List of Health Policy Briefs and Summaries

Long Term Care in Texas
Texas is at a Long-Term Care (LTC) crossroads: Americans are living longer; the baby boomer generation will begin turning 65 in 2011 and costs are rising at a rapid pace. The system is already struggling to provide individuals with limited finances access to quality care with limited public funds. This policy brief explores the Texas LTC system and the obstacles the system faces in assuming the delivery of varied and high quality LTC for the aged and persons with disabilities. First, the brief defines long-term care and reviews the current payment structure. Second, it identifies demographic and policy trends and discusses the impact on LTC in Texas now and into the future. It presents a series of policy options designed to increase access to and the delivery of quality long-term care in Texas. Finally, included in the appendices, this report includes a consensus by the industry on priorities, the priorities of the Texas Silver-Haired Legislature related to LTC and the priorities of a consumer advocacy group, ADAPT.
Long Term Care in Texas
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Access to Health Insurance for the Uninsured
Texas leads the nation in the number of people without health insurance, under the age of 65. There are various reasons people are uninsured or unable to obtain health insurance when they want it; employers cannot afford group plans, individuals cannot afford the employer group plan rates and individuals cannot afford private insurance. Access to health insurance means that coverage is available and affordable for each individual. Evidence shows that when people have access to and obtain health care coverage, they are more likely to seek medical care when needed and be healthier. This brief takes an in depth look at the issues facing Texans and some remedies being explored at both the state and community levels.
Access to Health Insurance for the Uninsured
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Obesity in Texas: Policy Implications
Obesity may be the most serious health problem in Texas today. It is linked to the majority of diseases that cause the most deaths in our state. It causes emotional distress as well, and takes a huge toll on the state budget. Overweight and obesity cost the state $10.5 billion in 2001, in direct medical costs and lost productivity. This health policy brief, "Obesity in Texas: Policy Implications," defines the scope of the Texas obesity problem, assesses workplace and school wellness policies and explores opportunities for policy change, and presents an overview of past Texas obesity prevention and control efforts.
Obesity in Texas: Policy Implications
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Medicaid Modernization Act (MMA)
Enacting the most dramatic change to Medicare in 40 years, Congress implemented a prescription drug benefit program that will begin coverage in January 2006, with enrollment beginning in November 2005. This primer explains how the new plan works and how it will impact beneficiaries with different levels of prescription drug expenses
Medicaid Modernization Act (MMA)
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The State of Health Care: A Few Indicators and Current Issues (March 18, 2005)
The Changing Health Care Workforce in Texas: Resources vs. Needs
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The Texas Workforce Healthcare Workforce: Innovative Strategies to Address Shortages (August, 2004)
The health care workforce is critical to the delivery of quality care. Persistent nationwide shortages of physicians, nurses and health professionals of all types already have taken a toll on the health care system. This policy brief explores health care workforce issues in Texas, focusing on their implications, factors that caused and continue to exacerbate workforce problems, and some initiatives underway to improve the situation. In addition, the brief presents an Institute of Medicine model of integrated health care delivery intended to help meet future health care needs even as workforce shortages persist.
The Changing Health Care Workforce in Texas: Resources vs. Needs
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Health Care Safety Net in Texas (December 2002)
While much of the policy discussion concerning the future of the health care safety net has focused on the mission to provide care for the poor and uninsured or underinsured, all Texans are potential consumers of safety net health services. The Institute's December 2002 forum explored the various health care safety net services available in Texas and threats to their continuation.
The Health Care Safety Net in Texas
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Physicians, Hospitals and Long-term Care Facilities Liability Issues (October 2002)
In October 2002, the Institute sponsored a forum focusing on the complex issues surrounding medical liability coverage for hospitals, physicians and long term care facilities. In Texas, malpractice can take up as much as a quarter of a physician's revenue. Our state had some of the steepest premium increases in the nation last year, along with some of the highest jury awards for medical malpractice. Physicians, hospitals and long term care facilities are essential in our society, as is a system for protecting patients and ensuring quality of care. The Institute has prepared two policy briefs titled "Liability Issues for Texas' Physicians and Hospitals" and "Texas Long Term Care Facilities and the Liability Issue". These briefs explore the perspectives of the various stakeholders regarding medical liability.
Physicians and Hospitals
Long-Term Care Facilities
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Children's Mental Health (March 2002)
Despite a focus on mental health in the 1990's, including a comprehensive Surgeon General's report strongly emphasizing the need to improve a system of mental health care (1999), recent studies show that services are inadequate and hard to access, particularly when it comes to children and adolescents. As a result, only a quarter of all children and adolescents with emotional problems and severe mental disorders receive any treatment. This paper explores mental health access and treatment issues relating to youth and describes the movement toward "wraparound care," or "systems of care" models for improving the availability and quality of mental health services for youth.
Children's Mental Health
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Bioterrorism and Preparedness (December 2001)
Close on the heels of the September 11 terrorist attacks, the dissemination of anthrax via the U.S. Postal System awakened our nation to our vulnerability to bioterrorism. This paper frames the issue in a historical context, discusses the likelihood of and the risks involved in an attack; provides a review of the policy and health implications, and describes some policy and preparedness initiatives and issues nationally and in Texas.
Bioterrorism Preparedness
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Emergency and Trauma Care in Texas (October 2001)
Despite the quality of our urgent care professionals, hospital emergency departments and trauma centers nationwide are in need of urgent assistance themselves. In Texas, hospital emergency departments struggle with overcrowding, financial woes and extreme staff shortages. This paper explores the "emergency in emergency care" and how it evolved. It provides a literature review of research regarding policy and health implications of an emergency system in crisis and describes some initiatives for change nationally, in Texas, and in other states.
Emergency and Trauma Care in Texas
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Nutrition and Fitness in Texas Schools (August 2001)
A healthy lifestyle is the single most important and effective means of avoiding life-threatening diseases and ensuring a high quality of life. Using public schools as a means to shape health habits among young children not only will help reap lifelong benefits for them; it will save millions of public dollars in health care costs. The Nutrition and Fitness paper explores the nutrition and fitness issues relating to youth. It provides a literature review of research regarding policy and health implications of an unhealthy lifestyle among juveniles and describes initiatives for change nationally, in Texas, and in other states.
Nutrition and Fitness in Texas Schools
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The Uninsured (September 2000)
With health care costs rising and more and more Americans becoming uninsured, many policy experts predict a health care crisis unless national and state leaders move quickly to improve access to care. For various reasons, Texas has an especially difficult problem to tackle. This paper explores some of the unique issues that Texas faces, and some of the initiatives underway to decrease the number of uninsured Texans.
The Uninsured in Texas
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Youth At-Risk (August 2000)
It is important for policymakers to understand what factors put youth at risk and what protects them from negative influences. Armed with an understanding of risk factors and protective factors, they can focus more resources on the programs and services that are most effective in assisting youth to become successful citizens. This paper discusses the background and events that lead to a renewed focus on youth policy and provides a literature review of research on factors that put youths at risk and factors that protect them. Finally, it highlights best practices and essential elements for quality youth programs
Youth in Texas
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Long-term Care (June 2000)
Texas has the fourth largest elderly population in the nation, and it is increasing steadily. In 1999, the Texas Department of Human Services estimated nearly 3.9 million non-elderly Texans with functionally limiting disabilities, more than 20 percent of whom live below the federal poverty level. The need for a variety of appropriate long-term care services is vital. This paper provides an overview of the state of long-term care services in Texas and the major issues facing legislators and other policymakers. It also summarizes recent legislation and initiatives to ease some of the strain on the continuum of services.
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