Reauthorizing SCHIP: Principles, Issues and Ideas from State Directors
This April 2007 Issue Brief describes the current views of SCHIP directors on key issues being considered in the reauthorization process. While it does not capture all of the views of all of the states on all issues relevant to reauthorization, it represents the views of most states on issues of priority concern to them.
The State Children’s Health Insurance Program (SCHIP) deservedly enjoys broad support as a successful program. That success rests on a legislative foundation enacted as a result of careful bi-partisan compromise. Title XXI of the Social Security Act established a federal-state partnership program with a delicate balance of state flexibility and core program requirements. SCHIP was created with the goal of providing health coverage for low-income, uninsured children. This essential program, now serving more than six million, is up for reauthorization this year.
Reauthorizing SCHIP is intended to inform federal policymakers working to review and renew SCHIP, as well as others concerned with its future, about the views of state SCHIP directors. It builds upon the 2005 report “Perspectives on Reauthorization: SCHIP Directors Weigh In.” These reports have been developed by the National Academy for State Health Policy (NASHP) through the generous support of the David and Lucile Packard Foundation as part of broader efforts to provide assistance for and report on state SCHIP programs over the past decade.
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For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
