resource File (ARF). Dependent Variables: Patient revenue and costs per resident day, Other Revenue and other costs per resident day, Op-erating margin and Total profit margin. Independent Variables: Variables of interest include 4 dichotomous variables: For Profit Chain (FPC) (reference group), For Profit No Chain (FPNC), Not-For-Profit Chain (NFPC) and Not-For-Profit No Chain (NFPNC). Control Variables includes Payer mix (Percent Medicare, Percent Medicaid, Percent Other), Case Mix (AcuIn-dex), Market Competition and Size. Analysis: The study uses Ordinary Least Squares Regression. All Revenue and Cost variables had to be transformed using the natural log function because of their skewness. The study then used the smearing method to retransform these variables into dollar values. The study also used fixed effects for years and for states and used the Huber-White correction. Results

for Profitchain

for Profitnon chain

not for Profitchain

not forProfitnon chain f test

Operating Revenue PPD $153 $149 $154 $157 F=521

Operating Expense PPD $134 $130 $137 $140 F=1220

Other Revenue PPD $4 $6 $16 $39 F=43168

Other Costs $18 $16 $18 $17 F=903

Operating Margin 10.3% 11.0% 8.0% 7.8% F=2622

Total Margin 1.2% 2.5% 1.2% 5.5% F=1306

FP nursing homes are successful at keeping costs down relative to NFP with FPNC having the lowest costs and the lowest revenues. In contrast, the NFPNC have the highest costs and highest revenues. Chain affiliated homes have higher costs than non chain in FP but the opposite holds among NFP. Although FP have superior operating margin than NFP, NFP tend to make up (and even surpass), the difference through non-operating revenue sources.

ConclusionsFP nursing homes when compared with NFP nursing homes 1) Provided care at a lower cost; 2) Provided care with lower revenue streams while still maintaining superior operating margins; and 3) Have lower total margins due to lower non- oper-ating revenue sources. This suggests that FP nursing homes are more efficient providers of care and transfer some of their cost savings to the payers. Prior studies have suggested that FP tend to provide a lower quality of care. Future studies are needed to determine if these cost savings are related to the quality of care provided.

ImplicationsGovernment payers like Medicare and Medicaid are responsible for the majority of the costs of nursing home care in the United States. Understanding the influence that ownership has on long term care costs is beneficial especially in the current fiscal environment.

Alex Laberge, MBA, PT1, Robert Weech-Maldonado, PhD1, Christopher Johnson, PhD2, Kathryn Hyer, PhD3 1University of Florida, Gainesville, FL; 2Texas A&M, College Station, TX; 3University of South Florida, Tampa, FL

PRIMARY FUNDING SOURCE: USF / Administration on Aging, Project Officer- Don Grantt

40

RESEARCH ABSTRACTS

MEDNET©: A Collaborative Approach to Prescription Drug Access

BackgroundAccess to prescription drugs is a critical element in the effective management of chronic disease. Health care consumers who are low-income, uninsured or medically under-served are often forced to choose between the use of prescription drugs and the purchase of other necessities like food and housing. In Pinellas County, a partnership of community organizations, government and foundation leaders, and private health care providers developed MedNet to secure free prescription medications from pharmaceutical companies.

MethodsMedNet Navigators assist clients at community partner sites, including: federally qualified community health centers, family health centers, free clinics, and mental health treatment centers. A Memorandum of Agreement defines the role of each party. Navigators work one-on-one with patients to identify free prescription drug pro-grams, complete program applications, and coordinate medication refills. Navigators use a client enrollment and service tracking database to enroll program clients, auto-populate manufacturer applications, record medication receipt, and calculate the retail value of secured medications.

ResultsIn 2007, MedNet Navigators secured 4,421 medications for over 1,600 residents in Pinellas County. The value of received medications exceeded $1.6 million. Heart, cholesterol and stroke-related medications represented 25% of medications secured and mental health drugs represented 16%.

Lessons Learned1. Clinic sites perform at higher rates than non-clinic sites2. Web-based data tools expedite client intake and forms completion and provide an opportunity to document

unmet need and share lessons learned in ‘real time’ 3. Targeted referrals are effective in reaching at-risk populations; e.g., mental health clients4. Pharmacy vouchers provide low-cost access to short-term medications5. The retail value of secured medications should be used to demonstrate Community Return on Investment6. A community network of MedNet Navigators can be built by training staff from other agencies to serve as

patient advocates

2007 MedNet Performance

MedNet returned $8

in FREE medications

for every $1 spent

to provide program

services.

Elizabeth Rugg, B.S., Director, Suncoast Health Council, Inc.Karen van Caulil, PhD, Director, Health Council of East Central Florida, Inc.

www.healthcouncils.org

2007 MedNet Program Performancedrug class value of medications Secured % of all medications

Arthritis $15,016 0.90%

Asthma/Allergy/Lung $237,635 14.25%

Diabetes/Endocrine $167,837 10.07%

Gastro-Intestinal $159,109 9.54%

Heart, Cholesterol & Stroke $417,167 25.02%

Mental Health $272,211 16.33%

Migraine/Other Pain $97,700 5.86%

Other, including Seizure $300,717 18.03%

value of all medicaTionS $1,667,392 100%

41

RESEARCH ABSTRACTS

Stage of Cancer Diagnosis among Medicaid Patients for Breast, Cervical, and Colorectal Cancers

ObjectivesTo examine the stage of cancer diagnosis for breast, cervical, and colorectal cancers among Medicaid patients in Florida.

BackgroundIn 2008, an estimated 1,437,180 people in the United States will be diagnosed with cancer, and 565,650 will die of cancer. Early diagnosis of cancer reduces cancer morbidity and mortality. Several cancer screening proce-dures are widely available for early detection of breast, cervical, and colorectal cancers. Types of insurance are associated with access to care, cancer screening, and early diagnosis and treatment.

MethodsFlorida Cancer Data System (FCDS) collects incidence and mortality data related to cancers in Florida. 2005 FCDS data on breast, cervical, and colorectal cancers were used for the analysis. Non-residents of Florida and duplicated cancer cases were removed from the analysis. Stage of cancer was grouped as early (local), ad-vanced (regional and distant), and unstaged (unknown stage). Percent of patients diagnosed at early stage was examined with patient’s insurance type. Chi-Square test was performed to test the significance of differences between insurance types.

ResultsAmong the new cancer cases diagnosed in 2005, 11,594 were breast, 834 were cervical, and 9,395 were colorectal cancer cases in Florida. Among the cancer deaths 2,663 were breast, 291 were cervical, and 3,693 were colorectal cancer deaths. Overall, above 60% of the breast cancers were diagnosed at an early stage, while 47% of cervical cancers and 40% of colorectal cancers were diagnosed early. Fourteen percent of cervical cancer patients had Medicaid. About 4% of the breast cancer patients and 3% of the colorectal cancer patients had Medicaid. Twelve percent of Medicaid patients with cervical cancer were diagnosed at an early stage. Three percent and 2% of Medicaid patients with breast cancer and colorectal cancer were diagnosed with an early stage.

ConclusionsIn spite of widely available screening procedures cancer staging techniques, low early stage diagnosis and diagnosis without a cancer stage highlights the importance of further education and awareness of cancer stag-ing and cancer screening tests. This attains even higher importance when observed among Medicaid patients because majority of the screening procedures and treatments are broadly available for them.

Aruna Surendera Babu MPHBureau of Epidemiology, Florida Department of Health

42

Conference Resources & Amenities

reSidence inn TallahaSSee universities at the capitol

600 W Gaines St Tallahassee, Florida 32304-4308

Phone: 850-329-9080 fax: 850-329-9070 Toll-free: 800-922-3291 Sales: 850-329-9050 Sales fax: 850-329-9060

This hotel is nonsmoking

arrival informaTion checK-in and checKouT • Check-in: 3:00 PM• Checkout: 12:00 PM • Express Check-In and Express

Checkout

ParKinG • Complimentary on-site parking

hoTel deTailS • 5 floors,135 suites • 3 meeting rooms, 4200 Square Feet

total meeting space

ServiceS comPlimenTarY ServiceS • Buffet breakfast • Cocktails • Coffee in lobby • Coffee/tea in-room • Newspaper delivered to room • Newspaper in lobby • Phone calls: toll-free • Complimentary wireless internet

access

GueST ServiceS • Full-service business center • Local restaurant dinner delivery • Safe deposit boxes, front desk

43

Tallahassee

• 1884 Paxton House Museum & Inn (35 mi) • The 621 Gallery• Birdsong Nature Center (35 mi) • Bradley’s 1927 Country Store• Brokaw-McDougall House• Calhoun Street Historic District• Camp Gordon Johnston World War II Museum

(56 mi) • Canopy Roads (Tallahassee’s Famous)• The Capitol• Historic Capitol of Florida• Challenger Learning Center & IMAX Theater• de Soto State Archaeological Site • Downtown Marketplace • Florida Agricultural and Mechanical University

(FAMU) • Florida Caverns State Park (66 mi) • Florida Korean War Memorial• Florida State University (FSU) • Florida Vietnam Veterans’ Memorial• Forest Capital State Museum (52 mi) • Goodwood Museum and Gardens• Governor’s Mansion• Gulf Specimen Marine Lab (30mi) • John G. Riley Center of African History and

Culture

• Knott House Museum• Mildred and Claude Pepper Library and Museum• Lake Jackson Mounds State Archaeological Site• Legislative Research Center & Museum• Le Moyne Center for the Visual Arts• Maclay State Gardens• Mary Brogan Museum of Art & Science• Mission San Luis• Museum of Florida History• Natural Bridge Battlefield State Historic Site (9 mi)• Nicholson Farmhouse • Park Avenue Historic District• Pebble Hill Plantation (35 mi) • San Marcos De Apalache State Historic Site

(20 mi) • Southeastern Regional Black Archives Research

Center & Museum• St. Marks Historic Railroad Trail• St. Marks National Wildlife Refuge (20 mi) • Tallahassee Automobile Museum• Tallahassee Museum• Torreya State Park (50 mi) • Union Bank Museum• Wakulla Springs State Park (19 mi) • Willow Pond Plantation (35 mi)

recreaTion Golf • Cross Creek • Hilaman Park Municipal • Seminole • SouthWood • Summerbrooke • Jake Gaither • Wildwood Country Club (27.1 mi) SPa (Appointment required)• Better Living Day Spa • Bernice at Betton - Salon and Day Spa

aTTracTionS & landmarKS

Thank You to Our Sponsors!

Major Sponsoring Partner

Gold Level Sponsors

Silver Level Sponsors

Friends Level Sponsors

2008 Florida Conference on Medicaid & the Uninsured Results of Conference Evaluations

All ratings are on a scale of 1-5 with 1 as worst and 5 as best rating

Ratings of the conference program Average rating of conference theme: 4.25 Average rating of conference program policy: 4 Average rating of conference program science: 4 Average rating of conference materials: 4.25 Average rating of conference facilities: 3.75 Average rating of conference overall: 4.25 Ratings of plenary sessions Average rating of Benson Presentation: 3.7 Average rating of Kenney/Biles Presentation: 3.5 Average rating of Town Hall Meeting: 3.6 Average rating of Duncan FL Research Presentation: 4.3 Ratings of proposed changes for the future Average rating of work group on access/use of Medicaid data: 4.7 Average rating of work group on technical issues with data: 4.3 Average rating of work group on contracting issues: 3.75 Average rating of work group on needs/interests of the Agency: 4.5 Average rating of panel/session on provider's perspective: 4.5 Average rating of panel/session on policy pros and cons: 5 Average rating of separate science/policy sessions: 3.75

Interest in other topics for conference:

1. Fraud/Abuse & its impact on Medicaid 2. Patient responsibility 3. Legislative Interaction

General Comments:

1. Not enough pros and cons on policy. We need to hear real debate 2. Hard to hear, nice conference, 1st class except room

Results of Breakout Session Evaluations (n = 134)

All ratings are on a scale of 1-5 with 1 as worst and 5 as best rating Number attended SCHIP: 26 Number attended Elderly & LTC 30

Number attended Local Health Reform: 24 Number attended Mental Health: 17 Number attended Private Sector Innovations: 20 Number attended Maternal & Child 17 Average rating of session theme: 3.7 Average rating of presentations: 3.8 Average rating of length: 3.5 Average rating of relevancy of presentations: 3.7 Average rating of session facility/room: 3.7 Average rating overall: 3.75 Number of University/Research Organization: Number of State Agency: Number of Other Affiliates:

Other Suggestions and Comments:

1. More on the sociodemographics and behaviors of the uninsured. 2. Medicaid/SCHIP Reimbursement, Incentives for Physicians. 3. Overview of basic Fed/Nat'l SCHIP eligibility, enrollment and implementation in FL. 4. Bring more meaningful topics. 5. Presentations were great, but the room was too cold! 6. Very informative - panelists were concise and knowledgeable. 7. Dr. Wan's presentation was extremely informative and helpful. Thank you! 8. The one-hour time gap between the end of the opening and the beginning of

the first breakout session was too long - would have been better to begin first breakout session earlier.

9. Handout illegible from UCF - best presentation - sad :( Dr. Wan really explain value of session, others presented papers.

10. Give background on some topics for attendees who do not work directly in the field.

11. It would be great to get more organized information on the status of NSG Homes in Florida as it relates to Medicaid & the Uninsured.

12. Questions answered and comments following presentations were far more meaningful than presentations.

13. Third presenter (in elderly and LTC) needed larger font and fewer words per slide. 14. Room extremely cold; too large for number of attendees; may ask registrants for

future conferences to indicate session preference. 15. Rooms for breakout session - too cold! 16. Some presentations needed more time, very good information - room was too

cold. 17. Large room for # of people, room was too cold, 3 speakers were interesting but

they were being rushed by the facilitator. 18. Dr. Lee's presentation was very good - I wish he had more time. 19. Presentations were good, but "discussion" afterwards was dull and not useful. 20. More time for Q&A, state of the art in diagnosis. 21. Breakout rooms were very cold. 22. BCBS presentation came off like a sales presentation. Walmart presentation was

good. 23. Great job with easy to understand examples. 24. Longer session time. 25. Nice job as moderator to tie talks together.

26. Room was still too cold; good information. 27. Significant aural interference from speaker/audience in adjourning room = poor

sound insulation. 28. Excellent. 29. Better "education" on how to use microphones for the presenters. (Sometimes,

they stood to far back from microphone.) 30. Good job! 31. Most of the powerpoint slides had way too much info and data on each slide.

Suggested Breakout Topics for Next Year:

1. More on local initiatives, employer/private/public parternships to increase points of access.

2. Focus on SCHIP/Title XXI Enrollment/disenrollment in Florida. 3. Family planning evaluations. 4. Oral Health. 5. Oral Health. 6. How can this data be presented to benefit patient/decision; to make good

decision as to what nursing home is good for them. 7. Budget cuts and reductions, Ambulatory services. 8. Integration of Health and Mental Services. 9. Improving access to health care, policy reform for health care initiatives 10. Please continue to have sessions like this, it is great to see what is happening at

the local level & what projects are working & might be feasible at a statewide level.

11. Loved the Shands Hospital presentation - learned a lot! 12. Hospital/Health Department collaboratives 13. More info on mental health, especially for the uninsured. (Should be interesting

though) 14. In some way, address clinical outcomes/best practices in Mental Health. 15. Performance Measurement. 16. Financing of Mental Health Care. 17. African-American Disparities. 18. Pros/cons universal health care. 19. Pros/cons universal health care.

Conference Evaluation

2008 Florida Conference on Medicaid and The UninsuredPlease assist us in evaluating this year’s conference. For each attribute listed below, please provide a rating, using a scale of 1–5, with 1 being the poorest rating possible and 5 being the most favorable rating possible.

Overall Program Evaluation

Conference Attribute(1)

Unsatisfactory(2)

Marginal(3) Meets

Requirements(4) Exceeds

Requirements(5)

Exceptional

Conference Theme (State & National Level Reforms: Research & Policy) In terms of its value and interest for you?

Conference Program In terms of its relevance to current policy issues in Florida?

Conference Program In terms of the scientific or technical merit of the presentations and panels?

Conference Materials (Printed materials such as the conference packet and booklet) in terms of their usefulness?

Conference Facilities In terms of their convenience for you and their suitability to the conference goals?

Conference Overall In terms of its value and interest for you?

Evaluation of Keynotes and Addresses

Session Name Did Not Attend(1)

Unsatisfactory(2)

Marginal(3) Meets


Requirements(5)

Exceptional

Day 1

Florida Medicaid: Overview and Status Holly Benson

Health Care Reform Initiatives at the National Level: The SCHIP Example Genevieve Kenney and Brian Biles

Day 2

Town Hall Meeting: Ask the Stakeholders about Uninsurance

Florida Research Initiatives: Medicaid Reform Evaluation and the Florida Health Insurance Study R. Paul Duncan

2008 Florida Conference on Medicaid and The Uninsured

It is our hope that, each year, the conference provides a valuable forum for researchers and policy makers to come together to explore issues related to Medicaid and its beneficiaries. As the conference has evolved to be larger and more comprehensive each year, we have contemplated making various changes to its format in the coming years. Please rate each possible change listed in the table below using a scale of 1–5, with 1 being the lowest possible rating and 5 being the highest possible rating.

Proposed Changes to the Conference

Proposed Change(1) Opposed to

this change(2)

Not Interested(3)

Indifferent(4) Somewhat

Interested(5)

Very Interested

Inclusion of focused work groups related to specific issues in Medicaid research and contracting

Access and use of Medicaid data for other (non AHCA-funded) research

Technical issues with using Medicaid data

Contracting issues

Research & evaluation needs/interests of the Agency

Other: (please specify)

_____________________________________

Inclusion of panels or other sessions focusing on the following issues:

Providers’ perspective

Specific policy pros and cons and debate

Other: (please specify):

_____________________________________

Conference Format

Change conference format to include separate sessions for the more scientific/technical content and for the more policy/evaluation content?

What is your primary affiliation?University/Research Organization

State Agency

Other: _________________________

Suggestions and Comments

Breakout Session Evaluation

2008 Florida Conference on Medicaid and The Uninsured

Breakout Session Evaluation

Session Attribute(1)

Unsatisfactory(2)

Marginal(3) Meets


Requirements(5)

Exceptional

Session Theme In terms of its value and interest for you?

Session Presentations In terms of the overall quality?

Session LengthIn terms of the length of presentations and time allowed for questions and discussion?

Relevancy of PresentationsTo the theme of the session?

Session Facility or Room In terms of its suitability for the session?

Session Overall In terms of its value and interest for you?

Session NamePlease select the name of the session you are evaluating on this form (do not select more than one).

Day 1 Sessions Day 2 Morning Sessions Day 2 Afternoon Sessions

Panel A: SCHIP

Panel A: Local Health Reform Initiatives

Panel A: Private Sector Innovations

Panel B: The Elderly & Long Term Care

Panel B: Mental Health

Panel B: Maternal & Child Health

Please assist us in evaluating this year’s conference. For each attribute listed below, please provide a rating, using a scale of 1–5, with 1 being the poorest rating possible and 5 being the most favorable rating possible.

Other Suggestions and Comments

Suggested Breakout Topics for Next Year

What is your primary affiliation?University/Research Organization

State Agency

Other: _________________________

Documents

Final Deliverable: 2008 Florida Conference on Medicaid ...fcmu.phhp.ufl.edu/publications/reports/pdf/MED054 Deliverable 7 2... · Final Deliverable: 2008 Florida Conference on