Policy Updates 10/28/22

1. Disparities
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In California, Some Latinos With Disabilities Don’t Get As Much Help As Whites Do: The system charged with ensuring that California adults with developmental disabilities get crucial services is plagued with stark differences in spending by race, ethnicity, and where people live, according to a report released Wednesday by a disability advocacy group. Read more from the Los Angeles Times and Southern California News Group.

CNN: People Of Color Less Likely To Receive Paxlovid And Other Covid-19 Treatments, According To CDC Study
People of color – especially Black and Hispanic people – were less likely to receive Paxlovid and other Covid-19 treatments, according to a study published Thursday by the US Centers for Disease Control and Prevention. Throughout the pandemic, Black and Hispanic people have been about two times more likely than White people to be hospitalized or die from Covid-19.The new study showed Black Covid-19 patients were 36% less likely than White patients to be treated with Paxlovid, and Hispanic patients were 30% less likely than non-Hispanic patients to receive the antiviral pill. (McPhillips, 10/27)

San Francisco Chronicle: Black Patients 36% Less Likely To Receive Paxlovid, CDC Study Shows
The ongoing racial and ethnic disparities of the COVID-19 pandemic affected access to life-saving treatments through this summer, according to a study published Thursday by the U.S. Centers for Disease Control and Prevention. (Vaziri, Buchmann and Ravani, 10/27)

Southern California News Group: It Helps To Be White If You’re Disabled In California, Study Finds
“California’s developmental disability service system is plagued with racial, ethnic and geographic disparities that can dramatically and dangerously impact the essential services received by adults with developmental disabilities,” concludes Disability Voices United, a statewide organization that advocates for people with disabilities and their families, in a report released Wednesday, Oct. 26. (Sforza, 10/27)

2. Children’s Health
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KQED: Bay Area Children's Hospitals Strained As RSV Surge Arrives
Patients are flooding Bay Area hospitals as a common respiratory virus sweeps across the region, mirroring a similar surge that has ravaged the East Coast this month. “Last night I admitted a 3-year-old child from the emergency department who spent nine hours in the emergency room waiting for a bed in the hospital,” said Dr. David Cornfield, pediatric pulmonologist at Stanford University. “And that's not terrifically unusual [right now].” (McClurg, 10/27)

Becker's Hospital Review: Amid Early RSV Surge, Treatment Options Remain Limited
Besides one preventive drug that can only be prescribed in some cases, there are no FDA-approved treatments for respiratory syncytial virus — which leaves healthcare workers with limited treatment options. (Twenter, 10/27)

ABC News: Some US Hospitals Report Beds Are Full Among Increase In Respiratory Infections In Children
Some hospitals across the United States say their beds are full as cases of respiratory viruses continue to increase among children. According to the Centers for Disease Control and Prevention, infections due to respiratory syncytial virus, or RSV, have spiked by 69% over the last four weeks from 4,667 to 7,917 and are appearing earlier than usual. (Kekatos, 10/27)

Los Angeles Daily News: Southern California Hospitals See Spike In Young Children With Respiratory Virus
From Los Angeles to Orange County and the Inland Empire, doctors at local hospitals say they, too, are seeing an increase in respiratory syncytial virus cases, or RSV. (Tat, 10/25)

Axios: Respiratory Virus Cases In Children Surging "Like Never Before"
Respiratory illnesses in children are overwhelming hospitals across the United States right now. The unseasonably high numbers of respiratory illness in kids has put a strain on hospitals that are already preparing for the typical wintertime surge of patients ill from viruses. (Scribner, 10/21)

3. COVID
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CapRadio: CDC Paves Way For California To Require School COVID Vaccines — But Lawmakers Have Given Up For Now
The U.S. Centers for Disease Control and Prevention’s vaccination advisors voted last week to recommend all children get the COVID-19 vaccine, a move that does not change California’s list of vaccines required for children to attend school. The addition of the COVID-19 vaccine to the CDC’s recommended vaccines for kids is not a mandate for states’ school attendance requirements. Any additions to California’s list must be made by the state Legislature or the state Department of Public Health. In the last 12 months, the Newsom administration and the Legislature separately tried to mandate the COVID-19 vaccine for kids to attend school, and both failed. (Aguilera, 10/27)

CalMatters: California Vaccination Requirements Could Add COVID
The U.S. Centers for Disease Control and Prevention’s vaccination advisors voted last week to recommend all children get the COVID-19 vaccine, a move that does not change California’s list of vaccines required for children to attend school. The addition of the COVID-19 vaccine to the CDC’s recommended vaccines for kids is not a mandate for states’ school attendance requirements. Any additions to California’s list must be made by the state Legislature or the state Department of Public Health. In the last 12 months, the Newsom administration and the Legislature separately tried to mandate the COVID-19 vaccine for kids to attend school, and both failed. (Aguilera, 10/26)

4. Health Coverage
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KHN: Ambulance Company To Halt Some Rides In Southern California, Citing Low Medicaid Rates
For 23 years, the private ambulance industry in California had gone without an increase in the base rate the state pays it to transport Medicaid enrollees. At the start of the year, it asked the state legislature to more than triple the rate, from around $110 to $350 per ride. The request went unheeded. In September, American Medical Response, the largest U.S. provider of ambulance services, announced it had “made the difficult decision” to end nonemergency transports in Los Angeles County and blamed the state for having one of the lowest Medicaid reimbursement rates in the country. (Kwon, 10/28)

Axios: Most States Have Extended Medicaid Coverage After Birth To One Year
More than half of the states have now expanded their Medicaid postpartum coverage from the federally mandated 60 days to one year, the Department of Health and Human Services confirmed to Axios. (Gonzalez, 10/27)

Bloomberg: Some States Push To Limit Health Coverage For Poor Children
About 4 million children in the US have no health insurance. That’s about 5% of Americans 18 and younger. The number of uninsured kids declined for years, until it began edging up at the end of the 2010s. New research blames that reversal on state policies that made it harder to get safety-net coverage. That’s likely to have useful lessons for the year ahead. (Tozzi, 10/26)

Axios: ACA's Preventative Care Requirement Under Attack
Plaintiffs in an Affordable Care Act lawsuit are now asking a federal judge to toss all parts of the law requiring coverage of preventive health services. The filing raises the stakes in the closely watched case, Kelley v. Becerra: If U.S. District Court Judge Reed O'Connor sides with the plaintiffs, millions of Americans could lose coverage for cancer screenings, behavioral counseling and other recommendations made by the U.S. Preventive Services Task Force. (Gonzalez, 10/25)

5. Women’s Health
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Scientific American: These Drugs Could Restore A Period Before Pregnancy Is Confirmed
Imagine this situation: A woman misses her period and worries she might be pregnant. She doesn’t want to be, so she schedules an appointment with a health care provider and tells them she wishes to get her period back. The provider prescribes her a course of “period pills.” She gets her period again, and that’s the end of it. Such a scenario is not purely hypothetical. Period pills are the same ones used in medication abortion—misoprostol alone or in combination with mifepristone—which could imply that menstrual regulation is just another name for early abortion. But the drugs might not be considered abortion medication because the patient never learns whether they were pregnant in the first place. (Lenharo, 10/26)

Axios: FDA Postpones Meeting To Review Over-The-Counter Birth Control Pills
"Protection of women’s health is of high importance to FDA," an FDA spokesperson told Axios. "The postponement does not indicate or affect any decision regarding the application," the spokesperson said, and added that the agency "remains committed to a timely review of this application." (Gonzalez, 10/26)

Scientific American: These Drugs Could Restore A Period Before Pregnancy Is Confirmed
Imagine this situation: A woman misses her period and worries she might be pregnant. She doesn’t want to be, so she schedules an appointment with a health care provider and tells them she wishes to get her period back. The provider prescribes her a course of “period pills.” She gets her period again, and that’s the end of it. Such a scenario is not purely hypothetical. Period pills are the same ones used in medication abortion—misoprostol alone or in combination with mifepristone—which could imply that menstrual regulation is just another name for early abortion. But the drugs might not be considered abortion medication because the patient never learns whether they were pregnant in the first place. (Lenharo, 10/26)

The Hill: House Investigation Finds Insurers, Benefit Managers Improperly Limit Access To Birth Control
Some of the nation’s largest insurers and pharmacy benefit managers (PBMs) impose coverage exclusions and other restrictions on birth control products, contrary to an Affordable Care Act (ACA) requirement, according to a House investigation. Under the ACA, health plans must cover Food and Drug Administration-approved contraceptive products without cost-sharing. But a staff report from the Democrats on the House Oversight and Reform Committee found insurers and PBMs required patients to pay some of the cost or otherwise limited coverage of more than 30 birth control products. (Weixel, 10/25)

6. Mental Health
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KHN: Employers Are Concerned About Covering Workers’ Mental Health Needs, Survey Finds
Almost three years after the covid-19 pandemic upended workplaces, mental health coverage remains a priority for employers, according to an annual employer survey fielded by KFF. Nearly half of surveyed large employers — those with at least 200 workers — reported that a growing share of their workers were using mental health services. Yet almost a third of that group said their health plan’s network didn’t have enough behavioral health care providers for employees to have timely access to the care they need. (Andrews, 10/27)

KHN: States Opting Out Of A Federal Program That Tracks Teen Behavior As Youth Mental Health Worsens
As the covid-19 pandemic worsened a mental health crisis among America’s young people, a small group of states quietly withdrew from the nation’s largest public effort to track concerning behaviors in high school students. Colorado, Florida, and Idaho will not participate in a key part of the Centers for Disease Control and Prevention’s Youth Risk Behavior surveys that reaches more than 80,000 students. Over the past 30 years, the state-level surveys, conducted anonymously during each odd-numbered year, have helped elucidate the mental health stressors and safety risks for high school students. (Chang, 10/26)

Reuters: Judges Must Divert More Cases To Mental Health Treatment, Task Force Says
Court systems in the U.S. need to do a better job of diverting individuals in some cases to mental health treatment and to establish new best practices for cases involving those with behavioral health issues, according to a task force that spent the last two years studying mental health in the judicial system. The National Center for State Courts, creator of the task force, said that at least 70% of people in the country's jails and prisons have been diagnosed with a mental illness or substance-use disorder, and people with mental illness are 10 times more likely to be put in a jail than a hospital. (Osakwe, 10/25)

7. Trans Care
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NPR: Study: Most Teens Who Start Puberty Suppression Continue Gender-Affirming Care
A large majority of transgender adolescents who received puberty suppression treatment went on to continue gender-affirming treatment, a new study from the Netherlands has found. (Wamsley, 10/26)

8. Disability Rights
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Limitation on Disability Rights

https://www.disabilityscoop.com/2022/10/10/supreme-court-case-could-sharply-limit-disability-rights/30070/

Influenza

The New York Times: A ‘Tripledemic’? Flu And Other Infections Return As Covid Cases Rise
With few to no restrictions in place and travel and socializing back in full swing, an expected winter rise in Covid cases appears poised to collide with a resurgent influenza season, causing a “twindemic” — or even a “tripledemic,” with a third pathogen, respiratory syncytial virus, or R.S.V., in the mix. (Mandavilli, 10/23)

10. Health Care Workforce
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CapRadio: Labor Tries City-By-City Push For $25 Minimum Wage At Private Medical Facilities
A class of health care facility support staff, including nursing assistants, security guards, and janitors, has worked alongside doctors and nurses throughout the covid-19 pandemic keeping patients and medical buildings safe and clean. It’s an unassuming line of work that some people consider a calling. Tony Ramirez, 39, a critical care technician at Garfield Medical Center in Monterey Park, California, finds more fulfillment in helping people in need than he once did editing technical documents for Disneyland. Before the pandemic, he would reposition and bathe patients and sometimes monitor their vital signs. After covid struck, he took on more duties, providing CPR or grabbing medications during an emergency, placing leads to monitor heart rhythms, and conducting post-mortem work. “We started doing that,” Ramirez said, “because of the influx of covid patients running very ill and in very intense situations.” (Bluth, 10/23)

Modern Healthcare: Physicians Left Their Jobs In Droves In 2021: Report
As a profession, physicians lost the most members, with 117,000 individuals leaving their roles last year, followed by nurse practitioners, which lost 53,295 members and physician assistants, with 22,704 positions vacated, according to a report published Thursday by Definitive Healthcare. (Devereaux, 10/20)

11. Medication Shortages
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The Washington Post: Doctors' Advice On Renewing Adderall Prescriptions Amid The Shortage
If you’re having trouble renewing your Adderall prescription, experts say you should work with your health-care provider to shop around at nearby pharmacies or discuss rewriting your prescription to a version of the medication that isn’t in such high demand. (Amenabar, 10/21)

Bloomberg: Amoxicillin, Common Antibiotic To Treat Infections In Children, In Short Supply In US
Three of the top four makers of the antibiotic amoxicillin, commonly used to treat bacterial infections in children, are reporting supply constraints in the US. (Swetlitz and John Milton, 10/21)

NBC News: Helium Shortage: Doctors Are Worried That Running Out Of The Element Could Threaten MRIs
Strange as it sounds, the lighter-than-air element that gives balloons their buoyancy also powers the vital medical diagnostic machines. An MRI can’t function without some 2,000 liters of ultra-cold liquid helium keeping its magnets cool enough to work. But helium — a nonrenewable element found deep within the Earth’s crust — is running low, leaving hospitals wondering how to plan for a future with a much scarcer supply. (Hopkins, 10/22)