Permission to park: A statewide study of high school parking permits to determine compliance with graduated driver licensing law.

BACKGROUND: Motor vehicle crashes are the leading cause of fatality among teens in the United States. Beginning in the 1990s, many states enacted graduated driver licensing (GDL) systems to delay full licensure while allowing beginners to obtain experience under lower-risk conditions. Many high schools require parent and guardians of newly licensed teen drivers to complete a student parking pass application (PPA) for their son/daughter to drive, park, and transport themselves to and from school activities. The objective of this study was to describe the content of these PPAs for compliance with Connecticut's GDL law. METHODS: PPAs were requested via e-mail, fax, or telephone from all Connecticut's high schools (n = 233). PPA variables included school demographics, parking rules, prohibitions and sanctions for violations, as well as reference to GDL law. RESULTS: Seventy-four schools were excluded because students were not allowed to park and schools did not require PPAs or declined to send us a copy of their PPAs. Of the remaining 159 schools, 122 (76.7%) sent us their PPAs. Responding schools were more likely to be suburban or rural. Most PPAs included a section on prohibitions and sanctions for driving misbehavior. Forty-three percent prohibited students from going to car during school hours, and 34% prohibited driving off campus/parking lot. Seventy percent warned of consequences for dangerous driving in parking lot, and 88% included the possibility of revocation for infractions. Only 14% had any reference to Connecticut's GDL law on their PPAs. CONCLUSION: A small percentage of Connecticut high schools include information about GDL laws on their PPAs. All states should examine their PPA content and adopt a uniform high school PPA that includes key provisions of their state's GDL laws in an effort to promote teen driving safety. LEVEL OF EVIDENCE: Therapeutic study, level V.

Medicare and Medicaid users speak out about their health care: the real, the ideal, and how to get there.

To inform the design of an integrated health and social service program that will better coordinate care for individuals dually eligible for Medicare and Medicaid, a qualitative study was conducted using 13 focus groups. Participants consisted of a purposeful sample of dually eligible individuals (1) aged 65+ years (8 focus groups: N=71), and (2) aged 18-64 years with disabilities (5 focus groups: N=45), recruited in collaboration with the Connecticut Legislature's Medical Assistance Program Oversight Council and numerous community-based agencies across the state. Older adult participants included nursing home residents, community-dwelling healthy individuals and individuals with chronic illness or disability, family members of individuals with chronic illness or disability, and 1 community-dwelling group of Spanish-speakers. Younger adult participants included persons with physical, intellectual/developmental, and/or mental health disabilities, and parents, case managers, nurses, and residential managers of persons with intellectual/developmental disabilities. Through the constant comparative method, results clustered in 4 domains: current experiences, care coordination, consumer protection, and elements of an ideal health care program. Significant findings include difficulty finding providers who accept Medicare/Medicaid, medication management, age and racial/ethnic discrimination, and care coordination. Findings highlight the policy implications of designing a person-centered, coordinated dual coverage system. Desired elements of an ideal system include greater choice in providers of all types, including culturally competent medical and home care providers, increased coordination among medical providers and between medical and home care/social service providers, and a prominent role for pharmacists in counseling participants and in serving as part of care coordination teams. (Population Health Management 2015;18:123-130).