Resources: Accessibility and Health Reform

The Association of Programs for Rural Independent Living (APRIL) has posted an outpatient accessibility form and guidebook, the Outpatient Health Care Usability Profile V4, for health care facilities. The form is a self-assessment that quickly generates a picture of accessibility for any type of building and could be used beyond the health care field. It covers accessibility to bathrooms, elevators, hallways, ramps to the building entrance, among others. However, the guidebook only discusses federal requirements; state and local regulations may be more stringent. Transportation to the facility - an assessment of whether transit, taxi service or other services are available - is not mentioned, but could be added.

For information about ADA paratransit eligibility, the National Transit Institute has a course on this topic and Easter Seals Project ACTION has an upcoming series of distance learning classes about ADA paratransit.

Health Care Reform

The Children’s Health Fund has posted a link to the video of the Kaiser Family Foundation's event last week, What Does the Election Mean for Health Reform and Other Health Issues?

For information on what states must accomplish and are doing to fulfill the mandates of the new health care law, the National Governors' Association (NGA) has created a website, the Health Reform Implementation Resource Center, a product of the State Consortium on Health Care Reform Implementation (State Consortium), which provides information and technical assistance to states about requirements, offers options and best practices and synthesizes feedback to federal agencies on issues that affect state implementation. The website has resources on aspects of the health reform law that are likely to have the biggest effect on states – the Medicaid expansion, the establishment of health insurance exchanges, insurance regulations, and delivery system initiatives, along with important governance, coordination and timing issues for states are available from NGA and on each of the Consortium members' websites.

The four consortium organizations are: National Governors Association (NGA), including the NGA Center for Best Practices, National Association of Insurance Commissioners (NAIC), National Association of State Medicaid Directors (NASMD), and National Academy for State Health Policy (NASHP).

Health care guidance for individuals is available from AARP. It's health reform fact sheets offer information about a wide range of changes and implications for consumers, particularly older adults.

External Costs of Auto-Dependent Lifestyle and Advances of Zero-Emission Modes

The American Public Health Association (APHA) follows up its 2009 report about the important link between transportation and public health. In At the Intersection of Public Health and Transportation: Promoting Healthy Transportation Policy, APHA turned its attention to mobility options, including public transit, walking, and biking. APHA questioned the current design of communities, the allocation of transportation dollars, and the paucity of public health funding to encourage mobility options that promote health.

Now APHA attempts to start quantifying the health-related external costs of auto-dependency in The Hidden Health Costs of Transportation. The report recommends a re-thinking of the current federal funding allocations that primarily support an inherently unhealthy mode of transportation.

A considerable increase in transportation investments is needed to offer more balanced and affordable modes of transport including biking, walking and public transit. Currently 80%of federal transportation funding goes toward building highways and improving road infrastructures, and approximately 20% goes toward public transit andmotor vehicle safety programs.

This report dovetails nicely with the Department of Transportation (DOT)report, The National Bicycling and Walking Study: 15–Year Status Report, which finds a considerable increase in biking and walking, with a reduction in fatalities. However, walking represents only about 10 percent of all trips, while biking, with all its increases and public relations, comes in at a measly (approximately) one percent.

The report does a good job of describing the available resources and explaining the limitations of its data collection and statistical findings.