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Health

 

Wisconsin is second state in region with Medicaid work requirement

by Tim Anderson ~ November 2018 ~ Stateline Midwest »
Wisconsin has received federal approval of changes to its Medicaid program that include requiring work for some enrollees and charging higher premiums based on the results of a health risk assessment. The approved waiver centers on childless adults applying for and receiving coverage through the public health insurance program. According to The Washington Post, Wisconsin also had originally sought to become the first state in the nation to impose drug tests on some of its Medicaid population. This requirement did not receive federal approval.
The state, however, can compel applicants to fill out a health-and-wellness questionnaire. The premiums charged to childless adults will vary depending on responses to questions such as whether they wear a seat belt, smoke cigarettes or use illegal drugs.
Wisconsin also joins Indiana and three other U.S. states with some type of Medicaid work requirement in place. (Kentucky’s law has been blocked by a federal judge.) According to the Kaiser Family Foundation, Kansas, Michigan, Ohio and South Dakota have similar proposals being considered by the U.S. Centers for Medicare & Medicaid Services.

 

 

To address the opioid epidemic, Wisconsin launches pre-booking diversion pilot program in select areas

by Jon Davis ~ November 2018 ~ Stateline Midwest »
Three Wisconsin law enforcement agencies are beginning a statewide experiment in gettingpeople who commit nonviolent crimes because they’re addicted to drugs into treatment rather than prison. The “Pre-Booking Diversion Pilot Program,” a key recommendation in a 2016 report of the Governor’s Task Force on Opioid Abuse, will split $267,000 in state funding annually over two years between a sheriff’s office and two city police departments. More »

 

 

Michigan adopts law — for now — ensuring workers paid sick time

by Tim Anderson ~ October 2018 ~ Stateline Midwest »

Michigan is the first state in the Midwest with a law requiring employers to offer paid sick time to their workers. But after the legislative vote, it was unclear how long the new measure would stay on the books. The Earned Sick Time Act began as an initiative petition and was scheduled to be on the November ballot. However, the Michigan Constitution gives the Legislature the opportunity to consider proposed ballot initiatives. Legislative approval of paid sick time came in early September — meaning no statewide vote on the measure.
According to The Detroit News, the Legislature could return later this year and “gut” the Earned Sick Time Act. Amending a voter-approved ballot measure, on the other hand, would have been much more difficult. For now, though, under the new law, an individual will receive one hour of paid sick time for every 30 hours worked. In a given year, a worker will be able to use up to 72 hours of sick time — paid at his or her normal hourly wage. This cap falls to 40 hours per year for workers at businesses with nine or fewer employees.
According to the National Partnership for Women & Families, 10 states outside the Midwest already have laws mandating paid sick days.

 

To increase farmers’ insurance options, two Midwest states try ‘coop,’ ‘association’ models

by Carolyn Orr ~ September 2018 ~ Stateline Midwest »
Residents living in more than half of the nation’s counties have only one insurer to choose from on their state’s Affordable Care Act health insurance exchange. This lack of options is most prevalent in rural areas: 41 percent of enrollees in non-metro counties vs. the overall rate of 21 percent, according to the Kaiser Family Foundation. Could the creation of agricultural cooperative health plans help fill insurance gaps, offer more choices for consumers and lower costs? More »

 

Indiana puts perinatal ‘levels of care’ standards into state law to reduce infant mortality

by Jon Davis ~ September 2018 ~ Stateline Midwest »
Earlier this year, Gov. Eric Holcomb signed SB 360, making Indiana the third Midwestern state to enshrine in state law a perinatal “levels of care” rating system for hospitals and birthing centers. SB 360 requires the Department of Health to create a program to certify levels-of-care designations for obstetrics and neonatal care for hospitals and facilities that provide birthing services. They will be measured in six categories ranging from organization to obstetric capabilities, personnel, equipment and medications. More »

 

Illinois expands legal use of medical cannabis to fight opioid crisis

by Tim Anderson ~ September 2018 ~ Stateline Midwest »
Illinois residents dealing with chronic pain have been given an alternative to opioids — medical marijuana.
SB 336 was signed into law in August. It provides certain individuals 21 and older with temporary access to the state’s existing medical cannabis program. This access is contingent on a licensed physician certifying that the individual has a condition for which opioids might be prescribed.
Participants must then register at a state-licensed dispensary. Dispensations are limited to 2.5 ounces every 14 days and cannot exceed 90 days per physician certification. The goal of the new law is to curb opioid addiction; according to the Illinois Department of Public Health, opioid deaths in the state increased 13 percent from 2016 to 2017.
Four other Midwestern states — Michigan, Minnesota, North Dakota and Ohio — have broad laws legalizing medical marijuana, Governing magazine reports. Earlier this year, the Minnesota Department of Health released a study showing that among patients using medical cannabis for “intractable pain,” the use of opioid medications fell by 38 percent. In June, Michigan added chronic pain to its list of debilitating medical conditions that qualify a person for the medical use of marijuana.

 

On measures of child well-being, 3 Midwest states rank near top

by Tim Anderson ~ August 2018 ~ Stateline Midwest »
In this year’s edition of a much-cited, comprehensive study of child well-being, Minnesota (fourth), Iowa (fifth) and Nebraska (ninth) ranked among the top-10 U.S. states. Results in the “2018 KIDS COUNT Data Book” (a project of the Annie E. Casey Foundation) are based on 16 indicators in four areas: economic well-being, education, health, and family and community. No Midwestern state ranked lower than 33rd (Michigan).
The region fared particularly well in the category of economic well-being, which is based on measures such as median family income and the percentages of children living in poverty, parents without secure employment, families receiving public assistance, and households with a high housingcost burden. North Dakota (first), Nebraska (second), Iowa (fourth), Minnesota (fifth), Kansas (eighth), South Dakota (ninth) and Wisconsin (tenth) all ranked in the top 10.
The data book’s national analysis points to positive trends since 2010 in areas tied to a child’s healthy development — for example, lower poverty rates, a slight increase in the percentage of young people with health insurance, and higher graduation rates. However, “KIDS COUNT” researchers also note that “troubling disparities persist among children of color and those from low-income and immigrant families.”

 

 

Dose of reality: How Canada's health care system really works

by Jon Davis ~ August 2018 ~ Stateline Midwest »
The reality of Canada’s health care system is different from the single-payer model sought by some U.S. liberals or the kind of government-controlled system often feared by U.S. conservatives, and different even from what many Canadians believe, Manitoba’s top health officials told lawmakers during a session at this year’s Midwestern Legislative Conference Annual Meeting. More »

 

School-based mental health care seen as way to better identify students in need, improve access

by Tim Anderson ~ August 2018 ~ Stateline Midwest »
For his first job out of college, psychologist Mark Weist went to work at a mental health center, splitting his time between providing services at the center and a local school. The differences in the two settings were dramatic. “At the mental health center, people weren’t showing up,” Weist, a professor of psychology at the University of South Carolina, said during a presentation at this year’s Midwestern Legislative Conference Annual Meeting. “We’d be scheduled to see six or seven families in a day, for example, and only somewhere between one and three showed up. “But in schools, there was this tremendous pent-up need for services.” More »

 

Midwest's legislators adopt resolution calling for greater mental-health supports for people living in rural areas

by Carolyn Orr ~ August 2018 ~ Stateline Midwest »
Myriad signs point to the need for better connecting farmers to services that help them deal with stress, depression and other mental health challenges. First, there is the history of the problem: In a study examining various industries between 1992 and 2010, The National Institute for Occupational Safety and Health found that farm operators and workers had the highest suicide rate. More »

 

Michigan will require lead service lines to be replaced starting in 2021

by Tim Anderson ~ August 2018 ~ Stateline Midwest »
As part of what state officials say is the strictest set of lead and copper standards in the nation, Michigan will require all of the state’s public water systems to replace their lead service lines. Starting in 2021, the Detroit Free Press reports, each public water system must replace, on average, 5 percent of its lead service pipes per year over a 20-year period, with water customers paying for most of the estimated $2.5 billion price tag.
The new state-level rules also create stricter “lead action levels,” the point at which a water system must take steps to control corrosion. The federal lead action level is 15 parts per billion; Michigan’s will be 12 ppb starting in 2025. In addition, the state will establish a new water system advisory council and mandate that two water samples be collected at sites served by lead service lines.
“The federal Lead and Copper Rule simply does not do enough to protect public health,” Michigan Gov. Rick Snyder said in June when announcing the new standards. The changes come four years after the start of a public health crisis in the Michigan town of Flint — the result of residents’ drinking water being contaminated with lead due to a switch in the town’s water source from Lake Huron to the Flint River.

 

Lawsuits as public health policy: North Dakota joins list of states suing opioid makers

by Jon Davis ~ June/July 2018 ~ Stateline Midwest »
North Dakota was one of six states to sue an opioid maker in May, alleging in part that it violated state consumer protection laws by falsely denying or downplaying the risk of addiction from opioids while overstating their benefits. More »

 

 

States are examining their mental and behavioral health systems with an eye on money- and life-saving reforms

by Jon Davis ~ May 2018 ~ Stateline Midwest »
A quiet health care revolution is under way as Midwestern states revamp their delivery of mental health services with an increasing focus on behavioral health, which integrates mental health and substance abuse treatments, and an expansion of mental health services to children. The changes reflect a growing realization that mental health and substance abuse disorders are interlinked; that effective treatment should run along a “continuum of care”; and that the earlier mental illnesses are recognized, diagnosed and treated in young people, the better for individuals and society. More »

 

Second state legislature in Midwest passes ‘fetal heartbeat’ bill

by Tim Anderson ~ May 2018 ~ Stateline Midwest »

Starting July 1, Iowa will have “the strictest abortion law in the country,” the Des Moines Register reports. SB 359 requires doctors to test for a fetal heartbeat; if one is detected, an abortion cannot be performed, except when required to preserve the life of the pregnant woman or protect her from “serious risk of substantial or irreversible impairment of a major bodily function.”
According to the American Pregnancy Association, a fetal heartbeat can be detected as early as between 5 1/2 and 6 1/2 weeks. North Dakota legislators passed a fetal heartbeat bill four years ago, but that measure was struck down in federal court. The constitutionality of Iowa’s SB 359 also will be challenged.
Forty-three states ban some abortions after a certain point in pregnancy, the Guttmacher Institute notes in its national review of laws. In the Midwest, these prohibitions apply at the point of “viability” in Illinois and Minnesota (exceptions made to protect the life or health of the woman) and Michigan (exception only in case of life endangerment). Bans in Indiana, Kansas, Nebraska, North Dakota, Ohio, South Dakota and Wisconsin take effect at 20 weeks postfertilization, with exceptions for cases in which continuation of the pregnancy threatens the woman’s life or physical health.

 

In Iowa, schools across state will offer yearly training on suicide prevention, ‘postvention’

by Jon Davis ~ April 2018 ~ Stateline Midwest »
By next year, school districts across Iowa must begin to provide at least an hour of annual training on suicide prevention and “postvention” — the coordinated school response following a student’s suicide — for all licensed personnel who have regular contact with students. More »

 

Wisconsin is latest Midwest state to fund reinsurance plan

by Jon Davis ~ March 2018 ~ Stateline Midwest »

Wisconsin became the second Midwestern state to adopt reinsurance as a way to knock down health insurance premiums when Gov. Scott Walker signed SB 770 into law in February. The bill, which commits up to $200 million annually starting in 2019, received overwhelming bipartisan support in the state Senate and Assembly. As part of the new law, the state will now seek a federal waiver to launch a reinsurance program covering 50 percent to 80 percent of medical costs between $50,000 and $250,000 — the same range as Minnesota’s two-year, $542 million reinsurance program (approved by the Legislature in March 2017).
Under reinsurance programs, insurance companies reinsure portions of their coverage with other insurers so they won’t be on the hook for 100 percent of all costs in a given cost range. In an editorial earlier this year, the Minneapolis StarTribune credited Minnesota’s state-funded reinsurance program with holding 2018 health insurance premiums steady, or even decreasing them.
Proposals for reinsurance and subsidies are pending in the U.S. Congress, but no votes have been taken. Insurers could start issuing 2019 plan prices as early as April.

 

Work requirements for Medicaid approved by federal government, being pursued by some states in Midwest

by Jon Davis ~ February 2017 ~ Stateline Midwest »
The idea of requiring able-bodied adults to work or be actively seeking it as a condition for government assistance is certainly not new, but its application to Medicaid is as of January, when the Trump administration began approving some states’ applications to impose work rules as a condition of eligibility for this public health insurance
program. More »

 

New laws seek to end ‘doctor shopping,’ prevent opioid abuse

by Tim Anderson ~ January 2018 ~ Stateline Midwest »
Seeking to make greater use of their states’ prescription drug monitoring programs and to prevent opioid abuse, Illinois and Michigan lawmakers have established new requirements for prescribers. These measures were signed into law in December. Under Illinois’ SB 772, a patient’s prescription history must be checked, via the state-run program’s database, before he or she is prescribed Schedule II narcotics.
This is the federal classification for drugs that have a “high potential for abuse.” Michigan providers will have to review a patient’s history in the state-run electronic database before prescribing Schedule II, III, IV or V controlled substances (SB 166 and 167). One goal of these mandatory checks is to make it harder for individuals to obtain prescriptions from multiple doctors.
Every Midwestern state has a prescription monitoring program. Ohio and North Dakota require, under certain circumstances, prescribers and dispensers to check a patient’s history in the database, according to the Prescription Drug Monitoring Program Training and Technical Assistance Center. This mandate only applies to prescribers in Illinois, Indiana, Michigan, Minnesota and Wisconsin. Other states have no such requirements on prescribers or dispensers.

 

New CSG report focuses on efforts to combat diabetes

by Jon Davis ~ January 2018 ~ Stateline Midwest »
A new report from The Council of State Governments, “Diabetes in the United States: Examining Growth Trends, State Funding Sources and Economic Impact,” spotlights state-by-state spending and states’ efforts to fight diabetes. More »

 

Telemedicine, school-based clinics being used to improve students’ access to care in underserved areas

by Carolyn Orr ~ December 2017 ~ Stateline Midwest »
In the rural southern Indiana school district that Rep. Terry Goodin not only represents in the state Capitol but also leads as its superintendent, there is no pharmacy or hospital. The district, too, has no full-time school nurse. But because of last year’s passage of HB 1263, a new model of delivering care to young people has been opened — school-based clinics that connect students with a health provider via telecommunication technologies. Along with establishing new standards for telemedicine, that 2016 state law allows prescriptions to be dispensed remotely and for physician-patient relationships to be established without an in-office visit. More »

 

States move to enable direct primary care as a new approach to health care services

by Jon Davis ~ December 2017 ~ Stateline Midwest »
A trip to the doctor, and treatment, without a co-pay? It’s possible under “direct primary care,” a model whose growing popularity can be traced by the number of states (23) with “enabling” laws to clarify that direct primary care is an acceptable health care model and not to be confused with health insurance coverage or a health plan under federal law. More »

 

Minnesota gets waiver for plan to solidify insurance exchange

by Jon Davis ~ November 2017 ~ Stateline Midwest »

Minnesota has secured federal approval for its $542 million reinsurance program, which was created earlier this year via legislation (HF 5) and has been credited by officials with lowering premiums on the state’s health insurance exchange by 20 percent. Gov. Mark Dayton signed the “Section 1332” waiver (named for that section of the Affordable Care Act) in October. It is effective through 2022.
According to the U.S. Centers for Medicare & Medicaid Services, these waivers let states implement “innovative ways” of providing access to health care as long as they don’t increase the federal budget deficit and don’t compromise the availability of care.
Iowa had also applied for a Section 1332 waiver, but withdrew its application last month due to what Gov. Kim Reynolds says were inflexible rules. Illinois, however, addressed its 2018 premium hikes by requiring those eligible for ACA cost-sharing subsidies to use them only for “Silver” plans on its exchange or at healthcare.gov ­— and directing insurers to add a surcharge to those plans. According to Modern Healthcare, as those premiums increase, so do the federal tax credits for qualified consumers, thus forcing the federal government to pick up the tab.

 

Report spotlights how states are responding to opioid crisis via their Medicaid programs

by Jon Davis ~ November 2017 ~ Stateline Midwest »
An extensive new report from the Kaiser Family Foundation, “Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018,” provides an overview of states’ approaches to eligibility, premiums and managed care initiatives, emerging delivery system and payment reforms, long-term services and support reform, and provider rates and taxes. More »

 

MLC Chair's Initiative: Policies seek more screening of, treatment for maternal depression

by Tim Anderson ~ November 2017 ~ Stateline Midwest »
Four years ago, Northwestern University Medicine researchers completed the largest-scale study to date of depression among postpartum women. The findings were surprising to some (including the researchers), and disturbing to most everyone: 14 percent of women in the study screened positive for depression, a condition among new mothers that often isn’t treated or even screened in today’s U.S. health care system. More federal resources for states to help with this public health problem will soon be on the way. Under the U.S. 21st Century Cures Act, signed into law in late 2016, federal grants will be awarded to states to develop or strengthen programs that improve the availability of maternal depression screening and treatment. More »

 

Help wanted in health care: Student recruitment, telehealth expansion and changes in scope of practices among strategies pursued by Midwest's states

by Jon Davis ~ October 2017 ~ Stateline Midwest »
It seems a recipe for health care disaster: Combine population growth with an aging population, add expanded health insurance coverage, and … hope for the best? The growing need for health care workers of all disciplines is well recognized. Midwestern states have already moved to address the growing crisis with recruitment and retention strategies, as well as by redefining professionals’ scopes of work and expanding the use of new applications of technology such as telehealth. More »

 

In Midwest, positive trends seen in rates of poverty, uninsured

by Tim Anderson ~ October 2017 ~ Stateline Midwest »
Some notable trends in poverty, health insurance and household income in the Midwest were revealed in recently released U.S. Census Bureau data. For example:

 

Wisconsin invests in school-based mental health initiatives

by Tim Anderson ~ October 2017 ~ Stateline Midwest »
Wisconsin’s recently enacted state budget includes money for schools to improve students’ access to mental health services. Gov. Scott Walker signed the budget bill (AB 64) into law in September. For the first time, Superintendent of Public Instruction Tony Evers says, the state will provide funds for mental health training and partnerships between schools and community providers.
The state-funded training will provide school personnel with evidence-based strategies for addressing mental health issues in young people. Schools also will get more money to hire additional social workers. Lastly, a new state grant program will be available for schools that work with local mental-health professionals to improve student access to mental health services. Combined, these three initiatives will cost a total of $7 million, The (Appleton) Post-Crescent reports.
According to the National Alliance on Mental Illness, 20 percent of children between the ages of 13 and 18 have a serious mental illness. That includes anxiety, mood and behavior disorders, all of which often go untreated. Four years ago, the Wisconsin Legislature created an Office of Children’s Mental Health that focuses on policies to improve the delivery of mental health services among young people.

 

Eleven new Wisconsin laws take aim at state’s opioid epidemic

by Jon Davis ~ August 2017 ~ Stateline Midwest »

Wisconsin Gov. Scott Walker signed 11 bills into law in July that seek to address myriad facets of the state’s opioid crisis. The bills were the product of a special session held earlier in the year. According to the Milwaukee Journal Sentinel, school employees and volunteers, along with residence hall directors, will now be protected from lawsuits if they administer drugs designed to treat opioid overdoses (SB 1). These individuals must be properly trained and call 911 immediately after administering the drugs.
Other new laws in Wisconsin authorize:

 

MLC Chair's Initiative: At MLC meeting, legislators learn how states can help save babies’ and mothers’ lives from before birth through infancy

by Jon Davis ~ August 2017 ~ Stateline Midwest »
In pursuit of healthy birth outcomes, nothing grabs attention like a personal story. So when Lezlie Mestdagh, outreach coordinator for the Count the Kicks campaign — an educational effort founded by five Iowa mothers who suffered stillbirths and are determined to prevent that pain for other mothers — showed Midwestern legislators a “Good Morning America” video clip featuring an Iowa couple whose infant daughter was saved by Count the Kicks’ phone app, they applauded. That video illustrated the heart of Mestdagh’s message to the region’s lawmakers in July at the MLC Annual Meeting: Invest pennies in prevention to save dollars down the road, both in direct costs (stillbirths require greater resources than live births) and indirect costs such as funerals, ongoing counseling, lost income and reduced or delayed employment for parents, and more expensive medical care during subsequent
pregnancies. More »

 

Public health officials, law enforcement urge holistic approach to stem widespread opioid crisis

by Jon Davis ~ August 2017 ~ Stateline Midwest »
Strategies to deal with the rise of opioid abuse and drug overdoses were a focus of state legislators and policy experts who took part in this year’s MLC Health & Human Services Committee meeting. “We can’t prosecute our way out of the problem; there needs to be cooperation between law enforcement and public health,” Kevin Techau, a former U.S. attorney for the Northern District of Iowa, said to lawmakers at the July meeting. More »

 

MLC Chair's Initiative: Home visiting can improve outcomes for mothers and babies

by Tim Anderson ~ June/July 2017 ~ Stateline Midwest »
As the Midwest’s legislators look for ways to reduce infant mortality, prevent maternal deaths, and improve long-term outcomes for mothers and children, one policy option is to invest in home visiting. The idea of bringing preventive services and resources to the place where families live has captured more interest, and funding, during this decade. In 2010, the U.S. Congress created the Maternal, Infant and Early Childhood Home Visiting Program, and every year since then, states have received federal dollars to provide home services for vulnerable or at-risk
families. More »

 

Seeking to reduce maternal deaths, Michigan requires reporting by providers in order to improve medical practice, public policy

by Tim Anderson ~ May 2017 ~ Stateline Midwest »
Take a look at the longer-term trends in maternal mortality rates, and you see one of the great success stories in modern-day public health: In 1900, for every 1,000 live births, up to nine women were dying of pregnancy-related complications; a century later, that rate had declined by almost 99 percent. But the story told by more recent data is less clear, and more troubling. According to the U.S. Centers of Disease Control and Prevention, the number of reported pregnancy-related deaths increased between 1987 and 2013 — from 7.2 deaths per 100,000 live births to 17.3 in 2013. More »

 

Shoring up health exchanges: Premium hikes in 2017 led Minnesota to intervene with funding for subsidies, reinsurance; all states face uncertainty

by Jon Davis ~ May 2017 ~Stateline Midwest »
Last summer, as insurers filed their individual health insurance plan rate premiums for 2017, it became clear that something was wrong: Rates in 31 states shot up by double digits (triple digits for Arizona); overall, the average increase in premiums was 25 percent. In the Midwest, Minnesota was socked with a 59 percent increase that further roiled an already shaky individual health insurance market (or exchange). Legislators there responded earlier this year by first providing help to those not covered by federal subsidies and then creating a state-funded reinsurance program. More »

 

Wisconsin wants to be first state to require Medicaid drug screening

by Tim Anderson ~ May 2017 ~ Stateline Midwest »
Some Medicaid recipients in Wisconsin will have to submit to drug screenings and tests if federal officials give the OK to a demonstration waiver submitted by the state in April. This new requirement would apply to childless adults who are eligible for health insurance through the BadgerCare Plus program. As a condition of eligibility, individuals would have to complete a state-administered questionnaire. If the answers indicate possible abuse of a controlled substance, a drug test would be required. For anyone who tests positive, Medicaid eligibility would be contingent on completing a substance-abuse treatment program.
According to The Washington Post, Wisconsin would be the first U.S. state to mandate drug screening for Medicaid enrollees. Its waiver also calls for a 48-month time limit for childless adults who are not working or not in a job training program. In addition, Wisconsin wants to establish monthly premiums (between $0 and $10, based on income) and increase copayments for multiple trips to the emergency room.
For the state’s entire Medicaid population, Wisconsin is looking to fully cover residential treatment for substance abuse disorders.

 

Nebraska joins states requiring dense breast tissue notification

by Jon Davis ~ May 2017 ~ Stateline Midwest »
Nebraska Gov. Pete Ricketts in April signed LB 195, also known as “Cheri’s Law,” requiring that women be notified of breast tissue density following mammograms. It had passed the states’ Unicameral Legislature by a vote of 48-0.
The law requires that written notice be given to women if a mammogram reveals heterogeneous or extremely dense breast tissue. Such tissue can make breast cancer more difficult to detect. Under the new law, mammography patients must be told that a finding of dense breast tissue is normal, and that notice is being given to raise awareness and so patients can further discuss risk factors and detection methods with their doctor.
According to the Nebraska Radio Network, the law was named for Cheri Rauth, an Omaha, resident who died of breast cancer within 18 months of a mammogram due, her family believes, to dense breast tissue. Nebraska is now among 32 states with breast density reporting laws, including Michigan, Minnesota, North Dakota and Ohio. Illinois and Indiana have public education efforts, but do not require reporting, according to DenseBreast-info.org.
Breast cancer is the second leading cause of cancer death among women.

Kansas law bars DNR orders for children without parents’ OK

by Jon Davis ~ April 2017 ~ Stateline Midwest »
A new law in Kansas will bar “do not resuscitate” or similar physician’s orders for unemancipated minors unless at least one parent or guardian has been told of the intent to issue such an order. SB 85 requires that parental notice be given orally and in writing, and prohibits a DNR or similar orders if there is a refusal of consent. Also under this measure, the minor’s medical record must include information about the DNR order and the nature of efforts to contact both parents.
The law is named for Simon Crosier, born in September 2010 in a Missouri hospital to Kansas parents. He was diagnosed with a chromosomal disorder and died in December of that year. The Crosiers subsequently learned that a DNR order had been placed on Simon’s chart without their knowledge or consent.
The advocacy group Protecting Children by Empowering Parents lists Kansas and Michigan as among the 11 U.S. states with statutory language defining and protecting parental rights. In other states, these protections have come from the courts. Under Kansas’ existing statute (even prior to Simon’s Law), parents have a “fundamental right” to control the medical care of their minor children. The Michigan statute declares that parents have a “natural, fundamental right” to “direct the care, teaching, and education of their children.”

 

With new laws and enhanced tracking of drug use, states advance fight against opioid abuse

by Tim Anderson ~ April 2017 ~ Stateline Midwest »
Over the course of a two-week period in late March and early April, the rules for prescribing painkillers were tightened in Ohio, an improved drug-monitoring system was unveiled in Michigan, and nine bills to prevent opioid abuse won passage in the Wisconsin Assembly. The flurry of activity in those three states illustrates just how big the opioid problem continues to be in many parts of the Midwest, as well as how much of a priority legislative leaders have placed on finding new ways to address it. Near the top of that priority list is better controlling how prescription drugs are dispensed, prescribed and used. More »

 

Improving healthy birth outcomes in the Midwest is focus of 2017 MLC chair's initiative

by Jon Davis ~ March 2017 ~ Stateline Midwest »
State policymakers are increasingly realizing that beyond the importance of early childhood development lies its foundation, a healthy birth outcome for parents and their newborns. The phrase “healthy birth outcome” can encompass numerous initiatives — safe-sleep education to reduce incidents of Sudden Infant Death Syndrome, mentoring and support for new and expectant mothers to combat child and infant mortality, and even the somber task of collecting child and infant mortality data. It can also include public education campaigns to raise awareness of not-always-apparent health hazards (such as congenital cytomegalovirus) and to reduce stress on new parents and parents-to-be. More »

 

More states requiring women to be notified that breast density can skew mammogram results

by Jon Davis ~ February 2017 ~ Stateline Midwest »
Mammograms are perhaps the best-known tool to detect breast cancer, but their effectiveness can be diminished if the breast tissue itself is dense enough to hide the tumors. And this potential problem is fairly common: 40 percent of women age 40 and older have dense breasts, according to DenseBreast-info, an education and advocacy group for patients and practitioners.
Connecticut in 2009 became the first state to require practitioners to notify women that they have dense breast tissue and should consider following up with three-dimensional breast scans. (Starting this year, the state also requires insurance companies to cover 3-D mammograms.)  Now, 27 U.S. states have such notification requirements in place, including Michigan, Minnesota, North Dakota and Ohio (as of January, North Dakota’s law was scheduled to sunset on July 31). More »

Minnesota providing relief for those hit by high health premiums

by Tim Anderson ~ February 2017 ~ Stateline Midwest »
The first bill signed into law in Minnesota this year will provide relief to the state’s 125,000 residents who purchase their health insurance in the individual market and are not eligible for subsidies under the Affordable Care Act.
The cost of premiums for Minnesotans in this population is rising by 55 percent in 2017.
According to The (Minneapolis) Star Tribune, eligible residents will get a rebate of 25 percent, at a cost of $327 million to the state. Another provision in HF 1/SF 1 allows for-profit health maintenance organizations to be part of the state-run, individual health marketplace, notes Session Daily, a news service of the Minnesota House. In addition, agricultural cooperatives can now offer group health insurance to members.
In a fall study of states’ insurance exchanges under the Affordable Care Act, Kaiser Family Foundation researchers found that premium hikes in 2017 would be more severe than in previous years. These increases, Kaiser found, are partly the result of losses experienced by insurers and a phasing out of the federal law’s reinsurance program. Its analysis focused on premiums being paid by health consumers in a major city in every U.S. state. The highest increases in the Midwest were reported in Minnesota (55 percent), Illinois (48 percent), Kansas (46 percent) and South Dakota (45 percent).

 

Illinois now requiring some schools to test for lead

by Tim Anderson ~ February 2017 ~ Stateline Midwest »
Some schools and day care facilities in Illinois must have their water tested for lead under a bill passed and signed into law in January. The new requirements apply to buildings constructed before 2000 where pre-kindergarten through fifth-grade classes are held.
According to the Illinois attorney general’s office, the lead tests will average $15 per drinking-water sample. If samples exceed 5 parts per billion of lead, the families of students must be notified. SB 550 authorizes community water suppliers to impose a “lead hazard cost recovery fee.” But minus such a fee, the tests will likely be paid by school districts, which can tap into existing funds set aside for safety or legal issues, the Chicago Tribune notes. As part of the new law, too, community water supplies will provide Illinois officials with an inventory of their lead service lines.
Other Midwestern states have also passed new laws in the aftermath of the drinking water crisis in Flint, Mich. Ohio’s HB 512 (enacted in 2016) requires water suppliers to test for lead and copper and to map areas being served by lead service lines. It also mandates training on how to identify lead in drinking water and control corrosion. And Michigan‘s HB 5120, signed into law in December, calls on water suppliers to alert the public within 72 hours after they learn that lead levels exceed prescribed “action levels.”

 

To stop opioid deaths, Michigan allows schools to stock naloxone

by Tim Anderson ~ January 2017 ~ Stateline Midwest »
In an effort to save young lives at risk due to drug overdoses, the state of Michigan is giving its schools the chance to stock naloxone, an “opioid antagonist” drug. SB 805 and 806, signed into law in December, set several parameters for school districts. They must have at least two employees trained on how to administer naloxone; call 911 when a student is having an overdose; and alert parents or guardians about the incident. Under another new Michigan law (HB 5326), a prescription will not be needed for pharmacists to dispense opioid antagonists to the family members and friends of recovering addicts.
New state laws are being adopted across the Midwest to address the rise in opioid use and overdoses. Examples include prescription drug monitoring programs and “Good Samaritan” laws that waive drug-possession penalties for individuals who report an overdose. According to the U.S. Centers for Disease Control and Prevention, three Midwestern states had among the nation’s highest number of drug-overdose deaths in 2015:
• Ohio, 3,310 deaths, second-highest;
• Michigan, 1,980 deaths, seventh-highest; and
• Illinois, 1,835 deaths, eighth-highest.

 

Midwest, led by Minnesota, shows well in report ranking nation’s healthiest states

by Jon Davis ~ January 2017 ~ Stateline Midwest »
Midwestern states were healthier, overall, than the country as a whole in 2016, according to the United Health Foundation’s newest “America’s Health Rankings Annual Report,” released in December 2016 (based on data as of October). More »

 

Results coming in from states’ drug testing of welfare recipients

by Jon Davis ~ December 2016 ~ Stateline Midwest »

A yearlong pilot program in Michigan to screen welfare recipients for drug use found no substance abusers, legislators were told. The program tested 14 of 443 participants (either applicants or recipients) of the state’s Family Independence Program in three counties between October 2015 and September 2016, according to The Detroit News. Only one applicant was found to have a “reasonable suspicion of use of a controlled substance and required a substance use test,” said a report from the Department of Health and Human Services. (That person dropped off the welfare roll before being drug-tested, for an unrelated reason, the report said.)
Kansas and Wisconsin are the only other Midwestern states that currently require welfare recipients to take drug tests. In Kansas, 5,541 adults were subject to that requirement from January through September 2015. Of the 260 people actually tested, 66 tested positive.
Since November 2015, Wisconsin tested 1,305 applicants in the Wisconsin Works and Transform Milwaukee Jobs programs, with 30 referred for drug screening. Of those, eight failed and were referred for treatment; two failed and refused treatment.

 

States put greater emphasis on lead testing after water crisis in Flint

by Tim Anderson ~ December 2016 ~ Stateline Midwest »
When the problem of tainted drinking water created a public health crisis in the Michigan city of Flint, the state’s legislators had two clear missions to fulfill. First, fix the problem, with strategies — both immediate and longer-term — that help affected residents, bring back some normalcy to their lives, and then assist in the entire community’s recovery. Second, find ways to prevent the problem from ever occurring in another Michigan city. And that idea of prevention has spread well beyond the borders of Michigan, with legislators in nearby states taking notice of the crisis and beginning to think more about the safety of the water supply in their own districts. More »

 

Group of Wisconsin lawmakers unveils plan to boost health workforce, services in rural areas

by Jon Davis ~ December 2016 ~ Stateline Midwest »
An informal group of 20 to 24 lawmakers in Wisconsin will concentrate its efforts in 2017 on proposals to boost the state’s supply of rural health care workers and services. The Rural Wisconsin Initiative unveiled its legislative agenda during the latter part of 2016. More ยป

 

Some states turning to provider taxes to pay their share of Medicaid expansions

by Tim Anderson ~ November 2016 ~ Stateline Midwest »
Starting in January, states that chose to expand their Medicaid programs under the Affordable Care Act will have to begin paying part of the associated costs, and three of the Midwest’s expansion states say they will rely at least in part on revenue from their taxes on health care providers. More »

 

Ohio looks to fill gaps in resources for young people, families in crisis

by Tim Anderson ~ October 2016 ~ Stateline Midwest »
In early 2012, a 17-year-old stood up in a high school cafeteria in northeast Ohio and began shooting. Three students died, three were injured. For the leaders of Ohio’s systems of mental health and developmental disabilities, that tragic incident became a call to action. What could the state do to help fill those resource gaps? How could it assist families and communities wanting to help a troubled young person? In part, the response has been the creation of Strong Families, Safe Communities. More »

 

New state laws, voluntary hospital initiatives aim to reduce deaths from sepsis

by Tim Anderson ~ October 2016 ~ Stateline Midwest »
For patients who develop sepsis, the ability of a health professional to recognize it early on can mean the difference between life and death, or between full recovery and permanent organ damage. For doctors and nurses, though, early recognition of this condition (caused by the human body’s response to an infection) can be difficult. Four years ago, that early detection did not take place in a case that led to the tragic death of a 5-year-old girl in Illinois. Gabby’s Law (SB 2403), signed into law this summer after receiving unanimous legislative approval, puts in place new statewide requirements for hospitals, which will now have to establish and then periodically implement evidence-based sepsis protocols. More »

 

Iowa launches plan to better meet children’s mental health, other needs

by Tim Anderson ~ September 2016 ~ Stateline Midwest »
Right now in Iowa, it’s no sure bet that a child in need of mental health services is going to get them. Instead, access can depend on where his or her family happens to live. But Iowa appears to be taking some important first steps to improving care, thanks to the recommendations of a work group formed by the Legislature in 2015 and actions taken by lawmakers during their 2016 session. More »

 

Girl’s allergy death spurs Illinois lawmakers to push for improved access to lifesaving medicines

by Tim Anderson ~ September 2016 ~ Stateline Midwest »
A new law will in Illinois will allow police to carry and administer epinephrine autoinjectors, which are used to prevent death from serious allergic reactions. More »

 

States adopting practical ‘harm reduction’ approach in effort to stem tide of overdose deaths

by Deb Miller ~ August 2016 ~ Stateline Midwest »
Drug overdose deaths are becoming all too familiar, even if the epidemic hasn’t spread yet to the state in which you live. In 2014, the last year for which the U.S. Centers for Disease Control and Prevention has compiled data, 47,055 individuals died of a drug overdose. Opioid-related overdose deaths — from prescription pain killers or heroin — accounted for 61 percent of the total that year. In the Midwest, opioid death rates in 2014 were higher than the national rate in three states: Michigan, Ohio and Wisconsin. Besides law enforcement strategies, many states are adopting a public health approach known as “harm reduction.” More »

 

Minnesota results show cost-cutting promise of patient-centered health care homes

by Deb Miller ~ June/July 2016 ~ Stateline Midwest »
Minnesota was an early adopter of the use of health care homes, and a five-year study of their impact shows promising results for any state looking to reduce health costs and improve patient outcomes. More »

 

Illinois aiming to ‘make every pregnancy planned’ by increasing access to improved long-acting reversible contraception

by Deb Miller ~ May 2016 ~ Stateline Midwest »
Illinois is leading the way in adopting Medicaid payment reforms to increase access to long-acting reversible contraception, known as LARCs. LARCs — intrauterine devices, or IUDs, and subdermal contraceptive implants — are highly effective forms of birth control, with a pregnancy rate of less than 1 percent within the first year, according to the Centers for Disease Control and Prevention. More »

 

Michigan considering tougher copper, lead pipe regulations

by Jon Davis ~ May 2016 ~ Stateline Midwest »
Michigan Gov. Rick Snyder has proposed tightening the state’s lead level guidelines to 10 parts per billion by 2020, stricter than the current federal mark of 15 ppb. The proposed change, announced at a meeting of the Flint Water Interagency Coordinating Committee, is part of a package of proposals that also includes annual water testing at day care centers and schools as well as a requirement that local governments create inventories of lead water pipes and then develop plans to replace them.
Critics of both Snyder’s plan and the federal Lead and Copper Rule say neither addresses the true lead danger level of 5 ppb. The U.S. Environmental Protection Agency is in the process of updating the Lead and Copper Rule, a process that began in 2010. Proposed changes are expected to be submitted to the U.S. Congress in 2017. The rule applies to about 68,000 water utilities nationwide. It requires them to take remedial action to improve pipe corrosion controls or eventually replace lead pipes if 10 percent of sites tested for lead or copper exceed the “action level” of 15 ppb.
The Michigan proposals require approval by the state Legislature.

 

Iowa becomes latest Midwest state to move to managed care for Medicaid enrollees

by Deb Miller ~ April 2016 ~ Stateline Midwest »
After some bumps along the way, the Iowa Medicaid program — and some 560,000 Iowans — transitioned to a managed-care model of care in April. Iowa now joins the majority of U.S. states nationally, and within the Midwest, that depend on private entities called managed-care organizations — or MCOs — to deliver Medicaid services to most enrollees in their public insurance programs for low-income families and individuals. More »

 

Minnesota, Wisconsin hail savings from new health care programs

by Tim Anderson ~ March 2016 ~ Stateline Midwest »
Eight years ago, Minnesota lawmakers established a new way of paying for health care that they said should lead to lower costs and higher-quality care. The hopes for this “health care home” model appear to have been realized. A five-year evaluation found that this model saved Medicaid and Medicare $1 billion. In addition, participating health clinics outperformed others on various quality measures, University of Minnesota investigators found.
Under this model, clinics voluntarily apply to be certified as a “health home”: This patient-centered approach to care involves coordination among a team of doctors, nurses and other providers. These clinics receive a per-patient payment for coordinating care. A central goal of this model is to improve how patients and their providers prevent and manage disease. The Minnesota study was released in February.
A month later, Wisconsin Gov. Scott Walker unveiled results of his state’s ramped-up efforts to prevent Medicaid fraud and overpayment. Five years ago, he created the office of inspector general within the state’s Department of Health Services. Between 2011 and 2015, the office recovered nearly $40 million in overpayments to Medicaid providers.

 

Aging infrastructure, lead pipes, nitrate runoff and funding among challenges vexing Midwest’s drinking water systems

by Jon Davis ~ March 2016 ~ Stateline Midwest »
The crisis in Flint, Mich., has pushed drinking water quality into the forefront of national conversation, but problems with the Midwest’s aging drinking water infrastructure are not new. Plenty of lead pipes nearing the end of their service lives remain, and nonpoint source pollution from agricultural runoff besets watersheds and municipal water systems before ultimately afflicting the Great Lakes, Mississippi River and Gulf of Mexico. More »

 

As Michigan water crisis boils, legislators mull ‘right to water’

by Jon Davis ~ February 2016 ~ Stateline Midwest »
As the realization that a generation of children in Flint, Mich., has been exposed to lead poisoning by their own water sets in, some Michigan lawmakers are pushing to enshrine access to clean, safe water in state law as a basic human right. More »

 

Do states have statutory provisions allowing paramedics to provide non-emergency health services?

by Katelyn Tye ~ February 2016 ~ Question of the Month »
Community paramedicine programs — sometimes known as field emergency medical services (EMS) or mobile integrated health care — expand the role of certified paramedics and allow them to provide non-emergency, preventative health care services to patients in their communities. More »

 

In aging Midwest, more emphasis being placed on Alzheimer's policies and care

by Laura Kliewer ~ January 2016 ~ Stateline Midwest »
In most Midwestern states, the number of people with Alzheimer’s disease is expected to increase by close to 20 percent or more between now and 2025. The heavy toll that Alzheimer’s takes on individuals and families is well known, but the disease also has high costs for state health care systems and will require lawmakers to consider policies that help meet the greater demand for quality services. More »

 

Illinois allows residents of nursing homes to install room cameras

by Tim Anderson ~ January 2016 ~ Stateline Midwest »

In response to concerns raised by family members about the care and safety of their loved ones in nursing homes, Illinois has become one of the first U.S. states to allow the use of cameras in resident rooms. HB 2462, signed into law in 2015, took effect in January.
Under the measure, recordings from these cameras can be admitted as evidence in administrative, civil and criminal proceedings. Criminal penalties have also been established for any person who intentionally tampers with or destroys a recording. The cameras must be paid for and maintained by nursing home residents or their representatives.
According to the Illinois attorney general's office, the state receives more than 21,000 calls annually and responds to approximately 5,000 complaints related to suspected neglect or negligence in nursing homes. In 2013, the Department of Public Health found 106 allegations of abuse, neglect or misappropriation of property against residents by facility staff to be valid. In 2014, the Pew Charitable Trusts reported that four other states (none in the Midwest) had laws permitting nursing home residents to install cameras in their rooms.

 

More states in Midwest enacting 'right to try' laws

by Tim Anderson ~ January 2016 ~ Stateline Midwest »
A nationwide legislative push to give terminally ill patients easier access to experimental medications has succeeded in changing the laws of six Midwestern states over the past two years. In this region, the trend began in late 2014 in Michigan, with bipartisan passage and the governor’s signing of SB 991 and HB 5649. More »

 

State programs aim to prevent premature births as part of strategy to reduce rates of infant mortality

by Tim Anderson ~ December 2015 ~ Stateline Midwest »
Three years ago, wanting to know the story behind the troubling data about infant mortality in Ohio, Sen. Shannon Jones decided to take a tour of her home state. Along with a colleague, Sen. Charleta Tavares, Jones organized visits to local hospitals and met with health care practitioners and social service providers. Legislators didn’t come back from the statewide tour with any easy answers or magical fixes, but they did return with a resolve to do more to address the problem. More »

 

Deadly rise in drug overdoses has Midwest states searching for answers: Policy responses include greater oversight of prescription drug use, access to treatment

by Tim Anderson ~ October 2015 ~ Stateline Midwest »
Across the country, communities are dealing with an epidemic of drug abuse and overdoses.
And nowhere is this health crisis more pronounced than in the Midwest: Between 2008 and 2013, the number of heroin-related overdose deaths in this region increased sixfold. States in the Midwest are adopting a number of strategies to address this health problem — for example, greater access to naloxone, more oversight of prescription drug use, and an expanded use of drug courts. More »

 

States tighten rules on vaccinations to bolster immunization rates

by Tim Anderson ~ September 2015 ~ Stateline Midwest »

New policies in three Midwestern states have the goals of boosting immunization rates among young people and preventing the spread of disease. In Illinois, a health care provider will have to sign a “certificate of exemption” in order for children not to be vaccinated on religious grounds. SB 1410 was signed into law in August. Before signing the certificate, a health care provider must provide education to parents about the benefits of immunizations and the health risks of not vaccinating students.
Every state in the Midwest allows for religious and medical exemptions to the vaccine mandate. Some states (Michigan, Minnesota, North Dakota, Ohio and Wisconsin in this region) also allow opt-outs based on philosophical beliefs, according to the U.S. Centers for Disease Control and Prevention. Michigan, though, has tightened some of its rules this year, mlive.com reports. Prior to opting out, parents must be educated by a local health worker and sign a form acknowledging that they may be putting their children and others at risk.
A new law in Ohio, meanwhile, requires children attending day care or preschool to be vaccinated (with exemptions). According to The Columbus Dispatch, Ohio had been the only state without this vaccine-coverage law.

 

Illinois legislators OK wide-ranging plan to prevent drug overdoses

by Tim Anderson ~ June 2015 ~ Stateline Midwest »
Last summer, lawmakers in the Illinois House declared a “heroin emergency” in the state. This year, the legislature overwhelmingly approved a comprehensive plan (HB 1) to deal with it. According to The State Journal-Register (Springfield), the state's new fight against drug abuse will cost between $25 million and $58 million. The bill’s components include:
States across the country have been experiencing a rise in heroin overdose deaths. Between 2010 and 2013, the number of these deaths increased from 3,036 to 8,257.

 

Indiana authorizes local needle exchanges to deal with health emergencies, disease outbreaks

by Tim Anderson ~ May 2015 ~ Stateline Midwest »
In the early part of 2015, an outbreak of HIV began spreading quickly in the small, southeast Indiana town of
Austin. By the end of April, the number of confirmed cases had reached nearly 150, with many of them linked to
use of the opioid painkiller Opana via needle injection. Gov. Mike Pence declared a public health emergency in Scott County to deal with the outbreak and to allow for a temporary needle-exchange program, but Sen. Patricia Miller says it was important for the legislature to act as well. And on the last day of session, lawmakers passed SB 461. More »

 

 

Rethinking health policy: State strategies look beyond access to care, focus on other factors that lead to poor outcomes and higher costs

by Kate Tormey ~ April 2015 ~ Stateline Midwest »
When it comes to improving health outcomes, many policymakers look first to strategies that can provide better care for people who are ill. But some experts argue that medical care itself accounts only for a small part of positive health outcomes. The vast majority of interventions that can make people healthier, and reduce spending on health care, need to happen long before someone enters a doctor’s office. More »

 

State vaccination, exemption policies scrutinized after measles outbreak

by Kate Tormey ~ March 2015 ~ Stateline Midwest »
Last month, a contagious disease that was once thought eradicated in the United States saw one of its largest outbreaks in recent years. The resurgence of the measles has sparked a nationwide discussion about vaccination policy. Each state has different requirements for vaccines that children must have in order to attend school. Likewise, each state has its own set of exceptions. Across the country, exemptions are provided for health reasons, but state policies vary when it comes to allowing parents to opt out of vaccines for other reasons. More »

 

Michigan joins two other Midwestern states tying public benefits to drug-testing

by Tim Anderson ~ February 2015 ~ Stateline Midwest »
Michigan has become the third state in the Midwest to require certain recipients of public benefits to undergo drug testing. Signed into law in late December, HB 4118 and SB 275 will operate as a one-year pilot program in three counties. In those counties, some recipients of cash assistance will be drug-tested based on an “empirically validated substance abuse screening tool.”
Individuals who test positive will lose assistance if they don’t participate in a treatment program or if they fail to submit to periodic testing. Since 1996, states have had the authority under federal law to require welfare recipients to undergo drug testing. Minnesota and Kansas are among the other U.S. states with drug-testing laws in place.
Kansas’ “suspicion-based” program was established by the Legislature in 2013 (SB 149) and began in July 2014. During the first four months of the program, The Kansas City Star reported late last year, 20 individuals had been tested. Four of the 20 failed the test and five refused to take it. In Minnesota, counties must conduct random tests of welfare recipients who have been convicted of a drug-related felony in the past 10 years.

 

States are not only expanding Medicaid; they're reshaping the health insurance program as well

by Kate Tormey ~ February 2015 ~Stateline Midwest »

The federal government has been granting unprecedented leeway to states in shaping Medicaid expansions. Some of the provisions recently approved have never been seen in the 50-year history of the program. More »

 

Ebola scare sparks discussion on quarantine, other policies to keep infectious diseases in check

by Kate Tormey ~ December 2014 ~ Stateline Midwest »
As the Ebola virus continues to affect tens of thousands of people halfway across the world in Africa, it is also spurring policy discussions in the United States about how governments can and should control the spread of serious infectious diseases. More »

 

What guidelines and regulations exist regarding human donor milk for infants whose mothers cannot provide breast milk?

by Laura Kliewer ~ December 2014 ~ Question of the Month »
Breast milk contains important nutrients, immune-system antibodies and growth factors that all contribute to a baby’s health, particularly babies who are vulnerable because they are premature or underweight. But a number of circumstances — including maternal illness, death, surgery, use of drugs or medications, and certain chronic conditions — can prevent a mother from being able to breastfeed. One potential alternative for some babies, then, is the use of human donor milk. Indiana, Iowa, Michigan and Ohio are among the states with nonprofit human-milk banks that have been certified by the Human Milk Banking Association of North America. More »

 

Be ready for anything: Recent infectious-disease outbreaks serve as a reminder that state public-health systems need to be strong before disaster hits

by Kate Tormey ~ November 2014 ~ PDF of Stateline Midwest article »
When emergencies strike — whether a disease outbreak or a natural disaster — it can feel like everything is out of the ordinary. But public-health experts say that during an emergency, the response should feel as familiar and routine as possible. That’s because in order to successfully handle a disaster, the preparation and practice should happen before trouble is on the horizon. More »

 

What policies are states adopting to encourage people to seek assistance during drug and alcohol overdoses?

by Kate Tormey ~ October 2014 ~ Question of the Month »
In the United States, 113 people die each day from a drug overdose, the leading cause of injury death. Among people age 25 to 64, drug overdoses kill more people than do motor vehicle accidents, the U.S. Centers for Disease Control and Prevention reports. Between 2010 and 2012, federal data show, deaths from heroin overdoses doubled. Partly in response, state policymakers have looked for new ways to help prevent these tragic incidents. One idea has been to create new immunity laws: protecting a person who seeks medical attention for someone believed to be in danger of overdosing. More »

 

Paying for value, not volume, in health care: States are experimenting with delivery and payment reforms focused on more-efficient, high-quality care

by Kate Tormey ~ September 2014 ~ Stateline Midwest »
In most industries, consumers pay more for receiving more goods and services. But in health care, more isn’t necessarily better — sometimes it’s just more expensive, some policy experts say. That’s why states around the country are currently testing new ways to deliver and pay for health care, with the goal of fostering quality, cost-effective services. More »

 

Debate over safety of triclosan sparks new bills in region; Minnesota first state to ban it

by Kate Tormey ~ July/August 2014 ~ Stateline Midwest »
As federal regulators take a closer look at the safety of triclosan, a substance found in many personal-care products, lawmakers in at least two Midwestern states are making moves to keep the substance out of homes and waterways. More »

 

Hidden, lifetime scars: States address the needs of children who have experienced trauma, aim to stem the cycle of negative outcomes

by Kate Tormey ~ May 2014 ~ Stateline Midwest »
Imagine being a young boy waking up one morning to the sound of your parents arguing and your mother being abused. You don’t get breakfast and you miss the bus — so you’re late for school. You get in trouble for being tardy, and by mid-morning, you’re hungry and frustrated, so you lash out at another student. You’re back in the principal’s office instead of learning in the classroom — and the vicious cycle continues. More »

 

 

New laws in Kansas, Nebraska require autism coverage

by Tim Anderson ~ May 2014 ~ Stateline Midwest »

The number of Midwestern states requiring insurers to cover the diagnosis and treatment of autism continued to rise in 2014, as the result of legislative measures in Nebraska and Kansas that passed with overwhelming support. The advocacy organization Autism Speaks now lists Ohio, North Dakota and South Dakota as the only states in the region that have not adopted autism insurance reform.
Under Nebraska’s LB 254, a wide range of services must now be covered, including up to 25 hours per week for behavioral health treatment, such as applied behavior analysis. The new mandate covers individuals up to the age of 21. Kansas’ HB 2744 covers children up to the age of 12. Like the Nebraska bill, too, it includes applied behavior analysis among the covered services. Other common treatments for children with autism include speech and occupational therapy. In both Kansas and Nebraska, some health plans will be exempt from the new mandates.
Earlier this year, the U.S. Centers for Disease Control and Prevention estimated that 1 in 68 children (and 1 in 42 boys) have been identified with autism spectrum disorder. The findings were based on results from sites in 11 different states, including Wisconsin.

 

States consider testing welfare recipients for drugs; Kansas and Minnesota have laws on books

by Kate Tormey ~ April 2014 ~ Stateline Midwest »
Since 1996, states have had the authority under federal law to require welfare recipients to undergo drug testing. In recent years, more and more legislatures have given serious consideration to using this authority, including a handful of states in the Midwest. More »

 

Question of the Month: What laws have states passed regarding sports-related concussion prevention and treatment?

by Laura Kliewer ~ April 2014 ~ Question of the Month »

 

In the span of just two years (during the 2011 and 2012 legislative sessions), every Midwestern state adopted laws to better protect young people from concussion-related injuries. These so-called “return-to-play” laws had three key components. More »

 

Indiana bill reflects concerns about rise in drug-addicted newborns

by Tim Anderson ~ March 2014 ~ Stateline Midwest »
Concerned about the rise in drug-related health problems among newborns, Indiana lawmakers unanimously approved a measure in February that takes a first step in trying to address Neonatal Abstinence Syndrome. Under SB 408, hospitals would be required to report cases of the syndrome to the Department of Public Health, which will develop a set of best practices on how to identify and document such cases. The bill also calls for the state to study treatment services for pregnant women addicted to drugs.
The abuse of illegal or prescription drugs during pregnancy can cause Neonatal Abstinence Syndrome. Symptoms among newborns include seizures, slow weight gain, and trouble sleeping or breathing. As of early March, differences in the House and Senate versions of Indiana’s SB 408 had to be worked out in conference committee.
More than 13,000 infants were born with Neonatal Abstinence Syndrome in 2009, a nearly threefold increase since 2000, according to a study published two years ago in the Journal of the American Medical Association. A recent Ohio Department of Public Health study found that hospitalization rates for the syndrome in that state grew sixfold between 2004 and 2011.

 

Can states require a photo ID on the electronic benefit transfer (EBT) cards used by individuals who receive food stamps?

by Kate Tormey and Deb Miller ~ February 2014 ~ Question of the Month »
Under federal law, states can require that EBT cards for the Supplemental Nutrition Assistance Program (SNAP) include photos of the beneficiaries or that customers show photo ID to use the cards. Massachusetts is the only state that currently has such a law. More »

 

Wisconsin OKs package of bills to strengthen mental health system

by Tim Anderson ~ February 2014 ~ Stateline Midwest »
Wisconsin legislators agreed in January to invest $4 million over the next two years on a plan to improve the state’s mental health system, the Milwaukee Journal Sentinel reports. Passage of the multi-bill package culminated months of legislative work that began in early 2013 with formation of the Speaker’s Task Force on Mental Health. The new measures will:
• create crisis-intervention teams made up of law enforcement officers who have undergone specialized mental health training;
• offer new incentives for physicians and psychiatrists (up to $60,000) to serve in underserved areas of Wisconsin;
• establish a hotline that connects mental health professionals with children who need help and live in underserved areas; and
• invest in job training for people with severe mental illnesses and in-home treatment for children.
Michigan legislators and other state leaders, meanwhile, have issued a set of recommendations calling for improvements to their state’s mental health system. They focus on three areas: independent living for people with mental illnesses; better access to high-quality, coordinated care; and new metrics that evaluate the effectiveness of different mental health services.

 

Glut of improper payments has states searching for new ways to weed out Medicaid fraud, abuse

by Kate Tormey ~ October 2013 ~ Stateline Midwest »
In fiscal year 2010, 9 percent of state Medicaid payments — totaling $11 billion — were considered “improper” by federal standards. Many of these payments were due to clerical mistakes or flagged because of insufficient documentation, and were not necessarily payments that shouldn’t have been made. More »

 

Small group, big health care bills: ‘Super utilizers’ of health care system are major drivers of Medicaid — and state — spending

by Kate Tormey ~ September 2013 ~ Stateline Midwest »
Picture an elderly man who is constantly visiting the emergency room with out-of-control blood sugar levels. His doctors can’t figure out why his insulin is failing to control his diabetes and why he keeps ending up in the hospital.
Enter a patient-centered team that starts asking the man questions about his daily life. The team finds out that the man doesn’t have a refrigerator to keep his insulin cool; by the second half of the month, his medication isn’t working properly. After the man receives a small fridge to store his insulin, his visits to the hospital stop. More »

 

Rural lawmakers fear loss of Critical Access Hospitals in Midwest

by Carolyn Orr ~ September 2013 ~ Stateline Midwest »
In Sen. Jean Leising’s eastern Indiana district, many of her residents — and communities — have long relied on their local “Critical Access Hospitals.” And like rural lawmakers across the Midwest, Leising has new reason to worry about the future of these hospitals, which rely in part on enhanced Medicare funding to keep their doors open. The specter of many of these hospitals losing their “critical access” status was raised in a recent report by the U.S. Department of Health and Human Services. More »

 

 

Iowa reforms of mental health system now under way

by Kate Tormey ~ 2013 MLC Annual Meeting Edition ~ Stateline Midwest »

Before Iowa’s mental health reform several years ago, people in the state were having trouble getting access to services. Waiting lists were increasing, financing was inconsistent in the county-based system, and there was a discrepancy in the number of providers available in rural and urban areas. More »

 

Fragmented mental health system target of reform: Focus is on cost-effective,
evidence-based care

by Kate Tormey ~ February 2013 ~ PDF of Stateline Midwest article »

State efforts to improve mental health systems: Innovations in the Midwest »

Roughly one in four American adults is struggling with a mental illness, according to the National Institute on Mental Health, and half of them are dealing with more than one disorder at the same time. About 20 percent of American children already have had a mental illness at some point in their lives. More »

 

What is an “essential health benefit” package, and how have states implemented this new federal requirement?

by Kate Tormey ~ February 2013 ~ Question of the Month »

A. Under the federal Affordable Care Act, all individual and small-group plans available in state health care exchanges must cover certain services, or “essential health benefits.” More »

 

States cultivate healthy options in food deserts: Policies focus on improving access to fresh food

by Kate Tormey ~ November 2012 ~ Stateline Midwest »
Illinois Sen. Jacqueline Collins remembers when her legislative district on Chicago’s South Side had plenty of grocery stores and family restaurants.
But today, she sees a very different picture. She says she counts “too many” fast-food outlets. And in the Auburn-Gresham neighborhood, for example, she counts just two full-service, sit-down restaurants.
Residents also have few option in terms of grocery stores; many of the stores left with the demographic shift that occurred in the 1970s, when large numbers of residents fled the city for the suburbs.
This landscape is part of the reason why Collins has helped support recent legislation in her state to lure those grocers back with grants and loans. More »

 

What states in the Midwest have freedom-of-conscience language in their constitutions or statutes?

by Tim Anderson ~ June 2012 ~ Question of the Month »
Every state constitution in the Midwest has language guaranteeing freedom of religion; in addition to these constitutional protections, many states have inserted statutory language often referred to as “conscience” or “refusal” clauses. More »

 

What requirements do Midwestern states have for health education in K-12 public schools?

by Laura A. Tomaka ~ March 2012 ~ Question of the Month »

A. Over the last few years, the number of Midwestern states including health education as a requirement for high school graduation has increased — a policy move that reflects growing recognition of the link between healthy kids and academic achievement, and between public health and safer, healthier communities. More »

 

Michigan ends health benefit for legislators now only available in 2 Midwestern states: Ohio and Illinois

by Tim Anderson ~ December 2011 ~ Stateline Midwest »

Michigan Rep. Joel Johnson says he entered elective office this year looking to save taxpayers money whenever and wherever he could. Within weeks, he found one of his first targets: a health care benefit for him and his legislative colleagues. More »

 

Reworking workers’ comp: On 100th anniversary of system, states focusing on changes that cut business costs, remove uncertainties

by Laura A. Tomaka ~ November 2011 ~ PDF of Stateline Midwest article »
For 100 years, employees injured on the job have been provided guarantees through state workers’ compensation systems that cover the cost of medical and rehabilitation services, as well as lost wages.
In return for carrying this mandatory insurance, employers are protected from potentially costly lawsuits.
But have the systems themselves become too costly for business and inefficient? More »