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.

Financial Cost to Connecticut Smokers Among Highest in the Nation

The financial cost of smoking in Connecticut is higher than just about anywhere in the United States.  The total cost over a lifetime per smoker is $2,183,204, the third highest in the nation, and the annual cost per year per smoker of $42,808, is also third highest in the nation, just behind New York and Massachusetts. The lifetime health care cost per smoker, $274,272 in Connecticut, is higher than every state but one, (Massachusetts), and the out-of-pocket cost per smoking individual of $170,513 for smokers living in Connecticut is third highest in the nation.

The data was compiled by the financial website WalletHub, where analysts calculated the potential monetary losses — including the cumulative cost of a cigarette pack per day over several decades, health-care expenditures, income losses and other costs — brought on by smoking and exposure to secondhand smoke. 

Emphasizing that “the negative physical and financial effects of smoking can be significant,” WalletHub noted that Connecticut’s rankings placed it as among the most costly in every category.

Over a lifetime, the financial opportunity cost for smokers living in Connecticut was $1.436,335 and the income loss per smoker was calculated at $286,950.  Other costs per smoker, such as not being able to qualify for homeowner’s insurance discounts for non-smokers, were $15,133.  In each instance, the costs in Connecticut were among the three highest among the 50 states and District of Columbia.

Annual income loss for Connecticut smokers is calculated at $5,626.  Only Maryland, Alaska, New Jersey and D.C. were higher, according to the analysis. Attributable factors included absenteeism, workplace bias or lower productivity due to smoking-induced health problems.  The website also noted that according to a recent study from the Federal Reserve Bank of Atlanta, smokers earn 20 percent less than nonsmokers, 8 percent of which is attributed to smoking and 12 percent to other factors.

For the calculations, WalletHub assumed an adult who smokes one pack of cigarettes per day beginning at age 18, when a person can legally purchase tobacco products in the U.S., and a lifespan thereafter of 51 years, taking into account that 69 is the average age at which a smoker dies. Data used in developing the ranking were collected from the U.S. Census Bureau, Bureau of Labor Statistics, Centers for Disease Control and Prevention, Insurance Information Institute, NYsmokefree.com, Federal Reserve Economic Data (FRED), Kaiser Family Foundation and the Independent Insurance Agents & Brokers of America.

In 2016, the American Lung Association gave Connecticut an “F” grade in its spending of tobacco prevention and control funds.  The ALA points out that 40 states and Washington D.C. spend less than half of what the Centers for Disease Control and Prevention recommends on their state tobacco prevention programs.  Overall, states spend less than two cents of every dollar they get from tobacco settlement payments and tobacco taxes to fight tobacco use.  Each day, more than 2,600 kids under 18 try their first cigarette and about 600 kids become new, regular smokers, according to nationwide data from ALA.

A report on Connecticut's spending on tobacco prevention just over a year ago found that the state was being outspent over 67 times by tobacco companies' marketing efforts - due in large part to the state spending only a small portion of tobacco settlement funds on anti-smoking efforts.

The report, “Broken Promises to our Children: A State-by-State Look at the 1998 State Tobacco Settlement 17 Years Later," said the state was spending $1.2 million in FY 2016 to fight tobacco use. That's compared to an estimated marketing investment of $80.4 million by tobacco companies in Connecticut that year. The national average shows a margin of 20.1 to 1.  At that time, Connecticut ranked 38th in spending on a percentage basis.  The state has consistently spend less than the CDC has recommended.

The annual report was developed by the Campaign for Tobacco-Free Kids (CTFK), a coalition that includes the American Heart Association, the American Cancer Society Cancer Action Network, the American Lung Association, the Robert Wood Johnson Foundation, Americans for Nonsmokers’ Rights, and the Truth Initiative.

A year later, the next report ranked Connecticut last, as Connecticut’s projected spending on smoke cessation and tobacco prevention efforts for FY 2017 dropped to zero.  The report found that 13.5 percent of adult state residents are smokers, and 10.3 percent of high school students smoke.  Just under 5,000 deaths each year are caused by smoking in Connecticut, and 27 percent of cancer deaths are attributable to smoking.  Connecticut’s cigarette excise tax, $3.90 per pack, is the second highest in the nation. It was estimated that the state would collect $519.7 million in revenue this year from the 1998 state tobacco settlement and tobacco taxes, but will spend none of it on tobacco prevention programs.

CT Council Urges Change in Focus to Combat Human Trafficking in State

Recognizing that the sex industry – especially when it involves underage children – is a form of human trafficking, the Connecticut Trafficking in Persons Council (TIP) is making several legislative recommendations aimed at shifting the onus for the crime of prostitution from the prostitute to “the demand side” – the buyers of sex. On National Human Trafficking Awareness Day, the TIP Council released its Annual Report and recommendations for the state legislature, and launched a new initiative and website, www.enddemandct.org.

“Conversations about sex trafficking almost exclusively disregard the role of the individual buying sex—the ‘john,’” says Jillian Gilchrest, chair of Connecticut’s Trafficking in Persons Council and Director of Health Professional Outreach at the Connecticut Coalition Against Domestic Violence. “The sex trafficking of Connecticut’s women, men, and children is driven by demand for the commercial sex acts they perform. Put simply, without ‘buyers’ to purchase sex there would be no sex-for-pay industry. So, we are embarking on an ‘End Demand’ campaign to bring much needed attention to those buying sex who create the demand that fuels sex trafficking.”

The TIP report questions why, since Connecticut enacted the felony crime of patronizing sex from a minor in 2013, there have been no arrests or convictions for the felony. Significantly, DCF has seen an increase in the trafficking of children; currently, there are 456 referrals for children at high risk of trafficking.

The report also calls on Connecticut lawmakers, state agencies, and advocates to work together to better understand the demand side of sex trafficking in order to effectively prevent this crime from happening. This begins, the report explains, with creating awareness, since more often than not, those buying sex are left out of conversations about human trafficking. With the use of social media, traditional media, and advertising, the TIP Council indicated it aims to raise public awareness about the individuals in our state who choose to pay to sexually abuse children and exploited individuals.

The report indicates that law enforcement and State’s prosecutors argue that those buying sex with children and exploited adults can be charged with other crimes, such as sexual assault in the second degree or risk of injury. The Council will be looking into this, the report notes, to better understand if buyers of sex are being arrested, and if not, why.

In addition, the report outlined that with over 100 members, the Department of Children and Families (DCF) Human Anti-trafficking Response Team (HART) comprises multi-department, multiagency partners, various levels of law enforcement, the provider community, faith-based network, among others. In 2015, DCF received 133 referrals of youth who were at risk or confirmed victims of human trafficking. As of September 2016, DCF has received 151 referrals of youth who were at risk or confirmed victims of human trafficking, the report indicated.

Tammy Sneed, Director of Gender Responsive Adolescent Services at Department of Children and Families and co-chair of DCF’s Human Anti-Trafficking Response Team, said: “Reports of children suspected to be victims of domestic minor sex trafficking are increasing every year -- and, in 2016, there were just under 200 such referrals. For every child victim, the number of buyers on a given day in Connecticut is unfathomable. Some children report 10 to 15 buyers per night, which leads us to estimate that a minimum of 2,000 buyers in Connecticut bought sex from children last year.”

In the report, the Council recommends:

• the Connecticut Sentencing Commission, Special Committee on Sex Offender, Subcommittee on Sex Offender Sentencing consider whether to include 53a-192a. Trafficking in persons and 53a-83(c), Patronizing a prostitute when such other person is under the age of 18, to the Registration of Sex Offender statutes;
• further discussion and inquiry on why there have not been any convictions under Sec. 53a-83(c), Patronizing a prostitute under the age of 18, effective 2013;
• further discussion on increasing the penalty for Sec. 53a-83(c), patronizing a prostitute under the age of 18, to align with similar sexual crimes against children; and
• further discussion on revising Sec. 53a-192a, Trafficking in persons, to include recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act and increasing penalties to recognize the severity of the crime.

The Trafficking in Persons (TIP) Council is convened by the Commission on Women, Children and Seniors and chaired by the Connecticut Coalition Against Domestic Violence (CCADV). The Council was formerly run by the Permanent Commission on the Status of Women. The council consists of members from a diversity of backgrounds, including representatives from state agencies, the judicial branch, law enforcement, motor transport and community based organizations that work with victims of sexual and domestic violence and immigrants and refugees, and address behavioral health needs and social justice and human rights.

“Demand keeps sexual exploitation and trafficking profitable,” says Beth Hamilton, associate director of the Alliance to End Sexual Violence (formerly CONNSACS). “We’ve started seeing the criminal justice system hold traffickers responsible, but we do not often see the people who purchase sex being held accountable for their role in keeping the industry thriving.  If we want to end commercial sexual exploitation, we need to focus on ending demand and creating survivor-centered services.”

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.

The report points out that “For many people, sex and labor trafficking bring visions of foreign places and people, but this idea is false. In reality, sex and labor trafficking are happening in the state, to Connecticut residents.”

CT Playing Catch-up to Other States in Reducing Childhood Obesity

Although Connecticut has fared comparatively well to other states in adult obesity rates, the state does “not do as well for children, especially low-income children,” according to two new national reports, the Child Health and Development Institute (CHDI) of Connecticut indicates in the organization’s latest issue brief. “Preventing children from being overweight or obese requires action in the earliest years since experts agree that reversing these trends later in life can be very difficult,” CHDI points out. “It is currently estimated that one in four children are overweight or obese by the time they enter kindergarten.

The reports highlight how Connecticut is doing relative to other states on early childhood obesity prevention. Data for low-income children was drawn from families participating in the federal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

The Trust for America’s Health and Robert Wood Johnson Foundation’s State of Obesity in America report shows that Connecticut ranks:

• 12th out of 50 states for highest WIC obesity rates (low-income children ages 2-4 years old)
• 27th out of 37 states for highest adolescent obesity rates (students grades 9-12) Mississippi high schoolers have the highest obesity rate in US: 18.9%. Montana the lowest: 10.3% Connecticut is 12.3%
• 42nd out of 50 states for highest adult obesity rates (18 and older)

A new report from the Centers for Disease Control (CDC), Early Care and Education State Indicator Report, tracks state policies aimed at preventing obesity in child care settings and shows that Connecticut is missing opportunities to address healthy nutrition in early childhood and education settings (ECE).

The 2016 report examines 15 data indicators including, assessing each state’s licensing regulations for high impact obesity prevention standards. Connecticut only had 2 out of 47 obesity prevention standards in State licensing regulations for early care and education programs and lacked ECE professional development training on obesity prevention that 42 other states offer.

CHDI explains that since 2014, Connecticut state agencies have started to address early childhood nutrition through licensing and training. The State is currently in the process of reviewing Early Childhood Education (ECE) licensing regulations, and has developed general training for some early childhood providers on nutrition and fitness.

Additionally, the Department of Public Health offers training to ECE providers via funding through the Centers for Disease Control and is working with the Connecticut State Department of Education (SDE), Office of Early Childhood (OEC), and the UConn Rudd Center for Food Policy and Obesity to enhance professional development training focused on obesity prevention.

“Despite this progress,” the CHDI stresses, “more needs to be done to catch up with other states and reduce obesity rates among young children.” CHDI adds that “Connecticut must look at best practice standards related to early childhood obesity prevention and do better for our children to ensure that they grow at a healthy weight.”

Connecticut now has the 10th lowest adult obesity rate in the nation, according to The State of Obesity: Better Policies for a Healthier America released September 2016. Connecticut's adult obesity rate is currently 25.3 percent, up from 16.0 percent in 2000 and from 10.4 percent in 1990.

CT’s Mortality Rate from Drug Poisoning is 11th Highest in US; Was 6th Lowest A Decade Ago

Connecticut’s mortality rate from firearms is less than half the national average, the state’s homicide rate is slightly above half the national average, but the rate of drug poisoning deaths exceeds the national average. Data from the Centers for Disease Control and Prevention (CDC) indicate that Connecticut’s mortality rate from drug poisoning was 17.6 per 100,000 population, with 623 deaths in the state in 2014, the 19^th highest rate in the nation.  The U.S. rate that year was 14.7, with 47,055 fatalities.  Last year, Connecticut’s mortality rate from drug poisoning climbed to 22.1, which was the 11^th highest rate in the nation, with 800 deaths. 

The states with the highest drug poisoning mortality rates in the nation in 2015 were West Virginia, New Hampshire, Kentucky, Ohio, Rhode Island, Pennsylvania, Massachusetts, New Mexico, Utah, Tennessee and Connecticut.  The lowest rates were in Nebraska, South Dakota, North Dakota, Texas and Iowa.

The CDC reported this month that opioids—prescription and illicit—are the main driver of drug overdose deaths. Opioids were involved in 33,091 deaths in 2015, and opioid overdoses have quadrupled since 1999.

In 2015, according to the CDC, 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.

The five states with the highest rates of death due to drug overdose were West Virginia (41.5 per 100,000), New Hampshire (34.3 per 100,000), Kentucky (29.9 per 100,000), Ohio (29.9 per 100,000), and Rhode Island (28.2 per 100,000).

The increase in drug overdose deaths in Connecticut from 2014 to 2015 was 25.2 percent, the fourth highest in the nation among states that had a statistically significant increase.  Only Massachusetts, New Hampshire and Maine had larger increases.

Among the 28 states meeting inclusion criteria for state-level analyses, 16 (57.1%) experienced increases in death rates involving synthetic opioids other than methadone, and 11 (39.3%) experienced increases in heroin death rates from 2014 to 2015, the CDC reported.

The largest absolute rate change in deaths from synthetic opioids other than methadone occurred in Massachusetts, New Hampshire, Ohio, Rhode Island and West Virginia. The largest percentage increases in rates occurred in New York (135.7%), Connecticut (125.9%) and Illinois (120%).

Connecticut, Massachusetts, Ohio, and West Virginia experienced the largest absolute rate changes in heroin deaths, while the largest percentage increases in rates occurred in South Carolina (57.1%), North Carolina (46.4%), and Tennessee (43.5).

Connecticut announced a detailed opiate response initiative this fall.  The Connecticut Opioid REsponse Initiative (CORE) is a strategic plan from Yale experts in response to the state’s opioid and overdose epidemics. It recommends: 1) expanding access to effective, medication-based treatment for substance use disorders; 2) improving transitions within the treatment domain; 3) increasing the availability of naloxone — the antidote to reverse an opioid overdose — and; 4) decreasing the over-prescribing of opioid at high doses or in combination with sedatives.

The CDC said “there is an urgent need for a multifaceted, collaborative public health and law enforcement approach to the opioid epidemic;” the Drug Enforcement Administration referred to prescription drugs, heroin, and fentanyl as the most significant drug-related threats to the United States, the CDC reported.

Connecticut Opioid REsponse Initiative (CORE) news conference, 10/6/16

https://youtu.be/fqw-AXvsL_8

Lead Poisoning Is A Problem for Connecticut Children, National Study Reveals

A Reuters news service examination of lead testing results across the country found almost 3,000 areas with poisoning rates far higher than in Flint, Michigan, which was the focus of national attention this year for its dangerously tainted water supply. The review and analysis found at least seven areas in Connecticut, based on zip code geography, where the percentage of children found to have elevated lead levels exceeded – more than doubled – the percentage in Flint.

The Centers for Disease Control and Prevention (CDC) estimates that nationwide, around 2.5 percent of children ages 0-6 have an elevated lead level, defined as 5 micrograms/deciliter or higher. Among small children tested in Flint, Michigan during the peak of that city’s lead contamination crisis, 5 percent had elevated levels, or double the average.

In many neighborhoods – census tracts or zip code areas – across the country, a far higher rate of children have tested high in recent years.  The zip codes in Connecticut with elevated lead levels in more than 5 percent of children tested include more than a dozen neighborhoods and communities scattered across the state, with the highest levels  in the towns of Canaan and Sharon, and the cities of Bridgeport, New Haven, and Waterbury.

The State Department of Public Health website indicates that “childhood lead poisoning is the most common pediatric public health problem, yet it is entirely preventable. Once a child has been poisoned, the impairment it may cause is irreversible. Lead harms children’s nervous systems and is associated with reduced IQ, behavioral problems, and learning disabilities.”

Since the 1970s, U.S. efforts to eradicate childhood lead poisoning have made what Reuters describes as “remarkable progress,” while pointing out that “the advances have been uneven.”  Legacy lead – in paint, plumbing, yards, well-water or even playgrounds – means that kids in many neighborhoods remain at a disproportionately high risk of poisoning, the news service report explained.

The news service conducted a nationwide analysis of childhood blood lead testing data at the neighborhood level. Census tract or zip code level data reflecting the local prevalence of elevated lead tests was obtained from 21 states, including Connecticut.  The highest prevalence was found in:

Zip Code                              Tested Children /Elevated Results

06031 Canaan                    107 / 15.89%

06608 Bridgeport            8,602 / 13.32%

06511 New Haven            15,731/12.88%

06519 New Haven            8,318 / 11.95%

06607 Bridgeport             4,079/10.9%

06710 Waterbury             6,133/ 10.48%

06069    Sharon                  137 /10.22%

Across the country, Reuters found nearly 3,000 areas with recently recorded lead poisoning rates at least double those in Flint during the peak of that city’s contamination crisis. And more than 1,100 of these communities had a rate of elevated blood tests at least four times higher.

Reuters reports that zip codes have average populations of 7,500. In each area, a relatively small number of children are screened for lead poisoning each year, the report indicated.

The poisoned places stretch from Warren, Pennsylvania, a town on the Allegheny River where 36 percent of children tested had high lead levels, to a zip code on Goat Island, Texas, where a quarter of tests showed poisoning, the Reuters analysis indicated. In some pockets of Baltimore, Cleveland and Philadelphia, where lead poisoning has spanned generations, the rate of elevated tests over the last decade was 40 to 50 percent.

“I hope this data spurs questions from the public to community leaders who can make changes,” said epidemiologist Robert Walker, co-chair of the CDC’s Lead Content Work Group, which analyzes lead poisoning nationwide. “I would think that it would turn some heads.”

The findings, Walker told Reuters, will help inform the public about risks in their own neighborhoods and allow health officials to seek lead abatement grants in the most dangerous spots.

Congress recently directed $170 million in aid to Flint - 10 times the CDC’s budget for assisting states with lead poisoning this year, Reuters reported.

Efforts Forge Awareness From Tragedy, As CT Nonprofit Stresses Fire Safety

Jeff Block founded One Innocent Life, a Connecticut-based nonprofit organization, 18 months ago while battling for a new state law to improve Connecticut fire safety standards. He has been campaigning for fire safety in Connecticut homes since 2012, when his daughter, Eva, of Woodbridge, and two friends, died in a fire in their off-campus housing at Marist College in upstate New York on January 21st.  Approximately 66 percent of students attending college in the U.S. live in off-campus housing, according to the Center for Campus Fire Safety Student Committee.

His efforts led to legislation in Connecticut, but One Innocent Life is continuing to advocate for greater awareness, in Connecticut and beyond, on campuses and in local communities.

According to the National Fire Protection Association, U.S. fire departments responded to an estimated annual average of 3,870 structure fires in dormitories, fraternities, sororities, and barracks between 2009 and 2013.  From 2000 - 2015, 89 fires that killed 126 people have occurred on a college campus, in Greek housing or in off-campus housing within three miles of the campus. Of these, 76 off-campus fires caused 107 deaths, while 7 on-campus building or residence hall fires claimed 9 victims and 6 fires in Greek housing took the lives of 10 people.

Public Act 15-5, approved by the Connecticut legislature in the June 2015 Special Session, took effect on October 1, 2015.  The law requires landlords to include a notice in each dwelling unit's lease disclosing whether the unit has a working fire sprinkler system. If a unit has a working system, the lease must also include a notice indicating the date of its last maintenance and inspection. Both notices must be printed in a uniform font of at least 12-point, boldface type.

Under the state law, a “fire sprinkler system” is a system of piping and appurtenances designed and installed according to generally accepted standards so that heat from a fire automatically causes water to discharge over the area, extinguishing the fire or preventing it from spreading.

There were seven college students in the rental house that night in Poughkeepsie. Four made it out. New Canaan resident Kevin Johnson, a student at Duchess Community College at the time, Kerry Fitzsimmons, a Marist senior from Long Island, and Eva Block, a Marist senior, did not. “One Innocent Life is dedicated to raising awareness about the living conditions of college students, involving fire safety,” the organization’s website explains.

“The annual number of fires in dormitories, fraternities, sororities and barracks reported to U.S. fire departments has been substantially higher in recent years than any time prior to 2000,” the NFPA’s Richard Campbell said in August 2016.

The National Fire Prevention Association suggests that students renting off campus housing – and other renters – ask the following of landlords:

• Does every room have a smoke alarm?
• What is the power supply to the detector (hardwire/battery/both)?
• Who provides the battery replacement?
• Does the off-campus housing have sprinklers and fire extinguishers?
• What is your disciplinary policy toward tenants who cause false alarms or fail to evacuate during an alarm?
• Do the rooms have enough outlets with enough power to feed energy needs?
• Can the exit doors be opened from the inside without a key?
• What fire safety training does your building staff receive?

One Innocent Life's video to extend awareness, made with the help of Wesleyan University, the City of Middletown Professional Firefighters Local 1073, includes more than a dozen volunteers from Connecticut.

https://youtu.be/9tVQGDyzUHQ

Mattress Recycling Has Solid First Year in Connecticut

Saying bye-bye to a used mattress in Connecticut has changed dramatically during the past year-and-a-half, as Connecticut became one of only three states in the nation to institute a statewide mattress recycling program. The initiative, approved by the state legislature two years ago and underway since May 2015, has gained a solid foothold here, according to its first annual report.  The Mattress Recycling Council (MRC), a non-profit organization established by the mattress industry that created and manages the program in Connecticut, California and Rhode Island, presented its inaugural Annual Report of the Connecticut Bye Bye Mattress Program to Connecticut municipal leaders and state regulators last month. The report summarized the Program’s performance from its inception through the end of the state’s 2016 fiscal year (June 30).

The Connecticut program has “exceeded, met or is on pace to achieve nearly all benchmarks” set in its plan, which was approved by the state in 2014. Highlights include:

• Recycled 150,000 mattresses.
• Recovered more than 2,800 tons of steel, foam and other materials that will be made into new useful products.
• Expanded the collection network to 101 free drop-off sites throughout the state.

“We are pleased with the program’s productive start and will continue to work with city leaders, businesses and the state to improve the program, expand the number of communities served, and increase the volume of mattresses recycled,” said Ryan Trainer, President of MRC and the International Sleep Products Association.

Bye Bye Mattress allows Connecticut residents to drop-off used mattresses at participating collection sites, collection events and recycling facilities free of charge. This collection network is made possible by the $9 recycling fee that Connecticut consumers pay when they buy a new mattress or box spring. The fee provides for collection containers, transporting the discarded mattresses and recycling costs.

Industry-led recycling programs like Bye Bye Mattress will play an important part in helping Connecticut reach its goal to divert 60 percent of materials from disposal by 2024, officials indicated in the 59-page report.

“We applaud the mattress industry for developing a successful statewide program under the mattress stewardship law that has already recycled thousands of mattresses in an environmentally sound manner,” said Robert Klee, Commissioner of Connecticut’s Department of Energy and Environmental Protection.  “This program has created jobs, recovered vast quantities of resources to be reused, saved municipalities $1.5 million in disposal costs and given residents an easy way to recycle a cumbersome item.”

MRC is also working with more than 130 other public and private entities, including mattress retailers, hotels, military bases, universities and healthcare facilities in Connecticut to divert their discarded mattresses from the solid waste stream.  The MRC website indicates that the organization continues to enroll interested municipal transfer stations in the program and work with those interested in hosting recycling events.

Connecticut’s Public Act 13-42 (enacted in 2013 and amended in 2014) required the mattress industry to create a statewide recycling program for mattresses discarded in the state. Connecticut residents can find their nearest participating collection site, collection event or recycling facility at www.ByeByeMattress.com.

Preventing Elder Abuse: CT Ranks 26th in USA

Connecticut ranks 26^th among the nation’s 50 states in providing protections for elder abuse, according to a new analysis of state policies by the financial website WalletHub. Connecticut is the 7^th oldest population in the nation.  The U.S. Census Bureau expects the national population aged 65 and older to nearly double from 43.1 million in 2012 to 83.7 million in 2050, in large measure due to aging Baby Boomers who began turning 65 in 2011.

Abuse happens every day and takes many forms, WalletHub’s explains. “Anyone can become a victim of abuse, but vulnerable older Americans — especially those who are women, have disabilities and rely on others for care or other type of assistance — are among the easiest targets for such misconduct.”

WalletHub’s analysts compared the 50 states and the District of Columbia based on 10 key indicators of elder-abuse protection. The data set ranges from “share of elder-abuse, gross-neglect and exploitation complaints” to “financial elder-abuse laws.” By one estimate, the analysis summary points out, elder abuse affects as many as 5 million people per year, and 96 percent of all cases go unreported.

States described as having the “Best Elder-Abuse Protections” are the District of Columbia, Nevada, Massachusetts, Wisconsin, Missouri, Tennessee, Iowa, Louisiana, Vermont and Hawaii.  At the bottom of the list were Rhode Island, California, Wyoming and South Carolina.

WalletHub’s review of data from all 50 states and the District of Columbia were conducted across three key dimensions: 1) Prevalence, 2) Resources and 3) Protection.  Connecticut’s highest ranking in the individual categories was in Resources, ranking 23^rd.  The Resources category included Total Expenditures on Elder-Abuse Prevention per Resident Aged 65 & Older, Total Expenditures on Legal-Assistance Development per Resident Aged 65 & Older, Total Long-Term Care Ombudsman Program Funding per Resident Aged 65 & Older.

The state legislature earlier this year folded the Legislative Commission on Aging into the new Commission on Women, Children and Seniors.  Former executive director Julia Evans Starr pointed out in an April article that "Elder abuse is a significant social justice issue that transcends race, ethnicity, religious affiliation, income, and education levels. At least 10 percent of older adults have suffered elder abuse — and that proportion is set rise among Connecticut’s rapidly growing, longer-lived population. It demands a strong policy response."

Panera in Connecticut: State of Flux

If you’re looking for a Panera location in Connecticut, check twice before you head out for a sandwich.  There may be a new location opening nearby, or the locale you’re familiar with may have already closed its doors. The churn at Panera may not be unusual, but it did come as an unwelcome surprise to regulars at the Newtown location when it abruptly closed in mid-November, with a sign on the door saying farewell (and please visit other locations.)   And later this month, the long-time location in Darien will be closing.

The Darien store has been renting 3,754-square-feet — the entire first floor of its building, since 2007, when it became the first Panera Bread restaurant to open up in Connecticut, according to published reports.

The chain now has more than 2,000 locations, including in Connecticut – some owned by the company, most by franchisees.  While the departure from Newtown was an unexpected surprise to customers, plans to leave the Darien location have been known since June, when it was first reported by local media.

Last fall, a Panera location closed in Meriden and a location in nearby Wallingford opened. Also on the plus side, a Panera opened earlier this year at Evergreen Walk shopping plaza in South Windsor.  As of this spring, there were 17 Panera Bread locations in Connecticut, all across the state.  The Downtown Hartford location, its first in the city, opened in 2013.

As of June 28, 2016, there were 2,007 bakery-cafes in 46 states and in Ontario, Canada operating under the Panera Bread, Saint Louis Bread Co. or Paradise Bakery & Cafe names. Published reports indicate the company has 97,000 employees nationwide and saw a 3.4 percent growth in sales in its third quarter this year. In 2015, it reportedly generated roughly $2.7 billion in revenue. Founder and CEO Ron Shaich attended college at Clark University in Worcester in the 1970’s.

Earlier this year, Fortune magazine reported that the company estimated that over 20% of orders would be produced and paid for digitally by the end of 2016, up from 16%. In some markets, digital sales are making up more than a third of retail sales, according to the company. The restaurant chain says digital orders could make up half of the total business down the road, the magazine reported.

According to the industry website Fast Casual, Panera Bread does not sell single-unit franchises, so it is not possible to open just one bakery-cafe. Rather, the company has chosen to develop by selling market areas which require the franchise developer to open a number of units, typically 15 bakery-cafes in a period of 6 years.

Panera says it serves 3 to 4 percent of all Americans every week.