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Am Fam Physician. 2003;67(5):919-920

Bush's 2004 Proposed Budget Includes Revised Medicare Fee Schedule

President Bush has proposed a $2.23 trillion budget for fiscal year 2004 that includes a Medicare fee schedule that uses actual data rather than estimates in current and previous updates that should result in higher updates for the next several years. However, the budget includes only $11 million for all Title VII Health Professions programs and does not include any funding for general training programs, including primary care, interdisciplinary community projects, and training for diversity and public health. The fiscal year 2004 budget increases funding for the Health Resources and Services Administration's Community Health Centers by $169 million to $1.6 billion with the goal of adding 1,200 new centers and increasing service to 6 million more people by 2006. The National Health Service Corps also receives a funding increase of $24 million, up to $213 million. Funding for the Agency for Healthcare Research and Quality (AHRQ) was decreased from $299 million to $279 million. The National Institutes of Health received a 2 percent increase over the fiscal year 2003 budget for a total of $27.9 billion. The NIH will make biodefense research its main priority while continuing to work on other priority issues such as cancer, human immunodeficiency virus, acquired immunodeficiency syndrome, diabetes, and Parkinson's disease. To read statements on the proposed budget by James Martin, M.D., president of the American Academy of Family Physicians (AAFP), go

Campaign Aims to Reduce Risk of SIDS-Related Deaths in Child Care Settings

The Healthy Child Care America Back to Sleep campaign was recently launched in an effort to reduce the risk of sudden infant death syndrome (SIDS) in family child care or center-based child care programs in the United States, where 20 percent of SIDS-related deaths occur. The partners in this campaign include the American Academy of Pediatrics (AAP), the First Candle/SIDS Alliance, and the CJ Foundation for SIDS, and will be sponsored by the U.S. Department of Health and Human Services (HHS) Child Care Bureau and Maternal and Child Health Bureau.

The annual SIDS rate has decreased by more than 50 percent since the AAP recommended that infants be placed on their backs for sleep. However, only 15 states in the United States have child care licensing regulations that mandate the AAP's recommendation in these settings. The goals of the campaign include providing technical assistance and resources to child care programs that promote the Back to Sleep message, raise awareness, and change practices, as well as supporting state child care regulations consistent with the AAP's recommendations. For more information on the campaign, go online

SCHIP Enrollment Increased 15 Percent to 5.3 Million Children in 2002

According to statistics from the HHS' Centers for Medicare and Medicaid Services, approximately 5.3 million children were enrolled in the State Children's Health Insurance Program (SCHIP) at some point during the fiscal year 2002, which was a 15 percent increase from the 4.6 million children who were enrolled at some point during the fiscal year 2001. The SCHIP program was created in 1997 to improve children's access to health insurance, many of whom came from working families with income too high to qualify for Medicaid but too low to afford private health insurance. The SCHIP law appropriated $40 billion in federal funds over 10 years. Since January 2001, HHS has approved more than 2,500 SCHIP and Medicaid waivers and plan amendments that have expanded eligibility to about 2.4 million people and enhanced benefits for about 6.5 million people. The original SCHIP law required states to return any unused funds from the previous three years. However, President Bush's fiscal year 2004 budget makes an estimated $830 million in unused SCHIP funds available to states to give them more time to take advantage of these funds. For a listing of SCHIP enrollment by state, go online

New ‘3-A-Day’ Campaign Promotes Importance of Adequate Calcium Intake

The American Dairy Association/National Dairy Council (ADA/NDC) recently launched the “3-A-Day” educational marketing campaign to stress the importance of eating three daily servings of dairy foods to ensure present and future bone health. The campaign will include the addition of the 3-A-Day logo on dairy products from major manufacturers and processors that are an excellent source of calcium, print advertisements in national consumer magazines, radio advertising, child-friendly 3-A-Day tips on school milk cartons, and in-store promotions. There will be a call-to-action to start eating 3-A-Day of dairy on 3-A-Day Day on March 3, which kicks off 3-A-Day Week (March 3–9). In addition to the ADA/NDC, the campaign has the support of the AAP, the AAFP, and the National Medical Association (NMA). For more information on this campaign, go online This Web site has sections for parents and health care professionals, and also provides information on correct dairy serving sizes and calcium information sheets.

Carolyn M. Clancy Named Director of AHRQ

Health and Human Services (HHS) Secretary Tommy G. Thompson recently announced the appointment of Carolyn M. Clancy, M.D., as the director of the department's Agency for Healthcare Research and Quality (AHRQ). Dr. Clancy served as acting director since March 2002 and will oversee the development of research that provides evidence-based information on health care outcomes, quality, cost, use, and access. Dr. Clancy also has served as director of AHRQ's Center for Outcomes and Effectiveness Research and as director of the Center for Primary Care Research where she helped develop the U.S. Public Health Service Primary Care Policy Fellowship.

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Copyright © 2003 by the American Academy of Family Physicians.

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