Changing Leadership Atop Leading Philanthropy Organizations

Two leading organizations in Connecticut’s philanthropic community are at the crossroads of leadership changes.  The Connecticut Council for Philanthropy (CCP) has announced the end of its national search for a new leader with the selection of Karla Fortunato to be its new president, effective May 1.  The Hartford Foundation for Public Giving, one of the nation’s largest community foundations, has embarked on its own national search, and announced that Yvette Meléndez has been appointed interim president, effective March 20, as that search process continues. Fortunato comes to CCP after 13 years at the Health and Environmental Funders Network (HEFN), a national alliance of 60 philanthropic organizations based in Rockville, MD.

As director of HEFN, she has managed its programming, outreach, and operations, promoting collaboration on shared goals among its members.  Fortunato previously served as associate director of policy for Health Care for All in Boston, engaging in policy research, communications, and campaigns, and as a consultant for The Public Policy Institute, also in Boston.

"Karla's experience in building alliances among funders and engaging in public policy outreach make her ideally suited to lead our organization," said Judith Meyers, chair of CCP's Board of Directors. "She is a proven leader with a strong vision of how to mobilize the power of philanthropy to effect positive change--and she has a true passion for the work."

Fortunato graduated magna cum laude from the Randolph-Macon Woman's College in Virginia and earned an MBA (also magna cum laude) from George Washington University. She serves on the Health Leadership Circle of MomentUs, a campaign for climate change solutions. She served as a member of the Serving Communities Committee of the National Conversation on Public Health and Chemical Exposures and as a citizen representative on the Montgomery County Citizen's Advisory Board. A native of Connecticut, she and her family look forward to relocating here from their current home in Jacksonville, Florida.

The Connecticut Council for Philanthropy (CCP) is an association of grantmakers committed to promoting and supporting effective philanthropy for the public good. CCP's 114 members are foundations (private, corporate, community), business and corporate giving programs, bank trusts, donor-advised funds, individual philanthropists and those serving the philanthropic sector. CCP members annually grant more than $858 million from assets of more than $7.6 billion.

Meléndez has served on the Hartford Foundation's board for close to 12 years, the last three as chair. She has more than 30 years of successful managerial experience in state government, higher education and at Hartford Healthcare, from which she is recently retired. She will take a leave of absence from the board during this time, and will serve as interim until a new president is named. Meléndez is not a candidate for the position. Linda J. Kelly announced her retirement as president of the Hartford Foundation for Public Giving, last March, effective next month, after 10 years leading the organization.

The Hartford Foundation for Public Giving is the community foundation for Hartford and 28 surrounding communities.  In 2015, the Foundation celebrated ninety years of grantmaking in the Greater Hartford region, made possible by the gifts of generous individuals, families and organizations.  It has awarded grants of more than $680 million since its founding in 1925.

PHOTO:  Karla Fortunato (left), Yvette Meléndez (right)

Health Consultants For Pre-School Age Children Can Improve Health; Report Urges Policy Changes in CT

Research shows that the presence of a health consultant, usually a nurse by training, in child care centers leads to positive outcomes including improved nutrition, better sanitation and infection control, increases in access to preventive health care, specialty health care, mental health care, and oral health services. That’s according to a report by the Child Health and Development Institute (CHDI), which recommends health consultation as a “key strategy for integrating health into early learning systems and maximizing the contribution of early learning programs to children’s healthy development.”

“We rely on child care health consultants to ensure children’s health and safety in early care settings according to child care licensing regulations, but these providers are not fully supported nor utilized by our child health systems,” said Lisa Honigfeld, co-author of the report and vice president for health at CHDI. “Policy reform can strengthen and expand the role of child care health consultants to connect parents, child health providers, and child care centers to better promote health and developmental outcomes for children.”

CHDI’s “IMPACT, Promoting Children’s Health in Early Care and Education Settings by Supporting Health Consultation,” summarizes research on the role and benefits of health consultation in early learning settings, and reviews policies, regulations, training, and payment structures used in Connecticut and other states. The report concludes that Child Care Health Consultants (CCHC) can be “instrumental in contributing to the achievement of pediatric population health goals in Connecticut by monitoring the health of young children at the community level and contributing to community health system efforts.”

The 30-page report provides a framework for Connecticut to integrate health into early learning systems by taking advantage of opportunities presented as part of the state's overall health reform efforts. Recommendations include:

1. Develop infrastructure within the State to support health consultation with training, reimbursement, and quality improvement.
2. Strengthen licensing requirements to collect and report detailed health consultation information for all licensed child care sites.
3. Advocate for inclusion of CCHCs in Connecticut’s health reform plans.
4. Use a multi-disciplinary oversight group to develop a system of health consultation services to the meet the needs of Connecticut’s child care programs.

The report notes that a majority of children younger than age five spend “significant time” in early care and education settings, with more than 98,000 children enrolled in licensed child care centers, Head Start programs, and family child care homes.

“Unlike mental health consultation,” the report states, “overall health consultation is not supported with state level infrastructure and payments for health consultants to early Childhood Education sites. For private child care or preschool programs, the cost to hire a health consultant is borne by the program, with no system in place to ensure the quality of the CCHC workforce or ensure that health consultation is implemented to maximize the health and safety of children in child care.”

Connecticut regulations allow child care sites to employ a registered nurse, advance practice registered nurse, physician, or physician assistant to serve as the site’s health consultant.  Child care licensing requires child care sites that serve children ages three to five have quarterly health consultation visits.

Indicating that “several states and initiatives are testing innovations to better support integration of primary care medical services and community services,” the report suggests that “Connecticut, too, is poised to promote increased cross-sector collaboration in early childhood,” citing the establishment in 2013 of the Office of Early Childhood at the state level, which brought under one roof a range of services and responsibilities that had been housed in a number of different state agencies.

In most states, including Connecticut, a CCHC is typically a licensed registered nurse, according to a survey of states undertaken for the report.  Two states (Hawaii and Indiana) require that the CCHC be a physician, the research found, and four states (Illinois, Maine, Maryland, and North Carolina) allow licensed practical nurses to be health consultants. North Carolina allows other disciplines (sanitarian, nutritionist, and dietician) to be trained and credentialed as a health consultant.

The report points out that “CCHCs need specialized training, skill sets, and experience to address health issues for individual children and for the group setting as a whole. They also need to be aware of health and community resources so they can link child care facilities and families to appropriate services when needed. Programs with a significant number of non-English speaking families benefit from the services of a CCHC who is culturally sensitive and knowledgeable about community health resources for parents’/guardians’ native cultures and languages.”

The Child Health and Development Institute of Connecticut (CHDI), a subsidiary of the Children’s Fund of Connecticut, is a not-for-profit organization working “to ensure all children have a strong start in life with ongoing supports to ensure their optimal health and well-being.” CHDI advocates for “effective policies, stronger systems, and innovative practices.”

Combating Opioid Epidemic in Connecticut Schools - Officials Team Up for Educators Workshop

The Connecticut Association of Schools (CAS), in partnership with the U.S. Attorney's Office, the FBI, the Drug Enforcement Agency (DEA), and victims of drug abuse, will be offering a one-half day workshop for administrators, teachers, and counselors on the devastating opioid epidemic that is growing in severity in Connecticut an across the country. This video-based educational program is designed for high schools and geared specifically for teens and adolescents, officials explain, and will be accompanied by an educator’s discussion guide. The guides will be available for participants to immediately use in a variety of educational settings.

Projections for 2016 by the State Medical Examiner indicate that close to 900 people died of accidental drug overdoses in Connecticut. That is almost three times the number of people who died in car accidents last year, organizers point out. Even more devastating, they note, is the fact that a majority of these deaths are of young people ages 18 to 25, many of whom developed an addiction to opioids after misusing prescription pills while in their teens or early adolescence. Sports injuries, dental pain and other illnesses are common reasons for the original prescription.

According to the Centers for Disease Control and Prevention, opioids were involved in 33,091 deaths nationwide in 2015, and opioid overdoses have quadrupled since 1999.Significant increases in drug overdose death rates from 2014 to 2015 were primarily seen in the Northeast and South Census Regions. States with statistically significant increases in drug overdose death rates from 2014 to 2015 included Connecticut, Florida, Illinois, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Washington, and West Virginia.  In Connecticut, between 2014 and 2015 the rate increased by 25 percent.  

Recognizing that law enforcement is only one facet of the solution, the U.S. Attorney’s Office is fighting this epidemic on several fronts, including criminal prosecution and outreach to schools for prevention, officials said. The office has formed a Heroin Education Action Team (HEAT), which includes parents of local overdose victims, to further assist in this effort.

“Opioid Epidemic in CT – Stemming the Tide” will take place on March 3, 2017, 8:30 to 11:00 a.m., at the CAS-CIAC Conference Center in Cheshire.  Registration deadline is February 24, 2017; the cost is $15.00

CAS officials are also calling for schools to show, “as soon as possible, and no later than the end of the school year,” videos about the crisis.

“Please ensure that every student in your high school sees at least one of the following two films,” the association urges:

• 1) a 15-minute film called The Opioid Crisis Hits Home: Stories from Connecticut that can also be used to educate educators, parents and the general public about the opioid epidemic; and
• 2) the FBI/DEA documentary film Chasing the Dragon: The Life of an Opiate Addict, which is 45-minutes long and accompanied by an educator’s discussion guide geared specifically to teens and adolescents.

Since last September, a number of Assistant U.S. Attorneys have partnered with parents of overdose victims, young recovering addicts, FBI, DEA, and local law enforcement to facilitate Chasing the Dragon presentations at high schools in Milford, New Haven, Danbury, Plymouth, Shelton, East Hartford and New Fairfield.

The films “are provided as a public service for the sole purpose of saving lives,” officials underscore. School officials can schedule an opioid awareness presentation by contacting  Assistant U.S. Attorneys Vanessa Avery or Robert Spector at 203-821-3700.

The Connecticut Association of Schools,  a non-profit, tax-exempt educational organization, has grown to represent well over 800 of Connecticut’s public and parochial schools.

Whalers Hartford Attendance 20 Years Ago Exceeds Islanders in Brooklyn

For Hartford hockey fans of the Whalers vintage, a peek at this year’s National Hockey League (NHL) attendance figures are either demoralizing or encouraging – or both.  It has been two decades since the Whalers were uprooted by ownership, replanted in North Carolina and renamed the Hurricanes, and two weeks since Gov. Dannel Malloy and Hartford Mayor Luke Bronin took their first shot at the now Brooklyn-based New York Islanders. Lowest attendance in the NHL this year belongs to the Carolina Hurricanes, at 12,025 through 24 home games, followed at the bottom of the league by the Islanders, averaging 12,829 through 32 home games, as of this week.

Last year, the 2015-16 season, the Hurricanes averaged 12,203 for their 41 home games, last in the league, while the Islanders were third lowest in the NHL at 13,626.  Both are lower than the Whalers average attendance in their final season in Hartford, nearly two decades ago.

In comparison, the top teams in the league this year for home attendance are the Chicago Black Hawks, averaging 21,669 and Montreal Canadians, seeing 21,288 per game thus far this year.

In their final season on Long Island at the Nassau Coliseum in 2015-16, the Islanders average home attendance was 15,189, an increase from the immediate previous seasons.  The Carolina Hurricanes had the second lowest attendance in the league that year, at 12,594.  During the 2012-13 season, the Islanders attendance was the lowest in the 30-team league, at 13,306.

With more than 1,000 obstructed seats in the Barclay Center arena that the Islanders share with the New York Nets in Brooklyn, rumors have circulated since last year of a possible move to a new arena in Queens built for hockey, unlike the Islanders current home, first and foremost a basketball arena.  There has been local opposition to that possibility.  Recent published reports have also indicated that the Barclay Center and Islanders could part company after the 2018-19 season or a year earlier if the team decides to relocate.

With no official word one way or the other, Connecticut officials are taking their shot, with a possible assist from a $250 million makeover of the XL Center, former home of the Whalers.  That proposal must be approved by the state legislature, a tall order at a time when the state budget deficit is approaching $2 billion.

In the Whalers’ final season in Hartford, 1996-97, attendance at the Hartford Civic Center had grown to 87 percent of capacity, with an average attendance of 13,680 per game.  Published reports suggest that the average attendance was, in reality, higher than 14,000 per game by 1996-97, but Whalers ownership did not count the skyboxes and coliseum club seating because the revenue streams went to the state, rather than the team.  Attendance increased for four consecutive years before management moved the team from Hartford. (To 10,407 in 1993-94, 11,835 in 1994-95, 11,983 in 1995-96 and 13,680 in 1996-97.)

During the team’s tenure in Hartford, average attendance exceeded 14,000 twice – in 1987-88 and 1986-87, when the team ranked 13th in the league in attendance in both seasons.

In recent years, the Islanders have been at or near the bottom of the league in home attendance:

• 2015-16       28^th
• 2014-15      25^th
• 2013-14      26^th
• 2012-13      30^th
• 2011-12      29^th
• 2010-11      30^th
• 2009-10      29^th

Whalers merchandise continues to sell well, despite the team not having played a single game in this century.  Whalers merchandise was Reebok's top selling non-current NHL team, according to published reports in 2015. While the company has expanded its lineup to include Whalers logos from different eras, the Hartford Business Journal reported, gear featuring the team's original logo remained the most popular and continues to be offered on the NHL Official Shop website, on multiple websites and in retail locations in the U.S. and Canada.

The Connecticut officials said “this is a ready market anxious for an NHL team, eager to fill seats, buy merchandise, and support your team,” reminding Islanders officials that ““Your AHL affiliate is in nearby Bridgeport, allowing quick and easy access to your minor-league players, and represents a footing in Connecticut of the Islander franchise.”

The NHL has given no indication that it will approve a move out of the New York market, according to NBC Sports, although Commissioner Gary Bettman has said that the teams owners “are reviewing the situation and looking very seriously at what their options are.”

The only statement released by Islanders ownership after receiving the letter last week from Malloy and Bronin said the team does “look forward to another great year of New York Islanders hockey at Barclays Center next season.”  No word on what might, or might not, occur after that.

CT’s Cuban-American Population Is Centered in Bridgeport, As Immigration to U.S. From Cuba Grows

The number of Cubans entering the U.S. has picked up dramatically since former President Barack Obama announced a renewal of ties with the island nation in late 2014, a Pew Research Center analysis of government data shows. The U.S. has since opened an embassy in Havana, a move supported by a large majority of Americans, and public support is growing for ending the trade embargo with Cuba, according to Pew surveys. Outside of Florida, the New York metropolitan area – including Connecticut - is home to the most Cuban Americans.  More than 10,600 Cuban-Americans call Connecticut home, according to U.S. Census 2014 data. The city with the largest Cuban population is Bridgeport, with more than 1,000 residents of Cuban heritage, according to published reports.

According to the website ZipAlas, the Connecticut communities with the largest percentage of Cuban residents among local their residents include Bridgeport, Hartford, Stratford, Westport, New Britain, Bolton, Stamford, Weston, New Haven, and West Hartford.

Overall, 56,406 Cubans entered the U.S. via ports of entry in fiscal year 2016, up 31 percent from fiscal 2015 when 43,159 Cubans entered the same way, according to the U.S. Customs and Border Protection data reported by Pew. Fiscal 2015 saw an even larger surge, as Cuban entries jumped 78 percent over 2014, when 24,278 Cubans entered the U.S.

There are 2 million Hispanics of Cuban ancestry living in the U.S. today, the fourth largest Hispanic origin group behind Mexicans, Puerto Ricans and Salvadorans. But population growth for this group is now being driven by Cuban Americans born in the U.S. The share of foreign born among Cubans in the U.S. declined from 68 percent in 2000 to 57 percent as of 2015, Pew reported. The Cuban population in the United States has steadily grown, accelerating from 737,000 in 1990 to 1,144,000 in 2013, according to the Migration Policy Institute.

According to the 2014 American Community Survey (ACS), 923,111 foreign-born Hispanics of Cuban origin lived in Florida, 47,016 in New Jersey, 30,398 in Texas, 28,436 in California, and 24,898 in New York, the Center for Immigration Studies reported.

The Cuban Lyceum of Bridgeport -- Liceo Cubano de Bridgeport- celebrated its 60^th year in 2014, the Connecticut Post reported.  Founded in 1954 on the East Side of Bridgeport, the organization continues as the longest running Hispanic social club in all of New England, according to local leaders. The Lyceum was officially incorporated on July 21, 1954, created to “promote unity, understanding and friendship among all Cuban and others Spanish-speaking people,” and “provide a welcomed place for newly relocated Cubans in the United States,” to continue the traditions of Cuban culture.

Bridgeport Police Chief A.J. Perez was born in Cuba migrated with his family as a youngster to the United States in 1968, according to published reports.  He joined the Bridgeport Police Department in 1983 and became Chief of Police last year, the first Cuban-American police chief in the state’s history.

Legislatures Consider Changes in Transportation Safety in CT, Nationwide

The National Conference of State Legislatures (NCSL), in cooperation with the National Highway Traffic Safety Administration, is tracking legislation on a range of traffic safety subjects that have been introduced in the 50 states and the District of Columbia – and is providing updates on the organization’s website.  The site reflects 14 proposed bills in Connecticut, being considered in the General Assembly session that began last month.   Traffic safety topics being tracked nationwide include: Aggressive Driving, Automated Enforcement/Photo Monitoring, Child Passenger Protection, Distracted Driving, Driver’s Licensing, Impaired Driving, Motorcycle Safety, Pedestrian and Bicycle Safety, School Bus Safety, Seatbelts and Occupant Protection, Senior Drivers Issues, Slow-Medium speed vehicles, Speed Limits, and Teen Driver Issues.

Among the proposals being considered in Connecticut is one that would require three-point seat safety belts for school buses and require passengers of a school bus to wear seat safety belts.  A similar proposal would require three-point seat safety belts for school buses that are model year 2019 or newer.  NCSL reports that 20 state legislatures are considering a variety of school bus safety proposals. 

Three proposals would increase fines for distracted driving offenses, including texting or using a hand-held mobile telephone while driving, and one calls for additional funds to be appropriated to the state Department of Emergency Services and Public Protection to “combat distracted driving.”  Connecticut is one of 14 states that have seen distracted driving bills suggested. 

Legislative proposals also include one that would mandate the use of helmets by motorcycle operators and passengers, and another that would regulate the operation of high-speed and low-speed electric bicycles in the state. Twenty-six states in addition to Connecticut have motorcycle safely proposals under consideration.

Members of the legislature’s Planning and Development Committee will consider proposals that call for modifications to urban street design guidelines, in order to “improve the safety, economic life and vibrancy of urban streets.”

Among the nation’s states, the largest number of legislative proposals relate to impaired driving, followed by motorcycle safety, pedestrian and bike safety, drivers licensing, drivers licensing, and school bus safety.

Forty-seven states have begun their 2017 legislative sessions.

Economic Insecurity A Key Factor in School Shootings Nationwide, Academic Study Finds

There is a connection between economic insecurity and gun violence in the nation’s schools.  That is the conclusion reached in a “rigorous” Northwestern University study of a quarter-century of data which found that when it becomes more difficult for people coming out of school to find jobs, the rate of gun violence at schools increases. The study, “Economic Insecurity and the Rise in Gun Violence at US Schools,” was published this week in the journal Nature Human Behaviour.  It breaks new ground, researchers explain, replacing a “patchwork of contradictory claims” with a clear finding that “multiple indicators of economic distress significantly correlate with increases in the rate of gun violence” at both K-12 and post-secondary schools.

The interdisciplinary study by data scientists Adam R. Pah and Luís Amaral and sociologist John L. Hagan reveals a persistent connection over time between unemployment and the occurrence of school shootings in the country as a whole, across various regions of the country and within affected cities, including Chicago and New York City, the university reported.

“The link between education and work is central to our expectations about economic opportunity and upward mobility in America,” said Hagan, the John D. and Catherine T. MacArthur Professor of Sociology in the Weinberg College of Arts and Sciences. “Our study indicates that increases in gun violence in our schools can result from disappointment and despair during periods of increased unemployment, when getting an education does not necessarily lead to finding work.”

The December 2012 school shootings in Newtown, Connecticut is among those routinely cited among a number of mass shootings that have garnered public attention in recent years.  While a number of factors have been said to have contributed to the violence, clear answers have been elusive as to the cause or causes.

The Northwestern researchers used data from 1990 to 2013 on both gun violence in U.S. schools and economic metrics, including unemployment, in an effort to determine factors that may be relevant. They found the rate of gun violence at schools has changed over time. The most recent period studied (2007-2013) has a higher frequency of incidents than the preceding one (1994-2007), contradicting previous work in this area, according to the university.

The researchers focused on all gun violence at schools, not only mass shootings. They used the following criteria for an event to be included in the study: (1) the shooting must involve a firearm being discharged, even if by accident; (2) it must occur on a school campus; and (3) it must involve students or school employees, either as perpetrators, bystanders or victims.  They then evaluated the timing of these events against multiple indicators of economic distress, including unemployment, the foreclosure rate and consumer confidence.

The researchers found that “given the nature of the school-to-work transition, it is predictable that more violence would occur closer to the last link in the chain from education to employment. An implication of our findings is that as economic prospects improve, the frequency of shootings in K12 schools should remain relatively stable, with declines at post-secondary schools.”

The research indicated that gang-related violence and lone mass shooters comprise only small fractions of the gun violence that occurs at U.S. schools. Gang-related violence constitutes 6.6 percent of all incidents.  Among the key findings were that gun violence at schools has not become more deadly over time and that most shootings are targeted, with the shooter intending to harm a specific person.

The report also noted that while Chicago is singled out in the study as one of the six cities with the most incidents from 1990 to 2013, Chicago schools are not any more dangerous than schools in other large cities.

The results suggest that during periods of heightened unemployment, increased gun violence may be a growing risk in American college and university settings, finding that “a breakdown in the school-to-work transition contributes to an increase in gun violence at schools.”

“Once we consider how important schools are to American ideas about economic opportunity and upward mobility, we can better understand why school settings are revealed in our research as focal points of violent responses to increased unemployment,” said Hagan, who also is a research professor at the American Bar Foundation. “Prior research about gun violence in schools has not adequately analyzed these connections.”

The Northwestern study differs from earlier studies on gun violence in U.S. schools by considering accumulated knowledge about the school-to-work transition in American society. In the last 25 years, there have been two elevated periods of gun violence at U.S. schools, the researchers found; 2007-2013 was largely due to events at postsecondary schools while 1992-1994 more often involved events at K-12 schools.

“Our findings highlight the importance of economic opportunity for the next generation and suggest there are proactive actions we could take as a society to help decrease the frequency of gun violence,” concluded Pah, clinical assistant professor of management and organizations at the university's Kellogg School of Management.

Connecticut Book Awards Set to Make a Comeback in 2017

Connecticut Center for the Book at Connecticut Humanities is now accepting submissions for the Connecticut Book Awards, returning after a multi-year absence from the literary landscape in the state.  The awards were last presented in 2011.  They were presented annually beginning in 2002. These awards recognize the best books of 2016 by authors and illustrators who reside in Connecticut.   The 2017 Connecticut Book Awards will honor authors in Fiction, Nonfiction, and Poetry. There will also be awards open to authors and illustrators in the category of Books for Young Readers (Juvenile, Young Adult, and Teen).  Book award nominations may be made through April 21, with the formal announcement of recipients later this year.

"There is a void in the Connecticut literary landscape for this kind of recognition of home grown authors. Several other awards and prizes in the state exist, awards such as The Nutmeg Awards, New Voices in Children’s Literature: Tassy Walden Awards, The Windham Campbell Prize, and a small handful of others, but these awards have specific criteria and don’t necessarily focus on Connecticut-based authorship," the Center for the Book website points out. "Without the Connecticut Book Awards, there is no statewide recognition of Connecticut authors who craft words and convey ideas in a compelling way."

Entry fee starts at $40 for a 2,000 copy or less print run. Award winners will receive exposure in Connecticut media outlets and personal appearances in Connecticut locations. For guidelines and to submit, please visit http://bit.ly/CTBook2017

The Center for the Book at Connecticut Humanities promotes the written and spoken word throughout the state and is an affiliate of the Center for the Book in the Library of Congress.  "We’re bringing the Connecticut Book Awards back. Because they are important," the website notes emphatically.

Nominated authors must currently reside in Connecticut and must have lived in the state at least three successive years or have been born in the state, or the book must be substantially set in Connecticut. Panels of five judges will assess nominated books in each category.

Eligibility Requirements for Book Awards to be made in 2017:

• Author must currently reside in Connecticut and must have lived in the state at least three successive years or have been born in the state. Alternatively, the work may be substantially set in Connecticut.
• Titles must have been first published between January 1, 2016 and December 31, 2016.
• All submitted books must have a valid ISBN.
• Authors may enter more than one book per year.
• Anthologies are acceptable. Author(s) must have resided in Connecticut for at least three years of have been born in the state. Alternatively, the works must be substantially set in Connecticut.
• Books by deceased authors will be accepted only if the author was still living at the beginning of the eligibility year (January 1, 2016).

Lembo Develops Plan Aimed at Bringing Drug Costs Within Reach

State Comptroller Kevin Lembo, after what was described as “exhaustive research and consultation with representatives across all sectors of the health care industry,” has developed a five-point plan to address “skyrocketing pharmaceutical drug costs.” Lembo’s proposed legislation, which is to be considered by legislators in the five-month session that began earlier this month, aims to be comprehensive in addressing a range of interrelated issues.  Those issues include requiring justifications for sharp price increases, establishing oversight of drug costs that exceed certain thresholds, ensuring that consumers benefit from rebate savings, promoting insurance plans that emphasize affordable co-pays and preventive care, and eliminating incentives that perversely encourage providers to prescribe the most expensive drugs.

“In a divided country,” Lembo said, “when we’re desperate to find common ground, virtually everyone can agree that prescription drug costs are out of control and must be fixed.  This rise in patient cost share, combined with the rising prices of pharmaceuticals is creating a significant financial burden for Connecticut residents,” Lembo added, noting that “consumers are increasingly bearing a greater share of those costs.”

Lembo, who served as Connecticut’s first Healthcare Advocate prior to being elected State Comptroller in 2010, currently administers the state health plan on behalf of approximately 200,000 people.  The plan includes:

• Require pharmaceutical manufacturers to justify launch prices and price increases over a certain threshold

To address rising drug prices that appear to be arbitrary and unjustifiable, Lembo proposes a requirement that when drug manufacturers increase prices beyond certain thresholds, (for example, list prices increase over 50 percent in the last five years or 15 percent in the last year or launch prices 30 percent or more above the average price for other drugs in a therapeutic class) they must provide the state with information about total costs for producing specific drugs and costs for research and development, marketing, different prices charged for the drug, total profit from specific drugs, research and development efforts that have not resulted in any approved drugs, details about discounts and rebates provided and, of course, a justification for the launch price or the price increase in question.

The findings of a state review would be reported to the legislature and governor to evaluate the appropriateness of the price increases in question.

• Limit the launch price and annual increases of certain high cost drugs

Establish a working group to evaluate the potential of using the information reported above to regulate drug prices in certain egregious instances through the creation of a state-level drug price review board. The authority would review the launch prices of new drugs and annual increases of existing drugs that exceed certain thresholds. The working group should recommend a process for determining if the launch prices or price hikes are justified and recommend possible state actions to take when increases are deemed unjustified.

• Promote the adoption of value-based insurance design

The state Department of Insurance (DOI) and the state health exchange should be required to promote the adoption of plans that use a value-based insurance design. Value-based insurance for prescription drugs generally encourage medication adherence by reducing or eliminating co-payments and deductibles for drugs that help control chronic conditions.  Better managed chronic diseases reduce in-patient hospital stays and emergency room visits by individuals with chronic diseases. The state employee plan has seen significant increases in medication adherence since adopting a lower co-pay structure for maintenance drugs through the state Health Enhancement Plan.

• Allow consumers to benefit from negotiated drug rebates.

Require health plans to base co-insurance and deductible payments on the net price of the drug, post rebate, rather than the list price, allowing the consumer to share in rebate savings negotiated by the pharmacy benefit manager or plan administrator.  For certain highly rebated drugs the list price can be as much as three times more than the final price paid by a health plan after manufacturer rebates.

• Remove incentives for physicians to administer higher cost drugs.

In 2004, Medicare began to reimburse physicians 6 percent of the acquisition cost of drugs for administration. Commercial payers, which often base their reimbursement policies off Medicare, quickly followed suit. The new policy created a perverse incentive in which physicians were paid more for using more expensive drugs even when lower cost equally effective alternatives were available. It also incentivized drug manufacturers to significantly increase prices. As a result, many physician-administered drugs have seen massive price increases since 2004, with many oncology drugs well in excess of $100,000 per regimen. The state should require state-regulated insurance plans to completely delink the reimbursement for physician-administered drugs with the costs of the drugs administered in order to eliminate such perverse incentives.

“This plan emphasizes transparency, accountability and common-sense health care policy that puts quality and wellness for everyone above the corporate profits of big Pharma,” Lembo said in recommending the five-part plan.

Over the past several years, Lembo has been working with state leaders and Connecticut’s congressional delegation to investigate flaws in the pharmaceutical market and implement policies to address the problem.   Last year, he co-hosted a forum at the State Capitol with the Connecticut State Medical Society (CSMS) that brought together physicians, pharmaceutical companies, academicians, patient advocates and other industry experts to address the skyrocketing cost of medications.

Lembo also serves on a working group of the NASHP (National Academy for State Health Policy), which recently issued a report recommending proposed state action, some of which is reflected in Lembo’s legislative proposal.  The Office of the Healthcare Advocate, which Lembo led for six years a decade ago, is an independent agency that helps consumers when they have disputes with their health insurance company. They also educate people about their health care rights and serve as a watchdog over Connecticut’s healthcare marketplace.

CT’s Local Government Workforce Shrinks 7.4% in Past Decade; 10th Largest Reduction in US from Employment Peak

Connecticut’s local municipal workforce has been shrinking for the past decade, and had been reduced 7.4 percent by 2015 when compared with the peak employment year of 2005, according to a new analysis by Governing magazine.  The drop in local government employment is the 10^th largest in the country by percentage of workforce, when peak employment levels were compared with 2015 numbers. “Going on nearly a decade since the start of the recession, localities in many parts of the country have since restored public payrolls to prior levels. But some still employ far fewer workers than they did before the downturn,” Governing reported.

Governing compared each state's pre-2010 peak aggregate totals to the latest 2015 data, excluding the education sector.  In all, the magazine reported, local governments in 26 states had yet to see payroll expenditures return to prior levels when adjusted for inflation. Similarly, local public employment remains below previous highs in most states and is down 3.5 percent nationally from 2008.

The steepest declines in local government payrolls, when 2015 data was compared with the peak pre-recession year, came in Delaware (-20.5% from 2007), Michigan (-18.2% from 2003), Arizona (-17.1% from 2008), Rhode Island (-16.5% from 2003), Massachusetts (-14.4% from 2008), Nevada (-14.1% from 2009), Florida (-11.0% from 2008), Indiana (-8.8% from 2008), New Jersey (-8.3% from 2009) and Connecticut (-7.4% from 2005).

Where localities chose to make payroll cuts has varied, according to the analysis, but a number of patterns were pointed out, based on Census data.  When national employment estimates were compared with 2008 levels, non-sworn police employees sustained the single largest reduction of any major category of workers, the analysis indicated. Governing suggested the reductions were likely a result of police departments trimming civilian staff to maintain the size of police forces on the streets. Nationally, the number of police and firefighters were down 2.6 percent from 2008 while all other areas of local government, excluding education and hospitals, experienced a larger 4.5 percent decline.

At the opposite end of the spectrum, North Dakota, South Dakota, Wyoming, Montana and New Mexico recorded the biggest increases in noneducation payrolls since the recession began in 2008-2009.  Half the states showed an increase in local government payrolls, and despite the generally slow recovery across many regions of the country, U.S. local government payroll spending overall showed a slight three  percent nationwide uptick between 2014 and 2015, according to the analysis.