Illinois Gov. JB Pritzker joined health leaders Monday to unveil several steps to increase access to reproductive care.

That includes a new hospital navigation program, set to debut this month, designed to give appropriate and expeditious treatment to patients who need a higher level of care than can be provided at a clinic. [Health News Illinois]

The hotline, to be staffed by nurse navigators, will help patients schedule appointments, acquire pre-operative testing and arrange payment, transportation and childcare for treatment.

The initiative will be a partnership between the Chicago Abortion Fund, the University of Illinois Chicago, Rush University System for Health and the departments of Public Health and Healthcare and Family Services. 

Pritzker said at an event at the University of Illinois Chicago that the plan will help reduce disparities for hospital-based abortion care, speed up medically urgent referrals and alleviate the strain on abortion clinics.

“In the Land of Lincoln, we've doubled down on our commitment to maintain and expand reproductive health access for patients and protect providers," he said.

Other initiatives announced Monday include:

·    The opening of requests for proposals to support a public-facing hotline for abortion service navigation throughout Illinois. The hotline is funded through $10 million allocated to IDPH in the current budget.

·    The creation of a Medicaid family planning program for people otherwise not eligible for Medicaid due to income. Covered services will include annual preventive exams, family planning counseling and all Food and Drug Administration-approved methods of contraception.

·    A new $5 million capital investment program to support reproductive healthcare providers in Illinois that are experiencing increased demand for their services for improvements and repairs to new or existing facilities.

·    Authorization for Illinois to cover transportation and lodging for state employees who must travel to access reproductive healthcare. 

Some of the initiatives will be supported by the $18 million allocated to IDPH in the current budget to support efforts to expand access to such services. The family planning program will be paid for with a mix of federal Medicaid and Title X funding.

“I feel so fortunate that IDPH is committed and dedicated to working across the administration and with our provider community to ensure that those seeking family planning and abortion services in Illinois get access to the reproductive care they need,” said department Director Dr. Sameer Vohra.

Chicago Abortion Fund Executive Director Megan Jeyifo said they have helped over 250 individuals that required hospital care in the year since the Supreme Court overturned the constitutional right to an abortion, a 26 percent increase from the prior year. 

An already stressful situation of receiving an abortion is made worse by individuals having to travel out of state to a place where they may not know anyone or know where services are available, she said. The hotline will help alleviate some of those challenges.

 “(The initiative) will strengthen the working relationships we have with four major hospitals in the Chicagoland area to make sure our callers and all people who require hospital-based care can access appointments as soon as possible,” Jeyifo said. “And most importantly, it will strengthen Illinois’ ability to do what we have already been doing in this landscape: stepping up as a national access point for hospital-based care.”

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E-cigarettes are now part of a state law that prohibits smoking in nearly all indoor public places. [Health News Illinois]

Gov. JB Pritzker signed the plan into law on Friday, which adds the use of alternative nicotine products and e-cigarettes to a law that bans smoking in public spaces, places of employment and within 15 feet of public entrances.

“Illinoisans deserve to enjoy public spaces without being exposed unwillingly to secondhand vapor and other electronic cigarettes byproducts,” Pritzker said in a statement.

Retail tobacco stores that derive at least 80 percent of total revenue from the sale of e-cigarette products are exempt.

Health advocates praised the law, saying it will further protect individuals from secondhand exposure to toxicants in public places.

“We commend the General Assembly for passing this important legislation and look forward to working with them to pass further public health initiative,” said Ally Lopshire, government relations director for the American Cancer Society Cancer Action Network.

Prtizker also signed other healthcare-related proposals into law Friday that will:

·    Task the Department of Natural Resources and the Department of Human Services with developing and administering an outdoor Rx program.

·    Establish primary goals for the Illinois Nursing Workforce Center and task the group with developing a strategic plan to address the state’s nursing workforce.

·    Clarify existing language related to the definition of abuse or criminal neglect of a long-term care facility resident.

·    Expand the definition of a “healthcare employer” to include a financial management services entity contracted with the Department of Human Services’ Division of Developmental Disabilities.

·    Require the state long-term care ombudsman to be notified when a resident is involuntarily transferred or discharged from a nursing home facility.

·    Require the Department of Public Health to create a pilot program so it can employ a certified plumbing inspector to perform municipal inspections.

·    Require hospitals to screen patients for financial assistance eligibility and to pursue all cost-reducing options before taking collection action against the patient.

·    Prevent health insurers, starting in 2025, from applying a higher standard of clinical evidence for the coverage of proton beam therapy than the insurer applies for the coverage of any other form of radiation therapy treatment.

·    Require the Department of Public Health to adopt rules for meeting specific standards for at-home continuing care. The department is also allowed to deny, suspend or revoke a certificate of registration for cause.

·    Expand access to those who can sell fentanyl test strips over-the-counter to pharmacists and retailers.

Create a state act outlining ways to improve quality and access to behavioral health crisis services, including requiring the Department of Human Services' Division of Mental Health to determine the “sound costs” associated with developing and maintaining a statewide initiative for the coordination and delivery of the continuum of behavioral health crisis response services. 

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The nation’s maternal mortality rate increased by nearly 40% between 2020 and 2021. The rate of US women who died during or soon after their pregnancies in the US is higher than at any other time since 2000, according to new data from the Centers for Disease Control and Prevention (CDC). [USA Facts]

The rate was higher for certain groups in the population, such as pregnant Black women. The COVID-19 pandemic and the rising age of pregnant women also contributed to the worsening rate.

It's not a new problem in the US. Although the maternal mortality rate dropped in some years over the last two decades, the overall trend has been upwards.

The World Health Organization defines maternal mortality as the death of a woman while pregnant or within 42 days of the end of pregnancy, regardless of how long the pregnancy lasted or any cause related to the pregnancy.[1]

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This issue features a collection of articles under the umbrella of “HIV, Substance Use, and Trauma: Mentoring to Dismantle Structural  Racism. [APHJ]

”Historically, most research on racial discrimination and trauma and HIV and substance use has examined these issues primarily as individual-level processes. Echoing themes from Krieger’s eco-social  theory (https://bit.ly/3MC6vIk), the articles in this collection seek to advance knowledge about how structural racism and intergenerational trauma are embodied for racialized US communities, resulting in disproportionate rates of HIV and substance abuse .Leveraging theoretical and empirical insights from the intergenerational trauma and structural racism literature, this collection seeks to contextualize racialized health inequities and pinpoint opportunities for multi-level (i.e., individual, community, and structural) intervention. These structural racism and intergenerational trauma contexts are vital because, as Resmaa Menakemwrites in his book, My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies(Las Vegas, NV: Central Recovery; 2017),

Many African Americans know trauma intimately—from their own nervous systems, from the experiences of people they love, and most often, from both. But African Americans are not alone in this. A different but equally real form or racialized trauma lives in the bodies of most white Americans. And a third, often deeply toxic type of racialized trauma lives and breathes in the bodies of many of America’s law enforcement officers. All three types of trauma are routinely passed on from person to person and from generation to generation. (p. 9)

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Certain COVID-19 indicators continued their recent rise last week, according to data from the Centers for Disease Control and Prevention. [US News-CDC]

SEE: 

Latest Coronavirus and Vaccine News

Both coronavirus emergency department visits and test positivity increased, according to CDC data. The agency no longer tracks COVID-19 cases. Instead, it focuses on hospitalizations and deaths, which don’t yet show an increase.

The CDC reported last week that it was the first time since January that COVID-19 metrics showed an increase. The uptick is small, but it’s a notable reversal after months of declining coronavirus numbers.

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The Cook County Medical Examiner’s Office said Tuesday that it has confirmed 2,000 opioid-related deaths last year, the highest number reported in a single year. [Health News Illinois] 

More than 91 percent of the opioid overdose deaths involved fentanyl, up about 2 percentage points from the prior year.

Of the deaths, 56 percent were Black residents, 29 percent were white and just under 15 percent were Latinx.

Just over 70 percent of opioid overdose deaths were in the city of Chicago.

The previous single-year high in opioid deaths was 1,935 reported in 2021.

 The office said data from 2023 is not yet available as it awaits toxicology results for pending cases.

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U.S. Health and Human Services Secretary Xavier Becerra used a Monday stop in Chicago to highlight steps the Biden administration has taken to increase access to healthcare services.  [Health News Illinois] That includes setting aside over $1 billion dollars to allow those either underinsured or uninsured to be able to access COVID-19 vaccines this fall. Becerra said at the UnidosUS Annual Conference that they will partner with federally qualified health centers and pharmacies to ensure individuals know they will be able to access vaccines. “We're gonna go where people are to get their healthcare," he said. Another area of focus has been the implementation of the 988 lifeline for those experiencing a mental health crisis. Becerra said they have made concerted efforts to recruit multi-lingual individuals to work call centers, specifically those who speak Spanish. Becerra visited Mount Sinai Hospital earlier in the day to discuss efforts to lower prescription drug costs, as well as to make sure individuals do not lose their Medicaid coverage during redeterminations. "I'd plead that everyone here in Chicago please work with us to ensure that people who currently have Medicaid don't forget to reapply,” he said. ###

Advocates from across the mental health spectrum told members of a Chicago City Council committee that more steps need to be taken to improve the region’s mental health infrastructure. [Health News Illinois] 

Dr. Arturo Carrillo, deputy director of health violence prevention at the Brighton Park Neighborhood Council and member of the Collaborative for Community Wellness, told the council’s Health and Human Relations Committee that Chicago must invest in community safety. That includes support for prevention, support during crises and after-care services.

He said they need to train more individuals to engage community residents at high risk of mental health before a crisis occurs.

“This long-term care can and will be provided by Chicago's public mental health centers as we reestablish this system and this infrastructure that is absolutely necessary for the well-being of all Chicagoans,” Carrillo said.

The collaborative released a white paper earlier this month outlining its proposal to improve the city's approach to crisis response and mental health.

The committee heard testimony related to an ordinance that would re-open the city’s shuttered mental health clinics, a stance supported by Mayor Brandon Johnson, as well as give the health department the ability to send out crisis response teams staffed by paramedics and social workers to address mental health crises.

Dr. Dave Chokshi, the former health commissioner of New York City, told the committee that the city has the chance to be the “vanguard of a bold new approach” to mental health. 

Along with the continued expansion and investment in community health workers that can work with residents and advocate for policy changes, Chokshi said they must invest in the public health infrastructure and a combination of physical facilities and mobile teams that can best reach individuals in need of services.

“My three themes were community, public and investment — public investment in our communities,” he said. “Broadly, this is what we need to reverse the decline in American life expectancy that is happening on our watch.”

The committee also heard from representatives from other municipalities about their models of care, such as Denver’s mixture of crisis response to non-emergency situations and its utilization of 24-hour walk-in crisis centers. 

Samantha Rabins, a supervisor for Denver County's Co-Responder Program that works closely with the region’s Support Team Assisted Response, said while their model is specific to the Denver community, it gives each individual "access to whatever crisis service that they feel is best for them."

Committee Chair Rossana Rodriguez Sanchez said Monday’s discussion is the “first step” in a multi-year process to improve the city’s systems of care.

 “We know that in order to have a safe city, we need to ensure that our most vulnerable people, the most at risk are protected,” she said. “We know that Black and Brown people, especially Black people, are most likely to be harmed or killed by police during a mental health crisis. We know we can save precious lives by caring for people instead of criminalizing them.”

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Medicare beneficiaries’ out-of-pocket costs for insulin exceeded $1 billion in 2020 vs $236 million in 2007.¹ High costs lead some patients with diabetes to reduce adherence to insulin, increasing the risk of adverse health outcomes.^{2-4 [JAMA Network]}

Although efforts to cap patients’ cost sharing for insulin have existed in some states since 2020, and in certain Medicare Part D plans since 2021, in January 2023 the Inflation Reduction Act⁵ capped cost sharing for insulin at $35 for a 1-month supply for all Part D beneficiaries and, therefore, may have a greater effect on adherence. This study measures the association of this cost-sharing cap with insulin fills.

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Chicago City Council approves $2.9 million purchase of Lincoln Square hotel for transitional housing, behavioral health support

The Chicago City Council signed off Wednesday on the $2.9 million purchase of the former Diplomat Hotel in the Lincoln Square neighborhood, with the goal to turn it into a pilot program site that provides behavioral health and housing support for those experiencing homelessness. [Health News Illinois]

The program will build off the experiences of the COVID-19 pandemic, when the city offered hotel rooms to those experiencing homelessness as well as on-site healthcare workers who monitored for the virus and provided medical care for chronic health and behavioral health conditions.

Fifty-one percent of those participating in that program successfully transitioned into some type of housing, according to the Chicago Department of Public Health.

Department Commissioner Dr. Allison Arwady said the pilot program will be the first long-term city program “solely focused on stabilizing people experiencing homelessness who also have major untreated health needs.”

“It’s about breaking the cycle of homelessness by first providing transitional housing while focusing on addressing these acute health needs, with a longer-term goal of eventually moving individuals into both permanent housing and ongoing healthcare,” she said.

The Diplomat Hotel was selected based on program needs, location accessibility and support from local Alderman Andre Vasquez.

In other business, the council approved a resolution to hold a subject matter hearing on an ordinance focused on addressing behavioral health in the city. 

Along with re-opening the city’s shuttered mental health clinics, the proposal would also give the health department the ability to send out crisis response teams staffed by paramedics and social workers to address mental health crises.

“These actions taken today are a tremendous step forward in implementing our vision of supporting workers and working families and individuals in need of mental healthcare and resources, which is essential to the success of our city,” Mayor Brandon Johnson said after the meeting. “While this kind of transformational change won’t happen overnight, we are determined to chart the best path forward and create a better future for all Chicagoans.”

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