At our upcoming conference on June 16-17 in Hampton, entitled Health on the Homefront, the Virginia Public Health Association will be deeply honored to welcome Retired Major General Mark Graham and Mrs. Carol Graham (pictured at right) as our keynote speakers. Their presentation, Our Sons Died Fighting Different Battles: One Family’s Story, will address the stigma surrounding mental health, raise awareness of the warning signs and risk factors for suicide, and discuss real life coping strategies. In a speech at Fort Knox in 2009, Major General Graham stated, “From our personal tragedies, my wife Carol and our daughter Melanie and I have come to realize that in order to survive, we had to use our brokenness to reach out and openly share our story and try to give hope to others…As an Army and as a nation, we must get in front of suicide, work to prevent it by action, not just figure it out after the fact…We have pledged to use Kevin’s death to raise awareness in the military to the dangers of untreated depression, post-traumatic stress disorder, traumatic brain injuries, and other mental health issues.” (Rose, M. (2009, Winter). Major General Mark Graham: A legacy of hope. T.A.P.S. Magazine, 15(4).)

In 2003 the Grahams’ son Kevin, a senior ROTC cadet at the University of Kentucky, died by suicide in the apartment he shared with his two siblings. Seven months after Kevin’s death, his brother - the Grahams’ eldest son - 2nd Lt. Jeffrey Graham, was killed in Iraq by an improvised explosive devise (IED). Jeffrey died with Kevin’s driver’s license in his pocket. Since that time, Major General Graham and his wife, Carol, have been tireless champions of military and civilian efforts to promote mental health and suicide-prevention awareness, and to eliminate the stigma surrounding mental health care. Their personal tragedy and dedication to honoring their sons (both pictured at left) have been widely documented in the media. 

Major General Mark Graham has had a distinguished thirty-five year career with the military, retiring from the US Army in 2012. His final position was as the Director, U.S. Army Forces Command, where he oversaw the plans, operations and training for Army forces stationed in the Continental United States and ensured conventional forces were prepared for worldwide deployment and combat.  Major General Graham’s numerous military awards include the Distinguished Service Medal, the Bronze Star Medal, the Defense Superior Service Medal, the Legion of Merit, the Meritorious Service Medal and the Humanitarian Service Medal.

Mrs. Carol Graham is nationally recognized for her efforts in suicide prevention and mental health. She has received numerous awards and other recognition including the President of the United States ‘Call to Service’ Award, Governor’s Commendation (State of Oklahoma) for Suicide Prevention and Depression Awareness; the Texas Governor’s “Yellow Rose of Texas” award; US Army Forces Command’s Commander’s Award; US Forces Command Well Being Award; Secretary of the Army Public Service Award; the 2009 Suicide Prevention Advocacy Recognition in Kentucky (SPARK) Award; and the Shining Lights of Hope Award of the Carson J. Spencer Foundation.

Click here for complete details on Health on the Homefront, and be sure to like the event on Facebook and follow us on Twitter @VPHAHomefront.

The Virginia Department of Health announced today that a portion of the Rappahannock River will be closed to shellfish harvesting due to flooding. The emergency closure is effective May 1 through May 15, 2014, though the area may be reopened earlier if water quality monitoring results indicate that the area is no longer unsafe.

Maps of the affected areas are posted on the Division of Shellfish Sanitation’s home page at www.vdh.virginia.gov/EnvironmentalHealth/Shellfish/. The affected shellfish are bivalve mollusks including oysters and clams, but not crabs or fin fish.

“Monitoring shellfish harvesting beds is an important means to protect the health of Virginians,” said State Health Commissioner Marissa J. Levine, MD, MPH, FAAFP. “We watch shellfish beds for contaminants after major storms to ensure any seafood harvested there does not contain harmful substances that will make consumers of these shellfish ill.”

Heavy rainfall in a portion of western Virginia with the ensuing runoff may have washed animal waste and human sewage into the rivers. Due to potential microbiological and chemical pollution hazards, shellfish taken from areas affected by the emergency closure are currently unacceptable for consumption.

Ingesting shellfish taken from the closed areas at this time could cause gastrointestinal illnesses including norovirus, hepatitis A and shigellosis.

For more information on shellfish closures, see the frequently asked questions on shellfish condemnations at www.vdh.virginia.gov/EnvironmentalHealth/Shellfish/faq/.

Today, as part of the Obama administration’s work to make our health care system more transparent, affordable, and accountable, Health and Human Services (HHS) Secretary Kathleen Sebelius announced the release of new, privacy-protected data on services and procedures provided to Medicare beneficiaries by physicians and other health care professionals. The new data also show payment and submitted charges, or bills, for those services and procedures by provider.

“Currently, consumers have limited information about how physicians and other health care professionals practice medicine,” said Secretary Sebelius “This data will help fill that gap by offering insight into the Medicare portion of a physician’s practice. The data released today afford researchers, policymakers and the public a new window into health care spending and physician practice patterns.”

The new data set has information for over 880,000 distinct health care providers who collectively received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service program. With this data, it will be possible to conduct a wide range of analyses that compare 6,000 different types of services and procedures provided, as well as payments received by individual health care providers.

The information also allows comparisons by physician, specialty, location, the types of medical service and procedures delivered, Medicare payment, and submitted charges. Physicians and other health care professionals determine what they will charge for services and procedures provided to patients and these “charges” are the amount the physician or health care professional generally bills for the service or procedure.

"Data transparency is a key aspect of transformation of the health care delivery system,” said CMS Administrator Marilyn Tavenner. “While there’s more work ahead, this data release will help beneficiaries and consumers better understand how care is delivered through the Medicare program.”

Last May, CMS released hospital charge data allowing consumers to compare what hospitals charge for common inpatient and outpatient services across the country.

To view the physician dataset, please visit: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier.html

Full Press Release

The nation’s health is improving in more than half of the critical measures that are known to have major influence in reducing preventable disease and death, according to a new report from the U.S. Department of Health and Human Services.

Healthy People 2020 represents the nation’s current 10-year goals and objectives for health promotion and disease prevention. Twenty-six specific measuresundefinedin categories such as access to care, maternal and child health, tobacco use, nutrition and physical activityundefinedwere identified as high-priority health issues. These Leading Health Indicators (LHI), if addressed appropriately, have the potential to significantly reduce major influences or threats on the public’s health that cause illness and death.

“The Leading Health Indicators are intended to motivate action to improve the health of the whole population. Today’s LHI Progress Report shows that we are doing just that,” says Dr. Howard Koh, Assistant Secretary for Health. Koh also notes that with the full implementation of the Affordable Care Act, we can expect to see more improvements across these indicators.

There are 14 health indicators that have either been met or are improving in this first third of the decade, including:

• Fewer adults smoking cigarettes;
• Fewer children exposed to secondhand smoke;
• More adults meeting physical activity targets; and
• Fewer adolescents using alcohol or illicit drugs. 

While progress has been made across several indicators, the LHI Progress Report highlights areas where further work is needed to improve the health of all Americans. There are 11 Leading Health Indicators that have not shown significant improvement at this point in the decade, and 1 indicator where only baseline data are available.

For more information about the Leading Health Indicators Progress Update, please visit http://www.healthypeople.gov/2020/LHI/default.aspx.

Full Press Release

The Virginia General Assembly returned on March 24, 2014 for a special session to complete the work on passing a budget and to consider options for closing the insurance coverage gap in Virginia.

The Affordable Care Act intended to expand access to health care coverage by increasing Medicaid eligibility to all individuals below 138% of the federal poverty limit and creating health care exchanges that would offer subsidies to individuals with incomes between 100% – 400% of the federal poverty limit. Many Virginia lawmakers have been opposed to expanding Medicaid, citing concerns that it would be too costly to the state budget and noting their opposition to expanding government funded health care. 

• Failure to expand Medicaid will leave a coverage gap in Virginia, with many individuals and families currently making less than the federal poverty level, but not otherwise eligible for Medicaid, being ineligible for insurance subsidies on the insurance exchange. 
• This means that while a family of four earning between $8,500 and $23,000 would need to pay full price for insurance, those earning more can qualify for subsidies.  Nearly 200,000 Virginians fall into this coverage gap, of whom, approximately 70% are working families.
• Virginia businesses already pay over $1 billion per year to insurers to cover costs for care for the uninsured.  These costs will continue to rise without closing the coverage gap of the uninsured. Most uninsured Virginians receive care at rural or teaching hospitals. Due to changes in federal funding, these hospitals face a shortfall of over $368M in indigent care funding from 2017-2022 if Virginia does not cover the uninsured.
• Virginia tax payers and businesses forgo $4-$5 million in revenues each day that the Commonwealth does not expand Medicaid coverage.

Neither the Senate nor House passed a bill for Medicaid expansion during the 2014 General Assembly.  However, the Senate has proposed an alternative, called Marketplace Virginia, which would seek to use federal money that would otherwise cover Medicaid expansion, to provide insurance premium assistance for low income Virginians, not covered by Medicaid, to purchase insurance through a managed care system.  The Senate Finance Committee has posted a presentation of Marketplace Virginia.

The House budget does not contain any provisions for addressing the coverage gap in Virginia and the majority of delegates are opposed to such a provision; the Senate budget includes Marketplace Virginia.  Governor McAuliffe is due to release his budget this week; he has indicated that he will not sign a budget that does not contain provisions for closing the coverage gap. 

With approximately one million Virginians (13%) currently uninsured, closing the coverage gap will have striking implications for the citizens of Virginia.  We urge you to get informed and to contact your state legislator to express your views.  You can find contact information for your legislator at the General Assembly website by clicking on Who’s My Legislator at the top of the page and entering your address.

Links to additional information and resources:

• Healthcare for All Virginians
• Kaiser Family Foundation: The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid
• McEachin and Watkins: Marketplace Virginia offers health, financial benefits (Richmond Times-Dispatch, March 23, 2014)
• Senator Walter Stosch: Special Session of the General Assembly to Begin MArch 24. Why is Healthcare
  Included in Virginia's Budget?
• Group: Medicaid expansion would cover some vets (The Virginian Pilot, March 10, 2014)
• Health Affairs Blog: Opting Out of Medicaid Expansion: The Health and Financial Impacts
• The Commonwealth Institute

(Richmond, Va.) The most recent surveillance data collected by the Virginia Department of Health (VDH)indicates that 6,600 women are living with HIV disease in Virginia.Forty-eight percent of those cases progressed to an AIDS diagnosis by the end of last year. This data shines a light on the impact that HIV has upon women.

“HIV and AIDS are taking a toll on the lives of women and their families,” said Interim State Health Commissioner Marissa J. Levine, MD, MPH. “The health of women is indicative of the health of our Commonwealth.One way to improve the lives of women, and therefore families, is to empower women with knowledge and support for healthy living.”

VDH is doing just that.In collaboration with a coalition of public and private sector partners, VDH has launched a new statewide public health campaign.The campaign, called Virginia Greater Than AIDS (Virginia>AIDS), reaches out to women through personal stories and conversations. More information...

The Virginia Foundation for Healthy Youth (VFHY) has released its FY 2013 annual report, outlining VFHY's latest initiatives to reduce and prevent youth tobacco use and childhood obesity across Virginia.

Since VFHY began its efforts in 2001, the number of high school smokers in Virginia has been cut more than in half and the number of middle school smokers has been reduced by more than 70 percent!

Download VFHY's 2013 Annual Report (PDF)

More information
 

27 percent of February Federal Marketplace enrollees are young adults

Enrollment in the Health Insurance Marketplace continued to rise in February to a five-month total of 4.2 million.

As in January, the percent of young adults who selected a Marketplace plan was 3 percentage points higher than it was from October through December (27 percent versus 24 percent).  Based on enrollment patterns in other health care programs, it is expected that more people will sign up as we get closer to the March 31st deadline.

“Over 4.2 million Americans have signed up for affordable plans through the Marketplace,” said HHS Secretary Kathleen Sebelius. “Now, during this final month of open enrollment our message to the American people is this: you still have time to get covered, but you’ll want to sign up today – the deadline is March 31st.”

Key findings from today’s report include:
•More than 4.2 million (4,242,300) people selected Marketplace plans from Oct. 1, 2013, through Mar. 1, 2014, including 1.6 million in the State Based Marketplaces and 2.6 million in the Federally-facilitated Marketplace. About 943,000 people enrolled in the Health Insurance Marketplace plans in the February reporting period, which concluded March 1, 2014.
•Of the more than 4.2 million: ◦55 percent are female and 45 percent are male;
◦31 percent are age 34 and under;
◦25 percent are between the ages of 18 and 34;
◦63 percent selected a Silver plan (up one percentage point over the prior reporting period), while 18 percent selected a Bronze plan (down one point); and
◦83 percent selected a plan and are eligible to receive Financial Assistance (up one point).

Today’s report details state-by-state information where available.  In some states, only partial datasets were available.

The report features cumulative data for the five-month reporting period because some people apply, shop, and select a plan across monthly reporting periods.  Enrollment is measured as those who selected a plan.

To read the report visit: http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Mar2014/ib_2014mar_enrollment.pdf

For state-level tables highlighting enrollment-related information for the Marketplace visit: http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Mar2014/ib_2014Mar_enrollAddendum.pdf

To hear stories of Americans enrolling in the Marketplace visit: http://www.hhs.gov/healthcare/facts/mystory/index.html

View Press Release

Tobacco is the only product that, when used as directed, kills. Every year, more than 480,000 Americans die, millions more get sick and health care and related costs reach more than $289 billion due to tobacco use.
   
Target, Wegmans and, most recently, CVS Caremark have all done the right thing – they removed tobacco from their shelves. We applaud their courage and believe that together we can build on this momentum. APHA is asking all pharmacies and retailers in the business of wellness to put their customers’ health ahead of profits from tobacco. Join us.
 
Sign APHA’s petition: No tobacco sales in stores with pharmacies and
clinics
 
Please add your voice to the growing number of people and organizations working to stop the epidemic of tobacco. Sign APHA’s petition and share it with family and friends.
 
Together we will make the U.S. the healthiest nation in one generation.

Sincerely,

Susan L. Polan, PhD
APHA associate executive director, public affairs and advocacy

View APHA message

The time is now for health care for all Virginians. The Legislature annually wrestles with questions of how to fund a long list of programs and services including quality public education for our children, supports and services for the elderly and disabled and adequate funding for public safety programs, to name a few. But, from the perspective of people of faith, caring for our neighbors and supporting families are guiding principles that shape our view of legislative decision-making and so we say clearly, the time is now for health care for all Virginians.

Nearly 400,000 Virginians would benefit from increased access to healthcare coverage. They include members of middle to low income families and about 70 percent of those who could be covered are part of a family where at least one adult works in a low-wage job that does not include benefits. They do not earn enough to buy private health insurance coverage.

The economic argument for expanding Medicaid is strong. What the uninsured aren’t getting is regular preventive health care that keeps them at work and out of expensive hospital emergency rooms. The Virginia Department of Medical Assistance Services estimates that the expansion could save Virginia $1 billion by 2022 largely because charity care at teaching hospitals, care for prisoners and mental health services would shift from the state's general fund to Medicaid, with the federal government picking up most of the cost. The Virginia Hospital and Healthcare Association reported that expanding Medicaid will create 30,000 new jobs in the state.
 ;
Ultimately, the decision is about helping people in need. The decision to support expansion does not rest on dollars and cents calculations. The General Assembly has concluded and there is still no solution to the health care coverage gap. The Virginia Interfaith Center for Public Policy is joining along with other advocacy groups to raise the voices of consumers and everyday people to call for the General Assembly to solve the coverage gap during a special session.

Please join us on March 15^th in Richmond, Virginia.  We will meet at the Capitol Bell Tower for a rally to solve the health care gap in Virginia.  All together we hope to have 1,000 people participate from all parts of the Commonwealth, so arrive early to allow for parking near the Richmond Convention Center. We are also making plans for buses to come from northern Virginia, Hampton Roads, and the New River Valley but those plans are still being finalized so let us know if you need help with transportation.

Rally for Health Care
Capitol Bell Tower
March 15, 2014
11 am to 12 pm
Register Online

Providing health care saves people’s lives, which is what our faith traditions are all about. It is time that our Legislators here in Virginia recognize what we already know: that access to health care is a moral issue, not a political one.

Marco A. Grimaldo