Illinois expects to receive an initial shipment of 500,000 doses of the Pfizer-BioNTech COVID-19 vaccine once it receives federal approval for use in children ages 5 to 11 years old, Gov. JB Pritzker announced Monday.[Health News Illinois 10.26.2021] 

"Thanks to scientists and doctors who've worked tirelessly for the last year, we are likely just days away from having the COVID-19 vaccine available for 1.1 million more Illinois children, ages 5 to 11," Pritzker said at a Chicago press conference. "As soon as the (Food and Drug Administration) and the (Centers for Disease Control and Prevention) have signed off, these kid-sized doses and kid-sized needles will be shipped out to pharmacies, pediatricians and other providers across Illinois.”

Nearly 306,000 of the initial doses will go to the state, 73,000 will go to the city of Chicago and over 100,000 will head to the federal government’s pharmacy partners.

The Illinois Department of Public Health has started to enroll pediatric offices to provide COVID-19 shots, with over 2,200 locations and providers already enrolled to provide doses to eligible children. The agency is also working with federally qualified health centers, local health departments and family practitioners to ensure equitable access to vaccines.

“I am urging every single parent or guardian to do this for their child, make a plan to get them vaccinated for COVID-19,” said IDPH Director Dr. Ngozi Ezike.

IDPH reported 1,565 new COVID-19 cases and eight deaths on Monday.

The new cases bring the state’s total to 1,686,048, while the death toll is 25,648.

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Industry lobbyists, business groups and private individuals all met with White House officials last week to ask for a push-back on the implementation of a COVID vaccine mandate for private companies, CNBC reported Oct. 25. [Becker's Hospital Review 10.25.2021] 

The administration is conducting its final review of the mandate, which will require companies with 100 or more employees to ensure their staff are fully vaccinated or undergo weekly testing. The mandate is estimated to affect around two-thirds of the private sector workforce. The Office of Management and Budget received the final rule Oct. 12 and is soon expected to finish its review, after which the mandate will quickly take effect. 

Employers are worried that the mandate will drive even more employees to quit amid the highest level of turnover in 20 years. A poll from health policy analysis firm KFF, published last month, revealed  30 percent of unvaccinated employees said they would rather leave their companies than comply with testing or get vaccinated. The responses in these polls are often exaggerated, however, according to financial services company Goldman Sachs. Goldman Sachs' research suggested that the mandate would actually encourage employment by reducing COVID transmission and creating a safer work environment to invite back the five million workers who left due to the pandemic.  

Industry lobbyists raised concerns about the cost of weekly testing. "If folks are allowed to refuse vaccination, and the employer takes testing obligations from a cost standpoint, then there's no real motivation for those employees to get the vaccine," Evan Armstrong of the Retail Industry Leaders Association said.

The National Retail Federation asked for 90 days for employees to comply with the mandate, effectively pushing back the order until January 2022. The Business Roundtable, another lobbyist group, also told CNBC  the administration should allow time for employees to comply.  Ed Egee, a lobbyist at the National Retail Federation, told CNBC, "This mandate cannot be implemented in 2021 without having serious repercussions on the American economy.

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Behavioral health providers call on Pritzker to provide $120 million for workforce challenges Behavioral health providers want Gov. JB Pritzker to steer $120 million in state and federal funds their way to address a workforce crisis exacerbated by the COVID-19 pandemic.  Illinois Association for Behavioral Health CEO Jud DeLoss said a majority of his members have had to cut back this year on treatments and services due to inadequate staffing levels. He said the issue took root before the pandemic.  As recently as 2019, the association said the state had only about a quarter of the behavioral healthcare professionals it needed in designated shortage regions.  “Behavioral health providers need this cash injection by Dec. 1 and they need it without unnecessary new programs, grant applications or complex red tape,” DeLoss plans to tell lawmakers Friday during a subject hearing initiated by his group, according to testimony provided ahead of time.  To help finance workforce retention and recruitment, DeLoss called on Pritzker to direct $50 million to behavioral health providers from funding the state received from the American Rescue Plan Act for mental health funds, as well another $54 million from federal COVID-19 money for substance use disorders. He said Pritzker could also draw upon $40 million in recreational cannabis tax revenues allocated for mental health and substance use disorders.  "The accelerating and dramatic loss of Illinois behavioral health workers – administrative and clinical staff alike – and a dwindling ability to recruit new workers by community health providers in your districts is why I am before this Committee today: to ask for your help to defuse the workforce shortage crisis," said DeLoss in written testimony to be delivered on Friday. "We are asking the Pritzker Administration to release $120 million for recruitment and retention efforts by behavioral healthcare providers by December 1." ###

A House committee approved a plan Wednesday incentivizing new owners to reopen closed hospitals in Illinois. [Health News Illinois 10.21.2021]

The bill would allow a reopened hospital to continue to receive enhanced Medicaid rates for certain services at the same rate as the prior hospital, if the facility closed within three calendar years. That rate would stay in place until utilization data for the new facility is available for the Medicaid inpatient utilization rate calculation.

House Majority Leader Greg Harris, D-Chicago, told members of the House’s Executive Committee that the proposal is in response to the number of hospital closures in recent years and is intended to “help bridge the gap and incentivize” new owners to reopen facilities in underserved communities.

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[American Public Health Association]

PROBLEM

Pre-Pandemic

People experiencing unsheltered homelessness — such as those sleeping in parks and vehicles, or on streets — were at higher risk of physical and mental health issues than their sheltered counterparts. (see Reference #1)

1 in 3 individuals experiencing homelessness is unsheltered.

The overall rate of homelessness grew from 2018-2019, due to an increase in the unsheltered population, particularly through growth in these groups. 

28% Native American
10% gender non-conforming
10% Black
12% female
43% transgender

NOW

Those experiencing unsheltered homelessness are at high risk of COVID-19 morbidity and mortality because they are less connected to health care and other support systems and more likely to have other health conditions. And, the groups that have increased the unsheltered population also represent those most at risk of negative health consequences of COVID-19. Despite increased risk, the true impact of the pandemic on the unsheltered is unknown, due to extremely limited data. 

Full article here>

Download PDF here

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Everyone should feel safe in their workplace and community. Yet this often is not the case. Across the country we see acts of violence in all its forms – from domestic violence to human trafficking to mass violence to workplace violence. 

Hospitals and health systems, because they are always there to serve, are not immune to violence. Hospitals and health systems are places where patients come to heal, and that includes treating patients who are victims of violence. Health care providers also experience violence, which now seems to be exacerbated by the COVID-19 pandemic, as enforcing mask and visitor requirements collide with health care workers who are enduring long shifts with less time off.

These increased tensions in the hospital setting make it difficult to mitigate workplace violence. It begs the question: What kind of care is provided to our health care workers when they experience trauma?

See full article here>

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The Centers for Disease Control and Prevention last week  released an operational planning guide for pediatric COVID-19 vaccination and preliminary information on the pediatric Pfizer COVID-19 vaccine. The Food and Drug Administration is considering whether to authorize emergency use of the Pfizer vaccine for children aged 5-11, with a decision expected in the coming weeks. The new planning documents expand on an initial CDC document released this week on packaging changes and storage requirements for the Pfizer pediatric COVID-19 vaccine for children ages 5-11. The new planning guide includes additional information about the rollout of the pediatric vaccine; projected launch plan considerations for jurisdictions; and a readiness checklist for supply and ordering, provider network adequacy, information technology systems for reporting and monitoring, and communications.

Read full article here>

Download the CDC Seven-Page Pediatric COVID-19 Guide here> 

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The scientific evidence on climate change has grown increasingly stark. Continued warming will further destabilize our climate and produce more frequent and intense storms, wildfires, and heatwaves as well as more damaging droughts and more extensive ecosystem losses. In August 2021, the United Nations’ Intergovernmental Panel on Climate Change released its latest report in which 234 of the world’s leading scientists, citing over 14,000 different studies, concluded with high confidence that the climate crisis is a “code red for humanity.”

This year alone, extreme weather has upended the U.S. economy and affected one in three Americans. Wildfires have burned nearly six million acres of land—equivalent to the total land mass of Massachusetts and Rhode Island combined—and destabilized international supply chains. After carving its destructive path through the Gulf of Mexico and stalling commodity exports to the world, Hurricane Ida took down the New York City subway system for hours, dumping a record 3.15 inches of rain in a single hour and bringing commerce in the most populous city in the United States to a halt.1 On the other side of the country, the Hoover Dam’s Lake Mead reached its lowest level since the dam was built in 1931, causing the government to declare the first-ever water shortage on the Colorado River and prompting water cutbacks for regional farmers and the economies they support. As this year draws to a close, the total damage of extreme weather will build upon the $99 billion already incurred by American taxpayers in 2020.

[Page 12 of the report] 

Protecting Vulnerable and Disadvantaged Communities

The burdens of climate change, including the disruptions caused by climate-related financial risks, will fall disproportionately on disadvantaged communities and communities of color.17 Climate risk will particularly impact the millions of Americans who live in underinvested and overburdened communities. Recent research shows these disadvantaged communities are disproportionately exposed to extreme weather as a result of climate change.18

Download the 40-page report here.

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In July, local health official Faisal Khan attended a county council meeting to do his job — talk about COVID-19 data and offer guidance on the best ways to save lives and contain the spread of the virus. He left the meeting needing security detail for his entire family.  [The Nation's Health October 2021, 51 (8) 1-13]

“I was prepared for a discussion, even skepticism,” said Khan, MPH, MBBS, director of the St. Louis County Department of Public Health in Missouri. “But in 25 years of public health service, I have never faced this sort of situation.”

That night at the council meeting, Khan explained why he and fellow county officials had decided to reinstate a mask requirement against a backdrop of surging infections, lagging vaccination rates and rising hospitalizations. Khan’s talk was met with jeers, taunts and verbal abuse. One council member pointed out that Khan was not born in the U.S.

As Khan left the meeting, an angry crowd hurled racial slurs and physically assaulted him, Khan later wrote in a letter to the council chair. The situation “saddens me beyond comprehension,” he told The Nation’s Health.

Full article here> 

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Our team of policy experts is closely monitoring new developments of the Senate reconciliation bill under consideration. As pieces of legislation make their way through Congress, we have identified multiple components that align with our 2021 Policy Agenda. Most recently, budget reconciliation set to be considered in the House Energy and Commerce committee seeks to provide access to health coverage for over 2 million uninsured Americans who fall into a gap in access to affordable health plans. [Coalition to Transform Advanced Care 10.6.2021]

This coverage gap is created by income limits for Medicaid eligibility and marketplace tax credits in states that have not expanded Medicaid to offer the coverage provided by the Affordable Care Act (ACA). As a result, low-income individuals, even those with incomes below the federal poverty line, may not be eligible for Medicaid, and are left to seek coverage in a marketplace meant for individuals earning at least 138% of the federal poverty line, pay for potentially costly coverage offered by employers, or go without insurance. This places more people at risk of serious illness derived from lacking preventive care, missed screenings, and lack of treatment adherence. Additionally, existing policies disproportionately impact Black and Latinx individuals, who represent more than half of those who fall into the coverage gap. The proposed legislation aligns with C-TAC’s commitment to advancing health equity and increasing access to critical treatments and services for those living with serious illness.

The legislation under consideration aims to close the coverage gap by implementing immediate and long-term solutions for low-income individuals who find themselves unable to access coverage. The bill would begin implementation in January 2022 by expanding eligibility for premium tax credits in ACA marketplaces to include low-income individuals in non-expansion states who would be eligible for Medicaid under ACA expansion guidelines. 

More details and full article>

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