Ohio Health Policy Review

Ohio turns down federal HIV education grant money

Ohio is one of only two states in the nation turning down $1.25 million in federal grant money intended to prevent HIV infections in teenagers. (Source: "Ohio doesn't accept federal money to fight HIV in teens," Plain Dealer, Oct. 30, 2007.) Ohio education officials say they don't think they qualify for funds because "they don't have the staff and don't have an HIV prevention program approved by the legislature." Ohio evidently received the HIV money for about 12 years but dropped out in 2000 after legislators raised concerns about explicit language and promotion of condoms in a teacher-training program. The state legislature then approved a law "requiring that education programs stress abstinence as the only 100 percent effective protection against sexually transmitted diseases."

Advocates for HIV/AIDS education in schools question the decision not to pursue the grant money. Marcia Egbert, a senior program officer for health and human services at the Gund Foundation, said "I don't think we have the luxury, given how AIDS and HIV numbers have spiked (in Cleveland), to miss any opportunity to get better education and to get better support into the state." According to the article, new cases of HIV/AIDS in Cuyahoga County jumped sharply in 2005 to 239, the highest number since 1997. There were 227 new HIV cases in the county in 2006. 

State launches awareness campaign on addiction, mental illness

The Ohio Department of Alcohol and Drug Addiction Services (ODADAS) launched its "Think Outside the Stigma" campaign yesterday, designed to boost public awareness of addiction and mental illness. (Source: "Ohio campaign aimed at reducing stigma for addiction, mental illness," Cincinnati Enquirer, Oct. 30, 2007.)  According to Angela Cornelius, director of ODADAS, "The bottom line is treatment works, people recover and Ohioans are worth the investment."

The key messages of the statewide campaign are that alcohol and drug addictions and mental illnesses are "treatable; can affect anyone; and are brain diseases. In addition, individuals with brain diseases should not be discriminated against." (Source: Gongwer Report, Oct. 30, 2007.) According to ODADAS, "every dollar spent on addiction prevention in Ohio saves about $7 by reducing lost job productivity, crime, child abuse and neglect and homelessness." In addition, the agency says that more than 650,000 Ohioans went without necessary treatment for alcohol abuse in 2005 while 228,000 Ohioans didn’t receive drug treatment.

Medicare to pay doctors more if they use health information technology

The Bush administration wants to recruit 1,200 doctors across the country who are willing to remove "the paperwork from their medical practice in return for higher Medicare payments." (Source: "Electronic Health Records Get Boost," Associated Press, Oct. 29, 2007.) During the test project, tasks such as ordering prescriptions or recording lab tests results would be done electronically; those physicians who use the technology most aggressively and score the highest in an annual evaluation would also receive the highest payment increases. According to the article, "Many health analysts believe widespread use of electronic health records will reduce medical errors and could potentially slow soaring health care expenses. Yet only about 10 percent of doctors in solo or small-group practices use such records. Upfront costs for putting in place such computer systems can range from $20,000 to $40,000."

Partnership to Fight Chronic Disease launches Ohio chapter

The Partnership to Fight Chronic Disease, a coalition of patient, health care, business and labor groups, are urging political leaders to focus on chronic diseases, one of the leading causes of skyrocketing health care costs. (Source: "Chronic disease costs: $1 trillion a year" The Daily Briefing, Columbus Dispatch, Oct. 29, 2007.) According to the Partnership, chronic disease accounts for more than "75 cents of every dollar spent on health care in the United States and is the No. 1 cause of death and disability."

The Partnership, which launched an Ohio chapter this week, was founded by health economist and former Clinton health policy advisor Kenneth Thorpe with former U.S. Surgeon General Dr. Richard Carmona and former Medicare chief Mark McClellan. The Partnership's Ohio chapter will officially launch on Thursday, November 1 with a news conference at 10 p.m., followed by an Ohio Advocates for Health Care Access (OAHCA) meeting with Thorpe and others. The news conference and meeting will be held on the 31st Floor of Riffe Center in Columbus. To register, contact Stephanie Pavol at (614) 220-8659.

Cleveland named one of America's most sedentary cities

Forbes Magazine has named America's most sedentary cities and Cleveland is on the list at number 19. As they state, "In recent years, Cleveland has planned for a more sustainable future, with better-connected neighborhoods and added bike paths and greenways, among other goals. At the moment, though, it's fighting to keep its weight down--63% of residents are either overweight or obese, and 22% don't exercise regularly. They also spend 29 hours a week watching TV." (Source: Cleveland profile, Forbes, Oct. 29, 2007.) The rankings were created "by collecting data on body mass index (BMI), physical inactivity and TV watching habits for the country's 50 largest metropolitan statistical areas." Columbus wasn't included in the calculations due to insufficient data. The most sedentary U.S. cities were Memphis, New Orleans, and Las Vegas. (Source: "America's Most Sedentary Cities," Forbes Magazine, Oct. 29, 2007.)

Health worries over heavier high school football players

According to an Associated Press report, "High calorie diets, almost year-round weightlifting and more intense competition have made 300-pound high school football players more common in northeast Ohio, bringing concerns from doctors and athletic officials that unhealthy eating patterns and obesity among student-athletes will carry into adulthood." (Source: "Heavier high school football players worries health officials," Oct. 27, 2007.) For example, fourteen players at Stark County's 20 high schools weigh more than 300 pounds, and 46 players weigh at least 270 pounds, weights not seen during the 1970s, while a recent study from Iowa found that 9% of that state's high school football players were obese. "The heaviest Ohio State player weighed 278 pounds 25 years ago, and 20 years ago, no player on the Cleveland Browns weighed as much as 300." Since overweight children and teens are at an increased risk for joint problems, heart disease, high blood pressure and diabetes, there is worry about the long-term effect of these weight gains.

Ohio cardiac death rate drops from 2005 to 2006

According to an analysis of statewide cardiac mortality statistics, which primarily include heart attacks, the cardiac mortality rate in Ohio was 199.3 deaths per 100,000 people last year, down from 224.2 in 2005. (Source: "Fatal heart attacks soar in Wood County," Toledo Blade, Oct. 29, 2007.) The analysis, based on Ohio Department of Health statistics and completed by Dr. William E. Feeman, Jr., showed that while the overall death rate from heart problems in the state fell, some counties reported a large increase in deaths. For example, Wood County had the 12th-highest cardiac mortality rate last year among all Ohio counties, up from a 38th ranking in 2005. According to Pamela Butler, commissioner of the Wood County health department, one explanation for Wood County's increase may be that 2006 was the first year death certificates in Ohio had to list a specific cause of death, not just "natural causes" or another vague explanation. 

Ohio Civil Rights Commission mandates maternity leave

New mothers working for employers with five or more employees will be entitled to 12 weeks unpaid leave under a new policy approved by the Ohio Civil Rights Commission. (Source: "Ohio Civil Rights Commission approves unpaid maternity leave," Columbus Dispatch, Oct. 25, 2007.) Employers with four or fewer employees, or those who can demonstrate a worker is "economically necessary" would be exempt. For thirty years, state law has stated that women are allowed a reasonable amount of time off for pregnancy, but the commission said that language was too vague. The policy would automatically becomes law "unless it is invalidated by a 10-member legislative committee when it meets later this year. If no action is taken by the Joint Committee on Agency Rule Review, the rule becomes state law within 41 days of being filed." (Source: "Maternity leave to be expanded," Cincinnati Enquirer, Oct. 25, 2007.)

Ohio business leaders said the commission "may have overstepped its authority by attempting to redefine Ohio pregnancy-leave law without approval from the General Assembly." The Ohio Chamber of Commerce said the commission lacks the statutory authority to pass such a rule and disputes the commission's opinion that the new policy can be accomplished at no cost to employers. Tony Fiore, director of labor and human resources policy with the Ohio Chamber of Commerce, said small companies will have to continue paying health benefits to the employee on leave while also hiring temporary workers and holding jobs open for new mothers. Further, he said, the change discriminates against new fathers who might want to take a comparable paternity leave.

Revised SCHIP bill up for new vote

The U.S. House is expected to vote as early as today on a revised State Children's Health Insurance Program (SCHIP) bill. (Source: "House to Vote on New Version of Child Health Bill," NY Times, Oct. 23, 2007.) In an attempt to win over Republican votes, Democrats have made several "minor changes" to the proposed law. While the bill would still cover 10 million children and increase spending on the program by $35 billion, for a total of $60 billion over the next five years, the new bill would "tighten eligibility for the program, generally barring the use of federal money to cover illegal immigrants, childless adults and children of families with incomes exceeding three times the poverty level: $61,950 for a family of four."

The Bush administration has signalled their desire for a compromise on the bill. Michael Leavitt, the secretary of health and human services, said the administration was willing to accept a $20 billion increase in spending on the program over the next five years, halfway between the $5 billion increase initially proposed by Mr. Bush and the $35 billion increase in first SCHIP bill, which Buch vetoed.

Talks underway in Cleveland for solution to crowded ERs

The Cleveland Clinic and University Hospitals have joined talks with regional officials in Cuyahoga County on the two nonprofit health systems treating more ER patients, which might "curb crowding at the county's public hospital emergency department." (Source: "Clinic and UH pressured to treat more ER patients," Oct. 24, 2007.) The conversations are still in the early stages and no definitive plans have been set. Cuyahoga County Commissioner Tim Hagan said that the constant rise in patients at MetroHealth (Cuyahoga County's public hospital emergency department) is not sustainable and that "Those (other) hospitals have a responsibility to share the financial burden."

According to the article, "The growing tension around health care in Cleveland epitomizes what some call a national health care crisis in which hospitals--especially those known for providing free care to the needy--are struggling to treat a growing number of uninsured." To handle this growing patient load, MetroHealth built a new emergency department in 2004, which initially served 67,600 patients annually and was constructed to accommodate up to 100,000 a year. Only two years later, the new department saw a 35 percent increase in patients and served 91,000 patients, just below the total number the department can handle. In comparison, the numbers of patients treated at University Hospitals and the Clinic's Cleveland campuses have remained relatively flat, although "University Hospitals reports that emergency departments at its main hospital and Rainbow Babies and Children's Hospital are treating as many patients as they can."