Tuesday, March 11, 2014

Off Label: Dangerous Drugs

Free Speech TV and Ring of Fire premiere Off Label tonight on Free Speech TV.  Off Label exposes the dangers of psychotropic drugs that are combined with other medications or used for unapproved or untested purposes. 

You can watch Free Speech TV on DISH ch 9415, DIRECTV ch 348, today, March 11th at 7:30 pm (mountain time) or at www.FreeSpeech.org where you can stream it live. 

 Off Label

*psychotropic or psychoactive or psychopharmaceutical drugs are chemical substances that alter mood by crossing the blood-brain barrier acting on the central nervous system.  They affect brain function and are used for a variety of reasons including mental health issues, ADHD and pain. 

Wednesday, March 5, 2014

UHA CAC Meeting Tonight in Roseburg

The Community Advisory Council of the Umpqua Health Alliance (UHA), will be holding the first of two public meetings to discuss what should be in our community health improvement plan.  

5:30 to 6:30 p.m. at the Cow Creek Office building on NE Stephens in Roseburg. 

Thursday, February 20, 2014

Medford News Story: Medical middle ground between marijuana and pain pills | MailTribune.com

 Although the title calls the position of the doctors in this story as taking the middle ground between marijuana and pain pills, this is not the case.  These doctors are not educating themselves about what the middle ground is; they are just deciding it is one or the other. 

This story illustrates why people should be filing complaints against the licenses of any medical professional who does not follow science and the law regarding patients' right to choice. 

Medical middle ground between marijuana and pain pills | MailTribune.com

Monday, February 3, 2014

Housing Is a Health Care Issue!

Dateline NBC January 6, 2014 clearly shows the connection between being healthy and the condition of your housing.  

You can view Breathless starting with the following link:

The first part shows the harm of asthma: the five remaining segments show the direct link between substandard housing and the disease.   

Although we are lucky here in Douglas County, Oregon because there are no problems in this regard with our local Public Housing Authority (PHA), HADCO, we do have such substandard rental housing throughout the county, which are usually owned by private investors.  However mold in significant in our rural Oregon community and it is not just old drafty slum housing.  The problem can actually be caused in new construction when it is not done properly.  

I personally know about one unit, owned by a local non-profit, where the local contractor who built the homes failed to provide the right ventilation for the units.  This caused too much humidity in the units leading to an on-going problem with mold growth.  After watching this program, I am more concerned that the units may have led to the development of asthma in the children living there, at least one of whom I personally know.  

Since housing is clearly a health care issue, shouldn’t our local Coordinated Care Organization, Umpqua Health Alliance (UHA) pay for housing people so they do not have to live in mice, cockroach and mold infested units because that is all the family can afford?   If they give a woman an air-conditioner to keep her out of the hospital, should they not do the same regarding healthy housing?  

Sunday, January 12, 2014

Roseburg VA Profiled in Narcotic Prescribing Controversy

The following video about the inappropriate prescribing of narcotic pain mediation was aired by PBS NewsHour this past October.  It illustrates the problem of not providing good medical care and the real danger narcotics can pose.  What happened to the veterans was the VA doctors malpracticed on both of them.  They did not provide the intensive services that each of them needed.  This is not a failure of pain medication: it is a failure of the VA medical system, including the one right here in our community. 


Monday, November 4, 2013

OPRA Confirms UHA's CAC violates State Law!

Oregon Patients Rights Association has confirmed that the composition of Umpqua Health Alliance's legally mandated Community Advisory Council (CAC) violates Oregon State law.

This fact was recently revealed to the public by the release of the legally required CAC Community Health Assessment and confirmed this evening at a community meeting in Roseburg by UHA representative Mike Shirtcliff.  

In answer to questions challenging the make-up of the CAC by an OPRA member,  Shirtcliff attempted to justify the composition of UHA's CAC by claiming that different CCOs in our state interpret the law differently.  That may be the case but that is the type of thing lawsuits are made of.

Oregon Revised Statute 414.625(1)(i) states:

(1) The Oregon Health Authority shall adopt by rule the criteria for a coordinated care organization and shall integrate the criteria into each contract with a coordinated care organization. Coordinated care organizations may be local, community-based organizations or statewide organizations with community-based participation in governance or any combination of the two. Coordinated care organizations may contract with counties or with other public or private entities to provide services to members. The authority may not contract with only one statewide organization. A coordinated care organization may be a single corporate structure or a network of providers organized through contractual relationships. The criteria adopted by the authority under this section must be designed so that:....

(i) Each coordinated care organization convenes a community advisory council that includes representatives of the community and of county government, but with consumers making up a majority of the membership, and that meets regularly to ensure that the health care needs of the consumers and the community are being addressed."

Now keep in mind, the term consumer in this legislation refers to Medicaid consumer because this law is only about Medicaid.  There would be no other "consumer" for the purpose of determining the health care needs and services for anyone but them given the intent and purpose of the law that created the CCO system.  

It seems that the only CCO that we can identify that tries to claim the language in the law allows them to pick anyone they want and are not mandated by law to pick Medicaid consumers is our very own Umpqua Health Alliance.  There may be some others out there but we have not found them. Not surprisingly they are also the one of the few CCO that operates in secrecy not even providing information about the CAC to the public.   

Fortunately the one thing the Community Health Assessment has accomplished is providing information to the taxpayer that confirms that the Community Advisory Council does not have a majority of Medicaid members.  See the letter below attached letter submitted to member of the UHA Board (Shirtcliff and Commissioner Susan Morgan) by an OPRA member that explains why.

What do you think?

November 4, 2013

Umpqua Health Alliance (UHA)
Community Advisory Council

To Whom It May Concern:

After reviewing the Community Health Assessment and the Oregon Revised Statute regarding the role of the Community Advisory Council (CAC) in overseeing it, I am very concerned about the fact that the makeup of our local CAC violates the law that was enacted to implement Oregon’s Medicaid reform efforts.  The failure of the CAC to comply with the requirements of the Oregon Revised Statute puts the validity of the Community Health Assessment, and any other work being done by the CAC, into question.   

Two statutory requirements of the CAC are to oversee the process of the Community Health Assessment and adopting a community health improvement plan based upon that assessment that will guide the provisions of services in our community.   If the configuration of the CAC does not comply with the legal requirement that 51% of its members be Medicaid consumers, then anything they come up in this process, starting with this Community Health Assessment, lacks credibility.     

Although this is not the fault of individual CAC members, it is the fault of those on the Umpqua Health Alliance (UHA) Board of Directors, DCIPA LLC and its parent company Architrave.  As Medicaid contractors, they should be well aware of the law regarding this.  So we can only assume that they are blatantly ignoring it and have failed to make sure that the current members of the CAC know the requirements of the law including the Medicaid majority.
One only need review the report itself to verify that the CAC does not have the majority of Medicaid consumers on it that is required by state law.   This same paragraph demonstrates the problem that failing to comply with the law creates.  The following appears on page 45 of the report:
“Variance between groups is notable. Higher socioeconomic groups (such as the CAC) rate lifestyle and the jobs as the biggest factors relating to health whereas those groups representing individuals living in poverty or those with health disparities listed access to health care, domestic violence, and housing as major concerns.”

As you will note, the report identifies the Community Advisory Council as being “higher socioeconomic” level.   It is clear from this that UHA acknowledges that the CAC is not 51% Medicaid consumers.  One has to be low-income to benefit from Medicaid, so by the very definition of eligibility, one could not be from a “higher socioeconomic” group.  The same sentence also makes it clear that there are differences in views among this group and those identified as “individuals living in poverty”.   This type of difference could have a dramatic impact about the very construction of the survey process, including what questions to ask and of whom.  

It seems a glaring omission to me that there is not more input from Medicaid recipients in the CHA.  One cannot identify from the focus group categories whether those responding represented Medicaid recipients either.  Although one might conclude that certain focus groups would have a at least some Medicaid consumers represented in them based on other information in the report, there is nothing that enumerates the number of Medicaid consumers participating in any part of the process.   One might also conclude that if the CAC had the required majority, there would be more engagement from Medicaid beneficiaries. 
The entire reason that the law requires a majority of those on the CAC to be consumers of Medicaid services is to ensure that those who benefit from the services are an integral part of the process.  It is no mistake that this requirement was put into the law governing CCOs and this requirement cannot be ignored.
There is really only one way to resolve this issue:
1.    The Community Advisory Council (CAC) must immediately be reconstructed to comply with Oregon Revised Statute (ORS) 414.625:
“414.625 Coordinated care organizations; rules. (1) (i) Each coordinated care organization convenes a community advisory council that includes representatives of the community and of county government, but with consumers making up a majority of the membership, and that meets regularly to ensure that the health care needs of the consumers and the community are being addressed.”
2.    The Community Health Assessment (CHA) should then be redone by the CAC with a majority of Medicaid consumers on it making the decisions about how the CHA will be conducted.  
It should go without saying that the selection of the CAC members should be done in a fair manner that does not discriminate against Medicaid beneficiaries and others who have exercised their rights, including any of those who may be here tonight to object to this process.  
Although the entire process is in question, it is hard to argue with some of the information set out in the report.  For a while, we have been aware of our low rankings in the state regarding overall health markers of our community.   The News Review has consistently reported that Douglas County has too many people who smoke, are overweight or obese, and suffer from more health problems that most of the other counties in Oregon.   Further, access to quality health care has been a problem in this community for some time, for a variety of reasons.
If we assume that these things are true, then there is nothing that stops our local CCO, Umpqua Health Alliance (UHA) from implement changes in the provision of services that includes promoting better health and health care.  These things include:
1.    Focusing on increasing access to primary care providers throughout the community.  This would include reopening clinics in Glide and Drain. 
2.    Making sure that patients receive health care services based upon individual patient need and choice. 
3.    Ensure all patients are provided with “informed choice” regarding all that is available to them, whether or not paid for by the CCO.
4.    Ensure that all providers know and honor patients’ right.  
5.    Ensure that providers are allowed to freely make medical decisions with their patients and are not forced to comply with unnecessary rules and restrictions created by the CCO.  
6.    Ensure that services are provided in a timely manner, such as dental health services.
7.    Create a global budget that adequately compensates providers for the services each patient needs, particularly in cases of chronic multiple health conditions or mental health services that may take more time and intervention than others.
8.    Include in the global budget money for health improvement such as:  YMCA and other health club memberships and exercise classes, as well funding hands-on healthy cooking classes that are free to participants.
These are just a few things that can be done to improve the health care and health in our community right now, while we are waiting for Umpqua Health Alliance to make sure their CAC complies with the law. 
Thank you for your time and consideration.

Betsy Cunningham
1026 SE Stephens
Roseburg, OR 97470
Telephone: 541-580-2746

Thursday, October 31, 2013

LUND Report Confirms: Freeman Gets Corporate Medicine Money

Today's article in the Lund Report confirms, Oregon Patient Rights Association claims that our local State Representative, Tim Freeman is in the pocket of our local health care monopoly.   Topping the list of donations to all Representatives in the State, Tim Freeman received a total of $33,500 just from the interests involved in formation of Coordinated Care Organizations (CCO), like our local Umpqua Health Alliance (UHA) during the last election cycle. 

This supports research done by OPRA that shows in the past two election cycles, Freeman received over $50,000 from DCIPA and Advantage Dental alone, both of whom are part of the local Coordinated Care Organization (CCO), Umpqua Health Alliance and whose leaders (Dr Bob Dannenhoffer-DCIPA, Mike Shirtcliff (Advantage Dental) claim to be part of the process of establishing CCO as the Medicaid transformation in Oregon.    

You can read the Lund Report article below or click the link to their website:  http://www.thelundreport.org/resource/coalition_of_ccos_and_doctors_groups_pour_14_million_into_elections

OPRA recommends the Lund Report for reliable information about health care related issues around the state.

Post date: Oct 31, 2013

Coalition of CCOs and Doctors' Groups Pour $1.4 Million into Elections

The Coalition for a Healthy Oregon proved an effective political counterweight to insurance, pharmaceuticals and hospital interests, backing legislation to create and strengthen CCOs.
Christopher David Gray
The combined efforts of a coalition of CCOs and doctor’s groups shelled out nearly $1.4 million in the last election cycle, roughly the same money spent by the Oregon hospital association, health insurance companies and drug companies combined.
The Coalition for a Healthy Oregon, a political action committee that represents seven coordinated care organizations, spent $478,000 since 2011 on political campaigns.
Rep. Tim Freeman, R-Roseburg, topped their list at $33,500, followed by his fellow Roseburg Republican, Rep. Bruce Hanna, who got $32,000. Sen. Arnie Roblan, a Coos Bay Democrat and former co-speaker in the House with Hanna, raked in $27,000.
All three represent parts of Douglas County, where coalition member Umpqua Health Alliance manages care for Oregon Health Plan members and the Douglas County Individual Practice Association is a prominent healthcare player. Western Oregon Health participates in the coalition and provides care in Coos and Curry counties.
Each CCO in the state has been allowed to form organically, creating different makeups at each one, but the CCOs in the Coalition for a Healthy Oregon are heavy with physician groups, while others give a more prominent role to hospital systems or insurance companies.
The other CCOs in the Coalition for a Healthy Oregon are Trillium in Lane County; Willamette Valley Community Health in the Salem area; FamilyCare in Portland; Cascade Health Alliance in Klamath Falls and AllCare in the Medford area.
Jeff Heatherington, the CEO of FamilyCare, said the organization formed a political action committee 10 years ago to comply with campaign finance law and influence health policy after the state Medicaid plan was hit with big cuts and faced an uncertain future.
“We were concerned about adequate funding for the Oregon Health Plan,” Heatherington said candidly. “Now it’s a matter of survival. We need to be at the table.”
Heatherington said bigger moneyed interests like drug companies, insurance companies and hospital systems have an outsized presence in healthcare, and the coalition allows the physician groups to even the playing field.
As a comparison, the Oregon Association of Hospitals and Health Systems spent $246,000 and 19 drug companies handed out $491,000. Leading insurer Regence BlueCross Blue Shield spent $236,000, almost entirely on Republicans, many of whom lost their elections.
The dollar amount is still lower than the combined total of four major unions — AFSCME, SEIU, the Oregon Nurses Association and the Oregon Education Association. The labor groups spent just under $2 million in the past election cycle.
SEIU spent $700,000 through two funds close to evenly split — one borne out of union dues and the other from a political action committee, Citizen Action for Political Education, in which thousands of SEIU members gave directly for political causes.
"The members are concerned about the affordability of healthcare. We're concerned about long-term care. We're concerned about worker's rights issues," said Arthur Towers, political director of SEIU. "We need to be involved in that process."
Heatherington said the coalition was effective in pushing legislation like Senate Bill 725 that gave more certainty to CCO contracts as well as keeping pressure on Salem Health to drop a lawsuit against the Willamette Valley CCO through the bad actor bill, House Bill 3309.
“It was used very prominently to get Salem Hospital to the table,” he said. “We hope that it calmed down everything.”
The bill died in the House Rules Committee, but the two parties agreed to a settlement just before the end of the session.
The coalition’s money was bolstered by doctor’s groups in several counties, including Douglas, Marion, Polk, Jackson and Josephine.
The Douglas Physicians spent $413,000, most heavily on Roblan, giving him $37,500. They also gave $28,500 to Sen. Laurie Monnes Anderson, despite her seat being across the state in Gresham. Monnes Anderson chairs the Senate Health Committee and wields hefty over healthcare bills.
These physicians also gave $28,500 to hometown son Hanna and $22,500 to House Speaker Tina Kotek, D-Portland.
The doctors in Marion and Polk counties, who worked to form the Willamette Valley Community Health CCO, paid out $441,000 under their political action committee, Doctors for Healthy Communities.
The Salem area physicians favored the same cast of characters — $31,000 to Monnes Anderson; $27,500 to Roblan; $20,500 to Kotek; and $19,000 to Hanna. Their committee also disbursed $17,500 to the campaign of Sen. Alan Bates, a Medford Democrat and osteopathic physician.
Bates was not up for re-election in 2012 but he faces a tough rematch in 2014 with his 2010 nemesis, retired Marine Col. Dave Dotterrer, whom he bested by just 275 votes last time, nearly sweeping Bates out of office in the Republican Tea Party wave.
The political action committee of the Mid Rogue Independent Physician Association chipped in another $50,000, about half of which went to Bates, who practices medicine in that region. Rep. Wally Hicks, R-Grants Pass, received $9,000, followed by Kotek with $5,000.
To review previous articles on campaign finance in Oregon click here and here.
Chris can be reached at chris@thelundreport.org.