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Monday, May 18 2015

Full Issue

State Highlights: Stats Show L.A. County Nursing Home Probe Moving Slowly; Indiana's HIV Outbreak Offers Caution To Rural Areas

News outlets examine health care issues in California, Indiana, Florida, Nevada, North Carolina, Virginia, New York, Maine, Maryland, Pennsylvania and D.C.

Statistics released this week on investigations of complaints of abuse, neglect and poor conditions at California nursing homes and other health facilities show Los Angeles County lagging behind other areas of the state. Los Angeles County is the only county that handles such investigations itself. Elsewhere, the program is run by the state's Department of Public Health. The county's responsibilities will probably be scaled back under a new contract with the state beginning in July. That agreement is expected to provide more money for investigations 鈥 but not as much as county officials say they would need to do all the work currently required. (Sewell, 5/16)

This small, close-knit community is a picture of rural America, with stubble-filled cornfields and a Main Street lined by churches, shops and sidewalks. It's also the unlikely epicenter of the largest outbreak of HIV, the AIDS virus, in Indiana's history 鈥 and a warning to the rest of the nation. Public health experts say rural places everywhere contain the raw ingredients that led to Austin's tragedy. Many struggle with poverty, addiction and doctor shortages, and they lag behind urban areas in HIV-related funding, services and awareness. And the same lack of anonymity that gives rural towns their charm foments a strong stigma that discourages testing and treatment. (Ungar and Kenning, 5/17)

As they reviewed legislative issues affecting children, lawmakers and state agency heads said this week they will push again in 2016 for two key bills that died in the abrupt end to this spring鈥檚 regular session. An overhaul of the state鈥檚 mental-health system and an upgrade of early-learning programs topped a list of legislative priorities atWednesday鈥檚 meeting of the Florida Children and Youth Cabinet in Stuart. (Menzel, 5/15)

It鈥檚 been a long-running criticism made by health care unions against nonprofit hospitals: They don鈥檛 give enough in return for their hefty tax breaks. The debate fired up again last week as hundreds of members of the California Nurses Association marched at the state Capitol to promote the union鈥檚 legislative agenda, including a recent bill to toughen reporting requirements by nonprofit hospitals on how much community benefit they provide to support their tax-exempt status. (Sangree, 5/17)

The elderly, the blind and the physically disabled. Thousands of people in these groups in Clark and Washoe counties face major changes in the way assistive services are provided to them should Assembly Bill 310 鈥 sponsored by Nevada Assembly Majority Leader Paul Anderson, R-Las Vegas 鈥 become law. The proposed changes in the bill that would privatize the provision of services have raised concerns among advocates for those who would be affected, but Anderson said last week the bill isn鈥檛 going anywhere. However, the proposed legislation remains alive in the Assembly Ways and Means Committee and has been declared exempt, meaning it鈥檚 not subject to deadlines that can quash other bills. (Amaro, 5/17)

Though their party complains often about health insurance coverage mandates from Washington, Republicans in North Carolina's legislature are OK with adding more requirements upon state-regulated insurance companies. (Robertson, 5/17)

The number of people opting out of the state's managed-health care pilot program for "dual eligibles" 鈥 those who qualify for both Medicare and Medicaid 鈥 has been so large in its first year the savings is expected to be far less than the $44 million that had been projected. More than 40 percent of the 66,000 eligible statewide to enroll in Commonwealth Coordinated Care, a three-year pilot program that launched last March, have either opted out or disenrolled from the program. (Salasky, 5/17)

Patients know that when their doctor recommends a brand name pill, a generic alternative might save them a lot of money. But many newer specialty drugs don鈥檛 come in a pill: medications such as Enbrel for arthritis or Avastin for cancer are members of a new class of drugs called 鈥渂iologics,鈥 usually administered by injection. They鈥檙e expensive and don鈥檛 have cheaper generic alternatives. With a unanimous vote in the Senate today, North Carolina becomes one of a handful of states that have passed laws creating extra physician notification when a pharmacist dispenses a interchangeable biosimilar to a patient. (Hoban, 5/15)

Gov. Andrew M. Cuomo is expected to introduce on Monday two new measures in the State Legislature that would give regulators greater authority to punish nail salons that mistreat workers and make it easier for manicurists to acquire licenses. The legislation follows emergency rule changes ordered by Mr. Cuomo, a Democrat, last week in response to a New York Times investigation that uncovered the widespread exploitation of nail salon workers, many of whom experience serious health problems linked to the chemicals they work with regularly. The changes will subject salons in New York to some of the strictest health regulations in the country. (Maslin Nir, 5/17)

Lawmakers in Maine are considering changes to the state's policies regarding life-sustaining treatment for minors after an 18-year-old mother went to court last year to fight a state-imposed do-not-resuscitate order on her brain-damaged daughter. Legislators are examining a bill that would prevent the state from withholding life-sustaining treatment for a child in its custody unless the parent's rights have been officially terminated. Supporters say that will protect parental sovereignty and clarify a legal grey area that drew national attention last year when Virginia Trask sued the state after a child welfare agency won a judge's approval to make medical decisions on behalf of her daughter. (Durkin, 5/17)

In the far-west counties of the state, finding services for special-needs kids is a chore. The Family Support Network is up for the challenge. (Sisk, 5/18)

We're going to hear some ideas now from someone who's working on that long-term project, Leana Wen. She is an emergency physician, and four months ago she became Baltimore's health commissioner. In the days since the unrest, she's been talking a lot about the role of public health in addressing the city's ills. First on her agenda - reaching the people she sees as the most vulnerable. (Cornish, 5/15)

Every year, hepatitis C kills significantly more Americans than HIV. Yet the liver-attacking virus doesn't get nearly the popular respect, or trigger the same fears. That understated reputation will be both a help and a hindrance as the public health community tries to control the spread of the virus. New cases of hepatitis C rose 150 percent between 2010 and 2013 nationwide, and even more in New Jersey and Pennsylvania. (Sapatkin, 5/17)

Paramedic Ryan Ramsdell pulled up to a single-story house not far from Reno鈥檚 towering hotels and casinos in a nondescript Ford Explorer. No ambulance, no flashing lights. He wasn鈥檛 there to rush 68-year-old Earl Mayes to the emergency room. His job was to keep Mayes out of the ER. Mayes, who has congestive heart failure and chronic lung disease, greeted Ramsdell and told him that his heart was fluttering more than usual. "I had an up-and-down night," he said. (Gorman, 5/18)

Not long ago, a man who had covertly dealt pot in the nation鈥檚 capital for three decades approached a young political operative at a birthday party in a downtown Washington steakhouse. He was about to test a fresh marketing strategy to take advantage of the District鈥檚 peculiar new marijuana law, which allows people to possess and privately consume the drug but provides them no way to legally buy it for recreational use. Those contradictions have created a surge in demand and new opportunities for illicit pot purveyors. (Cox, 5/17)

In the past five years, roughly a dozen states have enacted laws barring local governments from requiring businesses to provide paid sick leave to employees. The number of states banning local minimum wages has grown to 15. And while oil-rich states such as Texas and Oklahoma are pursuing bills banning local restrictions on drilling, other states where agriculture is big business have been banning local limitations on the types of seeds sown for crops. It seems no issue is too small for businesses to take to capitol halls. (5/18)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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