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Oregon Doctors Wait For Feds To Allow New Meningococcal Vaccine

Following several high-profile cases of meningococcal disease in Oregon, local doctors are waiting to see if the federal government will permit a new vaccine.

The rate of meningococcal disease has been dropping over the last two decades, but the illness can be fatal.

There is a vaccine. But it doesn't protect against the Serogroup B strain -- the one responsible for about 60 percent of cases in Oregon.

Dr. Paul Cieslak with Oregon's Immunization Program says the Centers for Disease Control and Prevention is looking at a new vaccine for that strain. "Rest assured that the CDC knows all about Oregon's outbreak," he said. 

"Since 1994 we've been working real closely with them and whenever they think of meningococcal disease, they think of Oregon and our particular problem with Serogroup B. So they're really all over it."The CDC's immunization committee meets next month to decide whether to permit the new vaccine.

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New Oregon Health Plan Enrollees Skew Younger And Healthier

The hundreds of thousands of Oregonians who signed up for Medicaid under the Affordable Care Act last year, are younger and healthier than expected -- according to a new study out of the state.

The age and health of new Oregon Health Plan enrollees is important, because on average a population is more expensive to care for if it's older and sicker.

But Lori Coyner with the Oregon Health Authority says the 380,000 Oregonians who were added to Medicaid last year, tended to be young and healthy.

"The biggest jump has been in the age 19 to 35 and then 35 to people in their 50s," said Coyner. "They do not have, it appears, a lot of what's called 'pent-up demand,' meaning that they are very sick and they haven't seen a doctor."

Other parts of the report show Oregon's Coordinated Care Organizations continue to see a decrease in ER visits and fewer hospital re-admissions. That has helped the bottom line, keeping the average cost of care below what it was 2011.

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140,000 Oregonians Signed Up For Health Insurance So Far

So far more than 140,000 Oregonians have signed up for individual insurance during this open enrollment season.

"We've been really happy with how the open enrollment period as been going for 2015," said Aaron Patnode, the executive Director of Cover Oregon.

"And the numbers that the carriers are reporting are actually right on track with where we expect to be from our enrollment projection standpoint for 2015."

Most are enrolling via the federal website, healthcare.gov. It took over from the failed Cover Oregon website. But three of every seven customers have gone directly to the insurer's website. People included in the Medicaid expansion of the Affordable Care Act, get coverage through the Oregon Health Plan.

The state says so far about 990,000 people are enrolled.

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Oregon Starts Insurance For Transgender Medical Procedures

This January, the Oregon Health Plan starts covering the cost of reassignment surgery for transgender people.  It also helps cover the cost of hormone therapy and puberty suppression.

Some politicians question the use of tax payer money, but people in the transgender community call it ground breaking.

When Alexis Paige was born 26 years ago, as far as doctors and family were concerned, she was a boy. But by 11, she began to grow breasts and wanted to be a girl, making school very difficult.

"It kind of culminated in an instance in which I was actually pressed against a wall by someone who groped my breast to see if they were real and wanted to check if I was actually a male or female," she said.

By 16 her hips began to spread. She says she always felt different -- as if she wasn't in the right body -- and it drove her to try suicide.

"I was riding my bicycle when I noticed a car coming, just in that moment, I decided I'd purposely ride out in front of it and I was hoping that it would kill me," she said.

By last year, Paige went through therapy and saw a doctor who prescribed estrogen.

"Suddenly for the first time I had energy, I wasn't feeling sad all the time," she said.  "I actually stopped getting sick. I stopped feeling sore. This was who I was supposed to be."

At that time, Paige had a job and insurance to cover medical expenses. But then she lost that job and was terrified she'd have to end the therapy.

She says knowing that the Oregon Health Plan will now cover her hormones if she losses her job again, is invaluable.

"I know there will be some people who will question that and question whether that's right or it's wrong," she said.

"There's people who argue back and forth about whether it's innate to be trans or it's psychological. And the thing is, so what? I mean, you don't look at someone with cancer and go, 'Oh your cancer wasn't caused by a genetic reason, it was environmental, so we're not going to treat you.'"

Oregon joins California, Massachusetts, Washington D.C. and Vermont as jurisdictions where Medicaid covers medical treatments for gender dysphoria.

By looking at medical billing data, the state estimates at least 175 people will use the new coverage this year.

But there are those who question its validity and expense.

"To a large degree I think the jury is still out on these procedures and whether or not they're legitimate," said Roseburg Republican, state Senator Jeff Kruse. 

He's on the Legislature's Senate Committee on Health Care and Human Services. He says the gender reassignment medical procedures are "elective" and "dubious at best."

Oregon's Health Evidence Review Commission decided to look into coverage for gender dysphoria last year -- after a psychiatrist pointed out that the state had lumped it with conditions like pedophilia.

"People with gender dysphoria that did not receive treatment had a much higher rate of hospitalizations or ER visits or doctor visits for depression and anxiety," said commission director, Dr. Ariel Smits.

"And they had a pretty significantly high suicide attempt rate -- some studies found about 30 percent.  But folks when they received the treatment that they felt was adequate for their gender dysphoria, had an almost normal rate of depression and anxiety compared to the general population."

Their suicide rate also dropped significantly.

But what about the cost?

"It may cost somewhere in the $100,000 to $200,000 range although these numbers are very vague," said Smits. 

"There's also the possibility that it'll be less, or even cost savings, because hopefully these folks will no longer be going to the ER or being hospitalized for their severe depression or suicide attempts."

While the coverage begins this month, Basic Rights Oregon says it may take the state a while to line up services.

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Benton County Voters Will Decide On GE Crop Ban Next Year

Michael Clapp, OPB

Oregon Secretary of State Kate Brown sounded the final knockout bell for Measure 92 this week when she certified the defeat of the state initiative to require labeling of genetically engineered foods. But a group of advocates in one Oregon county isn't giving up just yet.

In Benton County, a group called Benton Food Freedom filed signatures this week for a May 2015 ballot measure that would ban genetically engineered crops in the county, according to the Corvallis Advocate.

Benton County Supervisor of Elections Jeff Doty confirmed Friday that the measure will appear on the May ballot. He said the group had enough signatures to "easily qualify," and the measure is now awaiting a number.

And it might just pass: Secretary of State's office records show 52 percent of Benton County voters supported Measure 92.

Benton Food Freedom's pursuit of the ban comes even though it would run head-on into a state law passed in 2013 that prohibits such action at the county level.

"We're very confident that we can defend this once we pass it," said Corvallis resident Vernon Huffman, a field manager for Benton Food Freedom.

The group is already gearing up for legal wrangling with the state. They're working with the Community Environmental Legal Defense Fund, a nonprofit that provides low-cost legal services and advocates for "community rights" on environmental issues like hydraulic fracturing, mining and agriculture.

"The basic scenario is that communities are caught in a situation now where they are being kept out of big decisions," said Kai Huschke, community organizer for CELDF. "This is a proposition for the people of Benton County, not the state or corporations."

Huschke said the legal argument for Benton's ban would look something like this: Local governments have a constitutional right to create laws with tighter restrictions than what's mandated at the state or federal levels. 

It's an approach to genetically engineered crop bans that hasn't been tested fully anywhere else in the country yet, though CELDF has assisted about 160 communities in adopting similar laws on other environmental issues, according to Huschke.

Huschke said CELDF had wanted to try this approach in Hawaii, where three counties were trying to defend laws against genetically engineered crops there, but those counties eventually opted out of CELDF's approach. Federal judges struck down two of those efforts so far, and Huschke expects the third to go down as well.

Supporters of genetically engineered crops say they're keeping an eye on the Benton County effort. Scott Dahlman, executive director of advocacy group Oregonians for Food and Shelter, called the measure more "extreme" than similar bans that passed in Jackson and Josephine counties.

"Once Benton County residents have a chance to understand what's in this measure, they'll reject it," Dahlman said. "It's unfortunate that taxpayers have to pay for this to go to the ballot."

With lawsuits pending over Jackson County's ban, and Measure 92 being the most expensive ballot measure campaign in history, Benton County may be primed to be another high-dollar battle in Oregon's ongoing debate over GE foods.

But Huschke and Dahlman both say biotech companies will only pour money into Benton County if they feel like it poses a threat to their business.

"Right now, the Benton folks are gearing up for full campaign mode," said Huschke. "If the voters say yes, then we have to wait to see what happens with the legal system."

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Ebola Outbreak Exposes Gaps In Infectious Disease Care

The Ebola outbreak has exposed gaps in the nation’s ability to deal with severe infectious diseases, according to a new report from the Robert Wood Johnson Foundation.

Rich Hamburg of Trust for America's Health says Oregon only managed to meet five of the study's 10 key indicators: "Over the last decade we saw dramatic improvements in state and local capacities to respond to outbreaks and emergencies," he said.

"But," he continued, "this year Ebola has been what you'd call a wake-up call - a reminder that an infectious disease threat anywhere is a threat everywhere. It raised attention to serious gaps in our ability to manage disease outbreaks."

Oregon met the study's health funding indicator, but failed for a low vaccination rate, substandard food safety checks, and inadequate health security preparedness.

Half of all states met five or fewer of the key indicators.

Maryland, Massachusetts, Tennessee, Vermont and Virginia tied for the top score – with eight indicators.

Arkansas met two.

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New Project Could Lay Deceased To Rest As Tree, Patch Of Flowers

Eventually we're all faced with the question of what will become of our remains — burial, cremation or donated to science? Soon you could consider composting as another option.

A Seattle nonprofit, Urban Death Project, is hoping to become the world's first organization to offer human composting as an option, turning remains into nutrient-rich soil.

Seattle architect and project founder Katrina Spade first proposed the concept three years ago as both a meaningful and ecological alternative to standard burials.

“Our bodies have potential in them even after we’ve died," said Spade in an interview with Seattle member station KPLU. “I just think it's an absolutely beautiful idea that we can be productive one last time."

The group has designs for its facility, but the project is still in need of funding and a location, plus it needs to be licensed as a funeral home, according to state law.

Spade said the project would also do well in Oregon. Though there hasn't been any official interest from the state, she said she's received messages from numerous Oregonians.

The Urban Death Project would host ceremonies, after which friends and family could insert the body into the building's central core. The deceased would be left to decompose naturally between layers of high-carbon material. As remains break down, they'll compact and move down the communal core, before finally being pushed out into an outdoor grove. Spade predicts the organization can be up and running in three years.

The body would then turn into roughly one cubic yard of compost — enough for a tree or a patch of flowers. The family could take some of the resulting compost, or donate it to the project.

"I believe that this option will exist all over the world some day," said Spade. "I get emails from people as far away as South Africa, the UK, and Australia."

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Voices From 'Hunger In Oregon'

Nearly 15 years ago, Oregon had the highest rate of hunger in the nation. Today, the percentage of people facing hunger is nearly as high as it was in 2000. In OPB’s series Hunger In Oregon, Oregonians shared their experience getting food on the table. Here are excerpts from those stories.

 I went from $650 in benefits to just over $200. My income increased slightly as I am no longer a full-time student. I have to be extremely mindful now. We are eating less meat (this is good), more beans. I find we are eating less produce. I bought a bread maker and am no longer purchasing store bought bread.

— Tori Geter, Corvallis

 I'm poor, and they do give you a little status when shopping in a nice store like Fred Meyer — you can still "feel" like a middle-class person, even if you're very far from being middle class!

— Peter White, Chiloquin

My husband passed in January and then in July I was laid off. I almost went into foreclosure and if it wasn't for SNAP I probably would have starved. I didn't get much but it kept me in peanut butter and bread long enough to pull myself out of poverty.

— Darlene Wheeler, Coos Bay

I am a food stamps eligibility worker. The most distress comes from higher education students who have to meet extra eligibility rules in order to (qualify for) SNAP. They are the hidden population that is not being discussed in regular coverage on hunger. Our students go hungry every summer.

— Vesna Stone, Corvallis

We shop at Winco in Longview. Sometimes we are forced to buy things at local, more expensive stores. We started going to food banks to make it through the month. We have seen no "recovery". It is not right to cut [food stamps] and to let the 1 percent go without paying taxes.

— Eldon Rollins, Coquille

[I shop at] Fred Meyer Hawthorne once a week. It's not convenient. I don't have a car, so I need a ride to get there. [Benefits are] gone by the end of the second week in the month. I use my monthly income from SSI after I run out.

— Victoria Deeks, West Linn

My family has a lot of food allergies, so it's very important that we obtain the right ingredients for making meals. We eat less and now scrounge or ask people for money to try to have enough food for the month. Sometimes we just go without.

— Michael Davis, Portland

The SNAP program supplements my disability income. I already eat a very spartan diet -- as healthy as I can, but as cheaply as possible. My "big" splurge on meat comes in the form of cheap hot dogs, otherwise, my protein is supplied by eggs, dairy and beans.

— George Dennison, Lake Oswego

Our little market is very convenient for our local people. I’m here almost every day. Tonight I’m cooking fry burgers. I’m not working right now because of health reasons. It would be nice to get more [SNAP benefits]. But beggars can’t be choosers, you know?

— Jasmine Caldera, Warm Springs

I have a number of friends and colleagues with college age kids who are signing up for food stamps because they qualify as low income, yet are already surviving on student loans alone to get through school. Food stamps should keep you from starving - you are not starving when you receive plenty of student loan money to live on.

— Nicole Pucci, Oregon City

I received [SNAP benefits} the 9th of every month. I buy rice, beans, oil and oil first. In the middle of the month I’ll buy vegetables or fruit. In the last week of the month we go back and buy more. Sometimes when we don’t have any more food stamps we go to the food bank. Last week we went to the store and we spent $200! It would be really hard to feed our family without it.

— Gabriela Diaz, Madras

Living on minimum wage is in no way sufficient to meet the needs of families. Even single people without children can find it impossible. It's hard to determine which things are the most difficult to afford, because it's such a question of priority and necessity. What's more is that those things can change in a moment. Without food stamps and other assistance it can be a real hardship.

— Kristina Brewington, Albany

[SNAP is] a lifeline for people in this area. Nothing else matters if you can’t feed your family. It just seems like that’s such a tenuous existence. It’s a line of defense every week, every month. I do wish you could use it for things like personal hygiene products that are just as critical.

— Deb Goosev, Gilchrist

I spent my entire childhood on food stamps (grew up with a single, disabled mother in Rockwood, OR). Obviously, I owe a great debt to the SNAP program, but at the same time I feel there are some flaws in the system. My personal milk-crate is that, like any type of assistance, anywhere, provision is at best a (very) short solution without education. Things like SNAP, and food boxes, etc., are certainly important, but they are not nearly as effective without education on how to best use them: planning, shopping, and preparing healthy foods that don’t come in a box or bag.

— Perry Perkins

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Hospital Care Improves in Oregon, But Errors Persist

Many Oregon hospitals have made improvements to patient care over the last couple of years. But human error still results in serious complications.

Nineteen of Oregon's hospitals reduced the number of infections their patients contracted by 40 percent over the last two years.

Andy Van Pelt, with the Oregon Association of Hospitals, says the details are coming out of the federal Centers for Medicare and Medicaid Services, "The preliminary data that's coming out of CMS for Oregon is tremendous," he said. 

"With a reduction in 2,200 harms and a savings of over $12 million over the same time."

But errors still happen. The St. Charles Health System in Bend says 65-year-old Loretta Macpherson died after being given a paralyzing agent instead of anti-seizure medication.

The hospitals says she came into the ER earlier this week with questions after a recent surgery. Three employees have been placed on paid leave.

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Where You Live Affects Your Access To Food

A family's home address can dictate whether their kids get government help with food.

There are rural school districts in Oregon - where there's no free lunch. But in lots of places, needy students can get free lunch and breakfast. And Portland's now starting  to provide free dinners, too.

Jessica Morris is with Meals on Wheels. She's delivering frozen entrees, milk, and vegetables to Avoka Tavila and her five kids.

 

Tavila's two oldest are at school this morning, but it's a full house.

"I have three at home and these are my niece and nephew. My husband's sister's kids," Tavila says.

Avoka Tavila's husband works days. She works nights - and takes classes.  

"I go to school at ITT Tech. I'm graduating next year, with a networking, administrative service degree."

The Tavilas are the kind of family that officials had in mind when the Portland Children's Levy contracted with Meals on Wheels, for $1.3 million.

City commissioner Dan Saltzman chairs the children's levy committee that funded Meals on Wheels to take its meal-delivery to older people, and expand it to families in poverty.

"Could be Mom working the graveyard shift and doesn't have the means, or transportation or mobility to go to a food pantry,"   Saltzman explains.  "And it's also designed to deal with the one meal of the day that for many kids is often the biggest question mark - and that's supper, or dinner."  

But if the question mark is dinner, delivering food to the doorstep isn't the only answer.  

The Oregon Food Bank is getting money to expand its school-based pantries - from seven to 18 schools, over the next three years.

Mill Park Elementary in outer southeast opened its pantry this fall, in a converted office. Fresh apples and carrots, beans and onions pack the shelves, and there's more in a refrigerator.  

Many of the couple dozen families served in its first few weeks aren't native English speakers, like the Calderons.  

Ninth grader, Melanie interprets for her mom, Artencia.  "It's good, and really a good help for everyone and stuff."  

Food bank spokeswoman Myrna Jensen says it's a low-cost approach. "With our school-based pantries, our cost is about 48 cents per meal."   But the food bank doesn't prepare "meals" - so that estimate is really based on pounds of food.  

Meals on Wheels prepares and delivers meals to homes – and is more expensive. The levy pays about $2.70 a meal.    But that's not a fair comparison, says commissioner Dan Saltzman.  

"Looking at that is sort of like looking at how much does it cost you to prepare a meal if you go to the store and buy your food and prepare it yourself, versus ordering a prepared meal."  

Meals on Wheels interviews families to make sure they're struggling financially - and face barriers in acquiring and cooking their own food.

For Tavila, who works graveyard, time is an issue.   "When I get home from work then I prepare breakfast for them. It's not a big deal. They love oatmeal or cereal. But for lunch, I need the time to rest," She says.

Is the higher expense of Meals on Wheels worth it?  

"I'm sort of waiting - I think the jury is out on it,"   says Patti Whitney-Wise who directs Partners for a Hunger-Free Oregon.

"It's a very interesting model to take a look at, and see whether in fact, there is a subset of families who are hungry, where this really is a better model than what we have in place otherwise."

Officials in the non-profit and government ranks agree that feeding struggling families takes a variety of strategies --- pantries, financial assistance, and quite possibly, delivering dinner to a family's door.

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