[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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Register now for the November 12, 2021, virtual session: Cannabis- Everything You Need to Know and Be Pain-Free with CBD Cannabis Therapy in the 21st Century 

In the 19^th century, cannabis was the most common ingredient in the American pharmacopeia. Park-Davis, Eli Lilly, Johnson & Johnson, and Merck prepared digestible and topical medicines for prescription. By the 1930’s; however, a nefarious political agenda, grounded in an inert economy and racial and ethnic bias, passed the Marijuana Tax Law, ushering in decades of needless cannabis prohibition and a famous war on drugs.

Fortunately, the exploration of exogenous cannabinoids and discovery of the endocannabinoid system, combined with an informed public, have reconceptualized cannabis as a harm reduction (rather than gateway) substance that restores homeostasis, treats countless diseases and conditions, improves psychological health, secures sleep, and manages pain. 

Speakers

• Melanie Dreher, PhD, RN, Dean Emeritus, Rush University, and Anthropologist-Moderator
• Dr. Jeffrey Hergenrather, Founding member and President of the Society for Cannabis   Clinicians
• Jesse Lopez, Founder & CEO, SourceOne Global Partners, Geocann
• Eloise Theisen, RN, Adult Geriatric Nurse Practitioner, and President of the American Cannabis Nurses Association

For more details and to register, visit this page.

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Cook County Board President Toni Preckwinkle last week laid out her proposed $8 billion budget for the coming year, which includes allocating millions in federal relief funds to behavioral and mental health services. (HN IL 10.11.2021] The budget includes $60 million in American Rescue Plan Act funds for healthcare and access initiatives related to behavioral and mental health programming and services. Another $60 million will go toward equity and justice initiatives like alternatives to 911 for mental health crises. “It’s a budget that reflects our values, our commitment to advancing equity and creates a path to an even stronger Cook County,” Preckwinkle said. “I’m proud of our work to navigate this pandemic in a fiscally responsible manner.  Nearly half of the budget, $3.95 billion, is allocated for public health. That includes $384 million in charity care, as officials said Cook County Health’s two hospitals provide over half of the county’s total charity care. The plan also calls for hundreds of new full-time hires at Cook County Health, including 98 for health plan services and a net increase of 81 in hospital-based services. Other provisions of the budget include: ·    Funds for renovations and additions to Provident Hospital, including the restoration of ambulance runs and expansion of inpatient capacity at the facility, ·    expansion of the neurology, cardiology and oncology services, and ·    the opening of a health center in the Belmont Cragin neighborhood. The Cook County Board of Commissioners will take up the proposal later this year. Read the budget here.  ###

The Department of Healthcare and Family Services outlined a bevy of recommendations to reform how long-term care is funded in Illinois in a recent report for policymakers.  The agency recommends a patient-driven payment model to “improve payment accuracy and appropriateness by focusing on the resident, rather than the volume of services.”  It also calls for dedicating funding to staffing increases and workforce transformation, as well as rewarding providers for achieving higher levels of care. Other recommendations include: ·    prohibiting staffing agencies from having non-compete clauses that keep facilities from hiring agency staff that have been assigned to them,  ·    targeting additional federal relief funding to address urgent one-time needs - such as reducing room crowding and improving air quality, ·    boosting transparency of nursing home ownership and revenues and  ·    requiring HFS to study the impact on equity for residents and pay for workers. HFS Medicaid Administrator Kelly Cunningham told members of a Medicaid Advisory Committee’s Public Education subcommittee on Thursday that the report is the summation of over a year of work on how to address rate reform. “We look at nursing home rate reform to improve quality and staffing and outcomes for residents,” Cunningham said. “It’s really a moral imperative on the part of the department and it is a message that I think comes across fairly clearly in this report.” Download full report here> ###

As part of Hispanic Heritage Month, Cook County Health will be hosting a virtual event on Thursday, October 14 at 6 pm for a “Conversation with Hispanics, Latinos and Latinas in Medicine.”

Cook County Board President Toni Preckwinkle and Cook County Health leaders will discuss the historic role that Hispanics and Latino/as have played in medicine, especially in Cook County, as well as touch on the topics that are of most concern for the community, including COVID-19 and mental health.

 The virtual event will be live-streamed on their  Facebook page. 

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