CT Ranks As 7th Greenest State in the Nation, Analysis Says

Earth Day 2016 – celebrated on April 22 – will be observed in communities throughout Connecticut this weekend, against the backdrop of a new state-by-state analysis that ranks Connecticut as the 7^th “greenest” state in the nation. WalletHub’s analysts compared the 50 states across three key dimensions: 1) Environmental Quality, 2) Eco-Friendly Behaviors and 3) Climate-Change Contributions, including 17 key metrics that “speak to the health of the current environment as well as the environmental impact of people’s daily habits.”

Topping the list were Vermont, Washington, Massachusetts, Oregon, Minnesota, Maine, Connecticut, New York, New Hampshire and New Jersey.  The data set ranges from “Total Municipal Solid Waste per Capita” to “Energy Efficiency Score” to “Carbon Dioxide Emissions per Capita.”

Connecticut’s highest ranking in the individual categories was in Water Quality, where the state ranked first.  Other top finished include Energy-Efficiency (6^th), Carbon Dioxide Emissions per Capita (6^th), and Gasoline Consumption per Capita (12^th).

The state ranked in the middle-of-the-pack in Percent of the Population Not Driving to Work (22^nd), Air Quality (24^th) and Percentage of Recycled Municipal Solid Waste (25^th).

In the three overall categories, Connecticut ranked 2^nd in Climate Change Contributions, 5^th in Environmental Quality, and 23^rd in Eco-Friendly Behavior.

At the bottom of the WalletHub ranking were Oklahoma, Nebraska, West Virginia, Montana, North Dakota and Wyoming.

Gary Ginsberg Receives Public Communications Award from the Society of Toxicology

Dr. Gary Ginsberg, a Senior Toxicologist with the Connecticut Department of Public Health (DPH) has been awarded the “Public Communications Award” by the Society of Toxicology, an international organization dedicated to enhancing the impact and relevance of toxicology. Dr. Ginsberg was recognized by the organization for his efforts in explaining complex toxicology issues to the public, with the conference program noting that “Dr. Ginsberg is able to consolidate vast amounts of science into easily digestible useful information to help protect consumers from potentially hazardous situations.”

At DPH, Dr. Ginsberg regularly prepares educational material for citizens on emerging contaminant issues, such as arsenic in pressure treated wood, the hazards to children from mothballs, and chemicals in children’s products and toys.  He has represented DPH in the media on numerous topics ranging from mercury in fish to chemical spill emergencies. He has also appeared on television shows such as the Dr. Oz Show and had his own radio program covering environmental issues of the day.

The organization’s annual conference, attended by 6,500 toxicologists and 350 exhibitors from across the country, and held in New Orleans last month, honored Ginsberg, who has been employed by DPH for over 20 years and regularly communicates with the legislature, local health departments, the general public and other state agencies on a wide variety of toxic exposure issues.

The recognition comes as Connecticut and the nation mark National Public Health Week, April 4-10.

Conference organizers pointed out that “his dedication to toxicology is evident though his tireless endeavors to educate the public and other health care professionals with accurate and practical knowledge.”  Also noted were his regular contributions to a Yale University blog on toxicology issues, and his website, www.whatstoxic.org, as well as writing on toxicology issues in state and national publications. Dr. Ginsberg evaluates human exposures to chemicals present in the air, water, soil, food, and in the workplace, and provides risk assessment expertise to state agencies in standard setting and site remediation projects.

Dr. Ginsberg was featured in a recent “Wastebusters” video produced by the CT Department of Energy and Environmental Protection and CT DPH on the importance of selecting green cleaning products in schools and homes.  He has drafted numerous fact sheets on chemical hazards in consumer products, such as sun screen and chemicals in hand sanitizers. In 2006, Dr. Ginsberg co-authored a book called “What’s Toxic What’s Not” (Berkeley Books, 2006).

“We are extremely proud of Dr. Ginsberg and congratulate him on this prestigious and well deserved award,” said Ellen Blaschinski, DPH’s Regulatory Services Branch Chief.  “His expertise in toxic exposures and ability to consolidate vast amounts of science into easily digestible, useful information helps protect and inform Connecticut’s citizens.”

A resident of East Granby, Dr. Ginsberg received his PhD from UConn in 1986. In addition to working at DPH, Dr. Ginsberg is an assistant clinical professor at the UConn School of Community Medicine, an adjunct faculty member at Yale University and has served on a number of US EPA advisory committees and on the National Academy of Sciences.

The Society of Toxicology is a professional and scholarly organization of scientists from academic institutions, government, and industry representing the great variety of scientists who practice toxicology in the US and abroad. The Society’s mission is to create a safer and healthier world by advancing the science and increasing the impact of toxicology.

https://youtu.be/l1MIcvoWGMo

Paid Family Medical Leave Has Broad Support in CT, Survey Shows

Eighty-two percent of registered Connecticut voters age 45-plus and a similar majority of voters age 25-plus, 83 percent, support a paid family medical leave plan now being considered by the state legislature, according to a recent survey by AARP Research. The large majority is also present across the ideological spectrum, with 94 percent of registered Democrats, 79 percent of independents and 68 percent of Republicans indicating their support for state paid family medical leave to support Connecticut workers and family caregivers.

One-thousand state voters age 25-plus were asked two questions about the paid family medical initiative, whether they supported such a plan, and whether they would support political candidates who did.

Among the 83 percent over age 45 who said they supported a paid family medical leave plan, 65 percent indicted they strongly supported such a plan, which would give employees an opportunity to contribute to and utilize a limited amount of paid leave from work to care for themselves or a loved one who is recovering from a serious medical condition.

“Connecticut voters overwhelmingly support paid family leave for workers,” said Nora Duncan, AARP CT state director. “We urge lawmakers to give serious consideration to passage of SB 221, An Act Concerning Paid Family and Medical Leave, in the remaining weeks of the 2016 legislative session. Voters are clearly interested in this policy and will make it a part of their considerations at the ballot box this fall.”

Asked if they would support a candidate for state elections who worked to implement a paid family leave plan that included working caregivers, 74 percent indicated their support, with half saying they would strongly support such a candidate. 

SB 221 would create a statewide system of paid family and medical leave for workers needing time off to care for themselves, an ill loved one or a new baby. The system that’s being suggested would be fully funded by employees with no employer contribution. According to The Institute for Women’s Policy Research, the cost to Connecticut employees would be very low at just about one half of one percent of someone’s income.

Nearly half (46 percent) of registered voters in Connecticut ages 45-plus say they are currently providing or have provided unpaid caregiving to an adult loved one.  Among them, two in three (63 percent) say they have been employed either full or part time while providing that care, the survey found.

Versions of paid family medical leave laws have been approved in California, New Jersey, Rhode Island and Washington.  California's law took effect in 2004, New Jersey's in 2009 and Rhode Island's in 2014.  Washington's has yet to take effect.

Indiana Insurance Department to Hold Hearing on Anthem Acquisition of CIGNA on April 29

The Indiana Insurance Department will consider the proposed acquisition of Bloomfield-headquartered CIGNA Health Care by Indianapolis-based Anthem, Inc. at a public hearing on Friday, April 29 in Indianapolis. “Any member of the public interested in the proposed acquisition of control may attend the hearing,” indicates a public notice of the hearing. In addition, “Any policyholder of Cigna HealthCare of Indiana, Inc., or other person whose interests may be affected by the proposed acquisition of control shall have the right to appear and become party to the proceeding.”

Officials indicated that written testimony could be mailed in lieu of an in-person appearance, and would be considered. Members of the public may make written submissions  without appearing in person at the hearing. Length of submissions should not exceed 5 pages, double-spaced. Officials indiated that submissions should be sent to John Murphy, outside counsel to the Commissioner in this matter, by close of business on April 26, 2016. Contact information is: John T. Murphy, ICE MILLER LLP, One American Square, Indianapolis, IN  46282, (317) 236-2292, john.murphy@icemiller.com  [this information was updated on 4/19]

Consumer Groups, State Comptroller Call for Full Review

Among those aligned in opposition to the acquisition is the American Medical Association, noting that the deal would make the combined firm the nation’s largest insurer by membership and also give the company a tremendous amount of leverage when negotiating with providers.  In a press release, AMA President Steven J. Stack, MD, said such proposed mergers threaten to reduce competition and choice. “To give commercial health insurers virtually unlimited power to exert control over an issue as significant and sensitive to patient health care is bad for patients and not good or the nation’s health care system.”

Anthem and CIGNA suggested that the deal will create new efficiencies that will make the healthcare market function more efficiently.  A website, www.betterhealthcaretogether.com, has been established to highlight the companies commitment to “drive health care innovation.”

Last month, a coalition of consumer and medical organizations in Connecticut called for greater public input into the Connecticut Insurance Department’s review of the proposed Anthem-CIGNA  mega-merger, expressing concerns about the potential “negative impact on both the cost and quality of care in Connecticut” of that acquisition and the proposed Aetna-Humana merger. The groups – Universal Health Care Foundation, Connecticut Citizen Action Group and the Connecticut State Medical Society – formed the “Connecticut Campaign for Consumer Choice” coalition and urged state Insurance Commissioner Katherine Wade to “ensure an open, transparent hearing process in Connecticut, where policy holders, physicians and other interested parties are given maximum opportunity to share their views.” The coalition has been conducting public information sessions, including one in Mansfield this week, to provide state residents with information on "what the proposed health care mergers will mean for Connecticut consumers."

A week ago, State Comptroller Kevin Lembo, in a letter to the Department, urged an open and thorough review in order to address significant concerns raised by health care consumers and providers.  Lembo expressed his support for the efforts of the Connecticut Campaign for Consumer Choice, noting that a merger between Anthem and Cigna would increase the Connecticut health insurance concentration over 40 percent.   Lembo indicated that only Georgia is expected to experience a more significant increase in market concentration.

CIGNA Questions Anthem; Feds Question CIGNA

A week ago, Modern Healthcare, a web publication focused on healthcare business news, raised questions about the absence of detail in the year since Anthem disclosed “what was by far the largest data breach in healthcare history.  The cyberattack—in which hackers stole the names, birth dates, Social Security numbers, home addresses and other personal information of 78.8 million current and former members and employees – caused consumers to question “whether Anthem and other healthcare organizations could manage the volumes of data they had,” according to the news report. 

The publication also questioned whether state regulators would consider not only the breach, but CIGNA’s reaction to it at the time:

“Trust with customers and providers is critical in our industry, and Anthem has yet to demonstrate a path towards restoring this trust,” CIGNA CEO David Cordani and former Board Chairman Isaiah Harris Jr. wrote in a June 21, 2015 letter: “We need to understand the litigation and potential liabilities, operational impact and long-term damage to Anthem's franchise as a result of this unprecedented data breach, as well as the governance and controls that resulted in this system failure.”  It was estimated that in Connecticut, about 1.7 million people were affected.

In January, published reports indicated that U.S. regulators temporarily banned CIGNA-HealthSpring from offering certain Medicare plans to new patients after a probe uncovered issues with current offerings, citing that CIGNA’s deficiencies “Create a Serious Threat to Enrollee Health and Safety.”  CIGNA disclosed that the U.S. Centers for Medicare and Medicaid Services (CMS) had suspended the company from enrolling new customers or marketing plans for CIGNA Medicare Advantage and Standalone Prescription Drug Plan Contracts. CIGNA acquired HealthSpring in 2012.

In an enforcement letter, CMS accused CIGNA of "widespread and systemic failures," including the denial of health care coverage and prescription drugs to patients who should have received them. The actions "create a serious threat to enrollee health and safety," said CMS, which required CIGNA to appoint an independent monitor to audit its handling of the matter.

“Cigna has had a longstanding history of non-compliance with CMS requirements. Cigna has received numerous notices of non-compliance, warning letters, and corrective action plans from CMS over the past several years. A number of these notices were for the same violations discovered during the audit, demonstrating that Cigna has not corrected issues of non-compliance,” said the 12-page enforcement letter from the Director of the Medicare Parts C and D Oversight and Enforcement Group.

CIGNA, First in Connecticut

Nearly five years ago, in July 2011, CIGNA announced it was to receive $50 million in economic benefits from the Connecticut Department of Economic and Community Development with the promise of adding at least 200 jobs the following two years, which would increase the company’s employment in the state to more than 4,000.  CIGNA also declared Bloomfield its corporate headquarters in the United States, replacing Philadelphia which had been the company’s corporate headquarters since 1982.

CIGNA was the first company to receive economic incentives under Governor Dannel Malloy’s “First Five” program, which was designed to spur job growth and support Connecticut businesses in becoming more competitive in the global marketplace. “CIGNA is proof that these tools work and that Connecticut is open for business,” Malloy said at the time.

“Through this partnership with the Governor and the state, we are building upon our long history in Connecticut,” added CIGNA Chief Executive Officer David Cordani.

Anthem's application states it has "no current plans or proposals to reduce in any material respect the number of employees employed by the Cigna companies."  The $54 billion merger would increase Anthem's membership from 38 million to 53 million members nationwide.

Approval in Florida, Concerns in California

“There are no meaningful adverse impacts resulting from the acquisition,” Florida’s Insurance Commissioner said last week in approving the acquisition in his state. “The companies, individually or in combination, are an important part of, but not a dominant factor in, the Florida market, and their combination does not noticeably increase the market concentration across the broadly measured market on a statewide basis.”

In California, the combined membership of Anthem Blue Cross and Cigna would make it the largest insurer in the state with more than 8 million members.  At a public hearing in California last month convened by that state’s Insurance Department, consumer advocates and the AMA opposed the acquisition.

"This merger would create the nation's largest insurer, which could have a significant impact on California's consumers, businesses, and the healthcare marketplace," said California’s Insurance Commissioner. "I am considering what is best for consumers and the overall marketplace. Anthem and Cigna bear the burden of demonstrating this proposed merger is in the best interest of California consumers and the health-care marketplace."

Shareholders of Anthem and Cigna voted overwhelmingly in favor of the merger plan late last year, and regulators in 26 states where the companies operate are at various stages of considering the acquisition.  Attorneys General in a number of those states, including Connecticut, are looking into the proposed acquisition on anti-trust grounds, and the U.S. Department of Justice has the final authority to approve the deal, published reports indicate.

The news site Business Insurance reported soon after the acquisition was announced that “viewed in tandem with rival Aetna Inc.'s recent $37 billion merger agreement with Humana Inc.— as well as St. Louis-based health insurer Centene Corp.'s proposed acquisition of Woodland Hills, California-based Health Net Inc. for $6.3 billion — experts said regulators may be more stringent in examining the Anthem/Cigna deal's potential to dampen health insurer competition.”

CT Medical Examining Board Website Ranked 15th in US

If you’re looking for information about your doctor, you may find yourself searching the website of the state medical board.  In states across the country, those are the agencies that license physicians and also discipline them for offenses including sexual misconduct, substance abuse, and negligent care. But the accuracy and completeness of the information you find varies from state to state, according to a new analysis from Consumer Reports, which ranked the Connecticut Medical Examining Board as 15^th in the nation for the information readily available to the public from the agency website.

Consumer Reports Safe Patient Project partnered with the nonprofit Informed Patient Institute to evaluate the websites of state medical boards in all 50 states. They found that most are difficult to navigate and the information on them varies widely.

Overall scores were based on eight categories:  Search Capabilities, Complaint and Board Information, Identifying Doctor Information, Board Disciplinary Actions, Hospital Disciplinary Actions, Federal Disciplinary Actions, Malpractice Payouts and Convictions.

Connecticut, with an overall score of 58, was rated good in four categories, very good in two, and excellent in one category.  Only one category was given a poor rating.

The highest rated state medical board websites were in California (84), New York (79), Massachusetts (78), Illinois (76), North Carolina (76), Virginia (72), New Jersey (70), Florida (70) and Texas (68).

The Federation of State Medical Boards, which represents the boards and facilitates communication among them, acknowledges that variation is a potential issue. “Consistency is certainly a worthy goal,” Lisa Robin, chief advocacy officer for the organization told Consumer Reports. “Looking at the disciplinary trends to make improvements in the system … we would always encourage that.” Still, she also says that, “the rate of discipline alone is probably not a good picture of really what the boards do and how well they’re able to protect patients in their state.”

But, as Consumer Reports’ analysis found, those state boards fall short in other measures, too. In fact, in many instances, physicians who have been severely disciplined continue to practice while their offenses remain relatively hidden, buried deep on the boards' websites or unavailable entirely online.

The Connecticut Medical Examining Board website includes a listing of disciplinary actions taken by the Connecticut Medical Examining Board or the Connecticut Department of Public Health but notes that “information is not intended for licensure verification purposes.”  Actions taken – ranging from reprimands to civil penalties to license suspension or revocation are listed.  Board meeting minutes are also available on the site, as well as procedures for individuals to file complaints.

Gender Identity in Schools Among Topics at Connecticut School Health Issues Conference

The keynote address “When Boys Will be Girls: Getting A Grip on Gender” will greet attendees – school nurses and school health officials from across Connecticut - attending the 38^th Annual School Health Conference on Thursday in Cromwell. “Critical Issues in School Health 2016,” a two-day conference, will have expert presentations on issues ranging from absenteeism to infectious diseases, food allergies to mental health.  But no issue has grown in attention and interest recently than how to respond to LGBT students in the school setting.

The conference is coordinated by the Connecticut chapter of the American Academy of Pediatrics with the assistance of the Association of School Nurses of Connecticut.  

The keynote will be given by Robin McHaelen, MSW, founder and executive director of True Colors, a Hartford-based non-profit organization that works with social service agencies, schools, organizations, and within communities to ensure that the needs of sexual and gender minority youth are both recognized and competently met. McHaelen is co-author of several books and articles on LGBT youth concerns, and has a national reputation as a thought leader in LGBT youth concerns, programs and interventions.

In her presentation, titled “When Pink and Blue Are Not Enough,” McHaelen offers suggestions on working with LGBT students, and seeks to increase “understanding, knowledge and cultural competency regarding LGBT students,” while identifying issues of “risk, challenge and strengths specific to LGBT youth.”  She also will point to “opportunities for intervention that will ensure appropriate care within a safe, affirming environment.”

Among the recommendations:  offer gender-neutral bathroom options, always use the patients’ chosen name and chosen gender pronouns, and “recognize that there are additional stressors (and that there may be significant feat on the part of) transgender patients.” 

McHaelen will be offering a similar presentation at the New England School Nurse Conference, to be held in late April in Mystic, hosted by the Association of School Nurses of Connecticut.  The president of the Association is Suzanne Levasseur, Supervisor of Health Services for the Westport Public Schools.  The New England affiliates include Massachusetts, Vermont, New Hampshire and Maine.  The conference theme is “Waves of Change, Oceans of Opportunity.”

Lesbian, gay, bisexual, and transgender students are the targets of bullying, harrassment, and disproportionately high discipline rates at school, researchers have pointed out. But without consistently collected, reliable, large-scale sources of data, it's difficult to track the extent of those problems or the effectiveness of proposed solutions, a group of researchers at Indiana University said in a briefing paper released this week.

Expanding existing federal surveys on youth safety and well-being to include more questions about gender identity and sexual orientation could provide a clearer picture, according to the researchers, noting that “if you don’t measure it, you can’t improve it.”  They suggest addressing the data gap by adding discipline and harassment items to existing health surveys that currently include measures of sexual orientation and gender identity, such as the Youth Risk Behavior Survey, collected by the Centers for Disease Control and Prevention.

“Although these measures provide more specific information about sexual orientation and in some cases gender identity, they do not provide sufficient information about the specific negative outcomes experienced by LGBT students,” the research paper points out.  They conclude: “the availability of data documenting the experiences of LGBT students is a civil rights concern, and the expansion of data collection efforts to include sexual orientation and gender identity is a critical next step in ensuring the rights of LGBT and all students to participation and protection in school.”

The mission of the Association of School Nurses of Connecticut is to support, assist and enhance the practice of professional school nurses in their development and implementation of comprehensive school health services that promotes students' health and academic success.  The Connecticut Chapter of the American Academy of Pediatrics has over 600 active members committed to both improving the health and safety of Connecticut's children and supporting those who provide care to these children.

Survey Says: Parents Don't Trust On-line Doctor Ratings, But Use Them

As the annual observance of National Doctors’ Day approaches this week, a new national survey indicates that nearly one-third (30%) of parents report looking at online doctor ratings for themselves or a family member in the past year, with mothers (36%) more likely than fathers (22%) to visit such sites. Among these parents, two-thirds say they selected or avoided a doctor based on the ratings they viewed. Among parents who choose doctors based on the ratings, most (87%) say the online ratings accurately reflect their experience with the doctor. The survey was conducted for C.S. Mott Children’s Hospital at the University of Michigan.

The survey also found, however, that a majority of parents have concerns about doctor rating websites in general. About two-thirds of parents believe some ratings may be fake; slightly fewer feel there are not enough ratings on the websites to make a good decision. More than half of parents feel doctors may influence who leaves ratings. Among parents in this survey who had ever left an online rating about a doctor (11% overall), nearly one-third (30%) reported that the doctor or office staff had asked them to do so.

National Doctors’ Day was established to recognize physicians, their work, and their contributions to society and the community. National Doctors’ Day is observed on March 30 each year.  The holiday was officially signed into U.S. law in the early 1990s by President George H. W. Bush, although since the early 1930s patients and healthcare organizations across the country have been celebrating their physicians on this day.

In the on-line ratings survey, older parents generally had more concerns than younger parents. Of parents age 30 and older, 71 percent were concerned about the possibility of fake reviews compared to 59 percent of parents under age 30. Older parents (65%) also were more concerned about the low number of ratings compared to younger parents (55%).

The survey analysis pointed out that “while the use of online physician rating sites is expected to keep rising, their growth may be limited by concerns from parents about accuracy and authenticity.”

In recognition of National Doctors’ Day, Connecticut Children’s Medical Center in Hartford has urged patients to post a message to their doctor, and many of the messages have been displayed on the hospital’s web site.  Other organizations around the state also take note of the contributions of physicians to the well-being of the population.

Legislature to Examine Why Zero Convictions for Human Trafficking, Even As Incidents Increase in CT

Human trafficking is a form of modern-day slavery. This crime occurs when a trafficker uses force, fraud or coercion to control another person for the purpose of engaging in commercial sex acts or soliciting labor or services against his/her will.  It is happening in Connecticut. Connecticut’s Permanent Commission on the Status of Women (PCSW) is convening a Joint Informational Forum with the state legislature’s Judiciary, Public Safety and Security, and Children’s Committees on Thursday, March 31 at the Legislative Office Building to examine the issue, the response of law enforcement and other agencies in Connecticut, and where changes in state law need to be made.

A decade ago, in 2006, Connecticut enacted Public Act 06-43, which created the felony charge of trafficking in persons.

“And yet, since then, only 10 arrests have been made and there have been no convictions,” according to PCSW, which noted that during that same time, the Department of Children and Families has received more than 400 referrals of individuals with high-risk indicators for human trafficking that demanded a collaborative response, including the participation of law enforcement.  Those numbers have climbed each year, with 133 referrals in 2015, according to the Governor’s office. 

“We decided to convene trafficking experts because, as we learn more about human trafficking, in particular sex trafficking of adults and minors, we need to ensure that victims are supported and that law enforcement and prosecutors have the tools to adequately punish traffickers, those buying sex, and those permitting and facilitating the sale of sex in Connecticut,” said Jillian Gilchrest, senior policy analyst for the PCSW, and chair of the state's Trafficking in Persons Council.

“Although the legislature has made great strides to increase awareness and enhance training programs against human trafficking, and especially the sex trafficking of minors – the truth is that this modern-day slavery is a national issue,” said State Rep. Noreen Kokoruda, the ranking member of the General Assembly’s Committee on Children. “Connecticut must take the critical steps necessary to combat human trafficking and to make sure that the legislation we passed is enforced. In order to proactively address this issue, we need a collaborative effort from all agencies; this issue is simply too important to ignore.”

Data from the National Human Trafficking Resource Center (NHTRC) indicates that in 2015 there were 120 calls made and 39 human trafficking cases reported in Connecticut – the highest numbers in the past three years. The statistics are based on phone calls, emails, and webforms received by the NHTRC that reference Connecticut. The NHTRC works with service providers, law enforcement, and other professionals in Connecticut to serve victims and survivors of trafficking, respond to human trafficking cases, and share information and resources.

Since 2007, the NHTRC has received more than 600 calls to their hotline that reference Connecticut.  As Connecticut’s felony crime of trafficking in persons, Connecticut Statute §53a-192a approaches its 10-year- anniversary, members of the Judiciary, Public Safety, and Children’s Committees are interested in understanding why no one has been convicted under §53a-192a and what policy or legislative changes can help remove current barriers to prosecution in these cases, officials said.

In Connecticut, a person is guilty of trafficking in persons when such person compels or induces another person to engage in sexual contact or provide labor or services by means of force, threat of force, fraud or coercion. Anyone under the age of 18 engaged in commercial sexual exploitation is deemed a victim of domestic minor sex trafficking irrespective of the use of force, threat of force, fraud or coercion.

In a January report to the state legislature, the Trafficking in Persons Council pointed out that “Connecticut is not unique; there are many states that have yet to prosecute a trafficking case. In fact, according to the U.S. Department of State, as of 2011 only 18 states brought forward human trafficking cases under state human trafficking statutes.”

A series of proposals are now being considered by the state legislature.  In recent testimony, the PCSW pointed out that “the demand side of human trafficking and prostitution has all but been ignored in Connecticut. Arrests have been concentrated first on prostitutes, and secondarily on those buying sex. In fact, in the last 10 years in Connecticut, prostitutes were convicted at a rate of 7 times that of those charged with patronizing a prostitute It’s a basic premise of supply and demand: if you reduce the demand, you reduce the supply, which in this case, is the purchase of women and children for sex.”

In legislative testimony last month, the PCSW pointed out that “more and more trafficking and prostitution are being arranged online and taking place at hotels and motels throughout Connecticut. According to the National Human Trafficking Resource Center (NHTRC), Hotels and Motels are among the top venues for sex trafficking in Connecticut.”  PCSW stressed that “as we learn more about human trafficking, and what the crime looks like in Connecticut, we must ensure that our policies keep pace with that reality.”  Among the proposals is one designed to “give more tools to investigators,” Gov. Malloy and Lt. Gov. Wyman recently told a legislative committee.

The Trafficking in Persons (TIP) Council is chaired and convened by the Permanent Commission on the Status of Women and consists of representatives from State agencies, the Judicial Branch, law enforcement, motor transport and community-based organizations that work with victims of sexual and domestic violence, immigrants, and refugees, and address behavioral health needs, social justice, and human rights.

The report recommended that “Connecticut must ensure the creation of laws that address the continuum of exploitation, the implementation of laws, and the pursuit of criminal punishments for such cases. Sentences should take into account the severity of an individual’s involvement in trafficking, imposed sentences for related crimes, and the judiciary’s right to impose punishments consistent with its laws.”

Regarding victims of trafficking in Connecticut, the report recommended that “Key victim protection efforts include 3 "Rs" - rescue, rehabilitation, and reintegration. It is important that human trafficking victims are provided access to health care, counseling, legal and shelter services in ways that are not prejudicial to victims’ rights, dignity, or psychological well-being. Effective partnerships between law enforcement and service providers mean victims feel protected and such partnerships help to facilitate participation in criminal justice and civil proceedings.”

According to Rep. Rosa C. Rebimbas, ranking member of the Judiciary Committee, “Connecticut has made great strides to protect vulnerable women and children with strong laws against human trafficking, and resources to help them escape from the horrors of human trafficking, yet we are still behind when it comes to prosecution of the criminals who perpetrate such heinous offenses. We will continue to press for stronger laws to protect Connecticut residents, and to bring justice on their behalf.”

Coalition Calls for Public Input, Comprehensive Analysis, Greater Scrutiny of Cigna-Anthem Merger

A coalition of consumer and medical organizations is calling for greater public input into the Connecticut Insurance Department’s review of the proposed Anthem-Cigna health insurance mega-merger, and is expressing concerns about the potential “negative impact on both the cost and quality of care in Connecticut” of that merger and the proposed Aetna-Humana merger. The groups – Universal Health Care Foundation, Connecticut Citizen Action Group and the Connecticut State Medical Society – formed the “Connecticut Campaign for Consumer Choice” coalition and urged state Insurance Commissioner Katherine Wade to “ensure an open, transparent hearing process in Connecticut, where policy holders, physicians and other interested parties are given maximum opportunity to share their views.”

In a letter to Wade, the organizations urged a series of actions as part of the Anthem-Cigna review “to protect our health care options in Connecticut” – that a public hearing be held at a time and place that “allows for maximum public participation,” that interested parties be granted intervenor status (which would allow witnesses to be called and cross examined), and that a department commission a study that will “analyze the potential impact on cost, access, and the Connecticut economy, including jobs,” as part of the agency’s deliberations on the merger proposal. 

Bloomfield-based Cigna and Indianapolis-based Anthem are two of the nation’s five largest health insurance companies.  It is anticipated that a hearing would be held sometime this spring, but plans have not yet been announced. The coalition leaders indicated that “all eyes from around the country will be on Connecticut,” as home of two of the nation’s leading health insurance companies.

They also launched a new website, www.consumerchoicect.org, which will provide the public with information about the proposed mergers.  The site states that “what’s really happening is that fewer choices mean higher costs for consumers and employers. With fewer insurers for the remaining three national companies to compete against, there will be less of an incentive to keep costs low or develop innovative services to bring in new customers.”

Connecticut Insurance Department spokeswoman Donna Tommelleo said the department "is reviewing the proposed acquisition in accordance with all applicable  Insurance Holding Company Statutes. The Form A application is posted on Home Page of the Department’s Web site for public view and the site is updated frequently as more documents are filed. After the application is fully reviewed and deemed complete by the Department there will be public hearing held within 30 days. The public will be given ample opportunity to provide both written and oral comment."  She indicated that "the Department respects the coalition’s interest in the matter.” The Anthem-CIGNA merger was filed with the state Insurance Department last September.

In advocating for the merger, Anthem has established a website that highlights the company’s views on the benefits of a merged company, at www.betterhealthcaretogether.com  The site indicates that “the combined companies will operate more efficiently to reduce operational costs and, at the same time, further our ability to manage what drives costs, helping to create more affordable health care for consumers.”

Matthew Katz, executive director of the Connecticut State Medical Society, said that the merger “could be the demise of already struggling private practices,” and will adversely impact patient costs and access to care.  "Goliaths will not  benefit consumer choice," he said.   The Society opposes the merger, as do the other organizations in the coalition.  They indicated that a fair, open, transparent review process would make it more difficult for the merger to be approved as being in the public interest.

Noting that Wade serves as chair of the National Association of Insurance Commissioners working group on the Anthem-Cigna mercer, and that the working group’s proceedings are not open to the public, the coalition leaders stressed the importance of an open and comprehensive process in Connecticut.

The letter to Commissioner Wade, dated March 22, was signed by Frances Padilla, president of the Universal Health Care Foundation of Connecticut, Tom Swan, executive director of the Connecticut Citizen Action Group, and Matthew Katz, Chief Executive Officer of the Connecticut State Medical Society.

The Connecticut State Medical Society is a federation of eight component county medical associations, with total membership exceeding some 7,000 physicians. Universal Health Care Foundation of Connecticut is an independent, non-profit philanthropy, supporting research-based policy, advocacy and public education that “advances the achievement of quality, affordable health care for everyone in the state.”  CCAG, founded four decades ago by consumer advocate Ralph Nader,  has "created change on the issues members care about including quality, affordable health care, protection of consumers, the environment, and democracy."

Combatting Childhood Obesity Starts From Day One; Wide-Ranging Policies Proposed

Less “screen time,” more physical activity, more nutritional foods and fewer sugary beverages – that’s the formula to prevent obesity from taking root in infants and toddlers in the formative years of childhood, according to new recommendations by the Child Health Development Institute (CHDI) of Connecticut.  A series of “science-based policy opportunities” for Connecticut, outlined this week, also include support for breastfeeding in hospitals and child care centers. The need for stronger action is underscored by recent statistics.  In Connecticut, one of every three kindergartners is overweight or obese, as is one of every three low-income children. Children who are overweight or obese are more likely, according to the policy brief, to have:

• risk factors for future heart disease, such as high cholesterol and high blood pressure
• a warning sign for type 2 diabetes called “abnormal glucose tolerance,” although many children are being diagnosed with the full-blown disease in increasing numbers
• breathing problems such as asthma
• gallstones, fatty liver disease, and gastroesophageal reflux (acid reflux and heartburn)
• problems with their joints

“Recent research shows that obesity may be very difficult to reverse if children are not at a healthy weight by 5 years of age,” the policy brief indicated. “Investing early in preventing childhood obesity yields benefits for all of us down the line by fostering healthier children, a healthier population overall and greatly reducing obesity-related health care costs over time.”

The policy brief recommends five ways Connecticut’s child care settings and hospitals can help our youngest children grow up at a healthy weight:

1. Support breastfeeding in hospitals and in child care centers and group child care homes.
2. Serve only healthy beverages in all child care settings.
3. Help child care centers and group child care homes follow good nutrition guidelines.
4. Increase physical activity time for infants and toddlers in all child care settings.
5. Protect infants and toddlers in all child care settings from “screen time.”

The recommendations stress that “talking, playing, singing and interacting with people promotes brain development and encourages physical activity,” and urges that healthy infant and toddler development be encouraged by:

• Never placing them in front of televisions, computers, or tablets to occupy them
• Never allowing infants and toddlers to passively watch a television, computer, mobile phone or other screen that older children in the same room are watching

“Healthy lifelong weight begins at birth,” said Judith Meyers, President and CEO of CHDI and its parent organization the Children’s Fund of Connecticut. “Investing in obesity prevention policies makes sense for Connecticut.”  Meyers added that “the numbers are staggering,” and it has become clear that “to really address this problem we need to prevent it in the first place.”

If Connecticut were to implement the five recommendations highlighted in the policy brief, it would be the first state in the nation to do so, officials said.  A number of the proposals have been successfully implemented in other jurisdictions, including states and cities.  Marlene Schwartz, Director of UConn's Rudd Center for Food Policy and Obesity, noted that Connecticut has long been a leader in providing nutritional lunches in schools, and said that now the state’s attention needs to move to the earlier years of childhood.  “The field has realized that we need to start even earlier,” she said.  Rudd also indicated that determining "policy changes that might help reduce the disparities" in Connecticut, which are apparent in race, ethnicity and socioeconomic data, is also essential.

Legislation now pending at the State Capitol, which is not as comprehensive as the policy brief recommendations, is designed to "increase the physical health of children by prohibiting or limiting the serving of sweetened beverages in child care settings, prohibiting children's access to certain electronic devices in child care settings, and increasing children's participation in daily exercise."  The proposed legislation, HB 5303, was recently approved by a 10-3 vote in the Committee on Children, but has an uncertain future before the full legislature.

Dealing with childhood obesity has been a challenge because of the “many different systems and programs that impact childhood development – which can also provide “many different places for opportunities to influence what happens.”  Officials said that some of the policy proposals can be realized through legislative action, others by regulatory changes, and others through voluntary initiatives.  They indicated that since Connecticut established the Office of Early Childhood in recent years, coordination of oversight and services has improved, which is an encouraging development.  Child care settings provide an opportunity to impact a large proportion of the state’s pre-kindergarten children, but plans to disseminate the message more broadly, including through pediatrician’s offices, are being considered. 

The recommendations call for “allowing toddlers 60-90 minutes during an 8-hour day for moderate to vigorous physical activity, including running, and “adherence to federal nutrition guidelines” including more whole grains and low-sugar cereals, no sugary drinks, and fewer fried foods and high-sodium foods.  Through 11 months, infants should be served “no beverages other than breast milk or infant formula, and those 12 months through 2 years old should be served no beverages other than breast milk, unflavored full-fat milk water, and no more than 4 ounces of 100% fruit juice.”

The CHDI policy brief indicates that “childhood obesity can contribute to poor social and emotional health because overweight and obese children are often bullied and rejected by their peers as a result of their weight. That stress can affect every part of their development, interfering with their learning (cognitive), health (physical and mental), and social well-being.”

The recommendations, described as “affordable, achievable, common sense measures,” were prepared for CHDI as part of a grant to the UConn Rudd Center for Food Policy and Obesity, funded by the Children’s Fund of Connecticut.  The author was public health policy consultant Roberta R. Friedman, ScM.

CHDI began focusing on strategies to promote healthy weight in children from birth to age two after publishing the IMPACT “Preventing Childhood Obesity: Maternal-Child Life Course Approach” in 2014. The report reviewed scientific research on the causes of obesity and explored implications for prevention and early intervention. In 2015, the Children’s Fund of Connecticut funded four obesity prevention projects in Connecticut that addressed health messaging, data development, policy development and baby-friendly hospitals.