Ohio Health Policy Review

Allen County Board of Health decides to close its Child Health Clinic

On Friday May 8th, the Allen County Board of Health voted 6 to 1, with one member abstaining, to close its Child Health Clinic at the end of May (Source: "Health board decides to close children's clinic," The Lima News, May 9, 2008).  Its clinic currently serves 575 chilrden. 

Those supporting this decision cited two reasons for closing the clinic.  One reason is the diminishing need for its safety net services.  The Board reports that there is enough capacity between local physicians and the Allen County Health Partners, a federally qualified health center, to meet the needs of these children.  According to Allen County Health Commissioner, David Rosebrock, "It's a little different situation out there, and the safety net we've been providing we don't feel is necessary any longer. That decision can be revisited if we find there are continuing problems."

The second reason is financial.  The clinic had been using grant money from the Ohio Department of Health to help support the direct care it provided.  However, changes in ODH rules now only allow the money to be used for non-direct care, such as social work visits.  This change in grant rules requires the Health Board to find $100,000 in additional funds to run the clinic.

Board member Wilfred Ellis vehemently opposed the decision.  Among his objections, Ellis stated, "when you have patients with social issues, who miss appointments because they have other situations, the time allotted to address these situations may not be able to be managed by practices. A lot of practices just don't have the time to do that."

New report examines state of children's health in Franklin County and Ohio

Nationwide Children's Hospital released a new report today that highlights the health and well-being of children in Franklin County (Source: "Hospital reports sad facts on kids' health," The Columbus Dispatch, May 1, 2008).  The report's also includes comparison data for Ohio and the U.S.

On the 9 indicators with state and national level comparison information, Fraanklin County has better outcomes than the rest of Ohio and the U.S. on 4 measures (immunization, smoking, teenage smoking, and unintentional injuries.  Franklin County has a similar outcome on the asthma indicator with Ohio, and both Franklin County and Ohio are worse than the U.S.  For health insurance coverage, Franklin County has the highest level of Ohio's metropolitan communities, but it is still much better than the U.S.

Franklin County has much worse outcomes for infant mortality, adolescent homicide, and teenage pregnancy. The report also found that a sizeable percent of the youth of Columbus and Frankling County are overweight and that the number of overweight children has tripled in the past 30 years.

The issues that has the greatest area of attention is weight and physical activity.  According to Dr. Steve Allen, CEO of the hospital, "We know that it's not something they outgrow; 80 percent who are overweight or obese when they're 10 will be overweight or obese when they're adults,"

The data for the 10 indicators of child health included in the report are:

Infant mortality: (deaths per 1,000 live births) 8.4 Franklin, 8.3 Ohio, 6.9 U.S.

Immunization (fully immunized at 19-35 months) 86% Franklin, 84% Ohio, and 81% U.S.

Asthma: (children with asthma) 10% Franklin, 10% Ohio, and 9% U.S.

Smoking: (9th-12th graders who smoke) 14% Franklin, 24% Ohio, 23% U.S.

Teen pregnancy (births per 1,000 to 15-17 year olds) 25.9 Franklin, 19.6 Ohio, 21.4 U.S.

Unintentional injuries (rate of death per 100,000) 10.1 Franklin, 21.2 Ohio, 21.5 U.S.

Teen suicide (rate per 100,000) 7.5 Franklin, 11.6 Ohio, 10.3 U.S.

Adolescent homicide (rate per 100,000) 20.1 Franklin, 9.8 Ohio, 12 U.S.

Access to health care (children without health insurance) 7% Franklin, 5% Ohio, 9% U.S.

Obesity (overweight children) 30% Columbus, 25% Franklin,

Cincinnati Health Department home visiting program cuts infant mortality rate

The Cincinnati Health Department released an analysis showing that the infant mortality rate for women participating its home visiting prental care program was more than half overall infant mortality rate in Cincinnati, 5.3 deaths per 1,000 live births compared to 13.1 deaths per 1,000 live births (Source: "Care cuts mortality in children," The Enquirer, April 19, 2008).  According to Cincinnati's Health Commissioner Noble Maseru, "It's all the monitoring and going into the homes and talking to the mothers and providing that human interaction that is vital to having success with the mothers and their newborns. Our outreach workers are very key to the process, and their work is integral if we're going to keep lowering that infant mortality rate."

Groups protest naming of Nationwide Children's Hospital emergency dept.

"Nationwide Children's Hospital in Columbus has drawn criticism from a coalition of children's advocates that contends the hospital went too far in agreeing to name a new emergency department and trauma center after a locally based retailer in exchange for a $10 million donation." (Source: "Children's Advocates Protest Naming Gift to Ohio Hospital," Philanthropy News Digest, March 13, 2008.) "The coalition, made up of fifteen organizations and eighty individuals, including the Campaign for a Commercial-Free Childhood, Parents for Ethical Marketing, and several pediatricians, has asked the hospital to reconsider its 2006 decision to name the new center after Abercrombie & Fitch, the youth retailer known for its provocative advertising. The group contends that naming the center after the company would send the wrong message to the community. Groundbreaking for the building is scheduled to take place later this year."

School-based health centers making difference in Greater Cincinnati area

The Cincinnati Enquirer examines school-based health centers in the Greater Cincinnati area. (Source: "More schools offer expanded health centers," Cincinnati Enquirer, March 10, 2008.) The centers, "set up to help students in medically underserved communities get basic health care they might not otherwise be able to access," are funded by the Health Foundation of Greater Cincinnati. According to a new study from the foundation, the health of students who regularly use the centers improved to the point that they were among the healthiest in their schools.

Staffed by registered nurses and nurse-practitioners, the article states that the centers are more than old-style school nurses' offices. In addition to cuts and bruises, the centers also "perform physicals, help students manage diseases such as diabetes and asthma and hook students up with dental care, mental-health counseling and other health care." The Health Foundation is now taking applications to add six new centers at local schools over the next three years. While the initial program was only open schools offering grades K-8, the next round of applications will be open to high schools. More information on applying for the program can be found by contacting the Health Foundation of Greater Cincinnati.

Feds: All kids advised to receive flu shots

A new recommendation from the federal Advisory Committee on Immunization Practices says that all kids between the ages of 6 months and 18 years should receive flu shots. (Source: "All kids advised to get flu shots," Columbus Dispatch, Feb. 28, 2008.) "The change, likely to be made no later than the 2009-2010 flu season, would bring a huge expansion in national guidelines. Both the flu shot--which has been abundant in recent years--and the nasal vaccine may be used in children. At the moment, the Centers for Disease Control and Prevention recommends the vaccination of children 6 months to 5 years old, people 50 or older and those at highest risk of complications from flu." The Dispatch article quoted Dr. William Barson, an infectious-disease specialist at Nationwide Children's Hospital, as saying that vaccinating children helps protect their families and others from getting sick.

Strickland criticizes feds SCHIP rejection

In Washington D.C. on Tuesday to testify before the House Energy and Commerce Committee, Gov. Ted Strickland "criticized the Bush administration for blocking an expansion of a government health insurance program to cover uninsured Ohio children." (Source: "Strickland criticizes federal denial of health insurance expansion," Gannet News Service, Feb. 26, 2008.) Strickland said the Centers for Medicare and Medicaid Services' rejection of an Ohio plan to expand Medicaid eligibility for children in families up to 300% of the federal poverty level was a "clever bureaucratic maneuver" which denied coverage to an estimated 20,000 children. He also criticized several regulatory changes made in the Medicaid program which, while saving the federal government money, will drive up costs in Ohio and decrease the equality of care.

Regional forums on family violence prevention

A series of regional forums on family violence prevention will be held around Ohio starting in early March. The forums, hosted by the Health Policy Institute of Ohio with funding support from the Anthem Foundation of Ohio, aim to present the findings and recommendations in the recently released White Paper on Improving Family Violence Prevention in Ohio and create dialogue around this issue.

For specific dates, locations, and registration information, follow these links:

• March 7th in Canton
• March 14th in Athens
• April 4th in Youngstown
• April 11th in Cleveland
• May 2nd in Toledo
• May 9th in Lima
• May 16th in Cincinnati
• May 23rd in Zanesville

Report examines family violence and prevention efforts in Ohio

A new report commissioned by the Anthem Foundation of Ohio with support from the Health Policy Institute of Ohio examines family violence in Ohio, providing an in-depth look at the issue and recommendations on how to improve prevention efforts. According to the White Paper on Improving Family Violence Prevention in Ohio, last year in Ohio more than

• 64,000 children were abused or neglected;
• 166,000 people were physically or sexually assaulted by an intimate partner;
• 29,000 elders were abused or neglected.

Among all Ohio residents, at least 14% of children will be maltreated at some point before age 18. In addition, nearly one in four women will be a victim of intimate partner violence in her lifetime, while at least 3 percent of elders will be abused. Each year family violence directly costs Ohio more than $1.1 billion in health care and social services. Moreover, family violence is linked to a surprisingly wide range of outcomes, from lost worker productivity and housing instability, to smoking, obesity and chronic disease.

The white paper was created by the Ohio Family Violence Prevention Project, a group of academic researchers, agency personnel and practitioners with decades of experiences in dealing with family violence. Project directors were Kenneth Steinman, assistant professor at The Ohio State University College of Public Health, and Timothy Sahr, Director of Research at the Health Policy Institute of Ohio. For more information on the project and paper, please see the related press release or download the paper and executive summary.

Ohio resubmits more modest SCHIP expansion plan to feds

A month and a half after the federal government rejected Ohio's original request for an expansion in the State Children's Health Insurance Program (SCHIP), the Strickland administration has "asked federal regulators to approve a more modest expansion of Ohio's popular children's health insurance program. The state is proposing to offer insurance to children living in families earning up to 250% of the federal poverty level--$42.925 a year for a family of three--beginning April 1. Eligibility for Ohio's SCHIP program currently is capped at 200%." (Source: "Try, Try Again," Columbus Dispatch Daily Briefing, Feb. 4, 2008.) The state expects the expansion will bring an additional 8,168 children into the program this year and 10,750 more next year.