Tag Archive for: Public

Native Youth Count: The State of Native Youth 2019

Authors: Center for Native American Youth
Publication Year: 2019
Last Updated: 2020-07-15 16:23:47
Journal: Center for Native American Youth
Keywords: Native youth, census, citizenship, community and mental health, food sovereignty

Short Abstract:

Center for Native American Youth (CNAY) at The Aspen Institute, released "Native Youth Count: The State of Native Youth 2019,” on November 20.

The Center for Native American Youth (CNAY) at Aspen Institute releases this report annually. The report highlights young leaders who are working hard to create a brighter future for tribal nations, the programs that help them do so, and the policy issues that impact their lives. The report also shares what we’ve learned from community meetings with youth and service providers about the priorities and solutions that matter most. The State of Native Youth report is presented as a resource and roadmap to help decrease barriers and increase opportunity for Native youth.

As noted, the theme of this year’s report is Native Youth Count. CNAY discusses why being counted in the 2020 Census is critical, and they describe the impact of representation on the lives of youth. They share details about some of the people, initiatives, and organizations that help develop today’s youth as well as future generations of young people.  This year’s prompt was: What does citizenship and sense of belonging mean to you? Throughout this year’s report, CNAY highlights the importance of Native youth civic engagement and belonging.   They also feature artwork throughout the report that was submitted as part of the annual Gen-I Creative Native Call for Art.

Abstract:

Center for Native American Youth (CNAY) at The Aspen Institute, released "Native Youth Count: The State of Native Youth 2019,” on November 20.

The Center for Native American Youth (CNAY) at Aspen Institute releases this report annually. The report highlights young leaders who are working hard to create a brighter future for tribal nations, the programs that help them do so, and the policy issues that impact their lives. The report also shares what we’ve learned from community meetings with youth and service providers about the priorities and solutions that matter most. The State of Native Youth report is presented as a resource and roadmap to help decrease barriers and increase opportunity for Native youth.

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Prevalence of diagnosed diabetes in American Indian and Alaska Native adults, 2006–2017

Authors: Ann Bullock MD, Karen Sheff MS, Israel Hora , Nilka Rios Burrows, Stephen R Benoit, Sharon H Saydah, Edward W Gregg, Carmen Licavoli Hardin
Publication Year: 2020
Last Updated: 2020-07-15 15:45:06
Journal: British Medical Journal Open Diabetes Research and Care
Keywords: diabetes prevalence, IHS active clinical population,

Short Abstract:

The objective of this study was to examine recent trends in diagnosed diabetes prevalence for American Indian and Alaska Native (AI/AN) adults aged 18 years and older in the Indian Health Service (IHS) active clinical population.  The study found that diabetes prevalence in AI/AN adults in the IHS active clinical population has decreased significantly since 2013.

After increasing significantly from 2006 to 2013, diabetes prevalence for AI/AN adults in the IHS active clinical population decreased significantly from 2013 to 2017. Prevalence was 14.4% (95% CI 13.9% to 15.0%) in 2006; 15.4% (95% CI 14.8% to 16.0%) in 2013; and 14.6% (95% CI 14.1% to 15.2%) in 2017. Trends for men and women were similar to the overall population, as were those for all age groups. For all geographic regions, prevalence either decreased significantly or leveled off in recent years.

Abstract:

Diabetes prevalence in AI/AN adults in the IHS active clinical population has decreased significantly since 2013. While these results cannot be generalized to all AI/AN adults in the USA, this study documents the first known decrease in diabetes prevalence for AI/AN people.  What is already known about this subject?

â–º Diabetes prevalence in American Indian and Alaska Native (AI/AN) people is the highest of any racial or ethnic group in the USA, but no recent trends have been published. What are the new findings?

â–º After increasing significantly from 2006 to 2013, diabetes prevalence for AI/AN adults overall decreased significantly from 2013 to 2017.

â–º The trends for AI/AN men and women were similar to the overall adult population, with women consistently having slightly higher prevalence than men.

â–º All age groups had significant increases in diabetes prevalence from 2006 to 2013 or 2014 and then decreased significantly.

â–º For all geographic regions, diabetes prevalence either decreased significantly or leveled off in recent years. There were considerable differences in prevalence across geographic regions, with Alaska consistently having the lowest and Southwest subregion 2 consistently having the highest.

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Billing for Telehealth Encounters: AN INTRODUCTORY GUIDE ON FEE-FOR-SERVICE

Authors: Public Health Institute/Center for Connected Health Policy 2020
Publication Year: 2020
Last Updated: 2020-07-15 14:46:35
Journal: Center for Connected Health Policy
Keywords: Medicaid, managed care, CMS, Telehealth, fee-for-service, billing and coding

Short Abstract:

This guide provides a starting point on how to bill a telehealth encounter for eligible practitioners in your practice or your facility. The focus of this guide is primarily on fee-for-service Medicare and an example of one Medicaid program, California, whicg is highlighted in the text using blue MediCal boxes. 

Most of the descriptions and definitions are from the Centers for Medicare and Medicaid Services (CMS). Managed care plans, private payers and employer-based plans generally follow these rules though not every time, so coders and others should always check with the plan. This billing resource is only provided as a guide and should not be considered legal advice.

(For more detailed information on California billing, please visit the California Telehealth Resource Center’s website at www.caltrc.org.

Abstract:

This guide provides a starting point on how to bill a telehealth encounter for eligible practitioners in your practice or your facility. The focus of this guide is primarily on fee-for-service Medicare and an example of one Medicaid program, California, whicg is highlighted in the text using blue MediCal boxes. 

Most of the descriptions and definitions are from the Centers for Medicare and Medicaid Services (CMS). Managed care plans, private payers and employer-based plans generally follow these rules though not every time, so coders and others should always check with the plan. This billing resource is only provided as a guide and should not be considered legal advice.

(For more detailed information on California billing, please visit the California Telehealth Resource Center’s website at www.caltrc.org.

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Smoking Cessation: A Report of the Surgeon General

Authors: Jerome M. Adams, M.D., M.P.H.
Publication Year: 2020
Last Updated: 2020-07-15 11:29:32
Journal: Department of Health and Human Services
Keywords: tobacco cessation, nicotine replacement therapies (NRTs), AI/AN tobacco use, quit attempts, tobacco counseling support

Short Abstract:

Since 1990, the scientific literature has expanded greatly on the determinants and processes of smoking cessation, informing the development of interventions that promote cessation and help smokers quit.  Of all groups measured, the prevalence of past-year quit attempts and interest in quitting smoking was lowest among AI/ANs 18 or older. The prevalence of key indicators of cessation—quit attempts, advice to quit from a health professional, and access to cessation therapies—varies across populations, with lower prevalence among vulnerable subgroups like AI/ANs.  Further, of all groups measured, the prevalence of past-year quit attempts and interest in quitting smoking was lowest among AI/ANs 18 or older.

Health care providers who serve AI/AN populations may be a vital linchpin for efforts to improve tobacco cessation among AI/ANs.  

Abstract:

The purpose of this report is to update and expand the 1990 Surgeon General’s report based on new scientific evidence on smoking cessation. Since 1990, the scientific literature has expanded greatly on the determinants and processes of smoking cessation, informing the development of interventions that promote cessation and help smokers quit.

A considerable range of effective pharmacologic and behavioral smoking cessation treatment options are now available. As of October 16, 2019, the U.S. Food and Drug Administration (FDA) has approved five nicotine replacement therapies (NRTs) and two nonnicotine oral medications to help smokers quit, and the use of these treatments has expanded, including stronger integration with counseling support.  

The report documents specific challenges for American Indian and Alaska Native (AI/AN) tobacco use.  American Indian/Alaska Native women had the highest prevalence (16.7%) of pregnant women who smoked by race/ethnicity.  Further, of all groups measured, the prevalence of past-year quit attempts and interest in quitting smoking was lowest among AI/ANs 18 or older. The prevalence of key indicators of cessation—quit attempts, advice to quit from a health professional, and access to cessation therapies—varies across populations, with lower prevalence among vulnerable subgroups like AI/ANs.  Providers who serve AI/AN populations may be a vital linchpin for efforts to improve tobacco cessation among AI/ANs.  

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Billing for Telehealth Encounters: An Introductory Guide on Fee-For-Service

Authors:
Publication Year: 2020
Last Updated: 2020-02-19 13:15:25
Journal: NA
Keywords: telehealth, billing, coding, policy, medicare, medicaid, federally qualified health centers, HRSA

Short Abstract:

The Center for Connected Health Policy has released a new guide for successfully setting up and maintaining billing for telehealth services. The guide covers fee-for-service Medicare and Medicaid billing for live-video, store-and-forward, econsult, remote monitoring and mobile forms of telehealth.  

Abstract:

Among the most frequent questions raised regarding telehealth is how an encounter is billed. According to the American Hospital Association, “76 percent of U.S. hospitals connect with patients and consulting practitioners at a distance through the use of video and other technology.”1 It is not surprising then that the question of billing is the foremost question heard by telehealth resource centers, followed by, “will I get paid?” Further complicating the situation is that reimbursement policies vary from payer to payer. For example policies that apply to a Medicare beneficiary are different than those that apply to a Medicaid enrollee. Other common questions include: What are contracted rates with payers for in-clinic services and what are the state regulations? What are the plan terms? What, if any, financial obligations does the patient have? Plan terms may vary from plan-to-plan located in the same regions. How much you are paid depends on whom you bill for telehealth services and what services you provide.

Payment is not guaranteed for any type of visit, whether due to frequency limitations, diagnosis code or what the plan covers: is it an ambulatory clinic encounter, a surgery or an inpatient stay? Whatever the situation, this guide provides a starting point on how to bill a telehealth encounter for eligible practitioners in your practice or your facility. The focus of this guide will be primarily on fee-for-service Medicare and an example of one Medicaid program, California, highlighted in the blue MediCal boxes. (For more detailed information on California billing, please visit the California Telehealth Resource Center’s website at caltrc.org.) Most of the descriptions and definitions are from the Centers for Medicare and Medicaid Services (CMS). Managed care plans, private payers and employer-based plans generally follow these rules though not every time, so always check with the plan. This resource is only provided as a guide and should not be considered legal advice.

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Neonatal Abstinence Syndrome (NAS) Incidence and Health Care Costs in the United States, 2016

Authors: Gery Guy, Michele Bohm, MPH, Meghan Frey, MPH, Jean Ko
Publication Year: 2019
Last Updated: 2019-12-18 12:37:56
Journal: JAMA
Keywords: Neonatal Abstinence Syndrome, Opiods, Pediatrics, Infant Mortality

Short Abstract:

This study provides new national incidence and cost estimates for NAS in 2016....

"The overall incidence rate of NAS was 6.7 per 1000 in-hospital births in 2016 (Table 1); rates were highest among American Indian/Alaska Native individuals (15.9 per 1000)"

Abstract:

The study data came from the 2016 Healthcare
Cost and Utilization Project (HCUP) Kids’ Inpatient Database
(KID), a nationally representative sample of all-payer pediatric
discharges.We used the KID variable for in-hospital birth
(I10_HOSPBIRTH) to identify in-hospital births, which were
defined as those with a primary/secondary diagnosis of live
birth and no indication of birth outside the hospital or
transfer from another hospital. Hospitalizations for infants
born with NAS were identified using the International Classification
of Diseases, Tenth Revision, Clinical Modification
(ICD-10-CM) code P96.1 in any diagnosis field.We converted
hospital charges to costs using Healthcare Cost and Utilization
Project hospital–specific cost-to-charge ratios and
adjusted all costs to include physician fees based on the discharge
primary diagnosis.5 We used Stata, version 14.2
(StataCorp) for all analyses and included survey weights to
provide nationally representative estimates. Statistical significance
was set at P< .05. The Centers for Disease Control
and Prevention determined this study to be exempt from
human-subject regulations and institutional review board
approval, and consent was waived because deidentified retrospective
data were used

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An Environmental Scan of Tribal Opioid Overdose Prevention Responses: Community-Based Strategies and Public Health Data Infrastructure (Seven Directions University of Washington)

Authors:
Publication Year: 2019
Last Updated: 2019-12-18 11:50:11
Journal: NA
Keywords: opioid epidemic

Short Abstract:

Read Full Report

Read Summary

This scan looks at promising practices being developed and implemented by tribes around the country, the resource and infrastructure challenges they face, as well as the opportunities afforded by cultural resilience and sovereignty. While the current scan was compiled from publicly available information on the internet, annual updates will incorporate other sources of information, and become a more comprehensive living document that will help guide tribal community members, tribal and organizational leaders, and healthcare professionals who are at the forefront of opioid epidemic.

Abstract:

Read Full Report

Read Summary

Among racial groups in the US, American Indians & Alaska Natives experience the second highest fatality rate from opioid overdose.

This scan looks at promising practices being developed and implemented by tribes around the country, the resource and infrastructure challenges they face, as well as the opportunities afforded by cultural resilience and sovereignty. While the current scan was compiled from publicly available information on the internet, annual updates will incorporate other sources of information, and become a more comprehensive living document that will help guide tribal community members, tribal and organizational leaders, and healthcare professionals who are at the forefront of opioid epidemic.

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Preventing Adverse Childhood Experiences: Leveraging the Best Available Evidence.

Authors: Debra E. Houry, James A. Mercy
Publication Year: 2019
Last Updated: 2019-10-24 14:29:32
Journal: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control,
Keywords: traumatic events, social norms, social-emotional learning, victim-centered services, “technical packageâ€�, home visitation

Short Abstract:

ACEs are a serious public health problem with far-reaching consequences across the lifespan. They are also preventable. The strategies outlined here, drawn from the CDC Technical Packages to Prevent Violence, are intended to change norms, environments, and behaviors in ways that can prevent ACEs from happening in the first place as well as to lessen the immediate and long-term harms of ACEs. To maximize impact, these strategies and approaches are intended to be used in combination as part of a comprehensive effort to help ensure that all children have safe, stable, nurturing relationships and environments in which to thrive and achieve lifelong health and success. The hope is that multiple sectors, such as public health, health care, education, public safety, justice, social services, and business will use this information as a guide and join CDC in efforts to prevent ACEs.

Adverse Childhood Experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years) such as experiencing violence, abuse, or neglect; witnessing violence in the home; and having a family member attempt or die by suicide Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding such as growing up in a household with substance misuse, mental health problems, or instability due to parental separation or incarceration of a parent, sibling or other member of the household.  An estimated 62% of adults surveyed across 23 states reported that they had experienced one ACE during childhood and nearly one-quarter reported that they had experienced three or more ACEs.  ACEs can have negative, lasting effects on health, wellbeing, and opportunity. These exposures can disrupt healthy brain development, affect social development, compromise immune systems, and can lead to substance misuse and other unhealthy coping behaviors.

ACEs and their associated harms are preventable. Creating and sustaining safe, stable, nurturing relationships and environments for all children and families can prevent ACEs and help all children reach their full health and life potential. The evidence tells us that ACEs can be prevented by:

• Strengthening economic supports for families

• Promoting social norms that protect against violence and adversity

• Ensuring a strong start for children and paving the way for them to reach their full potential

• Teaching skills to help parents and youth handle stress, manage emotions, and tackle everyday challenges

• Connecting youth to caring adults and activities

• Intervening to lessen immediate and long-term harms

Abstract:

ACEs are a serious public health problem with far-reaching consequences across the lifespan. ACEs can have negative, lasting effects on health, wellbeing, and opportunity.  They are also preventable. An estimated 62% of adults surveyed across 23 states reported that they had experienced one ACE during childhood and nearly one-quarter reported that they had experienced three or more ACEs. 

ACEs and their associated harms are preventable. Creating and sustaining safe, stable, nurturing relationships and environments for all children and families can prevent ACEs and help all children reach their full health and life potential. The evidence tells us that ACEs can be prevented by:

• Strengthening economic supports for families

• Promoting social norms that protect against violence and adversity

• Ensuring a strong start for children and paving the way for them to reach their full potential

• Teaching skills to help parents and youth handle stress, manage emotions, and tackle everyday challenges

• Connecting youth to caring adults and activities

• Intervening to lessen immediate and long-term harms

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Priorities in Tribal Environmental Health

Authors: Annabelle Allison, Ivana Castellanos, Surili Sutaria Patel
Publication Year: 2018
Last Updated: 2019-10-09 10:22:06
Journal: American Journal of Public Health
Keywords: environmental injustice, health equity

Short Abstract:

In 2010, 5.2 million people, about 1.7% of the United States population, identified as
American Indian and Alaska Native (AI/AN), either alone or in combination with one or more other races. Out of this total, 2.9 million people identified as American Indian and Alaska Native alone, 0.9% of the U.S. population.1 There are 567 federally recognized Tribes in the U.S., yet the majority of Americans remain unaware of tribal public and environmental health concerns. American Indian and Alaska Native people have long experienced poorer health compared to other Americans. It is alarming to realize that American Indians and Alaska Natives live on average 4.4 years less than other Americans. They also experience higher rates of premature death compared to other Americans from diabetes, chronic liver disease, intentional self-harm and suicide, and chronic lower respiratory diseases.

Tribal Public and Environmental Health Think Tank

Since the group’s inception in 2011, the Tribal Public and Environmental Health Think Tank
has worked to promote the voice of tribal communities across the country as a strategy to
raise awareness about and achieve improvements in the unique environmental health, and
more recently public health, challenges faced by tribal communities.

Understanding the social and cultural contexts for why American Indian and Alaska Native peoples suffer from some of the highest disparity rates for public and environmental health is key in grappling with resulting tribal public and environmental health issues. The Think Tank therefore identified the following six public and environmental health priorities to continue to bring visibility to:

1. Food Sovereignty and Access

2. Infrastructure and Systems Development

3. Climate and Health

4. Resource Extraction

5. Clean Air

6. Clean Water

The Think Tank, with support from CDC and APHA, has identified strategies and products to produce over the next three years. The intention of these next steps is to promote the voice of Tribes across the country and raise awareness of the issues that disproportionately impact the health of American Indians and Alaska Natives. The Think Tank’s goals include:

ï‚· Advance principles of sovereignty through education

ï‚· Provide outreach and technical support to Tribes

ï‚· Promote the need for data equity among Native populations

ï‚· Engage with partners to broaden its impact

Abstract:

The Think Tank therefore identified the following six public and environmental health priorities to continue to bring visibility to:

1. Food Sovereignty and Access

2. Infrastructure and Systems Development

3. Climate and Health

4. Resource Extraction

5. Clean Air

6. Clean Water

The environmental injustices and lack of health equity that impact Indian Country need recognition, partners and action to remedy the deeply rooted causes of poor health to achieve a healthier future. The Tribal Public and Environmental Health Think Tank, commissioned by CDC and supported by the American Public Health Association, takes seriously the challenges faced by Tribal communities. It is imperative that this country’s national, state and local government officials, health professionals and citizens at large learn, understand, acknowledge and act on behalf of America’s indigenous peoples, who remain disenfranchised and endangered by historical maltreatment and persistent neglect.

The Think Tank, with support from CDC and APHA, has identified strategies and products to produce over the next three years. The intention of these next steps is to promote the voice of Tribes across the country and raise awareness of the issues that disproportionately impact the health of American Indians and Alaska Natives. The Think Tank’s goals include:

ï‚· Advance principles of sovereignty through education

ï‚· Provide outreach and technical support to Tribes

ï‚· Promote the need for data equity among Native populations

ï‚· Engage with partners to broaden its impact

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Funding: cooperative agreement U38OT000131 between the Centers for Disease Control and Prevention and the American Public Health Association.
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Unmasking the Hidden Crisis of Murdered and Missing Indigenous Women (MMIW): Exploring Solutions to End the Cycle of Violence

Authors: Sarah Deer, Ruth Buffalo, Mary Kathryn Nagle, Tami Jerue
Publication Year: 2019
Last Updated: 2019-10-09 09:45:31
Journal: US House of Representatives Committee Repository
Keywords: Sovereign Bodies Institute (SBI), National Indigenous Women’s Resource Center (NIWRC), jurisdictional barriers, sex traffickers, criminal jurisdiction over non-Indians, federal NamUs (National Missing and Unidentified Persons System), Savanna Lafontaine-Greywind

Short Abstract:

Testimony of Professor Sarah Deer:

...a citizen of the Muscogee(Creek) Nation and currently hold the position of Professor at the University of Kansas and serve as theChief Justice of the Prairie Island Indian Community Court of Appeals. Today I am testifying in my personal capacity.
My testimony today will focus on our knowledge in terms of the high numbers of MMIW based on open source reporting (media reports and family accounts). I will offer some theories about the causes of this high rate of MMIW. Finally, I will suggest how this committee, and Congress generally, can improve lawenforcement’s response to this crisis.

STATISTICS: WHAT WE KNOW

First, it is critical to understand that this crisis has deep roots in the historical mistreatment of Nativepeople throughout the history of the United States. Native women and girls have been disappearingsince 1492, when Europeans kidnapped Native people for shipment back to Europe. Targeted killing ofNative women is also not a recent phenomenon. This history of oppression makes it difficult to achieve buy-in from marginalized communities who have been victims of oppression at the hands of the federal government for centuries.


When crafting solutions, we have to be ready to accept that there will be no “quick fix” to this problem.This crisis has been several hundred years in the making and will require sustained, multi-year, multifaceted efforts to understand and address the problem.


Currently, there is no formal government-funded national database that carefully and deliberately tracks cases of MMIW. Fortunately, a Native-owned and -operated non-profit organization known as the Sovereign Bodies Institute (SBI) has been working tirelessly since 2015 to gather as much data as possible using open source reporting and input from family members of MMIW. I share this data with the permission of the Sovereign Bodies Institute (SBI):
Because this database has largely been built by hand, the data likely only represents a fraction of the true numbers. The SBI database currently tracks the following types of MMIW cases:
ï‚· Missing
ï‚· Murdered (both solved and unsolved)
ï‚· Suspicious deaths
ï‚· Deaths in custody (jail/prison/hospital)
ï‚· Jane Does (unidentified human remains thought to be Native women)

Abstract:

 focus on our knowledge in terms of the high numbers of MMIW based on open source reporting (media reports and family accounts). I will offer some theories about the causes of this high rate of MMIW. Finally, I will suggest how this committee, and Congress generally, can improve lawenforcement’s response to this crisis.

...Currently, there is no formal government-funded national database that carefully and deliberately tracks cases of MMIW. Fortunately, a Native-owned and -operated non-profit organization known as the Sovereign Bodies Institute (SBI) has been working tirelessly since 2015 to gather as much data as possible using open source reporting and input from family members of MMIW. I share this data with the permission of the Sovereign Bodies Institute (SBI):

Because this database has largely been built by hand, the data likely only represents a fraction of the true numbers. The SBI database currently tracks the following types of MMIW cases:
ï‚· Missing
ï‚· Murdered (both solved and unsolved)
ï‚· Suspicious deaths
ï‚· Deaths in custody (jail/prison/hospital)
ï‚· Jane Does (unidentified human remains thought to be Native women)

While there is no single cause (no primary risk factor), that one can point to as the reason for high rates of MMIW, experts suggest several explanations for the disparity.
These explanations include:


ï‚· jurisdictional barriers
ï‚· indifference from government officials
ï‚· the lack of cross-jurisdictional communication and planning
ï‚· failure to adequately fund tribal justice systems, and
ï‚· the problem of sex traffickers and other predators targeting Native women specifically.

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