Strategies to improve rural health care – National Consumers League

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Stephanie_Sperry.jpgBy Stephanie Sperry, NCL health policy intern

Stephanie is a 4th year Public Health Policy student at the University of California Irvine, interning at NCL as part of the University of California Washington DC Academic Internship Program.

“Just because we live in rural areas in this country, we shouldn’t have to settle for anything less than the best health care services” – Darrold Bertsch, CEO, Sakakawea Medical Center

The rural health care landscape in the United States is vastly different from the health care found in urban and suburban areas. On January 17, 2018, the Bipartisan Policy Center (BPC) and the Center for Outcomes Research and Education (CORE) held a briefing at which they released a report on the current state of rural health care in seven Upper Midwest states (Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota, and Wyoming) and identified opportunities for improvement. The panel included Senator Heidi Heitkamp (D-ND); Senator Mike Rounds (R-SD); Keith Mueller, Ph.D., Interim Dean, University of Iowa College of Public Health and Director, RUPRI Center for Rural Health Policy Analysis; John Dunn, R.N., MPA, Director Physician Services, Nebraska Methodist Health System; Heidi Duncan, M.D., Physician Director of Health Policy, Billings Clinic; and Darrold Bertsch, CEO, Sakakawea Medical Center. The BPC/CORE report focused on four key areas: rightsizing health care services to fit community needs, creating rural funding mechanisms, building and supporting the primary care physician workforce, and expanding telemedicine services.

The Centers for Medicare and Medicaid Services (CMS) has implemented programs to monitor the quality of health care and drive its improvement. However, many of these programs are not tailored for rural areas, and in turn, rural facilities often lack resources to provide more advanced procedures. As Senator Rounds noted, people in rural areas end up overpaying for their health care – the quality of which would not be accepted in urban areas. Health care policies should not come in a “one size fits all” option, but should be tailored to fit the needs of the community. Senator Heitkamp argued that flexibility from CMS would allow health care professionals in rural areas to provide higher quality care, like incorporating care options for the elderly that wouldn’t require relocation.

Funding for rural health care (and health care as a whole) is a recurring challenge. The current passage of short-term continuing resolutions does little to provide financial stability for health care delivery, hospitals, and any organization in a contract with the federal government. According to Senator Rounds, the best course of action to address this issue will start with Congress passing a budget for more than three weeks at a time, to provide stability for organizations that depend on federal funding.

Rural areas face different types of challenges in health care delivery, with transportation and shortage of workforce personnel presenting major struggles. The distances that must be travelled to reach necessary health services in rural areas place an added burden on the rural population. Not only are people spending more time to travel, they spend more money making the trip. To address this issue, the BPC and CORE study suggests an expansion in the use of telemedicine services. Senators Heitkamp and Rounds praised the work of the Helmsley Trust in the areas of e-pharmacy and telemedicine. Telemedicine relies on high-speed broadband connectivity, the current state of which Senator Rounds criticized when he said “if you can watch your favorite college team on TV or on a computer, you ought to be able to also provide appropriate connections in emergency situations, between professionals and institutions with huge capabilities, to make contact with people in rural areas.” Senator Heitkamp uses Netflix as her benchmark for measuring successful broadband connectivity, believing that “there isn’t any millennial who is going to live in any community where they can’t stream Netflix. So, if you don’t have it, then we’re failing.”

Dwindling numbers of primary care physicians have placed an added strain on rural health care accessibility. BPC and CORE support the encouragement of completion of medical residencies in rural areas, thus paving the way for more practices to be established nearby. Because less than 8 percent of all physicians and surgeons choose to practice in rural settings, the hope is that increased exposure to rural communities during medical training will increase the number of physicians who choose to stay upon completion, as noted by Heidi Duncan, Physician Director of Health Policy at the Billings Clinic. Physician Assistants, guided by physicians via broadband connectivity, present another promising option – utilizing the expansion of telemedicine to provide the same essential services to rural communities that would otherwise be easily accessible in an urban setting.

As detailed in the BPC/CORE report, additional strategies to build a diverse and sustainable rural health workforce include distributing Graduate Medical Education (GME) positions to rural institutions and reauthorizing the Primary Care Residency Expansion and Area Health Education Center programs. Loan-forgiveness programs could also be expanded to include dental therapists and community paramedics.

In alignment with the strategies outlined by BPC and CORE, the National Consumers League is working with the Patient Access to Pharmacists’ Care Coalition (PAPCC) to build support for the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592/S. 109), which would amend Medicare to increase medically underserved seniors’ access to health care through pharmacist-provided care. Since nearly 95 percent of the population lives within 5 miles of a pharmacy, improving access to pharmacists’ services can help to improve the care of our nation’s rural residents.

NCL statement on CHIP reauthorization – National Consumers League

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January 24, 2018

Contact: Carol McKay, (202) 207-2831 or carolm@nclnet.org

Washington, DC–The National Consumers League (NCL) welcomes news that Congress and the Administration have reauthorized funding for the bipartisan Children’s Health Insurance Program (CHIP) for six years, as part of the temporary spending bill to end the government shutdown. After an unprecedented 114-day lapse in funding, the nine million children and pregnant women who rely on the program for life-saving care can be confident that their coverage will not be snatched away from them, and states who had been scrambling to bridge the gap in funding may finally move towards a state of normalcy. CHIP has been integral in decreasing the number of uninsured children and ultimately improving their health outcomes, by bringing access to regular doctor visits, immunizations, essential prescription medications, and emergency services within reach. While we are pleased that this most urgent need has been filled, we will remain steadfast in ensuring that support for the health and well-being of America’s children is never again subject to partisan, political gamesmanship.

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

LifeSmarts program awards scholarship to student leaders from Anacostia, DC and Douglas County, GA – National Consumers League

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January 22, 2018

Contact: Carol McKay, National Consumers League, (202) 207-2831, carolm@nclnet.org

Washington, DC—Today the National Consumers League (NCL) has announced two scholarship recipients, honored for their involvement in a community service and leadership initiative made possible through its consumer literacy program, LifeSmarts (LifeSmarts.org). The students were awarded $1,000 academic scholarships for their winning entries based on their experiences serving as Safety Smart® Ambassadors, a partnership between LifeSmarts and UL that pairs high school students with elementary classrooms to teach lessons about health, safety, and the environment.

The scholarship winners are:

  • Takia Holsey, a freshman from UPO P.O.W.E.R Program in Anacostia neighborhood of Washington, DC
  • Rachel Dunnell, a junior from Douglas County 4-H in Georgia

Since 2013, when the LifeSmarts UL partnership began, hundreds of LifeSmarts students have become Safety Smart Ambassadors. Working in teams, high school students have made more than 1,000 interactive 30-minute presentations, sharing empowering, educational safety messages with thousands of younger children throughout their communities. LifeSmarts is a national program that competitively tests high school students’ knowledge of consumer awareness, with subjects including personal finance, health and safety, consumer rights and responsibility, technology, and the environment.

“We are so proud of our students who participated in the Safety Smart Ambassador program and the positive impact they made on their communities, and especially these two stand-outs,” said Lisa Hertzberg, LifeSmarts program director. “We truly appreciate this partnership with UL. It has been extremely gratifying to see LifeSmarts students embrace the Safety Smart Ambassador program, provide education and mentoring to younger children, and learn about themselves in the process.”

The LifeSmarts-UL partnership has underwritten the Safety Smart Ambassador program and provided LifeSmarts with access to the vast knowledge base of UL, including resources for LifeSmarts to bolster its science and environment curriculum, resources, and competitive opportunities.

For more information, please visit LifeSmarts.org/SafetySmart.

January 2018 Safety Smart Ambassador award winners – in their own words 

“Students really loved the video, even the older students, and they liked hearing the new vocabulary words and by the end of the session they were singing the Going Green song and using the vocabulary words.” – Takia Holsey

“I appreciated the opportunity to teach in front of children and to help them learn useful skills they will need as they grow older. They loved giving examples and reasons to conserve and protect our water.” – Rachel Dunnel

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About LifeSmarts and the National Consumers League

LifeSmarts is a program of the National Consumers League. State coordinators run the programs on a volunteer basis. LifeSmarts educational resources are available online throughout the year at LifeSmarts.org. Competition begins again in September. For more information, visit: LifeSmarts.org.

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit nclnet.org.

Script Your Future launches seventh annual student competition for innovations in medication adherence – National Consumers League

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January 15, 2018

Contact: Carol McKay, National Consumers League (412) 945-3242, carolm@nclnet.org

Washington, DC–January 15 marks the launch of the seventh annual Medication Adherence Team Challenge, a two-month-long intercollegiate competition among health profession student teams and faculty for creating solutions to raise awareness about medication adherence as a critical public health issue. The Challenge, hosted by the National Consumers League (NCL) and its Script Your Future campaign, is returning to university campuses across the country after six years of successful student competition and innovation.

The Challenge is an integral part of Script Your Future, a campaign launched by NCL and its partners in 2011 to combat the problem of poor medication adherence in the United States, where nearly three out of four patients do not take their medication as directed.

“With the uncertain future of healthcare in America, the role of health professionals in helping patients preserve and improve their own health is more critical than ever. The Challenge uniquely encourages an interprofessional approach and lays the foundation for adherence-minded care among future professionals before they enter the workforce,” said Sally Greenberg, NCL executive director. “Over the years we have been so impressed by the ingenuity of our student teams and their ability to impact patients in their communities. We look forward to seeing what this year’s Challenge will contribute to the discussion.”

The Challenge is sponsored by the American Association of Colleges of Pharmacy (AACP), the National Association of Chain Drug Stores (NACDS) Foundation, the National Community Pharmacists Association (NCPA), and the American Pharmacists Association (APhA).

From January 15 through March 16, inter-professional teams—including student pharmacists, nurses, doctors, and others—will implement creative outreach approaches in their communities to raise awareness and improve understanding about medication adherence. At the end of the Challenge, teams submit entries for review by national partner organizations, and winners are recognized for their efforts to improve medication adherence.

“The Script Your Future Adherence Challenge has provided a tremendous opportunity for health professions students to illustrate how they can work collaboratively to improve patient care through better medication adherence,” said Dr. Lucinda L. Maine, executive vice president and CEO at the American Association of Colleges of Pharmacy. “This challenge, now in its seventh year, continues to provide a great example of the power health professions teams can have on the public health issue of medication adherence.”

Since the Challenge began in 2011, more than 12,000 future health care professionals have directly counseled nearly 50,000 patients and reached more than 23 million consumers about the importance of medication adherence. Last year’s National awardees were the University of Charleston School of Pharmacy and Northeast Ohio Medical University (NEOMED). NEOMED also won two focused awards in the areas of health disparities and media outreach. The University of Pittsburgh School of Pharmacy earned the focused award for creative inter-professional team event. For the first time, NCL also honored an outstanding team in their first or second year of the Challenge with the Rookie Award. This prize went to University of the Sciences Philadelphia College of Pharmacy.

To learn more about last year’s winners, visit the Script Your Future website.

For more information on the Challenge visit the Challenge Community. Tweet along with us during the Challenge using #SYFchallenge and follow the campaign @IWillTakeMyMeds.

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Script Your Future is a campaign of the National Consumers League (NCL), a private, non-profit membership organization founded in 1899. NCL’s mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information about the Script Your Future campaign, visit ScriptYourFuture.org. For more information about NCL, please visit nclnet.org.

On MLK Day, leadership needed more than ever – National Consumers League

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Sally GreenbergToday, January 15, 2018, marks the 35th anniversary of national celebration of the life of Rev. Dr. Martin Luther King, Jr. As King’s widow Coretta Scott King observed, “This is not a black holiday; it is a people’s holiday,” She spoke these words after President Ronald Reagan signed the King Holiday Bill into law on Nov. 2, 1983.

She couldn’t have known how prescient her words were and that Dr. King’s message of love and tolerance is needed in America more than ever. King was a brilliant scholar, a gifted orator, and a bridge builder who reached across ethnic, religious, and racial lines to lift all downtrodden Americans and challenge long-held prejudices.

But in 2018, we are marking the first year in office of President Donald Trump, who was elected on a platform of overt appeals to racism and white supremacy and continues to invoke vulgar and crass language in discussions about race and gender. This shouldn’t come as a surprise: on the campaign trail, Trump said Mexicans are “murderers and rapists” and described African American neighborhoods as “more dangerous than the war zones.”

Just last week, on the eve of MLK Day, we got wind of his latest firebomb. In a series of overtly racist comments, in a public meeting with members of Congress, Trump grew frustrated with lawmakers gathered in the Oval Office, and while discussing protecting immigrants from Haiti, El Salvador, and Africa, Trump apparently said – and I say apparently because it’s hard to imagine a U.S. President uttering these words: “Why are we having all these people from shithole countries come here?” and “Why do we need more Haitians? ….Take them out.” He followed that up with the suggestion that the United States should instead bring more people from countries such as Norway. White people, in other words.

What a wrenching time this is for America. We have a massive leadership vacuum in the White House and in Congress; indeed, while many Democrats denounced Trump’s comments, Senate Majority Leader Mitch McConnell (R-Ky.) and GOP chair Ronna McDaniel were silent. House Speaker Paul Ryan (R-Wis.) called Trump’s comments “very unfortunate,” and Sen. Marco Rubio posted a long Twitter thread about the many ways Haitians have made an impact in the United States.

And while some Republicans at the meeting denied hearing the comments, Sen. Tim Scott (R-S.C.) said Sen. Lindsey Graham (R-S.C.) — who also attended the meeting — confirmed that the media’s reporting of Trump’s remarks was “basically accurate.” But only Sen. Graham told Trump his comments were unacceptable.

Fighting racism and bigotry used to be seen as a bipartisan cause. The National Consumers League’s history is one of championing racial equality; Florence Kelley participated in the founding meetings of the NAACP and worked with another republican icon, President Teddy Roosevelt, who had some old-fashioned ideas on race but did warn that “the debasement of the blacks will in the end carry with it [the] debasement of the whites.”

When President Ronald Reagan, a Republican icon, signed the MLK bill into law, he gave an eloquent speech citing King’s contributions:

…traces of bigotry still mar America. So, each year on Martin Luther King Day, let us not only recall Dr. King, but rededicate ourselves to the Commandments he believed in and sought to live every day: if all of us, young and old, Republicans and Democrats, do all we can to live up to those Commandments, then we will see the day when Dr. King’s dream comes true, and in his words, “All of God’s children will be able to sing with new meaning, ‘… Thank you, God bless you, and I will sign it. 

President Reagan finished with this:

All right-thinking people, all right-thinking Americans are joined in spirit with us this day as the highest recognition which this nation gives is bestowed upon Martin Luther King, Jr., one who also was the recipient of the highest recognition which the world bestows, the Nobel Peace Prize.

This eloquent and bipartisan message is more important today than ever. I only wish Republican leaders take note of the bold statement their iconic President made 35 years ago when he established this the MLK Jr. holiday and mark his commitment to racial justice and equality for all Americans.

DC City Council should protect consumers from deceptive automatically renewing subscriptions – National Consumers League

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Brian YoungThe scenario is all too familiar to thousands of District residents: while looking over a credit card bill, you notice a mysterious charge from a company or service you vaguely remember doing business with a year ago. Why do you keep getting charged for a cleaning service you only used once? If this sounds familiar, chances are that you are the unwitting victim of an automatic renewal clause.

These sneaky clauses typically state that unless you notify the company, your contract will automatically renew at the end of the term. Unsurprisingly, many companies love these clauses as it provides them with guaranteed income. Since consumers are often forced to go through the arduous process to cancel their subscriptions, even consumers who want out of these contracts can find it difficult to extricate themselves.

Not all automatic renewal contracts are wrong, however. For example, I am grateful that I do not have to write a check or pay an online bill each month just to keep using Netflix. However, many companies slip these automatic renewal clauses into the fine print and consumers do not know they have to cancel by a certain date (often as much as 3 months prior to the contract’s end date) to avoid being stuck with another year of service. This leaves consumers and businesses alike saddled with expensive contracts they have no desire to utilize and have no ability to cancel.

Fortunately, 22 states have laws on the books which require that automatic renewal clauses not be buried in pages of fine print. While the District does not yet have this consumer protection, Councilmembers Mary Cheh, David Grosso, and Anita Bonds recently introduced the Consumer Disclosure Act of 2017 which is currently pending before the Committee on Judiciary and Public Safety. This legislation would empower consumers by requiring businesses to provide notice to consumers if their contract is set to renew for a multi-month term. This reminder will need to include clear instructions on how and when consumers must cancel to prevent an automatic renewal of a contract.

The Consumer Disclosure Act of 2017 would not only protect consumers from unscrupulous business practices, but it would also help the District’s businesses and employers. For instance, my employer — the National Consumers League — recently found out that we were on the hook for a contract which automatically renewed for the year at the tune of $23,000. We were responsible for this large sum merely because we failed to provide a written notice of our intention to cancel the contract more than 90 days prior to the contract’s end. The person originally arranging for this service was no longer on staff and management wasn’t aware of the contract’s automatic renewal provisions. Had the Consumer Disclosure Act been law, not only would we have known before signing the contract that there was an automatic renewal clause, we would have received a notice prior to the contract’s 90-day cancellation window reminding us that we need to make a decision to cancel or renegotiate the contract.

Research suggests that the consumers has around 11 recurring charges. To help deal with this headache and avoid expensive surprises, we urge the DC Council to act quickly on this bill and begin giving residents in DC the protections from automatic renewal abuses that citizens in other states already enjoy.

FTC guidance to multi-level marketers highlights advocates’ priorities – National Consumers League

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January 9, 2018

Contact: Carol McKay, (202) 207-2831 or carolm@nclnet.org

Washington, DC – The National Consumers League (NCL) is pleased that the Federal Trade Commission’s (FTC) new guidance to the multi-level marketing (MLM) industry broadly reflects the priorities and concerns expressed by a broad coalition of advocacy organizations focused on fighting pyramid schemes. NCL also welcomed the Commission’s message that the benefit of relying on its existing authority under Section 5 of the FTC Act, as interpreted by decades of case law, rather than legislative action, is the best way to protect consumers from pyramid schemes. NCL, along with other national consumer advocacy and civil rights groups, pyramid scheme experts, and prominent direct selling companies, has opposed efforts by the MLM industry and its allies in Congress to weaken the FTC’s ability to investigate and prosecute pyramid schemes.

The following statement is attributable to John Breyault, National Consumers League Vice President, Public Policy, Telecommunications, and Fraud:

The FTC’s new guidance is consistent with existing case law and previous Commission guidance. In addition, it addresses topics such as income and product claim substantiation, internal consumption, and inventory loading that the MLM industry has frequently misinterpreted. Indeed, the guidance once again demonstrates that the FTC already has the tools it needs to do its job and protect consumers from pyramid schemes masquerading as legitimate MLMs.

Despite industry claims to the contrary, pending bills in Congress — H.R. 3409 and a House appropriations rider sponsored by Rep. John Moolenaar (R-MI) — would fundamentally weaken the FTC’s ability to hold MLMs accountable when they perpetrate fraud against prospective entrepreneurs. The Commission’s new guidance is clear and sound advice to the MLM industry about where the guardrails should be placed in order to avoid pyramidal behavior, and yet another indication that proposed legislation is unnecessary and, indeed, undermines the FTC’s authority.

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.