Economic Impact of CT Hospitals Highlighted in Report

Connecticut hospitals contribute $20 billion to the state and local economies, according to a report, Connecticut Hospitals: Improving Health, Strengthening Connecticut’s Economy, compiled by the Connecticut Hospital Association (CHA). According to the CHA report, Connecticut hospitals provide more than 54,000 jobs, with a total annual payroll of $5.2 billion.  Earnings by Connecticut hospital and health system employees reverberate through the community, creating an additional 55,000 jobs in the local economy.

The four-page report, which focused on the economic impact of Connecticut’s hospitals and was released in the opening weeks of the state legislative session, noted that “hospitals and health systems serve as a magnet for other healthcare businesses and a stimulus for new businesses such as retail stores, banks, grocery stores and restaurants.”

Connecticut hospitals are major employers and purchasers of goods and services, spending $9.6 billion in 2011 – funds that help to stimulate further economic growth across the state.  Goods and services purchased by hospitals, and funding spent on buildings and equipment, create additional economic value.  With these “ripple effects” included, an additional $10.4 billion is added to the Connecticut economy, resulting in a total contribution of $20 billion by Connecticut’s hospitals to the state’s economy, CHA official pointed out.

The report indicates that Connecticut hospitals treat more than 1.6 million patients in their emergency departments, bring nearly 38,000 babies into the world, and care for more than 420,000 admitted patients, providing more than 2 million days of inpatient care.

“Connecticut hospitals are a critical economic engine,” said Jennifer Jackson, President and CEO, CHA.  “They are often a community’s largest employer, stimulating jobs and attracting other businesses.  At a time when the state has never relied more on its hospitals for the safety net they provide, it is critical – both to our quality of life and economic health – that these institutions remain strong and stable.”

CHA membership includes 29 acute care hospitals and health care organizations and facilities throughout the state.  The report was issued at a time of considerable change in both the healthcare delivery and business sides of the industry, with mergers and affiliation agreements having been reached or under active consideration among industry leaders in Hartford, New Haven, Waterbury, New London and elsewhere across Connecticut, as well as nationally.

Connecticut Has 4th Highest Costs for Residents of Assisted-Living Facilities

The average monthly cost of a room in an assisted-living facility is higher in Connecticut than in 48 states.  Only Delaware, New Hampshire and the District of Columbia, on average, have higher rates than the Land of Steady Habits. The top twelve, as reported by the Wall Street Journal:

1. District of Columbia         $5,933
2. Delaware                             $5,249
3. New Hampshire                $5,086
4. Connecticut                        $4,935
5. Maine                                   $4,881
6. Alaska                                   $4,850
7. New Jersey                        $4,794
8. Vermont                              $4,741
9. Massachusetts                  $4,660
10. Hawaii                                   $4,659
11. Maryland                             $4,546
12. New York                            $4,011

The data reported in the WSJ was compiled by the MetLife Mature Market Institute, based on a survey of nearly 6,700 long-term care providers nationwide. At the other end of the spectrum, 12 states had average monthly costs that were below $3,000.  Lowest rate?  Arkansas at $2,355 – less than half that of the eight most costly states, including Connecticut.

Latino Community’s “Champions of Change” Have Leading Roles in 2013

Looking to 2013 as a year when “we can all increase our efforts to work together to affect change in so many arenas,” the website ctlatinonews.com has named five “Champions of Change” in the Latino community. The individuals “have accomplished change through various means, some through their professional work, others by generously volunteering their time, working for change through policy implementation or by using the legal system,” according to the website.  They were selected by the new site’s editorial team and represent many sectors that include: health, business, politics, media, art and law. In addition, ctlatinonews.com also selected Five Young Latinos already making a difference, Five Non-profit Organizations, Five Latinos in Media & Arts and the Most Visible Latino.

Connecticut’s top five Latino “Champions of Change” as selected by ctlatinonews.com are John Soto, Frances Padilla, Yvette Meléndez, Andres Ayala, and Beatriz Gutierrez.

Frances Padilla: Through her life-long personal commitment and volunteer work, and as well as being one of the state’s leading health reform advocates, Frances G. Padilla is impacting quality of life for all Connecticut residents. As president of the Universal Health Care Foundation of Connecticut, Frances has provided strategic direction and visionary leadership.  She is initiating new partnerships, increasing outreach and deepening civic engagement on one of the most important public policy issues of our time.  A graduate of Wesleyan University and Harvard’s Kennedy School of Government, Frances has also given much of her personal time over the years to benefit the state’s Latino community.

Yvette Meléndez: Yvette Meléndez had held several executive positions in key organizations where she has been able to affect policy change. She is currently the vice president, Government and Community Alliances, for Hartford Hospital. Prior to this post she served as chief of staff for the Connecticut State University System, deputy commissioner at the Department of Public Health and Addiction Services, and at the State Department of Education where she launched Connecticut’s entry into the charter school movement.She also serves as vice chair of the Board of Regents for Higher Education, and as vice chair of the Hartford Foundation for Public Giving.

Andres Ayala, Jr.: Born in Bridgeport, newly elected state Senator Andres Ayala Jr. is a champion of change in the political arena as well as through his role as a community leader, where he has spent his career building opportunities and opening doors for others. He was elected in November 2012 to represent the 23rd Senatorial District, the first Democrat Latino Senator in Connecticut history.   He previously served three terms as state representative for the 128^th district. Ayala’s political life began on the Bridgeport City Council, where he rose to City Council president – the first Latino ever to do so.   He worked to develop  Bridgeport’s school building plan, which created five new schools.   He is an educator in the Bridgeport school system, and has worked as a teacher, dean of students and advisor to the Aspira Youth Development Program.

Beatriz Gutierrez:  Beatriz Gutierrez is helping to change the future of Connecticut by making it more of a global player in the marketplace in her role as head of the Department of Economic and Community Development’s international business development efforts. She brings a unique perspective as a Latina with a strong business background and knowledge of the world.  Born in the United States to Colombian parents, and raised in Colombia, Gutierrez returned to the U.S. to study electrical engineering at Marquette University in Milwaukee,  graduating in 1990. Gutierrez’ office at DECD is currently developing a strategic plan for Connecticut to compete in international markets.

John Soto:  The owner of Space-Craft Manufacturing in New Haven, John Soto has used his business acumen and wealth for social and economic change through philanthropy. Born in Puerto Rico, he started his company 42 years ago with four employees and today Space-Craft Manufacturing is now recognized as an industry leader, Soto has personally donated hundreds of thousands of dollars over the years and devoted countless hours of his time to Latino related organizations, especially those whose mission is helping Connecticut’s youth.

CT Among Leaders in Heart Health; States Vary Significantly Study Finds

If  heart health matters to you and you live in New England – especially Vermont or Connecticut - you’re in good company.  Americans’ cardiovascular health varies greatly from state to state, according to new research in the Journal of the American Heart Association (JAHA) - the first study to assess cardiovascular health at the state level. Among the findings:  people living in the New England states – including Connecticut – generally reported having among the highest percentage with “ideal cardiovascular health.”  Only the District of Columbia had better across-the-board numbers.  Among the findings:

• The percentage of the population with ideal cardiovascular health varies from 1.2 in Oklahoma to 6.9 in Washington, D.C.
• The percentage of the population reporting ideal cardiovascular health — defined as having optimal levels of all seven factors — was lowest in Oklahoma, West Virginia, and Mississippi.
• Ideal cardiovascular health was highest in Washington, D.C. (6.9), Vermont (5.5), Connecticut (5.5), Virginia (5.0), Massachusetts (4.6), Maine (4.5), and New Hampshire (4.5).

Overall, in the nationwide study funded by the Centers for Disease Control (CDC):

• About 3 percent of the total U.S. population reported having ideal heart health.
• About 10 percent of the total population reported having poor cardiovascular health, with two or less heart-health factors at optimal levels.

Researchers collected information on the American Heart Association’s seven major heart-health factors: blood pressure, total cholesterol, smoking, body mass index, diabetes, physical activity, and fruit and vegetable consumption. (used as a proxy measure in the study for a healthy diet.)

“Since the CDC is funding state heart disease and stroke prevention programs, we thought it would be helpful to have cardiovascular health information on the state level,” said Jing Fang, M.D., M.S., an epidemiologist with the CDC’s Division for Heart Disease and Stroke Prevention.  “Americans reported having on average more than four of the seven risk factors for heart disease,” Fang said. “We also found large disparities by age, sex, race/ethnicity and levels of education.”

Using 2009 data from the Behavioral Risk Factor Surveillance System – a telephone survey was conducted of more than 350,000 people in the 50 states and Washington, D.C. The report, in December 2012, could help state officials set goals to reduce risk of heart attack and stroke and improve cardiovascular health.

The American Heart Association goal is, by the year 2020, to improve the cardiovascular health of all Americans by 20 percent while reducing deaths from cardiovascular diseases and stroke by 20 percent.

Health of Connecticut Drops Slightly as Disparities and Challenges Are Noticed

Connecticut is now the nation’s sixth healthiest state, dropping from number four in the previous year, according to state-by-state data compiled by the United Health Foundation in collaboration with the American Public Health Association and Partnership for Prevention.  Among the findings about Connecticut highlighted in the report, America’s Health Rankings, which was compiled in 2012:

• While Connecticut has one of the lowest smoking rates in the U.S., there are 475,000 adults who still smoke.
• In the past 5 years, the high school graduation rate declined from 80.7 percent to 75.4 percent of incoming ninth graders who graduate in four years.
• In the past 10 years, the percentage of children in poverty increased from 8.9 percent to 14.3 percent of persons under the age of 18.
• In the past 5 years, public health funding increased from $57 to $71 per person.
• In the past 5 years, the rate of preventable hospitalizations decreased from 67.3 to 60.4 discharges per 1,000 Medicare enrollees.
• In the past year, the infant mortality rate decreased from 6.3 to 5.8 deaths per 1,000 live births.

The state’s strengths, according to the report, include a low prevalence of smoking, low incidence of infectious disease, low rate of uninsured population and high immunization coverage.  Challenges facing Connecticut are the state’s moderate high school graduation rate and moderate levels of air pollution, the report noted.

Among the key health disparities highlighted from the Connecticut data, obesity is more prevalent among non-Hispanic blacks at 41.4 percent than Hispanics at 28.6 percent and non-Hispanic whites at 21.0 percent; and sedentary lifestyle is more prevalent among Hispanics at 27.5 percent than non-Hispanic whites at 19.9 percent.

Overall, Connecticut has consistently ranked in the top 10 among the states since 1994. Vermont topped the list for the fourth consecutive year in 2012.  New Hampshire, Massachusetts, Minnesota and Hawaii were deemed healthier than Connecticut.  An interactive web-based 3D chart provides comparisons among the states.

The reports’ authors state that the “ultimate purpose of America’s Health Rankings® is to stimulate action by individuals, elected officials, medical professionals, public health professionals, employers, educators, and communities to improve the health of the population of the United States.”

Hartford’s Institute of Living Plans Research into Schizophrenia and Autism Spectrum Disorders

Last month’s tragic killing of 20 children and 6 educators at a Newtown elementary school quickly generated speculation about possible links between mental illness and autism spectrum disorder, as questions about the gunman's medical history drew attention.  Although connections between the conditions were generally dismissed as media coverage proceeded, with distinctions being made by medical professionals and others,  a scientific research study into whether a relationship exists is apparently set to get underway in Connecticut. Writing in the Autumn 2012 edition of Rounds, the quarterly magazine of Hartford Hospital, Michal Assaf, M.D., director of the Autism and Functional Mapping Laboratory at the Olin Neuropsychiatry Research Center at the Institute of Living, says that “traditionally considered separate diagnoses, both schizophrenia and an autism spectrum disorder involve core social and communication deficits.  Not much is known, however, about exactly how each neurodevelopmental disorder disrupts the brain or how much they may overlap.”

“Schizophrenia and ASD are thought of as separate entities based on clinical symptoms, age of onset and the course of the illness,” says Dr. Assaf, who also is an Adjunct Assistant Professor at the Yale University School of Medicine.   “Recent evidence suggests a potential overlap.”

“Looking beyond clinical symptoms to the biological and genetic basis of these apparently different illnesses may someday lead to new treatments,” Assaf suggested in the article published prior to the Newtown killings.

She recently received a $2.9 million research grant from the National Institute of Mental Health (NIMH) to study social cognition and brain function in schizophrenia and ASD.  The study will directly compare a matched group of schizophrenia and ASD patients using a battery of social assessment tools and several neuro-imaging tasks that assess different aspects of social cognition.

Noting the commonly recognized distinctions, Dr. Assaf said that “Schizophrenia is a psychotic illness that typically appears in early adulthood.  In contrast, children with ASD show core deficits in social and communication skills – typically without psychotic symptoms – before age three.”

The Institute of Living has been seeking individuals to participate in the research study.  The Olin Neuropsychiatry Research Center at the Institute of Living, part of Hartford Healthcare, was founded in 2001. The mission of the Center is to be at the forefront of research in psychiatric and psychological disorders, in particular schizophrenia.

Early Identification of Mental and Behavioral Health Issues Critical, CT Study Finds

A recent report by the Connecticut-based Center for Children’s Advocacy revealed that early warning signs of mental and behavioral health problems are often not identified until middle school years, but could be uncovered much earlier. In any given year, the report noted that “about one out of every five Connecticut children (87,500 to 125,000) struggles with a mental health condition or substance abuse problem. More than half receive no treatment.”

With a grant from the Connecticut Health Foundation, Dr. Andrea Spencer, dean of the School of Education at Pace University and educational consultant to the Center for Children’s Advocacy, examined children’s educational records to identify how early these warning signs appear.  The report, issued in September 2012, documents the direct link between undiagnosed and unaddressed mental health issues with increases in school suspensions, expulsions and entry into the state’s juvenile justice system.  It also noted that:

• Over 70% of students diagnosed with mental illness and behavioral health problems by middle school exhibited warning signs by second grade.
• Almost 25% exhibited red flags during pre-Kindergarten years.

Early indicators, according to the report, included developmental and health issues, adverse social factors and exposure to trauma. The report, entitled “Blind Spot,” found that 25 percent of the children studied had documented traumatic experiences in their records  It recommends implementation of a series of initiatives:

• Improve screening for mental health risk factors
• Improve referral to early intervention services (mental health and special education)
• Improve collaboration between service providers
• Improve community and parent education about risk factors and support available
• Improve training and accountability for school staff and other providers

“Red flags for mental and behavioral health problems are often clear before the end of second grade,” said Dr. Spencer. “It is imperative that we improve screening and identification so support for these children can be provided before their academic careers are at risk.”

As a result of this report, the Center for Children’s Advocacy - a Connecticut nonprofit that provides legal support for abused and neglected children - introduced a statewide policy initiative to improve the quality and standard of care for children insured through the Connecticut’s Medicaid (HUSKY A) plan.

In addition, the Center noted that the Connecticut Department of Social Services (DSS) has agreed to convene a task force that includes representatives from the Center for Children’s Advocacy, Department of Children and Families, Department of Mental Health & Addiction Services, Office of Policy and Management, Value Options (contracted provider of mental health services under HUSKY/ Medicaid), American Academy of Pediatrics (CT Chapter), Academy of Child & Adolescent Psychiatrists (CT Chapter), Head Start, developmental pediatricians, Birth to Three Program, Department of Education, and the Connecticut Health Development Institute.

The task force is to review current regulations, make recommendations regarding screening and treatment protocols, and provide recommendations on reimbursement rates for pediatric providers, according to a news release issued by the Center.

CT's Mental Health Services Ranking is Good, But "Citizens Deserve Better"

The National Alliance on Mental Illness (NAMI), in its ranking of states in 2009, placed Connecticut as among the top six states in the nation, along with Maine, Maryland, Massachusetts, New York and Oklahoma.  However, it described Connecticut as “a state of paradoxes” in mental health care and treatment, stressing that “Connecticut’s citizens deserve far better.” The state ranked 31^st in the prevalence of mental illness, with 108,730 individuals, according to the organization, which pointed out that even in states with solid grades, “there is no doubt that many of their residents living with serious mental illnesses are not receiving the services and supports they need.”

Connecticut’s overall grade was “B,” according to the report, “Grading the States 2009.”  The Alliance graded states in four categories:  

• Health Promotion and Measurement,
• Financing & Core Treatment/Recovery Services,
• Consumer & Family Empowerment, and
• Community Integration and Social Inclusion.

Connecticut received a “C” in Community Integration and Social Inclusion, an “A” in Consumer and Family Empowerment – the only state in the nation to receive the top grade – and a “B” in the other two categories.

Three “urgent needs” were noted for Connecticut:  Increase community-based services, housing as an alternative to more restrictive placements, and ending nursing home warehousing.

In the days after the mass killings of 20 first-graders and six adults at the Sandy Hook Elementary School in Newtown, Connecticut, questions have been raised about the role of mental health services as part of a state and national response to the tragedy.

Overall, NAMI gave the United States a grade of “D.”  In the 2009 report, NAMI reviewed progress made since the organization’s previous state-by-state report in 2006, and found state mental health agencies “making valiant efforts to improve systems and promote recovery despite rising demand for services, serious workforce shortages, and inadequate resources.  Many states are adopting better policies and plans, promoting evidence-based practices, and encouraging more peer-run and peer-delivered services.”

However, NAMI reported that “these improvements are neither deep nor widespread enough to improve the national average. The grades for almost half the states (23) remain unchanged since 2006, and 12 states have fallen behind.”

Nearly 60 million Americans experience a mental health condition every year, according to data cited by NAMI, which  is the nation’s largest grassroots mental health organization dedicated to building better lives for Americans affected by mental illness.

The 2009 report concluded that “Without a significant commitment from our nation’s leaders—in Washington, among governors, and in state legislatures—state mental health agencies will continue to struggle to provide even minimally adequate services to people living with serious mental illnesses.”

Specifically, the report noted that as a nation, “We have too few psychiatric beds, treatment services, and community-based supports for those who need them; people with mental illnesses are neglected until they reach the point of crisis, and are then dumped onto other systems. Across the nation, people with mental illnesses are unnecessarily incarcerated, homeless, out of work, and unable to access needed medicines. On top of it all, we have an extremely limited capacity to monitor and measure our own efforts—the very foundation of effective reform.”

See NAMI video 

State's Childhood Obesity Numbers Continue to Raise Concerns

M. Alex Geertsma, Chairman of Pediatrics at St. Mary's Hospital in Waterbury and director of the Children's Health Center, says the road to childhood obesity is paved in tasty treats that are attracting children’s palates unnecessarily – and beginning very early in life. “Commercialism is driving change in how we feed our infants,” Geertsma recently told a group of advocates at a Capitol forum on childhood obesity.  Geertsma, who has practiced pediatrics in Connecticut for three decades, is a member of the Connecticut Commission on Children.

After being on a liquid diet for the first six months of life, they begin to taste discriminate, or recognize certain foods as tasty or disgusting. They begin to want something “novel” whether it is extremely sweet or really salty.  Food manufacturers take full advantage, producing choices with hefty salt content and other ingredients that begin to push the scales upward.

The increase in body fat has been occurring much earlier than seven to eight years of age in children who eventually become long-term obese. This pattern is worse in African-American and Latino children, Geertsma said.

A recently released report projects that if obesity rates continue on current trajectories, 46.5 percent of adults in Connecticut will be obese by 2030.  The rate in 2011 was 24.5 percent.  Commissioned by The Trust for America’s Health and the Robert Wood Johnson Foundation, the “F as in Fat Report” projects that nationally, 13 states could have adult obesity rates above 60 percent by 2030.

Currently Connecticut is not among the worst offenders, ranking among the states with the relatively lowest adult and childhood obesity rates (#40 in childhood obesity; #49 in adult obesity).

A report last year by the Connecticut Department of Public Health, “Overweight and Obesity Among Kindergarten and Third Grade Children in Connecticut,” found that the prevalence of obesity was significantly higher in grade 3 children than in kindergarten children. Third grade girls were more likely to be obese when compared to kindergarten girls.  Similarly, third grade boys were more likely to be obese when compared to kindergarten boys.

Almost one third (32%) of all the students in the sample were either overweight or obese. The prevalence was similar when compared by sex. Third-graders (33.6%) were more likely to be either overweight or obese than children in Kindergarten (29.8%), but the difference was not statistically significant. However, the non-Hispanic Black (40.8%) and Hispanic (43.3%) children in the sample were significantly more likely to be overweight or obese than non-Hispanic White (26.8%) children.

Obesity is the second-leading cause of preventable death in the United States, after smoking, according to the Connecticut Public Health Department.  If a child is overweight before age 8, obesity in adulthood is likely to be more severe, statistics by the American Academy of Pediatrics have noted.

The Connecticut Coalition Against Childhood Obesity, a coalition of more than 30 health advocacy organizations across the state which conducted the hearing, is encouraging discussion of ways to overcome the obesity epidemic, which they say is contributing to the academic achievement gap.

Public Invited to "Chat" About Plans for Health Insurance Exchange

The health care conversation in Connecticut goes public this week, with the launch of a series of public forums – dubbed “healthy chats” – across the state.  The Connecticut Health Insurance Exchange, led by a 14-member board, was established as a quasi-public agency to satisfy requirements of the federal Affordable Care Act (ACA). With President Obama re-elected, it would appear that it is full-speed ahead with implementation of the ACA, better known as ObamaCare. Starting in 2014, consumers and small businesses will have access to high-quality, affordable health insurance through an Exchange – a one-stop marketplace where consumers can choose a private health insurance plan that fits their health needs and have the same kinds of insurance choices as members of Congress.

In every state, Exchanges are to be designed to allow consumers to shop for and enroll in private health plans that meet their needs. Consumers will be able to learn if they are eligible for tax credits and cost-sharing reductions, or other health care programs like the Children’s Health Insurance Program. Small employers will be eligible to receive tax credits for coverage purchased for employees through the Exchange. These competitive marketplaces make purchasing health insurance easier and more understandable and offer consumers and small businesses increased competition and choice.

The Administration recently extended the deadline for states to indicate if they would develop their own Exchanges, or defer to the federal government to organize their states.

In Connecticut, however, the process has been proceeding for some time.  The state’s Exchange has been staffed and regular planning meetings have been held, in a public setting, to move forward with establishing the Exchange.  Four different advisory committees composed of a variety of stakeholders have been charged with providing the board with diverse perspectives on key initiatives and operations, providing opinions and recommendations.

Now the Exchange is looking hear directly from the public, and to respond to questions or concerns about the unfolding plans.  A series of “Health Chat” public meetings begin Tuesday, Nov. 27 in Hartford, and will be conducted around the state (see list below).

Each Healthy Chat is an open forum – a chance to meet and talk with Exchange CEO Kevin Counihan and other health care reform experts around the state.  Attendance is free. Advance registration is encouraged to ensure ample seating but not required.

Time-of-event registration and refreshments start at 5 pm. Upon arrival, individuals will have an opportunity to write down and submit questions. Chats will run from 5:30 – 7:00 pm and panelists will answer as many questions as possible.

Hartford  Tuesday, November 27 -Hartford Public Library

Waterbury  Thursday, November 29 -Waterbury City Hall

New London  Tuesday, December 4 - Mitchell College

New Haven  Thursday, December 6 - Regional Hall Career High School

New Britain  Tuesday, December 11 - Central Connecticut State University

Stamford  Thursday, December 13 - University of Connecticut Stamford

Bridgeport  Tuesday, December 18 - Bridgeport Holiday Inn

For additional questions, email cthix.inquiries@ct.gov or call 860-418-6420.