Advocates gathered under the capitol dome Monday to educate lawmakers about the prevention of addictions and mental health struggles.
Organizations from across the state spent Monday morning manning tables throughout the rotunda, educating the public and lawmakers about their prevention efforts against many issues, from gambling to tobacco use.
Sheila Moran is director of marketing and communications for First Choice Services which operates several programs and helplines to provide access to behavioral health and social services.
Moran said while emergency services are vital, she wishes people would reach out before a crisis so First Choice Services can offer them prevention tools.
“There is a strong prevention component, Moran said. “We really wish people would call us sometimes before things get to a crisis, maybe a family member who’s concerned about someone in their life who may be suicidal, they can call our 988 line and they can get a heads up, they can get some advice, some guidance to provide their loved one.”
Moran said she was encouraged by the show of participation and support from youth attending the event.
“I’ve been heartened to see how many of the young people have come up to our table,” she said. “So I think it’s a really different environment than it was many years ago. You know, so many of these kids are involved in clubs and organizations that are talking about some of the dangers.”
One of those student participants was Colt Castle, a seventh grader from Washington Middle School who attended the event as part of the Pocahontas Youth Coalition.
“We will throw parties every month, to give people a sense of community to come to, instead of going out committing crimes and doing drugs,” Castle said.
Castle said his involvement in the group came from a deep sense of community.
“I wanted to help create a better sense of community, so that people wouldn’t go to jail for it, and wouldn’t die because of it,” Castle said.
Debbie Goff with Putnam Students Against Destructive Decisions (SADD) said her student-led organization chooses which issues to address in their community.
“We come into the community, we do a lot of educating students, it’s student-led, so that students actually decide what issues they want to tackle the most,” Goff said. “Right now, it’s mental health and vaping.”
Goff said she hopes the education SADD provides its participants with will arm them in making decisions in the future.
“I’m not naive enough to think I’m gonna stop every kid from trying something,” Goff said. “But what do they do? What, how do they know? Give them the education and make that choice.”
A West Virginia prevention program targeted at high risk diabetes patients is showing almost immediate results for participants such as Selena Hanshaw, a working mom of four kids ages 6 to 20.
“As a mother of four, I know for myself, you just kind of forget about yourself. You’re just so worried about care for everyone else, you kind of neglect yourself,” said Hanshaw. “I just didn’t want to accept the fact that I had diabetes. I wanted to pretend that it didn’t exist.”
Hanshaw is a nurse who was struggling to manage her diabetes. So she joined a local chronic care management program. The program is piloted by Marshall University School of Medicine in partnership with community health centers.
“We’re working specifically with high risk diabetes patients because of the cost that they represent to the health care system,” said Professor Richard Crespo who heads up the program. In this program, high risk diabetes patients are referred to a team, which includes a mid-level provider, such as a nurse-practitioner or physician’s assistant, a nurse and community health worker. The community health worker is someone from he community they serve.
Credit Kara Ardron
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Community health workers Samantha Runyon (left) and Kelli Browning (right) dress a diabetic patient’s foot and talk about medication during a home visit.
“What the community health workers do in our model is work with patients on things that they should be doing for themselves, but because of a variety of circumstances are not able to,” said Crespo.
At her home, Hanshaw meets with her community health worker Kelly Browning. As part of her diabetes management, Hanshaw is trying to lose weight.
“What do you think this week you can do?” asked Browning.
“Realistically, if it’s pretty, I would like to walk,” Hanshaw answered.
“But if it’s not pretty what are you going to do?” Browning asked.
After weighing Hanshaw and going over her blood sugar, Browning works with her to develop a plan for the week.
“Each patient is completely different,” said Browning. “They all need something different from us. Some need that stability of ‘hey I’m going to call you every day and see that you took your medicine’. Whatever it is they need from us is what we do.”
Browning has 32 patients and is one of three community health workers serving Mingo County. The program started in 2011 and is now in three states employing more than 20 community health workers.
Crespo said that over the course of the program they’ve seen a clinically significant drop in blood sugar levels for participants.
“The more the blood sugar is controlled in the body, then [there is] less risk of amputation and heart disease,” he explained. “But more significantly is the decrease in using the emergency department and going to the hospital, and that’s the payoff is to the insurance companies– the decrease in using those resources.”
The chronic care management program grant is funded from about seven different sources, according to Crespo. But grants aren’t a long-term fix. Crespo said he’s been talking with West Virginia’s three private insurers and West Virginia Medicaid to continue funding the initiative.
“Conceptually it makes sense,” he said. “It’s just the way that funding and reimbursement happens in medical care in the United States is based on fee[s] for service, and this doesn’t fit that model. This is part of the dissonance, is figuring out a way to make it happen in how healthcare is paid for in the United States.”
It’s not just changing the way insurance companies fund health care, but also the way the legislature does.
“What worries me is that we keep cutting these programs in order to balance the budget,” said Senator Ron Stollings, an internal medicine doctor from Boone County. Stollings said the state legislature is zeroing out a variety of state prevention programs. For him, prevention needs more funding, not less, with a focus on obesity, since the condition is related so heavily to not only type 2 diabetes, but high blood pressure and heart disease among other things.
“I think people up here who do the budgeting needs to understand that it’s a $2.4 billion problem to West Virginia, and to really focus on school-based programs,” he said.
Prevention dollars are being redirected to opioid abuse prevention, but chronic diseases such as obesity, cancer and diabetes kill far more people and are far more expensive.
For Crespo, not all prevention dollars are the same. The work that they’re doing with the chronic disease management program is directly interrupting the cycle of expensive patients misusing the health care system. He said while “primary” prevention programs such as trying to prevent obesity and diabetes from happening in the first place, are important, it takes a longer time to see financial savings.
“The interesting thing about this project is that the savings are almost immediate when we are working with high risk patients, whereas in typical public health work, vaccinations and healthy eating, the benefit is there. But the benefits are going to happen 20-30 years down the road,” he said. “With this, the benefit happens at 5:00 today as far as the insurance companies are concerned.”
It costs about $250 to participate in the program. Before being referred, some patients might be hospitalized two-four times a year or more. The American Diabetes Association estimates that diabetes costs the state $1.9 billion in 2012, with another $627 million lost due to productivity. 15 percent of West Virginians have diabetes, ranking the state number one in the country.
But Crespo said what truly makes the program successful is the human relationships that community health workers build with their patients. Haynard is a nurse. She knows what diabetes does and how to care for it. But without Browning’s encouragement she wasn’t doing what she was supposed to. It’s the accountability, she said, that helps her stay on track.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Marshall Health, Charleston Area Medical Center and WVU Medicine.
Several West Virginia health organizations, including West Virginia Prevention First and the state’s Department of Health and Human Resources have joined together to launch the Health & Hope WV Initiative. Prevention First is a conglomeration of organizations that collect and disseminate information and facilitate communication, according to a press release.
Organizers say they hope the new site and media content will both serve as a comprehensive resource and help combat some of the stigma addiction still faces.
“One of the things we know in our state is that access to affordable health care carries a very large stigma with it, said Elizabeth Shahaan – one of the representatives from the six regions of the Prevention First Network. “And when it carries that it prevents people from accessing the care they desperately need.”
At a Monday media event in Charleston, other representatives shared about their work and hope for the project.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Marshall Health, Charleston Area Medical Center and WVU Medicine.
Free radon testing kits are now available to all 100 North Carolina counties, according to a press release earlier this week.
The kits are available through the NC Radon Program, which is administered by the Department of Health and Human Services. Officials are distributing the kits through county health departments, although the press release noted supplies are limited.
“Radon is the leading cause of lung cancer in the U.S. among non-smokers and, for no cost, citizens can test their homes and protect themselves and their loved ones,” says Mark Payne, Assistant Secretary of Audit and Health Service Regulation in a written statement.
According to the Environmental Protection Agency, radon is a naturally occurring, radioactive gas that is invisible, odorless and tasteless. Radon is released from the ground into outdoor air, but it can accumulate and reach harmful levels when trapped in homes and other buildings. The U.S. Environmental Protection Agency estimates that radon is responsible for more than 21,000 lung cancer deaths per year in the United States.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.
On the one end is stage I, on the other stage IV. Several subgroups are in between. For stage I patients, the five-year survival rate is 92 percent. For stage IV, that number drops to 11.
“If you’re screened early enough you can prevent yourself altogether from having cancer,” said Kevin Tephabock, senior manager of primary care systems for the American Cancer Society. His job is to work with health care facilities in West Virginia, Virginia, Delaware, Maryland, and Washington D.C. to improve cancer screening rates. Currently only about 63 percent of West Virginians are getting screened.
“For years, colonoscopy was the gold standard…and colonoscopy helps significantly. It decreases colorectal cancer mortality about 30 percent,” he said. “However, many people were not comfortable with the idea of having a colonoscopy. So now there is actually some new testing out there that’s available.”
Called Fecal Occult Blood Tests, they basically test for blood in feces. They are available at primary care facilities and can be taken home by the patient, used, then returned to the doctor or lab. If a polyp or cancer is suspected, further testing is needed.
Screenings are covered by insurance. A new nationwide initiative called 80 by 18 is attempting to increase screening rates to 80 percent by 2018. (Governor Tomblin was the first U.S. governor to sign the pledge.) State officials hope to achieve this goal, in part, by working with primary care facilities.
“In West Virginia one of our bigger barriers is just geographically,” said Tephabock. “We have somewhat of a shortage in terms of GI docs…and so someone in southern WV may have a very difficult time finding a GI doc.”
The screenings find precancerous polyps that can then be surgically removed. That’s it. You continue getting your screenings every year, but other than that, no major life changes.
Credit Kara Lofton / WVPB
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WVPB
Chris Stadelman receives treatment for stage IV colorectal cancer at Charleston Area Medical Center Cancer Center
“As I’ve told several people it’s a day and a half of really unpleasant experience, but it’s a whole lot better than carrying a chemo pack around every two weeks for the rest of your life,” said Chris Stadelman, Governor Tomblin’s Director of Communications.
Stadelman was diagnosed with stage IV colorectal cancer last year at the age of 44 – too young to have needed a screening by federal guidelines.
“I have now been through 28 rounds of chemotherapy,” he said. “Going every two weeks for about 4 hours in the David Lee Cancer Center and then have a 46-hour infusion that’s done through a shoulder badge, a little pack, that I take with me.”
He has been in treatment since October of last year. All the test results so far have been as positive as can be expected. He will likely be in treatment for the rest of his life.
“I had a sense something was wrong and I waited and I waited,” he said. “So paying attention to something that may seem like nothing – well I’m too young for that to happen – clearly a lot of us are not too young for that to happen so I think it makes sense to go ahead and get those screenings if you sense anything might possibly be wrong.”
Credit Crystal Collins / WV Public Broadcasting
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WV Public Broadcasting
Stadelman hid his diagnosis for months. He said he’s not entirely sure why. Then added, “I don’t want people to treat me any differently. I want to go about my job the same way…But the more I thought about it I have, because of my job with the governor’s office, because of my experience in media, I have opportunities and connections to help someone else.”
“I think that one to one connection makes such a difference. You can read the studies and hear about what you’re supposed to do, but knowing someone this has happened to makes a big difference for anyone. I have some credibility when it comes to telling people to go get your colonoscopy and get checked and pay attention to things.”
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.
