A House committee on Wednesday approved a plan to create a uniform statewide drug take-back program that would be funded and operated by drug manufacturers. [Health News Illinois 2.10.2022]

The plan would require licensed manufacturers to create programs, independently or jointly with other manufacturers, by July 2023. Every program must include promotion, education and public outreach about the proper collection and management of covered drugs.

House sponsor Jennifer Gong-Gershowitz, D-Glenview, told members of the House’s Prescription Drug Affordability & Accessibility Committee that the proposal builds on an existing take-back program in Illinois by shifting the cost onto manufacturers - as well as ensuring the program exists in more rural communities.

Alec Laird, vice president of government relations for the Illinois Retail Merchants Association, said the proposal includes collection take-back in rural areas that did not previously have access, as well as more collection points for retail, solid waste agencies, sheriff and police departments.

Gong-Gershowitz said the plan has been amended since first introduced in 2019, with changes bringing on board retail merchants, the Illinois Environmental Council and the broader environmental community.

PhRMA, which opposed the initial plan, filed as "no position" under the amended plan.

Rep. Deanne Mazzochi, R-Elmhurst, questioned why the plan does not go after distributors or the pharmacy benefit managers, rather than manufacturers. She also raised questions about the overall effectiveness of such programs.

“I'm not necessarily convinced that these take-back programs are accomplishing much of anything once you get beyond opioids and certain types of drugs that are scheduled drugs where you may actually be concerned about them getting into the wrong hands because they have addictive capabilities or have particular toxic activity or something along those,” she said.

Others raised concerns on how the plan will affect generic drugs. Ashlie Van Meter, senior director of state government affairs for the Association for Accessible Medicines, said they oppose the plan as written. The funding mechanism should be based upon a “reasonable market share” based on revenue within the state, Van Meter said.

“If it's the generics paying for most of this, it's going to increase the cost of drugs in Illinois,” Van Meter said. “It's going to potentially lead to lower availability to patients for medicines that they need at affordable prices.”

Gong-Gershowitz said a provision in the proposal states manufacturers may not charge an increase in the cost of covered drugs to recoup the costs of a drug take-back program, though Van Meter countered that such clauses have been overturned in other states as a violation of the Dormant Commerce Clause. 

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In honor of Black History Month. Black Healthcare Leaders: Theodore K. Lawless, MD

Theodore K. Lawless, MD: born 1892, was an internationally regarded dermatologist and the first African-American to hold a faculty post at what’s now Northwestern University Feinberg School of Medicine. After his post-graduate studies, which led him from Columbia University to Harvard Medical School to Europe, Dr. Lawless began clinical research at Northwestern University in 1924. He was the Elizabeth J. Ward Fellow in Dermatology from 1928 to 1936, and then he served as a member of the Northwestern University Feinberg School of Medicine faculty until 1940. 

Today, roughly 6 percent of physicians in the United States are African American.  

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The 2022 Annual Healthcare Leadership Awards are open for nominations. Check out the awards and deadlines here. 

Need help in determining who to submit for these stellar awards? Check out the 2021 Annual Healthcare Leadership Award winners here. 

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A majority of nurses are unhappy in their current roles, and about 4 in 10 would need to see changes in order to stay, according to a survey from Nurse.org. [Beckers Hospital Review 2.7.2022]

Download a PDF of the survey report here. 

The organization surveyed nearly 1,500 U.S. nurses in more than a dozen specialties between September and November 2021. 

Five survey findings: 

1. Overall, 12 percent of respondents said they are happy in their current role.

2. Nurses practicing in clinical settings were least satisfied with their jobs. Forty percent said changes would be needed for them to stay in the current role.

3. Eighty-seven percent of nurses reported feeling burned out in the past year, 84 percent said they were frustrated with administrators and 77 percent said they felt unsupported at work.

4. Fifty-six percent of nurses said they felt unsafe at work in the past year.

5. Eighty percent of respondents said their units are adequately staffed, and 53 percent said they feel like they cannot turn down extra shifts.

View the full survey here.

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Demand for N95s, KN95s and KF94s has skyrocketed, and, unfortunately, so have counterfeit masks. 

In 2020, ECRI reported 60 to 70 percent of KN95s it tested didn't properly filter 95 percent of particles as they claimed, according to The New York Times. In the same year, U.S. agencies seized 21.2 million fake N95s, a problem that carried over into 2021 and now 2022. [Becker's Health Review Gabrielle Mason ]

The best way to find legitimate masks is to buy from reputable manufacturers and trusted retailers, reports the Times. However it can be challenging to discern expertly copied masks from real ones. Below are tips for spotting fake masks, from both the CDC and the Times.  

Eight+ tips for spotting fake N95, KN95 or KF94 masks:  

The packaging

1. It's a warning sign if packing isn't tamper-proof. Legitimate masks are normally sealed to make it clear no one besides the manufacturer has handled the masks. 

2. Company or location information about where the masks were manufactured should be provided, along with a real website or physical address to contact the manufacturer.

3. There should be an expiration date, because the particle-repelling electrostatic charge on respirator masks degrades over time. 

4. It's a red flag if packaging states a mask is "FDA approved." N95s are approved by the National Institute for Occupational Safety and Health, not the FDA, though a surgical N95 must also be cleared by the FDA. Neither agency provides "certificates of approval."

5. Packaging that states "genuine," "legitimate," "authentic," or "reputable" should be viewed with skepticism. Established, trusted companies don't need to claim themselves as such. 

6. Typos or grammatical errors are also a red flag. 

The mask

7. The name of the company or logo should be right on the mask.

8. Masks shouldn't have any quality issues that affect fit and consistency, such as a crooked nose-bridge wire or elastics that lose stretch or detach easily.

Tips for N95s

• The NIOSH mark should be in block letters and easily detectable.
  
  
• There should be an approval number on the mask or the bands starting with "TC-84A" and followed by four more numbers.  
  
  
• Legitimate N95s never have ear loops, but instead elastic bands that go around the back of the head. 
  
  
• There aren't N95 masks for children. Only adult-size masks undergo NIOSH approval.

Tips for KN95s, KF94s

• KN95 masks made after July 1, 2021, must be stamped with GB2626-2019. A mask with a GB number ending in 2006 was made according to the previous standard and is still legitimate if not past the expiration date.
  
  
• Packaging may state that KN95s or KF94s are FDA-registered or -listed, but this just means the manufacturer has filed paperwork to notify the FDA of its existence. 

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Gov. JB Pritzker rolled out a $45.4 billion budget proposal Wednesday, with a specific focus on addressing the state’s healthcare workforce and behavioral health.   His proposal creates a $25 million program to help community colleges train nurses, technicians and other high-demand healthcare personnel. It also allocates $180 million through the Department of Healthcare and Family Services for providers in the Medicaid program to direct toward staff bonuses, continuing education, staff retention and recruitment. The Department of Public Health would receive an extra $10 million to hire 175 staff to survey and monitor nursing homes and assisted living facilities, and for epidemiologists and infectious disease specialists. It also includes $500 million for HFS’ proposed rate reform for long-term care facilities, which the agency says will maximize federal dollars to boost staffing and improve quality. Pritzker is also proposing to eliminate licensure fees for 470,000 nurses, physicians, pharmacists, pharmacy technicians, respiratory care workers, social workers and other healthcare workers in the coming fiscal year, something officials said could reduce expenses for providers by $21 million. “Let’s recognize the burden our healthcare workers have borne and give them a much-needed reprieve,” he said. Other pieces include $2.5 million for a collaboration between IDPH and education agencies to certify academic-based training programs for community health workers and a $2 million increase in scholarships for nurses. The budget also increases funding and support for behavioral health services in Illinois. That includes $140 million to HFS for behavioral health rate payments and $150 million to fully implement a program for children with serious mental illnesses. It also allocates $70 million to the Department of Human Services for the creation of the 988 hotline number for those in a mental health crisis, which is set to go live nationally this July. Pritzker also announced he will appoint a chief behavioral health officer to oversee and coordinate behavioral health services in Illinois. “I'm confident the chief behavioral health officer will succeed in streamlining and coordinating these services across state agencies,” he said. Rep. Deb Conroy, D-Villa Park, told Health News Illinois she was thankful for the decision. “(Pritzker’s) commitment to promoting mental health will help thousands of struggling Illinoisans,” Conroy said. “The focus of this officer will emphasize Illinois’ commitment to creating a continuum of care and mental health and addiction.” Other provisions in the budget include: ·    Maintaining $2 billion in federal funding and adding $20 million to IDPH for public health preparedness and COVID-19 response activities at the state and local health department level for vaccination efforts, contact tracing, testing and laboratory services. ·    $1 million for Alzheimer’s disease outreach, research, care and support. ·    $1 million for sickle cell prevention, care and treatment. ·    $3 million for technology improvements at IDPH laboratories. ·    $96.4 million to provide services to more individuals with disabilities needing assistance to stay in their homes through the Home Services Program and strengthens the program through provider wage increases. ·    $2.5 million for the Community Health Worker certification program. ·    An additional $100.7 million for the Department of Aging’s Community Care Program to accommodate caseload growth and utilization.  ·    $14 million to fund a rate increase for CCP providers starting in 2023. ·    $17.5 million to operate the new 200-bed Chicago Veterans’ Home. Healthcare associations across the spectrum heaped praise on the governor's spending plan, specifically as it relates to workforce challenges. “The governor’s budget proposal importantly allocates resources to begin addressing healthcare staffing shortages, which have been worsened by the pandemic," Illinois Health and Hospital Association CEO A.J. Wilhelmi said in a statement. "We support the governor’s proposed funding for programs designed to help bring more workers into healthcare professions, and to help recruit and retain healthcare workers." The Illinois Primary Health Care Association said they looked forward to working with policymakers “on efforts to improve providers’ ability to recruit, retain and develop healthcare workers.” Illinois State Medical Society President Dr. Regan Thomas said they appreciated Pritzker acknowledging the challenges faced by the workforce, as well as addressing the state’s reimbursement backlog. “For many years medical practices serving state employees and retirees struggled as they waited months and months for reimbursement,” he said. “The length of delayed reimbursement has improved in recent years and with this budget, if approved, should go away.” The Illinois Nurses Association said they support Pritzker’s efforts to ease the costs of obtaining a nursing license and investments in programs to increase the state’s healthcare workforce. “We welcome the governor’s support and are looking forward to working with him to help build the nursing workforce of the future,” they said in a statement. Community Behavioral Healthcare Association CEO Marvin Lindsey said a $140 million investment to rebuild the state’s behavioral health workforce “represents a historic financial investment in the care for individuals working to overcome mental health and substance use challenges.” Illinois Behavioral Healthcare Association CEO Jud DeLoss echoed that sentiment. “Depression, suicide, alcohol abuse and opioid overdoses have all soared during the COVID-19 pandemic, so Illinois behavioral health system needs every possible extra dollar to combat the behavioral health pandemic swamping the state,” he said. Illinois’ long-term care associations were also generally supportive. “Programs such as front-line worker license fee waivers, nurse scholarships and funding community colleges to expand the number of those who can serve as front-line workers are welcome initiatives,” said LeadingAge Illinois CEO Angela Schnepf. “However, these need to coincide with legislation supporting the creation of CNA intern and medication aides positions in senior living communities so that a career ladder can be made available to keep these workers in the healthcare field.” Matt Hartman, executive director of the Illinois Health Care Association, said he appreciates the allocation for rate reform, and he hopes long-term care is included “in a significant way” when it comes to workforce. “Nursing home reimbursement should be focused on quality outcomes for the residents receiving care in the bed, with an emphasis on appropriate staffing,” he said. “Similarly, the focus on and dedication of funding to workforce development in the governor’s budget is welcome at a time when our sector has been decimated by staffing shortages.” The Health Care Council of Illinois said Pritzker’s proposals are “concrete steps” that will help alleviate workforce shortages seen across nursing homes. They added they will work with the administration on the release of additional federal relief funds for the industry. “Lastly, HCCI remains committed to working with all stakeholders to enact a new reimbursement system focused on staffing and quality of care that will help stabilize the industry,” they said in a statement. “HCCI’s mission is to pass legislation that will prevent nursing home closures, save critical healthcare jobs and prevent the disruption of resident care.” ###

The first case of a new subvariant of omicron has been detected in Illinois, though officials said it remains too early to know how it will impact the state’s declining COVID-19 metrics. [Health News Illinois 2.2.2022]

BA.2, a sub-lineage of the omicron variant, was detected by Northwestern Medicine’s Center for Pathogen Genomics and Microbial Evolution in an individual who tested positive for COVID-19 on Jan. 18.

“Now the question is whether the new subvariant will extend the tail of cases infected with omicron,” Ramon Lorenzo-Redondo, the bioinformatics director at the center, said in a statement.

He said case numbers have plateaued in countries where the new variant is more prevalent, though it remains to be seen whether Illinois or the United States will follow the same trend. Early studies suggest BA.2 could be more easily transmissible than the original omicron strain, although they haven’t found it causes different symptoms or more severe disease. 

Meanwhile, Illinois COVID-19 hospitalizations have dropped below 4,000 for the first time since mid-December.

As of Sunday, 3,870 Illinoisans were in the hospital with COVID-19, down 78 from Saturday and down 1,368 from the prior week.

Of the patients in the hospital, 684 were in intensive care units, down 22 from Saturday and down 221 from the prior week. There were 406 patients on ventilators, the same as Saturday and down 135 from the prior week.

There were 6,664 new COVID-19 cases and 28 deaths reported on Monday.

The new cases bring the state total to 2,920,971, while the death toll increased to 30,913.

The seven-day average for new cases on Tuesday was 11,873, down 13,179 from the prior week. The seven-day average for daily deaths is 108, down 12 from the prior week.

The seven-day statewide positivity rate for cases as a percent of total tests is 7.2 percent. The seven-day statewide test positivity using the number of COVID-19 positive tests over total tests is 9.1 percent.

Eighty percent of eligible Illinoisans ages 5 and older have received at least one dose of a COVID-19 vaccine, while 70.3 percent are fully vaccinated.

 Illinois vaccinators have administered 20,520,124 COVID-19 vaccines, per state data, including 3,876,831 booster doses. The seven-day average of doses administered is 34,851.  

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“A people who don’t make provision for their own sick and suffering are not worthy of civilization.”
–Daniel Hale Williams

The son of a barber, Daniel Hale Williams founded the first black-owned hospital in America, and performed the world's first successful heart surgery, in 1893. Williams was born in 1858 in Hollidaysburg, Pennsylvania, the fifth of seven children. After his father died, his mother, Sara Price Williams, moved the family several times. Young Daniel started as a shoemaker, but quickly knew he wanted more education. He completed secondary school in Wisconsin. At age 20, Williams became an apprentice to a former surgeon general for Wisconsin. Williams studied medicine at Chicago Medical College. [Columbia |Surgery- New York Presbyterian ] 

After his internship, he went into private practice in an integrated neighborhood on Chicago's south side. He soon began teaching anatomy at Chicago Medical College and served as surgeon to the City Railway Company. In 1889, the governor of Illinois appointed him to the state's board of health.

Determined that Chicago should have a hospital where both black and white doctors could study and where black nurses could receive training, Williams rallied for a hospital open to all races. After months of hard work, he opened Provident Hospital and Training School for Nurses on May 4, 1891, the country's first interracial hospital and nursing school.

One hot summer night in 1893, a young Chicagoan named James Cornish was stabbed in the chest and rushed to Provident. When Cornish started to go into shock, Williams suspected a deeper wound near the heart. He asked six doctors (four white, two black) to observe while he operated. In a cramped operating room with crude anesthesia, Williams inspected the wound between two ribs, exposing the breastbone. He cut the rib cartilage and created a small trapdoor to the heart.

Underneath, he found a damaged left internal mammary artery and sutured it. Then, inspecting the pericardium (the sac around the heart) he saw that the knife had left a gash near the right coronary artery. With the heart beating and transfusion impossible, Williams rinsed the wound with salt solution, held the edges of the palpitating wound with forceps, and sewed them together. Just 51 days after his apparently lethal wound, James Cornish walked out of the hospital. He lived for over 20 years after the surgery. The landmark operation was hailed in the press.

In 1894, Dr. Williams became chief surgeon of Freedmen's Hospital in Washington, D.C., the most prestigious medical post available to African Americans then. There, he made improvements that reduced the hospital's mortality rate. In 1895, he helped to organize the National Medical Association for black professionals, who were barred from the American Medical Association. Williams returned to Chicago, and continued as a surgeon. In 1913, he became the first African American to be inducted into the American College of Surgeons.

As a sign of the esteem of the black medical community, until this day, a "code blue" at the Howard University Hospital emergency room is called a "Dr. Dan." In words that could later be said of Vivien Thomas, a colleague wrote, "His greatest pride was that directly or indirectly, he had a hand in the making of most of the outstanding Negro surgeons of the current generation."

Dr. Williams died in 1931. The Daniel Hale Williams Medical Reading Club in Washington, D.C., commemorates his achievements.

Excerpt from PBS American Experience “Partners of the Heart.”

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Join this virtual session on Feb. 25, 2022: Mental Health During The COVID Pandemic: A Status Report. 

We will have a dynamic overview of the mental health consequences of the COVID pandemic. First, we present studies on increasing mental illness prevalence and the developing mental health provider gap. Secondly,  Aunt Martha's Health and Wellness, a leading provider in the State of Illinois, will present their experience with the demand and provision of services. Finally, we will examine some of the best emerging practices nationally and regionally implemented by municipal governments, health systems, or other care providers.

Speakers

Maurice Lemon, MD, MPH, Co-Chair of the Program Committee and Billings Fellow 

Wanda Parker, EdD, Clinical Director, Aunt Martha's Health and Wellness 

Karen Batia, PhD, Consultant, Health Management Associates 

More details and to register, visit this page.

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Deaths among middle-age U.S. adults have increased substantially this century, reversing decades of progress. [ Melanie Padgett Powers The Nation's Health January 2022, 51 (10) 16]

Among the primary drivers are drug poisonings, alcohol-related causes, suicide and cardiometabolic diseases, which include cardiovascular disease, diabetes and chronic kidney failure, according to a March consensus study report from the National Academies of Science, Engineering and Medicine.

Life expectancy progress in the U.S. stalled in 2010 then fell between 2014 and 2017, the longest sustained decline in a century.

Report committee members examined mortality trends from 1990 through 2017 for people ages 25-64 by age, sex and geography. While they also looked at information by race and ethnicity, data on mortality trends among Asian Americans and American Indians and Alaska Natives was lacking.

The committee found that since 2010, death rates either leveled off or increased. Three groups had higher all-cause mortality rates in 2017 than they did 27 years before: white males ages 25-44, white females ages 25-44 and white females ages 45-54.

Drug poisonings were the largest contributor to all-cause mortality, according to Darrell Gaskin, PhD, MS, a professor at Johns Hopkins Bloomberg School of Public Health who served on the report committee. They increased in every demographic group studied and in every state, especially in Appalachia and parts of the Northeast. The largest increases were among white males ages 25-44, urban residents, people with lower education levels, and urban Black men ages 55-64.

The committee pointed to two themes underlying the increases: increased availability and increased vulnerability. The rise in drug poisoning deaths — which encompasses drug overdoses — is connected to the emergence of opioids being prescribed for non-cancer pain, coupled with opioid overprescribing and regulatory failures, Gaskin said during APHA’s 2021 Annual Meeting and Expo in October.

“The pharmaceutical industry had convinced the regulators that addiction would not be a problem with this pain treatment,” he said. “Unfortunately, the technology they used to develop these opioid treatments was easily defeated by users.”

The second wave of the opioid crisis began as policymakers and regulators placed restrictions on opioid prescribing, which caused many users to transition to heroin and fentanyl. A third wave of the crisis began when illegal drug suppliers began to mix other drugs with fentanyl. Overdoses spiked, and in 2010, fentanyl deaths surpassed heroin deaths.

Despite all this, the problem is bigger than the opioid crisis, Gaskin said. Deaths from cocaine and methamphetamine use also increased in the 2010s, as did alcohol use, linked to price decreases, increased availability, deregulation and flavored beverages.

“This trend in working-age increased mortality is a uniquely American phenomenon,” said Steven Woolf, MD, MPH, a professor at Virginia Commonwealth University who also served on the report committee. “It’s not happening in other high-income countries, so there’s a real need for cross-national research to understand ‘what is it about America that is responsible for this particular phenomenon?’”

For more information on “High and Rising Mortality Rates Among Working-Age Adults,” visit www.nap.edu.

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