Tag Archives: health

TN among the nation’s worst in health care rankings, survey finds

Nashville’s economy may be dominated by health care, but Tennessee’s health care landscape still ranks among the nation’s worst, according to the 2014 state health scorecard by the Commonwealth Fund.

Further from The Tennessean:

Overall, Tennessee ranked 40th out of 50 states and the District of Columbia. The Scorecard ranks states based on five categories: access, prevention and treatment, avoidable hospital use and cost, healthy lifestyles and equity — meaning availability of services across racial and socioeconomic groups.

The entire Southeast performed poorly. “In some areas, particularly in lower-income areas, people’s incomes haven’t been keeping up with premiums,” said Cathy Schoen, senior vice president for policy, research and evaluation at The Commonwealth Fund.

“That means even insured populations are often facing much higher deductibles and premium copayments, so they’re going without care,” she said. “Tennesseans are on the high end of that — one out of five adults are saying they went without care because they couldn’t afford it.”

The study suggests the population in Tennessee is relatively sick and has inadequate access to health care resources. Tennessee performed worst in the “avoidable hospital use and cost” and “healthy lives” categories, ranking 43rd and 46th respectively.

State stops admissions to two TN nursing homes

MEMPHIS, Tenn. (AP) — Tennessee Health Commissioner John Dreyzehner has suspended new admissions to two West Tennessee nursing homes because of alleged inadequate conditions at the facilities.

A news release from the Tennessee Department of Health says Dreyzehner has suspended admissions to Oakwood Community Living Center, a 50-bed licensed nursing home in Dyersburg, and Ripley Healthcare and Rehabilitation Center, a 144-bed licensed nursing home in Ripley.

Department investigators found violations of administration, performance improvement and nursing services standards at Oakwood. The department says surveyors found violations of administration standards at Ripley Healthcare.

The state imposed penalties of $1,500 for each of the facilities. A special monitor will review their operations.

The nursing homes can have the right to a hearing before the Board for Licensing Health Care Facilities or an administrative judge.

State Department of Health frets about electronic cigarettes

The Tennessee Department of Health has issued a rare public health advisory urging caution on the use of electronic cigarettes and other electronic nicotine delivery systems, reports the Commercial Appeal.

The advisory also addresses concern about inadequate oversight of the manufacture of the products and about second-hand exposure to their vapors and emissions.

“There is inadequate scientific information about the effects of using current electronic nicotine delivery systems to assure the public about the impact to safety and health. Coupled with the absence of state or federal regulation of manufacture, this information should prompt consumers to be cautious about using the devices as well as exposure to secondhand emissions,” the advisory says.

Dr. David Reagan, the department’s chief medical officer, said Wednesday that his agency promotes smoking cessation but there’s not enough evidence about the products’ effectiveness in reducing smoking.

Note: The Department of Health advisory (pdf) is HERE.

Parents of diabetic children split over bill expanding who can give insulin shots

Parents of diabetic children in Tennessee are divided about a proposed state law that would allow teachers and coaches, instead of school nurses, to administer insulin, according to The Tennessean.

Similar laws are being passed throughout the nation, and the American Diabetes Association is lobbying for Tennessee to make the change.

Current state law allows non-medical personnel to give glucagon shots — hormone injections that boost blood sugar levels in emergency situations — but it specifies that nurses provide diabetes treatment to students. The debate hinges on whether access to daily care or the potential for dosage mistakes is the greater issue facing diabetic children.

Not every school has a school nurse. That’s the reason the ADA is pushing for the legislation, said Brittany Freeman, state advocacy director for the organization in the southeast.

“Even if there is a school nurse, oftentimes she or he is not available full time,” Freeman said. “Sometimes, you are sharing schools. Sometimes, you can’t be in two places at once. You might have two children with two different needs at any given time.”

…The legislation to change the Tennessee law is Senate Bill 1445 and House Bill 1383.

(Note: Sponsors are Sen. Steve Dickerson, R-Nashville, and Cameron Sexton, R-Crossville.)

Education, TennCare seek spending increases in Haslam’s ‘hardest budget’

“I think this will actually be our hardest budget,” said Gov. Bill Haslam Tuesday as he opened department-by-department hearings on spending plans.

He’s asked each department to have a plan for cutting expenditures by 5 percent, just as he did last year. But last year, state revenue came in ahead of projections and that wasn’t necessary. Now, revenue collections have fallen below projections for the past three months.

Excerpt from the Chattanooga TFP’s report on the Department of Education and the Department of Health hearings Tuesday:

Education Commissioner Kevin Huffman.. outlined a $57.4 million state-funded increase, most of which would go to required boosts in the state’s Basic Education Program funding formula for public K-12 schools.

At the same time, Haslam has pledged to make Tennessee teachers’ salaries the fastest-growing in the nation in the next five years. Huffman put no figure on that.

Overall, education under the 5 percent cut scenario would see its estimated current budget of $5.71 billion fall to $5.45 billion, much of it in the form of federal dollars due to the end of a $501 million federal Race to the Top education grant, which by July 1 will largely have run its course.

Meanwhile, Health Commissioner John Dreyzehner outlined $3.27 million in potential cuts to his department with reductions or eliminations of contracts with federally qualified health centers and faith-based centers accounting for a recurring amount of $2.19 million.

But Dreyzehner said available one-time money should be able to carry the contracts forward for two years as officials assess the impact of the federal Affordable Care Act on indigent health care.

The department is requesting $574 million in funding, down from an estimated 593 million this year.

Meanwhile, Haslam is keeping his eye on the impacts of the Affordable Care Act on TennCare, the state’s Medicaid program. Haslam is still struggling over whether to pursue the Medicaid expansion to adults making up to 138 percent of the federal poverty level, which the federal law envisions.

But Haslam noted that even without the expansion, TennCare will grow due to increases in rolls from already eligible but not enrolled Tennesseans.

TennCare Bureau figures project 53,200 people will come on to the program next year at a cost of $137.5 million.

Haslam said he expects up to 70 percent of next year’s budget increases will be driven by TennCare.

See also The Commercial Appeal report, including this line:

As usual, increasing costs of TennCare and to a lesser degree K-12 public education are the biggest drivers of the budget, he said. Both are formula-driven, by increasing enrollment and costs.

But TennCare — Tennessee’s version of the federal- and state-funded Medicaid program — will see an extra surge in enrollment as low-income people who were eligible but not enrolled are expected to sign up as a result of the Affordable Care Act’s individual mandate for health coverage. Policy officials call that the “woodwork effect” — new enrollees coming “out of the woodwork” — and Haslam said TennCare cost increases will account for 60 to 70 cents out of every new dollar the state spends in the next fiscal year.

“Now that everyone is forced into a plan, we know it will increase our enrollments and costs,” the governor said.

Raw milk, semi-legalized in TN, blamed in eight cases of child illness

Raw milk is likely to blame for eight sick kids in East Tennessee, reports WPLN, and state health officials are using the small e. coli outbreak to warn against unpasteurized milk.

Several of the recent illnesses were traced back to the Knoxville-area farm of Marcie McBee, which supplies hundreds of families with raw milk. She acknowledges that several customers were showing flu-like symptoms. One girl remains very ill.

“We’re praying for her every day. We want her well,” she says. “But we have to remember there’s a lot of ways to get contamination here. I’m not in charge of the owners’ jars. I don’t clean them. I just put milk in them.”

As in many states, it is technically illegal to sell raw milk in Tennessee. But a law passed in 2009 creates a loophole allowing people to buy “shares” in a cow herd, giving them a legal way to obtain unpasteurized milk.

A press release from the state departments of Health and Agriculture says, “although it is legal in Tennessee for individuals to consume raw milk from their own animals, it doesn’t change the risk to their health.”

Note: The press release is posted below.
Continue reading

TN Child Obesity Rate Increases; Haslam Announces ‘Healthier TN’

Gov. Bill Haslam is traveling the state this week, officially announcing his new “Healthier Tennessee” initiative, approved by the Legislature in the past session. In timing, it seems appropriate since the Centers for Disease Control this week announced the first evidence of a decline in childhood obesity nationwide – though the child obesity rate actually increased in three states, including Tennessee.

Here’s the AP brief on Haslam’s announcement in Memphis Tuesday and, below that, the national story on childhood obesity rates.

MEMPHIS, Tenn. (AP) — Gov. Bill Haslam has announced a new statewide health and wellness initiative.

Haslam visited the Church Health Center Memphis on Tuesday to launch the “Healthier Tennessee” program.

Haslam said the initiative will encourage residents to be more physically active and eat nutritious foods like fruits and vegetables. The program also asks people to stop using tobacco, or never start.

Haslam noted Tennessee is one of the least healthy states, with high rates of high blood pressure, stroke, diabetes and heart disease.

The initiative will bring together employers, health care providers, health insurance companies, schools and community organizations to promote healthier behaviors.

The Governor’s Foundation for Health and Wellness, based in Nashville, will direct the initiative.

Haslam plans stops in Chattanooga, Knoxville, Kingsport and Nashville this week to promote the program.
Continue reading

State Opens First ‘Recovery Court’ for Prisoners

Next month, in the quiet Morgan County city of Wartburg, the state Department of Mental Health and Substance Abuse Services, along with the Tennessee Department of Correction, will open what the state says is the nation’s first statewide residential Recovery Court, reports the News Sentinel.
The 24-hour, 100-bed facility, which opens its doors Aug. 1, will allow the state to divert people with substance abuse or mental health issues from prison beds, with the hope of halting the cycle of hospitalization, incarceration and homelessness that plagues many.
In a November budget hearing meeting with Gov. Bill Haslam, Mental Health Commissioner Doug Varney laid out such a plan as being a humane and cost-effective way to deal with what he sees as one of the state’s biggest problems. In 2011, he told Haslam, for the first time ever, the state saw more people seeking treatment for narcotics addiction than for alcoholism — and the state’s system was sorely taxed.
“A large number of people in jails … their core problem is really drug abuse,” he said. Such an intensive program could “change their (lives) before they ever get that far.”
TDOC estimates the average daily cost to house a prison inmate at just more than $67. The Recovery Court residential program, even being more service-intensive than existing programs, will cost an average of $35 per person per day, the state said. But it also will, in theory, save money by reducing recidivism — “repeat offenders” — by using “evidence-based” programs “proven to have a larger impact on reducing recidivism.”
The state said studies have shown the recidivism rate for people who participate in such programs is one-third that of those who don’t.
However, it should not been taken as the state going “soft on crime,” TDOC Commissioner Derek Schofield said.
“What it says is that we’re going to place people in the best option to ensure they don’t re-offend. But also, we’re going to make sure we have a prison bed available for people who commit violent offenses that harm our communities,” he said.

Five Mental Health Institute Workers Fired Amid Patient Abuse Allegations

Five former state employees have been accused of abusing patients at Middle Tennessee Mental Health Institute and the TBI is investigating, according to WSMV-TV.
“If those vulnerable patients are being mistreated by state employees, harmed or injured, we need action,” said State Rep. Gary Odom, D-Nashville.
…The five former employees (not named in the report) are accused of abusing two patients, one of them confirmed by the I-Team to be Matthew McDougal of Brentwood.
The termination records read that in two separate instances, once in April, and another in May, employees inflicted bodily injuries on McDougal and the other patient.
The reported abuse occurred in the forensic services program, where some of the most at-risk patients are located.
“If a patient is abused in that situation, there’s a failure of the system,” said Jeff Fladen, with the National Alliance on Mental Illness.
A spokeswoman for the TBI confirms on May 23, some 22 days after the last reported abuse, the Tennessee Department of Mental Health, which oversees the institute, asked the TBI to investigate.
The five employees were then fired the next month.

Legislators criticize prison medical contract

A legislative watchdog group agreed Monday to delve deeper into the state Department of Correction’s awarding of a $200 million-plus contract to handle inmate health care to a relative newcomer despite its $6.4 million higher bid, reports the Chattanooga TFP.
Fiscal Review Committee members want the winner of the contract, Centurion LLC, to come before the panel in September.
Correction Department officials went before Fiscal Review for approval of their request to extend the current contract of Brentwood, Tenn.-based Corizon until Sept. 30 to provide Centurion additional time to prepare taking over the service.
While the business at hand was the 90-day extension of Corizon’s existing contract, committee members devoted most of their time questioning Centurion’s winning of the new three-year contract.
Corizon, which had the existing contract, lost the competition to Centurion on the new three-year contract. Corizon protested but two state panels upheld the award to Centurion, the most recent coming in a June 6 ruling.
Recently, Correction Department officials said, Corizon indicated it would not push the protest further by going to court.
Lawmakers criticized the request-for-proposal process and raised concerns about the higher cost and what they see as the recently created Centurion’s relative lack of experience.
Rep. Tim Wirgau, R-Buchanan, said it raises “red flags” for him.
“Give me some reasons why you decided to spend $6.4 million more,” he told Wes Landers, chief financial officer for the Correction Department.
Rep. Jeremy Faison, R-Cosby, was highly critical of Centurion’s experience.
“That seems a little shady there,” Faison said, adding that the state either had standards or not in awarding points in the request-for-proposal process for experience.
In remarks both during the committee and afterward, Wes Landers, the Correction Department’s chief financial officer, defended the decision to go with Centurion.