PUBLIC POLICY ACTIVITIES

The United States boasts numerous federal and state agencies working on issues of public health. It likewise has private attorneys representing institutions and individuals whose personal and business lives occasionally intersect with issues of public health. The pace of interactions among these entities is generally slow and irregular. Not so, however, if a serious public health emergency arises. The attack of an infectious disease, bioterrorism agent, or other disaster quickens the pace, intensity, and importance of these interactions by several orders of magnitude. And yet these various agents, all working on issues of public health, seldom have time to come together and lay the groundwork for the sort of close cooperation and communication that a crisis demands. In March 2004, the Health Law & Policy Institute hosted a pioneering educational program intended to bridge the gaps and build relationships of trust between these actors in the public health arena. The conference, sponsored by the Centers for Disease Control and Prevention Public Health Law Program, the Texas Department of Health, the Health Law Section of the Houston Bar Association, and others, was a pilot program to be used by the CDC as a model for other states. For local health care attorneys and public health lawyers, the conference provided education about ways in which they can help their clients achieve greater preparedness for the legal and practical ramifications of a public health emergency in their communities. Medicare Part D THE FEDERAL MEDICARE PRESCRIPTION DRUG, IMPROVEMENT, AND MODERNIZATION ACT OF 2003 (MMA) will offer both challenges and opportunities for Texas. At the request of a legislator, the Institute prepared a briefing paper that will help legislators and state agencies to understand both the policy and budgetary implications arising from the MMA. For example, Texas should eventually benefit fiscally from the new provisions providing prescription drug benefits to dual eligibles (those eligible for both Medicare and Medicaid) through Medicare Part D, but Texas will incur significant expenses in administering a new lowincome Part D subsidy. Texas state retirement plans may also benefit from the subsidy provided to qualified retiree health plans.

EARLY CHILDHOOD DEVELOPMENT

IN COLLABORATION WITH THE TEXAS PROGRAM FOR SOCIETY AND HEALTH, a unit of the James A. Baker III Institute for Public Policy of Rice University, the Institute directed an analysis of policies related to early childhood education and development in the state of Texas. Research Professor Phyllis Griffin Epps prepared and presented the results at a summit on early childhood education in January 2004. The analysis will appear later this year in an edited publication examining the role and significance of early childhood education and development as a social determinant of health.