January 25, 2015

Report says Iowa failing in key anti-tobacco efforts

cigaretteA new report card on Iowa’s efforts to cut the use of tobacco products gives the state one A and three Fs. Iowa received failing grades for its funding for cessation programs, funding for prevention and control and for its tax of $1.36 for a pack of cigarettes. James Martinez, spokesman for the American Lung Association of the Upper Midwest, says Iowa’s grade point average of just one on a four-point scale is “unacceptable.”

“When we’re looking at access to cessation services, in other words, if someone wants to quit smoking, we do believe the state should help them,” Martinez says. “It saves health care costs across the state as well as it helps people make that decision and take that important step in their lives.” Iowa’s only passing grade came for its statewide smoking ban which covers virtually all public places and workplaces.

There’s a toll-free number smokers can call to reach counselors at Quitline Iowa, which offers up to eight weeks of free nicotine replacement therapies. Still, he says the state doesn’t make nearly enough of an effort to fund its cessation and prevention programs. “When you get an F in something like that, it’s alarming,” Martinez says, “and it really calls attention to our leadership in the state to do something about it.”

Iowa gets many millions of dollars every year in tobacco settlement money as well as federal dollars, but only spends a small fraction of it on programs that help people quit smoking or programs to keep them from starting. Plus, Iowa is spending much less on tobacco control and prevention than just a few years ago. While the state invested more than 12-million in the effort in 2008, it will spend less than five-million this year.

“It’s unfortunate that when they allocate the funding for something like tobacco prevention and control programs, they’re not using all of those funds,” Martinez says. “They’re not even using half of what they should be using that funding for. It’s unfortunate.” The report says more than 44-hundred Iowans die every year from smoking-related causes, while 19.5 percent of Iowa adults smoke along with 18.1 percent of high schoolers.

See the full “State of Tobacco Control 2015″ report at the website: www.lung.org.

 

Governor says care will improve with closing of Mt. Pleasant and Clarinda Mental Health Insitutes

Governor Terry Branstad during an event at the capitol Wednesday.

Governor Terry Branstad during an event at the capitol Wednesday.

Governor Terry Branstad says the state will look to other facilities to provide care if his proposal to close the state-run Mental Health Institutes in Clarinda and Mount Pleasant moves forward. The governor’s budget sent to legislators does not include any money to keep the institutions open past June 30.

“We had two mental health centers that were not accredited, we have no psychiatrist in Mt. Pleasant, the one in Clarinda is going to retire. So, we wanted to provide better services, and also we are going to work with the University of Iowa Hospitals. The governor says they want to use facilities that have the proper staffing to help patients. “We think we can provide better services to people with mental health issues with making this transition and not continuing those facilities where they’re not accredited and where we don’t have psychiatrists,” according to Branstad.

The idea is not favored by everyone, including Representative Dave Heaton, a Republican from Mount Pleasant. Heaton is chairman of the subcommittee that writes the budget for the Iowa Department of Human Services, the agency in charge of the Mental Health Institutes, and he’s arranged for the agency’s director to go to Mount Pleasant Saturday (January 24th) to explain the proposed closure to the community.

Five years ago a consulting firm hired by then-Governor Chet Culver recommended that the Mental Health Institutes in Clarinda and Mount Pleasant close, but Heaton and others worked to keep the institutions open. The Mental Health Institutes are routinely the treatment option of last resort for acute care of mentally ill patients. The governor’s budget indicates the state will save $15.5 million by closing the two facilities.

The MHI at Clarinda opened in 1888 while the Mount Pleasant facility opened the year the Civil War broke out, in 1861.

 

Safe Haven law used for 22nd time

Safe-HavenIowa’s Safe Haven procedures were put to use last week. “An individual brought a newborn boy to an Iowa health care facility on January 13,” Amy Lorentzen McCoy, spokesperson for the Iowa Department of Human Services, said.

This marks the 22nd time an infant has been turned over to the DHS since Iowa’s Safe Haven law was enacted in 2002. The law was approved in the wake of a high-profile case in 2001 involving a teen mother in eastern Iowa who killed her home-delivered newborn.

“This law provides a person with the ability to safely drop off an infant with no legal repercussions,” McCoy said. “What it does is really helps a parent in crisis safely hand over care and help another child be paired with a stable, loving family.” In all previous cases, the Safe Haven babies have been successfully adopted.

Last year, the Safe Haven law was used four times — including threes time in a four month span. “We have had more Safe Haven babies in the past year than in previous years,” McCoy said. “I think when a child is turned over as a Safe Haven child we see a lot of media coverage…and more people find out about the law and the about the ability to safely hand over the care of a child if they’re unable to provide safety and stability to the infant.”

Under Iowa’s Safe Haven law, parents have the option to safely hand over custody of babies age 14 days or younger without fear of prosecution for abandonment. The parent, or their authorized representative, can leave the newborn at a hospital or health care facility, and remain anonymous.

Alcohol use by pregnant women still impacts 300 Iowa newborns a year

Medical LogoEven though it’s completely preventable, there will likely be around 300 babies born in Iowa this year with what’s known as a Fetal Alcohol Spectrum Disorder.

Stephanie Trusty, a nurse clinician at the Iowa Department of Public Health, says the disorders come in many forms but they all have the same cause: the mother drank alcohol when she was pregnant.

“It causes brain damage,” Trusty says. “It also can cause abnormal facial characteristics, abnormal growth of the child, it can cause heart, lung and kidney defects, poor memory, poor coordination and motor skill delays.”

The list of disorders can also include learning disabilities, which can have a lifelong impact. The severity of the health issues depends on the timing and frequency of the mother’s alcohol consumption, which Trusty reminds, should not be a single drop.

Trusty says, “Of all the substances of abuse, including cocaine, heroin and marijuana, alcohol produces by far the most serious neuro-behavior effects in the fetus.”

People simply don’t realize how damaging alcohol can be to an unborn child, she says, as alcohol can impact a fetus at three weeks, which is before the woman may even realize she’s pregnant.

“It’s legal and it’s acceptible by society,” Trusty says. “I do think it’s often minimized. The perception, I think, by a lot of people is that other drugs are more dangerous than alcohol.”

Birth defects due to alcohol are 100% preventable, she says, if women commit to not drinking for nine months or when they begin trying to get pregnant.

There are about 40,000 babies born in Iowa each year. Studies find, about 7.5 in every 1,000 are born with Fetal Alcohol Spectrum Disorder.

A recent survey found nearly 22% of Iowa adults reported binge drinking in the previous month, significantly higher than the national rate of around 17%.

 

Iowans switching to new insurers following health co-op collapse

David Fairchild and Clara Peterson own a small cleaning business in Iowa. The couple had health insurance via CoOportunity Health before the co-op faltered.

David Fairchild and Clara Peterson own a small cleaning business in Iowa. The couple had health insurance via CoOportunity Health before the co-op faltered.

Iowa’s insurance commissioner says it’s too early to make predictions about the fate of health co-ops set up under the Affordable Care Act, but thousands of Iowans are scrambling to find a new insurer after one of those co-ops essentially collapsed last month. Nick Gerhart was recently assigned management of the nonprofit insurance provider CoOportunity.

The leaders of CoOportunity initially thought they would enroll about 12,000 people in Iowa and Nebraska, but they got about ten times that, according to Gerhart. “Ours was the second largest (health co-op) in the country, so you’ve got to look at it that way.” Gerhart says. “If the second largest can’t make it, how viable are the other ones? I don’t know. But at the end of the day they didn’t have enough capital to support 120,000 members.”

CoOportunity hit a kind of perfect storm, according to Peter Damiano, director of the University of Iowa’s public policy center. First, the co-op had to pay a lot more medical bills than those in charge expected. “CoOportunity Health’s pool of people was larger than expected and was sicker than expected,” Damiano says. “So their risk became much greater than the funds that were available.”

The reason the co-op’s customers were sicker has a lot to do with what the insurance market looked like in Iowa before Obamacare. The largest insurer by far in the state was and still is Wellmark. But Wellmark decided not to offer any plans on Iowa’s health exchange, leaving just CoOportunity and one other insurer – Coventry – offering plans on the exchange throughout the state.

Gerhart says, the co-op thought it was going to get more federal money, but learned on December 16 that financing wasn’t being extended. Gerhart says even though CoOportunity is not officially dead yet, customers should switch insurers.

David Fairchild and his wife, Clara Peterson, own a small cleaning business in Ames. David has chronic leukemia but treats it with expensive medicine. Last year, the couple saved hundreds of dollars switching from the insurer Wellmark to a plan run by CoOportunity Health.

For the first time in a long time, Fairchild said, they felt like they had room to breathe. “Basically it covered our office visits; covered exams, it covered all but $40 of the medicine every four weeks. It was just marvelous. It probably was too good to be true,” Fairchild said. Fairchild and his wife have already applied through healthcare.gov to switch to Coventry.

In a written statement, Dr. Martin Hickey, chairman of the board of the National Alliance of State Health Co-Ops, said, “The news about CoOportunity Health is not a statement on the health insurance co-op program or the co-op concept. It’s a reflection on the fact that all insurers – not just co-ops – are operating in unique markets with unique business plans and varying state regulations. The circumstances for CoOportunity Health in Iowa are not the same as those in the 23 other states in which co-ops are currently operating.”

Story and photo credit: Clay Masters, Iowa Public Radio

Key lawmaker ‘disturbed’ by Branstad’s call to close Mental Health Institutes in southern Iowa

Dave Heaton

Dave Heaton

Governor Branstad is proposing that the state-run Mental Health Institutes in Clarinda and Mount Pleasant be closed this summer. The budget Governor Branstad delivered to legislators this week does not include any money to keep the institutions open past June 30. Representative Dave Heaton, a Republican from Mount Pleasant, says there will be push back from the two communities as well as legislators.

“It’s like a lot of things today,” Heaton says. “It seems like administrations whether it’s in Des Moines or Washington, D.C. are going around the legislative bodies and moving forward their own agendas and I am disturbed about that.”

Heaton suggests Branstad was likely emboldened to make this move after legislators failed to block the governor’s abrupt closure of the Iowa Juvenile Home a year ago.

“I think the governor is violating the budgetary process,” Heaton says. “He’s making a unilateral decision without input from the legislature…He’s saying: ‘I just want to close ‘em.’ And that’s not right.”

Heaton is chairman of the subcommittee that writes the budget for the Iowa Department of Human Services, the agency in charge of the Mental Health Institutes, and he’s arranged for the agency’s director to go to Mount Pleasant on the morning of Saturday, January 24 to explain the proposed closure to the community. Five years ago a consulting firm hired by then-Governor Chet Culver recommended that the Mental Health Institutes in Clarinda and Mount Pleasant close, but Heaton and others worked to keep the institutions open.

“It was a long process in which the communities had an opportunity to get involved in the decision-making,” Heaton says. “This time it was done in the night and the governor just said: ‘We’re closing.'”

The state has four Mental Health Institutes. The Clarinda facility has 24 patients and there are 47 patients in Mount Pleasant. Amy McCoy, the spokeswoman for the Iowa Department of Human Services, says it’s likely those patients would be transferred to the other state-run facilities in Cherokee and Independence.

“Number one, we’ll be focusing on patient safety and quality as we make any transitions,” McCoy says. “The mental health delivery is changing and has been changing for a number of years and we must keep up with these best practices, but we value our staff very much and the service they’ve provided at these facilities has benefitted many, many Iowans over the years.”

About 80 people currently work at each of the facilities targeted for closure. McCoy says it’s unclear how many might be offered jobs in Independence or Cherokee.

“This is an extremely difficult situation for our staff and we want to be able to offer them as many details as possible,” McCoy says. “We’re going to work very, very quickly so they have the information they need to make their personal plans.”

The president of the union the represents many of those workers says Branstad’s “secretive decision” took “almost everyone by surprise,” even legislators. AFSCME Council 61 president Danny Homan says the governor’s “drastic recommendation” will impact “some of the most vulnerable Iowans.”

The Mental Health Institutes are routinely the treatment option of last resort for acute care of mentally ill patients. The governor’s budget indicates the state will save $15.5 million by closing the two facilities. The MHI at Clarinda opened in 1888 while the Mount Pleasant facility opened the year the Civil War broke out, in 1861.

(Reporting by Theresa Rose, KILJ, Mt Pleasant; additional reporting by Radio Iowa’s O. Kay Henderson)

Davenport man in medical marijuana debate dies

Medical-marijuanaThe family of a Davenport-area man who was at the center of Iowa’s medical marijuana debate is now mourning his death. Forty-nine year-old Benton Mackenzie died Monday of cancer at his parents’ Long Grove home. Mackenzie made national news when he fought Scott County in court over his efforts to grow marijuana for his use as a medicine.

Jurors were not allowed to hear any testimony about his health and convicted him and his wife and son of manufacturing marijuana. Mackenzie and his wife were sentenced to three years of probation. Their son received a suspended sentence.

The family is appealing the convictions. Before his illness, Mackenzie was known for putting on a Scottish kilt and playing bagpipes to honor firefighters and veterans on various occasions, including September 11th.

(Reporting by Phil Roberts, Davenport)