First-ever report ranks states based on depression status; calls for mental health monitoring system to inform state policies impacting access to care

Source: Mental Health America

From press release:
Mental Health America today released its report, “Ranking America’s Mental Health: An Analysis of Depression Across the States,” a first-of-its-kind study examining state and national data for statistical associations between access-to-care factors and actual health outcomes, namely a state’s mental health status and suicide rate. Included in the study is a ranking of the 50 states and the District of Columbia based on rates of depression and suicide. South Dakota is found to lead the nation with the best depression status while Utah ranked last.

Ranking America’s Mental Health: An Analysis of Depression Across the States

CMS Publishes a National List of Poor-Performing Nursing Homes, Key Tool for Families Seeking Quality Care

Source: Centers for Medicare & Medicaid Services (HHS)

From press release:
The Centers for Medicare & Medicaid Services (CMS) today released the first ranking of the nation’s poor-performing nursing homes. Release of the national list of facilities, identified as special focus facilities (SFFs), is expected to offer individuals, seeking long-term health care services, and their families powerful new information when choosing nursing homes.

The creation of the list was prompted by the number of facilities that were consistently providing poor quality of care, yet were periodically instituting enough improvement that they would pass one survey only to fail the next (for many of the same problems as before). Such facilities with a ‘yo-yo’ compliance history rarely addressed underlying systemic problems that were giving rise to repeated cycles of serious deficiencies.

Once a facility is selected as an SFF, the state survey agency conducts twice the number of standard surveys and will apply progressive enforcement until the nursing home either (a) significantly improves and is no longer identified as an SFF, (b) is granted additional time due to promising developments, or (c) is terminated from Medicare and/or Medicaid. CMS and the state can more quickly terminate a facility that is placing residents in immediate jeopardy.

The CMS policy of progressive enforcement means that any nursing home, not just those identified as an SFF, that reveals a pattern of persistent poor quality is subject to increasingly stringent enforcement action. If problems continue, the severity of penalties will increase over time, ranging from civil monetary penalties, denial of payment for new admissions and, ultimately, removal from Medicare and/or Medicaid.

As of October 2007, there were 128 SFFs, out of about 16,000 active nursing homes. The number of SFFs in each state varies according to the number of nursing homes in the state. These nursing homes, at the time of their selection as an SFF, had survey results that were among the poorest five or 10 percent in each state.

Today’s list includes 54 facilities that are at the top of the poorest performers in those states and among those facilities that have failed to improve significantly.

Special Focus Facility Background Information (PDF; 15KB)

Special Focus Facility Public List (PDF; 16 KB)

2007 Nursing Home Action Plan (PDF; 993 KB)

Immigrants in the United States, 2007: A Profile of America’s Foreign-Born Population

Source: Center for Immigration Studies

This Backgrounder provides a detailed picture of the number and socio-economic status of the nation’s immigrant or foreign-born population, both legal and illegal. The data was collected by the Census Bureau in March 2007.

Among the report’s findings:
• The nation’s immigrant population (legal and illegal) reached a record of 37.9 million in 2007.
• Immigrants account for one in eight U.S. residents, the highest level in 80 years. In 1970 it was one in 21; in 1980 it was one in 16; and in 1990 it was one in 13.
• Overall, nearly one in three immigrants is an illegal alien. Half of Mexican and Central American immigrants and one-third of South American immigrants are illegal.
• Since 2000, 10.3 million immigrants have arrived — the highest seven-year period of immigration in U.S. history. More than half of post-2000 arrivals (5.6 million) are estimated to be illegal aliens.
• The largest increases in immigrants were in California, Florida, Texas, New Jersey, Illinois, Arizona, Virginia, Maryland, Washington, Georgia, North Carolina, and Pennsylvania.
• Of adult immigrants, 31 percent have not completed high school, compared to 8 percent of natives. Since 2000, immigration increased the number of workers without a high school diploma by 14 percent, and all other workers by 3 percent.
• The share of immigrants and natives who are college graduates is about the same. Immigrants were once much more likely than natives to be college graduates.
• The proportion of immigrant-headed households using at least one major welfare program is 33 percent, compared to 19 percent for native households.
• The poverty rate for immigrants and their U.S.-born children (under 18) is 17 percent, nearly 50 percent higher than the rate for natives and their children.
• 34 percent of immigrants lack health insurance, compared to 13 percent of natives. Immigrants and their U.S.-born children account for 71 percent of the increase in the uninsured since 1989.
• Immigrants make significant progress over time. But even those who have been here for 20 years are more likely to be in poverty, lack insurance, or use welfare than are natives.
• The primary reason for the high rates of immigrant poverty, lack of health insurance, and welfare use is their low education levels, not their legal status or an unwillingness to work.
• Of immigrant households, 82 percent have at least one worker compared to 73 percent of native households.
• There is a worker present in 78 percent of immigrant households using at least one welfare program.
• Immigration accounts for virtually all of the national increase in public school enrollment over the last two decades. In 2007, there were 10.8 million school-age children from immigrant families in the United States.
• Immigrants and natives have similar rates of entrepreneurship — 13 percent of natives and 11 percent of immigrants are self-employed.
• Recent immigration has had no significant impact on the nation’s age structure. Without the 10.3 million post-2000 immigrants, the average age in America would be virtually unchanged at 36.5 years.

Hospitalizations and Deaths Caused by Methicillin-Resistant Staphylococcus aureus, United States, 1999-2005

Source: Emerging Infectious Diseases (via Robert Wood Johnson Foundation)

From press release:
Hospitalizations related to methicillin-resistant Staphylococcus aureus (MRSA) infections more than doubled, from 127,000 to nearly 280,000, between 1999 and 2005, according to a new study in the December issue of the journal Emerging Infectious Diseases. During that same period, hospitalizations of patients with general staph infections increased 62 percent across the country.

Staph, or Staphylococcus aureus, are a kind of bacteria that attack wounds and cause life-threatening infections, such as blood poisoning and pneumonia. Methicillin-resistant S. aureus (MRSA) are “superbugs” that have evolved resistance to most commonly used antibiotics, so they are more difficult and expensive to treat.

The study, which is the first to examine the recent magnitude and trends related to staph and MRSA infections, found that such infections are now “endemic, and in some cases epidemic,” in many U.S. hospitals, long-term care facilities and communities. Study researchers say that control of the infection should be made a “national priority.”

Full Document (PDF; 192 KB)

Undocumented Immigrants as Taxpayers

Source: Immigration Policy Center

As the debate over illegal immigration continues to rage, some pundits and policymakers are claiming that unauthorized immigrants do not pay taxes and rely heavily on government benefits. Neither of these claims is borne out by the facts. Undocumented men have work force participation rates that are higher than other workers, and all undocumented immigrants are ineligible for most government services, but pay taxes as workers, consumers, and residents.

Full text (PDF; 62 KB)

In the Shadow of Globalization: Changing Firm-Level Employment Practices and Shifting Employment Risks in the United States

Source: UCLA School of Law, Law-Econ Research Paper

Globalization generates increased competition between firms in the product market, which induces firms to seek flexibility in their labor relations – flexibility to hire and fire on short notice, to increase or shrink the overall size of their workforce, to adjust pay to short-term performance results, to redeploy workers within the firm and to outside production partners, and to retain workers with particular skills on an as-needed basis. These practices are in tension with the labor law regimes throughout the Western world. In the United States, employers’ drive for flexibility has fueled aggressive de-unionization efforts, and has induced employers to increase their use of temporary workers and independent contractors and to restructure pension and benefit plans. A crucial question for employment regulation thus becomes how to protect workers – how to mitigate their vulnerabilities and ameliorate the shifting risks that today’s workplace practices impose. The author argues that other countries are experiencing the same tension between flexibility and worker protection, and suggests that we learn from other countries’ efforts to devise mechanisms to preserve worker security at the same time relaxing traditional labor protective regimes.

Full text (PDF; 184 KB).

IRS Issues Fall 2007 Statistics of Income Bulletin

Source: Internal Revenue Service

From press release:
The Internal Revenue Service today released the fall 2007 issue of the Statistics of Income Bulletin, featuring data from 134.4 million individual income tax returns filed for tax year 2005.

U.S. taxpayers reported $7.4 trillion of adjusted gross income less deficit in tax year 2005, up 9.3 percent from tax year 2004 when 132.2 million returns were filed.

Certain types of income posted strong gains between 2004 and 2005. Net capital gains climbed 41 percent and taxable interest rose 29.5 percent, while net partnership and S corporation income gained 27.3 percent.
Taxable income totaled $5.1 trillion in tax year 2005, up 10 percent from the prior year. Total income tax increased for a second straight year, rising 12.4 percent to $934.8 billion. Between tax years 2003 and 2004, total income tax rose 11.2 percent, the first increase in 4 years.

The alternative minimum tax (AMT) grew 33.7 percent between 2004 and 2005 to $17.4 billion. Four million taxpayers paid the AMT in 2005, compared to almost 3.1 million in tax year 2004.

Fall 2007 SOI Bulletin (PDF; 3.6 MB)

Everything You Ever Wanted to Know about the Iowa Democratic Caucus…But Were Afraid to Ask

Source: FairVote

Iowa Democratic Caucus

Quick Facts:
• If a Democratic candidate doesn’t reach the threshold of support necessary to win delegates (typically 15 percent, but sometimes higher) at a particular caucus, the candidate’s supporters usually switch to their second choice.
• Republicans choose candidates by secret ballot, but for Iowa Democrats, there are no ballots. All caucusing is done by physically standing with fellow supporters.
• The number of delegates up for grabs depends on how many Democrats voted in each precinct in the last gubernatorial and presidential elections.
• We may never know the raw vote count in the Democratic caucuses, or how the vote count changed after second choices come into play.
• The number of voters could be very small. In 2004, only 125,000 people participated in the Iowa caucus. On January 3, 2008, some sports fans may be lured away from the caucuses by the Orange Bowl, starting at 7 pm Iowa time.

EEOC issues fact sheet on employment tests and selection procedures to screen applicants, workers

Source: U.S. Equal Employment Opportunity Commission (EEOC)

Press release:

The U.S. Equal Employment Opportunity Commission (EEOC) today issued an extensive fact sheet on the application of federal anti-discrimination laws to employer tests and other selection procedures to screen applicants for hire and employees for promotion. The fact sheet describes common types of employer administered tests and selection procedures used in the 21st century workplace, including cognitive tests, personality tests, medical examinations, credit checks, and criminal background checks. The document also focuses on “best practices” for employers to follow when using employment tests and other screening devices, and cites recent EEOC enforcement actions. Discriminatory employment tests and selection procedures are prohibited by Title VII of the Civil Rights Act, the Americans with Disabilities Act, and the Age Discrimination in Employment Act — which are all enforced by the EEOC.

Employment Tests and Selection Procedures

Co-pays and Coinsurance Percentages for an Office Visit to a Physician for Employer-Sponsored Health Insurance in the Private Sector, by Firm Size Classification, 2002-2005

Source: Agency for Healthcare Research and Quality

In recent years, premiums for employer-sponsored health insurance have risen dramatically. However, premium costs are only one of several factors that determine costs of health care for enrollees. Other factors, such as whether an enrollee has a co-pay and the size of co-pays and coinsurance percentages, also contribute to differences in cost of care.

This Statistical Brief examines what percentage of enrollees had a co-pay and the amount of such co-pays and coinsurance percentages. Using private sector estimates from the Insurance Component of the Medical Expenditure Panel Survey, data for 2002 are compared to those for 2005. Estimates for small firms (fewer than 50 employees) and large firms (50 or more employees) are analyzed.

+ Full Document (PDF; 90 KB)