Category Archives: Health Reporting

OU HCOM Professor chronicles Kasich’s Medicaid expansion and reform in national journal

I had read a lot to grasp this story, but I think it turned out nice.

(Photo Provided via HCOM, Jim Phillips)

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Although his recent presidential campaign has placed Ohio Gov. John Kasich in the national spotlight, one Ohio University professor is more enthralled by the governor’s unique Medicaid decisions central to the Buckeye State.

Daniel Skinner, an assistant professor of health policy at OU’s Heritage College of Osteopathic Medicine at Dublin, contributed an article to the bi-monthly, nationalJournal of Health Politics, Policy and Law that chronicles Kasich’s embracement of Medicaid expansion in 2012 and his subsequent reform of it during its reauthorization this past year.

The piece is part of a series the publication runs called Reports from the States.

Colleen Grogan, a professor at the University of Chicago and editor of the journal, said the journal is not only focused on health policy but also investigating the subject’s history and background which shaped its current form.

“There are big political issues on the table and states are deciding on how to best (adapt) to them,” Grogan said.

Skinner said he wrote the piece to “tell the tale of Medicaid expansion in Ohio” and give national readers a perspective on the inner workings of the state.

He argues in the essay that Kasich finds himself in a limited cadre of Republican governors — along with Gov. Rick Snyder of Michigan and, to a lesser extent, Gov. Mike Pence of Indiana — who expanded Medicaid in their states despite their party’s opposition to the Affordable Care Act, otherwise known as “ObamaCare.”

Despite Kasich’s acceptance of federally granted monies through the Controlling Board, a committee outside of the legislature that could allocate funds, the Ohio governor would later reform the Medicaid expansion he originally initiated, placing him in an uncommon position that blurs party lines.

And, because Ohio functions as a swing state and the political atmosphere isn’t heavily skewed to one party, Kasich had more political freedom in his stances than governors in states that more closely adhere to party lines, Skinner’s essay maintained.

“What I think makes Kasich a very interesting figure is that he appears to have carved out a space for him to say ‘Look, I’m willing to take on my own party and do what I think is right,’” Skinner said, “as well as having many positions that his party generally finds acceptable.”

He said the expansion of Medicaid helped to insure 100 percent of residents below the federal poverty level along with 38 percent of residents that land just above it. Prior to the expansion, only the bottom 90 percent of individuals below the federal poverty level could qualify.

“When you start adjusting those numbers, what you’re doing is moving people on and off Medicaid and access to healthcare,” Skinner said. “Over 50 percent of kids born in Ohio are born on Medicaid. So, it plays a hugely important role in child health.”

Since it is typically thought as a governor’s job to bring in as much money to the state as possible, Kasich finds himself in a situation that a senator or congressman would not face, Skinner said.

“You have to have a good reason to not take federal money,” Grogan said. “So Republican governors have found themselves in a quandary.”

The word “hey” has been abundantly used to energize audiences throughout the history of popular music; however, many instances of the word are placed lazily in the background

Grogan also said the ongoing state implementations of the Affordable Care Act, which includes Medicaid, is a subject often covered by the journal.

Skinner also has a political and rhetorical background and has written about subjects such as reproductive health.

“I am extremely proud of the work being done by our Dublin faculty,” Dr. William Burke, dean of HCOM’s Dublin campus, said.

@LukeFurmanOU

lf491413@ohio.edu

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HCOM student develops new test for quicker diagnosis and treatment of Type 1 diabetes

This was one of my favorite stories to write. I talked to a bunch of interesting people.

(Photo Provided via Ben Siegel/Ohio University)

http://bit.ly/1KwKUpp

Identifying a life-altering disease before it claims a vital organ is undoubtedly a step many doctors and patients alike wish to take, but it is unfortunately not always an option.

However, following two years of research, development and optimization, an Ohio University medical student might have granted this collective wish for one of the most common and currently incurable autoimmune diseases: Type 1 diabetes.

LaDonya Jackson, a second-year graduate student in OU’s Heritage Osteopathic College of Medicine, engineered an innovative medical test that makes checking for Type 1 diabetes more expedient and proactive than the traditional method, which is only effective when the disease has already caused significant damage to the pancreas.

With the assistance of two HCOM faculty mentors, Dr. Kelly McCall and Dr. Frank Schwartz, Jackson discovered a technique to measure the level of beta cells in the human pancreas.

Pancreatic beta cells function to create insulin, an essential hormone that tells the body to break down glucose from food and turn it into energy the body can use, Jackson said. Diabetes is diagnosed when all beta cells in a person’s pancreas are destroyed.

Unlike the traditional test for Type 1 diabetes that measures the accumulated reservoir of un-signaled glucose, Jackson’s new test focuses on recognizing the destruction of beta cells before all of them are wiped out.

Jackson compared the test to preparing to defend oneself from a certain attack rather than filing a police report after the attack.

Using this proactive method, health professionals might have the chance to quell the progression of the disease and “intervene with therapies” before the disease fully takes hold, McCall, an associate professor of endocrinology, said.

Ohio University’s Heritage College of Osteopathic Medicine breaks enrollment record and continues rising trend of recent years.

McCall said diabetes is one HCOM’s biggest focus areas, calling both types of the disease a “worldwide epidemic.” According to the Center for Disease Control and Prevention, 29.1 million Americans were reported to have Type 1 or Type 2 diabetes in 2014.

The Osteopathic Heritage Foundation provided funds for this project, along with money from an endowment by J.O. Watson awarded to Shwartz, a professor of endocrinology and director of HCOM’s Appalachian Rural Health InstituteDiabetes Center.

Originally from California, this is not Jackson’s first foray into scientific research. In her undergraduate studies at Utah State University, she worked to clone horses, specifically stallions and bucking bulls, which fetch a high price if genetically modified because of their sporting capabilities.

Despite wanting to work as a veterinarian since kindergarten, Jackson said the ability to transform life through science shifted her academic and career interests.

“You can change life, you can alter life, you can create life,” Jackson said about bioengineering. “You have so much potential with the knowledge that we have now.”

Jackson and her mentors are currently pursuing a patent for the test.

“We would love to have this in the hospital,” Jackson said. “To let people and children be tested to see if they’re going to develop (Type 1 diabetes) so we can protect them.”

@LukeFurmanOU

lf491413@ohio.edu

A local nonprofit receives $500,000 to further maternal and pediatric care

(File photo by Arielle Berger)

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Ohio recently bolstered the medical stability of children growing up in the state’s southeastern Appalachian counties by giving $500,000 to an Athens-based nonprofit organization, according to a press release sent out by Ohio University’s Heritage College of Osteopathic Medicine Friday.

The Ohio Legislative Service Commission gave Integrating Professionals for Appalachian Children the half million dollars from the state budget for the 2016 fiscal year to further the development of children and mothers throughout a nine county service area, including Athens County.

IPAC is made up of multiple agencies throughout Southeast Ohio and works with several departments and clinics at OU. According to a previous release, along with OU’s Heritage College of Osteopathic Medicine, the nonprofit has worked with OU’s College of Health Sciences and Professions, Scripps College of Communication and the Voinovich School of Leadership and Public Affairs.

The medical school will join the Athens Photographic Project to create a research community for mental health patients.

“We are really thrilled to be recognized as an organization that can be trusted to work on behalf of children and families in our region,” Jane Hamel-Lambert, an associate professor of family medicine at OU’s HCOM and longtime IPAC contributor, said in the news release.

Ohio State Senator Lou Gentile, D-Steubenville, advocated and celebrated the measure that he said might provide the resources to lower the “statewide crisis” of infant mortality.

“This funding will go a long way in improving both health outcomes and the quality of life for area residents, as well as continuing the fight against infant mortality,” he said in the release.

According to the Ohio Department of Health, Athens County saw an average of 16 infant deaths per year from 2006 to 2010.

Since 2002, IPAC has worked to improve pediatric screenings, integrating behavioral health in primary care and public preschools and furthering several other programs pertaining to the wellbeing of maternal and child health.

In 2006, it gained a non-profit status.

@LukeFurmanOU

lf491413@ohio.edu

HCOM opens up a new human clinical trial facility

(Photo provided)

http://bit.ly/1NbliRf

Human experiments will begin to take place on Ohio University’s main campus this summer, but, don’t worry, they’re part of the curriculum.

OU’s Heritage College of Osteopathic Medicine opened a new facility April 30, geared toward conducting clinical trials and other studies on human subjects.

The college’s new space, located in Irvine Hall on West Green, houses the newly created “Clinical & Translational Research Unit.” Occupying nearly 4,000 square feet, the converted facility is equipped with patient examination rooms, an exercise physiology laboratory, an electrophysiology laboratory, a phlebotomy room, imaging facilities and a laboratory processing station, according to a news release.

Through OU-HCOM’s medical clinics, students can learn and observe basic skills while helping patients.

Through its Vision 2020: Leading the Transformation of Primary Care Award, the Osteopathic Heritage Foundation provided $6 million in startup funding for the unit, which was used to purchase “vital equipment,” medical supplies and a staff, Dr. Laura Rush, the executive director of the unit, said.

OU also worked with the college during the move.

The Clinical & Translational Research Unit looks to support OU faculty in various aspects of clinical trials, including budget development, project coordination, subject recruitment, data collection and institutional review board assistance, according to the release.

OU students have the opportunity to utilize the unit either to assist in studies or to conduct their own studies under the supervision of a faculty mentor, Rush said.

Nearly 60 percent of OU-HCOM’s graduates currently practice in the state of Ohio.

The faculty of the Clinical & Translational Research Unit consists of eight people, which, along with the Rush, include a medical director, two research nurses, two projects managers, an administrative associate and a clinical research scientist.

Rush applauded her staff as people who love the Athens community and want to move health care forward.

“We have top-notch staff who know clinical trials, maintain the high standards required for patient safety and observe meticulous record keeping,” she said in the release.

Rush also said that because of the degree of difficulty faced when conducting clinical trials, the new facility would allow faculty to help better execute them from start to finish and allow the scientists to focus on science.

HCOM Executive Dean Kenneth H. Johnson said the unit will give the college recognition as a program for cutting-edge clinical research.

“Clinical studies that tackle pervasive health problems bring attention to the college and the university,” he said in the release. “They open the door to more opportunities for collaboration and funding, which are essential to help researchers advance medical care in our communities.”

@LukeFurmanOU

lf491413@ohio.edu

Ohio Supreme Court amends adult guardianship rules

I worked on this story for a while but I eventually finished it.

http://bit.ly/1TN8EMU

The Ohio Supreme Court moved last month to try to ensure a better quality of life for adults suffering from mental illness or who are unable to make sound decisions for themselves — a measure that has been hailed by at least one local disabilities expert.

The court amended state policy regarding adult guardianship cases on March 10, which made guidelines for family members acting as guardians, set in place training requirements for guardians and called for closer supervision of all guardians, according to an Ohio Supreme Court news release.

The amendment defines a ward as “any adult person found … to be incompetent and for whom a guardianship is established.”

Dennis Lehman, director of Service and Support Administration for the Athens County Board of Developmental Disabilities, said the new amendments could help guardians understand their roles and expectations.

“… In one particular case a guardian was a pastor and he superimposed his beliefs on his wards,” he said. “He would not allow them any Halloween decorations, or to have R-rated videos in the house, or anything like that. He did not consider what the individual wanted in that case.”

Lehman said training session might help guardians understand the wishes of their wards.

“Guardians are responsible for the decisions they make, but they should consider what their wards want,” he said.

During a nearly one-year period of discussion, the Ohio Supreme Court’s Advisory Committee on Children and Families successfully recommended three rule changes, which will take effect June 1.

According to the news release, the current changes include applying guardianship regulations to family members, requiring courts to monitor a roster of guardians with 10 or more wards and requiring guardians to meet with wards quarterly.

Michael Smalz, a member of the Advisory Committee on Children and Families, called the amendments “a significant step forward.” He added, though, that there is still need for improvement.

“Statutory changes are also needed,” Smalz said in an email. “A pending bill … contains some helpful provisions, including the creation of a ward’s bill of rights and a requirement that every ward be given a copy of the bill of rights.”

Maureen O’Connor, Chief Justice of the Ohio Supreme Court, said these new amendments meet the standards set by the National Guardianship Association.

“The ultimate goal is to provide our probate courts with effective means to ensure the safety and well being of people who need our protection,” O’Connor said in the news release.

One of the amendments also requires adult guardian to attend a minimum of six hours of training courses as well as a three-hour course every year.

According to the report, the course review establishing the guardianship, the ongoing duties and responsibilities of a guardian, record keeping and reporting duties of a guardian and any other topic that concerns improving the quality of the life of a ward.

“While I would like to have seen training and visitation requirements that were as rigorous as the national standards envision, these new mandates are a very positive step,” Julia R. Nack, a past president of the National Guardianship Association, said.

Nack is also a certified master guardian who helped to draft the current rules.

The training courses — provided by the Supreme Court of Ohio or any other approved entity — will be free of charge for a limited time, and will be made available online by the end of 2015. The yearly three-hour courses will begin in the first quarter of 2016.

“It is important now for Ohio lawmakers to take up the issue of guardianship and provide the courts with the statutory and financial support they need to make these changes effective,” Nack said.

@LukeFurmanOU

lf491413@ohio.edu

Athens man among first in U.S. to get new prosthetic eye

The Post published this story as a centerpiece.

(Photo by Lauren Bacho)

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After 15 years of living in complete blindness, David Parker thought he would never see his five grandchildren’s faces.

But after receiving a surgical implant in December that he called “a miracle,” the 47-year-old Athens resident’s wish has become more possible than he ever imagined.

“I was able to see my children enough to recognize, but my grandkids I’ve never seen,” Parker, who now wears a pair of specialized, black-tinted glasses, said. “I waited for this all my life.”

Parker is one of 126 patients with retinitis pigmentosa who has received the newly U.S. Food and Drug Administration-approved Argus II Retinal Prosthesis System, pioneered by Second Sight Medical Products, Inc.

The FDA first gave the thumbs up to his so-called “bionic eye” in February 2013, and Health Canada approved the vision apparatus in December 2014 — making it available in 16 major markets between the two countries, according to Second Sight’s website.

The nearest implant centers are in Ann Arbor, Michigan, and Cleveland.

Doctors diagnosed Parker with retinitis pigmentosa at the age of four. Growing up in Toledo, he learned to read braille at 6 years old, but after years of progressively weakening retinas, lost total sight at about age 30.

After that, Parker moved to Athens in December 2012 to start a vending company called “Grumpy’s Vending,” where he oversees vending machines in 20 Ohio University buildings.

“I couldn’t distinguish … one thing from another. Everything was just one big blur,” Parker said. “I didn’t follow the research (because) it let me down. Until they came up with (the Argus II), I figured that I wouldn’t be able to see anything.”

Parker first learned about the Argus II and its accompanying four-hour surgery through his brother, who saw it on television. Parker researched the procedure and discovered the University of Michigan Kellogg Eye Center in Ann Arbor offered the surgery under certain prerequisites: being older than 25, having been able to see before, having cataract lenses and being willing to commit to the process.

Parker met all of those requirements.

“As Buckeye fan, it (was) kind of hard for me to go (to the University of Michigan),” Parker joked.

He later received an eye test from a local doctor and submitted the results to the institution. In September 2014, the institution informed Parker that he was qualified.

Parker’s surgery was paid for with insurance, but the procedure typically costs $150,000, according to VisionAware, a website that provides resources to those with vision loss.

Betsy Nisbet, a spokeswoman for the center, said surgeons at Kellogg Eye Center have performed six surgeries since the FDA’s approval.

“When the signal gets to the chip that’s on your retina, it’s transmitted to your brain through your optic nerves,” Parker said. “Some of my nerves thinned out so they weren’t sure if it would work.”

Yet, on Dec. 4, a “great team” of surgeons installed the Argus II chip into Parker’s right eye. Coming out of surgery, he was surprised at how little pain he felt, although he could tell something was in his eye, he said. The surgery, however, did not instantaneously gift him with full vision.

“Everybody thinks you’ll be able to see, but that’s really not true,” Parker said. “My wife describes it as kind of a silhouette. You have to scan something and then go by what’s in your memory bank. That’s why you have to had sight in the past.”

After six to eight weeks of healing, Parker returned to the facility “about every three weeks,” where he practiced using the apparatus through various tests, such as following a 2-by-2 inch square on a computer screen.

“The first test they did was they put a square on the screen,” he said. “That really shook me up because I could see the square.”

It was the first thing he had seen in 15 years.

Since the FDA approved the surgery, there have been 24 commercial surgeries in the U.S., 70 commercial surgeries in Europe, and an additional 32 clinical trial surgeries worldwide, Gary Peyser, a spokesman for Second Sight, said.

“David has a very positive attitude, is willing to learn, is very cooperative and helpful and even gives us suggestions on our testing schemes,” said Naheed Khan, an electrophysiologist at Kellogg Eye Center, in an email. “We have learned a great deal from him and we are always impressed by his motivation and commitment.”

The Argus II Prosthesis System works by using a camera on specialized glasses to take in an image and send it to the computer processor worn around the user’s neck. The processor sends instructions through an antenna to the retinal chip, which sends electrical pulses through optic nerves for the brain to decipher.

That process bypasses the damaged photoreceptors in the retina that otherwise would produce sight in a healthy eye.

Parker said images stay five or six seconds before he has to move his head and “refresh” the image, which he considers good, compared to some patients’ one or two second staying power.

“I’m starting to (be) able to recognize shapes … a square versus a circle,” Parker said. “I really have to concentrate, and it’s based on light and dark and contrast. The more contrast, the more you’re able to visualize and it picks it up.”

Although Parker can only see the shape of his grandchildren at this point, he said that with more practice and new developments with the Argus II — including clearer images and color-vision — he will be able to improve his sight even further.

“The main reason that I did the surgery is to see my grandkids enough to know that they are there,” Parker said. “I can’t make out faces right now, but I know if something is there. Once you can distinguish it’s a person other than a wall, and then you distinguish that it’s a short person, and that must be my grandkid.”

@LukeFurmanOU

lf491413@ohio.edu

City officials are concerned about sanitation at Number Fest

(File photo by Calvin Matheis)

http://bit.ly/1DmlOKL

When students take to the muddy grounds of Number Fest this year, they might want to consider what exactly they’re stepping, stomping or rolling in.

Based on previous years, the absence of permanent bathroom facilities on the festival property — coupled with an insufficient number of Port-a-Johns — suggested that the sanitation measures of the event could spawn bacterial diseases like E. coli, according to Athens City Councilwoman Chris Fahl, D-4th Ward.

“My take and others on council is that it is very difficult to have 15,000 to 20,000 people at an event and only provide Port-a-Johns,” Fahl said in an email. “There has been concern by both county and city officials about the event having enough bathroom facilities. In the past the answer was definitely no. Hopefully this year will be better.”

By the looks of it, this year’s fest — which occurs outside of the city’s jurisdiction and on private property — should be much more sanitary.

“The organizer of the event has gotten better at ‘covering himself in terms of security, safety and transportation,’” Athens Mayor Paul Wiehl said.

Dominic Petrozzi, event organizer for Number Fest, said 13Fest will boast nearly twice as many bathroom facilities as last year’s festival.

“We have worked with the city of Athens to find a more feasible number of restrooms and sanitation/wash stations on site,” Petrozzi said in an email. “We will have over 125 facilities on site this year versus the 65 we had last year. There are also going to be several sanitation and hand washing stations throughout the venue.”

Petrozzi also said the organizers are looking to create “a more sustainable festival environment” and will lay chips, gravel and shaved asphalt around the 20 food trucks where concertgoers order and eat food. These areas will be dubbed “dry zones.”

In terms of crowd-control, Petrozzi said there will be more than 150 security and staff personnel at this year’s festival.

Organizers also plan to double the Athens County Sheriff’s Department’s presence from what it was last year, specifically to patrol the neighborhoods surrounding the venue, Petrozzi said.

Athens City-County Health Commissioner James Gaskell and Ron Lucas, Athens deputy service safety director, agreed that an increase in bathroom facilities should help eliminate the threat of diseases like E. coli.

“It would seem to me that an increase in numbers of Port-a-Johns would decrease the chance of having water supply contamination,” Gaskell said.

Gaskell also explained that E. coli is a predominant gastrointestinal pathogen that is common in most human stool. However, if stool with enough E. coli present contaminates a water supply, it might lead to diseases such as gastroenteritis for those who consume the contaminated water.

Despite there not being any recorded incidences of E. coli in Athens County in 2014, according to Tonya McGuire, the epidemiologist for the Athens City-County Health Department, Fahl said there was a concern regarding E. coli contamination at last year’s Numbers Fest.

“E. coli is a serious potential health concern and if there is contamination of the nearby (Margaret Creek) that can impact people downstream,” Fahl said. “This just invites problems both at the event and to the general environment and people off site.”

Lucas suggested several ways to “mitigate the problem”, including an increase in bathroom facilities and event security along with having the sheriffs patrol the outskirts of the festival to police any misconduct.

“(Disease) is always the concern with public sanitation at events like these,” Lucas said. “How many Port-a-Johns are enough and how do we get people to use them? There’s always going to be people who don’t use toilets.”

@LukeFurmanOU

lf491413@ohio.edu