October 2019, Volume XXXIII, No 7
Clinic provides free Narcan directly to patients
Nura Pain Clinic now provides free Narcan kits and training directly to select patients who take opiate analgesics. Narcan, generically known as naloxone, is a medication that can be used to reverse an opioid overdose.
The clinic has long advocated for multidisciplinary alternatives to opioids for pain management. “We do everything we can to reduce and eliminate the need for opioids in our chronic pain patients,” said Peter Schultz, MD, MPH, a partner in the practice with his brother and clinic founder, David Schultz, MD. “Nonetheless, some patients are referred to us on high dose opioids and it may take us weeks or even months to transition them away from opioids and into more effective and safer alternatives. During this transition period, we believe that access to, and education about, naloxone will help keep these patients safe as we taper opioids over time.”
Underscoring Nura’s new initiative is an August CDC announcement calling for increased access to naloxone, and reporting that only one naloxone prescription was dispensed for every 70 high-dose opioid prescriptions nationwide. In 2018, the Minnesota Department of Health reported 331 deaths due to opioid overdose.
While Minnesotans can now obtain naloxone without a prescription, there are still social stigmas and financial barriers to its access and use.
Nura began testing its program in August and is now looking at rolling it out to all of its opioid-using patients.
Air pollution linked to violent criminal behavior
Exposure to high levels of air pollution is known to cause asthma attacks, cardiovascular disease, and other health problems in people. New research from the University of Minnesota School of Public Health and Colorado State University shows that breathing dirty air—even for just a day—also likely causes people to become more aggressive and violent. Their findings were recently published in the journal Epidemiology.
The researchers examined the association between daily violent and non-violent crimes and short-term increases in air pollution across 301 counties in 34 states during a 14-year period. Data for the study was gathered from the FBI’s National Incident-based Reporting System and the Environmental Protection Agency’s Air Quality System. Daily pollution levels were determined based on the amount of fine particulate matter—such as diesel exhaust chemicals—and ozone in the air.
The study found:
Results were consistent across different community types, including regions with different socioeconomic status, racial diversity, and age. In other words, it is not the community driving this relationship.
“While our study cannot identify the exact processes that link air pollution and violent behavior, we believe that exposure to air pollution has immediate effects on the brain, which results in behavioral changes,” said study lead author and Assistant Professor Jesse Berman.
These effects may increase the impulsivity of people and escalate what is known as their “fight or flight” stress response. Everyday minor conflicts, such as an argument with a neighbor, may become quickly heated and result in more serious physical altercations.
Allina Health joins UCare Individual and Family plans network
UCare, a community-based, nonprofit health plan, has expanded its provider network to include Allina Health for Individual and Family plan members. The Twin Cities-area Allina Health system includes 11 hospitals, 90+ clinics, and 6,000 associated and employed physicians. UCare’s Individual and Family plans available through MNsure will be the only health plans to feature three major care systems—Allina Health, Fairview Health Services, and Park Nicollet—in their network.
Allina Health and UCare share a common mission to improve the health of communities through exceptional care and service. Both organizations put the member/patient at the center.
UCare currently has the largest enrollment of Individual and Family plans through MNsure—32,000+ members. Since MNsure’s opening in 2014, UCare has been committed to offering and expanding plans for people who buy health insurance on their own. UCare Individual and Family plans are available in 28 Minnesota counties and offer some of the lowest rates on MNsure.
Senior care organizations partner to offer Medicare Advantage plans
Seniors living in 78 Twin Cities-area long-term care and assisted living communities will have a new Medicare Advantage health coverage option to select for 2020 coverage if they qualify for its requirements.
Medica Advantage Solution PartnerCare (HMO I-SNP) is the new Institutional Special Needs plan offered through a collaboration between Genevive, Medica, and 10 of the largest senior care organizations in the region. The plan is designed to meet the often complex health needs of adults living in long-term care, assisted living, and memory care settings. The plans will be available for a Jan. 1, 2020, effective coverage date. They are the first in the region to offer Genevive’s integrated care team expertise aligned with Medica’s care model experience across a diverse number of residential settings.
The plans will be offered exclusively to eligible individuals residing with the 10 senior care providers: Benedictine Health System; Cassia, an Augustana/ELIM affiliation; Catholic Eldercare; Episcopal Homes of Minnesota; Goodman Group; North Cities Health Care Inc.; Presbyterian Homes & Services; Saint Therese; Volunteers of America; and Walker Methodist.
Genevive, co-owned by Allina Health and Presbyterian Homes & Services, will provide primary care and care management services and act as the contracting agent on behalf of Medica, with the participating senior care organizations representing approximately 5,500 eligible individuals. Medica has designed and offers the health insurance plan, which includes coverage for prescription drugs, transportation, dental, vision, and hearing care. Medica-participating providers will provide hospital services, subject to appropriate placement based on clinical considerations and patient choice.
New M Health Fairview brand launches
Following a recent announcement of a joint clinical agreement between the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services, the organizations on Oct. 1 launched a new M Health Fairview brand. M Health Fairview represents the best of academic and community medicine, bringing world-class medical research and advances to thousands of Minnesotans as part of one of the state’s largest health care networks, providing expanded access to breakthrough care.
M Health Fairview closely links the University of Minnesota Medical Center—a hub for medical research—with Fairview’s extensive network of 10 hospitals, 60 primary care clinics, and numerous other services to provide top-tier care.
M Health Fairview focuses on creating an easier, simpler health care experience for patients, designing the care experience around them—an approach built on significant learning and collaboration, including educational visits to the National Aeronautics and Space Administration (NASA), Southwest Airlines, and FedEx.
Each service line organizes around specific health conditions rather than traditional boundaries, such as geographic areas or departments. Led by a single leadership structure pairing academic physicians with operations leaders, the service line approach translates health care innovations developed at the University of Minnesota into care at the community level.
Children’s Minnesota receives grant to bolster program addressing community health
Children’s Minnesota has received a $500,000, two-year grant from Kohl’s Cares to support the health system’s Community Connect program, an initiative that goes beyond basic medical care to support the social determinants of health impacting kids.
Community Connect is transforming Children’s approach to health care by connecting families to existing community resources, including housing, food, and other needs. Beginning with the proactive social determinants of health screening, clinicians at Children’s make real-time referrals to onsite Resource Navigators who can design a responsive plan of action to help families on an on-going basis. Available resources include food access, transportation services, legal assistance, housing support, early childhood education programs, employment search assistance, and more.
“As a pediatric health care system, it’s important that we support kids beyond the care we provide in our hospitals and clinics, and recognize the multitude of factors that contribute to their health, said Gigi Chawla, MD, chief of general pediatrics at Children’s Minnesota. “Improving a child’s overall circumstances can make all the difference when it comes to outcomes.”
Research shows that:
© Minnesota Physician Publishing · All Rights Reserved. 2019
Community Connect is currently available at Children’s St. Paul and Minneapolis Primary Care clinics as well as the Adolescent Health, Asthma and Endocrine Diabetes specialty clinics in Minneapolis and St. Paul. The grant from Kohl’s Cares substantially funds Community Connect at Children’s hospital-based Primary Care clinic in Minneapolis.
Michael Reyes, MD, has joined Essentia Health–St. Joseph’s Medical Center in Brainerd, where he will practice anesthesiology. Dr. Reyes earned a medical degree from Vanderbilt University School of Medicine in Nashville, Tennessee, and completed a residency in anesthesiology at Mayo School of Health Sciences in Rochester, as well as a fellowship in pain medicine at the University of Iowa.
Melena Bellin, MD, pediatric endocrinologist for University of Minnesota Physicians and professor in the University of Minnesota Medical School’s Department of Pediatrics and Surgery, has been named a recipient of the Presidential Early Career Awards for Scientists and Engineers (PECASE) by President Donald Trump. The award is the highest honor bestowed by the federal government to science and engineering professionals who are beginning their independent research careers.
Sarah Clausen, MD, has joined St. Luke’s Obstetrics & Gynecology Associates in Duluth. Dr. Clausen received her medical degree at the University of North Dakota School of Medicine and Health Sciences in Grand Forks. She is board-certified by the American Board of Obstetrics & Gynecology. In addition, St. Luke’s Rheumatology Associates has hired Adam Elisha, DO. Dr. Elisha received his medical degree from Arizona College of Osteopathic Medicine in Glendale, Arizona. He completed his residency in internal medicine at Providence Internal Medicine Residency in Spokane, Washington, and a fellowship in rheumatology at the University of Pittsburgh Medical Center.