Accelerating Efforts to Prevent Suicide in CT as Numbers Climb

The Centers for Disease Control and Prevention (CDC) released a report this year which indicated that suicide rates nationally jumped by 25 percent since 1999, a finding that “shocked” even experts who believed the rate had been flat. Each year, more than 41,000 individuals die by suicide, leaving behind their friends and family members to navigate the tragedy of loss, according to the National Alliance on Mental Illness. Connecticut's rate, 9.7 deaths per 100,000, rose 20 percent during that time, and 49 states saw an increase, according to the CDC. Connecticut’s suicide rate, is ranked number 46 in the country.

Suicide is the 10th leading cause of death in the U.S. with one occurring on average every 13.3 minutes.

For every suicide, there are 30 people who made the attempt, Dr. James F. O'Dea, vice president of the Behavior Health Network of Hartford Healthcare, recently told the Meriden Record-Journal.  The U.S. Health Resources & Services Administration reports that “approximately 45% of suicide victims had contact with primary care providers within 1 month of suicide.”

“Connecticut suicide rates may have not have increased as much in comparison to other states, but isn’t the real question, ‘Why is it increasing at all?’” Luis Perez, president and CEO of Mental Health Connecticut, told The Hartford Courant earlier this year.

“It’s been well-researched that most people who die by suicide do so because they want the pain to stop — and they don’t see any other way,” Perez said. “Prevention is critical. Knowing the safe and right way to talk to someone who may have thoughts of suicide and letting people know they are not alone, that millions of people struggle with suicide ideation is key.”

According to the state Department of Public Health, approximately 31 percent of victims had a history of treatment for mental illness and 42 percent had previously attempted or thought about suicide or disclosed their intent to commit suicide. The CDC offers 5 steps to help someone at risk: 1. Ask. 2. Keep them safe. 3. Be there. 4. Help them connect. 5. Follow up.

The U.S. government’s anti-bullying website, stopbullying.com, points out that “many issues contribute to suicide risk, including depression, problems at home, and trauma history. Additionally, specific groups have an increased risk of suicide, including American Indian and Alaskan Native, Asian American, lesbian, gay, bisexual, and transgender youth.”  The site indicates that “this risk can be increased further when these kids are not supported by parents, peers, and schools. Bullying can make an unsupportive situation worse.”

Matt Riley, Chief Operating Officer of the Connecticut-based Jordan Porco Foundation, recently told WTNH-TV that suicide is the second leading cause of death for Americans ages 15 to 24. One in ten college students and one in five high school students consider suicide. Young people considering suicide are most likely to talk to peers, so the Jordan Porco Foundation focuses on peer-to-peer outreach and awareness, with a series of successful program initiatives on college campuses in Connecticut and across the country.

In recent years, a new student-driven primary prevention program was piloted to help high school students develop positive coping skills and enhance protective factors in preparation for life beyond high school. Schools and organizations participating included Manchester High School, Immaculate High School in Danbury, Enfield Public Schools, Capital Preparatory High School in Hartford, Institute of Living in Hartford, Jewish Family Services in West Hartford, Wilton High School, Boys & Girls Club of Bristol, and Guilford Youth & Family Services.

Numerous organizations across Connecticut offer Mental Health First Aid, an 8-hour training to teach participants how to help someone who is developing a mental health problem or experiencing a mental health crisis. The evidence behind the program demonstrates that it helps trainees identify, understand and respond to signs of mental illnesses and substance use disorders.  The course is often offered to participants free of charge.

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Report Provides Guidance for School Districts and State Policymakers to Address Students’ Trauma & Mental Health Needs

It is described as a “framework to advance policy and strategic school district planning to more effectively address the mental health and trauma needs of students and promote student success.”  A new report, driven by research highlighting the connection between mental health and educational outcomes, is aimed at school districts looking to increase integration of student mental health services and supports. The 40-page report, developed by The Child Health and Development Institute of Connecticut (CHDI), a subsidiary of the Children’s Fund of Connecticut, in partnership with the national Center for School Mental Health at the University of Maryland, provides a framework for policymakers and school districts interested in improving outcomes by addressing the mental health and trauma needs of students. The report indicates that “in a typical classroom of 25 students, approximately five will meet criteria for a mental health disorder but most of them are not receiving appropriate mental health treatment or support. Among those who do access care, approximately 70 percent receive services through their schools.”

Connecticut is cited as an example of how states can promote collaborations within and across the behavioral health, education, and juvenile justice systems to provide an array of trauma-informed, evidence-based, and tiered services for students.  It notes that school principals indicate that mental health is one of the most challenging unmet needs among their students and schools are increasingly seen as a critical setting for the delivery of mental health services.

The report provides “a blueprint and resources to guide state policymakers and school district leaders," including:

• an overview of core components of the Comprehensive School Mental Health
• Systems (CSMHS) model structured around family-school-community partnerships and the delivery of evidence-based mental health services within a multi-tiered system of supports;
• examples of best practice strategies to develop, implement, and sustain CSMHS;
• a model for a trauma-informed multi-tiered system of supports for school mental health;
• creative approaches to advance policy and funding structures to sustain CSMHS; and
• recommendations for state-level policymakers, districts, and schools to advance a comprehensive statewide system of school mental health to improve outcomes for all students.

“Approaching student mental health with a comprehensive lens that integrates health promotion, prevention, early intervention, and more intensive treatments leads to better school, student and community outcomes," said Dr. Sharon Hoover, Co-Director of the Center for School Mental Health at the University of Maryland and lead author of the report.

National prevalence rates indicate that approximately 20 percent of children meet criteria for a mental health disorder; however, many children’s mental health needs are not identified and the majority of children with identified challenges do not receive services, the report explained.  Among those who do access care, approximately 70 percent receive services through their schools. Linking children to services through their schools reduces many traditional barriers to care. School mental health services are also associated with higher completion rates than treatment delivered in traditional outpatient community-based settings.

The report uses Stamford Public Schools (SPS) as a” local model for improving outcomes by adopting a trauma informed approach to school mental health.” CHDI began working with SPS in 2014 to conduct a review of the district’s mental health system and to develop a plan to enhance trauma-informed mental health services district-wide.  That plan was subsequently implemented, and “lessons learned in Stamford are being used to engage other Connecticut districts to … integrate school and community-based mental health services, and promote quality and sustainability of these enhancements.”

“Schools are well positioned to promote wellness and social emotional competence for all students, as well as identify and address mental health concerns for students in need,” said Dr. Jeana Bracey, Director of School and Community Initiatives at CHDI and report co-author. “However, the responsibility is not on schools alone to integrate or fund these supports. This framework helps districts connect to and collaborate with Connecticut’s robust network of trauma-informed state and community-based services and programs so all students can be successful.”

The report concludes that a “systematic and streamlined partnership between families, schools, and communities to support a continuum of mental health supports in schools can lead to better behavioral health for all students, as well as increased access, earlier identification and intervention, and ultimately better outcomes for students with mental health challenges.”

[Visit wwws.chdi.org to download the IMPACT report or to read more about CHDI’s work related to school mental health.]

CT Office of Early Childhood Receives Global Recognition for Effective Communication

The Connecticut Office of Early Childhood (OEC) – a state agency that didn’t exist just over five years ago - has earned global recognition for success and innovation in serving the state’s youngest children and their families. The agency was chosen to receive the “Future of Feedback Award” at the annual Feedback Summit in Washington, D.C.   The award was presented last week to OEC Commissioner David Wilkinson for his agency’s efforts at effective listening to the people it serves and the nonprofit providers who serve them.

“The Office of Early Childhood is honored to be recognized for its efforts in communicating effectively with Connecticut’s families and providers, and for finding strategies to meet their needs,” said Commissioner Wilkinson. “The parents we serve and the community providers we support are the best experts in what they need to succeed, but too often they don’t have a seat at the table.  OEC is trying a new approach to put parents and our hardworking providers at the center of our policymaking.  We’re saying, ‘nothing we plan for you should be done without you.’’

"Connecticut’s Office of Early Childhood is pioneering innovative ways of both listening and acting.  OEC’s outreach to families – and frontline service providers – is creating conversations about what matters most, and what they can all do together," said Dennis Whittle, Co-Founder of Feedback Labs and GlobalGiving.

Feedback Labs, the organizer of the Summit, is a global network of over 400 leading aid, philanthropy, and governance organizations around the world.  Feedback Labs was conceived in 2013 and launched in connection with the Obama White House. Whittle also co-founded GlobalGiving, a leading marketplace connecting social, environmental, and economic development projects to individual and corporate donors. Since its inception GlobalGiving has facilitated $335 million in funding to over 20,000 projects in 170 countries.

Established in 2014 through a bipartisan effort of Gov. Dannel Malloy and the legislature, OEC oversees and funds Connecticut’s early childhood programming – including child care, pre-K, early intervention for children with developmental delays, and family support services for at risk families – components that once were housed in five disparate state agencies.

Among the 10 largest state agencies in Connecticut, OEC’s goal is to keep the state’s children safe, healthy, learning and thriving. Through its innovative feedback efforts, the agency is acting on evidence that engaging providers and parents in policymaking yields better results.  Officials said that the agency combined data from 1,700 family surveys, another survey shared with all providers in the state, and 400 community and provider meetings in order to build a draft plan to transform the ECE system in the state, which serves 200,000 children.

Wilkinson added that “An award like this is an encouraging validation of our efforts to listen to families and providers, and then do all we can to act on their advice.  We believe that by listening and responding, we will provide better, more effective services for Connecticut families with young children – and in so doing help create a brighter future for the state.”

"OEC’s approach contains key ingredients of more responsive, innovative, and effective government.  OEC’s leadership in asking for and responding to feedback has the potential to spread widely through the public sector,” Whittle added.

“Child care centers work hard every day for children,” Said Dr. Monette Ferguson, Executive Director of ABCD, Inc., a nonprofit operating several leading child care centers in and around Bridgeport. “Usually the state tells us what to do and by the time we share any concerns, it’s too late.  I am not used to a state agency asking what I think before it acts.  It’s good to feel heard and to see OEC acting on our advice.”

David Wilkinson was named Commissioner by Gov. Malloy in April 2017 to serve as the second Commissioner of the state’s Office of Early Childhood (OEC). He previously served as Director of the White House Office of Social Innovation and Civic Participation under President Barack Obama. While at the White House, Wilkinson worked closely with the Malloy Administration on signature early childhood efforts, including a first-of-its-kind initiative – scaling a program proven to reduce parental substance use and child welfare interaction – for which the administration has achieved national acclaim.  He has also served as an advisor to the Yale Child Study Center, a leading collaborator with the state and its early childhood service providers.

Christine Johnson-Staub is the Interim Director of Child Care and Early Education at CLASP, a 50-year-old national nonprofit based in Washington, D.C., that focuses on shaping policy to support families living in poverty. She said, “OEC’s approach to setting its policy direction was unique because not only did it build on input from the community and existing research and data, but it went back to a wide range of impacted people, including parents, providers and other stakeholders, to make sure they got it right.”

“Parents and child care providers know the challenges facing the early care system better than anyone but rarely does anyone from state government ask our opinion,” said Merrill Gay, Executive Director of the nonprofit Early Childhood Alliance, a state consortium of providers and advocates. “That's why it was so refreshing to have the Office of Early Childhood ask us: ‘What are the pain points?  How do we make this system work better for you?’  I'm really excited to see OEC now turning that agenda for improvement into concrete action to better serve children and families.”

The strategy of communicating successfully with a target audience, and then acting upon that communication, is known as a “feedback loop” – an approach widely studied and increasingly appreciated by thought leaders, initially gaining traction in international development, but seen to have powerful implications for advancing more responsive, cost-effective and impactful government services in the US. The 2018 Feedback Summit was attended by over 150 feedback pioneers and leaders from around the U.S. and the world.

“They speak. We listen. We make change. It’s about being responsive to the needs of the young children in our state and, of course, their parents and caregivers,” Wilkinson said.  To contact the Office of Early Childhood, visit www.ct.gov/oec or call (860) 500-4412.

Read This: Finalists Announced for 2018 CT Book Awards

Connecticut Center for the Book, a Connecticut Humanities program, has announced the finalists for its 2018 Connecticut Book Awards. The awards recognize and honor authors and illustrators who have created the best books in or about our state in the past year.  A total of 140 books were submitted this year, up 28 percent over last year, as the returning awards program gains momentum. The annual awards returned last year after a multi-year hiatus, to solid reviews. Between three and five finalists have been selected in each of five categories: Fiction, Nonfiction, Poetry, Young Readers – Young Adult, and Young Readers – Juvenile. Five distinguished judges per category read each entry and reviewed works using rigorous criteria.

Winners will be announced at the 2018 Connecticut Book Awards ceremony on Sun., Oct. 14, from 2:00-3:00 p.m. at Staples High School in Westport.  Okey Ndibe, the 2017 Connecticut Book Award winner for nonfiction, will deliver the keynote speech. He has taught at Brown University, Connecticut College, Simon’s Rock College, Trinity College, and the University of Lagos (as a Fulbright scholar). He is the author of two novels, Arrows of Rain and Foreign Gods, Inc., and a memoir, Never Look An American In the Eye, for which he won the 2017 Connecticut Book Award for nonfiction.

A reception and book signing with this year’s winners, finalists, and Mr. Ndibe will immediately follow from 3:00-4:00; all finalists’ and winners’ books will be available for purchase.  Connecticut Humanities (CTH) is the state affiliate of the National Endowment for the Humanities and administers the Connecticut Center for the Book.  Established by Congress in 1977 to “stimulate public interest in books and reading,” the Center for the Book in the Library of Congress is a national force for reading and literacy promotion.

The finalists:

Fiction

• Abby Fabiaschi, of West Hartford, Conn., “I Liked My Life”
• Jane Green, of Westport, Conn., “The Sunshine Sisters”
• Georgia Hunter, of Rowayton, Conn., “We Were the Lucky Ones”
• Rene Denfeld, of Portland, Oregon, “The Child Finder”
• Courtney Maum, of Norfolk, Conn., “Touch”

Nonfiction

• Virginia DeJohn Anderson, of Boulder, Colo., “The Martyr and the Traitor – Nathan Hale, Moses Dunbar, and the American Revolution”
• Duo Dickinson, of Madison, Conn., and Steve Culpepper, of New Haven, Conn., “A Home Called New England”
• David Hays, of Chester, Conn., “Setting the Stage: What We Do, How We Do It, and Why”
• James C. Scott, of Durham, Conn., “Against the Grain: A Deep History of the Earliest States”

Poetry

• Gina Athena Ulysse, of Middletown, Conn., “Because When God is too Busy”
• Jose B. Gonzalez, of Quaker Hill, Conn., “When Love was Reels”
• John Surowiecki, of Amston, Conn., “Martha Playing Wiffle Ball in Her Wedding Dress”
• Charles Rafferty, of Sandy Hook, Conn., “The Smoke of Horses”

Young Readers – Young Adult

• Jake Burt, of Hamden, Conn., “Greetings from Witness Protection!”
• Karen Romano Young, of Bethel, Conn., “Whale Quest”
• Sarah Albee, of Watertown, Conn., “Poison”

Young Readers – Juvenile (includes authors and illustrators)

• Gigi Priebe, of New Canaan, Conn., “The Adventures of Henry Whiskers”
• Lauren Baratz-Logsted, of Danbury, Conn., “I Love You, Michael Collins”
• Susan Hood, of Southport, Conn., “Double Take! A New Look at Opposites”
• Deborah Freedman, of Hamden, Conn., “This House, Once”
• Andrea Wisnewski, of Storrs, Conn., “Trio, The Tale of a Three-legged Cat”

The awards ceremony and reception are open to the public, and conclude Saugatuck StoryFest, a three-day literary festival and writers’ conference. Tickets purchased online before Sept. 15 are $20; then $25 through Oct. 11. Tickets will also be available at the door for $30.

Report: Medicaid's Impact Goes Beyond Health Care to Economy

Medicaid is, at its core, a health insurance program that provides coverage to low-income Connecticut residents.  A new report in Connecticut finds that the program also plays a key role in the state’s economy, budget, and ability to weather economic challenges. The report was developed for, and released by, the Connecticut Health Foundation. In Connecticut, Medicaid is known as HUSKY and covers approximately one in five state residents – close to 800,000 people. HUSKY covers more than one third of Connecticut children, nearly 47 percent of non-elderly adults with disabilities, 15 percent of seniors, and 70 percent of nursing home residents.

The report, developed by the Georgetown University Center for Children and Families, finds that the program is deeply woven into Connecticut’s health care system and plays a major role in a sector of the economy that has been central to job growth in the state. Health care makes up nearly 15 percent of the state’s gross domestic product. Medicaid finances about 20 percent of health care expenditures in Connecticut.

“It is important for policymakers to understand the full impact of Medicaid in the state, particularly as they face difficult budget decisions,” said the report’s author, Edwin Park, research professor at the Georgetown University Center for Children and Families. “Medicaid plays a key role in the state’s economy and is linked to long-term positive outcomes for children like better health, obtaining a college degree, and higher earnings.”

Among the report’s other key findings:

• Research has linked Medicaid coverage of children and pregnant women to long-term health and economic benefits when children reach adulthood: better health outcomes, greater educational attainment such as completing high school and obtaining a college degree, and higher employment and earnings.
• Medicaid can help states cope with recessions and economic downturns because it automatically increases federal funding in response to higher state costs, such as those resulting from enrollment increases as people lose their jobs and health insurance.
• Medicaid contributes the majority of the federal funding spent through Connecticut’s state budget – 58 percent in the 2016 fiscal year. The federal government pays more than half of the state’s Medicaid costs. For every $10 spent on Medicaid in Connecticut, approximately $5.92 comes from the federal government.

“Connecticut invests significant resources in HUSKY and the findings of this report underscore the impact of this investment,” said Patricia Baker, president and CEO of the Connecticut Health Foundation.

The report also indicted that “research has found that Medicaid eligibility during childhood is tied to higher wages and cumulative higher tax payments made as young adults. It also increases employment and reduces the need for public assistance, especially assistance needed due to disability. According to the report, in 2016 Medicaid covered:

• 4 percent of the nearly 400,000 hospital discharges and 12.9 percent of hospital payments.
• 63 percent of the 373,200 patients who received care at community health centers.

The Connecticut Health Foundation is the state’s largest independent health philanthropy dedicated to improving health outcomes for people of color. Since its creation in 1999, the foundation has awarded more than $62 million to nonprofit organizations and public entities to expand health equity, reduce health disparities, expand health coverage, and improve the health of all Connecticut residents.

Struggles Continue for Thousands Who Relocated from Puerto Rico to Connecticut in Storm Aftermath

About 13,000 residents of Puerto Rico and the U.S. Virgin Islands who arrived in Connecticut in the aftermath of the hurricanes Maria and Irma continue to struggle with obtaining basic needs including adequate housing, food, medical care and jobs, according to a survey commissioned by the Hartford Foundation for Public Giving. The vast majority of those who have come to Connecticut, over 70 percent, have extremely low incomes (under $30,000), adding a heavy responsibility on an already over-extended and resource-limited Puerto Rican community in Connecticut, given the extreme levels of need that are present in the community, even before the storms, the Foundation pointed out.

Approximately 1,300 people participated in the survey, which utilized online and in-person questionnaires in English and Spanish and field research.  It was conducted by the University of Connecticut’s El Instituto: Institute for Latina/o Caribbean and Latin American Studies and the Center for Puerto Rican Studies at Hunter College. The objective was to understand the long-term impact of displacement on Puerto Rican households in the Greater Hartford region.

“The Hartford region has one of the highest concentrations of people of Puerto Rican origin outside Puerto Rico and last year’s hurricanes brought thousands more to the region, many of whom will likely stay,” said Scott Gaul, the Hartford Foundation’s director of Research and Evaluation. “The hurricanes were an unprecedented event, but we can anticipate similar crises will happen again. The survey is one tool to help the Hartford region understand the needs of evacuees and the potential long-term impacts of displacement.”

The survey found that while some households surveyed had initially relied on the Federal Emergency Management Agency (FEMA) for funding basic needs, the majority of those affected relied on Greater Hartford’s nonprofit organizations, school districts and family members for support.

During the 2018 Legislative Session, the Connecticut General Assembly  approved $4.4 million in education and housing assistance for displace residents, including $1.5 million in aid to the departments of education, housing and social services.

More than half of respondents (56%) mentioned that it was very likely (36%) or somewhat likely (22%) that kin would relocate from the Caribbean to Connecticut, with most of those relatives and friends staying with respondents.  Those living in Hartford’s outer ring suburbs were relatively less likely (72%) to have kin in the Caribbean than those living in Hartford or its immediate suburbs. And they expect nearly 1,500 additional people to arrive from Puerto Rico in the wake of the hurricane.

In addition, those responding to the survey indicated that they expected displaced kin to remain in Connecticut into the medium and long terms. Nearly a third of respondents (32%) reported that kin would stay in Connecticut for a few months, and a quarter (26%) would remain for a few years.

The survey also found:

• The most pressing need for respondents hosting displaced Puerto Ricans is lodging, with fully one-third indicating that housing was one the biggest needs they face.
• Nearly three-fifths of respondents indicated housing was displaced person’s first order need, followed by 16 percent who mentioned it in second order.
• Food was a first order need for one-fifth of survey respondents’ displaced friends and relatives and second order need for 35 percent.

Survey respondents identified housing issues and insufficient food as the most critical needs they are facing in Connecticut, along with healthcare, in the after aftermath of the crisis. These are needs not only of those who are in the state already, but of those who are very likely to arrive in the short term,” wrote Professors Charles R. Venator-Santiago, Associate Professor, Department of Political Science and El Instituto and Carlos Vargas Ramos, Center for Puerto Rican Studies.

"These needs are adding a heavy responsibility on an already over-extended and resource-limited Puerto Rican community in Connecticut, given the extreme levels of need that are present in the community and pre-dated the crisis created by hurricanes Irma and Maria," the report stated.

Results from the survey are aimed at helping to inform long-term planning and action by funders, nonprofits, municipalities and schools.  The Foundation intends to work with community organizations and leaders in the region to disseminate and act on survey results.

The report indicated that preliminary estimates by the government of Puerto Rico indicate that approximately 70,000 residential properties were totally destroyed, with an additional 300,000 partially damaged residences. As of February 2018, 1.1 million households had applied for disaster aid from the Federal Emergency Management Agency (FEMA).

Connecticut Children's, Yale New Haven Ranked Among Best in Neonatology

Two of the nation’s top 50 hospitals for neonatology are in Connecticut.  Connecticut Children’s Medical Center ranked #25 and Yale New Haven Children’s Hospital ranked #36 in the latest analysis by US News & World Report, which publishes hospital rankings in various medical specialties. Atop the rankings in the pediatric specialty were Children’s National Medical Center (Washington, DC), Children’s Hospital of Philadelphia, Boston Children’s Hospital, Children’s Hospital Colorado, Cincinnati Children’s Hospital Medical Center, Rainbow Babies and Children’s Hospital (Cleveland), UCSF Benioff Children’s Hospital of San Francisco and Oakland, New York-Presbyterian Morgan Stanley-Komansky Children’s Hospital, St. Louis Children’s Hospital-Washington University, and C.S. Mott Children’s Hospital – Michigan Medicine (Ann Arbor).

Fifty pediatric centers were ranked for care of fragile newborns. Breast milk at discharge, patient volume, infection rates in the NICU and other data collected from a detailed U.S. News clinical survey of children's hospitals, produced 85 percent of each hospital's score. The other 15 percent reflects nominations from pediatric specialists and subspecialists who responded to surveys in 2016, 2017 and 2018 and recommended the hospital for serious cases in their specialty.

Yale’s highest ranking among nearly a dozen pediatric specialties was in Pediatric Diabetes & Endocrinology, where it ranked eighth.  Connecticut Children’s is ranked in four specialties, including Pediatric Urology (#30), Pediatric diabetes & Endocrinology (#37), and Pediatric Cardiology & Heart Surgery (#49).  Yale New Haven Children’s Hospital is nationally ranked in nine specialties. (U.S. News includes Yale New Haven Hospital and Connecticut Children's Medical Center in evaluating the performance of Yale New Haven Children's Hospital in Pediatric Cardiology & Heart Surgery and Pediatric Urology.)

Yale New Haven Children’s Hospital admits approximately 125 patients a day. With 208 licensed beds, the hospital has neonatal and pediatric intensive care units, a 24-hour pediatric emergency room and a children's surgery center, according to US News.

Connecticut Children’s reports it has established the largest newborn delivery services network in the state of Connecticut based on the number of hospitals for whom it provides neonatology care.  In addition to Connecticut Children’s two NICUs located in Hartford and Farmington, Connecticut, the Medical Center also provides newborn delivery services at nine hospitals, including five additional NICUs. Hospital partners include Hartford HealthCare (4 hospitals), Western Connecticut Health Network (2 hospitals, as of this month), Ascension (St. Vincent’s Medical Center), Eastern Connecticut Health Network (Manchester Hospital), and Day Kimball Healthcare.

“We’re excited to bring our expertise to more babies in Connecticut,” said Jim Moore, MD, Division Chief for Neonatology at Connecticut Children’s. “My goal is for Connecticut Children’s to develop a truly comprehensive, regionalized, clinically integrated network for newborn care across the state.”

Connecticut Children’s drives innovation across its newborn delivery service locations by sharing best practices and protocols across the network, and ensuring that family centered rounding is done for every patient, according to hospital officials. It also practices “family centered care” - moving patients to the right location for the care they need, but then returning them to their home hospital when they no longer need that higher level of care, officials point out.

“The recognition from U.S. News & World Report is a testament to our dedicated physicians, nurses and staff who care for the sickest children while working tirelessly on advancing research and clinical outcomes at the Medical Center,” said Jim Shmerling, President & CEO at Connecticut Children’s Medical Center. “We continue to expand our care network, making it easier than ever for our patient families to access the care they need, when they need it and most importantly where they need it; close to home.”

K-12 School District Regionalization May Do More Harm Than Good, Analysis Reveals

“Generalizations about regionalization oversimplify a complex topic,” according to a new report on K-12 School District Regionalization in Greater Hartford, which warns that “K-12 regionalization can actually increase costs and harm educational outcomes.” As some school districts in Connecticut have been considering regionalizing their K-12 education services as a way to reduce costs, the 23-page report prepared for the Hartford Foundation for Public Giving raises some red flags, noting that “policies that call for wholesale regionalization based on imposed criteria (e.g., minimum/maximum number of students) can have unpredictable, and often adverse, consequences.”

In an effort to get a clearer understanding of the potential educational and community impacts of school and district regionalization, the Hartford Foundation for Public Giving sponsored the comprehensive analysis to help inform those efforts gathering data on what is known about the effects of K-12 regionalization on education expenditures and educational achievement, based on recent empirical studies.

“The Hartford Foundation is committed to the availability of high-quality, impartial research,” said Scott Gaul, the Hartford Foundation’s Director of Research and Evaluation. “As policymakers continue to consider strategies to reduce the costs of government, the issue of regionalizing services continues to draw attention. This research is intended to provide a clearer picture on the potential benefits and challenges of regionalizing school districts in an effort to support a shared understanding and to support informed decision-making.”

K-12 regionalization generally includes combining school districts, boards of education, and central office staff. This can result in closing schools, eliminating teaching positions, reducing administrative staff, and increasing student-to-teacher ratios, among other consequences, according to the report.  Connecticut, like other New England states, relies mainly on municipalities to provide government services, including K-12 education, to its residents.  In 2017, there were 196 public school districts including town districts, charter school districts, regional districts, and regional education service center districts.

The review of the research, conducted by Connecticut-based Rodriguez Data Solutions, points out that policymakers often promote K-12 regionalization as a way to achieve cost savings, but often fail to consider the consequences for student educational achievement. The report reviewed initiatives to promote K-12 regionalization in several states including Connecticut, Maine, New York and Vermont.  Among the findings:

• While there is no definitive answer on optimum school size, research on Connecticut suggests that a district with 2,500 to 3,000 students may be both cost-effective and foster educational achievement. This roughly matches the range suggested in research from other locations. In at-risk communities, research suggests that elementary school enrollment should not exceed 300 students, and high school enrollment should not exceed 500.
• In rural communities, closing a town’s school can cause the social fabric of a community to unravel. Research also suggests that “impoverished regions often benefit from smaller schools and districts and they can suffer irreversible damage if consolidation occurs.”
• The literature review suggests that deconsolidation of large school districts be considered as an option for cost savings.  In Connecticut, it is estimated that the total savings from the 129 smallest school districts would match the combined equivalent per-pupil savings from the three largest school districts.  Consequently, a significant reduction in statewide education costs requires reducing per-pupil spending in urban areas, not just in small rural districts.

Researchers found that “regionalization may lead to diseconomies of scale resulting from: higher transportation expenses because of longer bus routes, overall increases (leveling up) in staff salaries because of seniority and/or contract renegotiation, and increases in the number of mid-level administrators and administrative support staff.”

Warning of the perils of large, consolidated schools, the report also included the finding that “Students who are involved in extracurricular activities (e.g., band, sports, clubs) have higher graduation rates and it is widely accepted that participation in extracurricular activities decreases as enrollment increases.”

The report also provides a cautionary tale regarding demographics and the impact of school closing decisions:  “While it seems apparent that the closing of school buildings will reduce costs, savings are limited because there may not be buyers, and the facilities still must be maintained by the school district. In already struggling neighborhoods, these now empty school buildings (with boarded windows)

contribute to a downward economic spiral by attracting scavenging, dumping, drug users, and graffiti. The neighborhood children who previously attended the now closed school are then exposed to an increase in crime resulting from the blighted property.”

“Connecticut’s Black and Hispanic children,” the report adds, “are already disproportionately overexposed to crime in their neighborhoods.”

In addition, the report explains, “Students from advantaged (i.e., high socioeconomic status) households have similar educational achievement in both small and large schools. However, the situation is much different for students from low-income communities for whom “… smaller [school] size mediates the association between

socioeconomic status and achievement.” The potential for high educational achievement diminishes for at-risk students when they attend large schools that are disconnected from their communities.”

The report also included an update on the state’s student population.  From 2010-2011 to 2016-2017, the state’s public school enrollment dropped by 25,606 students – a decline in enrollment of 4.5 percent. The analysis found that “most Connecticut school districts have declining enrollments and it is more prevalent in rural areas.”

The report also cited a survey of Vermont voters, who expressed preferences for saving money and maintaining local control of local schools. “Vermont voters had not grasped that saving money may inherently include loss of local control,” the report indicated, concluding that “Vermont voters had conflicting goals, which could also be expected from Connecticut voters.”

Report: Connecticut's Medicaid Expansion Increased Coverage, Access to Preventive Care and Behavioral Health Treatment

A recently issued report found that emergency department visits are down; coverage seen as critical in fight against opioids has expanded, and preventative care and mental health care have become more prevalent – all resulting from a 2010 policy decision made by Connecticut’s elected officials to expand Medicaid coverage. That decision, made collaboratively by a Republican Governor (M. Jodi Rell) and Democratic-controlled legislature – helped to reduce Connecticut’s uninsured rate from 9.1 percent in 2010 to 4.9 percent in 2016 and created a significant source of coverage for preventive health services and behavioral health care, according to the report developed by the Connecticut Health Foundation.

The report examines the impact of HUSKY D, as the Medicaid expansion is known, and highlights a number of key findings:

• Most people covered by HUSKY D are using their insurance to get care. Just over 80 percent of people with HUSKY D used the coverage for preventive or outpatient health services in 2016.
• Emergency department usage among HUSKY D members is down significantly. The rate of emergency department visits fell by 36 percent from 2012 to 2016.
• HUSKY D is a significant source of coverage for behavioral health care. In 2016, more than one in three HUSKY D members – 36 percent – used their coverage to get care for a mental health condition or substance use disorder.
• Outcomes have improved for diabetes patients with HUSKY D. A review of more than 500 HUSKY D members with diabetes found that the percentage whose blood glucose was under control rose from 31 percent to 50 percent from 2012 to 2016.

The report also examines the role HUSKY D plays in other policy work in the state, including addressing the opioid crisis and helping those leaving prison get medical and behavioral health treatment when they return to society. The report notes that before HUSKY D, individuals with substance use disorders were generally not eligible for Medicaid, creating a major barrier to treatment.

“Health insurance coverage is a critical first step to health, but it is also important to ensure that people are able to use that coverage to get care, and for that care to make a difference in people’s health,” said Patricia Baker, president and CEO of the Connecticut Health Foundation. “This research underscores the importance of HUSKY D in giving low-income state residents the tools to take care of their health.”

HUSKY D covers adults ages 19 to 64 who do not have minor children and whose income falls below 138 percent of the poverty level – the equivalent of $16,643 for an individual. (For comparison purposes, a person working 30 hours per week at Connecticut’s minimum wage – $10.10 per hour – would earn $15,756 in a year, the report indicates.)

The report concluded that “nearly eight years after Connecticut expanded HUSKY to cover more low-income adults, HUSKY D has made a significant impact on the state’s uninsured rate and the lives of thousands of people. The majority of those covered are using this insurance to get preventive care, and the rate of emergency department usage has declined, a promising trend.”

The report also notes that the federal government has “financed more than 90 percent of the cost of the program, allowing Connecticut to cover more than 200,000 people with a relatively small budgetary impact.” Currently, the federal government pays 94 percent of the cost of coverage and the state pays 6 percent. The report also identifies challenges associated with HUSKY D, including concerns raised by health care providers about Medicaid payment rates and uncertainty in federal funding.

The report’s analysis indicates that HUSKY D enrollees live in every city and town in Connecticut.  The largest number of covered individuals live in Hartford (18,404), Bridgeport (16,330), New Haven (15,583), Waterbury (13,989), New Britain (8,439) and Stamford (6,110).

The Connecticut Health Foundation is the state’s largest independent health philanthropy dedicated to improving lives by changing health systems. Since it was established in 1999, the foundation has supported innovative grantmaking, public policy research, technical assistance, and convening stakeholders to achieve its mission – to improve the health of the people of Connecticut. Since its creation, the Connecticut Health Foundation has awarded grants totaling more than $60 million in 45 cities and towns throughout the state.

High School A Risky Time for CT Students, Survey Finds

The Youth Risk Behavior Surveillance System was designed to focus the nation on behaviors among youth related to the leading causes of mortality and morbidity among both youth and adults and to assess how these risk behaviors change over time. In Connecticut, the times they are a changin’.  Data released this week by the state Department of Public Health highlights changes over the past decade, and disparities among current students depending upon their grades in school.

The Youth Risk Behavior Surveillance System measures behaviors that fall into six categories:

• Behaviors that contribute to unintentional injuries and violence;
• Sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including HIV infection;
• Alcohol and other drug use;
• Tobacco use;
• Unhealthy dietary behaviors; and
• Inadequate physical activity.

The 2017 Youth Risk Behavior Survey (YRBS) includes randomly chosen classrooms within selected schools, and is anonymous and confidential.  It was completed by 2,425 students in 38 public, charter, and vocational high schools in Connecticut during the spring of 2017. The school response rate was 76%, the student response rate was 81%, and the overall response rate was 61%. The results are representative of all students in grades 9-12, according to the state Health Department.

The survey found that during the past decade, the percentage of students who rarely or never wore a seat belt has declined by one-third, as has the percentage who drove a car at least once in the previous month after they had been drinking.  That drop was between 2013 and 2017.

The percentage of students who “felt sad or hopeless” almost every day for a two week period “so that they stopped doing some usual activities” during the previous year climbed from 228% in 2007 to 26.9% in 2017 – more than one-quarter of students.  The survey found that in 2017, 13.5% of students seriously considered attempting suicide and 8.1% attempted suicide during the past year.

More than one-third of students (34.6%) of students did not eat breakfast every day in the week preceding the survey, and 14.1% did not eat breakfast on any of those days.  The percentage of students who got 8 or more hours of sleep on an average school night dropped from 26% in 2007 to 20% in 2017,

The survey also found that 25.8% of students with mostly A’s and 48.6% of those with the lowest grades (D or F) have used marijuana at least once in their lifetime.  More than one-quarter of students, across all academic grades (A-F) responded that they drank alcohol at least once in the month prior to the survey.

The survey found that 38 percent of students whose grades were mostly A’s texted or e-mailed while driving a car on at least one occasion in the 30 days prior to the survey.  The percentage was slightly less among students with lower grades:  31% of students with mostly B’s, 30% of students with mostly C’s and 23% of students with mostly D’s and F’s.

When it came to the percentage of students who rode with a driver who had been drinking alcohol (one or more times during the 30 days prior to the survey), students with better grades did so less often, ranging from 12% of students with mostly A’s to 26% of students with mostly D’s and F’s.

The survey also found that 1 out of 5 students (20.1%) whose grades were mostly D’s and F’s did not go to school because they felt unsafe at school or on their way to or from school, on at least one day during the 30 days prior to the survey.  Among those with mostly A’s, that percentage was just under 4 percent.

Among those with the lowest grades, 38.9% were in a physical fight at least once during the previous 12 months, and 19.7% were threatened or injured with a weapon on school property, such as a gun, knife, or club, at least once during the past year.  Among those with mostly A’s, the percentages were 10.2% and 3.6%.

https://youtu.be/d63xyYs9s94