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This is a guest post by Ms. Brett Thompson-May, General Counsel at Mississippi Board of Nursing Ms. Thompson-May is currently enrolled in George Washington University’s Health Policy and Media Engagement Certificate program.

~There can be no keener revelation of a society’s soul than the way in which it treats its children.~ 

Nelson Mandela

Children have become the biggest losers to the opioid crisis impacting our nation as foster care entries have spiked 32% due to drug related causes.  With ninety-one Americans dying daily of opioid abuse, the effect upon foster care services has become overwhelming.  The opioid epidemic does not discriminate, and the children of many parents who have abused drugs are taken from their families, forced to cope in new environments and who, by no fault of their own, become the real victims. 

The epidemic has extended to pregnant women who give birth to infants diagnosed with the condition of neonatal abstinence syndrome (“NAS”).  The syndrome arises when mothers who used opioids or other drugs go through agonizing withdrawal symptoms. NAS symptoms include high pitched cries, tremors and difficulty sleeping.  Babies with NAS are usually born prematurely, underweight and at high risk for exposure to Hepatitis and HIV due to their mother’s drug abuse. 

Fraternal twins Mary and Evan were born in a Mississippi hospital January 2016.  Their biological parents were addicted to opioids, and the children, who were born premature, were also addicted.  Mary and Evan were born with significant levels of opioids in their systems, and medical personnel immediately injected each one with a shot of Methadone to begin the purging process of drugs in their systems.  Three days after their birth, child protection services placed the care and custody of Mary and Evan with their elderly maternal grandparents.  The biological parents’ rights were temporarily suspended, and they were both placed in treatment and rehabilitative programs to reunite with their children.  The plan ultimately failed as the parents could not overcome their addictions.

Babies like Mary and Evan are not exceptions as there are more infants born with drugs in their systems and who, like Mary and Evan will end up in the foster care system.  Because of the opioid crisis, an increasing number of children removed from mothers with opioid addictions are being placed in foster care thus lowering the average age of children who enter into the system by as much as three years. 

Mary and Evan had an option for custody and care in their aging grandparents.  Steve and Edith were in their 70’s, had been retired for several years and were looking forward to a slower and easier time of life when the twins were placed in their home, turning their lives upside down.  The couple had already raised three children and were now faced with being new parents —again.

Raising twin babies who also suffered from opioid withdrawal proved to be a challenge.  Edith and Steve lost many a night’s sleep while taking turns rocking the children to comfort them, as they suffered from constant tremors.  Weekly trips to the doctor to receive more methadone injections became routine while financial resources to provide for food, shelter and clothing were depleted. Steve went back to work in order to pay increased expenses and sold their retirement home to buy a more suitable home for the children.  While child protection services provided some financial help, those funds were not adequate to offset the increased financial responsibilities.

At the federal level, the Department of Health and Human Services (DHHS) documented the correlation between increasing foster care entries and drug abuse, as well as overdoses.  DHHS found a 10% rate of increase in overdose deaths that directly corresponded to the 4.4% rate of increase in foster care entries.  In 2016, 92,000 children entered foster care due to substance abuse by at least one parent.  Thus, the need for supportive services to address co-occurring problems of both parent’s recovery and child safety are imperative to help combat the problems the opioid crisis has created.  

Funding for child and family services has been eliminated or severely limited at both the national and state levels.  The 2018 federal budget proposes substantial cuts to groups such as Administration for Children and Families, the Substance Abuse and Mental Health Services Administration, and the Temporary Assistance for Needy Families program.  Efforts to repeal and replace the Affordable Care Act have also included initiatives to cut Medicaid funding even though Medicaid is the largest payer for addiction and family services.  While current administration stands behind the Family First Prevention Services Act, this Act makes families choose who should receive Title IV monies—the addicted parents or children who need foster care services.  

In Steve and Edith’s situation, they didn’t receive a dime initially because the parents benefited from Family First monies to help with treatment and rehabilitation.  Only when the parents failed with their plan could Steve and Edith become eligible to receive meager financial assistance. 

Fighting the opioid problem has taken its financial and emotional toll on Steve and Edith as well upon states and community resources and families.  Thankfully, 24 Senators in Washington led by Chuck Grassley (R- Iowa) and Dianne Feinstein (D- Calif.) are requesting funding specifically for the needs of children in foster care systems.  These funds would be directed toward community programs, counseling and treatment, mental and behavioral health services and care coordination/ reunification services.  Grassley and Feinstein have made public the statement that “investing in prevention, as well as treatment, will help reduce the number of children and families impacted by this epidemic.”

In Mississippi, the opioid crisis has caused the number of children in foster care to increase, prompting the hiring of an estimated 150 more social workers to handle the influx of children.  Former Mississippi Supreme Court Justice Jess Dickinson now serving as Commissioner of Mississippi’s Department of Youth Protection Services is pleading with state leadership for more prevention services and community partnerships to help Mississippi recover from the opioid crisis and devastation upon children families. 

Mississippi ranks last in overall childhood welfare and has increased its foster care entries by 30%.  More awareness, more funding and more involvement in saving our children is paramount to fighting the opioid crisis that has plagued our nation, our state and our neighborhoods.  Little Mary and Evan may have had a chance to thrive thanks to their grandparents and a pro bono Mississippi attorney who helped Steve and Edith eventually adopt Mary and Evan.  So many more children in our state and nation are in need.  Those who are interested can contact their U.S. Senators

This is a guest post by Ms.

This is a guest post by Dr. Jacqueline J. Hill, Associate Dean of Nursing and Allied Health at Southern University and A & M College. Her involvement and advocacy in healthcare and educational issues spans over 20 years. 

 

As you may remember, in 2010 the Affordable Care Act (ACA) or as it’s known Obamacare, was signed into law by President Barack Obama. Of the various provisions included in the Act, one of the more popular provisions was the coverage of pre-existing conditions. That’s the provision that prevents insurance companies from denying coverage for a condition the person had before they tried to get insurance. 

Even with the repeal and replace movement of the ACA by the Trump administration, removal of the pre-existing provision was not one of the changes proposed.  In November 2016, the Kaiser Family Foundation conducted its health tracking poll to determine if healthcare was a major factor in the presidential election. The survey found that many of the law’s major provisions (e.g., health coverage for 26-year olds and pre-existing conditions) were quite popular, even across party lines –which begs the question, “why would President Trump want to overturn the pre-existing provision of the ACA?”

Initially, I thought this effort was driven by the insurance industry, but after further investigation, my findings revealed that was not the case. It seems that America’s Health Insurance Plans (AHIP), the trade association for health insurance companies, supports the pre-existing condition protections under the ACA. According to AHIP “Removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, cause rates to go even higher for older Americans and sicker patients, and make it challenging to introduce products and rates for 2019,” They plan to file an amicus brief to support the ACA law. 

So if insurance companies are supporting it, what’s pushing the movement?  Apparently, a lawsuit was filed by 20 states in February 2017 challenging the constitutionality of the individual mandate. Despite the Supreme Court’s ruling earlier this year on the individual mandate, the Republican tax bill eliminates the penalty for not buying insurance, which goes into effect in 2019.  To put it simply, the individual mandate is the part of the law that required everyone to have health insurance. The attorney general of Texas, Ken Paxton, asserts that without the individual mandate, which is the cornerstone of the ACA, the ACA is unconstitutional.

If the courts are in agreement with him then that means that persons with pre-existing conditions would be subject to the pre-ACA era of insurance companies denying them insurance coverage. Unfortunately, the Justice Department has refused to defend the ACA law and are leaving it to the courts.

According to Health and Human Services, approximately 130 million people in US under 65 years of age have pre-existing conditions.  We all know someone who was denied insurance or could not afford the exorbitant cost of insurance for having a pre-existing condition, e.g., diabetes, hypertension, etc. prior to the implementation of the ACA.

Recognizing the role that the ACA has played in assisting people who were previously unable to be insured justifies the importance of maintaining the pre-existing component of the ACA. 

So, what should we as citizens do? We should write our legislators and implore them to not allow this to occur. Recommend that they not tamper with the pre-existing provision, since removing it will negatively impact so many Americans.

Additionally, we should inform key stakeholders such as the insurance companies, nursing associations, and other grassroots organizations and voice our support of the pre-existing provision.  As noted earlier, it’s one of the provisions that most people agree is a good one. What we don’t want to occur is go backwards to a time when so many were not afforded insurance.

Dr. Jacqueline J. Hill is Associate Dean of Nursing and Allied Health at Southern University and A & M College. Her involvement and advocacy in healthcare and educational issues spans over 20 years. 

This is a guest post by Dr.

 

 

This serves as the third edition of HealthCetera’s global health policy and media action news update curated by the Center’s Katherine (Kayte) Green. This bi-weekly round-up intends to keep our community appraised of up-to-date news, policies, and ideas important to policy and social issues facing national and international health. This selection gathers information from a wide range of sources including, but not limited to: health associations and organizations, news sources, government agencies, academic publications, policy centers, and other national and international experts. 


NATIONAL NEWS


SCOTUS 

Washington – It has been a busy June for the Supreme Court of The United States. First Amendment Rights hearings have been tried and these cases will affect civil liberties for years to come. These decisions are a continuum of debates in the Supreme Court about how courts analyze First Amendment challenges.

Earlier this month, on June 4th, SCOTUS ruled in favor of a Colorado baker who refused to bake a cake to celebrate the marriage of a same sex couple because of a religious objection. The ruling was 7-2.

Tuesday June 27th’s ruling in favor of California anti-abortion clinics’ first amendment right, stating that these “clinic pregnancy centers” are not mandated to provide information on how to end pregnancies. The vote was 5-4.

Also on Tuesday, Trump’s Travel Ban was upheld handing the president a political victory and validating his power for border and immigration control. The vote was 5-4.

On Wednesday, the Court handed down a major blow to organized labor – ruling that government workers who chose not to join unions won’t have to pay for collective bargaining. The vote was 5-4.

And, the balance of the Supreme Court of The United States is in jeopardy with the announcement on Wednesday June 27th that Justice Anthony K. Kennedy will be stepping down. The bench was tipped right when Trump appointed Justice Gorsuch last year; and with another SCOTUS judge nomination for this administration, the scale will most likely tip further to the conservative right. In the coming years civil liberties will be called into question including: LGBTQ, Affirmative Action, Death Penalty, Abortion, Voting Rights and Gerrymandering, and Immigration.

LGBTQ RIGHTS:

SCOTUSblog: Justice Kennedy: The linchpin of the transformation of civil rights for the LGBTQ community

VOX: Anthony Kennedy’s retirement is devastating for LGBTQ rights

The Advocate: Justice Kennedy Retires, Putting Rights in Jeopardy

ABORTION:

NYT: Supreme Court Backs Anti-Abortion Pregnancy Centers in Free Speech Case

The Washington Post: Supreme Court says crisis pregnancy centers do not have to provide women abortion information

Reuters: Supreme Court Blocks California Law On Anti-Abortion Centers

The Hill: Supreme Court Ruling May Pave Way For More Faith-Based Pregnancy Centers

TRAVEL BAN:

NYT: Trump’s Travel Ban is Upheld by Supreme Court

The Chronicle: In Upholding Trump’s Travel Ban, Supreme Court Ratifies Worldview That Worries Colleges

UNIONS:

NYT: After Janus, Unions Must Save Themselves

The American Federation of Government Employees (AFGE): Following Janus ruling, workers must unite to preserve rights

Time: Supreme Court Deals Big Setback to Labor Unions

JUSTICE KENNEDY:

The New Yorker: Justice Kennedy’s Travel-Ban Opinion, in Light of His Retirement

“On Wednesday, what had seemed a particularly contentious finale to the Supreme Court’s term—with major cases involving union dues, the President’s travel ban, cell-phone location data, and anti-abortion “crisis pregnancy centers”—turned out to be a prelude to a bigger fight, when Justice Anthony Kennedy announced that he would retire at the end of July.” 

NPR: Trump Says He Will Nominate New Supreme Court Justice From This List

The Atlantic: Justice Stevens: Roe Will Be Overturned if Kennedy Retires

RESOURCES: 

United States Office of Labor 

Utility Worker Union of America Education Portal 

SCOTUSblog

 

Obamacare’s Pre-Existing Protections Under Siege, Again

” WASHINGTON — After failing to repeal the Affordable Care Act with a Republican-controlled Congress, the Trump administration is seizing on a different strategy for dismantling the law, one fraught with political risk. It is asking a court to throw out major elements, including hugely popular provisions that protect sick people from being denied health insurance or charged higher rates.” – Abby Goodnough, Robert Pear and Charlie Savage

RESPONSES:

Associated Press: Worker protections seen at risk in Trump health care shift

Reuters: U.S. Justice Department says Obamacare individual mandate unconstitutional 

The Commonwealth Fund: The New Obamacare Lawsuit Could Undo Far More Than Protections for Preexisting Conditions

The NYT: Justice Dept. Says Crucial Provisions of Obamacare Are Unconstitutional

VOX: The Trump administration believes Obamacare’s preexisting conditions protections are now unconstitutional

Huffington Post:Trump Administration Takes New Aim At Obamacare’s Pre-Existing Protections

The New England Journal of Medicine: Repealing the ACA without a Replacement — The Risks to American Health Care

 

 Trump’s Zero Tolerance Border Policy and Enforcement

This image of a mother seeking asylum on the Mexico border, who is being arrested for deportation in front of her two-year old daughter, has become the symbol of the devastating effects of Trump’s Zero Tolerance border control. It has been reported that over 2,300 children have been taken away from their families on the Mexican border since the beginning of May.  The Zero Tolerance policy has immediate and long-term consequences for the children that are being torn from their families.

RESPONSES: 

The Guardian: ‘Dumb, stupid’ family separations harm children, says detention camp manager

Politico: ‘Some Of The Kids I Spoke To Were Traumatized. Some Could Barely Speak.’ 

Reveal: Migrant Children At Risk Of Disease Outbreaks, Doctors Say 

Bloomberg: Immigrant Children Forcibly Medicated While In U.S. Custody, Lawyers Say  

The Associated Press: A Day With Border Patrol: Imperiled Infant, Distraught Dad 

The Associated Press: Migrant Kids Could End Up In Already Strained Foster System 

Time: Donald Trump Border Separation Policy 

Newsweek: Immigrant children separated at border could suffer depression, disease and even earlier death, doctor says 

The New Yorker: The Courageous Woman Who Is Organizing Separated Mothers Inside an ICE Detention Center

Kaiser Health News: Separating Children From Parents Can Make Them Easy Prey For Traffickers, State Department Report Warns

Michigan Health Lab: What Neuroscience Tells Us About Family Separation

Take a closer look at the detention centers and “tender age” shelters for immigrant children:

Kaiser Health News: 1 In 5 Immigrant Children Detained During ‘Zero Tolerance’ Border Policy Are Under 13 

The Associated Press: Young Immigrants Detained In Virginia Center Allege Abuse 

The New York Times: The Billion-Dollar, Secretive Business Of Operating Shelters For Migrant Children 

 


GLOBAL NEWS


Migration Crisis in Europe

As the debate over migration in the United States heats up, Europe continues to be torn over what to do with the continent’s long running migration crisis. Many of those entering into the borders of Europe are coming from Northern Africa and crossing the Mediterranean Sea to seek asylum from terrible living conditions in their countries, spurred by economic conditions, political turmoil, and human rights violations.

RESPONSES:

Politico: EU leaders clinch migration deal in marathon summit

ODI: Aquarius, immigration caps and family separation: three lessons for doing migration differently

The Lancet: The displaced: looking for home away from home

BMC: European Union citizens’ views on development assistance for developing countries, during the recent migrant crisis in Europe

The Lancet: Offline: Migration—the new revolution

Devex: EU states push external migrant centers despite IOM doubts

The Washington Post: E.U. leaders agree on outline of migration deal

PAPERS:

Stevens, D. & Dimitriad,A.  Crossing the Eastern Mediterranean Sea in Search of Asylum: Re-Evaluating Access, Agency, Policy and Protection. Academia.com

 

UN Sexual Misconduct

In the era of the #MeToo movement, the United Nations is not immune to sexual harassment claims and has convened this week to investigate and address sexual misconduct within its organization.  UNAids is under scrutiny for the mishandling of serious workplace sexual harassment claims. Female whistleblowers and HIV activists are urging global leadership to demand the Executive Director of UNAIDS, Michel Sidibé’s, step down because of his mismanagement of these claims.

The United Nations Secretary General, António Guterres has promised to make accountability for sexual misconduct a central part of his leadership.

RESPONSES:

Health Policy Watch: Accountability, Sexual Harassment Concerns In Spotlight At UNAIDS Board Meeting

NYT: U.N. Cases Read Like ‘Manual in How Not to Investigate’ Sexual Assault

UN News: UN leaders vow to stamp out workplace sexual harassment

The Guardian: UN sexual misconduct chief was promoted while facing harassment claims

 

European Food Labeling

PLOS Global Health: Cracking the Codex: the new frontier for nutrition labelling

The Codex Alimentarius Commision has been created by the United Nations World Health Organization Food and Agriculture Organization as the body that has outlined an international food standard. This is a two-prong mandate with the aim to: promote fair trade practices and protect consumer health. Although the standards are voluntary, these types of policies are often guidance for countries looking to develop national policies and could have the potential to show up in trade discussions globally. There will be a general meeting in Rome next week to further a discussion paper about these outlined standards.

“In short: what happens at Codex matters for public health nutrition.” – PLOS

RELATED REPORTS:

NYT: In Nafta Talks, U.S. Tries to Limit Junk Food Warning Labels

Other News:

EuroHealthNet Annual Report

” EuroHealthNet is a not-for-profit partnership of organisations, agencies and statutory bodies working on public health, promoting health, preventing disease, and reducing inequalities. EuroHealthNet supports members’ work through policy and project development, knowledge and expertise exchange, research, networking, and communications.” – EuroHealthNet

Global Health Council – ADVOCACY UPDATE ~ JUNE 25, 2018

Global Health News Resources:

NYT Global Health News

CDC Global Health News

Global Health NOW

Global Health Council 

STAT


WEEKLY OP-ED

(Unsponsored and unsolicited)


NPR Health: Atul Gawande’s Aim For Health Care: ‘Make It Simpler To Do The Right Thing’

Dr. Atul Gawande, the surgeon-writer-researcher has been named the CEO of a joint health care partnership venture unveiled earlier this year by Amazon, Berkshire Hathaway and JPMorgan Chase. These three prominent employers hope to bring down health costs for their employees. Gawande says his biggest goal is to help professionals “make it simpler to do the right thing” in delivering care to patients.

” The new enterprise will oversee health coverage for about 1.2 million employees of the companies and their families. Gawande said he will focus on the same behaviors by doctors and hospitals that he studies at his Boston-based think tank, Ariadne Labs. One of the biggest problems in health care is that “doing the right thing is incredibly complicated,” he told the Aspen gathering, and one of the biggest sources of waste in the system is that patients are given “the wrong care in the wrong way at the wrong time.” Read More.


Katherine Green works for the George Washington School of Nursing’s Center for Health Policy and Media Engagement. She holds a Master’s Degree in International Relations and Service Development. The focus of her research is gender equity and empowerment. She is passionate about working on unresolved social issues that deal with health, gender rights, LGBTQ, risk reduction, the arts, and justice. She has a background in social sciences and fine arts. Prior to joining GW, Katherine has worked in global and national health advocacy, development, and policy.

To subscribe and submit content to HealthCetera News Action Update email: nursingpolicy@gwu.edu

    This serves as the third edition of