California, Oregon pharmacists to be allowed to prescribe birth control | The Seattle Times


nuvaring contraceptiveIn the next few months, women in California and Oregon will be able to obtain hormonal contraceptives like pills, patches and rings by getting a prescription directly from the pharmacist, a more convenient and potentially less expensive option than going to the doctor.

Source: California, Oregon pharmacists to be allowed to prescribe birth control | The Seattle Times


States freed to use Medicaid money for housing


Homeless_person_in_New_York_CityBy Michael Ollove

Communities with big homeless populations are increasingly turning to a strategy known as housing first.

The idea: helping chronically homeless people to find a permanent home—and stay in it—is the best way to help them lead stable, healthy lives.

The approach has been used in cities like Chicago and Cleveland, as well as in several states, such as Massachusetts, Minnesota and Washington, as local nonprofits have worked to provide both housing and health care to homeless people.

And it got an important endorsement in June, when the Centers for Medicare & Medicaid Services (CMS) told state Medicaid offices around the country that Medicaid dollars, usually reserved for clinical services and medications, could be used to help chronically homeless people and others with long-term disabilities to find and maintain permanent housing.

The approach has been used in several states, such as Massachusetts, Minnesota and Washington, as local nonprofits have worked to provide both housing and health care to homeless people.

That means a fresh source of funds for everything from helping homeless people apply for housing and understand the terms of their lease to teaching them how to get along with neighbors and make healthy food choices.

The CMS policy statement comes as many states continue to struggle with large homeless populations. The U.S. Department of Housing and Urban Development (HUD) reported Thursday that while the overall number of homeless in the U.S. dropped by 2 percent, or by 11,742 people, this year over last, it increased in 17 states. New York had the largest increase, of 7,660 people, followed by California with 1,786 more homeless.

PHOTO: Lujoma ny via Wikipedia (CC)

Continue reading


Medicaid denies nearly half of requests for hepatitis C drug

Hepatitis C virus

Hepatitis C virus

By Michelle Andrews

People with hepatitis C who sought prescriptions for highly effective but pricey new drugs were significantly more likely to get turned down if they had Medicaid coverage than if they were insured by Medicare or private commercial policies, a recent study found.

Researchers at the University of Pennsylvania Perelman School of Medicine analyzed the hepatitis C prescriptions from 2,342 patients in Maryland, Delaware, Pennsylvania and New Jersey that were submitted between November 2014 and April 2015 to a large specialty pharmacy that serves the region.

The drugs included Sovaldi, Harvoni and Viekira Pak, and others that are part of the treatment regimen. A 12-week course of treatment for one patient can reach more than $90,000. Continue reading


Cancer meds can have high out-of-pocket costs for patients, report


Twenty-dollar bill in a pill bottleBy Julie Appleby

Cancer patients shopping on federal and state insurance marketplaces often find it difficult to determine whether their drugs are covered and how much they will pay for them, the advocacy arm of the American Cancer Society says in a report that also calls on regulators to restrict how much insurers can charge patients for medications.

While the report found fairly broad coverage for prescription cancer medications, most insurance plans in the six states that were examined placed all or nearly all of the 22 medications studied into payment “tiers” that require the biggest out-of-pocket costs by patients, the American Cancer Society Cancer Action Network said. Continue reading


Health plan buyers will save if they shop around


Photo by Sanja Gjenero

By Phil Galewitz

You better shop around.

For holiday gifts?

No, for a 2016 health insurance plan on the federal marketplace,

Millions of consumers who are enrolled this year could pay higher rates if they stay in the same health plan next year, according to a study released Wednesday by the Kaiser Family Foundation.

The KFF analysis found that in nearly three-quarters of counties in 36 states served by, the lowest-priced silver plan this year will not be the lowest priced next year.

People in those plans could save money on premiums by switching to a different silver plan in 2016. (KHN is an editorially independent program of the foundation.) Continue reading


10 percent of US adults have drug use disorder at some point in their lives


75 percent report not receiving any form of treatment.

From the National Institutes of Health

Three red and white capsulesA survey of American adults revealed that drug use disorder is common, co-occurs with a range of mental health disorders and often goes untreated.

The study, funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, found that about 4 percent of Americans met the criteria for drug use disorder in the past year and about 10 percent have had drug use disorder at some time in their lives.

“Based on these findings, more than 23 million adults in the United States have struggled with problematic drug use,” said George F. Koob, Ph.D., NIAAA director. “Given these numbers, and other recent findings about the prevalence and under-treatment of alcohol use disorder in the U.S., it is vitally important that we continue our efforts to understand the underlying causes of drug and alcohol addiction, their relationship to other psychiatric conditions and the most effective forms of treatment.”

“Based on these findings, more than 23 million adults in the United States have struggled with problematic drug use.” —George F. Koob, Ph.D.

NIAAA directorA diagnosis of drug use disorder is based on a list of symptoms including craving, withdrawal, lack of control, and negative effects on personal and professional responsibilities. Continue reading


Cities and states try to crack down on distracted cycling


BikeBy Jenni Bergal

Worried that bicyclists who chat, send messages or listen to music on smartphones are creating a danger, a number of cities have banned cyclists from using hand-held cellphones or texting while riding. And several states prohibit bicyclists from using headphones or earplugs.

The efforts to reduce the risk to cyclists, pedestrians and motorists come as cities are trying to become more bike-friendly, and people increasingly turn to electronic devices to communicate and navigate.

“If they want to share the road, they have to share the responsibility as well,” said Massachusetts state Rep. Steven Howitt, a Republican, who has introduced a bill that would prohibit bicyclists from wearing headphones.

Bicycle advocates also say there’s no evidence that such use has resulted in deaths or serious injuries, and question whether creating laws or slapping fines on cyclers makes sense.

Bicycle advocates say cyclists should use common sense and not use hand-held electronic devices at all when riding. Nor should bikers use headphones if they are distracting.

But advocates also say there’s no evidence that such use has resulted in deaths or serious injuries, and question whether creating laws or slapping fines on cyclers makes sense.

“There’s a huge difference between distracted driving that kills someone and distracted biking that doesn’t,” said Peter Wilborn, founder of Bike Law, a network of personal injury lawyers that focuses on cycling issues. “I don’t think we need laws specifically for this.” Continue reading


Opioid epidemic continues in Washington


Tablet Thumb BlueFrom the Washington State Department of Health

New Washington health data shows a significant drop in deaths from prescription narcotics in recent years.

Tragically, the decline is offset by a doubling of the number of heroin deaths in our state during the same time.

Both heroin and prescription narcotics are types of drugs known as opioids.

Progress in preventing deaths from prescription narcotics compromised by rising heroin fatalities

Data from 2014 state vital statistics records show the number of deaths from prescription narcotics has steadily dropped from a peak of 512 deaths in 2008 to 319 in 2014.

At the same time, heroin killed 293 people in Washington last year, about twice as many as in 2008. Overall, the number of deaths from opioid overdose in Washington remains at about 600 a year. Continue reading


Federal privacy laws don’t cover those apps on your phone


Privacy Not Included: Federal Law Lags Behind New Tech

By Charles Ornstein ProPublica, Nov. 17, 2015, 10 a.m.
This story was co-published with the Washington Post.

Data GlobeThe federal privacy law known as HIPAA doesn’t cover home paternity tests, fitness trackers or health apps. When a Florida woman complained after seeing the paternity test results of thousands of people online, federal regulators told her they didn’t have jurisdiction.

Jacqueline Stokes spotted the home paternity test at her local drugstore in Florida and knew she had to try it. She had no doubts for her own family, but as a cybersecurity consultant with an interest in genetics, she couldn’t resist the latest advance.

At home, she carefully followed the instructions, swabbing inside the mouths of her husband and her daughter, placing the samples in the pouch provided and mailing them to a lab.

This year, ProPublica has been chronicling how weaknesses in federal and state laws, as well as lax enforcement, have left patients vulnerable to damaging invasions of privacy.

Days later, Stokes went online to get the results. Part of the lab’s website address caught her attention, and her professional instincts kicked in. By tweaking the URL slightly, a sprawling directory appeared that gave her access to the test results of some 6,000 other people.

The site was taken down after Stokes complained on Twitter. But when she contacted the Department of Health and Human Services about the seemingly obvious violation of patient privacy, she got a surprising response: Officials couldn’t do anything about the breach. Continue reading


New health plans offer discounts for diabetes care


Glucometer showing a blood sugar of 105By Michelle Andrews

Talk about targeted. Consumers scrolling through the health plan options on the insurance marketplaces in a few states this fall may come upon plans whose name — Leap Diabetes Plans — leaves no doubt about who should apply.

Offered by Aetna in four regions next year, the gold-level plans are tailored for the needs of people with diabetes.

They feature:

  • $10 copays for the specialists diabetics need such as endocrinologists, ophthalmologists and podiatrists, and offer
  • free blood sugar test strips, glucose monitors and other diabetic supplies, and
  • A care management program with online tools and coaching helps people manage their condition day-to-day.

The plans also offer:

  • Financial incentives, including a $50 gift card for getting an A1c blood test twice a year to measure blood sugar levels and
  • a $25 card for hooking up a glucometer or biometric tracker to the Aetna site.

“It was a good time to design a product that was a little more personalized, as opposed to generic,” says Jeff Brown, vice president of consumer product, network and distribution at Aetna. “We saw diabetes as a compelling need, and a growing need.”

It’s unclear whether the diabetes plans are a good buy for people with diabetes.

Aetna is debuting the diabetes plans next year in four markets: Charlotte, N.C., Phoenix, Ariz., Northern Virginia and southeastern Pennsylvania.

It’s unclear whether the diabetes plans are a good buy for people with diabetes. The cut rates for specialist visits only apply if they’re related to diabetes care, not for other conditions someone may have.

Meanwhile, coverage for medications, which may cost consumers hundreds of dollars every month, is no different in the diabetes plans than in other gold plans. Continue reading


What to do if the lights go out


Screen Shot 2015-11-17 at 6.23.48 AMMeredith Li-Vollmer
Public Health – Seattle & King County

The forecast calls for high winds and rain through Tuesday night, and that means power outages are likely when trees or their limbs topple.

Power outages don’t seem like a big deal until they happen–then they are a pain in the you-know-what at best, and a serious health hazard at their worst.

Who do I call if the power goes out?

  • Check your neighborhood to see if others are without power.
  • Call to report the power outage. Call only once to keep the line open for other customers.

For residents of the Seattle area, call Seattle City Light Power Outage Hotline at 206-684-7400.

For other King County residents
, call Puget Sound Energy Customer Service at 1-888-225-5773 or report an outage online through your My PSE account at

What should I do when you see damaged or downed power lines in your neighborhood?

  • Don’t get near any fallen or sagging power line!
  • Call the utility company about the line.

What about people who are using life support equipment at home?

  • People who depend on electrical equipment to treat a health problem should have a plan in advance of a power outage.
  • In some cases, this may mean purchasing a back-up power supply such as a generator or going to a health care facility that has back-up power.
  • People who use life support equipment should register with the local utility. When they do this, the utility will make them a top priority for power supply repair and restoration.

How should I use a power generator?

  • For your safety, always follow the manufacturer’s instruction on the use of power generators.
  • Since most generators are powered by gasoline and can generate carbon monoxide gas, run them outdoors where the fumes will not cause illness.
  • Power generators should never be plugged into your home’s main electrical panel as this may result in serious injury or death to utility personnel working to restore power. Instead, plug the generator directly into the appliance you wish to use during the outage.

How long will the food in my refrigerator and freezer remain cold enough to prevent food borne illness?

  • Keep freezer and refrigerator doors closed to prevent the loss of cold air.
  • A fully loaded refrigerator may keep food fresh for about six hours.
  • A fully loaded freezer may keep food frozen for up to two days.
  • If any food in the refrigerator or freezer is warmer than 41° F, throw it out.

My power has been out for a while and my home is too cold. What are my options?

In a severe emergency or disaster, expect electric power to be out for several days. If that happens, consider relocating to a shelter or to a friend’s home where heat and power are available.

And one more important warning:

Never use charcoal, gas, or propane heaters indoors. Odorless, invisible fumes from charcoal, gas, and propane can lead to carbon monoxide poisoning. Using these heaters indoors can also increase the risk of fire.


Violence abroad and at home – Viewpoint


DuchinThe following is a message from Public Health – Seattle & King County’s Health Officer Dr. Jeff Duchin to the agency’s staff. The agency decided to share the message with the public because it thought “the message will resonate with those inside and outside of our agency.”

Dear Colleagues,

On Friday, I spent the day with others from Public Health – Seattle & King County and regional local health departments, Washington State Department of Health, and the University of Washington at a conference organized by the Northwest Center for Public Health Practice to help find solutions to the problem of injury and violence in our communities.

It was therefore especially ironic and sickening to hear the news of the Paris terrorist attacks on the car radio as I returned from the meeting.

Many of us, including myself, feel overwhelmed trying to fathom the reasons for, and solutions to, the type of mindless killing that has been routinized by repeated violent terrorist attacks happening around the world, most recently in Paris, Beirut, Nigeria, Somalia, Cameroon, Turkey, Israel and Gaza, Iran, and elsewhere.

Here at home, we are struggling with many incarnations of violence in our own communities and country, including intentional violence from suicide, gun violence, intimate partner and domestic violence, adverse childhood experiences and other emotional trauma, and multiple causes of unintentional injury and death.

As public health professionals we share a common purpose: Improving the health of communities through prevention. Accordingly, we bring our public health approach to addressing the wicked problems of violence and injury.

I sincerely hope that in addition, this most recent abomination in Paris will motivate not only public health professionals but all of us, including governmental, business and community leaders across the country to acknowledge all types of violence – even terrorist violence– as a public health problem – a disease – and treat it accordingly.

Although we will not be able to easily solve the problem of global terrorist violence through our actions here at home, redoubling our efforts to end the ongoing devastation of violence of all types in our communities would be a meaningful start.

I’m optimistic that with the same perseverance, dedication, and intelligence that we used to put a man on the moon, conquer smallpox and polio, and harness the energy of the atom, we can make real progress in reducing violence from all causes in our communities, our country, and the world.