Archive for January 25, 2013

How Flu-Related Web Apps Help Protect Citizen Health

The annual flu pandemic usually peaks each January and February, and 2013 is no exception. According to data from the Centers for Disease Control and Prevention, there were 22,048 flu cases from Sept. 30, 2012 through that year’s end, and as of Jan. 9, 2013, more than 40 states experienced widespread flu infection.

Right now, it’s handy for public health officials to know about Web apps that can help citizens deal with the flu if their areas are hit. Earlier this month, Emergency Management magazine reported on four online tools that track the flu, and Government Technology reviewed two of them, Google Flu Trends and Flu Near You, and how they educate citizens about influenza and its spread.

Users visit the Google Flu Trends Web application to see a map of Google’s estimates on what areas of the world have the most flu sufferers. Google’s engineers theorize that flu sufferers are many of the same people who search for flu-related terms on Google. Consequently, Google staff estimate where the flu strikes strongest by taking the company’s own internal data on searches for flu terms and comparing it with official flu symptom data from organizations like the Centers for Disease Control and Prevention. 

Flu Near You allows users to fill out an online form about their flu symptoms, and the results populate an interactive map on the homepage. The data requested includes symptoms experienced and whether the user has been vaccinated yet. The website also discloses how many people in each state filled out the form, and users can see where local vaccination centers are. The site was created by a collaboration between Boston Children’s Hospital, the Skoll Global Health Fund and the American Public Health Association.

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Veterans Access Federal Benefits, Save States Millions

One man’s effort in Washington state to help veterans find federal benefits has grown into independent efforts by dozens of states. Repurposing an existing reporting tool, states are not only connecting veterans to better benefits, but also saving millions in Medicaid costs. 

Washington state’s Public Assistance Reporting Information System (PARIS) allowed them to identify war veterans who were enrolled in Medicaid but not taking advantage of federal veterans’ benefits. The state then notified them of the benefits to which they were entitled, and moved them off of state Medicaid and onto federal program.

Since 2004, Washington state has saved more than $30 million using this system, while helping veterans get access to more comprehensive care.

History of PARIS

PARIS, a 20-year-old system operated by the U.S. Department of Health and Human Services’ Administration for Children and Families, was originally intended to help states identify Medicaid recipients who were cheating the system by applying for benefits in multiple states.

In 2002, Bill Allman, then an employee of the Washington Department of Social and Health Services, began looking for a way to see if the veterans he was helping were eligible for federal veterans’ benefits.

The information he was looking for was in PARIS. Using the system in a way no one had thought to try before, Allman, now the president of PARIS, realized savings for his state and greater benefits for the veterans he was helping. Allman launched the Veterans Benefit Enhancement Project, now a core component of PARIS. He now advises more than 30 states looking to realize the same savings he found for the state of Washington.

“Medicaid dollars, particularly long-term medicaid dollars, are going up at the rate of 200 to 250 percent,” Allman said. “By 2015, it will go up by 300 percent.”

As Medicaid costs rise and an increasing number of veterans are unable to pay back their long-term care Medicaid loans, the state is often forced to put liens on veterans’ homes. There’s no reason for veterans to be put in a position like that, Allman said, especially when they may not need to be on Medicaid in the first place. “When we tell them about the benefits they’re entitled to, they always say the same thing,” Allman said. “They say, ‘Why did no one tell me about this before?'”

Following the PARIS mandate

All states are now required to participate in PARIS, per a 2010 mandate from the Centers for Medicare and Medicaid Services. Naturally, states want to get the most out of the system they are required to use, by following Allman’s lead. “I want every state to do this,” Allman said. With the Affordable Care Act, Allman pointed out, states will need to offer health care options to all citizens anyway, so it would be in the states’ best interest to shift some of the support to the federal level.

Officials in more than 30 states are now in various stages of implementing the Veterans Benefit Enhancement Project.

California ran a pilot program from 2009 to 2011. Limited to a handful of counties, the pilot  focused on veterans classified as 100 percent disabled, saving the state $1.6 million. A report on the pilot deemed the program cost-efficient and suggested that it be expanded.

One of the biggest challenges in California was dealing with large sets of overlapping data. While more than 16,000 matches were initially identified as potentially eligible to be moved to federal benefits, duplicates and other complications reduced that number to just 4,000. Of those, just 990 veterans were contacted to gather further information on their eligibility. In the end, just 24 veterans were taken off Medi-Cal and moved to federal benefits. The savings to the state were significant, however, and the veterans also benefitted as they could now pay living expenses with VA benefits, which never need to be repaid.

The program continues to be effective in California, but Manuel Urbina of the California Department of Health and Human Services Medi-Cal Eligibility Division said the state needs dedicated personnel in order to expand implementation. “For this to be successful,” Urbina said, “the state experience has been that you need people to do dedicated case management. … The return on investment equation is there. We didn’t invest hardly anything, and we got this large return, so the potential is there.”

Additional outreach needed

What the Veterans Benefit Enhancement Project does is very basic, Allman said. The program is simply identifying veterans who would benefit from federal funding and then educating them. The problem for states is identifying who those veterans are. A report by the U.S. Government Accountability Office (GAO) found that 62 percent of veterans may be eligible for enhanced monthly VA benefits, but only 22 percent of veterans receive those benefits. The GAO recommended that the VA conduct more focused outreach to educate veterans in order to address the disparity.

“It bothers me that states don’t do outreach on their own or that the VA doesn’t do some kind of national campaign to help veterans understand what the benefits are,” Allman said. “So I think it’s up to the states to do the outreach for the VA.” Being a veteran himself, and passionate about helping people, Allman said that the money states can save through this program has always been a secondary consideration to him. He concedes, however, that the potential savings is compelling motivation for states to educate their veterans and consider adopting his system.

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3 Social Action Projects to Watch in 2013

On Saturday Jan. 19, at Google’s headquarters in Mountain View, Calif. — called the Googleplex — 300 thought leaders from around the country gathered at The Intersection, a conference focused on innovation and collaboration.

At this event, six organizations presented social action projects, all of which were included in the 10 finalists for the Gratitude Awards — awards that recognize social entrepreneurs for their innovative efforts that focus on social action. The awards were established through The Gratitude Network venture philanthropy organization, which mentors and funds innovator social entrepreneurs in nonprofit and for-profit organizations, and hosts The Intersection conference. 

Of the six projects presented at The Intersection, these three are the ones to watch this year:

This nonprofit organization, which won the 2013 Gratitude Award at The Intersection event, aims to help “young global citizens” get the support they need to succeed. Through partner organizations and mentors, the young adults involved in the program can design and carry out a range of social action projects, learn 21st-century skills and receive micro-grants to support their projects.

The foundation’s website serves as an online crowdsourcing platform, similar to sites like Kickstarter and Citizinvestor, so donors can help fund projects. People can also view projects in progress, including a brief description of what the project is, where in the world it’s taking place, how much funding has been raised and how much more it needs to be completed. The site then showcases the completed projects and the respective partners that were involved.

One project was completed in Niger, Africa, to help a school and community create awareness about drinking safe water. The group that carried out the project, called Water Circle, did not request funding; however, according to its project page, the group created an advocacy campaign and conducted fundraisers to help support the drilling of borehole wells in villages in Niger.

To help young minds learn math skills, Motion Math developed a suite of mobile games that the organizations calls “rigorously educational, stylish and awesomely fun.”

The organization’s mission, according to its website, is to help children develop an intuitive mastery of math through a visual and physical understanding. The idea is to help children learn math as a stepping stone for other fields like science, technology and engineering.

One game available through Math Motion is called Hungry Guppy – designed for 3- to 7-year-olds — to help with learning addition. The game, available on iOS devices, costs $3.99 from the iTunes store. 

According to a study funded by a grant from the Noyce Foundation, fifth-graders’ fractions test scores improved by 15 percent after playing Motion Math for 20 minutes over a five-day period.

Like the name says, nonprofit organization OneGoal has one goal in mind – to help students graduate from college. And according to the organization, only 8 percent of ninth-graders living in low-income communities are expected to graduate from college by age 25.

The teacher-led college persistence program selects teachers who are nominated to participate in OneGoal. After teachers are selected, OneGoal program directors work with those teachers and their respective schools to then work with students (OneGoal fellows) to stay on track for college graduation.

According to OneGoal, 95 percent of its fellows have enrolled in college and 85 percent of alumni are on track to graduate from college to date. The program, which began in 2007 now currently serves 1,200 students. 

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San Francisco Posts Restaurant Health Inspection Data on Yelp

In an effort to improve public health and data transparency, San Francisco Mayor Ed Lee announced on Thursday, Jan. 17, a partnership with Yelp, a site that connects people with local businesses and restaurants. The goal? To link the city’s restaurant health score data with the popular restaurant review website — and to standardize health score data nationwide.

Yelp is currently doing a limited release, so some San Francisco restaurants already have their city health inspection score listed in their Yelp review. On Korean restaurant Cocobang’s Yelp page, for instance, a government health score of 92 out of 100 from Nov. 12, 2012, is visible above the hours of operation, as is a link to the full restaurant inspection report. 

And all San Francisco restaurants will have their health scores listed in the next couple of weeks, said Jay Nath, the city’s Chief Innovation Officer. Data from New York City and Philadelphia also is expected in coming weeks, according to a press release from Lee’s office.

“They want to make sure they do it right,” Nath said, adding that the past year was spent getting the company comfortable with investing in the idea. “That sometimes take time, right? [Yelp] has a lot of different directions that they’re thinking about, and for this to filter up and be embraced is a recognition on their part of how much impact it can make and how they can serve their customers better.”

For Lee, this new partnership with Yelp is another significant step in the open data movement. “By making often hard-to-find government information more widely available to innovative companies like Yelp, we can make government more transparent and improve public health outcomes for our residents through the power of technology,” he said in a prepared statement.

Other cities can pledge to implement the LIVES standard on, which is part of the Code for America Peer Network.

Doing so, said San Francisco Chief Innovation Officer Jay Nath, doesn’t require a tremendous investment.

“I think that most cities have this information,” he said. “They have inspections throughout their cities, they are throwing them in a database, and it’s really just constructing a report that pushes the information out.” 

And when a group of cities are aware of what one another’s doing, said Code for America Founder and Executive Director Jennifer Pahlka, “you can get so much more done by doing things together — and this is really a great example of that. Getting as many cities as possible to start publishing that food inspection data in that format – it’s a virtuous cycle.”

And the more platforms like Yelp are interested in publishing the data, Pahlka added, the more the cities are interested in publishing and providing in the standardized format. “And then the more cities that are providing it, additional platforms that then see it as valuable to integrate into their site or into their services, because it’s work that’s done not by a city necessarily but one change – one architectural change – and then you can have more and more of that data available to people. So the network plays a critical role in getting that virtuous cycle going.”

Image courtesy of Code for America

At the plan’s core is the creation of a new national open data standard called the Local Inspector Value-Entry Specification (LIVES), which would enable any city to voluntarily share restaurant inspections scores on Yelp or other websites to make that data more transparent.

Code for America was originally approached to spread the word about LIVES and the Yelp integration, but  Founder and Executive Director Jennifer Pahlka said the organization wanted to work with the network of cities with which it has relationships “to make this not just a New York and San Francisco thing, but something that’s available in Yelp nationally,” she said.

And Code for America’s interest isn’t just in having the information on Yelp. Pahlka said her organization wanted to make the data available “wherever consumers are making decisions about where to eat, because it’s pretty relevant information. So the fact that they [San Francisco] had done this as a data standard that other cities can publish to and that other platforms can then consume is fantastic.” 

Nath said the new LIVES data standards are similar to transit data standards developed by Google and the city of Portland, Ore., called  General Transit Format Specifications. These standards have enabled apps in multiple cities that allow users to map trips using public transit.

“Those apps would not be possible without this data standard,” Nath said. “That’s a really important piece of working toward the specification; it allows for anyone to utlize this information, and it makes it much easier to take this information and make it much more accessible.”

Maintaining open data on restaurant inspections is beneficial for consumers in numerous ways, according to Code for America. When the data is more accessible and user friendly, consumers can make more informed decisions based on how well a restaurant is adhering to food safety regulations. Opening up the data through Yelp can also help promote public health. Having that accountability should motivate and encourage restaurants to aim for better inspection ratings.

“Looking at the [Los Angeles] study that demonstrated a reduction in food-borne ilnesses associated with greater access to health inspection scores, in addition to the median score being raised — I think it’s really interesting to think about how access to information can change behavior and can produce better results,” Nath said.

The other benefit Nath says he hopes to see is that this partnership starts a culture change — that other cities recognize the value of data and of working together as cities to determine how to establish standards and interoperability.

“So it’s not just a conversation with people who are technical,” he said. “But mayors can now understand that data is of great importance, that we’re stewards of this really imprtant asset and that we need to work together as mayors and cities to standardize it and put it out there to provide better services for our constituents and citizens.”

Pahlka echoed that sentiment. “I think that data standards provide an opportunity for collaboration that’s very, very lightweight,” she said. “So when you have a network of cities that are aware of what each other’s doing, and then of course that happens through the Code for America Peer Network, it also happens through publications and just the general flow of knowledge.”

Photo via Jorg Hackemann /

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HHS Rebrands Health Exchanges as ‘Marketplaces’

As part of its campaign to increase public awareness about the Affordable Care Act (ACA), the U.S. Department of Health and Human Services (HHS) introduced some new terminology Wednesday: the entities formerly known as ‘health insurance exchanges’ — websites similar to Expedia or Orbitz where people can purchase health coverage — will now be called ‘health insurance marketplaces.’

It’s a subtle distinction, but one that could be key for branding purposes. Exchange is a wonky term, while marketplace will likely be more intuitive for the general public. To illustrate that point, Governing already commonly described the exchanges as “insurance marketplaces,” as did most other media outlets.

HHS Secretary Kathleen Sebelius made the transition official in a blog post published Wednesday, which coincided with a total relaunch of, the Obama administration’s online home for the ACA.

“Over the last two years we’ve worked closely with states to begin building their health insurance marketplaces, also known as exchanges…,” Sebelius wrote.

An HHS official told Governing that the department had begun using ‘marketplace’ in place of ‘exchange’ informally in recent months, and Wednesday’s announcement simply finalized the change.

“We felt simpler was better,”Jason Young, HHS deputy assistant secretary for public affairs, told USA Today in a story on the new branding campaign.

HHS could end up running exchanges in as many as 30 states in 2014, which could explain the renewed focus on public relations. So far, 17 states have committed to a state-run exchange, and two others will partner with the federal government for an exchange.

States have until Feb. 15 to decide if they want a partnership exchange. For those that don’t, HHS will be responsible for the whole operation, including public outreach.

Image via iStockphoto

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