Monthly Archive for July, 2011

220 Reasons That Paid Sick Days Campaigns Will Succeed

Published on July 22, 2011 in Judith Lichtman and Work & Family. 0 Comments

Judith L. Lichtman, Senior Advisor

Momentum and support for paid sick days policies in this country are growing like never before. Just last month, Connecticut passed the nation’s first statewide paid sick days bill, which was signed into law by Governor Dannel Malloy July 1st, and the Philadelphia City Council took a stand despite mayoral opposition by passing a paid sick days measure.

With the energy and activity around state and local paid sick days campaigns providing an exciting backdrop, the National Partnership and our ally Family Values @ Work brought together 220 advocates, policy experts, workers and business leaders from 23 states and Washington, D.C., for the 2011 National Summit on Paid Sick Days and Paid Family Leave. The Summit, held in Washington, D.C., on July 11th, included stimulating strategic discussions about the past, present and future of efforts to secure paid sick days and paid family leave for America’s workers.

From the opening plenary panel on the economic realities facing today’s workforce to a range of small group workshops, the Summit provided advocates, workers and businesses multiple opportunities to discuss new research, share creative ideas and best practices, and make their voices heard. The lively discussions and exchange of ideas among such a diverse group of supporters and advocates inspired all of us to redouble our efforts.

On the day of action that followed the Summit, participants shared their stories and enthusiasm with their members of Congress. In total, nearly 100 congressional offices heard about the need for the Healthy Families Act and the state paid leave fund proposed by President Obama. Congressional action on these policies would show working families that policymakers understand the conflicts they face every day trying to manage the dual demands of work and family.

Now that everyone is back home, we’re looking forward to seeing the great energy and momentum we felt in D.C. continue. In Seattle, where support is growing for an innovative paid sick days bill created through a partnership of advocates and business leaders, we could see progress by the end of the summer. In Denver, voters will cast their ballots on a popular paid sick days standard in November. And in Massachusetts, New York City, Philadelphia and elsewhere, promising activity continues.

With more victories on the horizon, fewer workers will have to choose between their health and their economic security. All of the advocates, policy experts, workers and business leaders who attended the Summit – along with the hundreds who couldn’t make it – are committed to ensuring that, very soon, no worker will have to make these impossible choices. With their energy and dedication, forward-thinking businesses, and savvy policymakers in support, there is no doubt we’ll get there.

To get the latest news on paid sick days efforts throughout the country and new research and resources on the importance of this basic labor standard, visit PaidSickDays.org. For more information on paid family leave, check out our paid leave research library.

View photos from the Summit here.

In Science v. Politics, Science Scores a Win

Published on July 21, 2011 in Debra Ness, Health Care, Reform, Repro Health Watch and Reproductive Health. 0 Comments Tags: .

Debra Ness, President

A milestone for women’s health is finally within reach: On Tuesday, the Institute of Medicine (IOM) identified the full range of FDA-approved contraception and birth control options as preventive health services – and recommended that they be made available to women without additional fees or co-payment under health care reform. IOM’s decision, which was based on strong scientific evidence, finally confirms what most women already know: that birth control is basic preventive care.

Preventive care is at the heart of the Affordable Care Act, so IOM’s recommendation is an encouraging step toward realizing the promise of health care reform for women. For most women of reproductive age, contraception and birth control are the care they need most, the care they get most regularly, and their main reason for interacting with health providers and thereby receiving other kinds of health care they need. Timely access to contraceptive services vastly improves maternal and child health, and it has been the driving force in reducing rates of unintended pregnancy in this country.

On average, women spend at least 30 years being sexually active but trying to avoid pregnancy. But with 30 years of fertility comes 30 years of expensive contraception – and studies show that even minimal co-pays deter individuals from obtaining the care they need. [1] In fact, one study found that low-income Americans reduced their use of effective health care by 44 percent when required to make co-pays. [2] In 2008, 36 million women — more than half of women of reproductive age — needed contraceptive services and supplies. [3] Of that group, 17.4 million needed publicly funded contraception. [4] For these women, eliminating expensive co-pays is the key to ensuring they have access to the care they need. So IOM’s recommendation is vital to the health of millions of individual women — and of our country as a whole.

At long last, it’s time to put politics aside. These science-based recommendations must guide policy, and politics should not intrude.  Secretary Sebelius should move quickly to make these recommendations policy under the Affordable Care Act, so women are able to access the contraceptive services they truly need. It’s about time.

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[1] Solanki G and Schauffler HH, Cost-sharing and the utilization of clinical preventive services, Am J Prev Medicine 17, no.2 (Aug 1999) 127-133.
[2] Ku L, Charging the Poor More for Health Care: Cost-Sharing in Medicaid, Washington, DC: Center on Budget and Policy Priorities, 2003.
[3] Frost JJ, Henshaw SK and Sonfield A, Contraceptive needs and services: national and state data, 2008 update, New York: Guttmacher Institute, 2010.
[4] Frost JJ, Henshaw SK and Sonfield A, Contraceptive needs and services: national and state data, 2008 update, New York: Guttmacher Institute, 2010.

Cause for Hope in North Carolina

Published on July 12, 2011 in Lee Partridge and Reproductive Health. 1 Comment

Lee Partridge, Senior Health Policy Advisor

Infant mortality rates are widely used in this country and internationally as a barometer of the quality of a community’s, or a nation’s, health care system – and with good reason. Despite our sophisticated and expensive health resources, the infant mortality rate in the United States is significantly higher than that of many other countries.  In 2005, for example, our infant mortality rate of 6.9 per thousand births put us above that of most European countries, Canada, Australia, New Zealand, Hong Kong, Singapore, Japan and Israel.[1]

Our maternal mortality rate – the measure of women dying in childbirth – is also shockingly high compared to that of European countries.  What’s worse, it is rising.  In 1990 in the United States, 343 women died in childbirth; by 2007 that number had increased to 548.[3] A report[4] released July 6 by the National Institute of Child Health and Human Development documents some progress on reducing the incidence of preterm birth, down from 12.8 percent in 2006 to 12.2 percent in 2009.  But that rate is still woefully behind the U.S. Healthy People 2010 target of 7.6 percent of all live births.

Taken together, these statistics should be a cause of major concern and inspire action to reverse that trend.

One state, North Carolina, has set out to address these problems.  In March, North Carolina opened a Pregnancy Medical Home program for women eligible for Medicaid.   Working with their medical community, local health departments, and a network of community support organizations called Community Care of North Carolina (CCNC), state health leaders combined payment incentives and specific care requirements into a package they believe will improve pregnancy outcomes throughout the state.

Here’s how the new program works.

Maternity care providers – obstetricians, family practitioners, nurse midwives, community clinics – can apply to be designated as a Pregnancy Medical Home.  They must agree to do four things:

  1. At the first obstetric visit, administer a standardized pregnancy risk tool that provides not only clinical health history but other information about the woman and her situation that could indicate she is at risk of a poor outcome.  The questions include poor nutrition, smoking status, use of alcohol or possible physical violence.   If a women looks like a high risk, the provider must contact his or her CCNC network and arrange for care management services for that patient throughout her pregnancy.  The provider and patient also develop a plan for managing her care.
  2. Ensure that none of the providers in the Pregnancy Medical Home perform “elective” deliveries – deliveries for which there is no medical reason to induce labor — prior to 39 weeks of gestation.  Early deliveries increase the likelihood of infant death, admission to a Neonatal Intensive Care Unit, or life-long health problems for the child.
  3. Provide the drug 17 alpha hydroxyprogesterone caproate (commonly called 17P) to patients at risk of preterm delivery.
  4. Aim for a caesarean-section rate for low-risk, singleton births below 20 percent.  C-sections expose both mother and child to surgical risk and possible infection, and can create complications for future pregnancies.

To encourage providers to enroll in the Pregnancy Medical Home program, the state Medicaid agency will pay Pregnancy Medical Home practices $200 more per patient over the state’s usual maternity fee.  $50 of this money is paid upon completion of the pregnancy risk tool, and the remaining $150 for managing the care is paid once the women has had her post-partum visit.  The post-partum visit must include screening for depression, reproductive life planning, and referral for ongoing care if necessary.  The state expects to offset the cost of the additional reimbursement through savings in hospital costs.

North Carolina is not the only place trying to improve maternity outcomes; projects are underway, for example, in California, Ohio and Washington state.  But to my knowledge, North Carolina is the first to employ the patient-centered medical home model in that effort.    This is a promising program, and we will all likely learn a lot from the state’s experience.

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[1] NCHS Data Brief, #23, November 2009; www.cdc.gov/nchs/data/databriefs/db23.htm.

[2] NCHS Health US 2010, Table 36; http://cdc.gov/nchs/data/hus/hus10.pdf#glance.

[3] Child Health USA 2010, Health Resources and Services Administration, U.S.DHHS; www.mchb.hrsa.gov/chusa10/hstat/hsi/pages/202lbw.html.,

[4] America’s Children: Key National Indicators of Well-Being 2011; http://childstats.gov.