Truvada Becomes Flashpoint In N.Y. Gov's Anti-AIDS Plan; L.A. County To Consider Court-Ordered Mental Health Treatment Proposal

A selection of health policy stories from Connecticut, New York, Wyoming, Kentucky, Ohio, Massachusetts, Texas, Illinois, Maryland and Florida.  

The Wall Street Journal: Truvada, The Drug In Cuomo's AIDS-Eradication Plan, Spurs Debate
A cutting-edge medication that can help prevent HIV in healthy individuals is gaining favor with government officials, including New York Gov. Andrew Cuomo. But in advocating for the drug, sold under the brand name Truvada, officials seeking to curtail HIV/AIDS infections are going up against some surprising opponents: high-profile AIDS activists who say they have serious questions about the drug's cultural and health impacts (Vilensky, 7/13).

CT Mirror/Hartford Courant: Children In Crisis: ER System Failing Those With Mental Health Needs
The number of children and teens going to emergency rooms in mental health crisis, some waiting days for an inpatient bed, has been growing for more than a decade. ER staff are used to seeing a bump in patients at the end of each school year. But what happened this spring was unprecedented, say people who work at Connecticut Children's Medical Center, parents of kids with psychiatric illnesses and community mental health providers. "I don't remember a period like that before where the volume was so high and we had so many kids where there wasn't a place to facilitate them to, there wasn't a place for them to go to," said Gary Steck, CEO of Wellmore Behavioral Health, based in Waterbury (Levin Becker, 7/13). 

Los Angeles Times: L.A. County Board To Vote On Court-Ordered Mental Health Treatment Law
The Board of Supervisors is expected to vote Tuesday on a proposal that would increase money for outpatient treatment of people with a history of mental illness and expand efforts to identify potential patients. The vote would also set in motion a process that would allow family members, treatment providers and law enforcement officers to seek a court order to make people take part in the program, under which people can be ordered to undergo treatment but can't be forced to take medication (Sewell, 7/13). 

The New York Times: Rikers: Where Mental Illness Meets Brutality In Jail
The study, which the health department refused to release under the state’s Freedom of Information Law, found that over an 11-month period last year, 129 inmates suffered “serious injuries” — ones beyond the capacity of doctors at the jail’s clinics to treat — in altercations with correction department staff members. The report cataloged in exacting detail the severity of injuries suffered by inmates: fractures, wounds requiring stitches, head injuries and the like. But it also explored who the victims were. Most significantly, 77 percent of the seriously injured inmates had received a mental illness diagnosis (Winerip and Schwirtz, 7/14).

The Associated Press: Wyoming Is No. 3 Spender On Inmate Health Care
Wyoming spent about $20.7 million on prison health care services in 2011, ranking it third-highest among states in such spending per inmate, according to a new report. A study released this past week by the State Health Care Spending Project found that Wyoming spent an average of $10,870 on health care per inmate in 2011, the latest year that nationwide statistics were available. Wyoming had an average daily prison population of 1,905 in 2011. The national average was for states to spend about $6,000 per inmate during that time. Only California and Vermont spent more per inmate than Wyoming (7/14).

Kaiser Health News: Kentucky Law Gives Nurse Practitioners More Flexibility
Starting July 15, nurse practitioners in Kentucky who have completed a four-year collaboration with a physician will be allowed to prescribe routine medications without a doctor’s involvement, a major shift that could help improve consumers’ access to care. The law that makes this possible passed after five years of legislative debate. Nurse practitioners are fighting in other states for more authority to treat patients at a time of rising concern over the impact of the federal health law. As more Americans get insurance, there may be shortages of primary care doctors, especially in states like Kentucky that have many rural areas (Gillespie, 7/14).

The Boston Globe: Walsh Announces Plan To Aid Alzheimer’s Victims
Alzheimer’s disease is a personal issue for Martin J. Walsh. The Boston mayor remembers his grandmother reverting to childlike behaviors when her children implored her to remember them. She did not recognize her children, or her grandchildren, or any of the family members who surrounded her in her home in Ireland in the last years of her life. Walsh talked about his late grandmother, Mary Ann O’Malley, when he announced an Alzheimer’s initiative Friday that will make Boston the first major city to join the Alzheimer’s Workplace Alliance. The national group has nearly 2,000 companies and organizations that support employees with information on Alzheimer’s (Abutaleb, 7/11).

Texas Tribune: Women Wants State’s Help In Pelvic Mesh Fight
When Aaron Leigh Horton’s mother received a plastic mesh implant in 2009 to repair her pelvic organ prolapse, a type of pelvic floor disorder, she expected her pain to recede. Instead, she faced complication after complication — resulting in a surgical implant removal that her daughter says left her bedridden. Horton, who founded the Mesh Warrior Foundation, is among the thousands of women across the country who are engaged in lawsuits against manufacturers of pelvic mesh implants after suffering severe complications, including extreme pain, bleeding and infections.  In Texas, a coalition of “pelvic mesh survivors” has asked Texas Attorney General Greg Abbott, who is also the state’s Republican nominee for governor, to pursue legal action against Johnson & Johnson, one of the largest implant makers. The women say Johnson & Johnson violated a state law that prohibits deceptive business practices, citing the company’s “knowledge of the inherent danger” of the mesh implants and the cost to Texans of subsidizing care for women treated at taxpayer-funded facilities (Ura, 7/14).

Baltimore Sun: Planned Drug Treatment Clinic In Maryland Sparks Conflict
The developer says his planned center for heroin addicts in a North Baltimore neighborhood would be revolutionary: a primary care facility that would treat all aspects of addict's lives, not just dole out methadone. But Harwood residents see it as more of the same for a community they say is already filled with people bused in for addiction services. More addicts, they say, lead to more public urination, drug use and crime. The issue of how and where to treat Baltimore's population of addicts is always cause for debate, but this one has reached a fever pitch. City Council members Carl Stokes and Mary Pat Clarke have introduced a bill to rezone the area, which could halt the project, at least temporarily. And developer Noah Nordheimer inflamed tempers last week by bringing about 100 protesters to picket a meeting of the Central Baltimore Partnership — paying some of them with $20 bills (Broadwater and Campbell, 7/13).

Baltimore Sun: Group Home For Disabled Children Struggled To Provide Adequate Care
The recent death of a 10-year-old disabled foster child at an Anne Arundel County group home was just the latest in a series of problems at LifeLine, the state contractor that has been paid millions in taxpayer funds to care for "medically fragile" individuals, a two-month investigation by The Baltimore Sun has found. Even before Damaud Martin's death on July 2, LifeLine had struggled for years to provide around-the-clock care for its residents — adults and foster children often confined to a bed or wheelchair by paralysis, cerebral palsy and other disabilities. Its founder, Randall Martin Jr., is imprisoned for felony arson, the state disciplined the company for inadequate care after the death of three adult residents, and it is burdened by tax liens and other debts (Donovan, 7/12).

ProPublica: Why Are Obstetricians Among The Top Billers Of Psychotherapy In Illinois?
A few years ago, Illinois' Medicaid program for the poor noticed some odd trends in its billings for group psychotherapy sessions. Nursing home residents were being taken several times a week to off-site locations, and Medicaid was picking up the tab for both the services and the transportation. And then there was this: The sessions were often being performed by obstetrician/gynecologists, oncologists and urologists — "people who didn't have any training really in psychiatry," Medicaid director Theresa Eagleson recalled. So Medicaid began cracking down, and spending plummeted after new rules were implemented. In July 2012 the program stopped paying for group psychotherapy altogether for residents of nursing homes. Yet Illinois doctors are still billing the federal Medicare program for large numbers of the same services, a ProPublica analysis of federal data shows (Ornstein, 7/13).

The Associated Press: Ohio Rural Hospitals Face Financial Woes
Rural hospitals across Ohio face financial straits worse than their urban counterparts as expenses rise and health care reimbursements decline. A January snapshot by iVantage Health Analytics found hospitals in the state's metropolitan counties were running slightly in the black, while those in non-metro counties — often the largest employers — showed narrow losses, The Columbus Dispatch reported Sunday. Four years ago, struggling hospitals in Washington Court House and Logan closed their maternity units. More recently, hospitals in Chillicothe and Zanesville saw their bond ratings downgraded (7/13).

Tampa Bay Times: The Buzz: Gov. Scott Vetoed Money To Fight Health Care Fraud
Gov. Rick Scott, who will spend the next few months fending off familiar criticism of the health care fraud at his former hospital company, had a chance to put more money into fighting health care fraud in Florida. But to the disappointment of a key Republican lawmaker, he said no. One of Scott's little-noticed line-item vetoes in the new $77 billion budget would have set aside more money to investigate fraud in the Medicaid program. Scott gave no reason for the veto at the time he signed the budget (Bousquet and Leary, 7/12). 

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