ABSTRACT
PURPOSE: To examine how Medicaid and the State Children's Health Insurance Program (SCHIP) could improve health care access for youth aging out of foster care, a vulnerable population with multiple health concerns. METHODS: On the basis of an analysis of state and federal laws, state plans and amendments, and a telephone survey of state officials, this article identifies options in Medicaid and SCHIP for states to provide health insurance coverage for these youth, examines states' use of available options, and highlights other relevant federal health care programs. RESULTS: Numerous Medicaid and SCHIP eligibility categories could provide coverage for older adolescents leaving foster care. The federal Foster Care Independence Act of 1999 (FCIA) created a new Medicaid expansion option for this group and other opportunities for states to address their health care needs. Numerous other federal programs also finance health care that could serve this population. CONCLUSIONS: The potential exists through Medicaid or SCHIP to ensure that nearly all former foster youth have health insurance as they leave state custody, but Medicaid and SCHIP cannot alone meet all health care needs of these youth. Financing available through other public programs is essential. A few states have adopted the new FCIA Medicaid expansion option for former foster youth, and a larger number have implemented other relevant Medicaid options. Additional states have used other innovative approaches to facilitate health care access. Most states could do much more. A major challenge is to find approaches that can be implemented during times of severe budgetary limitations.
Subject(s)
Adolescent Health Services/economics , Aid to Families with Dependent Children/legislation & jurisprudence , Foster Home Care/economics , Health Services Accessibility/economics , Medicaid/legislation & jurisprudence , State Health Plans/legislation & jurisprudence , Adolescent , Adolescent Health Services/legislation & jurisprudence , Adult , Centers for Medicare and Medicaid Services, U.S. , Eligibility Determination/legislation & jurisprudence , Foster Home Care/legislation & jurisprudence , Foster Home Care/statistics & numerical data , Health Policy/economics , Health Status , Homeless Youth , Humans , United States , Vulnerable PopulationsABSTRACT
Increasing physical activity among youth represents a national health goal, and using volunteer activity providers at schools offers one possible solution. This paper describes results from a program to recruit volunteer physical activity providers in middle schools. Twenty-one volunteers provided 850 physical activity hours at seven schools, including 575 activity sessions and 7,186 student contacts. Volunteers who received incentives offered more minutes of activity, conducted more activity sessions, reached a greater number of students, and logged more student-minutes of physical activity than those who received none. Male volunteers provided more activity minutes than female volunteers, but females were marginally more successful in engaging female students. Results can help guide schools to more effectively increase student physical activity throughout the school day.
Subject(s)
Physical Education and Training/organization & administration , School Health Services/organization & administration , Volunteers/organization & administration , Adult , Analysis of Variance , California , Child , Female , Health Priorities , Humans , Interpersonal Relations , Linear Models , Male , Middle Aged , Motivation , Program Evaluation , Sex Factors , Students/psychology , Time Factors , Volunteers/psychology , WorkforceABSTRACT
This study addresses four major questions about the delivery of community-based mental health services: Which target groups are benefiting from recent policy shifts? What services are expanding? What staffing changes are occurring? How are these changes being financed? Findings indicate that state policies are aiding chronically mentally ill clients, but that services for other important target groups are being reduced substantially.
