E-Newsletter

Linking People to Health that Matters . . .

Monday, November 25, 2013

Public Health  
In This Issue
Healthcare and Social Services Access
1. Healthcare.gov Application Tools in 26 Languages
2. Readers Ask If They Can Buy A Policy After March 31
3. Doctors Complain They Will Be Paid Less By Exchange Plans
4. Safety-Net Hospitals Lose More Under Medicare's Quality-Based Payments, Analysis Finds
5. Costliest 1 Percent Of Patients Account For 21 Percent Of U.S. Health Spending
Health Studies and Guidelines
6. Risk Calculator for Cholesterol Appears Flawed
7. Statins and Cardiovascular Conflicts of Interest
8. Sofrito is a Delicious Way to Lower Heart Disease Risk
9. Six Unexpected Ways Writing Can Transform Your Health
Product Risks and Recalls
10. Shopping For Cosmetics? Get the "Skin Deep" App
Public Health News
11. When the Choice is Between Abuse and Homelessness
12. Research Confirms Access to Healthy Food Still Matters
13. "Advanced Primary Care" at Heart of State's Health Improvement Plan
14. Workers at 9/11 Site Get Workers' Compensation and Disability Extension
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Healthcare and Social Services Access
1. Healthcare.gov Application Tools in 26 Languages
National Immigration Law Center - by Jenny Rejeske, Health Policy Analyst, [email protected]

(Nov. 19, 2013)   Passing along a link to healthcare.gov's translated materials - http://marketplace.cms.gov/getofficialresources/other-languages/other-languages-materials.html  - including application tools in 26 languages. 

Spanish materials are available here: http://marketplace.cms.gov/getofficialresources/spanish-materials/spanish-materials.html.
 
Just a reminder that translated application tools in languages other than Spanish cannot be mailed in to HHS - they are "tools" to facilitate completion of the English-language application.
2. Readers Ask If They Can Buy A Policy After March 31
Kaiser Health News -  by Michelle Andrews

(Nov. 18, 2013)   The news has been focused on the troubles of people trying to use the health care law's insurance exchanges and new options for people whose individual policies are being canceled. But open enrollment continues, and people who are shopping for individual or job-based coverage have many questions. Here are some answers.

Q. I know there's an enrollment period for the health law's insurance marketplaces, but people can also buy a policy directly from a company or agent, outside the marketplaces. So will people be able to buy a regular health insurance policy from a company or agent after March? If so, won't people wait until they're sick or injured to buy insurance?

A. The open enrollment period, when people can buy an individual plan for 2014 directly through the health insurance marketplace or outside it from an insurer or agent, began in October and runs until the end of March.

The law requires that health plans sold either through the marketplace or outside it be comparable in many ways, including the benefits that are covered and consumer cost-sharing requirements, such as the rule that plans pay at least 60 percent of medical costs. In addition, all plans sold on the individual market, whether through the exchange or outside it, must offer open enrollment during the same time period.

So there's no easy way to game the system by waiting to buy a plan until you get sick. If you skip open enrollment, you've generally missed your chance to buy coverage for the year unless you have a significant change in circumstance, such as losing your job-based insurance. You'll also face a penalty for not having insurance: $95 or 1 percent of your income in 2014, whichever is greater.....

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(Nov. 19, 2013)   Many doctors are disturbed they will be paid less -- often a lot less -- to care for the millions of patients projected to buy coverage through the health law's new insurance marketplaces.

 

Some have complained to medical associations, including those in New York, California, Connecticut, Texas and Georgia, saying the discounted rates could lead to a two-tiered system in which fewer doctors participate, potentially making it harder for consumers to get the care they need.

 

"As it is, there is a shortage of primary care physicians in the country, and they don't have enough time to see all the patients who are calling them," said Peter Cunningham, a senior fellow at the nonpartisan Center for Studying Health System Change in Washington D.C.

If providers are paid less, "are [enrollees] going to have difficulty getting physicians to accept them as patients?"

 

Insurance officials acknowledge they have reduced rates in some plans, saying they are under enormous pressure to keep premiums affordable. They say physicians will make up for the lower pay by seeing more patients, since the plans tend to have smaller networks of doctors.

 

But many primary care doctors say they barely have time to take care of the patients they have now. 

 

The conflict sheds light on the often murky world of insurance contracts in which physicians don't always know which plans they're listed in or how much they're being paid to treat patients in a particular plan. As a result, some doctors are just learning about the lower pay rates in some plans sold in the online markets, or exchanges....

4. Safety-Net Hospitals Lose More Under Medicare's Quality-Based Payments, Analysis Finds
Kaiser Health News - By Jordan Rau
Source: Kaiser Health News analysis of data from the Centers for Medicare & Medicaid Services

(Nov. 19, 2013)   Medicare's effort to reward hospitals for quality is leaving many of the nation's safety-net hospitals poorer, a new analysis finds.

 

Dr. Ashish K. Jha, a professor at the Harvard School of Public Health, has found that hospitals treating the most low-income patients on average had their payment rates reduced by 0.09 percent in the latest round of Medicare's program that rates hospitals' quality. The hospitals with the fewest low-income patients received an average bonus of 0.6 percent. Government-owned hospitals in particular fared poorly, with Medicare reducing their payment rates by 0.10 percent for a year, according to Jha's analysis, which he published Tuesday on his Harvard blog.

 

Medicare bases its bonuses and penalties, created by the federal health care law, on 24 quality measurements, including how patients rated hospitals in surveys and on mortality rates. In the second year of the program, which stretches from last month through September 2014, Medicare has reduced payments to 1,451 hospitals and increased payments to 1,231 hospitals based on those scores.  During that period, Medicare will distribute $1.1 billion in the program, known as Value-Based Purchasing, with bonuses going to hospitals that either have better quality than most or that have improved their scores more than most.

 

A Kaiser Health News analysis of this year's financial incentives shows that while safety-net hospitals as a group had larger penalties than  other types of hospitals, 32 percent of safety-net hospitals fared well, earning bonuses of at least 0.2 percent, while 29 percent were given penalties of 0.2 percent or more.

 

But the group of hospitals with the fewest low-income patients did significantly better: 53 percent earned bonuses of 0.2 percent or more. Only 13 percent of these hospitals lost 0.2 percent or more, the KHN analysis found....

5. Costliest 1 Percent Of Patients Account For 21 Percent Of U.S. Health Spending

Kaiser Health News 

 

(Oct. 2013)   A 58-year-old Maryland woman breaks her ankle, develops a blood clot and, unable to find a doctor to monitor her blood-thinning drug, winds up in an emergency room 30 times in six months. A 55-year-old Mississippi man with severe hypertension and kidney disease is repeatedly hospitalized for worsening heart and kidney failure; doctors don't know that his utilities have been disconnected, leaving him without air conditioning or a refrigerator in the sweltering summer heat. A 42-year-old morbidly obese woman with severe cardiovascular problems and bipolar disorder spends more than 300 days in a Michigan hospital and nursing home because she can't afford a special bed or arrange services that would enable her to live at home.

Illustration by Alex Nabaum/For The Washington Post and KHN

These patients are among the 1 percent whose ranks no one wants to join: the costly cohort battling multiple chronic illnesses who consumed 21 percent of the nearly $1.3 trillion Americans spent on health care in 2010, at a cost of nearly $88,000 per person. Five percent of patients accounted for 50 percent of all health-care expenditures. By contrast, the bottom 50 percent of patients accounted for just 2.8 percent of spending that year, according to a recent report by the federal Agency for Healthcare Research and Quality.

 

Sometimes known as super-utilizers, high-frequency patients or frequent fliers, these patients typically suffer from heart failure, diabetes and kidney disease, along with a significant psychiatric problem. Some are Medicare patients unable to afford the many drugs needed to manage their chronic health problems. Others are younger "dual eligibles" who qualify for Medicare and Medicaid, and who often bounce from emergency room to emergency room, struggling with substance abuse, homelessness and related medical conditions. Still others have private health insurance.

 

Nearly all wind up in emergency rooms because they have enormous difficulty navigating the increasingly fragmented, complicated and inflexible health-care system. Because of lack of alternatives or force of habit, they use hospitals, often several in the same city, for care that could be provided far more cheaply and effectively in outpatient settings. Many suffer from the phenomenon known as "extreme uncoordinated care."

 

In the past few years, efforts to lower costs and improve care have proliferated. In Ann Arbor, Mich., two programs at the University of Michigan Health System assign specialized case managers to super-users, some of whom have been in the ER more than 100 times in a year. In a largely rural swath of central Pennsylvania, Geisinger Health System enrolls elderly Medicare patients in its Proven Health Navigator program, calling them after they leave the hospital and providing heart failure patients with scales that transmit data to nurses: Sudden weight gain can signal a problem. In the Washington area, a program sponsored by Medical Mall Health Services -- a program founded by civil rights activist and physician Aaron Shirley that targets medically underserved patients -- provides home visits and helps arrange services for newly discharged patients.

 

"We've seen situations where for want of a $20 cab ride to get to dialysis, a patient ended up with an emergency hospitalization costing $20,000," said Tim McNeill, chief operating officer of Medical Mall, which is headquartered in Jackson, Miss.....

Health Studies and Guidelines

6. Risk Calculator for Cholesterol Appears Flawed
New York Times - by Gina Kolata

(November 17, 2013)   Last week, the nation's leading heart organizations released a sweeping new set of guidelines for lowering cholesterol, along with an online calculator meant to help doctors assess risks and treatment options. But, in a major embarrassment to the health groups, the calculator appears to greatly overestimate risk, so much so that it could mistakenly suggest that millions more people are candidates for statin drugs.

The apparent problem prompted one leading cardiologist, a past president of the American College of Cardiology, to call on Sunday for a halt to the implementation of the new guidelines.

"It's stunning," said the cardiologist, Dr. Steven Nissen, chief of cardiovascular medicine at the Cleveland Clinic. "We need a pause to further evaluate this approach before it is implemented on a widespread basis."

The controversy set off turmoil at the annual meeting of the American Heart Association, which started this weekend in Dallas. After an emergency session on Saturday night, the two organizations that published the guidelines - the American Heart Association and the American College of Cardiology - said that while the calculator was not perfect, it was a major step forward, and that the guidelines already say patients and doctors should discuss treatment options rather than blindly follow a calculator.

Dr. Sidney Smith, the executive chairman of the guideline committee, said the associations would examine the flaws found in the calculator and determine if changes were needed. "We need to see if the concerns raised are substantive," he said in a telephone interview on Sunday. "Do there need to be changes?"

The problems were identified by two Harvard Medical School professors whose findings will be published Tuesday in a commentary in The Lancet, a major medical journal. The professors, Dr. Paul M. Ridker and Dr. Nancy Cook, had pointed out the problems a year earlier when the National Institutes of Health's National Heart, Lung, and Blood Institute, which originally was developing the guidelines, sent a draft to each professor independently to review. Both reported back that the calculator was not working among the populations it was tested on by the guideline makers.....

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7. Statins and Cardiovascular Conflicts of Interest
Health News Review - by Gary Schwitzer

(Nov. 24, 2013)    I'd like to see a public survey of comprehension of the recent splash of news about new guidelines for heart disease prevention and statin drug use.  Heads must be spinning.  Here are some of the pieces that I found noteworthy:

"The chairman and one of two additional co-chairs of the working panel that wrote the controversial cholesterol guidelines on reducing cardiovascular risk, released last week, had ties to the drug industry at the time they were asked to lead the panel. And, in all, eight of the 15 panelists had industry ties."

"The process by which these latest guidelines were developed gives rise to further skepticism. The group that wrote the recommendations was not sufficiently free of conflicts of interest; several of the experts on the panel have recent or current financial ties to drug makers. In addition, both the American Heart Association and the American College of Cardiology, while nonprofit entities, are heavily supported by drug companies.

The American people deserve to have important medical guidelines developed by doctors and scientists on whom they can confidently rely to make judgments free from influence, conscious or unconscious, by the industries that stand to gain or lose.

We believe that the new guidelines are not adequately supported by objective data, and that statins should not be recommended for this vastly expanded class of healthy Americans. Instead of converting millions of people into statin customers, we should be focusing on the real factors that undeniably reduce the risk of heart disease: healthy diets, exercise and avoiding smoking. Patients should be skeptical about the guidelines, and have a meaningful dialogue with their doctors about statins, including what the evidence does and does not show, before deciding what is best for them."

"even if these guidelines were not written by people in the pay of the drug industry, they could just as well have been. And somehow, while important new evidence against the routine use of statins, and suggesting that we really don't know much about the true mechanism by which these drugs work in the cases where they do, crept into the guidelines for the first time, the bottom line is largely unaffected by such enlightened thoughts. We're back to putting statins in the water supply."

by Brian McFadden for Daily Kos 

8. Sofrito is a Delicious Way to Lower Heart Disease Risk, Study Finds
Emax Health - by Harold Mandel

(Nov. 19, 2013)   A simple intervention like eating Mediterranean Sofrito could help lower your risk of heart disease. What's in the food that's so heart healthy?

Heart disease is becoming of greater concern to more and more people as they confront problems with weight control and aging. There are a myriad of medicinal treatments for heart disease with bypass surgery often being presented as an option when drugs fail to prevent and treat heart disease. The side effects from drug treatment and the fears of increased pain and suffering along with high costs from cardiac surgery have people searching for natural manners to help them maintain a healthy heart. Great news is that nutritional approaches to preventing heart disease are often very successful. Recent research points to Mediterranean sofrito as offering a tasty option to help you prevent heart disease.

The first question which comes to mind for a lot of us is what is sofrito? An in depth appreciation of what safrito is made up of is not something we find could learn in a good cooking class. Sofrito is a Spanish word for a delicious and tasty sauce. The Italian word soffritto refers to something which is sauteed, which helps us appreciate what sofrito is. To make sofrito you sautee vegetables and spices.

There are many different types of sofrito sauces. Sofrito is made by mixing tomatoes, garlic, and onions together and cooking them in olive oil in Spain, Haiti, France and Italy. In the Caribbean Islands and Latin America, sofrito also includes roasted peppers and herbs mixed together. Cuban sofrito is very similar to that in the Caribbean and Latin America. Many spices, including bay leaves, cilantro, cumin, and oregano, are added to Cuban sofrito to give it a delicious taste. Puerto Rican cooks also often add bell peppers to this tasty sauce. Sofrito is also often used in Mediterranean cooking.

Sofrito has heart healthy bioactive compounds: There are bioactive compounds present in the Mediterranean sofrito which appear to be associated with lowered risk for cardiovascular disease, as written about in the journal Food Chemistry. Sofrito is a primary component of the healthy Mediterranean diet. This diet is strongly associated with a lowered risk of cardiovascular events. Sofrito contains polyphenols and carotenoids which have beneficial health properties.

A review of this research by Sinc highlights that the combination of tomato, olive oil, garlic and onion which is found in sofrito increases the amount of healthy polyphenols and carotenoids which are present in this tasty sauce. These bioactive compounds respectively may help to prevent cardiovascular diseases and cancer.

A study at the University of Barcelona and the CIBERobn network in Spain, confirmed these findings with sofrito being seen as vital part of the Mediterranean diet. The study has demonstrated the association between the Mediterranean diet and low levels of cardiovascular disease. Denise Reynolds RD writes that the Nordic Diet has also been found to be a heart healthy diet.

The researchers have identified polyphenols and carotenoids, which are both healthy antioxidant substances, in sofrito, with the use of a high resolution mass spectrometry technique. The presence of at least 40 types of polyphenols has been demonstrated. Researcher Rosa Mar�a Lamuela has said, "These compounds produced by plants and which we eat are related to reduced cardiovascular diseases."

The bioactive compounds carotenoids and vitamin C have also been found in sofrito. It has been shown in other studies that the consumption of carotenoids such as lycopene prevents prostate cancer. It has also been shown that the consumption of foods which are rich in beta-carotene help to lower the incidence of lung cancer. Lamuela explains that adding sofrito to a daily pasta dish will give you a healthy intake of polyphenols and carotenoids.....
9. Six Unexpected Ways Writing Can Transform Your Health

Huffington Post - by Amanda L. Chan      

 

(Nov. 12, 2013)   When is the last time you wrote something? Really wrote something, putting pen to paper, and not just typing away an email or report on a computer or smartphone. If it's been awhile, you might want to consider getting back into the practice -- writing (whether it be expressive writing, like you would do in a diary, or keeping a gratitude journal) has been linked with a number of benefits for both body and mind. Read through the list for some ways to write your way to a better you.

 

Writing by hand can help you learn better.

Step away from the computer -- the very act of using a pen or pencil to put things on paper can help you better retain the information you are writing, according to research. That's because in the physical act of writing, signals are being sent from your hands to your brain to build motor memory.

 

Expressing emotions through words may speed healing.
Writing down your thoughts and feelings after a traumatic event can actually make physical wounds heal faster, according to a study from New Zealand researchers. In this study, participants were assigned to write in a journal either about their deepest, most innermost thoughts and feelings, or about anything except their feelings or beliefs. Then, after two weeks, they had skin biopsies taken -- which left a wound on their arms. Researchers followed up with the participants until those wounds were healed, and found that those assigned to expressively write in the journals had faster healing times than those told to avoid writing about their feelings, TIME reported.

 

It could help change the way cancer patients think about their disease.
Attitude is everything, and that phrase couldn't be truer for people going through a life-changing experience like a cancer diagnosis. A 2008 study in the journal The Oncologist showed that expressive writing could help cancer patients not only think about their disease in a different way, but also improve their quality of life. "Moreover, despite the pilot nature of the present study, initial findings suggest that a single, 20-minute writing exercise led to changes in how some patients thought about their illness," the researchers wrote in the study.

 

Consider it a fundamental part of your gratitude practice.

When's the last time you counted out everything you have to be thankful for in life? Keeping a gratitude journal could help you feel happier, according to a study conducted by researchers from the University of California, Davis and the University of Miami. The New York Times reported that people in the study who kept a gratitude journal that they wrote in once a week for two months were more optimistic about life (and, interestingly, exercised more), compared with people who did not keep such a journal....

Product Risks and Recalls

10. Shopping For Cosmetics? Get the "Skin Deep" App from Environmental Working Group
http://www.ewg.org/release/shopping-cosmetics-take-ewg-s-skin-deep-app
 

(November 20, 2013)   Environmental Working Group's Skin Deep App is here!

EWG's popular online consumer guide to more than 78,000 personal care products is now available as an App for the iPhone and Android.

 

"Safety profiles for tens of thousands of products are now literally at the fingertips of everybody strolling the aisles of any store in the country," said Heather White, executive director at Environmental Working Group.  "This app will make choosing safer products for yourself and your family that much easier."

 

Shoppers will be able to quickly see the Skin Deep score of a product by simply scanning the bar code with their iPhone or Android devices. The App can be downloaded for free at the following links:

iTunes Apple Store 

Play Google for Android devices 

 

EWG's Skin Deep Cosmetics Database is an online guide with safety ratings for more than 78,000 cosmetics and other personal care products and more than 2,500 brands.  It has been searched more than 200 million times.  It was launched in 2004 to help people find safer products with fewer ingredients that are hazardous or haven't been thoroughly tested.

 

Skin Deep combines product ingredient lists with information in more than 60 toxicity and regulatory databases.  EWG created it because personal care products are not rigorously tested and regulated.  Chemical ingredients common in many of these products are associated with a number of serious health problems, including cancer, hormone disruption, development and reproductive problems and allergies.  Some companies use hazardous ingredients like formaldehyde and coal tar, both human carcinogens.

EWG's Skin Deep has transformed the marketplace.  Since it came online, shoppers are increasingly buying products that have fewer toxic ingredients.  

To appeal to health-conscious consumers, many manufacturers have introduced product lines with fewer hazardous ingredients. "We've heard from top cosmetics industry executives that Skin Deep fundamentally changed the way people look at these products," said Nneka Leiba, deputy director of research for EWG. "They used to think they were just applying makeup and lotion, but now they know they are applying chemicals too.  As with the launch of the Skin Deep database a decade ago, we anticipate the new Skin Deep App to be a game changer for concerned consumers as well as companies who value their brands and loyal customer base."  

 

The Skin Deep App for the iPhone is one of the top 20 free lifestyle Apps available in the Apple Store.  Since Sunday, November 17, there have been more than 21,000 downloads of the App and over 114,000 product barcodes have been scanned.... 

Public Health News

11. When the Choice is Between Abuse and Homelessness
      Almost one-third of homeless families in the shelter system are survivors of domestic violence. Mayor-elect de Blasio needs to act quickly to more adequately serve this vulnerable population.
City Limits - By Carol Corden and Shola Olatoye

(Nov. 20, 2013)   Mayor-elect Bill de Blasio's support for affordable housing is critical to the future of New York, but not just because affordable housing means stable rents and mortgages for the city's low- and moderate-income families. It is also a critical tool that the city can wield to help homeless persons get back on their feet, as well as to save lives by providing survivors of domestic violence and their families with long-term safety and stability. Yet, homeless persons, particularly survivors of domestic violence, struggle to access existing housing resources, an area where de Blasio can make a difference.

New Yorkers know they need affordable housing options; according to a poll released before the election, more than eight in 10 New Yorkers believed affordable housing is a top priority for the next mayor. And they're right. Affordable housing needs to be at the forefront of discussions between lawmakers, developers, and everyone who has a stake in New York City.

Low- and moderate-income families already struggle to make ends meet. One-third of families in New York City spend at least half of their income on housing, forcing them to make difficult tradeoffs between food, clothing, transportation and healthcare. An astounding 1.4 million New Yorkers rely on soup kitchens and food pantries to put nutritious meals on the table.

These already difficult experiences are exacerbated among the city's most underserved and neglected populations. Every night, 64.060 New Yorkers sleep in a shelter or on the street. Homeless persons often cycle in and out of the city's shelter system, unable to get back on track without the stability that real permanent affordable housing would provide them.

Almost one-third of homeless families in the shelter system are survivors of domestic violence with children whose lives are up-ended as their parents seek to escape abuse. Even worse, 80 percent of survivors who leave the emergency shelter system have no safe place to go. In fact, many survivors of domestic violence stay with their abusive partner because of fears of becoming homeless if they were to escape. For survivors with children this can be an especially difficult and emotional decision to make and could be made easier with more affordable housing options.

So what should be done? De Blasio's affordable housing plan, in addition to encouraging the creation of new housing, should also address existing housing policies. For example, survivors of domestic violence in the Human Resources Administration (HRA) shelter system are not considered homeless and therefore are not eligible for the same housing resources as homeless New Yorkers in the Department of Homeless Services (DHS) shelter system.

Easy fixes to existing policies could give survivors equal access to permanent housing. These include making available the Department of Housing Preservation and Development's (HPD) Section 8 and homeless set-aside units to victims of domestic violence using the HRA shelter system, and revising the criteria to gain access to New York City Housing Authority (NYCHA)'s Domestic Violence priority housing by adding a risk assessment tool and accepting more sources of documentation. Less than one-third of survivors in domestic violence emergency shelters meet the current criteria.

The application process for HPD and NYCHA housing should also be streamlined and made easier for survivors to ensure that they have a safe place to stay before their shelter stay expires. Finally, de Blasio should include in his housing plan a local rent subsidy, in partnership with New York State, to provide another bridge for families out of homelessness and into permanent housing.

The good news is that affordable housing is incredibly cost-effective and, according to the Independent Budget Office, allocating priority housing would save the city millions of dollars currently spent on costly shelters. The actual cost to house a family in a shelter for one year is $36,000, compared to an average of $12,000 per year in rent for affordable housing.....

Read more
12. Research Confirms Access to Healthy Food Still Matters
Policy Link

(Nov. 19, 2013)   A new joint report by PolicyLink and The Food Trust, Access to Healthy Food and Why It Matters: A Review of the Research, underscores healthy food access as the foundation necessary for reaping the positive benefits associated with healthy food.

 

Without access to healthy foods, a nutritious diet and good health are out of reach. And without grocery stores and other fresh food retailers, communities are also missing the commercial vitality that makes neighborhoods livable and helps local economies thrive.

 

The report reveals that improving healthy food access in low-income communities and communities of color continues to be an urgent need with nearly 30 million people living in low-income areas with limited access to supermarkets (defined as the closest store being more than a mile away). The problem is particularly acute in low-income communities of color.

 

The new report reviews research reaffirming that access to healthy food is a critical component of healthy, thriving communities. The report reviews more than 170 studies, published between 2010 and 2013, in an attempt to synthesize and present the latest research on healthy food access and identify where gaps may still exist since the publication of the first groundbreaking 2010 report, The Grocery Gap: Who Has Access to Healthy Food and Why It Matters.

 

The report includes three primary findings:

  • Accessing healthy food is still a challenge for many families, particularly those living in low-income neighborhoods, communities of color, and rural areas.
  • Living closer to healthy food retail is among the factors associated with better eating habits and decreased risk for obesity and diet-related diseases.
  • Healthy food retail stimulates economic activity.

The research review led to the following policy and research recommendations:

  • Comprehensive equity-oriented approaches to improving food retailing and access, that take economic, social, and environmental contexts into account, are needed to improve health.
  • Strategies should focus on those most in need-low-income people and communities of color.
  • Research that examines local lived experiences and uncovers lessons about the implementation of recent initiatives to improve food retailing in communities with limited access will be critical to understanding how healthy food can be accessed by all.
To download an executive summary of the report, click here. To download the full report, click here.
13. "Advanced Primary Care" at Heart of State's Health Improvement Plan
by Ronda Kotelchuck, CEO, Primary Care Development Corporation (PCDC)

(Nov. 19, 2013)  Last week the New York State Department of Health released a draft of its State Health Innovation Plan - an ambitious plan to make significant improvements to health outcomes, healthcare quality, and healthcare costs (the "Triple Aim") throughout New York State. The Plan will serve as the basis of a subsequent grant application to CMMI that is expected to provide as much $60M in support of the proposed initiatives. The Department is eager to receive feedback, and I urge you to read the plan and provide comments. The deadline for comments is November 27.
 
We are delighted that one of the Plan's key objectives is to assure that by 2019, 80% of the State's population will receive health care in an integrated delivery system with "Advanced Primary Care" (APC) at its core.  Building on the principles of the Patient-Centered Medical Home, APC envisions primary care providers taking responsibility for coordinating the complete health and social care needs of their patients in a comprehensive population health management model.

In essence, the Plan puts primary care providers in the driver's seat, marking a fundamental shift in how health care is delivered and paid for in New York State.  Getting there will be challenging, and the Plan recognizes that critical to its success are payment reform (among all payers), transparency of health cost and quality information, public-private partnerships, and training and technical assistance.
 
The Plan has many other components, so I urge you to download and read it, and send your comments to [email protected] no later than November 27.  If you have any questions or would like to share your comments with us, please email Dan Lowenstein, PCDC Senior Director of Public Affairs.

This is an exciting advancement for all of us who have worked to make sure primary care is valued for its essential role in improving health, reducing disparities and lowering costs. It is important that we now make our voices heard in this process.
14. Workers at 9/11 Site Get Workers' Compensation and Disability Extension
NYS AFL-CIO
 
(Nov. 15, 2013)  The re-opener of workers' compensation and disability retirement registry for workers at 9/11 Site (A7803A -Abbate / S5759A -Golden) has been signed into law and is Chapter 489 of the Laws of 2013.

This bill reopens the registry for workers' compensation and disability pension for those who were at or near the ground zero after the 9/11 terrorist attack. The new open period will extend through September 14, 2014. If eligible, workers who are on the registry will be presumed to have contracted certain illnesses that manifest themselves later in life as a result of their work at or near the site during that time period. The bill also addresses a shortfall in the law that prohibited vested members of a retirement system who worked at the site during the time in question but who subsequently left service, from being eligible for the registry.

The NYS AFL-CIO will continue to work with affiliates to spread the word and encourage any members or other workers who may be eligible for to register to do so prior to the new expiration date of September 14, 2014.

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