Rhode Island Public Radio will be taking a look at some of the top stories from 2015 in the coming days – from developments in the 38 Studios case to the state’s first female governor. But for this week’s The Pulse, Rhode Island Public Radio’s Kristin Gourlay joins news director Elisabeth Harrison to talk about some of the health care stories that deserve a second look.
Here's a transcript of their conversation.This week's The Pulse looks back on some of the health stories of 2015 that deserve a second look.
ELISABETH: Kristin, good morning. There was certainly no shortage of important health stories this year. But what really stands out for you in terms of the impact on Rhode Island?
KRISTIN: One of the biggest stories is about vaccination. I think the fact that 70 percent of all seventh grade boys and girls got a new vaccine this year – the one that protects against the Human papillomavirus or HPV – is huge. HPV is a sexually transmitted infection that can lead to certain cancers. And Rhode Island is the first state to require the HPV vaccine for all seventh graders. 70 percent coverage for the first year of a requirement makes a lot of public health officials jump up and down. There was, as you might recall, some pretty vocal opposition to this new requirement, though, and the number of parents requesting religious exemptions from vaccinations for their children went up, as well.
ELISABETH: But Rhode Island has typically pretty good vaccination rates, right?
KRISTIN: Yes – it’s a success story for the state in many ways. But Rhode Island has not been so successful at curbing other diseases. Sexually transmitted infections are up this year. But the disease of addiction is still the big killer. Prescription painkiller and heroin addiction and overdose deaths have lingered in our headlines for several years now. But a few things happened this year that merit another look. One is that the number of overdose deaths is not going down. That’s despite the fact that there’s lots of attention on this problem, and some new interventions. More of those deaths involve heroin than ever before – which suggests more people have turned from prescription painkillers like OxyContin to heroin. That’s especially concerning because a lot of the heroin has been found to contain another, even deadlier substance, called fentanyl. Also, new data suggests that victims have been mixing opioids like heroin or prescription painkillers with another class of drugs called benzodiazepines. These are anti-anxiety medications, and the combination can stop your breathing.
ELISABETH: But you mentioned there was quite a bit more attention on this problem than in previous years – what do you mean by that, Kristin?
KRISTIN: One of the first things the newly elected governor Gina Raimondo did when she took office was to convene an overdose prevention task force. That group came up with a strategy to reduce deaths by a third over the next few years – and I spoke to a couple of outside experts, like the former head of public health for the city of Baltimore, who say it’s a really good, really innovative plan. Right now the members of that task force are hammering out the details of how to make it happen.
But also, we’ve seen more emergency departments staffing up with what they’re calling peer recovery coaches, people who are trained to talk to overdose survivors about getting into treatment. There have been renewed calls at the federal level to reduce the prescribing of addictive painkillers. And also there’s a new push to make medications that can help people kick the opioid habit more widely available.
ELISABETH: Kristin Gourlay, you also focused quite a bit on the economics and business side of health care this year. What are the big stories there, and what are you expecting for next year?
KRISTIN: A couple of big stories: one is that Care New England picked a partner organization to affiliate with. That deal is still very preliminary. But if it’s approved, it could change the health care landscape – meaning, where you get care, what it costs – significantly. These health care company mergers you’re hearing about so much, these stories may just be background chatter for most people who have bigger concerns to deal with in their everyday lives. But I’ll keep my eye on them because in the end, some of the deals will affect how much we pay for health care, for one thing.
ELISABETH: And when it comes to how much we pay for health care, I remember that recent “total cost of care” study that came out, showing Rhode Island isn’t paying as much for health care as everyone thought. That was a big premise for Governor Gina Raimondo’s early efforts to rein in the cost of Medicaid. What do you make of that?
KRISTIN: That’s right – the beginning of this year saw a flurry of activity at the statehouse trimming budgets and redesigning programs to deliver better value. Rhode Island may not be spending more per Medicaid enrollee than a lot of other states. But the fact remains that it is a third of our state’s budget. And if we can be keeping people healthier for less money – that’s something everyone can agree is a good thing. It’s still too soon to say exactly how some of those initiatives will pay off, though.
ELISABETH: Kristin, before we wrap up, I just want to come back to stories you reported earlier this year about child welfare. New management has uncovered that the state’s Department of Children, Youth, and Families is pretty dysfunctional in lots of ways. That’s not necessarily unique among states. But you found that Rhode Island’s troubles run a little deeper.
KRISTIN: Yes. Kids who enter the child welfare system in Rhode Island are more likely to be placed in group homes here than in other states, and that’s troubling because it’s a kind of care most people would rather avoid. We don’t have enough foster families in the pipeline to take in kids who need homes. And while children are in the system, they and their families aren’t always getting the health care – especially mental health care – they need. That’s not to say that DCYF staff aren’t hardworking or well-meaning. It’s just that the system that developed to handle all of these functions is pretty broken. And there’s a team in place trying to make it better now.
ELISABETH: Kristin, thank you.