Why competencies in graduate health management and policy education?

During the past decade there has been a growing interest in learning and competency-based systems in various areas of education, training, and professional development. As a result, a number of competency initiatives have been undertaken across the health professions, including medicine, nursing, and pharmacy. Concurrent with these activities have been the resounding calls for: 1) both curricular content and process review in health administration and related training programs, 2) rethinking and reform of current educational practices, and 3) evidence-based, outcomes-focused education in health management and policy education. In spite of governmental mandates and accrediting body specification for educational improvement, the debate about the use of competency models, competencies themselves, and competency-based education (CBE) still continues in a number of post-secondary educational settings-both within and outside of the professions. Specifically, faculties in health management and policy educational programs, including undergraduate and graduate education across the US, have questioned the need for the evolving competencies, competency models, and outcomes-based educational processes and assessment methods currently being developed and or adopted within the profession. Outlined in this paper are four of the current inflection points related to the competency/outcomes-based movement in the professions during the past decade: 1) The Changing Workforce and Workplace, 2) Reform in the Educational Continuum, 3) Evolving Accreditation Requirements, and 4) Continuous Quality Improvement (CQI) in Health Management and Policy Education.

Options to liberalize Social Security disabled widow(er)s benefits.

Each month, 200,000 widows and 6,000 widowers receive Social Security disabled widow(er)s benefits, each benefit averaging about $550. Among the most economically at-risk Social Security beneficiaries, their benefits are permanently reduced. This paper reviews the legislative history of the disabled widow(er)s benefit, identifying key decisions that gave shape to this benefit. Social Security program data and six years of Current Population Survey data (March Annual Demographic Files, 1995-2000) are used to profile the economic status of current and potential disabled widows. The analysis, including comparison with other widows, provides strong evidence of economic need among disabled widows with, for example, 44% of disabled widow beneficiaries, ages 50-59, having below-poverty incomes compared with 15% of like-aged non-disabled widows. We conclude that serious consideration should be given to extending eligibility to all widow(er)s disabled before the normal retirement age; to providing a benefit equal to 100% of the deceased spouse's private insurance amount (PIA); to eliminating the unnecessarily restrictive seven-year rule; and to protecting beneficiaries from losing their eligibility to Medicaid. Even in the context of today's heated Social Security debate, we suggest that a rare opportunity may exist to garner bipartisan support for meaningful, low-cost improvements, in a benefit that primarily targets women.