September 7, 2000
August 11, 2000
July 26, 2000
For Release: Immediately
Contact: HRSA Press Office
Headline: HHS ANNOUNCES $22 MILLION IN NEW GRANTS TO IMPROVE SERVICES TO UNINSURED AMERICANS
HHS Secretary Donna E. Shalala announced today that 23 local networks of health care providers, hospitals, community health centers and local governments have been awarded about $22 million under a new federal program designed to improve access to health care for uninsured Americans.
The Community Access Program (CAP) grants will help grantees in 22 states build integrated health care systems among local partner organizations, all of which are committed to expanding health services to uninsured individuals.
"This grant program's goal is to assure that more uninsured people receive needed care, that the care received is of higher quality, and that the uninsured are served by providers who participate in accountable health systems," said Secretary Shalala.
The integrated systems will link all levels of care, including primary healthcare, mental health services, substance abuse counseling, and dental and pharmacy assistance. Grant amounts vary in size, based on the scope of the project and the size of the service area.
Interest in the competitive CAP grants was strong. The Health Resources and Services Administration (HRSA), an HHS agency, received more than 2,300requests for application kits and 207 applications for the 23 available grants. Funding requests came in from 44 states, the District of Columbia and Puerto Rico.
"The huge number of applications reflects the importance of the administration’s efforts in trying to bring access to health care to people who need it in communities across the country," said Secretary Shalala. "This funding is the first installment for what is intended to be a $1 billion initiative over five years and that will ultimately reach approximately 100communities."
CAP grant recipients will use the funds to create and expand collaboration among local partners through such strategies as management information systems, referral networks, care coordination and enrollment processes. This year’s grants will bolster efforts at sites that have already begun organizing community-based coalitions to coordinate services to the uninsured.
"The grantees have developed strategies that rely on local resources to build and strengthen integrated health care delivery systems," said HRSA Administrator Claude Earl Fox, M.D., M.P.H. "These are federal grants, but the design of each grantee's health care network and its implementation are locally driven."
All of the grant applications targeted access to health care to uninsured persons. Because racial and ethnic minorities in most communities are more likely than non-minorities to be uninsured, CAP grants support the federal government’s goal - as stated in the Healthy People 2010 document released by the Secretary last January -- to eliminate disparities in health status among all groups by 2010.
President Clinton's budget request for fiscal year 2001 calls for $125 million for CAP, five times the program's fiscal year 2000 operating budget. If approved, some of that money would be used to fund many of the more than 50additional applications that were approved in the current grant cycle but not funded due to budget limitations. Fiscal year 2001 money would also be used to fund additional applicants who are approved in a new competition.
For more information on the Community Access Program, call 301-443-0536 or go to the program office Web site at: http://www.hrsa.gov/cap. The list of CAP grantees is available at: http://www.hrsa.gov/newsroom.
Note: For other HHS Press Releases and Fact Sheets pertaining to the subject of this announcement, please visit our Press Release and Fact Sheet search engine at: http://www.hhs.gov/search/press.html.
Date: August 11, 2000
For Release: Immediately
Contact: HCFA Press Office (202) 690-6145
Headline: HHS ANNOUNCES ELECTRONIC STANDARDS TO SIMPLIFY HEALTH CARE TRANSACTIONS
HHS Secretary Donna E. Shalala today announced standard formats to streamline the processing of health care claims, reduce the volume of paperwork, save the U.S. health care system billions of dollars and provide better service for providers, insurers and patients.
The new standards, described in a regulation to be published in the Federal Register, establish standard data content and formats for submitting electronic claims and other administrative health transactions. All health care providers will be able to use the electronic format to bill for their services, and all health plans will be required to accept these standard electronic claims, referral authorizations and other transactions. "From the beginning of this administration, President Clinton has been committed to using new technology to benefit both the American people and American business. This is just the latest in a series of actions by the Clinton administration that improve quality and efficiency while also cutting costs and protecting privacy," Secretary Shalala said. "These standards are important steps toward a faster, simpler, less costly and more efficient health care system. Working closely with the private sector, we have developed standard electronic formats to replace today's costly and complex forms."
By promoting the greater use of electronic transactions and the elimination of inefficient paper forms, the administrative simplification regulations are expected to provide a net savings to the health care industry of $29.9 billion over 10 years.
The proposed regulation was required by the Health Insurance Portability and Accountability Act of 1996, known as HIPAA. In developing the proposal, HHS consulted extensively with private sector organizations and individuals and published a preliminary rule in 1998. More than 17,000 public comments on the proposal were received.
"Each comment was studied in preparing the final rule issued today," Shalala said. "The issues were very complex, but our consultations with the private sector helped us to resolve the issues and present solid solutions in the final regulation."
HHS will take additional steps later this year, issuing further regulations under HIPAA authority to improve the processing of health care transactions. These regulations will establish national identification numbers for employers and health care providers to speed claims processing and lower costs. In addition, HHS will lay out steps to make electronic health data secure, and protect the privacy of patients' medical and health insurance records. This will be done without the need for a unique personal identifier for individual patients.
At present, different insurers require different electronic and paper forms from health care providers filing claims. Under the new regulation all electronic claims transactions must follow the single standardized format. Providers will still be allowed to use paper forms, but the simplified process is expected to encourage more electronic filing. By law, health plans --with the exception of small self administered plans -- health care clearinghouses, and health care providers that choose to transmit their transactions in electronic form must comply with these rules within 26 months from the date of publication of this final rule, except that small health plans have an additional year in which to comply.
Other provisions include the following:
"These new standards are a win-win for health care providers and their patients," said Nancy-Ann DeParle, administrator of the Health Care Financing Administration, which runs the Medicare and Medicaid programs. "Information exchange will be more efficient and accurate, and providers will be able to spend less time on paperwork, and more time on the health care of their patients." Secretary Shalala cautioned that this rule is being released under the assumption that privacy protections will be in place at approximately the same time the rule takes effect. By the compliance date, HHS expects that its regulation on privacy of medical records will also be in effect, or Congress will have enacted such protections. The HHS regulation on privacy has been published as a proposal and is expected to be issued as a final rule later this year. If such privacy protections were not in place, HHS will seriously consider suspending or withdrawing the transaction regulation, pending appropriate privacy protections.
Note: For other HHS Press Releases and Fact Sheets pertaining to the subject of this announcement, please visit our Press Release and Fact Sheet search engine at: http://www.hhs.gov/news/press/.
Entitled "The JJAMD TMJ Millennium Era" this work traces The TMJ Dilemma from the beginning of our involvement 20 years ago to the present. We look back at the accomplishments and the lack of accomplishments in the TMJ field over this span. The controversies that have placed obstacles in the way of more significant progress toward resolving this horrendous Medical-Dental health disorder affecting millions of Americans are reviewed. We look at the omissions, commissions, and the failure of established institutions to come to grips with a true profile of the TMJ Patient, thereby affecting the accuracy and quality of current research into diagnosis and treatment and in dealing with health insurance issues affecting this huge population. In this atmosphere of futile rhetoric, JJAMD believes that the most doable humane effort that these established agencies could and should perform is the promotion of awareness and prevention. We also take a critical look at our own strengths and weaknesses, and that of the failure of TMJ Patients and TMJ Advocacy Organizations to come together in a unified, visible, viable grass roots movement.
While not intended as an exposé, the fact that we have been eyewitnesses and advocates in this turbulent era has given us a unique platform from which to view and report the total TMJ picture from our own perception. We also explain the trials and tribulations we have had to endure while being pro bono advocates for patients of a "Great Imposter Disorder." The reader will come away with an understanding of the stresses and strains that accompany what is, arguably, one of the most complex, confusing, and controversial health disorders. One will also gain a new appreciation for what the TMJ Patients must endure in terms of loss of respect, entitlements, and quality-of-life as they are consigned to "fall between the cracks of Medicine and Dentistry" and, as a result, are disenfranchised.
Initiated in 1993, JJAMD’S exhaustive project has been analyzed and published. It contains 60 pages of important information about TMJ "direct from the patients mouths." Until now, much of this data had been trapped inside the patients’ minds and bodies and in our files. This study provides an unusual insight into the thinking and experiences of this disenfranchised population.
The Survey was designed to collect information about TMJ Patients and their experiences with TMJ. The Checklist was intended to help TMJ Patients catalog all of the pain and dysfunction symptoms they are experiencing throughout their entire neuro-vasculo-musculo-skeletal system. Besides being of use to patients as a guide to communicating their history to health providers, the Checklist also correlated the numerous body-wide problems that are allied with TMJ, but often are not asked when taking a medical/dental history and, therefore, go unreported. Patients also volunteered rich, heretofore untapped, anecdotal information that has been captured in the analysis. Professor Robert B. Goldstein, Ph.D., a computer scientist and health care researcher, performed the analysis. Experts at The Forsyth Institute, University of Massachusetts, and Massachusetts Blue Cross Blue Shield reviewed and edited the report.
The analysis will be sent free to all the patients who generously participated in the study. Others may receive this important and beautifully published 60-page report by sending a $15 donation to cover our costs.
Following on the heels of our original TMJ Patient Survey and Checklist, we have now produced a new TMJ Patient Survey. Designed by a professional survey team, it goes more deeply into quality-of-life and whole body illness of TMJ sufferers. It looks into patient’s level of energy, sleep, social activity, independence, and other every-day activities. It then inquires into TMJ and related pain and dysfunction, and concludes with a medical history. What the Survey hopes to accomplish is an examination of the health experience as a very important source for understanding how disorders to the Jaw Joints affect not only the oral cavity and the entire body, but also overlap with other known disorders. While lengthy, the questions are presented in a logical progression and are relatively simple to answer.
The Survey is now available for downloading on our website www.TMJoints.org. Copies will be sent to all who participated in the previous Survey and Checklist, as well as to any others who have indicated a willingness to participate. We consider this the first phase towards a more comprehensive "TMJ Patient Survey and History" in the future.
Renée and Milton visited Senator Edward M. Kennedy’s office in March to discuss The TMJ Dilemma with his health aide. We emphasized the need for more and better research, awareness, health insurance, and promotion of prevention.
Later that month, Milton had an opportunity to introduce the Senator to a health care conference held in Boston. Before the meeting, we had an opportunity to discuss TMJ, as we have done with both the Senator and Mrs. Kennedy before. Not only was Senator Kennedy most willing to participate, but in his address to the meeting he publicly praised Milton’s commitment to health care over a 30-year period and in particular the work of our foundation.
On March 21, Senator Kennedy sent letters to the Director of the Centers for Disease Control and Prevention and the Acting Director of the National Institutes of Health. He expressed his interest in Temporomandibular Joint Disorder [TMJ] and his concern that not enough is being done to understand the causes of TMJ and to improve the therapies available to treat this condition. "Convening an NIH Working Group on TMJ and beginning a national TMJ Registry are important first steps in improving scientific understanding of this condition. I look forward to working with you on this important health problem and to the results of your work in establishing a TMJ Registry and enhancing research on TMJ," he wrote.
Dr. Harold C. Slavkin, Director, National Institute of Dental and Craniofacial Research [NIDCR] has presented a budget of $284 million. This is an increase of $15 million. His charts showed that "6% of adults report pain symptoms commonly associated with temporomandibular joint disorders." JJAMD doesn’t know who is counting heads, but to us this translates to an 18 million TMJ population, up from the 10 million usually quoted by NIH. While we wished Dr. Slavkin had added "dysfunction" to the "pain symptoms"--to validate many of the TMJ Patients who have equal problems of a dysfunctional nature--we are gratified that he used the words "Temporomandibular Joint Disorders." It is important to JJAMD, that the Director relies on the Joint to communicate the TMJ issues. One wonders if he had said "Temporomandibular Disorders" what blank stares he would have received from the Committee Members who might question how the Joint disappeared from the ADA-NIDR dental equation of "TMD".
The following represents some core quotations from Dr. Slavkin’s presentation to the Congressional Committee:
"The mission of our Institute is to reduce the burden of diseases and disorders that are among the most common health problems both nationally and globally.
The NIDCR supports research ranging from prenatal developmental processes that form the human face and dentition, to the many local and systemic diseases and disorders that involve craniofacial tissues and structures throughout the life span. Solving the problems can range from a chess match between grandfather and granddaughter, preventing disease, and designing ‘smarter’ diagnostics and therapeutics for diseases and disorders that compromise health. By discovering solutions to the complex problems posed by craniofacial, oral and dental diseases and disorders, NIDCR-funded scientists are fulfilling the mission of the Institute to improve and promote health through research."
Dr. Harold C. Slavkin, a distinguished scientist and charismatic leader, will be leaving his post soon to return to private life as Dean of the Dental School at the University of Southern California. Dr. Slavkin brought a lot of new energy and new direction to NIDR/NIDCR and coupled it with other NIHs. He gave a lot of time and attention to TMJ, but perhaps the restraints imposed upon him to do more about the emergency situation regarding the silastic/proplast Jaw Joint Implants had precluded his ability to do more with JJAMD. Efforts of the Institute were mostly directed to the imperative to "do something quickly" about the failed Jaw Joint silicone implants that have devastating and life-threatening consequences to some 26,000 mostly female victims. This was considered the "Blackest Period in Dental History.
While we applaud this excellent effort, unfortunately it has not trickled down to help the millions of other TMJ Patients for whom we are advocating, and who need similar energy, attention, care, help and hope for wellness and a better quality of life. In our many meetings and discussions with Dr. Slavkin, he exhibited a keen understanding of The TMJ Dilemma and seemed sincere in wanting to partner with JJAMD’s efforts, particularly regarding the promotion of prevention to the public.
He has been effective in advocating for more basic and clinical TMJ research. He told us that there are 24 RFA’s [request for application] currently available for TMJ researchers which have not been applied for. Our constant concern has been, and continues to be, that monies are being largely allocated to studies on chronic pain and psychological issues, while clinical and basic science regarding TMJ "goes begging."
We are uncertain about what a new NIDCR Director will bring to the TMJ Dilemma, but we must hope for the best. At minimum, it may take him or her an extensive period of time for orientation to understand the underlying issues involved. We worry that he may not have the commitment, passion, leadership skill, and alliance building capacity of a Dr. Slavkin. Most importantly for the TMJ patient population, his vision to get beyond the Dental/Mental mantra that has been imposed within his ranks, must be clear and straightforward.
We received this letter addressed to "Milt and Renée" from Dr. Harold Slavkin, praising our advocacy efforts:
"I am very proud of you and your untiring efforts to increase awareness for temporomandibular joint diseases and disorders. You and your foundation have been and continue to be invaluable partners as we work towards reducing the burden of disease and improving the quality of life of millions of American people. Your keen interest in promoting scientific studies that result in evidenced based health care for chronic and disabling diseases and disorders is very important. I congratulate the value of partnerships between patient advocacy groups, scientists, and federal funding agencies. You are making a profound difference!"
Dr. Slavkin also enclosed a video that was made to highlight TMJ disorders in which he reviews a presentation of charts and illustrations posted in the halls of the Office of The Director. TMJ was the feature of the month of March 2000.
National TMJ Public Relations Campaign Planned for
Jaw Joints - TMJ - Awareness Month®
JJAMD is calling on all TMJ Patients to help publicize "Jaw Joints - TMJ -Awareness Month®" and in the process help in their own empowerment.
We have suggested press releases, letters to legislators, and other materials which can be used to explain The TMJ Dilemma. We also have very attractive "T" shirts with appropriate TMJ messages. Please let us know about your willingness to participate. You can contact us by e-mail at TMJoints@aol.com, by mail at JJAMD, The Forsyth Institute, 140 Fenway, Boston MA 02115, or by Fax at 617-267-9020.