The impact of state community benefit laws on the community health orientation and health promotion services of hospitals

This study examined the effect of state community benefit laws and guidelines on the community health orientation and the provision of hospital-based health promotion services in hospitals. The sample included all not-for-profit and investor-owned acute-care hospitals in the United States during the year 2000. Multiple regression procedures were used to test the effect of community benefit laws and type of ownership while controlling for organizational and environmental variables. The results of these procedures indicated that, on average, not-for-profit hospitals in the ten states with community benefit laws/guidelines reported significantly more community health orientation activities than did not-for-profit hospitals in the forty other states. The results of the multiple regression procedures also indicated that, on average, the investor-owned hospitals in the ten states with laws/guidelines reported significantly more community health orientation activities than did the investor-owned hospitals in the forty other states. The study found that community benefit laws had the effect of decreasing ownership-related differences in reported community health orientation activities. Further, Levene's test of equality of variance showed that the not-for-profit hospitals in community benefit states exhibited significantly lower variance in the community health orientation activities when compared with the not-for-profit hospitals in non-community benefit states. However, none of the statistical tests supported the hypotheses that community benefit laws compelled or induced hospitals to offer significantly more health promotion services. The study concluded that coercive measures such as community benefit laws were effective in compelling not-for-profit hospitals to report increased community orientation activities, and it also concluded that the mimetic pressures associated with these laws were effective in inducing investor-owned hospitals to report increased community orientation activities.     

Expanding a traditional criminal justice curriculum into an innovative social control curriculum

Most criminal justice curricula are limited to crime and the criminal justice system. Such programs could profit from evolution into a curriculum covering all means by which behavior is controlled in society. Subject areas of such a social control curriculum would include: sources and nature of behavior; selection of behaviors for social control; criminal justice systems; non-criminal justice, legal, social control systems; and nonlegal, social control systems. Crime and criminal justice would remain major topics, but would be complemented by and blended with the topics of noncriminal behavior and non-criminal justice system controls on behavior. However, the focus would remain on social control of behavior and would not be expanded to include all community interaction.     

Moving prison health promotion along: towards an integrative framework for action to develop health promotion and tackle the social determinants of health

The majority of prisoners are drawn from deprived circumstances with a range of health and social needs. The current focus within ‘prison health’ does not, and cannot, given its predominant medical model, adequately address the current health and well-being needs of offenders. Adopting a social model of health is more likely to address the wide range of health issues faced by offenders and thus lead to better rehabilitation outcomes. At the same time, broader action at governmental level is required to address the social determinants of health (poverty, unemployment and educational attainment) that marginalise populations and increase the likelihood of criminal activities. Within prison, there is more that can be done to promote prisoners’ health if a move away from a solely curative, medical model is facilitated, towards a preventive perspective designed to promote positive health. Here, we use the Ottawa Charter for health promotion to frame public health and health promotion within prisons and to set out a challenging agenda that would make health a priority for everyone, not just ‘health’ staff, within the prison setting. A series of outcomes under each of the five action areas of the Charter offers a plan of action, showing how each can improve health. We also go further than the Ottawa Charter, to comment on how the values of emancipatory health promotion need to permeate prison health discourse, along with the concept of salutogenesis.     

Designation of health services areas and health systems agency application information--HRSA. Notice designating health services areas in Ohio

This notice is issued to announce the establishment of ten health service areas for the State of Ohio and to provide information on the application procedures to become a federally designated and funded health systems agency.     

Mental health services in New Zealand

The development and reorganization of mental health services in New Zealand is underpinned by a national strategy, with increased funding from the government, and is occurring on a background of radical change in health service policy and delivery. The major challenge will be to sustain the developments to date, and increase the quality and quantity of services in a climate of ongoing change. A more integrated form of service delivery and funding would potentially enhance the development of population-based mental health services, which will allow the alignment of targeting specialty service to the 3% of the population with the highest need, with a more comprehensive approach to overall mental health service through the primary sector.     

Distance health services under the general agreement on trade in services

This Article discusses the state of distance health with respect to the General Agreement on Trade in Services (GATS). After examining the various aspects of telemedicine and its place in international trade, the author looks at the structure and functioning of GATS and how telemedicine is regulated under this agreement. The author argues that the potential for telemedicine under this agreement has yet to be fulfilled and suggests a number of ways to realize its potential. Ultimately, however, the author concludes that the single most important international trade objective for the United States healthcare industry should be to get its own house in order with respect to cross-border provision of health services. From an international trade perspective, the problem of non-uniform state licensure requirements within the United States makes it very difficult for the United States to negotiate market access commitments for distance health services with other countries. Therefore, it is not realistic to expect significant progress in the liberalization of distance health services until the United States has in place a reasonably uniform domestic system of licensure and regulation for telemedicine practitioners.     

HMO promotion and the privatization of health care in Chile

Since 1973 the Chilean junta has privatized sectors of the national economy. This paper analyzes the country's policy process of promoting private medical programs through HMO-like plans (ISAPREs, or Institutes of Provisional Health). These plans have captured less than half of their originally anticipated market share. It is argued that the future performance of ISAPREs will be undermined by their limited maternal benefits, their targeting to a small upper-income group which cannot sustain many private medical programs, and competition with less expensive yet equally competent public medical programs. The paper briefly compares privatization in Chile with the experiences of other countries, and specifically contrasts the restructuring of health services under military rule in Chile with those of Argentina and Uruguay. The paper concludes that the Chilean experience with HMOs epitomizes the perils of planning health care during short-term periods of economic prosperity as well as failing to consult medical care providers and consumers.     

Putting mental health into mental health law

This article critiques the traditional doctrinal approach to mental health law and compares the traditional approach with a new, interdisciplinary approach known as therapeutic jurisprudence. Therapeutic jurisprudence views the law itself as a potential therapeutic agent. Examples are given of how legal rules, procedures, and the roles of legal actors may produce therapeutic or antitherapeutic results and of how the law may improve therapeutic outcomes without sacrificing the interests of justice.     

Provision of health services to irregular migrants with a special focus on children

All European countries are now facing a situation where a part of the population consists of migrants without a permit to stay or reside. These persons may have health problems, and the question then rises regarding health services to irregular migrants. Normally, welfare benefits are offered those with a relationship to the country concerned, as citizen, asylum seeker, tourist, etc. Irregular migrants are outside the society, and it could be suggested that they therefore should be denied health services. On the other hand, common European standards of humanity lay obligations on the States, for example, where situations are life-threatening. This contribution gives an overview of relevant legal instruments, both from the UN, Council of Europe and the European Union. Although there are many similarities, the instruments have their differences, and there may even be some tensions regarding the underlying values.     

Availability of funds for home health services and training--HRSA

The Health Resources and Services Administration (HRSA) announces that funds are available for grants and loans for the development and expansion of home health programs and services. Public Law (Pub. L.) 98-139, the Labor, Health and Human Services, and Education Appropriations Act of 1984, signed on October 31, 1983, appropriates $5 million under section 339 of the Public Health Service (PHS) Act (42 U.S.C. 255) to provide home health services and for the training of paraprofessionals to provide home health services. This notice contains information of interest to prospective applicants for such funding.     

Inmate fees for health care services. Final rule

The Bureau of Prisons (Bureau) finalizes rules describing procedures we will follow for charging inmates fees for certain kinds of health services, as required under the Federal Prisoner Health Care Copayment Act of 2000 (Pub. L. 106-294, October 12, 2000, 114 Stat 1038, codified at 18 U.S.C. 4048).