State highlights: Texas lawmaker proposes '3 strikes' for nursing homes

A selection of health policy stories from North Carolina, South Carolina, Texas, Iowa, New Mexico, Illinois, Missouri, Georgia, Wisconsin and California.

Stateline: Southern States Now Epicenter Of HIV/AIDS In U.S.
New Yorker Deadra Malloy was diagnosed with HIV in 1988, but she remained healthy for so long she wasn't completely convinced she was positive. When she finally started getting sick in 2006, she decided to embrace her "ancestral roots" and accepted a job down South, where her mother was from. Malloy didn't know that the move, first to North Carolina and then to Columbia, South Carolina, would make it much more difficult to manage her disease. New York offers free health care, including HIV drugs, to HIV-positive state residents who are uninsured or underinsured, while assistance is harder to come by in North Carolina and South Carolina. At the time a single mother of two, Malloy couldn't afford her medication, which cost upwards of $2,500 a month. So she did without it for nearly a year -- and ended up in the emergency room with a raging case of pneumonia (Wiltz, 9/8).

Texas Tribune: '3-Strikes' Plan Spurs Nursing Home Regulation Debate
At a hearing in August to evaluate the state agency responsible for Texas' elderly residents, State Senator Charles Schwertner singled out seven of the 1,200 nursing homes licensed by the Department of Aging and Disability Services. "These seven facilities are the worst of the worst," said Mr. Schwertner, a Republican from Georgetown. At the hearing, he proposed a "three strikes" rule that would force the state to close nursing homes found to have the highest-level violations of federal quality standards on three separate days over 24 months (Walters, 9/6).

Des Moines Register: State Paying For Pricey Pill To Treat Hepatitis C
The state of Iowa has started paying $1,000 per pill for a new drug targeting hepatitis C, but officials don't plan to buy the medication for every person who carries the virus and qualifies for public health care. The issue could be particularly acute for the state prison system, because more than 10 percent of its inmates are infected with hepatitis C. The prison system recently started paying to treat two inmates with the new drug, called Sovaldi. The total cost to treat them is expected to hit $147,000, said Dr. Harbans Deol, the corrections department's medical director. Deol said about 830 of Iowa's 8,200 inmates carry the hepatitis C virus. That level is more than 10 times the rate in the general population, mainly because many prisoners have a history of using intravenous drugs (Leys, 9/7).

The Associated Press: New Mexico College To Train Community Paramedics
A New Mexico community college is launching a program to get critical medical services into rural parts of the state. The Albuquerque Journal reports that Central New Mexico Community College is starting a Community Paramedic Program this fall semester. Students who already have their paramedic licenses and have been working in the field for at least three years can enroll in the certificate program. Students will take courses such as community health care and cultural competency and complete a clinical rotation (9/8).

North Carolina Health News: A Trailer, Electricity And A Nurse Practitioner Might Be The Future Of Primary Care In Rural Areas
Cows and tobacco fields easily outnumber people in the pastoral community of Snow Camp in Alamance County. And like many rural areas in the state, access to primary health care services was a big challenge, until last year. That's when a partnership between the UNC-Chapel Hill School of Nursing, Piedmont Health and the Alamance-Burlington School System led to the creation of the Sylvan Community Health Center, a clinic that operates out of a donated trailer on the grounds of Sylvan Elementary School in Snow Camp. Tucked away on a corner of school property, signs point the way to the Sylvan Community Health Center. The center has two exam rooms, a children's play area and a lab. Before Sylvan Community Health Center opened up, there were no health care services in Snow Camp (Namkoong, 9/8).

Chicago Tribune: Health Management Plans Underused At City Schools
Chicago Public Schools students with asthma or food allergies often don't have health management plans on file at their schools, according to a new study, potentially leaving the district ill-equipped to respond to life-threatening medical situations. Researchers at Northwestern University's Feinberg School of Medicine, who led the study to be published Monday in the medical journal Pediatrics, said the research is the first effort to examine how a large urban school district manages and reports on asthma and food allergies. The study concluded that about a quarter of some 18,000 CPS students with asthma and about half of 4,000 children with food allergies during the 2012-13 academic year had a school health management plan on file with the district. (Perez, 9/8).

St. Louis Post-Dispatch: Funding Loss Forces Local Nonprofit To End Program That Cuts Infant Mortality
A local nonprofit organization on the front lines of reducing infant deaths in at-risk neighborhoods is ending a key program this month after the loss of federal funding. Officials with the Maternal, Child, Family Health Coalition were informed on Aug. 28 that they will no longer be receiving millions of dollars in federal funding for its Healthy Start program, according to Executive Director Kendra Copanas. The program's federal funding, which totaled $7.1 million since 2001, represented about one-third of MCFHC's annual budget, she said. The funding allowed the nonprofit to send nurses to expectant mothers' homes to provide health care and education about pregnancy. The program also provides case management to help mothers navigate the health care system for up to two years after the child is born. Each year the program serves about 250 to 300 mothers and their babies, Copanas said (Liss, 9/6).

Georgia Health News: Feds Slam Care At Augusta Facility For Disabled
A federal agency has warned Georgia officials that it will end Medicaid payments to an Augusta facility for the developmentally disabled unless the state improves conditions there. The Centers for Medicare and Medicaid Services (CMS), in an August report, said the state-run Gracewood Developmental Center has repeatedly failed to ensure the safety of patients, who have been subjected to physical and verbal abuse (Miller, 9/7).

Milwaukee Journal-Sentinel: Judges Question Size Of State's $1.15 Billion Malpractice Fund
The $1.15 billion state medical malpractice fund came under fire from two Milwaukee County judges who questioned the need for such a large cushion to protect doctors and hospitals. The fund was placed under the judicial microscope during separate hearings on the validity of the state's $750,000 cap on noneconomic damages for such things as pain and suffering that can be awarded in medical malpractice cases. In one case, a jury in July awarded a woman -- who lost all four of her limbs as the result of an undetected Strep A infection -- $15 million for her pain and suffering and another $1.5 million to her husband for the loss of her companionship (Spivak, 9/6).

Milwaukee Journal-Sentinel: In Milwaukee, Efforts Aim To Address Gaps In Health Care System
David Goines helps people manage chronic diseases, such as diabetes and high blood pressure, but spends little time within the walls of a clinic. Goines is a community health worker, and his clinic is churches and other places in the community. Part of his job is helping people understand their disease and how to navigate the health care system. But a good part of it also is building relationships with people who often are intimidated by the health care system and who face day-to-day problems much more pressing than their health. ... Community health workers are an example of how health systems, public health departments and others in the Milwaukee area are working to address broader problems that may underlie the persistent gaps in health between people who are poor and those who are not (Boulton, 9/6).

Sacramento Bee: Health Costs For Counties Rise With Influx Of Inmates
Since the state gave counties responsibility for incarcerating lower-level offenders three years ago, health care costs at county jails have gone up dramatically -- and legal actions threaten to push them even higher. The state's 10 biggest counties spent $560 million on medical and psychological care for inmates last fiscal year, a 16 percent jump over the fiscal year that ended in 2011, according to a Sacramento Bee analysis of data provided by the counties. Figures collected by the state over roughly the same period show a similar pattern for all counties: Spending on medicine is up 21 percent and out-of-jail medical visits have increased 32 percent (Banan, 9/8).