July 2020, Volume XXXIV, Number 4
Racism is a public health crisis, says Hennepin County resolution
The Hennepin County Board of Commissioners voted July 1 in favor of a resolution declaring racism as a public health crisis.
The board’s resolution was prompted by several recent events, including the Memorial Day murder of George Floyd and the worldwide protests that followed. Since 2017, the board has reviewed data that clearly shows disparities in education, jobs, income, housing, justice, transportation, and health for people of color living in Hennepin County. These disparities have lifelong impacts, leading to higher disease rates, including a disproportionately higher burden of COVID-19 infection rates and fatalities.
“Ultimately this resolution is about the health and well-being of Hennepin County residents who have borne the brunt of racial discrimination and racial inequity through various different systems,” said Commissioner Angela Conley, who introduced the resolution with Commissioner Irene Fernando.
She urged her colleagues to stop “treating symptoms of disparities—such as poverty—and step back to see all the connections that got people there. It’s critical that the county adopt a lens of health to examine policies and practices to ensure we are not overtly engaging in racist behavior.”
HealthPartners closes seven clinics
In response to the COVID-19 pandemic and a shift to telehealth services, HealthPartners is permanently closing seven clinics and a drug and alcohol treatment program.
The move follows temporary closures of HealthPartners sites prompted by stay-at-home orders, reluctance by some patients to visit clinics, and the previous ban on elective procedures.
The seven permanently closed clinics are Park Nicollet Cottage Grove; Highland Park in St. Paul; Riverside in Minneapolis; Stillwater Medical Group in Mahtomedi; Westfields HealthStation in New Richmond, Wis.; Regions Maplewood Behavioral Health Clinic; and HealthPartners’ Central Minnesota Clinic.
In addition, HealthPartners is closing Regions Alcohol and Drug Abuse Program in St. Paul.
Some clinical services will be consolidated at other HealthPartners sites, and former patients of the closed clinics will have access to expanded telehealth services.
Some jobs likely will be eliminated, but most workers will shift to other locations.
Zero-copay, zero-deductible plan unveiled
Health benefits company Gravie recently announced a new zero-deductible, zero-copay health plan that employers can offer to their workers. “Gravie Comfort” offers 100% coverage on most common health care services, including preventive care, primary care, specialist visits, labs and imaging, generic prescriptions, online care, and more at a cost comparable to most traditional group health plans. For less frequently used services, such as hospitalization and specialty drugs, the plan allows employees to choose an out-of-pocket expense limit.
The employer-sponsored plan offers full coverage for most services on day one, with access to a broad, national network. It will be available to enrollees for the upcoming 2021 plan year.
Marek Ciolko, CEO of Gravie, said the plan was designed to address concerns over continuing reductions in coverage under employer-provided plans, as well as increasing out-of-pocket costs, narrowing choice of providers, and administrative obstacles. Ciolko noted that employee health care often represents employers’ second highest expense category.
Gravie’s defined contribution approach allows employers to set and stick to a benefits budget that works for their business, and employees are free to choose the out-of-pocket maximum that works for them.
Physician groups stress value of vaccinations
The Minnesota Medical Association (MMA), the Minnesota Chapter of the American Academy of Pediatrics (MNAAP), and the Minnesota Academy of Family Physicians (MAFP) have launched Practice Good Health, a unified effort encouraging Minnesota families to proactively care for their physical and emotional well-being, especially during the pandemic. The program promotes vaccinations, provides patient information, and supports physicians.
Vaccinations in Minnesota and across the country have drastically decreased due to COVID-19 and fears associated with seeking health care at a physician’s office or other medical clinics. It is estimated that from 70–80% of Minnesota’s children have experienced delayed physician visits, important vaccinations, chronic health care, and routine treatment of everyday illnesses because parents are concerned about bringing their children to the clinic for fear of exposure to the virus.
Under current state law, children must be vaccinated to attend public school in Minnesota. However, Minnesota is one of about 15 states that allow parents to exempt their children from immunization requirements based on their personal beliefs. Statewide, about 2% of children are exempted from immunization requirements. These children are concentrated in certain areas of Minnesota. For example, about 10% of kindergartners in Wadena County have not received their MMR vaccine.
Two pieces of legislation that would eliminate the personal belief exemption for vaccine requirements and fund a grant program that supports community outreach and education about the importance of vaccines have been introduced in recent sessions, but neither has been signed into law.
Wastewater testing strategy may help trace spread of COVID-19
A new testing strategy involving samples from wastewater treatment facilities may soon complement state-funded testing measures to monitor COVID-19 prevalence across Minnesota.
Developed by two researchers at the Duluth campus of the University of Minnesota Medical School—assistant professors Glenn Simmons Jr., PhD, and Richard Melvin, PhD—the testing strategy is intended to help state leaders and health care professionals trace the spread of COVID-19 and overcome limitations imposed by current population testing strategies.
“We know that there are a good number of infected people who are not actually symptomatic, so they may not qualify for diagnostic testing because they don’t present symptoms, but they are still infectious,” Simmons said. “We are looking at a way of getting a population-level understanding of how much infection exists within the community. And by doing that, we’ll then be able to monitor how well our state’s mitigation and treatment efforts are really working.”
After exploring past studies and literature about coronaviruses, particularly the strains causing the MERS and SARS outbreaks, Simmons recognized similarities, including symptoms of gastrointestinal distress that could lead to infection in other parts of the body.
The researchers formed an agreement with the Minnesota Environmental Science and Economic Review Board, which represents more than 50 Minnesota wastewater treatment facilities. He and Dr. Melvin will test wastewater using a PCR (polymerase-chain reaction) process to detect COVID-19 genetic material, ultimately gathering numerical data about the virus’ presence and expansion in various Minnesota communities.
Data will be gathered through fall 2020. Simmons said findings could support under-resourced areas in Minnesota, and could potentially eliminate some aspects of health disparities. He also noted that some people who may be symptomatic are uncomfortable getting tested due to discrimination and bias or lack of trust or access to health care.
Grant supports mental health programs
Wilderness Health has received a $771,767 grant from the Health Resources and Services Administration (HRSA) to support the development of a telehealth program across its 10-member health system network, focusing initially on mental health services.
The grant funds will be used to develop telehealth capacity and infrastructure, including the addition of a dedicated program manager, equipment, and training resources. Successful implementation will facilitate increased access to care. In-person mental health services can involve wait times of several months. Telehealth can reduce that timeframe and allow patients in remote areas to avoid traveling long distances. It can also benefit primary care providers by pairing them with specialists for treatment consultations as well as medication management assistance.
“The network has been working on improving access to mental health resources in our region for several years and had identified expansion of telehealth capacity as a crucial need in our strategic plan,” said Cassandra Beardsley, executive director at Wilderness Health.
Members of Wilderness Health include Bigfork Valley Hospital; Community Memorial Hospital, Cloquet; Cook Hospital; Ely Bloomenson Hospital; Fairview Range Hospital, Hibbing; Grand Itasca, Grand Rapids; Lake View, Two Harbors; North Shore Health, Grand Marais; Rainy Lake Medical Center, International Falls; and St. Luke’s, Duluth.
UCare wins top workplace honors
UCare, an independent, nonprofit health plan, has been named one of the Top 150 Workplaces in Minnesota by the Star Tribune.
Top Workplaces recognizes companies in Minnesota based on employee opinions measuring engagement, organizational health, and satisfaction.
The analysis includes responses from over 76,000 employees at Minnesota public, private, and nonprofit organizations. Rankings are based on survey information collected by Energage, an independent company specializing in employee engagement and retention.
Abdurrahman Hamadah, MD, has joined St. Luke’s Nephrology Associates in Duluth. Dr. Hamadah is board-certified in internal medicine and in nephrology, and is also certified by the American Society of Diagnostic and Interventional Nephrology. He completed his internal medicine residency and a nephrology fellowship at Mayo Clinic in Rochester.
Rachel Hardeman, Phd, MPH, associate professor at the University of Minnesota’s School of Public health, has been named the inaugural chair of the Blue Cross and Blue Shield of Minnesota Foundation’s Endowed Professorship of Health and Racial Equity. The professorship was created with a $500,000 grant from the Blue Cross Foundation to the University of Minnesota to establish an endowed chair focused on health insurance research and course work.
Rahul Koranne, MD, has been appointed by DHS Commissioner Jodi Harpstead to the Comprehensive Health Association Board of Directors, which governs programs to provide basic health insurance coverage to Minnesotans unable to obtain coverage through the open market. Dr. Koranne is president and CEO of the Minnesota Hospital Association.
Santo M. Cruz, JD, is now senior vice president and general counsel for CentraCare, where he will lead the health system’s legal and compliance functions and report to President and Chief Executive Officer Ken Holmen, MD. Mr. Cruz previously served as CentraCare’s associate general counsel and vice president of community and government relations. Prior to joining CentraCare, he was deputy commissioner of DHS.
© Minnesota Physician Publishing · All Rights Reserved. 2019
UCare is ranked 23rd on the large company list, and is one of only a small number of companies to be named a Top 150 Workplace all 11 years of the program.
Matthew Prekker, MD, medical director of Hennepin Healthcare’s Extracorporeal Membrane Oxygenation (ECMO) Program, and his colleagues have received the Award for Excellence in Life Support–Platinum Level, the highest designation level given by the Extracorporeal Life Support Organization (ELSO). The award recognizes programs worldwide that distinguish themselves by having exceptional personnel, procedures, and systems in place to support critically ill patients with ECMO.