Oregon Public Broadcasting

Bill Would Make It Easier To Compare Health Plans

A bill that would make it easier to compare health insurance plans has made it out of an Oregon Senate committee.

Oregon's current health care experiment measures performance in many ways — like what percentage of health records are computerized or how many patients get a follow up visit after a hospital stay.

Such metrics it makes it easier to compare the quality of health plans, but they're only used by Oregon's Medicaid system.

Sen. Elizabeth Steiner Hayward, D-Portland, says Senate Bill 440 would require everyone to use the same metrics.

"Different insurance companies have held providers accountable to different metrics," she said. "And for primary care providers, it's really tough when you have patients who are covered by multiple different types of insurance, to make sure that you're meeting the metrics from different insurance carriers and Medicaid at the same time."

Passage of the bill is far from assured. Proposed changes are expensive for insurance companies, hospitals and clinics.

A spokeswoman from Gov. Kate Brown's office says she will review it once it reaches her desk.

The bill now moves to the House.

News source: 
Original site: 

VA Wait Times Slowly Improving In Northwest Clinics

Most of the wait times for patients at VA clinics around the Pacific Northwest fall below the national average, according to an analysis of data by the Associated Press.

Twelve of the 29 clinics analyzed in Oregon and Washington had appointments that didn’t meet the agency’s goal of seeing a patient within 30 days, according to the analysis of data by the AP.

From September 2014 to February 2015, the AP found that 2.78 percent of wait times at VA clinics around the country were delayed at least 31 days.

Regionally, the Salem VA  -- at 5.49 percent -- had the highest percentage of appointments that were delayed at least 31 days. The lowest was the La Grande VA Clinic with .05 percent of appointments over the VA’s goal, according to the AP.

A report last April from the Department of Veterans Affairs Office of Inspector General found Portland VA clinics had some of the longest wait times in the country, something that’s since been improved, Portland VA official and veteran group both said.

According to the AP, 3.58 percent of the appointments at the Portland VA from September 2014 to February 2015 exceeded the agency’s 30 day goal.

News source: 
Original site: 

VA Wait Times Slowly Improving In Northwest Clinics

Most of the wait times for patients at VA clinics around the Pacific Northwest fall below the national average, according to an analysis of data by the Associated Press.

Twelve of the 29 clinics analyzed in Oregon and Washington had appointments that didn’t meet the agency’s goal of seeing a patient within 30 days, according to the analysis of data by the AP.

From September 2014 to February 2015, the AP found that 2.78 percent of wait times at VA clinics around the country were delayed at least 31 days.

Regionally, the Salem VA  -- at 5.49 percent -- had the highest percentage of appointments that were delayed at least 31 days. The lowest was the La Grande VA Clinic with .05 percent of appointments over the VA’s goal, according to the AP.

A report last April from the Department of Veterans Affairs Office of Inspector General found Portland VA clinics had some of the longest wait times in the country, something that’s since been improved, Portland VA official and veteran group both said.

According to the AP, 3.58 percent of the appointments at the Portland VA from September 2014 to February 2015 exceeded the agency’s 30 day goal.

News source: 
Original site: 

Vancouver Hospital CEO Stepping Down

PeaceHealth Southwest CEO Sy Johnson said he’s leaving the Vancouver, Washington-based medical center later this month.

Johnson told OPB the decision to leave was his own.

“I have a large family — five young children — and I need to spend a little bit more time with them. So a lot of it is a family decision," he said. "Every organization has its life cycles and places in time. … This is a place and time for me to make this choice.”

Johnson became CEO of PeaceHealth Southwest in November 2013.

During his tenure, the hospital notified more than 930 former patients to get tested for Hepatitis C after a former hospital employee was found to have diverted drugs.

After a five-month investigation, no patients were found to have contracted the virus.

Johnson will be succeeded by Nancy Steiger. She is currently the CEO for PeaceHealth in Washington and Alaska.

News source: 
Original site: 

Effort To Increase Organ Donors Delayed By ODOT Concerns

A plan to increase the number of organ donors in Oregon is being delayed by Transportation Department concerns.

Three out of four Oregonians tick the box to become an organ donor when they get a driving license.

Now the organization responsible for matching organ donors with recipients wants to add a new box - a $3 donation for outreach to attract more minority and rural donors.

But Tom McCellan with the Oregon Department of Transportation told a state senate committee that could cost hundred of thousands of dollars in computer re-programming, "Our concerns really deal with that cost and maybe it's a policy question for you, whether state employees should be collecting money on behalf of non-profit organizations."

A number of senators expressed support for the $3 box. One suggested it could be added when ODOT gets its new computer system.

Another hearing on the bill is expected next week, when fiscal impact statements should be ready.

News source: 
Original site: 

Cities Think Walking To School Is Good For Health

Tigard and Milwaukie are the first cities in the Portland area to pass resolutions asking Metro to make it safer for kids to walk to school.

LeeAnne Fergason with For Every Kid estimates that walking to school could meet 60 percent of the average child's daily physical activity need. "One in four kids in Oregon is considered unhealthy and obese and at risk for related diseases," she said.

Metro spokesman, Jim Middaugh said the agency has funds for making streets safer around school, but it's a competitive process. "This is the beginning of several steps in an effort to pick the most important projects in the Portland Metropolitan area that will help all of us spend less time in traffic and more time with our friends and family," he said.

Some communities are also setting up what are called "Walking School Buses" and "Bike Trains," where kids meet up for their trip to school -- and benefit from the safety in numbers.

News source: 
Original site: 

Why There's More Concern For Farmworkers After Pesticide Cancer Study

Few people come into contact with farm chemicals the way agricultural workers do. That's why a new health report on a commonly used herbicide is raising special concerns about farmworkers and cancer.

For years, researchers have seen glyphosate as one of the least harmful herbicides. It doesn’t cause as many acute poisonings. But now the World Health Organization has said there’s “limited evidence” long-term exposure can cause non-Hodgkin lymphoma in people.

Chuck Benbrook studies glyphosate, the active ingredient in Roundup, at Washington State University. He said it’s the most heavily applied herbicide in history.

“This comes as a really huge surprise. It’s going to have a chilling effect worldwide on the use of Roundup,” Benbrook said.

Benbrook said this new report could be bad news for farmworkers — especially people applying the herbicide by hand or from four-wheelers.

“The people doing those applications, unless they’re very careful and wear proper protective equipment, they’re getting significant exposures,” Benbrook said.

In the Northwest, the herbicide is used on crops like barley, garbanzo beans, and wheat. Roundup is most often used on genetically modified crops — like corn and soybeans — that Roundup doesn’t kill. These crops aren’t grown in the Northwest.

Many farmworker unions and clinics try to teach people how to reduce their exposure to pesticides.

Virginia Garcia Memorial Health Center in Hillsboro, Oregon, west of Portland is one of those clinics. It recently expanded its pesticide safety education.

Spokeswoman Olivia MacKenzie said a team helps workers learn how to properly outfit themselves and how to take off clothing and protective gear — without dragging pesticide residue home. She says right now physicians treat things like rashes and asthma from pesticide exposure.

“We do expect that there will be long-term issues that some of these farmworkers who have a long duration of exposure will be experiencing,” MacKenzie said.

MacKenzie said the center is also training its physicians to educate and treat farmworkers with pesticide exposure.

News source: 
Original site: 

Oregon Health Plan Pays For Puberty Suppression

Some states now cover the cost of medical treatment for people who are transgender. Oregon is one of them. But, since January, Oregon is going one step further.

It now pays for drugs that suppress puberty in children who think they might want to change their gender - if they're on the Oregon Health Plan.

An upcoming story will look into the medical pros and cons of the therapy. But first, here's a look at how a 13-year-old and her family came to the tough decision to suppress puberty.

Michael was born biologically male 13 years ago in the community of Grand Ronde.

Michael's Mom, Dee, remembers bringing three dresses home for three cousins when Michael -- who now goes by Michaela -- was about six.

"When she saw those dresses, her eyes just lit up. And she said, 'who are those for?' I'll never forget it. And I said, 'well, these are for the girls. Do you like them?' And she said, 'yeah.' So I said, 'well do you want to try any of them on? If any of them fit you, do you want to wear them?' And she said, 'yeah.'"

"She just twirled and twirled in that dress it was so wonderful," Dee says.  "And that's when I knew. At that point. I'm not wrong here."

To protect her privacy, OPB has agreed not to use the real names of Michaela or her mother.

When Michaela turned seven, the family went on a trip to California where she wore dresses and went out in public as a girl.

"She had the best week of her life up to that point," her Mom says.  "And she was so open and had just so much fun."  But there were problems. "She wouldn't wear her pink and purple to school anymore, like she used to," Dee explains. "She was starting to get teased, which was way too hard for me to take."

"I don't really remember any of that," says Michaela crying, "...other than some of [what] Ray's friends did." Ray is her older brother.

The family decided to move to Portland so Michaela could attend a school where people only knew her as a girl.

"Any boy who wants to look like a girl can just grow your hair long and put some mascara on, put a dress on and they'll look very female," says Doctor Karin Selva. She is Michaela's pediatric endocrinologist at Randall Children's Hospital in Portland. "But as soon as puberty hits, that's when the body pretty much turns on someone who is transgender." So for Michaela that would mean growing an Adam's apple, facial hair and a heavy male body structure.

Dutch researchers, in a study published in the journal, Pediatrics, found that puberty suppression gave transgender youth, "the opportunity to develop into well-functioning young adults."

So last year, when Michaela started to experience the first signs of puberty, Dr. Selva started puberty suppression injections.

Michaela's family has private health insurance. But for someone on the Oregon Health Plan, the hospital says Lupron  - the puberty suppression drug - costs about $7,500 for three months.

Dr. Selva says now they need to discuss how long to keep Michaela on the suppression drugs and whether she wants to start taking the female hormone, estrogen. "Some people are ready and want the cross hormones yesterday, and they're 12. Well, we're not going to do that. That's a little young for our comfort level."

"But around 14, 15, we'll discuss with the parents and patient and talk about long term," she continues. "Because once you start cross hormone therapy, that is the permanent changes that can affect fertility and there are some things we do not know about long-term outcome for prolonged hormone exposure." As Dr. Selva tells Michaela, the important thing is that she can develop as she wants to develop, and in a way that doesn't attract unwanted attention. "No one in your school knows? Right? Does anyone know? No one has to know." The state estimates that about 175 people will use some kind of transgender treatment under the Oregon Health Plan this year, but it doesn't have figures on how many of those people might be seeking puberty suppression.

 Look for a story, Wednesday, on the pros and cons of puberty suppression therapy.

News source: 
Original site: 

What Fat Grizzlies Can Teach Us About Obese Humans

Grizzly bears pile on the fat every autumn. But in their obese state through hibernation, they don’t appear to suffer health consequences like overweight humans do. Scientists in eastern Washington are trying to figure out why. A new study involving those bears may yield insights into possible therapies for human obesity and diabetes.Michael Werner: Plump. Pudgy. Portly. Call them what you will, but for grizzlies, being fat is being happy.Heiko Jansen, Associate Professor, Washington State University: They’re sort of OCD eaters in the fall. They will consume so much of that that they're putting on nearly 10 pounds a day. If you translate that to pizzas, it’s about 16 large pepperoni pizzas a day.Werner: For humans, this kind of weight gain could cause some serious health problems like heart disease, stroke and type 2 diabetes. But grizzlies have trouble surviving without it.Jansen:  All their focus is on, is eating. It’s just born out of necessity. If they don’t have enough fat, they won’t survive hibernation. Brutal lesson to learn, if you’re a bear.

Werner: Grizzly bears can easily double their body fat in the lead up to hibernation. Some of the brown behemoths here at Washington State University's Bear Center will reach more than 700 pounds!Wild bears developed the ability to hibernate as a way to survive winter, when food is scarce. The fat they store up over the summer and fall fuels them through their six to seven month slumber.And during that time, their bodies change in surprising and incredible ways.Joy Erlenbach, WSU Bear Center Manager: They don’t eat or drink or urinate or defecate during the hibernating season. The bear’s metabolism decreases drastically. Their heart rate drops from somewhere around 60 beats per minute to much lower, maybe around 10 beats per minute.

Werner:  But perhaps the most remarkable adaptation during hibernation is that the bears become diabetic, or something that looks a lot like it. Their bodies become resisitant to insulin, a hormone that regulates blood sugar.Jansen: What we see in bears looks very similar to what happens in diabetic humans. The big difference, though, the bears transition into and out of that state every year. So they exhibit a reversible, if you want to call it, diabetic state. Which is not something that’s very easy to do for humans.Werner: Heiko Jansen studies seasonal changes in grizzlies, with help from the biotech giant Amgen, he is trying to solve the mystery of how the bears make this switch. The answer could one day lead to a treatment for human diabetes.But to study this phenomenon you need access to hibernating bears, and the WSU bear center is the only place in the world where captive grizzlies hibernate.

Jansen: We know so little about bear physiology that every time we generate a hypothesis, it’s almost invariably rejected because we just know so little. And despite our best efforts, the questions we ask are almost always answered in a very different way than we expected.Werner: Many of these bears were nuisance animals rescued from the wild. And studying a wild 700-pound grizzly is no picnic.Jansen: The bears are not something you can mess with. Even trained bears will rear their ugly heads at time, unpredictably. So we have to work with them in a protected environment and very, very carefully.Erlenbach: The bear center has worked to train bears because, if we can work with trained bears, we can avoid the need to anesthetize them to do simple procedures like blood draws and echocardiograms.Erlenbach: We feed the bears honey when we’re doing voluntary blood draws because they like it and it’s a way to reward them for working with us and it’s also a way to keep their mouth occupied. As soon as we start feeding them honey, we can ask them to sit, and we can ask them to lay down, and then we can ask them to stick out their foot and then they’ll stick their foot out through one of the slats in the crate and we’ll be able to do a voluntary blood draw that way.

Werner:  But not every bear is so accommodating. Some have to be tranquilized.Erlenbach:  We’ll load up a darting pistol with the drug that we’ll use to anesthetize the animal, and we’ll use that to inject the drug into the animal, and then a few minutes later, the bear will basically fall asleep.Werner:  Researchers can then draw blood and take tissue samples. The key to understanding how beras switch in and out of a diabetic state may lie in the bear's fat cells. Here in Jansen's lab they're growing grizzly fat cells, hoping to get an up-close look at the mechanism that allows grizzlies to go from being diabetic to non-diabetic, and back again.

Jansen: Our hypothesis is that it’s occurring at the fat cell, so we wanted to work with those cells directly. Somewhere within that cellular molecular machinery is a mechanism that can explain this switch. I think ultimately the hope of everyone is that we would be able to treat diabetes. Of course we all realize that it’s a very long shot and we’re working with exotic species that have mechanisms that we don’t fully understand, but insulin seems to do similar things in the bear that it does to people, and thereby understanding those mechanisms could allow diabetics to overcome their disease.Jansen: Studying the bears has forced us to rethink so many things not only about our biology but their biology. We’re understanding and learning more every day.Werner: As long as food is involved, the bears at the center are happy to help.This was first reported for the KCTS9 program, IN Close, which airs throughout Western and Central Washington Thursdays at 7 p.m.

News source: 
Original site: 

Oregon Health Policy Board Wants To Stop Personal Belief Vaccination Exemptions

The Oregon Health Policy board met Tuesday to try to reduce the state's vaccination exemption rate, which is the highest in the nation.

Over the last decade, Oregon's vaccine exemption rate for kindergartners has risen to seven percent.

In some schools it's as high as 70 percent.

Most of those exemptions are given because of a parent's personal beliefs. Mississippi and West Virginia don't allow that kind of exemption and more than 99 percent of their kids are vaccinated.

Oregon Health Sciences University president Joe Robertson sits on the Oregon Health Policy Board, and says something needs to be done. "The trends are alarming. When you're not vaccinated, you are a clear and present danger to others," he said. "These are potentially lethal diseases."

There's a bill in the legislature to end Oregon's policy of allowing personal belief exemptions.

The Oregon Heath Authority's new policy is that exemptions should only be allowed for medical reasons.

News source: 
Original site: 

Pages

Subscribe to Oregon Public Broadcasting