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mathematics, science and oral expression, but no effect of the program was evident for standardized testscores for reading or math, for teacher-rated classroom behavior, or for attendance. The Tinkelman(Tinkelman & Schwartz, 2004) case study of the DSCM asthma school program incorporating a respiratorynurse care manager, web-based interactive educational tools, and an interactive asthma diary for 41elementary and middle school public school students did report a drop in school absences by 2/3.However, the Christiansen (Christiansen et al., 1997) study of the five-session bilingual, interactivecurriculum teaching about asthma in a school setting did not report an effect on school absences amongthe 27 intervention students compared to the 15 control asthmatics. The Clark (Clark et al., 2004)randomized controlled trial is perhaps the strongest study in terms of design and sample size and thisstudy found higher grades for science but not for reading, math or physical education. Parents oftreatment children reported fewer absences attributable to asthma in the past three months, but nodifferences in school absences were noted in school records. The mixed results for the effects of theprograms on school attendance is disheartening given that asthma is considered to be the leading causeof school absences (Tinkelman & Schwartz, 2004). However, the studies are limited by weaknesses indesign and sample size and challenges in the accurate measurement of school absences along with thecause of the absence. The paucity of research linking asthma programs with academic performancesuggests that more work needs to be done in both the development and implementation of school-basedasthma management programs and the evaluation of those programs.School-Based Mental Health InterventionsGall and colleagues (Gall et al., 2000), found that among 13- to 18-year-old public high schoolstudents, two months after they received school-based mental health and counseling services,absenteeism decreased by 50% and tardiness decreased by 25% (p
intervene upon these chronic conditions measure health outcomes as opposed to academic outcomes orschool performance. This is not to imply there is no connection between school health programs andacademic outcomes. More research exploring this link is necessary before it can be determined. There issome evidence that increasing physical activity and providing appropriate nutrition services, such as aschool breakfast program, may improve school performance and reduce the incidence of certain chronicconditions. The recommendations made in this report will be based on this evidence.A summary of the studies reviewed appears in Table 4 below. As noted earlier, most of the studiesthat considered the impact of interventions focused on health as their endpoint and not on academicachievement. Part of this may have been a function of the interests of the funders; those with healthmissions were not accountable for improvements in academic performance. Studies of interventions thattargeted obesity, for example, seldom included any academic measures. The exceptions were few, butnotable. We have several excellent studies of physical inactivity that demonstrate academicimprovements. To the extent that obesity is highly correlated with physical inactivity, we could posit anindirect effect from programs designed to increase physical activity. The same is true of diabetes. To theextent that physical activity is a preventative against the onset of type 2 diabetes, we can infer an indirecteffect through diabetes reduction as well.As the table indicates, we have primarily three areas of scientifically documented healthinterventions that yield academic dividends: physical activity, asthma and under-nourishment. We willaddress the consequences of this in a later section.E-24
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Appendix ATask Force Members and St
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Hector Balcazar, Ph.D.Regional Dean
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Charles Haley, M.D., M.S.Medical Di
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Michael McKinney, M.D.Senior Execut
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M. Roy Wilson, M.D.PresidentTexas T
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Appendix BMedicaid and the State Ch
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services. There are two broad types
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Mandatory and Optional Covered Popu
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• Nurse-midwife services;• Fede
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Disproportionate Share Hospital Pro
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March 13, 2001, that limited the am
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year from FFY 2002-2004, $4.05 bill
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Medicaid beneficiaries. Section 191
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started in 2001 and 2002 to curb in
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urban and with fewer than 250,000 p
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Protection Act of 2000 and the Medi
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orientation). Recipients of Supplem
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enrollee is assigned a primary care
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Table 7. Texas Medicaid Policy Chan
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Table 8. Texas SCHIP Policy Changes
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families (through the employer’s
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share of the match must come from t
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Reinstating the Medically Needy Spe
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Endnotes1 Texas Health and Human Se
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35 Powers, Pyles, Sutter, and Vervi
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73 Office of Management and Budget,
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113 TexCare, Children’s Health In
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150 Lyndon B. Johnson School of Pub
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States by Groupings with Current El
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Medicaid and the State Children’s
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Graduate Medical Education ProgramA
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needs, however, there is a shortage
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15 Texas Association of Counties,
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ecording and evaluation; physical e
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Medicaid and the State Children’s
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ReferencesAmerican Academy of Pedia
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downloads/bipa.pdf#search='Medicare
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Texas Health and Human Services Com
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Appendix CAn Analysis of Reform Opt
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Encouraged by these low rates, Cong
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Establishing state-only tax incenti
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New York passed the Health Care Ref
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Hospital Cost Containment — Maryl
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dollar spent. 237 Texas spent almos
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Another option for small businesses
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• Medical equipment and supplies,
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pay the premiums for Medicaid benef
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Medicaid to children born after Sep
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Bill of Rights or “TABOR”; and
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The federal share for CHP+ is 65 pe
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SCHIP: increased eligibility in CHP
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• Medical equipment and supplies
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6. Funds obtained through the recov
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Status ReportMaineCare Program Expa
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the federal poverty level. 404 Sinc
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need their jobs as a source of empl
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Endnotes191 Deborah Chollet, Issue
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225 Ibid.226 Maryland Health Care C
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259 Kaiser Family Foundation, State
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SCHIP&subcategory=Medicaid+Spending
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325 Kaiser Family Foundation, State
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361 State Coverage Initiatives, Sta
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SCHIP&subcategory=SCHIP&topic=Feder
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An Analysis of Reform Options Devel
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ReferencesAdvantage Insurance and F
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Donnell-Kay Foundation. “Amendmen
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Kaiser Family Foundation. Demograph
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State Coverage Initiatives. Profile
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Appendix DLocal Initiatives to Expa
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with more coordinated services that
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FinancingSources of revenue include
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AdministrationThe Health and Hospit
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Until 1993, Denver Health (DH) was
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different benefit plans are offered
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Cost SharingPatient cost-sharing is
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management programs. I-Care promote
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the county indigent care plan. Bene
Page 158 and 159: Firstplan xxvi,12Moore County, Mich
Page 160 and 161: Benefits and ServicesEnrollees can
Page 162 and 163: EligibilityAs of 2005, enrollment i
Page 164 and 165: etween $23 and $120 per month. Ther
Page 166 and 167: Healthcare Accountability Act xxxvi
Page 168 and 169: Coordination - When health care age
Page 170 and 171: subsidized initiatives offer exposu
Page 172 and 173: arriers, two health plans attempted
Page 174 and 175: xxi Simmons, Sandy Coe, Gionfriddo,
Page 176 and 177: Table 1 (Continued). Local Care Ini
Page 178 and 179: Table 2 (Continued). Local Coverage
Page 180 and 181: Appendix EEducation and Health:A Re
Page 182 and 183: The human capital approach suggests
Page 184 and 185: etween standardized test scores (St
Page 186 and 187: INTRODUCTIONEducation plays a wide
Page 188 and 189: of children with chronic health con
Page 190 and 191: Implications. Given the current pre
Page 192 and 193: DiabetesPrevalence. Diabetes in chi
Page 194 and 195: Limitations. The cross-sectional de
Page 196 and 197: chronic lung disease, cystic fibros
Page 198 and 199: significant differences between tho
Page 200 and 201: Table 1. Prevalence of Selected Chr
Page 202 and 203: findings of lower test scores are b
Page 204 and 205: al (McKewen et al., 1998) report a
Page 206 and 207: Section 3. School-Based Interventio
Page 210 and 211: Table 4. Summary of Research Findin
Page 212 and 213: etween SES and health is a dose-res
Page 214 and 215: Self-Rated Health. Evidence accumul
Page 216 and 217: economic hardship. One of the skill
Page 218 and 219: Education also improves the stabili
Page 220 and 221: sex in the expectation of a more pr
Page 222 and 223: TABLE 6. SUMMARY OF EXPLANATIONS FO
Page 224 and 225: According to the Census 2000 data,
Page 226 and 227: Policy Reports Recommendations (Tot
Page 228 and 229: Section 2. Recommendations on Schoo
Page 230 and 231: Childhood ConditionsSchool-based Pr
Page 232 and 233: Childhood ConditionsDiabetes (n=11)
Page 234 and 235: eduction in reading test scores com
Page 236 and 237: Table 10. Estimates of the Cost of
Page 238 and 239: National Asthma Education and Preve
Page 240 and 241: REFERENCESAck, M., Miller, I., & We
Page 242 and 243: Elo, I. T., & Preston, S. H. (1996)
Page 244 and 245: Kaemingk, K. L., Pasvogel, A. E., G
Page 246 and 247: Miller, D. S., & Miller, T. Q. (199
Page 248 and 249: Ross, C. E., & Wu, C. L. (1996). Ed
Page 250 and 251: Williams, D. R. (1990). Socioeconom
Page 252 and 253: SAMPLE, DESIGN, & INTERVENTIONACHIE
Page 254 and 255: SAMPLE, DESIGN, & INTERVENTIONStudy
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SAMPLE, DESIGN, & INTERVENTIONACHIE
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SICKLE CELL ANEMIAArmstrong(1996)SA
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SAMPLE, DESIGN, & INTERVENTIONSickl
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SAMPLE, DESIGN, & INTERVENTIONhemog
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SAMPLE, DESIGN, & INTERVENTIONStudy
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Curriculum Content: Statute §28.00
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• HEALTH PROMOTING ENVIRONMENTSch
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• COORDINATION/IMPLEMENTATIONCoor
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Education and Health: A Review and
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Appendix FState Regulation of Healt
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coverage they offer. 14 By 2004 onl
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poor health may make coverage more
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account for most, or even much, of
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More active state intervention in t
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Table 3 (GAO Appendix IV) shows whi
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Appendix GEmergency and Trauma Care
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The treatment of shock prior to sur
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the EMS needs in rural areas of the
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Level IV trauma centers should be a
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Table 2. Trends in Trauma Severity,
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the hospitals were on diversion or
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Representative Delisi was successfu
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Mental Health Access ChallengesCare
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fhttp://www.techproservices.net/his
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oohttp://www.saveourers.org/reports
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Appendix HBrief: Consulate ClinicDe
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In addition, the roundtable discuss
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clinic(s) affiliated with medical s
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Appendix ICommon Abbreviations
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HMOHRQOLHRSAICF/MRIHCTAIOMISSLBBLIU
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Appendix JPresentersDate/Location:
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Appendix KProvider Taxes: A Differe
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were previously categorized as char
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