October 2019, Volume XXXIII, No 7

  CAPSULES

Clinic provides free Narcan directly to patients

Nura Pain Clinic now provides free Narcan kits and training directly to select patients who take opiate analgesics. Narcan, generically known as naloxone, is a medication that can be used to reverse an opioid overdose.

The clinic has long advocated for multidisciplinary alternatives to opioids for pain management. “We do everything we can to reduce and eliminate the need for opioids in our chronic pain patients,” said Peter Schultz, MD, MPH, a partner in the practice with his brother and clinic founder, David Schultz, MD. “Nonetheless, some patients are referred to us on high dose opioids and it may take us weeks or even months to transition them away from opioids and into more effective and safer alternatives. During this transition period, we believe that access to, and education about, naloxone will help keep these patients safe as we taper opioids over time.”

Underscoring Nura’s new initiative is an August CDC announcement calling for increased access to naloxone, and reporting that only one naloxone prescription was dispensed for every 70 high-dose opioid prescriptions nationwide. In 2018, the Minnesota Department of Health reported 331 deaths due to opioid overdose.

While Minnesotans can now obtain naloxone without a prescription, there are still social stigmas and financial barriers to its access and use.

Nura began testing its program in August and is now looking at rolling it out to all of its opioid-using patients.

Air pollution linked to violent criminal behavior

Exposure to high levels of air pollution is known to cause asthma attacks, cardiovascular disease, and other health problems in people. New research from the University of Minnesota School of Public Health and Colorado State University shows that breathing dirty air—even for just a day—also likely causes people to become more aggressive and violent. Their findings were recently published in the journal Epidemiology.

The researchers examined the association between daily violent and non-violent crimes and short-term increases in air pollution across 301 counties in 34 states during a 14-year period. Data for the study was gathered from the FBI’s National Incident-based Reporting System and the Environmental Protection Agency’s Air Quality System. Daily pollution levels were determined based on the amount of fine particulate matter—such as diesel exhaust chemicals—and ozone in the air.

The study found:

  • Increases in daily air pollution levels raised the risk of violent criminal behavior, such as assaults.
  • Air pollution did not increase the risk of non-violent crime, which are crimes that do not involve force, threats or injury (e.g., property theft).
  • The risk of violent behavior increased even at low pollution concentrations that are usually considered safe for people to breathe.

Results were consistent across different community types, including regions with different socioeconomic status, racial diversity, and age. In other words, it is not the community driving this relationship.

“While our study cannot identify the exact processes that link air pollution and violent behavior, we believe that exposure to air pollution has immediate effects on the brain, which results in behavioral changes,” said study lead author and Assistant Professor Jesse Berman.

These effects may increase the impulsivity of people and escalate what is known as their “fight or flight” stress response. Everyday minor conflicts, such as an argument with a neighbor, may become quickly heated and result in more serious physical altercations.

Allina Health joins UCare Individual and Family plans network

UCare, a community-based, nonprofit health plan, has expanded its provider network to include Allina Health for Individual and Family plan members. The Twin Cities-area Allina Health system includes 11 hospitals, 90+ clinics, and 6,000 associated and employed physicians. UCare’s Individual and Family plans available through MNsure will be the only health plans to feature three major care systems—Allina Health, Fairview Health Services, and Park Nicollet—in their network.

Allina Health and UCare share a common mission to improve the health of communities through exceptional care and service. Both organizations put the member/patient at the center.

UCare currently has the largest enrollment of Individual and Family plans through MNsure—32,000+ members. Since MNsure’s opening in 2014, UCare has been committed to offering and expanding plans for people who buy health insurance on their own. UCare Individual and Family plans are available in 28 Minnesota counties and offer some of the lowest rates on MNsure.

Senior care organizations partner to offer Medicare Advantage plans

Seniors living in 78 Twin Cities-area long-term care and assisted living communities will have a new Medicare Advantage health coverage option to select for 2020 coverage if they qualify for its requirements.

Medica Advantage Solution PartnerCare (HMO I-SNP) is the new Institutional Special Needs plan offered through a collaboration between Genevive, Medica, and 10 of the largest senior care organizations in the region. The plan is designed to meet the often complex health needs of adults living in long-term care, assisted living, and memory care settings. The plans will be available for a Jan. 1, 2020, effective coverage date. They are the first in the region to offer Genevive’s integrated care team expertise aligned with Medica’s care model experience across a diverse number of residential settings.

The plans will be offered exclusively to eligible individuals residing with the 10 senior care providers: Benedictine Health System; Cassia, an Augustana/ELIM affiliation; Catholic Eldercare; Episcopal Homes of Minnesota; Goodman Group; North Cities Health Care Inc.; Presbyterian Homes & Services; Saint Therese; Volunteers of America; and Walker Methodist.

Genevive, co-owned by Allina Health and Presbyterian Homes & Services, will provide primary care and care management services and act as the contracting agent on behalf of Medica, with the participating senior care organizations representing approximately 5,500 eligible individuals. Medica has designed and offers the health insurance plan, which includes coverage for prescription drugs, transportation, dental, vision, and hearing care. Medica-participating providers will provide hospital services, subject to appropriate placement based on clinical considerations and patient choice.

New M Health Fairview brand launches

Following a recent announcement of a joint clinical agreement between the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services, the organizations on Oct. 1 launched a new M Health Fairview brand. M Health Fairview represents the best of academic and community medicine, bringing world-class medical research and advances to thousands of Minnesotans as part of one of the state’s largest health care networks, providing expanded access to breakthrough care.

M Health Fairview closely links the University of Minnesota Medical Center—a hub for medical research—with Fairview’s extensive network of 10 hospitals, 60 primary care clinics, and numerous other services to provide top-tier care.

M Health Fairview focuses on creating an easier, simpler health care experience for patients, designing the care experience around them—an approach built on significant learning and collaboration, including educational visits to the National Aeronautics and Space Administration (NASA), Southwest Airlines, and FedEx.

Each service line organizes around specific health conditions rather than traditional boundaries, such as geographic areas or departments. Led by a single leadership structure pairing academic physicians with operations leaders, the service line approach translates health care innovations developed at the University of Minnesota into care at the community level.

Children’s Minnesota receives grant to bolster program addressing community health

Children’s Minnesota has received a $500,000, two-year grant from Kohl’s Cares to support the health system’s Community Connect program, an initiative that goes beyond basic medical care to support the social determinants of health impacting kids.

Community Connect is transforming Children’s approach to health care by connecting families to existing community resources, including housing, food, and other needs. Beginning with the proactive social determinants of health screening, clinicians at Children’s make real-time referrals to onsite Resource Navigators who can design a responsive plan of action to help families on an on-going basis. Available resources include food access, transportation services, legal assistance, housing support, early childhood education programs, employment search assistance, and more.

“As a pediatric health care system, it’s important that we support kids beyond the care we provide in our hospitals and clinics, and recognize the multitude of factors that contribute to their health, said Gigi Chawla, MD, chief of general pediatrics at Children’s Minnesota. “Improving a child’s overall circumstances can make all the difference when it comes to outcomes.”

Research shows that:

  • Eighty percent of kids’ health happens outside clinic walls—where they live, learn, and play.
  • Early childhood development dramatically impacts a child’s future, as the brain grows most rapidly from ages 0–3.
  • Additionally, the American Academy of Pediatrics recommends 12 well-child visits before age 3, giving health care providers regular and frequent opportunities to support children and families. These visits are particularly critical for very young children before they are connected to other supportive systems, such as schools.

Community Connect is currently available at Children’s St. Paul and Minneapolis Primary Care clinics as well as the Adolescent Health, Asthma and Endocrine Diabetes specialty clinics in Minneapolis and St. Paul. The grant from Kohl’s Cares substantially funds Community Connect at Children’s hospital-based Primary Care clinic in Minneapolis. 

  Medicus

Mark R. Schleiss, MD, a professor and researcher at the University of Minnesota Medical School, has been awarded a National Institutes of Health (NIH) grant for $3.9 million to conduct research studies of novel vaccine strategies for cytomegalovirus (CMV). Nationally, about one baby in 100 is born with CMV, the most common infection that causes birth defects and disabilities in babies in the United States.

Ian Malm, MD, an otolaryngologist, has joined the Allina Health Faribault Clinic, where he treats a wide variety of ear, nose, and throat conditions in both children and adults. A graduate of the Johns Hopkins University School of Medicine in Baltimore, his professional interests include general otolaryngology, laryngology, nasal obstruction, sinus surgery, and thyroid surgery.

Matthew Emme, MD, a physician with St. Luke’s Urology Associates, now sees patients on a monthly basis at Gateway Family Health Clinic. Dr. Emme, who joined St. Luke’s Urology Associates in 2006 and is board-certified by the American Board of Urology, received his medical degree from the University of Minnesota Medical School in Minneapolis.

Ryan D. Miller, PsyD, a psychologist in the St. Cloud VA Health Care System, has received the Minnesota Hospital Association’s quarterly Good Catch for Patient Safety Award. While discussing a patient’s interest in cognitive behavioral therapy for weight loss, he detected symptoms that warranted immediate attention. The patient was assessed and transferred immediately to CentraCare–St. Cloud Hospital for emergency medicine.

Katie Thornton, MD, a pediatrician, has joined the Essentia Health St. Joseph’s–Baxter Clinic in Baxter, Minnesota. Dr. Thornton earned a medical degree from Midwestern University in Glendale, Arizona, and completed a residency in pediatrics at Saint Louis University School of Medicine in St. Louis. 

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Community Connect is currently available at Children’s St. Paul and Minneapolis Primary Care clinics as well as the Adolescent Health, Asthma and Endocrine Diabetes specialty clinics in Minneapolis and St. Paul. The grant from Kohl’s Cares substantially funds Community Connect at Children’s hospital-based Primary Care clinic in Minneapolis.