Thursday, November 21, 2019

Colorado's Medicaid payment system is "endangering patients," hospitals claim

Posted By on Thu, Nov 21, 2019 at 4:33 PM

  • Shutterstock
State policies governing Medicaid patients are "endangering patients, putting their health information at risk, and ignoring the agreed-upon contracts and reimbursements with hospitals," which pushes cost of care onto hospitals, a group of hospitals executives said in a letter to Gov. Jared Polis on Nov. 21.

The letter, also addressed to the state's Department of Health Care Policy & Financing (HCPF), notes the signatories represent more than 80 percent of hospital care in Colorado.

The executives represent both hospital systems serving Colorado Springs — Centura Health which operates Penrose-St. Francis Health Services and UCHealth, which runs the city-owned Memorial Hospital System.

"At a time when we all need to work to reduce medical costs, Colorado’s Medicaid office is increasing health care expenses and providers’ losses, while overall Medicaid reimbursements have fallen to the lowest level in eight years – just 69% of overall costs," the letter says.

The hospital executives asks Polis and the HCPF to "work with us" to fix the problems within the next 90 days and that the state honor agreements made with providers.

At issue is how the state's Medicaid office reimburses hospitals for care and the mechanics of achieving that.

In the letter, the hospitals express concern the state has "lost its focus" on uninsured and Medicaid patients, "as evidenced by an 8% drop in Colorado Medicaid participants while the rest of the country saw only a 2.3 percent decrease."

Polis has boasted in recent weeks about the state's efforts to provide health coverage for Coloradans. Just a day ago, Polis issued a statement touting that because of health care reforms installed by the state under his leadership, citizens will save 20 percent on average when buying health insurance through the state exchange. He also noted the state's efforts to adopt a prescription drug importation program and work toward a public option.

But none of that affects how Medicaid patients are handled. The hospitals noted in their letter:

• HCPF’s new system requiring prior authorizations and reviews delay surgeries and admissions for "urgent health care needs" by a week or more, which impacts patients' outcomes negatively.

• While HCPF recently embraced a national standard for admission notification, it still requires manual upload or faxed information, antiquated means that place patients’ protected health information at risk, causes time delays and adds cost. "Our hospitals and systems have hired additional employees just to handle and fax this paperwork."

• Even if patient receives prior authorization, Colorado Medicaid may still deny a patient's claim, leading to months- or years-long appeals.

• Tens of thousands of claims for patients placed in observation for 48 hours have been denied since 2017, complicating the placement of patients for rehab and long-term care.

• HCPF regularly refuses billing responsibility for behavioral health patients, pawning it off on behavioral health organizations, which also refuse, resulting in patients being denied the post-hospital behavioral health care they need.

• HCPF’s refusal to reimburse hospitals for the cost of the drugs they administer to patients has caused hospitals to eat more than $30 million in losses since 2016. A single high-priced drug can lead to a loss of over $80,000 because HCPF reimburses less than hospitals' costs for the drug. "Nationwide, there is consistency among state Medicaid programs with high-cost drug policies to reimburse at 100%," the letter says. This concern dates to 2017.

The HCPF is run by former Gov. John Hickenlooper appointee, Kim Bimestefer, who ran a health care consulting company and before that she served as president of Cigna Mountain States.

We've asked Hickenlooper, who served from 2011 to January 2019 when Polis took over and is now running for U.S. Senate, to comment and will update when we hear from him.

We've also reached out to Polis' office for a comment and will circle back when we hear something.

Read the letter here:
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Wednesday, November 20, 2019

Corrected: ACLU sues GEO Group in immigrant's death at Aurora detention facility

Posted By on Wed, Nov 20, 2019 at 11:49 AM

The Aurora Contract Detention Facility faces an ACLU lawsuit. - JOSEPHROUSE / SHUTTERSTOCK.COM
  • JosephRouse /
  • The Aurora Contract Detention Facility faces an ACLU lawsuit.

The family of an immigrant who died at an Aurora detention center seeks damages in a wrongful-death lawsuit filed Nov. 12 by the American Civil Liberties Union of Colorado.

Kamyar Samimi died at the Aurora Contract Detention Facility, a for-profit detention center operated by GEO Group Inc., in December 2017. According to the lawsuit, Samimi had been taking methadone — a form of medication-assisted treatment for opioid use disorder — every day for 25 years before being arrested by ICE agents at his home in Thornton.

"Dr. [Jeffrey Elam] Peterson, the only full-time physician at the facility, cut Mr. Samimi off his methadone cold turkey," the ACLU's complaint says. "That action was medically unjustifiable. Then, Dr. Peterson failed to treat and respond properly to Mr. Samimi’s severe withdrawal symptoms."

The family — three children between the ages of 22 and 38 — seeks damages from both Peterson and the GEO Group, alleging "negligence, medical malpractice, wrongful death, and violations of the Rehabilitation Act."

In a statement provided to the Independent, a GEO spokesperson said the company "strongly rejects" the allegations in the lawsuit.

“The Processing Centers we manage on behalf of ICE are top-rated by independent accreditation entities, including the National Commission on Correctional Health Care, and provide high-quality residential care," the spokesperson said. "We are committed to providing a safe and secure environment for everyone in our care.”

Samimi was born in Iran in 1953 and entered the U.S. as a student in 1976, the lawsuit says. In 1979, he became a legal permanent resident.

Samimi's arrest on Nov. 17, 2017 was based on his conviction "for possession of a small amount of a controlled substance twelve years earlier. The immigration charge asserted
that Mr. Samimi’s twelve-year-old conviction rendered him removeable from the country," the lawsuit says.

The complaint paints a harrowing picture of Samimi's final days, in which medical professionals denied Samimi methadone and allegedly ignored his serious withdrawal symptoms and abdominal pain, until paramedics were finally called as Samimi lay on the floor vomiting blood.

"The sudden cessation of methadone violates the applicable professional medical standard of care, and causes excruciating withdrawal symptoms that include severe dysphoria, cravings for opiates, irritability, sweating, nausea, tremors, vomiting, insomnia, and muscle pain," the complaint notes. "It also leads to seizures in some cases. These symptoms can sometimes lead to life-threatening complications. Psychological symptoms of withdrawal may include decompensation, severe depression, and suicidality."

The Office of the Coroner for Adams and Broomfield Counties concluded in a January 2018 report, according to the ACLU's complaint, that Mr. Samimi died "of undetermined causes," but that emphysema and gastrointestinal bleeding "likely contributed" to his death.

"Methadone withdrawal cannot be ruled out as the cause of death,” the coroner's office noted.

In a detainee death review obtained by Rocky Mountain PBS in October, ICE's Office of Professional Responsibility, External Reviews and Analysis Unit found the detention facility "did not fully comply" with ICE standards for medical care, safety and security.

The review lists 12 deficiencies, which it states "should not be construed as contributory to the detainee's death."

They include:

• The facility's director of nursing and midlevel provider positions were vacant for longer than six months.

• Nurses administered less than half of the doses prescribed on an as-needed basis for Samimi's withdrawal symptoms.

• Samimi's possible withdrawal did not lead staff to conduct an initial provider assessment within two days of intake.

• Despite Samimi's life-threatening withdrawal symptoms, staff didn't transfer him to an emergency department in the week following intake.

• Staff did not complete an initial physical assessment during Samimi's 15 days at the facility.

• Staff did not complete a Medical/Psychiatric alert for Samimi.

• Samimi was not scheduled for a dental exam.

• The day Samimi died, the facility's physician did not answer or return two phone calls from medical staff.

• Nurses "failed to document administration of Samimi's medications on numerous occasions."

• Staff did not tell ICE's field office director about Samimi's withdrawal symptoms and deteriorating conditions.

• Staff did not obtain Samimi's informed consent before administering the anti-depressant and sedative drug Trazodone.

• During the 14 hours between Samimi's placement on suicide watch and his psychiatric evaluation, staff did not conduct a welfare check.

Correction: A previous version of this story incorrectly stated in the headline that the ACLU was suing ICE. The ACLU is in fact suing the GEO Group, and ICE was not named in the lawsuit.
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Wednesday, November 6, 2019

Cigarette, vaping taxes pass in several Colorado cities and counties

Posted By on Wed, Nov 6, 2019 at 3:35 PM

Cities and counties on the Western Slope passed new taxes on nicotine products. - SHUTTERSTOCK
  • Shutterstock
  • Cities and counties on the Western Slope passed new taxes on nicotine products.

Earlier this year, state lawmakers passed a bill allowing cities and counties to impose their own taxes on nicotine products without losing out on their share of proceeds from a state tobacco tax.

So, this fall, local governments across the state jumped at the chance to ask voters whether the government could collect new taxes, ostensibly aimed at curbing teen vaping.

Voters approved the measures by sweeping margins.

As part of their respective ballot initiatives, Crested Butte, Vail, New Castle and Glenwood Springs will impose a tax between $3 and $4 per pack of cigarettes, and a 40 percent tax on nicotine products other than cigarettes.

Crested Butte and Vail will tax $3 per pack, New Castle will tax $3.20 per pack and Glenwood Springs $4 per pack. Boulder, which has already banned flavored vaping products, approved a 40 percent tax on e-cigarette products.

Voters in Eagle, Summit and Pitkin counties also approved a nicotine tax mirroring the one passed in Glenwood Springs. Those counties' teen vaping rates are among the highest in the state, according to the 2017 Healthy Kids Colorado Survey.

That survey showed 27 percent of Colorado teens vape, the highest statewide rate in the country.

The new taxes come on the heels of a nationwide outbreak of a mysterious vaping-related illness that has claimed the lives of 37 people, according to the Centers for Disease Control and Prevention, which had logged more than 1,800 total cases as of Oct. 29.

Colorado has seen 11 cases of the vaping-related illness, according to the state Department of Public Health and Environment.

Out of the 1,364 patients nationwide for which the CDC has data on age and sex:
  • 70 percent are male.
  • The median age is 24, and ages range from 13 to 75 years.
  • 79 percent of patients are under 35 years old.
States reporting 100 or more cases include California, Utah, Texas and Illinois.

The CDC reports that most people affected by the outbreak reported vaping products that contained THC, the psychoactive component of cannabis. However, the CDC has not determined a cause of the illness.

Instead, the agency continues encouraging the millions of Americans who vape to stop vaping, though it has issued some new advice recently:
  • "If you are an adult using e-cigarettes, or vaping, products, to quit smoking, do not return to smoking cigarettes. Adults addicted to nicotine using e-cigarettes should weigh all risks and benefits and consider utilizing FDA-approved nicotine replacement therapies."
  • "If people continue to use an e-cigarette, or vaping, product, carefully monitor yourself for symptoms and see a healthcare provider immediately if you develop symptoms like those reported in this outbreak."
The CDC urges people not to buy black market vaping products, or modify products in ways not intended by the manufacturer.
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Wednesday, October 30, 2019

Trump administration limits fee waiver eligibility for would-be citizens

Posted By on Wed, Oct 30, 2019 at 4:04 PM

  • U.S. Department of Homeland Security
  • USCIS Acting Director Ken Cuccinelli.
In order to become naturalized U.S. citizens, immigrants must have been lawful permanent residents (green card-holders) for at least five years, speak English and pass a civics test.

They also must pay a $725 application fee — which since 2010 has been waived for people who receive public benefits through Medicaid, the Supplemental Nutrition Assistance Program (SNAP, or food stamps), Temporary Assistance to Needy Families, and Supplemental Security Income.

But an incoming change by U.S. Citizenship and Immigration Services means those who receive such benefits won't automatically be eligible for the fee waiver. Instead, fee waivers will be limited to those at or below 150 percent of the federal poverty level, or $25,365 per year for a two-person household. Applicants who successfully "demonstrate financial hardship" in some other way can still qualify.

Immigrant advocacy organizations threatened legal action in response to the move.

“Waivers of the $725 application fee make it possible for thousands of hard-working people to become U.S. citizens,” Anna Gallagher, executive director of Catholic Legal Immigration Network Inc., said in a statement from her organization. “This change is a roadblock on the path to the American Dream."

CLINIC estimates that 40 percent of people who apply for naturalization currently receive a fee waiver.

In an Oct. 25 statement announcing the change, USCIS argues that the changes were necessary given that income and eligibility requirements for public benefits vary from state to state.

"The revised fee waiver process will improve the integrity of the program and the quality and consistency of fee waiver approvals going forward," USCIS Acting Director Ken Cuccinelli is quoted as saying.

The agency estimates that the total dollar amount of fee waivers increased by more than $23 million between 2016 and 2017, from $344.3 million to $367.9 million. Last year, though, USCIS granted $293.5 million worth of waivers. Revenue from application fees accounts for more than 95 percent of the USCIS budget, the statement notes.

Unless activists secure a court injunction to stop the change from taking place, it will go into effect Dec. 2 for anyone applying for naturalization.

Sound familiar? The federal government has recently drawn ire with two other proposals that make it harder for people to upgrade their immigration status and receive public benefits.

A USCIS rule change allowing immigration officials to deny green cards to immigrants deemed likely to use public benefits was recently blocked in federal court. Opponents said it would discourage those in need from applying for nutrition and health care assistance.

Another proposed rule from the U.S. Department of Agriculture would mandate that individuals aged 18 to 59 making between 130 and 200 percent of the federal poverty level could no longer receive SNAP benefits. Parents in that income bracket could only receive SNAP benefits if they also qualify for at least $50 in other federal assistance each month.
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Wednesday, October 16, 2019

Where to get flu shots in Colorado Springs

Posted By on Wed, Oct 16, 2019 at 3:57 PM

  • Shutterstock
The Centers for Disease Control and Prevention recommends you get a flu shot before the end of October, but getting vaccinated remains worthwhile late into the year.

"The question is typically, 'Will it last? If I get it early, will it last through the season?' And the answer to that is yes," says Cynthia Wacker, manager of Mission Ministry & Outreach for Penrose-St. Francis Health Services. "It really does last — keeps that immunity for up to a year — but you do need to get a flu shot every year. It's critical."

Flu shots are especially important for members of high-risk groups, including children younger than 5, adults older than 65, pregnant women, nursing home residents and those with certain medical conditions. People from these groups are prone to complications such as pneumonia, bronchitis, and sinus and ear infections, according to the CDC.

But Wacker says the flu can affect everyone differently. For example, a 20-something with a poor diet might experience worse symptoms than a healthy, active senior.

Regardless of your own risk factors, don't just get a flu shot for yourself, Wacker says.

"It's important for your family," she points out. "If you're a grandparent, it's important that you are not going to get the flu so that your children don't get it, your grandchildren don't get it, the people in your church. All the people that you're around."

El Paso County Public Health recorded 458 influenza-related hospitalizations last winter. If that doesn't scare you, at least take pity on your neighbors, relatives and coworkers, and go get a dang shot.

Here's how...

Visit the HealthMap Vaccine Finder for a list of clinic locations. Your insurance should cover a flu shot without charging a copay, but may restrict the locations or health care providers — so check with your insurance provider if you're worried about that.

Most pharmacies charge around $20 to $45 per flu shot for people paying out of pocket.

Penrose-St. Francis Faith Community Nurses will also provide free flu shots for uninsured and underinsured adults, and children over 4 years old, at one-day clinics in various locations around the city.

The nurses have a limited number of free vaccines available, Wacker says, so they ask that if you do have insurance and can get a free shot elsewhere, to please do so.

Their remaining schedule for 2019 includes the following dates:

Wednesday, Oct. 16 from 10 a.m. to noon at Family Connections, 917 E. Moreno Ave.
Thursday, Oct. 17 from noon to 2 p.m. at Tri-Lakes Cares, 235 Jefferson St., Monument
Saturday, Oct. 19 from 5 to 7 p.m., and
Sunday, Oct. 20 from 9 a.m. to 2:30 p.m. at Our Lady of Guadalupe Church, 2715 E. Pikes Peak Ave.
Wednesday, Oct. 23 from 9:30 to 11:30 a.m. at Ecumenical Social Ministries, 201 N. Weber St.
Tuesday, Oct. 29 from 9:30 to 11:30 a.m. at Westside Cares, 2808 Colorado Ave.
Wednesday, Oct. 30 from 1 to 3 p.m. at Grace Be Unto You Outreach Church, 3195 Airport Road
Tuesday, Nov. 5 from 11 a.m. to 1 p.m. at the Marian House, 14 W. Bijou St.
Wednesday, Nov. 27 from 11 a.m. to 1 p.m. at Springs Rescue Mission, Thanksgiving, City Auditorium, 221 E. Kiowa St.
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Friday, October 11, 2019

Springs Rescue Mission shelters record number of homeless

Posted By on Fri, Oct 11, 2019 at 11:56 AM

Springs Rescue Mission sheltered a record number of guests Oct. 10. - THOMAS VOSS
  • Thomas Voss
  • Springs Rescue Mission sheltered a record number of guests Oct. 10.
On Oct. 10, Colorado Springs experienced an early cold snap with nearly an inch and a half of snow accumulation.

The National Weather Service in Pueblo recorded a low temperature of 14 degrees, beating the previous record of 17 degrees, set in 1946.

It was also a record-breaking day for Springs Rescue Mission, Colorado Springs' largest homeless shelter. The facility housed approximately 475 people experiencing homelessness Oct. 10 — shattering the shelter's previous record of 447, set in May, according to Chief Development Officer Travis Williams.

Daily shelter bed counts recorded by Colorado Springs homeless shelters show that Springs Rescue Mission had zero available beds, compared with more than 100 left unoccupied the previous night.

Williams attributes the increase to plunging temperatures that may have caught some people (who might have expected to sleep outside or in vehicles) by surprise. The previous day, Oct. 9, the Weather Service recorded 80-degree temperatures during the afternoon, which dropped to 32 degrees by 11:59 p.m.

While Springs Rescue Mission had to bring in mats to accommodate some of the shelter guests, Williams says that there's no reason the shelter couldn't find room for more people if needed.

He points out that if Greenway Flats, a permanent supportive housing facility, and Springs Rescue Mission's addiction recovery program are included in the totals, the nonprofit kept around 585 people out of the cold that night.

At the Salvation Army Shelter & Services at RJ Montgomery, zero men's beds and one women's bed was left open Oct. 10 — meaning around 200 beds were occupied. The Salvation Army had 22 family beds available, according to the shelter bed count.

The Place (formerly Urban Peak), a 20-bed shelter for youths ages 15 through 20, had three available beds. Family Promise, a family shelter, had zero beds open.

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Friday, October 4, 2019

CDC logs 275 more cases of vaping-related illness

Posted By on Fri, Oct 4, 2019 at 3:19 PM

  • Amani A /
The Centers for Disease Control and Prevention on Oct. 4 reported 275 more cases of "lung injury associated with e-cigarette use," bringing the total number nationwide to 1,080 cases.

It also announced six more deaths tied to the vaping-related health condition, now totaling 18.

Colorado added one case that incurred hospitalization, bringing the state's total number of cases to nine, according to the Colorado Department of Public Health and Environment. There have been no deaths tied to the lung injury outbreak in the state.

The CDC is now reporting that most people who suffered from the illness reported vaping THC, the psychoactive component of cannabis.

More information from the CDC:

• Out of the patients who died, the median age was 49.5. Deceased patients ranged in age from 27-71 years old.

• Out of the 889 patients for which the CDC has data on age and sex:
     - 70 percent are male.
     - The median age is 23. Patients range in age from 13-75 years old.
     - 81 percent are younger than 35.

• Out of the 578 patients for which the CDC has information on the substances vaped in the three months before they fell ill:
     - About 78 percent reported vaping THC. Thirty-seven percent reported vaping THC only.
     - About 58 percent reported vaping nicotine. Seventeen percent reported vaping nicotine only.

States reporting 50 or more cases include California, Utah, Texas, Minnesota, Wisconsin, Illinois and Indiana.

Despite months of investigation, the CDC says it still has not figured out what exactly is causing the illness, and continues encouraging all to "consider not vaping."
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Wednesday, October 2, 2019

Firefighters have "unacceptably" high levels of PFAS in blood, new report says

Posted By on Wed, Oct 2, 2019 at 1:26 PM

A state law banning PFAS-based foam doesn't apply to the military. - U.S. AIR FORCE/EDDIE GREEN
  • A state law banning PFAS-based foam doesn't apply to the military.
Per- and polyfluoroalkyl substances, or PFAS, a group of toxic chemicals found in firefighting foam, have polluted water supplies near 206 military installations where the foam was used, according to a map created by the nonprofit Environmental Working Group and researchers at Northeastern University.

Last year, a study showed that people who lived near one such site, Peterson Air Force Base, had abnormally high levels of PFAS — often called "forever chemicals" — in their blood years after water districts changed sources or filtration methods to make their water safe to drink.

Recent research now suggests PFAS also present a danger to firefighters.

According to a new scientific review by IPEN, a global nonprofit network of public interest groups, firefighters who've used PFAS-based foam have "unacceptably elevated blood levels" of two PFAS chemicals, perfluorohexane sulfonic acid (PFHxS)  and perfluorooctane sulfonate (PFOS).

Frighteningly, it's not just veteran firefighters who have elevated blood levels of PFOS and PFHxS.

"Elevated blood levels are found not just in longserving personnel who may have been exposed to legacy PFOS-containing [aqueous film forming foams, or AFFFs], but also in much younger firefighters and recruits who have never used or been trained with these foams," the report says. That could be equipment and training areas contaminated long ago by the "forever chemicals."

Most research showing PFAS has contributed to negative health effects in humans has focused on perfluorooctanoic acid, or PFOA (linked to cancer) and PFOS (linked to thyroid hormone effects).

Likewise, the Environmental Protection Agency has set a lifetime health advisory, or LHA, for PFOA and PFOS only, and has taken preliminary steps toward setting a legally enforceable maximum contaminant level, or MCL, for these two chemicals.

But the PFAS group contains hundreds of toxic chemicals. For many of these chemicals, little research has been done into the health effects they pose and their environmental pervasiveness.

IPEN's review goes so far as to say that PFHxS, a newer chemical found in PFAS-based firefighting foam, "is more bio-accumulative and hazardous in humans than PFOS.”

Researchers from the Colorado School of Public Health and Colorado School of Mines found last year that El Paso County residents who lived near Peterson Air Force Base for at least three years before 2015 (and were therefore exposed to contamination from firefighting foam discharges) had blood levels of PFHxS 10 times higher than the general U.S. population. They showed levels of PFOS that were twice as high as normal.

IPEN's report explains that when manufacturing company 3M phased out use of PFOS-based products, including firefighting foam and ScotchGard fabric and leather treatments, the PFAS chemicals perfluorobutane sulfonate (PFBS) and PFHxS replaced legacy PFOS in products such as stain repellents, surfactants and firefighting foams.

The “Firefighter Cancer Registry Act of 2018,” signed into law last year by President Donald Trump, "establishes and maintains a voluntary registry of firefighters to collect data on cancer incidence," the report notes. This registry could potentially aid research into the health effects of long-term PFAS exposure.

“Our firefighters and first responders are already asked to put themselves in harm’s way virtually every day,” Environmental Working Group Senior Scientist David Andrews said in response to the IPEN review. “Forcing them to use firefighting foams containing dangerous chemicals when there are alternatives that work puts their long-term health at unacceptable risk.”

Both the House and Senate versions of the National Defense Authorization Act — a bill to fund the military through 2020 — end the use of PFAS-based foams by 2023, an EWG statement notes. Manufacturers have developed some types of foams that don't contain PFAS that would presumably replace these foams.

But the military has so far resisted to switching to such "non-fluorinated" foam formulas. While the Department of Defense has completely phased out its original foam formula and replaced it with a new, supposedly safer formula using different PFAS. The Air Force's website explains that, so far, no non-fluorinated foam formula meets "performance criteria necessary to safeguard our Airmen from real time fire emergency responses."

PFAS-containing foams "are the most effective foams currently available to fight flammable liquid fires in military, industrial, aviation and municipal arenas," it continues. Chemical manufacturers also argue that the newer versions shouldn't be banned outright.

While Colorado lawmakers passed a bill earlier this year banning all PFAS-based foams (as have lawmakers in a few other states), the state bans don't apply to the U.S. military or the Federal Aviation Administration, which requires the foam's use at airports.
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Wednesday, September 25, 2019

Health Access Survey: Coverage rates steady, but other stats look troubling

Posted By on Wed, Sep 25, 2019 at 2:33 PM

Statewide, 30.6 percent of people had a surprise medical bill in the last year. - VOLODYMYR MAKSYMCHUK / SHUTTERSTOCK.COM
  • Statewide, 30.6 percent of people had a surprise medical bill in the last year.

On Sept. 25, the Colorado Health Institute released the first batch of results from its biennial Colorado Health Access Survey detailing a number of health coverage factors for Coloradans.

On the surface, the nonprofit's analysis notes, the numbers look good. Coverage rates remain steady, showing just 6.5 percent of Coloradans do not have health insurance. That's the same as in 2017, and represents a drop of nearly 8 percentage points from 2013, the year before the Affordable Care Act took effect.

In El Paso County, the uninsured rate actually decreased from 7.5 percent in 2017 to 5.6 percent in the latest report.

But "churn" — the percentage of people who lost, switched, or gained coverage in the past 12 months — edged slightly upwards.

"Churn can make it difficult for people to maintain continuity in their medical care," CHI's report says. "When churn increases, insurance companies and government programs have a harder time predicting the health needs of the people they cover."

Statewide, 19.1 percent of respondents experienced this, up from 16.5 percent in 2017. In El Paso County, "churn" increased from 14.5 percent to 18.6 percent. That means about 130,000 people in the county switched insurance or went without it for at least part of the year prior to when they were surveyed.

Also troubling from a statewide perspective: “Over 10 percent of Hispanics, over 11 percent of residents in some west slope communities, and nearly 12 percent of working- and middle-class families (those making $60-$75,000/year with a family of four) are uninsured," notes Adam Fox, director of strategic engagement for the Colorado Consumer Health Initiative, who is quoted in a Sept. 25 statement.

"With some rural Coloradans having only one insurance provider to 'choose' from, they can’t afford the premiums offered in a monopoly market," Fox continues. "Eighteen percent (up from 14 percent in 2017) expressed trouble paying medical bills."

While trends on mental health also appear worrying, they could be influenced by factors outside the survey's purview, such as decreasing stigma.

The share of people who reported poor mental health increased from 11.8 percent to 15.3 percent statewide, and from 12.1 percent to 14.6 percent in El Paso County. For the purposes of the survey, "poor mental health" was defined as "eight or more days of experiencing stress, depression, and problems with emotions out of the past 30."

But these stats "don’t necessarily mean that more people are experiencing poor mental health," the CHI report explains. "Instead, the rise could mean that more Coloradans are comfortable talking about their mental health, either because of increasing awareness of the topic or because most respondents took the survey online, rather than by phone, in 2019."

Below, view a profile of El Paso County (Health Statistics Region 4) based on the initial survey results. You can also visit CHI's website to see a statewide analysis and download profiles by region. CHI's next round of findings will be released in December.

Other useful links:

2017 Health Access Survey

2017 profiles by county and region

Correction Sept. 25: This story has been updated to reflect the correct source of the survey, Colorado Health Institute. A previous version incorrectly attributed the survey to the Colorado Consumer Health Initiative.
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PFAS study will look at health effects on El Paso County residents

Posted By on Wed, Sep 25, 2019 at 2:29 PM

Contamination of El Paso County water supplies stemmed from the military's use of PFAS-based firefighting foam. - U.S. AIR NATIONAL GUARD PHOTO BY AIRMAN 1ST CLASS AMBER POWELL
  • U.S. Air National Guard photo by Airman 1st Class Amber Powell
  • Contamination of El Paso County water supplies stemmed from the military's use of PFAS-based firefighting foam.

Researchers at the Colorado School of Public Health will study the health effects of toxic PFAS chemicals — found in firefighting foam used by the military — in residents of El Paso County, thanks to a $1 million federal grant.

Colorado is just one of seven states named in a multisite study into the health effects of the chemicals. Nationally, the study will recruit "at least 2,000 children aged 4–17 years and 6,000 adults aged 18 years and older who were exposed to PFAS-contaminated drinking water," according to a statement from the Agency for Toxic Substances and Disease Registry, which is funding the project along with the Centers for Disease Control and Prevention.

The Colorado School of Public Health, at the University of Colorado Anschutz Medical Campus in Denver, plans to recruit 1,000 adults and 300 children for the study. Previous research has found that people who lived in the Fountain and Security-Widefield areas, near Peterson Air Force Base, prior to 2015 have higher-than-normal levels of PFAS chemicals in their blood.

The research team will include experts from the Colorado School of Mines, Children’s Hospital Colorado, the Colorado Department of Public Health and Environment, and the University of Southern California, according to a statement from CU Anschutz.

John Adgate, chair of the school's Department of Environmental and Occupational Health and the co-principal investigator on the study, says it's not yet clear which members of the PFAS chemical group will be looked at, but the list will likely include "PFHxS, PFOS and PFOA, as well as a bunch of others."

Most extensive research into PFAS chemicals has so far been focused on PFOS and PFOA, while health effects of other PFAS aren't as well established.

"The El Paso County site is interesting because [the contamination is] mostly from firefighting foams, which results in people having elevated blood levels of what's known as PFHxS and PFOS," Adgate explains.

Adgate and his research team found last year that study participants who'd been exposed to the contamination had blood levels of PFHxS about 10 times as high as U.S. population reference levels. Levels of this chemical were also higher than those for residents in other communities exposed to PFAS.

That study included 220 blood samples from people who lived in Fountain or Security-Widefield for at least three years prior to 2015, when PFAS-based firefighting foam from Peterson contaminated the drinking water. This time, the study will likely also include people who lived in the Stratmoor Hills area just southeast of Colorado Springs, Adgate says.

Fountain, Security-Widefield and Stratmoor Hills water districts have all switched to different sources or added treatment systems in the past few years, so the public water supplies are now safe to drink.

Unfortunately, though, that doesn't mean residents who've lived in the area for a while no longer have PFAS — often called "forever chemicals" — in their bloodstreams.

"What's unique about this site is that exposure stopped, but people — because of the persistence of these compounds — people still have, I think, relatively high body burdens," Adgate says. "I'd like to think of it as kind of an unfortunate natural experiment, and it's my hope that the results of the study will provide some peace of mind to people in terms of what their levels are and whether or not it affects their health."

The study will examine health factors including lipids, kidney function, liver function, thyroid and sex hormones, glucose and insulin parameters, markers of immune function, and neurobehavioral outcomes in children.

"We are really excited to have Dr. Adgate spearheading this," says Liz Rosenbaum, who leads the Fountain Valley Clean Water Coalition, a citizens' group advocating for clean water. Rosenbaum notes that many of the residents concerned about their exposure have already worked with Adgate to have their blood tested.

Soon, those residents could have a better idea of what the elevated levels actually mean for their health.

Based on conversations with residents, Rosenbaum believes kidney cancer and autoimmune diseases are among the most common health concerns in El Paso County, and those she's spoken with fear their conditions are tied to the PFAS chemicals previously found in public drinking water.

Rosenbaum says she hopes the study will lead to more research — and an eventual federal ban on PFAS in food packaging.

The Fountain Valley Clean Water Coalition helped to pass a state bill this spring that restricts fire departments from using PFAS-based foam. As part of that legislation, the Colorado Department of Public Health and Environment is holding policy work group meetings through February to discuss how the state should address the chemicals.

The coalition's "next plan of attack," Rosenbaum says, is passing a state bill that would lengthen the statute of limitations for reporting PFAS contamination.

Lawsuit looms for PFAS manufacturers

Meanwhile, a Colorado Springs law firm is participating in a massive class-action lawsuit meant to hold chemical companies accountable for their role in polluting the environment.

At a recent meeting of the Fountain Valley Clean Water Coalition, attorney David McDivitt of McDivitt Law Firm updated attendees on the status of the case.

McDivitt's firm teamed up with Napoli Shkolnik, a personal injury law firm in New York, to file suit against 3M, the manufacturer of the firefighting foam that contaminated water supplies in El Paso County (and at other sites near military installations around the country).

The case was consolidated with other class-action suits concerning PFAS manufacturers and moved to Charleston, South Carolina, where District Judge Richard Gergel on Oct. 4 will hear from scientific experts on both sides in an effort to understand the nature of the contamination before hearing arguments.

Gergel has said the case could represent an "existential threat" to 3M, DuPont and other manufacturers named in the lawsuit.

Still, the road ahead won't be easy. One of the plaintiffs' biggest challenges, McDivitt says, will be overcoming the "government contractor defense," which 3M will likely use to say it's not liable for health effects of PFAS products since it was commissioned by the military to make firefighting foam.
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Wednesday, August 21, 2019

Importing drugs from Canada may be a pipe dream

Posted By on Wed, Aug 21, 2019 at 12:00 AM

  • Shutterstock
Colorado’s effort to legalize the importation of drugs from Canada as a cost-saving measure for patients could be in trouble.

Canadian officials say they haven’t been consulted on the program, which also is being pursued by Florida, the Colorado Sun reports.

Our neighbor to the north could pass a law blocking prescription drug exports or add the drugs to its export control list, which would complicate Americans obtaining drugs from Canada.

Not surprisingly, PhRMA, the pharmaceutical industry trade group, and the Healthcare Distribution Alliance, oppose it.

Even without those roadblocks, several steps remain for approval by the United States Department of Health and Human Services, including drafting rules, taking public comment and finalizing those rules.

On the other hand, the Trump administration appears to support creating rules for states to set up programs to import prescription drugs from Canada.
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Monday, August 19, 2019

Should you buy a Breathalyzer?

Posted By on Mon, Aug 19, 2019 at 4:47 PM

  • Shutterstock
Should you buy a Breathalyzer?

If you've ever asked yourself that question, now might be your best chance to answer in the affirmative. A device that measures your blood alcohol content can keep you out of jail — and more importantly, save lives — if you heed its warning before getting behind the wheel.

Plus, the Colorado Department of Transportation has partnered with BACtrack to offer Coloradans a 50 percent discount through September, or while supplies last, on personal Breathalyzer-type devices.

The BACtrack Mobile Pro device for sale is not necessarily cheap — $49.99 after the discount — but it just might be worth it.

I mean, think about the possibilities. Not only can you make sure you aren't too drunk to drive, but you can annoy all your friends at parties by forcing them to test their blood alcohol content before they leave.

State and local agencies across the state are conducting extra enforcement operations to catch impaired driving between Aug. 16 and Sept. 3. Last August and September, 44 people were killed in crashes involving impaired drivers — accounting for more than 20 percent of impaired driving-related fatalities for the year, according to a statement from CDOT.

During last year's Labor Day DUI enforcement period, 936 impaired drivers were arrested in Colorado.

Colorado laws specify that a BAC above 0.05 percent can land you a citation for Driving While Ability Impaired (DWAI), and a BAC above 0.08 percent equates to a Driving Under the Influence (DUI) citation. (If you have consumed any amount of alcohol, and appear impaired to a police officer, you can get a DWAI citation even when your BAC is below 0.05 percent.)

BACtrack's personal device integrates a police-grade device with a mobile app, and it looks pretty nifty. It'll even help you estimate how long it will take for your BAC to hit 0 percent. Check it out here.

Not in the market at the moment? The Foundation for Advancing Alcohol Responsibility offers a "Virtual Bar" to provide estimates of what your BAC could look like after consuming different amounts of alcohol and food, based on your height, weight and age.

For example, if I took a shot of tequila right now, the Virtual Bar estimates that my BAC would be 0.068 percent — enough for a DWAI. But if I'd had some pepperoni pizza 15 minutes before drinking, it would be around 0.047 percent. (Probably still a little too close for comfort.)

If you're bored at work, it doesn't hurt to check out the Virtual Bar. And if what you find surprises you, maybe you should buy a Breathalyzer.
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Thursday, August 15, 2019

Rabies found in Rainbow Falls bat, impacted visitors urged to get help immediately

Posted By on Thu, Aug 15, 2019 at 3:06 PM

Bats, like this one, can carry rabies. - COURTESY EL PASO COUNTY PUBLIC HEALTH
  • Courtesy El Paso County Public Health
  • Bats, like this one, can carry rabies.

A bat with rabies was found at the Rainbow Falls Historic Site on the western edge of Manitou Springs, El Paso County Public Health reports.

Any people or pets who may have come into contact with a bat in the area are urged to immediately contact the Public Health Communicable Disease Division at (719) 578-3220. Vaccines are available for people who have been infected with rabies, a virus that can be fatal if allowed to progress to its later stages.

According to the Centers for Disease Control and Prevention:

The first symptoms of rabies may be very similar to those of the flu including general weakness or discomfort, fever, or headache. These symptoms may last for days.

There may be also discomfort or a prickling or itching sensation at the site of the bite, progressing within days to acute symptoms of cerebral dysfunction, anxiety, confusion, and agitation. As the disease progresses, the person may experience delirium, abnormal behavior, hallucinations, hydrophobia (fear of water), and insomnia. The acute period of disease typically ends after 2 to 10 days. Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive. To date less than 20 cases of human survival from clinical rabies have been documented, and only a few survivors had no history of pre- or postexposure prophylaxis.

Here's the full release:
El Paso County, CO – A bat found at the Rainbow Falls Historic Site near Manitou Springs was recently confirmed to have rabies, making it the 12th animal to test positive for the disease in El Paso County this year. People who may have come in contact with, or had their pets come in contact with, the bat are encouraged to contact the Public Health Communicable Disease Division at (719) 578-3220.

Rabies is a virus that infects wild mammals, especially bats, raccoons, skunks and foxes. Squirrels and rabbits are not considered a rabies risk. The disease is more common in the summer months, and El Paso County Public Health urges people to protect their pets and families by taking the precautions listed below.

“We want to make sure that everyone remains safe around wildlife,” said El Paso County Public Health Communicable Disease program manager Kimberly Pattison. “People should stay away from animals that are acting abnormally, like a bat that is outside during daytime hours or unable to fly. Strange behaviors are indicators that the animal might be sick. The best practice is to always keep yourself and your pets at a safe distance from wildlife.”

Rabies is a viral disease that affects the brain and other parts of the central nervous system, causing brain swelling and damage, and is nearly always fatal once symptoms appear. Rabies spreads primarily through the bite of rabid animals, via infected saliva. Rabies can also be spread when saliva from an infected animal gets into open wounds, cuts or enters through membranes of the eyes, nose, or mouth.

Preventive vaccination is available for people known or suspected to have been bitten by a rabid animal. It is important for people bitten or scratched by an unfamiliar animal to contact their doctor immediately.
Rainbow Falls Historic Site is on the west side of Manitou Springs. - EL PASO COUNTY
  • El Paso County
  • Rainbow Falls Historic Site is on the west side of Manitou Springs.
Take these precautions to prevent rabies:

Vaccinate your pets against rabies by using a licensed veterinarian. Rabies shots must be boosted, so check your pet’s records or talk to your veterinarian.
When walking or hiking with your dog, protect them and wildlife by keeping your dog on a leash.
Keep cats and other pets inside at night to reduce the risk of exposure to other domestic animals and wildlife. Keep dogs within your sight (in a fenced yard, or on leash) during the day while outside.
Contact your veterinarian promptly if you believe your pet has been exposed to a wild animal.
Do not touch or feed wild animals. Wild animals such as skunks and foxes adapt to residential environments if food is available – please do not leave pet food outdoors.
• If people or pets are bitten or scratched by an aggressive wild or unknown animal, call your doctor and report to El Paso County Public Health.
Bat bites can be difficult to detect. If you find a bat in your house and are unsure how long it has been there, do not release the bat. Contact Public Health at 719-578-3220.
• If you encounter a lost or stray dog or cat, contact the Humane Society of the Pikes Peak Region for options at (719) 473-1741.

So how common is rabies in our area? The Health Department provides these statistics:
Reports of Confirmed Rabies in El Paso County, Colorado (2010-2019)

2019: 12 (3 bats, 7 skunks, 1 fox, 1 dog)

2018: 67 (6 bats, 60 skunks, 1 raccoon)

2017: 28 (7 bats, 21 skunks)

2016: 3 (bats)

2015: 6 (5 bats, 1 cat)

2014: 10 (bats)

2013: 8 (4 bats, 2 foxes, 2 skunks)

2012: 3 (bats)

2011: 15 (5 bats, 1 fox, 9 skunks)

2010: 17 (8 bats, 4 foxes, 5 skunks)
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Officer-involved shooting update: Police release body cam footage

Posted By on Thu, Aug 15, 2019 at 1:21 PM

A group gathers in front of City Hall Aug. 5 to protest the shooting death of De'Von Bailey. - FAITH MILLER
  • Faith Miller
  • A group gathers in front of City Hall Aug. 5 to protest the shooting death of De'Von Bailey.

The Colorado Springs Police Department has released the body cam footage from officers involved in the Aug. 3 shooting of De'Von Bailey. WARNING: Graphic material.

CSPD OIS August 3 2019 from COS Police Department on Vimeo.

—————-UPDATE TUESDAY, AUG. 13—————

The Colorado Springs Police Department and El Paso County Sheriff's Office have committed to releasing the body-worn camera footage by the end of the week, in the following joint statement from Aug. 9 (emphasis added):
Following the Sheriff’s Office’s announcement on the pending conclusion of its investigation in the Devon Bailey case next week, CSPD anticipates releasing body worn camera footage from two responding officers at that time. The footage scheduled for release captured the moments leading up to, including and immediately following the shooting. As the releasing authority, CSPD has committed to releasing the footage only at such a time when it will not jeopardize or compromise the investigative or judicial process. We thank the community for its patience as we work through the process required to effectively investigate an officer-involved shooting.

New developments emerged in the death of De'Von Bailey, a black teenager shot by at least one Colorado Springs Police Department officer Aug. 3.

Mayor John Suthers released the following statement Aug. 6 (emphasis added):
The City of Colorado Springs and CSPD recognize the concerns of many citizens of our community following the officer-involved shooting of Devon Bailey on Saturday night. It is in the best interest of everyone involved, and our entire community, to ensure that the incident is fully and effectively investigated and an appropriate conclusion is reached. We know that there can be frustration with the time this takes, but we cannot compromise the investigation by failing to spend the appropriate time gathering the facts; that would serve no one.

We pledge that the City and CSPD will work cooperatively and diligently with the investigating agency, the El Paso County Sheriff’s Office, to ensure a thorough evaluation of the evidence, and there is a robust process in place to accomplish this. The evidence gathered by the EPSO will be provided to the district attorney who will review the evidence and apply the Colorado law regarding use of force by police officers. The DA can decide whether or not to bring charges or refer the matter to a Grand Jury to make the determination. If the DA decides not to charge an officer with criminal conduct, he is required by law to issue a public report explaining his findings. A Grand Jury, in its discretion, can issue a report concerning its decision.

A credible investigation and charging decision takes time and I ask the community to exercise patience as we allow the investigative and judicial process to work.

On Aug. 7, the Gazette published surveillance video that appears to show the shooting. In the video, a black man is seen running away from two white officers before he collapses and slumps forward.

A third officer picks up an unknown object from the ground and takes it to Bailey.

While the officers were reportedly wearing body cameras, the El Paso County Sheriff's Office will not release body-worn camera footage at this time, nor is it the agency that will release the footage, says Natalie Sosa, a sheriff's office spokesperson.

"Once we complete our investigation, we turn those findings over to the district attorney's office," Sosa says.

After the DA makes a decision about the officer-involved shooting, the police department could decide to release the body-worn camera footage, says Lt. James Sokolik, a police department spokesperson.
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Tuesday, August 13, 2019

Peak Vista receives $1.5 million from El Pomar Foundation for new Southeast clinic

Posted By on Tue, Aug 13, 2019 at 3:58 PM

Peak Vista Community Health Centers received a $1.5 million grant from the El Pomar Foundation to help finance its new medical clinic in Southeast Colorado Springs.

The funding, to be paid out in three annual installments of $500,000, will help pay for extensive renovations for the Health Center at Jet Wing.

In other Peak Vista news, Dr. Lisa Ramey, the nonprofit’s former senior vice president of medical services, moved into a new role as chief medical and dental officer.

In addition to leading the medical, dental and behavioral health departments at Peak Vista, Ramey will “focus on effectively and strategically promoting the well-being of the organization to community partners for the benefit of all community members,” the nonprofit noted in a statement.
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