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Blog

August Provides a 2-fer for Vaccine Information and Education

8/18/2021

2 Comments

 

The Immunization Partnership Staff

 

​August is National Immunization Awareness Month and we are featuring a guest blog from The Immunization Partnership, who distributes resources to promote adult and child vaccinations across the state. Read more below to learn about their efforts and recommendations. As the state’s public health institute, we prioritize sharing both internal and external information that contributes to advancing the health of all.

August provides The Immunization Partnership the opportunity to reach out to parents and the public in general about the importance of keeping current on adult and children vaccines. By combining social media and traditional media messaging for National Immunization Awareness Month and Back to School, we can reach out to Texans in a variety of ways.
 
We made available to Texas county health districts and public health agencies a NIAM and Back to School proclamation template, which allows customization by inserting the name and title of the proclamation issuer, such as mayor or county judge. We also will provide targeted news releases about NIAM and Back to School, which include quotes from the local public health professional and our interim Executive Director. The local public health person can revise or extend the quote. We use the main news release, which includes only quotes from our interim Executive Director, for the rest of the state.

We are proud to announce the distribution of a series of English/Spanish animated videos we hope will answer COVID-19 vaccination questions and lead to more Texans exercising their right to bare arms and take a shot for Texas. Americagroup Texas funded the project, which The Immunization Partnership produced.
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Misinformation, or simply the lack of information, regarding COVID-19 and the authorized vaccines has led to confusion and hesitancy. Hill Powell, our interim Executive Director, is excited about the role these videos can play in reducing the number of COVID-19 cases throughout Texas because they bring the right message at the right time. “The best way to counter relatively common misperceptions and misinformation, such as the belief that vaccines might change a person’s DNA, is through basic information about the vaccines and how they work. And these videos do just that.”
 
Katy Gore, our Coalitions and Education Program Manager, designed the videos that run about a minute or less. They not only explain the virus and the vaccines in a format we hope will dispel doubts but they also give doctors, nurses, and health professionals an opportunity to answer patients’ questions and concerns about the vaccines. “We want to create comfort with the vaccine among individual Texans, families, and communities,” Katy says.
 
The videos will run on a loop in the lobbies of Federally Qualified Health Clinics and in reception areas of Texas Community Health Centers members. Coastal Health and Wellness clinics in Galveston County are the first FQHCs to run the videos. We also will share them on social media and with other clinic systems across the state. We have the videos on our COVID-19 webpage. Contact Katy at kgore@immunizeusa.org if your organization would like the videos. They’re free!
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In the Eye of Hurricane Season: Remembering Harvey and Storm Preparation

7/22/2021

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JOHN OEFFINGER

DIRECTOR, ELEARNING AND TRAINING​
​TEXAS HEALTH INSTITUTE

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​August 25th marks the fourth anniversary of Hurricane Harvey slamming into Rockport, Texas- most people will remember the devastating rainfall. The Category 4 hurricane and its 130-mph winds created a path of destruction through the city of 10,000 people as it came ashore. Over 2.5 million cubic yards of debris were removed from Rockport in the five months after the storm. By comparison, Houston, a city 216 times Rockport’s size cleared 3 million cubic yards of debris. A front row seat watching the eye roll across Rockport provides an eye-opening view of Harvey’s force. Cleared cubic yards of debris are not necessarily based on the size of the city.
 
National Oceanic and Atmospheric Administration (NOAA) predicts another active hurricane season this year, which began June 1st, and forecasters predict multiple major Category 3 to 5 storms. It’s not too early to prepare for a hurricane or tropical storm. The CDC provides excellent guidance including what emergency supplies to stock in your home, planning to evacuate, and protecting older adults and pets. CDC’s practical information and guidance should be bookmarked on your browser. Staying safe after a storm is just as important as preparing for one.

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Your mental health and resilience should not be forgotten in planning. THI’s Texas Hurricane Response Hub created eight online courses for public health, first responder, emergency response and preparedness professionals, and healthcare practitioners. Protecting Your Physical and Mental Health Before, During, and After a Disaster provides guidance on how to prepare yourself and your family for a hurricane, both for health professionals and members of the community.
 

Almost four years later, Rockport is still rebuilding. Crumbling foundations, remains of rusting light posts ripped from their bases, and remnants of a fire extinguishing system all serve as reminders of the devastation the city faced. But, Rockport is resilient, the town is rebuilding, and businesses and tourism are coming back. The COVID-19 pandemic didn't help matters but driving through the town you can see rebuilding and positive changes. A community does what they can with the resources available. Again whether it’s media attention to stay in the public’s and funder’s view or the number of staff to chase down different funding opportunities, size matters.
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Rockport and other coastal areas will see storms this year and in the future. There is still work to be done, and doing it correctly will require applying a health equity lens to planning and rebuilding efforts. Hurricane Katrina exposed inequities in racially, ethnically, and linguistically diverse communities across a continuum of preparedness, response, recovery, and mitigation activities. THI's Health Equity team created a body of work post-Katrina that can help local agencies orient and consider the importance of health equity in hurricane planning and recovery. Preparing Racially And Ethnically Diverse Communities For Public Health Emergencies and Guidance For Integrating Culturally Diverse Communities Into Planning For And Responding To Emergencies: A Toolkit are excellent starting points.
 
“Now is the time for communities along the coastline as well as inland to get prepared for the dangers that hurricanes can bring,” said Secretary of Commerce Gina Raimondo. Regardless of a city’s size, a hurricane can come ashore anywhere along the Texas coastline spanning 15 counties and 3,359 miles. Per the CDC "planning for hurricane season and other potential disasters can be stressful, and because the 2021 hurricane season comes during the coronavirus disease 2019 (COVID-19) pandemic, it may be especially so.
 
Public health and emergency response professionals have advice to help you safely prepare, evacuate, and shelter for severe storms while protecting yourself and others from COVID-19." Now is the time to prepare for this year’s storms.

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Being Right is Not Enough. How Advocates Brought Dental Access to Medicaid Adults with Disabilities

6/30/2021

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Dennis Borel

EXECUTIVE DIRECTOR
COALITION OF TEXANS WITH DISABILITIES

​As the executive director at the Coalition of Texans with Disabilities (CTD), I interact with many people with disabilities. Poor oral health is endemic and obvious, particularly among adults with disabilities living in the community. It’s common to see missing or broken teeth and even the complete lack of teeth. Frankly, I got tired of seeing people I care about in this condition and began to do research on how this can be addressed. CTD is an advocacy organization and my thoughts led to public policy.
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Very-low-income people with disabilities can get health coverage through Texas Medicaid. Children, adults in institutions, and a small percentage of adults in the community have a dental benefit. Many people react in disbelief when learning that most adults with disabilities in Medicaid community care do not have access to a dentist. This leads to very bad outcomes, like resorting to an emergency room when in severe dental pain. The treatment there is not dental, only antibiotics and painkillers, often opioids. Some people are in such bad shape they must be hospitalized, and a few actually die from complications. What caused this? Simply, untreated cavities, a treatment that is usually done in a dental clinic. That’s not all. Poor oral health leads to elevated heart disease, diabetes, hypertension, stroke, cancer and more. These facts make a strong argument for adding a dental benefit.
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Texas leadership believe in limited government and low services. Texas ranks 49th in community services for people with disabilities[1] and remains among the minority of states not adopting Medicaid Expansion. To succeed, we would need a collective effort. CTD is well positioned in the Capitol and would serve as advocacy lead, including bringing self-advocates, individuals with disabilities. We would need to make the business case, that requires a skilled health research organization. Texas Health Institute filled that role. Influential legislative champions had to be recruited and supported. Our top champions are Senator Lois Kolkhorst and Representative Joe Deshotel. And we needed to show broad support from other groups. That meant putting together a strong list of supporting organizations. Among those would be some obvious groups like the Texas Oral Health Coalition and the Texas Dental Association, but we went beyond and added major trade associations for doctors, hospitals, nurses, health plans and dozens of disability organizations.

It took time. In 2017, we secured a study of the issue. In 2019, we passed a bill to pilot comprehensive dental care. In 2021, after the language passed through five bills, on the last day, a preventive dental benefit was passed. This was the result of many hearings, legislative visits, and organizing. It’s not over as we will continue to monitor the rollout. Yet, the impact is huge. Around 450,000 adults with disabilities, who would have had no dental visits in their adulthood, will now be able to see a dentist every year. The smiles will look very nice indeed.


[1] United Cerebral Palsy and ANCOR Foundation, The Case For Inclusion Report 2019

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Public Comment for Texas' Request to Extend Medicaid 1115 Waiver

6/15/2021

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ANDY MILLER, MHSE

CHIEF STRATEGY AND IMPACT OFFICER
TEXAS HEALTH INSTITUTE

As you have likely heard by now, Texas will be refiling with the Centers for Medicare and Medicaid Services (CMS) a request to extend the uncompensated care pool part of the Medicaid 1115 waiver for 10 years after the previously approved waiver was rescinded in April. This request will seek billions of dollars to continue reimbursing hospitals that incur costs due to uninsured patients, many utilizing emergency rooms for non-emergency conditions as they are required by law to treat anyone who presents for care. It has long been established that using the emergency room as the primary mechanism for providing health care is expensive, inefficient, and fails to enable people to get preventive services, medications, and effectively manage their chronic conditions.

Alternatively, expanding health insurance coverage in addition to adequate funding for safety net providers to cover uncompensated care costs for those who are not eligible for affordable insurance coverage could lead to both improved health outcomes for Texans and reduced costs to over time.

The state is holding a public comment period for stakeholder input before sending the application to CMS, which will then hold a second, federal public comment period prior to issuing its decision. CMS specifically cited the lack of a public comment period as its reasoning for rescinding Texas’s previous waiver extension. It is critical that Texans make their voices heard on this issue. The deadline to submit written comments is June 28, 2021.

For more information and to submit written comment, please visit the Texas HHS website. 
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Behavioral Health in the Wake of COVID-19 and the Health Care Community’s Response

5/17/2021

2 Comments

 

Daniel Crowe, MD, FACP

TEXAS HEALTH INSTITUTE BOARD OF TRUSTEES

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The coronavirus pandemic of 2020-2021 has had a profound impact on the mental health and well-being of Texans, as well as the rest of the US. The pandemic highlighted the need to revitalize the infrastructure of our public health system and to protect it from political influence at all levels. The trauma inflicted by the pandemic has touched all of us. Many have lost family members or friends. Other stresses include loss of employment, insurance coverage, housing, and access to healthcare. Children have lost more than a year of seeing their classmates and friends in person and have had to learn how to learn through a virtual school environment. Many small business owners lost their sole source of income due to restrictions required to minimize the spread of the virus.
 
The CDC reports that as a result of all of this, there has been a 27% increase in symptoms of anxiety and depression between April 2020 and February 2021. Emergency room visits due to overdoses and suicide attempts were up 36% and 26%, respectively. More than 87,000 Americans died of drug overdoses in the year ending in September 2020, representing a profound increase. Behavioral health service providers reported increased demand at the same time that they were decreasing staff sizes and closing clinics. Although the use of telehealth has risen dramatically, the effect on providing care for those with behavioral health and substance use disorders (SUD) has yet to be determined. The impact of the pandemic has disproportionately affected our communities of color. It has highlighted how a system that prioritizes a law enforcement and criminal justice approach to psychiatric crises often results in unnecessary injuries and deaths.
 
The health care community has responded rapidly to the new environment created by the pandemic. Some best practices have emerged:
  • Increased access to behavioral health and SUD providers via telehealth
  • Integration of behavioral health into primary care practices
  • Integration of evidence-based treatment of SUD into behavioral health and primary care practices (medication-assisted therapy or MAT)
  • Use of mobile applications to support healthier behaviors and activities including use of rewards when individuals are behaving in ways that support improvement in mental health symptoms and maintenance of recovery (contingency management)
 
There has also been a significant increase in enrollment in Medicaid and the Healthcare Exchange during the pandemic leading to many gaining or regaining access to health care.
 
As the public health institute of Texas, Texas Health Institute (THI) is committed to helping Texas overcome the trauma from the pandemic through their continued devotion to advancing the health of all Texans and their communities. THI’s dedicated staff continues to produce outstanding research and translational activities such as the recent work on health equity through the HOPE Initiative that is featured by the New England Journal of Medicine. THI works with the Texas Primary Care Consortium to integrate behavioral health into primary care practices throughout Texas. THI has been a leader in advancing collaborative action on chronic pain, SUD, obesity, oral health, genetic disorders and other topics important to Texans. To quote THI, “We strive to advance the health of all.”

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