21.   The House Republican plan also deleted the legal requirement that agencies provide preventive services to keep families together before placing a child in foster care.

22.   The money for the programs dried up when the state slashed its appropriations for preventive services last year.

23.   The state also paid localities extra money for so-called preventive services for troubled families where children were at risk.

24.   The shift occurred with the growth in managed health care and the free preventive services that came with HMO policies, Lake said.

25.   What Oregon has done is it focuses on the provision of preventive health care services and assesses an access to primary health care before serious health problems develop.

26.   Cost-effectiveness was measured as the cost of a preventive service divided by its medical effectiveness.

27.   Medical effectiveness was measured by calculating the deaths or injuries that could be delayed or avoided if the preventive service reached its entire target population.

28.   More women are getting mammograms, and more older Americans report getting preventive services like blood pressure checks, cholesterol screening and prostate exams.