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Democrats Question Trump's Effort To Allow States To Penalize Medicaid Recipients

Senate Democrats are questioning the Trump Administration’s authority to allow states to run Medicaid programs that penalize users.

The Trump Administration released guidance last week, saying states could require Medicaid recipients to work. It said states could do other things like put lifetime caps on Medicaid benefits and impose mandatory drug testing.

Oregon Senator Ron Wyden and 28 other Democrats have written a letter to acting Health and Human Services Secretary Eric Hargan, expressing serious concern. “The vast majority of Americans who get the Medicaid benefit either already have a job or are unable to work due to age or impairment," said Wyden.

“Harmful ideological policies such as work requirements, mandatory drug testing, time limits, onerous cost-sharing and the like undercut and exceed the statutory authority provided to the secretary under Section 1115 and contravene longstanding congressional intent,” said the letter.

“Ultimately, this leads to poorer health and more frequent use of the emergency room, all of which ends up costing the system and taxpayers more in the long run. Such harmful proposals clearly undermine the purpose of the Medicaid Act, prioritizing ideology over health.”

The Centers for Medicare & Medicaid Services recently approved a Medicaid waiver for Kentucky that imposed work requirements on eligible individuals and lockout periods that would hurt low-income individuals.

States like Oregon, that embraced the Affordable Care Act, have secured federal waivers to try to improve care and reduce costs.

The Democrats worry states will use the waiver to reduce the number of Medicaid recipients in areas where the act isn't popular.

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OSU Holds Student Vaccination Clinics For Meningococcal B

Oregon State University is holding mass vaccination clinics at its Corvallis campus to deal with a Meningococcal disease outbreak.

The clinics are part of an attempt by the university to control the spread of the disease, which has so far infected six students since November.

"We believe our students’ public health is very, very essential," said Steve Clark, vice president of university relations and marketing for OSU.

The disease is a serious, potentially fatal infection that can cause meningitis or a serious blood infection.

The clock to get all OSU students vaccinated began ticking in December last year, when the university began requiring all students age 25 and under to get immunized.

According to its website, OSU already required incoming students to get Meningococcal B vaccinations before expanding the requirement to all students.

Students have until Feb. 15 to get two of the required vaccinations. Those who don't get vaccinated won't be able to register for classes in the spring or receive final grades for the winter term.

"We’re very definite about this," Clark said. "It is so important that they act now."

So far, approximately 60 percent of OSU's 25,000 students have gotten at least one of the two required vaccines. About 9,000 more have not gotten vaccinated at all.

There are medical and non-medical exemptions for students, as required by state law. If an exemption is requested, the university says it's requiring students meet with a medical care provider to understand the risk of the disease.

The vaccine costs $235 a dose, which Clark says is covered under the Oregon Health Plan and a health insurance plan students can purchase through the university.

"We're going to work with them to determine ways that they can, in fact, be vaccinated," he said.

The OSU MenB clinic runs through Jan. 13.

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80 Homeless People Died In Multnomah County In 2016

Eighty people who were homeless in Multnomah County died in 2016, according to a report released Thursday.

That's similar to the number of deaths of homeless people the county recorded in 2015: 88, the highest number since the record-keeping began.  

The report is titled “Domicile Unknown,” after the box the medical examiner marks on paperwork to indicate a person was homeless.

The report highlights the dramatically lower life expectancy of people who live on the street. 

Most of the 80 houseless people who died in 2016 were men. They were, on average, 51 years old at death. The homeless women who died were, on average, even younger, at 43 years old.

Many of them died in outdoor public places, but homeless people also died in hospitals. Others were found in motels, shelters, cars and in the river.

Their causes of death included accidents, illness, suicide and homicide. In half of the deaths, drug or alcohol toxicity was the cause or a contributing factor. Heroin and prescription opioids were noted in 19 people, or close to one-quarter of all homeless deaths in 2016. 

The report is part of the legacy of local advocate and journalist Israel Bayer.

Bayer, the longtime executive director of the weekly paper Streetroots, pressed the county to track deaths of homeless people. He says his goal was to honor the dead and to compel people to take action to help end homelessness.

“Given the fact that dozens of people are dying on our streets every year, it shows that homelessness remains an emergency situation that we have to be able to prioritize,” Bayer said.

Bayer says the latest report reveals “the scale of the poverty that is affecting our sisters, fathers, mothers and neighbors.”

The report is based on data gathered by the Oregon State Medical Examiner and the Multnomah County Medical examiner. Those agencies investigate suspicious or unattended deaths, including accidental or violent deaths or overdoses.

The county health department does further research into cases the medical examiner flags as people who were likely homeless.

“It does not capture all deaths among people who were homeless, such as those who died in a hospital of natural causes. As a result, it is almost certainly an undercount,” the report notes.  

Ninety-one deaths in 2016 were initially coded “domicile unknown” by the medical examiners.  

Reviewers ultimately confirmed 80 of those deaths as people who were experiencing homelessness in Multnomah County.

Eleven cases were excluded from the county’s official tally and analysis.

Those included six people that reviewers determined were likely not homeless, three who records indicated died in Multnomah County but were transient in another county, and two infant or fetal deaths with mothers who likely were transient in another county.

The Domicile Unknown project has identified 359 deaths in Multnomah County since the first report in 2011.

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Health Report Due This Month Delayed As Bullseye Glass Launches Federal Case

The Oregon Health Authority is pushing back release of a public health assessment on airborne hazards in the vicinity of the southeast Portland production headquarters of Bullseye Glass.

The assessment, scheduled for release this month, was delayed as the company’s attorneys prepared to file a $30 million lawsuit against Oregon.

A Dec. 8 letter from the Oregon Health Authority to community partners notified them that the key health report, promised for early- to mid-December, would be pushed back for a “significant extension” until sometime in 2018.

OHA, working with the Agency for Toxic Substances and Disease Registry, has spent more than a year gathering air, soil and water data to monitor health risk in the area near Bullseye's southeast Portland headquarters.

One of those data sets included air samples from October 2015, as part of a study by the Department of Environmental Quality and the U.S. Forest Service. The study's goal was to determine whether moss can tell scientists more about toxins in the air. It was that same study that set off alarm bells about heavy metals near Bullseye and other industrial companies in Portland.

 

After obtaining draft versions of the health assessment via a public records request, Bullseye’s attorneys are planning to challenge the draft. OHA has since promised to review the data because of a potential error.

Oregon DEQ spokeswoman Laura Gleim said the standard procedure is to compare the filters holding field samples with blank filters carrying no sample material. If the metal amounts are similar, the samples may not be enough to show a correlation.

That comparison wasn’t done for the October 2015 samples.

In this case, two of the eighteen filters showed significantly more chromium than the blank filters. Still, Gleim said, DEQ is confident the samples related to Bullseye are accurate.

Bullseye Vice President Jim Jones said there was no relationship between the timing of the company’s queries to OHA and the federal court filing.

“Data was used by government agencies in a rush to judgement based on faulty science,” Jones said.

OHA’s letter indicated that only chromium pollution data collected in October 2015 is under scrutiny, it also warns the draft health report in circulation “should not be relied on for any purpose.”

The state will now take on a review of whether the data should remain in the report. That means Portlanders who live in the area and are anxious to see the full report will have to wait a bit more.

OHA said it hopes to publish the full health assessment sometime next year.

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Trauma Among Foster Kids Leads To Health Issues In Later Life

People who experience trauma and end up in foster care are more likely to suffer from chronic health conditions later in life, according to a new study.

Researcher Keri Vartanian, with the Providence Center for Outcomes Research and Education, said the fact that foster kids experience trauma isn’t surprising.

“What we found surprising was the extreme prevalence of trauma in this population," she said. "Every single measure of adversity that we looked at in childhood was significantly more prevalent in the foster care population.”

Vartanian's study found half of the kids who were in foster care at some point reported physical, verbal or sexual abuse. They also reported being far from prepared to live on their own afterwards.

The study also found they were more likely to experience poor physical health, mental illness, food insecurity and housing problems.

A spokeswoman with Oregon's Child Welfare office said the report does not include date from children currently in foster care, so it wouldn’t be appropriate to comment.

The Portland area coordinated care organization Health Share commissioned the report, saying it’s trying to improve care for people who’ve been through the foster care system.

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