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Health Care

Morton Hospital In Taunton Converting To COVID-19 Center

CommonHealth (WBUR) - 1 hour 26 sec ago

Steward Health Care is also making changes in Ayer, Haverhill and Methuen.

Categories: Health Care

New England Patriots Open Virus Testing Site

CommonHealth (WBUR) - 1 hour 25 min ago

The New England Patriots are opening a drive-through testing site at their stadium in Massachusetts.

Categories: Health Care

Mass. Health Officials Report More Coronavirus-Related Deaths At Holyoke, Chelsea Soldiers' Homes

CommonHealth (WBUR) - Sat, 04/04/2020 - 5:24pm

There have now been at least 22 veteran deaths at Holyoke, while state officials reported an additional death at Chelsea, bringing the death toll there to at least three. Both are state-run nursing facilities for elderly veterans.

Categories: Health Care

'It's Frightening': How New Moms Are Experiencing The Coronavirus Pandemic

CommonHealth (WBUR) - Sat, 04/04/2020 - 1:28pm

The worries that almost all new mom can relate to can be exacerbated in a time of crisis.

Categories: Health Care

Preparing For COVID-19 'Surge,' Mass. Hospitals Are Losing $1 Billion A Month, Says Hospital Association

CommonHealth (WBUR) - Fri, 04/03/2020 - 8:54pm

For more on what else hospitals are doing to fortify themselves, president of the Massachusetts Health and Hospital Association spoke to WBUR. He said it's impossible for hospitals to over-prepare for the expected spike in cases, and the preparation is taking a great financial toll.

Categories: Health Care

Partners In Health Helps State Launch First-In-Nation Contact Tracing; COVID-19 Deaths Near 200

CommonHealth (WBUR) - Fri, 04/03/2020 - 8:52pm

Steve Brown talks about the state's new "contact tracing" efforts. Plus, Massachusetts issues its largest number of deaths reported in a single day so far.

Categories: Health Care

'A Heck Of A Time To Get Cancer': Hospitals Defer All But The Most Urgent Treatments

CommonHealth (WBUR) - Fri, 04/03/2020 - 5:50pm

From hip replacements to cancer surgery, some of the "elective procedures" that have had to be postponed because of the coronavirus may not feel very "elective" to the patients who need them, but the risk-benefit ratio has shifted.

Categories: Health Care

‘You’ve Been Served’: Wisconsin Hospitals Sued Patients Even During Pandemic

Kaiser Health News - Fri, 04/03/2020 - 4:43pm

When her doorbell rang Sunday night, Blanche Jordan was just starting a new Game of Thrones puzzle on her living room floor.

Jordan, 39, is a breast-cancer survivor who is taking social distancing seriously, so she put on a mask before opening the door. A woman handed Jordan a paper and said: “You’ve been served.”

The paper was a court summons that said Froedtert Memorial Lutheran Hospital, Inc. was suing Jordan for $7,150. Just three weeks before, Jordan had paid off a different $5,000-plus Froedtert debt linked to a hysterectomy that her insurance did not cover.

A lawsuit was the last thing Jordan expected during a viral pandemic.

“This lady came to my door. She didn’t have a mask on. She didn’t have gloves. And she looked at me like I’m crazy because I had a mask across my face,” said Jordan, who lives in Milwaukee and works as a caregiver at an assisted living facility outside of the city. “I’m high-risk,” she said.

Life in Wisconsin, as in the rest of the country, has been transformed by COVID-19 in the past three weeks. Wisconsin declared a public health emergency on March 12, yet firms representing health systems in the state continued to sue patients over medical debt.

Jordan is one of at least 46 people sued by Froedtert in small claims court since March 12. Those cases are among at least 104 similar suits filed statewide by health systems over the same period, according to an analysis of small claims cases by Wisconsin Public Radio and Wisconsin Watch.

Steve Schooff, a spokesman for the hospital, said Tuesday that Froedtert “suspended filing small claims suits” as of March 18 in response to COVID-19.

“In addition, we continue to work with patients related to financial counseling and are allowing patients with financial hardship who are on a payment plan to defer payments while financial assistance is discussed with them,” he said.

Yet court records at the time showed at least 18 lawsuits filed on the hospital’s behalf since then, including 15 filed on March 31 alone. (The suit against Jordan was filed on March 17; she was served on March 29.) Schooff did not explain the discrepancy. All 18 of those cases have since been dismissed.

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‘Really? In The Middle Of All This?’

Court records show that at least six additional health systems have also sued patients during the pandemic.

UW Health in Madison has filed 19 lawsuits since March 12. Marshfield Clinic, which covers northern, central and western Wisconsin, has filed at least 14 since that date, followed by Bellin Health, based in Green Bay (11); La Crosse-based Gundersen Health System (10); and Aspirus Grand View Health System, which serves parts of northern Wisconsin (3). Froedtert South, which serves southeastern Wisconsin, also filed one suit.

Bellin chief operating officer and chief financial officer Jim Dietsche said Thursday the health system ceased legal actions on debt collection on March 18, and that the nine suits filed since then were “an error and we apologize for that.”

The five other systems contacted for this story said they have since paused certain legal actions, which court records support.

Tom Russell, a UW Health spokesman, said the health system instructed its legal agencies on March 26 “to cease pursuit of any legal activity.”

“These should be stopped for now,” he said.

Tom Duncan, vice president and chief operating officer for Froedtert South, said his system has generally “suspended filing small claim suits” during the pandemic. “However, in rare circumstances, certain small claim suits may be filed to preserve Froedtert South rights. For example: If a medical debt has been in existence for six years, and the statute of limitations is about to end.”

One Madison resident described being “mortified” when a process server knocked on her family’s door on March 28 to serve papers for a UW Health lawsuit over $1,135.90 in medical debt. UW Health filed that lawsuit before March 26. In a phone interview, the resident asked not to be named in this story because she was embarrassed by the debt related to her husband’s heart condition.

“I couldn’t believe someone would do that,” she said about receiving legal papers during a pandemic. “They’re our bills, but really? In the middle of all of this?”

The woman said her husband offered the process server sympathy, apologizing that the man had to serve papers during a public health emergency.

The woman, who works for a Madison-based nonprofit, saw things differently. “That’s a choice, too. I wouldn’t be able to sleep at night.”

Medical Debts And State Response

Some hospitals have stopped the practice of suing patients in recent months following investigative reporting by Kaiser Health News, MLK50, ProPublica and other outlets.

Jessica Roulette, an attorney with Legal Action of Wisconsin, which provides free legal services to low-income people, said medical bills often fall below things like rent, utilities and food in the “hierarchy of bills and obligations.” Most people facing hospital lawsuits are working and “underinsured,” with plans that leave them on the hook for thousands of dollars in health bills, Roulette said.

Bobby Peterson, executive director of ABC for Health, a nonprofit public-interest law firm in Madison, called it stressful under normal circumstances to face a medical debt lawsuit.

“Today it’s a whole new ballgame,” he said, referring to workers who have lost their jobs and possibly health insurance during the pandemic.

Peterson saw a possible disconnect between some hospitals’ recent decisions to stop suing and the law firms they’ve retained.

“Are the hospitals communicating their own policies internally? And are they communicating with their hired guns out there, making sure that they back off?” Peterson asked.

Paycheck To Paycheck

The state of Wisconsin considers Blanche Jordan, the Milwaukee caregiver, an “essential” worker during the pandemic, meaning her job is not subject to the “Safer At Home” order. She works five days each week at an assisted living facility from 7 a.m. to 3 p.m., alternating work on the weekends. The pay — $15.75 per hour — barely covers her expenses.

Rent, health insurance, utilities and the nearly $300 in garnishments by Froedtert that recently ended, left Jordan with little of her $1,300 biweekly paycheck to spend on other necessities. She filed for bankruptcy in 2016 when, despite being insured, she said she could no longer afford to pay off her debts from treating her aggressive breast cancer.

That journey briefly left her homeless following an eviction, but she generally manages to pay her current landlord on time, Jordan said.

“I’m blessed to have a landlord that’s understanding because his wife died of breast cancer,” she said.

Jordan said her most recent medical debt stemmed from a hysterectomy that was separate from but related to her cancer treatment. She chose Froedtert to perform the procedure, considering it “the best hospital that we have in Wisconsin.”

What she did not realize, she said: Froedtert did not accept her insurance, which she purchased on a federal exchange created by the Affordable Care Act. Hospital administrators accepted and ran her insurance card, Jordan said, but never mentioned that her insurer would not cover the procedure.

In 2019, a judge in the Milwaukee County Small Claims Commissioner Court awarded Froedtert a judgment against Jordan for about $5,300, including court fees, which the hospital claimed by garnishment of her wages. She finished paying that debt during the first week of March — only to be served papers for the alleged $7,150 debt three weeks later.

Jordan assumes this covers the remainder of the bill for her hysterectomy, which she remembers totaling around $12,000. Wisconsin caps small claims at $10,000.

She will eventually see her day in court, although it’s not clear when. The coronavirus postponed her court date to May 28, assuming court proceedings resume by then.

Until then, Jordan will continue to take care of people at the assisted living facility, and she will otherwise stay isolated at home, she said, likely playing Scrabble or Uno with her family.

This story is part of a partnership that includes Wisconsin WatchWisconsin Public RadioNPR and Kaiser Health News.

Categories: Health Care

2 Veterans With COVID-19 Moved From Chelsea Veterans Home To Bedford VA Medical Center

CommonHealth (WBUR) - Fri, 04/03/2020 - 4:38pm

Two veterans were moved to a newly converted ward at the Bedford VA Medical Center Thursday night.

Categories: Health Care

51 Of 98 Residents In Wilmington Nursing Facility Test Positive For Coronavirus

CommonHealth (WBUR) - Fri, 04/03/2020 - 3:25pm

State officials had been in the process of moving residents out of the nursing home in order to temporarily convert it into a COVID-19 recovery building. Those plans have been halted.

Categories: Health Care

As Coronavirus Spreads, Workers Could Lean On ACA Coverage Protection

Kaiser Health News - Fri, 04/03/2020 - 3:20pm

Concerns about health care during the coronavirus pandemic are raising the profile of the federal Affordable Care Act, which can help those who have lost their jobs with an option to get insurance.

Julie Rovner, Kaiser Health News’ chief Washington correspondent, talked to WBUR’s “Here & Now” host Jeremy Hobson on Friday about efforts to get the federal government to let people have a special enrollment period for coverage plans sold on the ACA marketplaces, as well as the effect massive job layoffs will have on Medicaid.

Rovner pointed out that workers whose insurance was cut off because they lost their jobs are eligible to buy a new plan through the ACA but that consumer advocates are pressing for the marketplaces to reopen to give others who didn’t sign up for coverage last fall an opportunity to reconsider.

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Rovner also recently spoke with Lauren Gilger and Steve Goldstein at KJZZ in Phoenix about Gov. Doug Ducey’s unsuccessful request to the federal government to reopen the insurance marketplace in Arizona.

Julie Rovner discussed the denial of Arizona’s request to extend its open enrollment period with KJZZ’s “The Show” on April 1.

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Categories: Health Care

Trump Administration Uses Wartime Powers To Be First In Line On Medical Supplies

Kaiser Health News - Fri, 04/03/2020 - 2:39pm

The Trump administration quietly invoked the Defense Production Act to force medical suppliers in Texas and Colorado to sell to it first — ahead of states, hospitals or foreign countries.

It took this action more than a week before it announced Thursday that it would use the little-known aspect of the law to force 3M to fill its contract to the U.S. first. Firms face fines or jail time if they don’t comply.

The Cold War-era law gives federal officials the power to edge out the competition and force contractors to provide supplies to them before filling orders for other customers.

While it’s unclear how many times the power has been used during the coronavirus pandemic, federal contracting records examined by Kaiser Health News show that federal authorities staked first rights to $137 million in medical supplies. The orders in late March flew under the radar, even as dog-eat-dog bidding wars raged among states and nations for desperately needed medical protective gear.

“It’s like ‘Lord of the Flies’ out there for states and hospitals as they bid against each other for critical medical supplies and equipment,” Sen. Chris Murphy (D-Conn.) said in a statement to KHN. “Plus, there’s no transparency about what the federal government is doing with the equipment that they purchase when they outbid states and hospitals.”

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Without public awareness of what was taken on a federal-first basis — and who it was given to — the states are left in the dark after being told repeatedly to procure their own goods. The federal government, President Donald Trump has said, is not the states’ “shipping clerk.”

“It’s putting people into the free market where the invisible hand doesn’t care who it strangles,” said Arthur Caplan, director of the division of medical ethics at New York University School of Medicine.

Trump enacted the first-in-line power of the DPA for the Health and Human Services Department in an executive order on March 18 — and nine days later extended the power to the Department of Homeland Security, which includes the Federal Emergency Management Agency.

On Thursday at his White House press briefing, Trump announced he had invoked the DPA “against” 3M. His executive order states that the government “shall use any and all authority available under the Act to acquire … the number of N-95 respirators that the Administrator determines to be appropriate.”

“We hit 3M hard today after seeing what they were doing with their Masks. ‘P Act’ all the way,” the president tweeted. “Big surprise to many in government as to what they were doing – will have a big price to pay!”

While the administration had asked the company to stop exporting respirators to the Latin American and Canadian markets, 3M stated in a press release Friday there would be humanitarian implications, since the company supplies a critical amount of those countries’ N95 masks. 3M also warned such a move could create a potential trade war where other countries then refuse to sell N95s to the U.S., potentially resulting in fewer N95s in the United States.

When federal authorities use the DPA to seek a so-called rated order, it relieves companies from having to decide which state or hospital or foreign government gets the goods first, said Eric Crusius, a partner at the Washington, D.C., firm Holland & Knight and a contract law specialist. It makes things simple — the federal government’s order is filled first.

The defense law was cited in contracts for an estimated $54 million in medical supplies from Colorado-based Marathon Medical Corp., a medical supply distributor, and an estimated $84 million from Texas-based Retractable Technologies Inc., which makes retractable needles.

A woman who answered the phone at Marathon Medical declined to give her name and said the company policy is not to talk to the media. Officials for RTI, contacted by phone and email, did not respond by press time.

Contracts show that federal HHS officials also invoked their right to be first in line for an estimated $13.5 million in goods produced by New Jersey-based health care products manufacturer and supplier Becton, Dickinson and Co.

A modification to that contract signed March 23 says it applies to “medical and surgical instruments, equipment and supplies” and cites “delegation of authority” under the Defense Production Act “ordered by President Donald J. Trump in response to” the threat of the coronavirus. It’s not clear what product officials ordered from the company.

Becton, Dickinson and Co. told KHN on Thursday that the contract had been modified — again — so that the Defense Production Act was not invoked. Because there is a lag in federal contract disclosures, it’s possible that the contracts for Retractable Technologies and Marathon Medical also have been modified.

All three records name the contract-awarding agency as the HHS Office of the Assistant Secretary for Preparedness and Response and note: “Only the agency awarding the contract may place orders.”

When federal officials made a similar move in Massachusetts, it took state leaders by surprise. Marylou Sudders, who leads the state coronavirus command center, said an order of 400 masks from MSC Industrial Supply was canceled abruptly due to federal intervention, according to a report in The Boston Globe.

MSC spokesperson Paul Mason told KHN that the Defense Production Act compelled his company to put federal orders first.

That cancellation and a similar seizure of goods sowed so much distrust in Massachusetts that the New England Patriots sent a team plane to ship personal protective gear from China, according to The Boston Globe.

Officials from the White House and FEMA declined to directly answer questions about the use of the 1950 law to put the feds first in line for goods. HHS provided a statement saying the Defense Production Act is “an important tool that may be used when necessary to ensure needed supplies are available and going where they are most urgently needed. HHS and FEMA are and will continue working with the private sector and States to increase supply and allocate needed PPE.”

Top Democratic leaders and even a Republican governor were clamoring for a change in how the market was run in recent weeks, as health care workers warned against being sent out to the coronavirus front lines without proper supplies.

In a letter to the president Thursday, Senate Minority Leader Chuck Schumer called for strong federal intervention and leadership on the issue, citing the need for a military logistician to run such a response.

“While you continue to dismiss the Defense Production Act as not being needed, it is clear that the capacity of American industry has not yet been fully harnessed,” Schumer’s letter says.

Trump fired back with his own letter that evening, stating that Navy Rear Adm. John Polowczyk, currently serving as the leader of FEMA’s supply chain task force, was in charge of “purchasing, distributing, etc.”

“The Defense Production Act (DPA) has been consistently used by my team and me for the purchase of billions of dollars’ worth of equipment, medical supplies, ventilators, and other related items,” he wrote. “It has been powerful leverage, so powerful that companies generally do whatever we are asking, without even a formal notice.”

But if the government is going to take more control — which many health and government leaders have urged it to do — it should be transparent about its actions, said Dr. Atul Grover, executive vice president of the Association of American Medical Colleges. He said medical leaders have been whiplashed by their orders for protective gear falling through and speculated that they lost out to federal agencies.

Some institutions “fully expected to be able to purchase [personal protective equipment] from contractors who then turned around and said, ‘No, we’re going with another buyer instead,’” he said.

When asked about this phenomenon during Thursday’s national briefing, Trump said the governments could work it out.

“If you think there is bidding between federal government and state, let us know and we’ll drop out immediately,” Trump said. “There are 151 countries that have this problem, and they’re ordering, too. It’s really a mess.”

Categories: Health Care

Mass. To Begin Contact Tracing Program To Track New Coronavirus Cases

CommonHealth (WBUR) - Fri, 04/03/2020 - 2:16pm

Gov. Charlie Baker announced the ambitious project during a press conference on Friday, saying the state will work with Partners in Health to stand the program up.

Categories: Health Care

Must-Reads Of The Week From Brianna Labuskes

Kaiser Health News - Fri, 04/03/2020 - 1:55pm
The Friday Breeze

Newsletter editor Brianna Labuskes, who reads everything on health care to compile our daily Morning Briefing, offers the best and most provocative stories for the weekend.

Hello! It is once again Friday, which means I’m going to attempt to do my very best to give you a snapshot of some (read: a fraction) of the best stories from the week amid a flood of them.

But first! Take yourself on this journey about how the most well-known coronavirus image (that gray blob with stone-like texture and red crowns and colored flecks) was made. Sometimes when the government is creating informational illustrations it focuses on the vector or the symptoms, but for this coronavirus the CDC’s Alissa Eckert and Dan Higgins went with what’s called a “beauty shot.” It’s a very cool read!

All right, here we go:

The confirmed number of confirmed cases globally ticked past a million this week in a grim milestone that experts still say represents only a percentage of the actual cases out there. The U.S. had recorded over 250,000 cases as of press time, with more than 6,500 deaths.

President Donald Trump invoked his wartime powers to help manufacturers secure supplies needed to make ventilators and protective face masks, but is it too little, too late? New York Gov. Andrew Cuomo, whose state has become the epicenter of the nation’s outbreak, said on Thursday it will use up all available ventilators in less than a week. Meanwhile, FEMA said that most of the ventilators Trump promised to obtain won’t be ready until June.

Governors are distraught over their inability to obtain the needed supplies, likening the process of requesting the equipment to eBay auctions. “You now literally will have a company call you up and say, ‘Well, California just outbid you,’” Cuomo said.

Another roadblock is that 2,000 of the ventilators in the national stockpile are unusable because of a lapse in a contract that left a monthslong gap, during which the machines weren’t being properly maintained.

In the meantime, General Motors has shrugged off Trump’s attacks on the company (he said GM and its chief executive were dragging their feet on the project) and are moving full-throttle ahead at producing the needed equipment. “Every ventilator is a life,” said one GM exec.

With so much focus on ventilators, doctors are being advised on how to ration care and being told that they’ll be supported in their decisions not to perform futile intubations.

One quick note on that front: New York lawmakers are moving on legislation that would grant sweeping civil- and criminal-liability protections to hospitals and health care workers dealing with coronavirus patients.

And even though there’s a ton of attention on ventilators, the survival rate of any patient who requires one is only 20% — meaning that even without a shortage, they can only help a fraction of patients.

In other important news on the preparedness front:

The Friday Breeze

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Trump warned Americans this week that “hard days” lie ahead and that people should be braced for a “bad two weeks,” with the White House projecting that the death toll could be somewhere between 100,000 to 240,000. For what it’s worth, disease forecasters were mystified over where the task force got those numbers, mostly because we don’t yet know enough about the virus.

(What helped change Trump’s mind, considering he’d previously mused that the country could return to normal in time to fill the pews on Easter? Polling numbers.)

To help states deal with the crisis, CMS relaxed safety rules for hospitals, giving them unprecedented flexibility. The changes include what counts as a hospital bed, how closely certain medical professionals need to be supervised and what kinds of health care can be delivered at home.

The administration decided not to follow suit after a handful of states reopened their exchanges, though Trump seemed to hint that the possibility was still on the table “as a matter of fairness.” Also, to note, if people have lost their insurance because of their jobs, that counts as a qualifying event and they have 60 days to enroll in the federal exchanges, regardless of what Trump does with a special session.

And although Drs. Anthony Fauci and Deborah Birx, along with Vice President Mike Pence, have emerged as the leading voices of the administration’s pandemic response, Trump’s son-in-law Jared Kushner has taken charge behind the scenes. Critics say its adding confusion to an already chaotic situation.

And reports continue to emerge that the Trump administration was cutting pandemic detection positions in China just months before the outbreak.

In other news on the administration:

House Speaker Nancy Pelosi will be creating a special committee to oversee the implementation of the $2.2 trillion stimulus package and any other coronavirus legislation coming down the pike. “Where there’s money there’s also frequently mischief,” Pelosi said, in perhaps one of my favorite quotes of the week. Meanwhile, House Democrats may be raring to get started on a fourth stimulus package, but Republicans are pumping the brakes. At the very least, they say, they want to see how the current stimulus package plays out.

The news came the same day as it was reported that 6.6 million Americans filed for unemployment benefits. That eye-popping number blows past all previous records. And experts say it represents only a sliver of the economic devastation the virus is wreaking on the country. There are many affected Americans who remain uncounted — some have lost jobs or income and did not initially qualify for benefits, and others, encountering state unemployment offices that were overwhelmed by the deluge of claimants, were unsuccessful in filing.

In other news about Congress and the economic damage from the outbreak:

The Democratic National Convention, expected to draw as many as 50,000 visitors, was postponed from July to August in one of the largest disruptions to the 2020 elections so far. On the other hand, Wisconsin is going ahead with its primary on Tuesday, which is causing mixed reactions … including apoplectic rage.

More stories on elections:

Much focus this week was on serology tests that serve the dual purpose of finding Americans who can safely return to some normalcy and helping researchers find treatments for COVID-19. Experts are fairly unified on the fact that to get the country back into operation, we need a way to identify those who are now immune to the disease. And using plasma collected from recovered patients is a century-old practice (which, to be clear, has had mixed results in past diseases).

Beyond studies on actually treating the coronavirus illness (a small study out this week showed a much-touted malaria drug combo had positive results), doctors are also trying to figure out how to treat the phenomenon known as “cytokine storm,” in which the body’s own immune system attacks its organs. This is thought to be the cause of some of the severe cases seen in younger patients.

On a side note, the Food and Drug Administration on Sunday issued an emergency-use authorization for hydroxychloroquine and chloroquine, despite scant evidence that they work against COVID-19.

With Florida (and three other states who had been hesitating) finally caving into pressure to issue the stay-at-home order, the vast majority of Americans are now huddled at home. The good news is that the extreme measures seem to be working in California, which was an earlier disciple of flattening the curve.

Google, meanwhile, is offering the government a report on “mobility data” to help states recognize where social-distancing measures are failing, with a specific focus on how foot traffic has increased or declined to six categories of destinations: homes; workplaces; retail and recreation establishments; parks; grocery stores and pharmacies; and transit stations.

Although things might seem a bit grim right now because of these measures, a look at data from the 1918 flu pandemic shows cities that locked down emerged from the crisis stronger economically than those that didn’t. One caveat, though: Because working-age people were harder hit by the 1918 flu (and the coronavirus strikes worse among older generations), any comparisons might not hold.

So, onto some of the stories I find most fascinating … aka the science behind all of this.

I’m going to cut this off here, or else this will no longer be able to be called the Breeze. If you want a more comprehensive roundup, please check out the Morning Briefings from the week, which are chock-full of more stories than you could ever finish reading. Including ones on workers’ protests and the supply chain; the gun store debate; how jails are “ticking time bombs;” autocrats’ power grab; snapshots from a New York in crisis; health disparities; and a call to arms for medical workers that doesn’t guarantee coverage of potential hospital bills.

Please have a safe and restful weekend, if possible!

Categories: Health Care

Health Care Workers Push Back Against Rationing Of Protective Equipment

CommonHealth (WBUR) - Fri, 04/03/2020 - 1:03pm

“You are allowed one N95 mask per patient. That means as many times as you go into that room, all your shifts, you are using the same mask and putting it in a brown paper bag again and again,” says nurse Alex Wright. “If you told any nurse that a month ago, they would look at you like you had three heads.”

Categories: Health Care

3 Residents At Worcester Nursing Home Have Died Of The Coronavirus, 13 Others Tested Positive

CommonHealth (WBUR) - Fri, 04/03/2020 - 9:23am

State health and human services secretary Marylou Sudders said there are now clusters of the virus in close to 80 longterm care facilities in the state.

Categories: Health Care

Medicaid en el “ojo de la tormenta” por nuevos desempleados que buscan cobertura

Kaiser Health News - Fri, 04/03/2020 - 9:23am
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Con más desempleados aplicando para seguro médico, Medicaid podría colapsar

A medida que el coronavirus agita la economía y deja a millones de estadounidenses sin trabajo, Medicaid surge como el plan de salud obvio para muchos de los nuevos desempleados. Eso podría generar tensiones sin precedentes en este vital programa, según funcionarios estatales y analistas.

Forma parte del grupo de Facebook de Kaiser Health News en español “KHN-Hablemos de Salud”.

KHN-Hablemos de Salud

A los estadounidenses se los insta a quedarse en casa y a practicar el “distanciamiento social” para evitar la propagación del virus, lo que hace que las empresas cierren sus puertas y despidan a sus trabajadores.

El Departamento de Trabajo informó el jueves 2 de abril que más de 6.6 millones de personas se suscribieron al seguro de desempleo durante la semana que terminó el 28 de marzo. Este número rompió el récord establecido la semana anterior, de 3.3 millones. Muchos de estos nuevos desempleados pueden recurrir a Medicaid para sus familias.

A menudo los legisladores han usado Medicaid para ayudar a las personas a obtener cobertura y atención médica en respuesta a desastres como el huracán Katrina, la crisis del agua en Flint, Michigan, y los ataques terroristas del 11 de septiembre.

Pero nunca ha enfrentado una crisis de salud pública y una emergencia económica en la que las personas en todo el país necesitan la ayuda prácticamente en el mismo mes.

“Medicaid va a estar absolutamente en el ojo de la tormenta”, dijo Joan Alker, directora ejecutiva del Center for Children and Families de la Universidad Georgetown. “Es la columna vertebral de nuestro sistema de salud y cobertura públicas, y verá una mayor inscripción debido a las condiciones económicas”.

Satisfacer esas necesidades requerirá grandes inversiones, tanto en dinero como en mano de obra.

Medicaid, que es administrado conjuntamente por los estados y el gobierno federal, y cubre a unos 70 millones de estadounidenses, ya está experimentando picos de solicitudes tempranas. Debido a que las solicitudes de seguro generalmente van a la zaga de las de otros beneficios, se espera que los números crezcan en los próximos meses.

“Hemos pasado por recesiones en el pasado, como en 2009, y vimos lo que eso significaba”, dijo Matt Salo, quien dirige la Asociación Nacional de Directores de Medicaid. “Vamos a ver eso un aumento dramático”.

Desde 2014, la mayoría de los estados han ampliado sus programas de Medicaid para cubrir a más adultos de bajos ingresos en virtud de una disposición de la Ley de Cuidado de Salud a Bajo Precio (ACA). Eso puede ayudar a proporcionar un colchón en esas áreas. En los 14 estados que han optado por no expandir el programa, muchos de los adultos recién desempleados no serán elegibles para cobertura.

Es posible que la pandemia pueda cambiar el cálculo de la toma de decisiones para los estados sin expansión, dijo Salo. “La pandemia es como un puñetazo en la boca”.

Pero incluso sin expansión en esos estados, las listas de Medicaid podrían aumentar con la llegada de más niños al sistema a medida que las finanzas de sus familias se deterioran. Muchos estados no cuentan con los recursos o sistemas para satisfacer la demanda.

“Va a golpear más rápido y más fuerte que nunca”, enfatizó Salo.

Las circunstancias únicas de distanciamiento social imponen nuevos desafíos para aquellos que trabajan en la inscripción. En California, donde más de un millón de personas han solicitado un seguro de desempleo desde el 13 de marzo, gran parte de la fuerza laboral que normalmente inscribe y procesa documentos ahora trabaja desde casa, lo que agrega una capa de complejidad en términos de acceso a archivos y documentos, y puede complicar la comunicación.

“Va a ser más difícil de lo que fue durante la recesión [2008]”, dijo Cathy Senderling-McDonald, subdirectora ejecutiva de la County Welfare Directors Association de California. Agregó que, aunque se han hecho avances en la última década para establecer mejores formularios en línea y centros de llamadas, aun así, será un gran esfuerzo inscribir a las beneficiarlos sin verlos en persona.

En algunos estados, los desafíos para el sistema ya son notables.

Utah, por ejemplo, ha visto un aumento del 46% en las solicitudes de Medicaid. (Estas solicitudes pueden ser para individuos o familias). En marzo de 2019, unas 14,000 personas presentaron una solicitud. Este marzo, fueron más de 20,400.

“Nuestros servicios se necesitan ahora más que nunca”, dijo Muris Prses, director asistente de servicios de elegibilidad para el Departamento de Servicios Laborales de Utah, que procesa la inscripción a Medicaid, que en todo el país no está sujeta a un período específico, sino que está abierta todo el año. El estado generalmente se toma 15 días para determinar si alguien es elegible, dijo. Ahora serán varios más.

En Nevada, donde la economía dominada por hoteles y casinos se ha visto particularmente afectada, las solicitudes de beneficios públicos, incluidos cupones de alimentos y Medicaid, se dispararon de 200 por día en febrero a 2,000 a mediados de marzo, según el Departamento de Salud y Servicios Humanos estatal. El volumen de llamadas a una línea directa de consumidores para preguntas sobre Medicaid y cobertura de salud es cuatro veces la cifra regular.

En Ohio, el número de solicitudes de Medicaid ya superó lo que es típico para esta época del año. El estado espera que esa cifra continúe subiendo.

Los estados que aún no han visto el aumento advirtieron que casi seguro se avecina. Y a medida que continúan los despidos, algunos ya están experimentando tensiones en el sistema, incluidos los tiempos de procesamiento que podrían dejar a las personas sin seguro durante meses.

Para Kristen Wolfe, de 28 años, de Salt Lake City, que perdió su trabajo y su seguro de salud patrocinado por el empleador el 20 de marzo, es un momento aterrador.

Wolfe, que tiene lupus, un trastorno autoinmune que requiere citas médicas regulares y medicamentos recetados, solicitó rápidamente Medicaid. Pero después de completar el formulario, incluido un ingreso de cero dólares, supo que la decisión sobre su elegibilidad podría demorar hasta 90 días. Llamó a la agencia de Medicaid de Utah y, después de estar en espera durante más de una hora, le dijeron que no sabían cuándo conocería la decisión.

“Con mi salud, da miedo dejar las cosas en el limbo”, dijo Wolfe, quien usó su seguro casi vencido la semana pasada para surtir sus medicamentos por 90 días, por si acaso. “Estoy bastante segura de que calificaré, pero siempre existe la duda… ¿Y si no?”.

Sin embargo, otros han informado una navegación más suave.

Jen Wittlin, de 33 años, quien, hasta hace poco, administraba un bar ahora cerrado en el hotel Dean, en Providence, Rhode Island, calificó para la cobertura de Medicaid a partir del 1 de abril. Pudo registrarse en línea después de esperar media hora por teléfono para que le contestaran preguntas específicas. Una vez que reciba un cheque por desempleo, el estado reevaluará sus ingresos, actualmente cero, para ver si aún califica.

“Todo fue inmediato”, dijo.

De hecho, dijo, ahora está trabajando para ayudar a ex colegas sin seguro médico a inscribirse en el programa, siguiendo los consejos que le dio el estado.

En California, funcionarios están tratando de reasignar algunos empleados, que ahora trabajan de forma remota, para ayudar con este flujo de gente. Pero el sistema para determinar la elegibilidad para Medicaid es complicado y requiere capacitación, dijo Senderling-McDonald. Agregó que está tratando de volver a contratar a las personas que se han jubilado y depende de las horas extras de los empleados.

“Es difícil expandir esta fuerza laboral en particular”, dijo. “No podemos poner a una nueva persona frente a una computadora y decirle comienza. Arruinarían todo”.

Alejarse de las inscripciones en la oficina también es una desventaja para las personas mayores y aquellos que hablan inglés como segundo idioma, dos grupos que con frecuencia se sienten más cómodos al inscribirse en persona, agregó.

Mientras tanto, aumentar la inscripción y las realidades del coronavirus probablemente creará la necesidad de atención médica costosa en toda la población.

“¿Qué pasa cuando comenzamos a tener muchas personas que pueden estar en el hospital, en cuidados intensivos o con ventiladores?”, dijo Maureen Corcoran, directora del programa de Medicaid de Ohio. “Todavía no tenemos respuestas específicas”.

Estos factores afectarán al igual que los estados, que experimentarán una reducción de los ingresos tributarios debido a la economía en picada, tienen menos dinero para pagar su parte de Medicaid.

El gobierno federal paga, en promedio, cerca del 61% de los costos de Medicaid tradicional y aproximadamente el 90% de los costos de las personas que se unieron al programa a través de la expansión de ACA.

El resto proviene de las arcas estatales. Y, a diferencia del gobierno federal, los estados están obligados constitucionalmente a equilibrar sus presupuestos. La restricción financiera podría forzar recortes en otras áreas, como educación, bienestar infantil o fuerzas policiales.

El 18 de marzo, el Congreso acordó aumentar lo que Washington paga en 6.2 puntos porcentuales como parte del segundo gran proyecto de ley de estímulo dirigido a las consecuencias económicas de la pandemia. Eso apenas alcanzará, enfatizó Salo.

Esta historia de KHN se publicó primero en California Healthline, un servicio de la California Health Care Foundation.

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