How Does Your Health Insurance Plan Stack Up? There’s A Resource for That

Connecticut’s Insurance Department has issued its 2018 Consumer Report Card on Health Plans in Connecticut, providing consumers with an updated snapshot of 12 health carriers in the Connecticut marketplace.  The goal:  to help consumers make informed choices when choosing a health plan. “The Department’s annual Report Card is designed to deliver side-by-side comparisons of health carriers across a variety of quality measures, including coverage for mental health and substance abuse treatment,” Commissioner Katharine L. Wade said recently. The analysis includes health claims, mental healthcare, pregnancy coverage and preventative care, and reviews the reasons cited in instances of denial of coverage. 

Among the trends identified in the latest annual report care are:

• Total enrollment over 2.2 million, a slight increase from 2016.
• 5 percent of those covered (1.85 million people) get their insurance from large group plans
• 131,000 people have individual plans (5.9 percent)
• 235,000 people are covered under small group plans (10.6 percent)

The 72-page data-filled report card also notes that there was an increase in the number of primary care providers, specialists and pharmacies participating in health plan networks. There was a decline in the number of participating hospitals, officials indicated, but attributed it “primarily due to consolidations in the industry and not facilities closing.”

Customers surveyed said they were always or usually able to see a specialist or get routine care as soon as they wanted.  The enrollment breakdown in Connecticut is lopsided.  Among HMO's, Anthem has 81% of the market, ConnectiCare 17%, Oxford 2%.  Among indemnity enrollments, Anthem has 42%, followed by Aetna's 20%, CIGNA's 19%, United's 7% and ConnectiCare's 5%.

The report card, issued this fall,  includes “terms” that consumers should know, a series of frequently asked questions and answers, and results of a member satisfaction survey for HMO’s Anthem, ConnectiCare, Harvard Pilgrim and Oxford Health.  Indemnity insurers Aetna Life, Anthem, CIGNA, ConnectiCare, Harvard Pilgrim, United Health and Oxford Health also had members surveyed on a range of “satisfaction” queries.

This report includes three years of data, where available, to be informative for consumers, officials said.  The data utilized was through 2017.

The mission of the Connecticut Insurance Department is to protect consumers through regulation of the industry, outreach, education and advocacy. The Department recovers an average of $4 million yearly on behalf of consumers, according to officials, and regulates the industry by ensuring carriers adhere to state insurance laws and regulations and are financially solvent to pay claims.

Each year, the Department returns an average of $100 million a year to the state General Fund in license fees, premium taxes, fines and other revenue sources to support various state programs, including childhood immunization. The Department’s annual budget is funded through assessments from the insurance industry.

Individuals with questions or seeking further information may contact the Department at  insurance@ct.gov or 860-297-3900.

CT Attorney General Initiates Lawsuit Against Stamford's Purdue Pharma for Role in National Opioid Crisis

Connecticut Attorney General George Jepsen has initiated a lawsuit against Stamford-based Purdue Pharma and several current and former members of Purdue's management and board of directors alleging that they designed, financed and waged a pervasive and aggressive campaign to mislead doctors and patients, claiming that prescription opioid medications manufactured and marketed by the company were safe and effective and strategically downplaying risks of addiction that they knew were inherent in their opioid products. The state alleges that Purdue "peddled a series of falsehoods" to push patients toward its opioids, reaping massive profits from sales while opioid addiction skyrocketed to the crisis level that is currently impacting Connecticut and states across the country.

"For a number of months, Connecticut and our multistate partners have been engaged in intensive negotiations with opioid manufacturers and distributors in the hope of resolving potential legal claims in a way that would avoid protracted litigation and would bring opioid treatment resources to those who are desperately in need," said Attorney General Jepsen.  Jepsen, who leaves office next month, currently serves as  part of the leadership of a multistate coalition of attorneys general who are investigating opioid manufacturers and distributors. "I expect those negotiations to continue, and I remain hopeful they will bring a resolution that helps to address this ongoing crisis."

In Connecticut, 1,038 people died of accidental drug overdoses in 2017, the vast majority from opioid-related overdoses. The Connecticut Office of the Chief Medical Examiner has projected that 1,030 more people will die of overdoses in 2018. From 2013 to 2016, Connecticut experienced a fourfold increase in deaths from prescription opioid overdoses, and the estimated economic cost of the opioid epidemic in Connecticut in 2016 was $10.27 billion.  Nationwide from 2002-2017 there was a 4.1-fold increase in the total number of deaths involving opioids, according to the National Institute on Drug Abuse. 

The Attorney General said that Purdue Pharma “has not demonstrated to me that it is serious about addressing the states' very real allegations of misconduct and coming to a meaningful settlement. It is my hope that, in filing this lawsuit at this time, Connecticut can assist in the collective effort to hold this company and responsible individuals accountable.

Jepsen said the state alleges that “Purdue knowingly put its own exorbitant profits first when it purposefully and systematically misled doctors by not just downplaying the terrible risks of addiction, but by forcefully asserting that opioid products were safe, that the risk of addiction was low, and that patients experiencing symptoms of addiction should actually be prescribed higher and greater doses of Purdue's opioid drugs. We allege that this behavior was endorsed and promoted by the highest leadership of the company and that it was in violation of Connecticut law."

The state alleges that Purdue misinformed patients and doctors to get more and more people taking its premier opioid drug, OxyContin, and its two other opioid medications, Hysingla and Butrans.

The lawsuit will be filed in Superior Court in Hartford. It alleges four counts of violations of the Connecticut Unfair Trade Practices Act and seeks damages, civil penalties, forfeiture of ill-gotten profits and restitution as well as permanent injunctive and other relief.  The suit indicates that Purdue allegedly:

• led patients and doctors to believe that opioids were safe to treat even minor pain, and that patients could and should take higher and more dangerous doses.
• sent sales representatives to doctors' offices, clinics, pharmacies and hospitals in Connecticut to make deceptive sales pitches about opioid drugs;
• rewarded high-prescribing doctors with attention, meals, gifts and money; and
• awarded prizes and bonuses to sales representatives who generated the most opioid prescriptions.

The company did not tell doctors that higher doses of opioids carried heightened risk of addiction, overdose and death, the state alleges, and the company funded and distributed publications that misrepresented the addictive nature of prescription opioids and made claims that were not supported by scientific evidence.

The state further alleges that Purdue promoted the idea of "pseudoaddiction," suggesting that patients who appeared to be addicted were instead receiving inadequate doses and needed more prescription opioid drugs.

In addition to the company, the state's lawsuit names current and former board members as defendants, alleging that they tracked sales representatives and oversaw the tactics used to push opioid drugs. The individual defendants include: Richard Sackler, Jonathan Sackler, Mortimer D.A. Sackler, Kathe Sackler, Ilene Sackler Lefcourt, Beverly Sackler, David Sackler, Theresa Sackler, Cecil Pickett, Paulo Costa, Ralph Snyderman, Frank Peter Boer and Judy Lewent. The lawsuit also names past CEOs John Stewart and Mark Timney as defendants.

Connecticut Ranks Third in U.S. in Preventing Youth Homelessness; Grant to Support Efforts

Washington, Massachusetts, and Connecticut are the most successful states at preventing youth homelessness, with Connecticut ranking third in the nation, according to the 2018 State Index on Youth Homelessness.  The report, by the True Colors Fund in partnership with the National Law Center on Homelessness & Poverty, analyzed 61 metrics in the 50 states and the District of Columbia. Homelessness is defined as experiences of sleeping in places not meant for living, staying in shelters, or temporarily staying with others while lacking a safe and stable alternative living arrangement. Alabama, South Carolina, Wyoming, and Arkansas were the least successful states at preventing youth homelessness.

In recent weeks, it was announced that Connecticut will use $6.5 million in federal grants to provide housing opportunities for homeless youth, building on its successful track-record. The grants will fund new, innovative housing assistance programs for young adults as part of a coordinated housing continuum that assures those in need can quickly obtain permanent housing and necessary supports, according to state officials.

The grants were allocated as part of a competitive process through the U.S. Department of Housing and Urban Development’s (HUD) new Youth Homelessness Demonstration Program (YHDP). To date, Connecticut has been awarded the largest grant of any jurisdiction in the country.

Building off the state’s nationally recognized progress in ending homelessness under the Malloy administration – which includes being the first state in the nation certified for ending chronic veteran homelessness, being one of only three states certified for ending general veteran homelessness, and matching all chronically homelessness individuals to housing – the state has set a goal of ending both youth and family homelessness by the end of 2020.

Speaking last week before a legislative working group, Gov. Malloy said “Nothing I suspect is more shattering as a child than to find oneself homeless – or even as a young adult – so I’m particularly happy over this past year that we’ve been able to fund a number of units designed specifically to meet the needs of younger homeless individuals.”

Overall, at the start of the year, homelessness in Connecticut was at a record low, according to a report from The Connecticut Coalition to End Homelessness.  It found that homelessness in the state has decreased for a fifth consecutive year and was at its lowest level to date. The report found that, as of Jan. 2018, roughly 3,300 people were homeless in Connecticut.  The Connecticut Coalition to End Homelessness states that overall homelessness in the state is down 25 percent from 2007.

Since 2011, the state Department of Housing and the Connecticut Housing Finance Authority have created, rehabilitated, or committed funding for nearly 25,000 units of housing – approximately 22,000 of which are affordable to low and moderate income individuals and families, officials point out. This represents a state investment of more than $1.42 billion, which has been matched by over $2.45 billion from other financial sources, including the private sector.

Failures in Federal Housing Policy Focus of Media Investigation, Hartford Concerns Highlighted

An NBC News investigation of the federal Department of Housing and Urban Development has found that more than 1,000 out of HUD’s nearly 28,000 federally subsidized multifamily properties failed their most recent inspection — a failure rate that is more than 30 percent higher than in 2016, according to an analysis of HUD records. When NBC broke the story last week of the agency’s dismal record of responding to conditions that at times have been described a “life-threatening,” the example cited most prominently was in Hartford.

The news report stated that “A federal housing inspection in February confirmed living conditions were abysmal … throughout the 52-unit Section 8 development known as the Infill apartments. The property scored only 27 points out of 100, far below the 60 points needed to pass the mandatory health and safety inspection.”  Infill is located in Hartford’s North End. 

“More than nine months after the inspection, federally mandated deadlines for action have come and gone, and residents say little has changed,” NBC’s Stephanie Gosk reported, despite “citations for exposed wiring, missing smoke detectors and bug infestations,” noted that “the Infill units racked up 113 health and safety violations — including 24 that HUD deemed ‘life-threatening.’”

“In one of Hartford’s poorest neighborhoods, a three-month investigation by NBC News found that HUD failed to comply with federal laws requiring prompt action against the owner of a property that authorities knew was unsafe, unhealthy and in disrepair, according to documents released through the Freedom of Information Act,” Gosk reported.

While the agency pointed out that 96 percent nationwide passed inspections, NBC reported that “HUD’s enforcement office, tasked with going after the worst landlords, now has the lowest staff levels since 1999, according to a federal watchdog.”

“In the case of Infill, though, HUD acknowledged that the landlord failed to deliver,” NBC News reported. “The owner provided certain assurances to our field folks that, in the end, did not happen,” HUD spokesman Brian Sullivan said in an email to NBC News. “That hasn't stopped the federal subsidies,” NBC News reported.

"It's a flow of money that continues to come," AJ Johnson, a local pastor who has helped the tenants organize, told NBC News.  “Whether it’s indifference or incompetence, the Trump administration’s failures in Connecticut and around the country cannot be excused. Someone must be held accountable,” said U.S. Sen. Chris Murphy, who led previous efforts to strengthen the HUD inspection process, NBC News reported. “Secretary [Ben] Carson owes it to these families to present a concrete plan for how he will make this better, and how he’ll make sure nothing like this ever happens again.”

Infill’s owner, meanwhile, is “set for years to come,” the NBC News report concluded.  “In July 2017, just seven months before the failed inspection, HUD renewed its contract with Isaacson for 20 years — a deal worth over $14 million.”

The NBC News investigation was reported, in addition to Gosk, by Suzy Khimm, Laura Strickler and Hanna Rappleye, and included interviews with numerous tenants of the property and other individuals in Hartford and Washington.

Marijuana Sales Begin Tuesday in MA; CT Expected to Consider Legalization in 2019

Massachusetts begins the sale of recreational marijuana on Tuesday, in Northampton and Leicester, as Connecticut looks ahead to a new Governor and new legislature, taking office in six weeks, with the addition of recreational sales on the agenda to complement a thriving medical marijuana program. Thirty-three states and the District of Columbia currently have passed laws broadly legalizing marijuana in some form.  The District of Columbia and 10 states -- Alaska, California, Colorado, Maine, Massachusetts, Michigan, Nevada, Oregon, Vermont and Washington -- have adopted the most expansive laws legalizing marijuana for recreational use, according to Governing magazine.  The Massachusetts law was approved two years ago, but retail sales have not begun - until this week.

Governor-elect Ned Lamont told Connecticut Public Radio listeners, just a few days prior to his election, that “I think legalizing marijuana is an idea whose time has come…and I’m gonna push it in the first year” of the new administration.  He added that “maybe we should tax this, regulate it in a serious way, put some of that money toward opioid treatment.”

Most recently, Michigan voters approved a ballot measure permitting adults age 21 and over to purchase and possess recreational-use marijuana. Vermont became the first state earlier this year to legalize marijuana for recreational use through the legislative process, rather than via a ballot measure. Vermont's law allows for adults age 21 and over to grow and possess small amounts of cannabis. However, it does not permit the sale of nonmedical cannabis. Some other state laws similarly decriminalized marijuana, but did not initially legalize retail sales.

The Connecticut General Assembly's Regulations Review Committee agreed last week that chronic neuropathic pain associated with degenerative spinal disorders is eligible for treatment with the drug, adding that to the list of approved conditions.  There are now 31 conditions that have been approved for adults and eight for patients under 18 that can be treated with medical marijuana. Minors can be treated for eight conditions.

There are currently 29,543 patients in Connecticut's medical marijuana program and 1,000 certifying physicians, according to published reports. In recent months, DCP has launched a database listing medical marijuana brands registered with the state and added eight new conditions to the program. The eight new conditions for adults added this summer include: Spasticity, or neuropathic pain associated with fibromyalgia; Severe rheumatoid arthritis; Postherpetic neuralgia; Hydrocephalus with intractable headache;  Intractable headache syndromes; Neuropathic facial pain; Muscular dystrophy; and Osteogenesis imperfecta.

Connecticut’s nine dispensaries and four growers are reportedly discussing adding more storefronts and growers in light of an increasing patient count.

Last month, Rhode Island’s Department of Health this week approved medical marijuana use for people who suffer from some severe manifestations of autism, most of whom are children.  But before doctors can recommend marijuana, the health department has implemented several safeguards "to ensure that patients are being treated safely." Seven other states have made autism a qualifying condition for medical marijuana, according to advocacy group #cannabis4autism: Delaware, Georgia, Louisiana, Michigan, Oregon, Minnesota and Pennsylvania.

At the University of Connecticut, Professor Gerald Berkowitz will teach students about marijuana growing, a burgeoning industry as more states legalize cannabis use for medical and/or recreational purposes. The UConn class — called "Horticulture of Cannabis: from seed to harvest" — is a lecture course, and it's attracted about 270 students who will begin studies in January, Hartford Business Journal reported this month.

In Colorado, the adult-use marijuana market continues to surge nearly five years after the launch of recreational sales in the state, according to a recent news report.  Through August 2018 – the most recent data available from the Colorado Department of Revenue – recreational marijuana sales topped $800 million and the state is on pace to surpass $1.2 billion by the end of the year. That would represent a 12 percent increase over total sales in 2017. As of August 2017, 498 recreational stores were licensed throughout the state; that number grew to 541 by September 1, 2018 – a 9 percent increase

Accelerating Efforts to Prevent Suicide in CT as Numbers Climb

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

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

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

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

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

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

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

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

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

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

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Westport Earns Top 20 Ranking Among Nation's Small Cities; Shelton Reaches Top 100

For those looking to identify the best small cities in the nation - with populations between 25,000 and 100,000 – the search may not need to go further than Connecticut, according to a new analysis. Westport was the lone Connecticut community to reach the top 20 nationally, at number 19, with Shelton also earning a place in the top 100, at number 85, and Norwalk (#146), Trumbull (#157) and West Hartford (#159) also reaching the top 200.

The analysis, by the financial services website WalletHub, was based on 40 key indicators of livability, ranging from housing costs to school-system quality to restaurants per capita.  The indicators were grouped into five categories – affordability, economic health, education & health, safety, and quality of life.

On those scales, Westport was ranked 20^th in education & health, 65^th in safety, 82^nd in economic health, 258 in affordability and 595 in quality of life.  Other than Westport, no Connecticut community reached the top 30 in any overall category.

"Of the 22 Connecticut cities analyzed, 18 ranked in the top half. This is an indication that many Connecticut communities are able to offer high quality of life at low living costs," said WalletHub analyst Jill Gonzalez.  "Westport in particular made it to the top of our ranking due to several factors. The city has a very healthy economy, demonstrated by the fact that its residents have one of the highest median household incomes, and had absolutely no personal bankruptcies filed in the past year. It also has one of the lowest crime rates in the country."

Westport tied for fourth in the U.S. for the highest percentage of the population with a high school diploma or higher.  Trumbull had the second lowest percentage of population in poverty in the U.S., just behind Plainfield, lllinois.

Just outside the top 200 communities, were Stratford, Milford, Middletown, Danbury, Newington, Torrington, Bristol, Manchester, and Naugatuck.

Nationwide, among the 1,200 communities included in the analysis, leading the way were Leawood, KS; Carmel, IN; Princeton, NJ; Brentwood, TN; Milton, MA; Needham, MA; Los Altos, CA; Littleton, CO; Newton, MA; and West Fargo, ND.  Massachusetts placed three communities in the top 10 and a total of six in the top 20.  Also reaching the top 20 from the Bay State were Arlington, Melrose and Wellesley.

CT Residents Concerned About Healthcare Costs, Suggest Policy Actions

Connecticut residents are worried about paying for health coverage and care, and are delaying or skipping recommended medical treatment and tests. They also support bold solutions across party lines, according to policy briefs released this month by Universal Health Care Foundation, based on the results of a statewide survey conducted in partnership with Altarum Institute’s Healthcare Value Hub. The poll found that state residents:

• Avoided or delayed treatments and tests, cut pills in half or did not fill prescriptions because of cost concerns
• Worry about affording health care in the future
• Had difficulty navigating our complex health care system, including dealing with surprise medical bills

The survey revealed that residents are not satisfied with the current health care system: 80 percent agree or strongly agree that “the system needs to change.”  When given more than 20 options, they focused on the high prices charged by industry players, citing most frequently as a “major reason” for high health care costs:

• Drug companies charging too much money—81 percent
• Hospitals charging too much money—74 percent
• Insurance companies charging too much money—74 percent

When asked about possible strategies for tackling high health care costs, residents expressed strong support, across party lines, for government to take action.

• Show what a fair price would be for specific procedures – 95 percent
• Authorize the Attorney General to take legal action to prevent price gouging or unfair prescription drug price hikes – 94 percent
• Set standard payment to hospitals for specific procedures – 89 percent
• Set standard prices for drubs to make them affordable – 89 percent

The survey found relatively little statistical difference in the responses of individuals indicating their political party affiliation as Democrat, or neither.

In the poll of 900 Connecticut adults, nearly 9 in 10 people (88%) who take prescriptions regularly worry they won’t be able to afford their medication.  And 20 percent reported that they were so worried about drug prices that they did one or more of the following:  not fill a prescription, cut pills in half, or skip a prescribed dose. 

Half of Connecticut adults indicated that they experienced a problem with health care affordability in the past year, and nearly as many, 43 percent, delayed or did not get care due to cost, with one-third indicating that they delayed going to the doctor or having a procedure done.

Universal Health Care Foundation is supporting IVote4Healthcare, a nonpartisan voter registration, education and engagement effort, with Protect Our Care CT, to highlight those findings and changes in the health care system.

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

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

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

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

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

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

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

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

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

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

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

New Haven, Bridgeport at Bottom of Ranking for Disability-Friendly Cities

Connecticut’s two largest cities are not particularly hospitable for individuals with disabilities, according to a new national analysis.  New Haven and Bridgeport are at the bottom of a list of 182 cities that were included in the review, released this month to coincide with National Disability Employment Awareness Month The personal-finance website WalletHub compared the largest U.S. cities – including at least two from each state - across 31 key indicators of disability-friendliness. The data set ranges from wheelchair-accessible facilities per capita to rate of workers with disabilities to quality of public hospital system. The 31 indicators were grouped into three categories:  Economy, Quality of Life and Health Care.

The report on 2018’s Best & Worst Cities for People with Disabilities placed New Haven at the bottom of the list, and Bridgeport just two positions higher.  They were the only Connecticut cities evaluated in the analysis.

According to the Centers for Disease Control and Prevention, one in four U.S. adults, or 61 million total, have a disability that impacts their major activities. And among Americans age 65 and older, that number rises to two in five. In 2017, nearly 5.7 million people with disabilities were employed.

New Haven, which ranked number 182 overall, ranked 180 in Economy, 134 in Quality of Life and 173 in Health Care.  Bridgeport, just above New Haven at number 179 in the overall ranking, placed 164 in Economy, 128 in Quality of Life and 163 in Health Care.

WalletHub analyst Jill Gonzalez explained that among the metrics dragging down New Haven's overall ranking was the second lowest employment rate for people with disabilities, at 71.03 percent. This refers to the civilian non-institutionalized population aged 18-64 in the labor force. Other areas where New Haven ranked poorly, Gonzalez pointed out, were the share of people with disabilities living in poverty, which is almost 37 percent, and the relatively low number of family doctors and general practitioners per capita.

Bridgeport ranked as the fourth worst city for people with disabilities. One of the issues driving the ranking, Gonzalez said, was similar to New Haven's - a low employment rate for people with disabilities, at 74.28 percent. The other issues are mostly related to the quality of life.

“Bridgeport has one of the lowest number of wheelchair accessible art, entertainment and recreational establishments per capita, and a large number of older buildings with little to no access for disabled residents," Gonzalez said.

The analysis found that only Detroit had a lower employment rate for individuals with disabilities that New Haven.  On the overall list, Providence, RI was just one notch above New Haven, at the bottom of the rankings.

The cities ranked at the top of the list were Overland Park, KS; South Burlington, VT; Sioux Falls, SD; Scottsdale, AZ; Columbia, MD; San Francisco; Rapid City, SD; St. Louis, MO; Bismarck, ND; and Grand Rapids, MI.

Data used to create this ranking, according to WalletHub, were collected from the U.S. Census Bureau, Bureau of Labor Statistics, Department of Housing and Urban Development, Council for Community and Economic Research, Centers for Disease Control and Prevention, National Center for Education Statistics, Centers for Medicare & Medicaid Services, Trust For Public Land, Genworth Financial, United Cerebral Palsy, WalkScore, Yelp, Rails-to-Trails Conservancy, Affordable Housing Online, Kaiser Family Foundation, Eligibility.com, Redfin and WalletHub research.