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Bill won’t control health care costs in California, but it will devastate hospitals

Last week, a bill that would dismantle California’s health care delivery system as we know it was introduced in the Legislature. Assembly Bill 3087 would penalize millions of patients through massive cuts in services and result in as many as 175,000 hospital workers losing their jobs.

The sponsors of AB 3087 – which is to be heard Tuesday by the Assembly Health Committee – falsely believe that this bill would lower health care costs by imposing a mandatory rate-setting system on doctors, hospitals, dentists and insurers.

They claim their proposal is based on a similar system that operates in Maryland. As the former head of the Maryland Hospital Association, I know that nothing could be further from the truth.

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AB 3087, introduced by Assemblyman Ash Kalra, D-San Jose, is entirely different from Maryland’s rate-setting process. The bill simply caps payment rates for services covered by commercial health insurance and does not address the chronic payment shortfalls that plague Medicare and Medi-Cal.

Carmela Coyle

Maryland has had “all payer” system in which the state sets payment rates for hospital services for all payers – Medicare, Medicaid, private insurers and the uninsured. No matter who is paying the bill, a hospital receives the same amount for the same service in the same hospital. That’s a huge contrast with the California proposal.

In our state, Medi-Cal pays hospitals only 68 cents for every dollar of care provided to patients, and Medicare roughly 77 cents for every dollar. AB 3087 does nothing to increase the rates paid by these programs, resulting in huge losses for California hospitals.

Another difference: In Maryland, the state is required o pay rates that at least cover the cost of care delivered by efficient providers. AB 3087, by contrast, ties payment rates to a percentage of what Medicare pays. Medicare rates, set by Congress, are often based on political priorities in Washington, D.C., not California.

The Maryland system also was designed to control the annual rate of increase in the cost of inpatient hospital services. The California proposal is not about controlling the rate of increase at all. Instead, it would actually cut and “re-base” amounts paid to providers and plans to some unspecified percentage of Medicare payments.

In Maryland, payment rates were based originally on the different costs of different types of hospitals – urban, rural, academic research facilities and community facilities. AB 3087 creates a one-size-fits-all payment rate, regardless of whether the hospital is in Chico or Los Angeles. That makes no sense.

Finally, Maryland’s rate-setting commission is selected based on experience in health policy, not political constituencies. But it, like the one proposed in California, allows a handful of people to exert enormous control over the economics of health care.

Based on nearly 10 years of experience in Maryland, I can say that one of the most impractical parts of AB 3087 is its so-called appeals process. This clumsy approach would set all payment rates the same and then force doctors, dentists and hospitals to appeal for more equitable payments. In reality, the appeals process is an empty promise because the bill’s stated goal is to cut payments to hospitals, doctors and other caregivers without regard to the actual cost of care.

AB 3087 will cripple patient access to care and do nothing to reduce health care costs.


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Carmela Coyle is president CEO of the California Hospital Association. She can be contacted at

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Why this family blames mental health system for teen’s suicide

Jordie’s older brother, Tony Binion, says they were best friends growing up.

“I was the older brother, but sometimes I felt like the younger brother because he was the one that was like, “Let’s go do this, let’s jump off this, let’s dive into this,’ ” said Tony Binion. “He was a fun kid.”

But around the age of 15, Jordie changed.

“Sometimes he started to withdraw from family and friends — he isolated himself a lot,” said his mother. “He just wasn’t functioning like his usual self. His grades were slipping a little bit.”

Tuesday on “NBC Nightly News,” see how the Binions are changing the lives of tens of thousands of high school students though a creative new mental health curriculum.

His mother thought he was depressed.

Jordie went to a family physician, who prescribed him an antidepressant. But after a few months, his parents say, he seemed to be having other issues.

“We would catch him at times talking to himself, and then he would laugh out loud, sometimes inappropriately,” said Will Binion.

His worried parents took him to Seattle Children’s Hospital, which has a psychiatric unit for children and adolescents.

The next day, Jordie wanted to leave. Washington State law permits people 13 or older to decide whether they will stay in a psychiatric facility. The Binions said someone from the hospital called them and told them to either come get Jordie or the hospital would “release him to walk the streets of Seattle.” The Binions picked their son up.

What they didn’t know was that the law allowed them to force Jordie to stay — an option that they say the hospital never gave them.

NBC News called all 50 states and learned that nearly 40 percent give minors — some as young as 12 — the power to consent to treatment. Designed in the 1970s to protect young people, the laws can have the opposite effect. Deb Binion says they were handed Jordie’s clothes “and basically that was it.”

The hospital, while saying it could not comment on Jordie’s case due to privacy laws, called his death a “terrible tragedy.” The hospital said it was committed to improving mental health care for children and adolescents and had taken several steps to improve care at its facility and in the region. “There is a tremendous need for improved access to mental health care and resources for children and youth all across the country, and we share the community’s concern about the increasing issue of suicide in youth.”

At home, Jordie was still struggling. The very night they got back from the hospital, his parents say, he was lying on the floor of his bedroom crying and holding his head saying he had “hurt so many people.”

Jordie saw a doctor when he got home, but his parents say it took them five months to schedule a full psychiatric evaluation. One reason is a shortage of child and adolescent psychiatrists in the country — only 8,300 to help an estimated 17 million kids who need it.

The day before that long-awaited appointment, Jordan Binion took his own life.

His parents believe that the mental health system let Jordie, and them, down, and resolved to change that. They went to the Washington State Legislature and successfully petitioned for a change to the law, which now requires that parents be informed that they can petition to keep a child in an evaluation and treatment center for 72 hours over the child’s objection.

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4 New Exemptions To The Tax Penalty For Lacking Health Insurance

The new exemptions will mostly apply to penalty payments tied to 2018 taxes and to the previous two years.

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The new exemptions will mostly apply to penalty payments tied to 2018 taxes and to the previous two years.

PeopleImages/Getty Images

There already have been more than a dozen reasons U.S. consumers can use to avoid paying the penalty for not having health insurance. Now the federal government has added four more.

These “hardship exemptions” let people off the hook if they can’t find a marketplace plan that meets not only their coverage needs but also reflects their view if they are opposed to abortion.

Your 2018 Health Plan Must Comply With ACA Rules Or You Risk Tax Penalties

It’s unclear how significant the impact will be, policy analysts say. That’s because starting in tax year 2019 the penalty for not having health insurance will be eliminated, so the new exemptions will mostly apply to penalty payments for 2018 taxes and in the previous two years.

“I think the exemptions … may very marginally increase the number of healthy people who don’t buy health insurance on the individual market,” says Timothy Jost, emeritus professor of law at Washington and Lee University in Virginia, whose specialty is health law.

Under the new rules, people can apply for a hardship exemption that excuses them from having to have health insurance if they:

  • Live in an area where there are no marketplace plans.
  • Live in an area where there is just one insurer selling marketplace plans.
  • Can’t find an affordable marketplace plan that doesn’t cover abortion.
  • Experience “personal circumstances” that make it difficult for them to buy a marketplace plan, including not being able to find a plan in their area that gives them access to specialty care they need.

The first new exemption isn’t relevant for consumers in 2018. Since the Affordable Care Act’s marketplaces opened, there have been no “bare” counties that lack insurers.

However, in about half of the U.S. counties — in which 26 percent of enrollees live — there is only one marketplace insurer this year, according to the Kaiser Family Foundation.

As for the abortion exemption, in many places it won’t be an issue either. Women in 31 states didn’t have access to a marketplace plan that covered abortion in 2016, according to another Kaiser Family Foundation analysis.

Still, a few states — California, New York and Oregon — generally require abortion coverage in their marketplace plans, and women who live there might have trouble finding a plan that excludes that coverage, according to people who have studied the situation.

From its inception, the ACA has allowed several different types of exemptions from the penalty for not having coverage. Among them are exemptions for not being able to find coverage that is considered affordable or being without insurance for less than three consecutive months in a year.

People claim these more common exemptions when they file their tax returns.

In addition, hardship exemptions that were already on the books protected people who faced eviction, had filed for bankruptcy or had racked up medical debt, among other difficulties. Consumers apply for these exemptions by submitting an application to the ACA insurance marketplace.

A Health Plan 'Down Payment' Is One Way States Try Retooling Individual Mandate

The new hardship exemptions apply to people in all 50 states, according to an official at the federal Centers for Medicare Medicaid Services, which oversees the health law’s insurance marketplaces. To apply, people generally need to provide a brief explanation of the circumstances that made it a hardship for them to buy a marketplace plan, along with any available documentation, when they submit their application to marketplace officials. They can apply for the current calendar year or going back two years, to 2016.

It’s difficult to gauge how many people will try to take advantage of the changes, says Tara Straw, a senior policy analyst at the Center on Budget and Policy Priorities.

“People aren’t sure how to apply, or if they’re eligible, and that discourages them from applying,” Straw says.

The penalty for not having health insurance in 2018 is the greater of $695 or 2.5 percent of household income.

During the 2017 filing season, there were more than 106 million tax returns reporting that all family members had health insurance, and nearly 11 million tax returns that claimed an exemption from the requirement to have it, according to a report from the Treasury Department’s inspector general for tax administration.

In addition, more than 4 million returns reported paying penalties totaling nearly $3 billion for not having health insurance.

People often don’t realize they may owe a penalty until it’s time to do their taxes, says Alison Flores, a principal tax research analyst at HR Block’s Tax Institute. HR tax preparers first check to see if clients can qualify for an exemption that can be claimed on their tax returns, Flores says. If that doesn’t work, they move on to the hardship exemptions.

The preparers help people get the hardship exemption application, but it’s up to consumers to send it to the marketplace and get the exemption certificate.

The federal guidance about the new exemptions was released April 9, shortly before the end of the income tax filing season. People who’ve already filed their taxes and qualify for the new exemptions for tax years 2016 or 2017 and get marketplace approval can file an amended tax return to receive a refund of any penalty they paid, says Katie Keith, a health policy consultant who writes regularly about health reform.

“You have to really be motivated,” Keith says.

Kaiser Health News is an editorially independent news service that is part of the nonpartisan Henry J. Kaiser Family Foundation. Michelle Andrews is on Twitter @mandrews110.

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Health Insurers: Trump’s Short-Term Plans Will Trigger Loss Of Coverage

U.S. President Donald Trump (L) acknowledges the audience as Administrator of the Centers for Medicare and Medicaid Services Seema Verma (R) looks on as he stops by a Conversations with the Women of America panel at the South Court Auditorium of Eisenhower Executive Office Building January 18, 2018 in Washington, DC.  (Photo by Alex Wong/Getty Images)

The Trump administration’s proposed cheaper short-term plans may not provide adequate coverage and would trigger an increase in the number of uninsured and under-insured Americans, say health insurers that would be expected to sell such coverage.

Through their lobby, America’s Health Insurance Plans, companies Monday were the latest to weigh in on the Trump administration’s proposed rule on short-term plans. Comments are due by a 5 p.m. deadline Monday.

The Trump administration has said Americans need more choices than Obamacare, saying the cost of individual coverage offered on public exchanges under the Affordable Care Act is too expensive for an increasing number of people. “This action is being taken to lengthen the maximum period of short-term, limited duration insurance, which will provide more affordable consumer choice for health coverage,” the Trump administration wrote when it proposed the rule earlier this year.

But health insurance companies Monday morning issued their critique of the Trump administration’s proposal, joining a parade of doctor groups concerned about any effort to reduce coverage or pare benefits

“We are concerned that this proposed rule will lead to more people being uninsured and under-insured, and to higher costs in the long run,” AHIP chief executive Matt Eyles said. “Short-term plans can provide an important temporary bridge for Americans who are transitioning between plans. But they are not a replacement for comprehensive coverage.”

AHIP’s comments are significant considering it represents companies that are currently selling individual coverage now like Anthem, Cigna, Centene, Oscar Health and various Blue Cross and Blue Shield plans.

Eyles, who is replacing the retiring Marilyn Tavenner at AHIP, is concerned the effort to push lower cost premium plans into the market could cause problems if consumers don’t know what they are buying.

Short-term plans “may not be available to individuals with pre-existing health conditions or may not cover any treatment for pre-existing conditions,” AHIP’s Eyles said. (Such short-term plans also) may not cover preventive care, prescription drugs, mental health care or treatments for chronic health conditions.”

The health insurance industry also worries those offering short-term plans will be able to impose lifetime or even daily limits on coverage. “We urge the administration to limit the duration of short-term plans to six months, ensure clear disclosures to consumers about what short term plans do and do not cover, and inform consumers of the potential availability of discounted coverage through the marketplace,” Eyles said.

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PODCAST: Alex Depledge "Let’s talk about mental health"

Alex Depledge, co-founder of Hassle.Com

Winning at Work is the new podcast from Forbes that helps you be more productive, happier, and get ahead at the office.

Whether you’re working at a startup or a big corporate, you can learn from the smartest people in European business. In every episode you’ll hear about the highs and lows of life in the fast lane and discover the secrets behind becoming a productivity guru. 

Listen to “Winning At Work” every Monday exclusively on Apple Podcasts, and the new PodcastOne app:

We all know it’s important to talk about how we’re feeling, yet it’s a subject many of us avoid.

In our first episode, we sit down with serial entrepreneur Alex Depledge to chat about something we all need to be more open aboutour mental health. You’ll hear the raw truths behind what it’s really like to start your own business and much more.

If you love the show, share it with a friend and leave us a rating and review.

This podcast was sponsored Barclays High Growth Entrepreneurs. For innovative banking, visit Barclays Entrepreneurs.

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Henry Schein to spin off, merge its animal health business with start-up

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Henry Schein and Vets First to merge animal health biz

Health-care products distributor Henry Schein is spinning off its animal health business and merging it with Vets First Choice to form a new company called Vets First Corp.

The deal, announced Monday, will combine Henry Schein’s veterinary supplies, software for practices and distribution network with Vets First Choice’s prescription management platform.

Henry Schein anticipates receiving from the transaction about $1 billion to $1.25 billion in cash on a tax-free basis. Its shareholders will own about 63 percent of the new company, and Vets First Choice shareholders will own about 37 percent of it.

Americans are investing more in their pets, spurring interest from companies searching for growth. In February, General Mills said it would buy pet food maker Blue Buffalo for $8 billion. MM-owner Mars has bulked up its pet business, which includes Iams, Pedigree and Whiskas brands. Last year, it acquired animal hospital company VCA for $9.1 billion.

Meanwhile, the threat of Amazon’s entry into health care looms. The company already sells some supplies to doctors and dentists through its Amazon Business division. Henry Schein says spinning off and merging the animal health business will allow it to focus more on the dental and medical supply businesses.

“Some people felt this (deal) is perhaps to fend off online retailers, but it has absolutely nothing to do with that. This is about bringing two great companies together where (veterinary) practitioners will be more successful,” Henry Schein CEO Stanley Bergman said in an interview with CNBC.

Stanley Bergman, CEO, Henry Schein

Henry Schein’s stock has slid nearly 18 percent over the past year. The stock opened more than 4 percent higher Monday.

Its animal health business posted $3.48 billion in revenue last year. Within three years, the deal is expected to accelerate revenue growth as the merged company adopts the Vets First Choice platform across the Henry Schein customer base, potentially adding more than $100 million in operating income.

The merger gives 8-year-old Vets First Choice the chance to become public without going through an initial public offering. The Portland, Maine-based company raised $223 million from a group of investment firms last year.

At the time, founder and CEO Ben Shaw said the money would help Vets First Choice expand globally. The combination with Henry Schein gives it an immediate opportunity for that.

“These are very sensitive, high-touch services — prescription management, inventory management, workflow of the business — that’s crucial to day-to-day work,” Shaw said. “To extend that globally is unique.”

Shaw will become CEO of Vets First Corp. Henry Schein will nominate six board members and Vets First Choice will nominate five. Bergman will serve on the board while continuing to serve as Henry Schein’s CEO.

“By combining forces with (Henry Schein Animal Health), we anticipate accelerating the introduction of new and enhanced programs, services, and technology to veterinary teams so they can deepen their focus on doing the great work of caring for the animals in our lives,” Shaw said in a statement.

The deal is expected to close by the end of the year.

Angelica LaVito


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UPDATE: Indiana health officials encourage hepatitis vaccine as Ky. numbers climb – WSAZ

FRANKFORT, Ky. (WSAZ) — UPDATE 4/21/18 @ 9:45 p.m.
As the number of reports of hepatitis A continue to climb in Kentucky, a neighboring state is urging residents to get vaccinated if they plan to visit the Bluegrass State.

The Indiana Department of Health issues a statement urging their residents to get the vaccine if they have any immediate plans to visit Kentucky or Michigan, another state seeing a hepatitis A outbreak.

Now with Indiana health officials making their recommendation and the Kentucky Derby just two weeks away, officials with the Kentucky Department for Public Health is easing minds and maintaining that it is safe to travel to Kentucky.

“Some misleading information has raised concerns about travel to Kentucky and even the Derby,” said Acting Commissioner of the Department for Public Health, Dr. Jeffrey Howard. “Let me say that it is safe to travel to Kentucky and it is safe to attend the Kentucky Derby.”

In a video published by the department, Howard says the state has been working closely with the CDC during the outbreak and there is currently no restrictions or recommendations for out of towners and Kentucky.

“The CDC, the country’s foremost expert body in outbreak response, has not levied any travel restrictions nor made any recommendations for people to get vaccinated prior to traveling to a state with an active hepatitis outbreak.”

With no signs of the numbers leveling off and dropping, state officials say they will continue working to get vaccinations in to areas seeing the most cases, which includes Boyd, Greenup, and Carter Counties.

“We will continue to work diligently with federal, regional and local partners to ensure the greatest protection of Kentuckians and visitors to our great Commonwealth.”

UPDATE 4/20/18 @ 10 p.m.
Three people are confirmed dead from Hepatitis A in Kentucky according to health officials.

Here’s a county breakout of Hepatitis A cases in our region: Greenup has 16, Carter has 6, and Boyd has 31.

Those three counties are among six in Kentucky where the State Department for Public Health is recommending vaccines for all residents.

In West Virginia, there are now 31 confirmed cases of Hepatitis A in Kanawha and Putnam counties according to health officials there.

The rise in cases has many scrambling to get the vaccine.

Multiple pharmacies in eastern Kentucky Friday were out of the vaccine because of the high demand.

Friday CVS announced they have the vaccine at all 79 of their stores in Kentucky, including 9 in the target locations. It’s also available at CVS stores across the Kentucky border in places like Kenova and Ironton.

Stultz Pharmacy in Flatwoods ran out of the vaccine earlier this week. They got a shipment of 300 shots in Friday morning and say by the afternoon, they’d already gone through half.

Griffith Feil in Kenova told WSAZ Friday afternoon they had a little more than 20 Heptatis A vaccine shots available. They said they’ve seen a lot of Marathon workers from Catlettsburg coming in to get the vaccine.

Three deaths are now blamed on the hepatitis A outbreak in Kentucky, according to a news release from the state Department for Public Health.

Those statistics, through April 14, also show 352 cases and 246 hospitalizations. The statistics do not show a county breakdown for where the deaths occurred.

Here is a county breakout of actual hepatitis A cases in our region:

Greenup: 16
Carter: 6
Boyd: 31

Boyd, Carter and Greenup are among six Kentucky counties where the state Department for Public Health is recommending vaccines for all residents.

Hepatitis A is primarily spread from stool to oral contact and is often connected with improper hand washing and IV drug use. It has affected some residents in eastern Kentucky, including in the Ashland area of Boyd County where some restaurants have been impacted.

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State of mental health care in Peoria continues to evolve

From a Bartonville insane asylum to the Zeller Mental Health Center to the Brighter Days Ahead drop-in clinic, treatment protocols have changed along with the understanding of mental illness. This is the first of two parts in our series.

PEORIA — It’s one of the first details to emerge, often before the initial pandemonium of an officer-involved shooting settles: the final actions a person took before being shot by police appeared to be influenced by mental illness.

In the first public statements Friday about a fatal encounter in Tazewell County, police described the nature of the call as one for an 18-year-old suicidal male with a history of “mental disturbance.”

Last fall, when members of the Peoria police Special Response Team shot and killed Eddie Russell, Jr., 25, outside his mother’s home, it quickly became apparent that his history of mental illness contributed to the situation. Officers almost immediately recognized and knew to search for the suspected bank robber at that location because of frequent interactions related to his mental health status.

The Russell family disputes specific details of the official version of events leading to his death, and not enough time has elapsed for an official version of the deadly situation Friday to develop.

But the presence of mental illness in those scenarios begs the question: Could something more have been done to prevent those deaths?

An adequate answer may prove impossible, but an accounting of help available to Tri-County residents is not.

The state of mental health care in the Peoria area has followed a similar trajectory to other regions of the nation and state, influenced by court decisions and policies set at all levels of government.

Treatment protocols also have changed along with the understanding of mental maladies, with an emphasis today on the adoption of evidence-based practices and a goal of helping those with mental illness advance in society.

“As the field has evolved, with medication and different kinds of treatment strategies, there’s a growing belief, and one we support strongly, that people can be maintained out in the community most of the time,” said Mike Kennedy, president and CEO of the Human Service Center, the largest provider in the region.

The treatments themselves are as different from earlier approaches to psychiatric disease as the settings in which they are delivered: from the old state hospital in Bartonville to a drop-in day center in the North Valley.

Some forces have always had a disproportionate influence on the services available to many who need them.

The recent Illinois budget stalemate, for instance, left service providers such as the Human Service Center to survive without vast sums promised as payment from the state. Cuts to programs such as Medicaid imperil services for other recipients.

But the modern approach also has a certain flexibility built into it, with an objective to help those with mental illness be more self-sustaining and multiple avenues to achieve it.

“There are all kinds of ways that people get better. There’s no one way for people to recover,” Kennedy said. “That’s probably the biggest thing we’ve learned. You don’t have to do it one certain way.”

The evolution of mental health care — from the dark days of state hospitals and warehoused institutionalization to the modern-day community-based system — was not always driven by altruism and what was thought to be best for individuals most affected in the system.

Illinois adopted a “zone centers” concept in the 1980s that was intended to provide intensive treatment for a shortened period of time in facilities such as the Zeller Mental Health Center in Peoria.

But a federal court intervened a few years before the state moved on from the zone center concept.

In 1999, three years before Zeller closed, the U.S. Supreme Court ruled against the practice of institutionalization in Olmstead vs. L.C., a case dealing with aspects of the Americans with Disabilities Act.

The court decided that “institutional placement of persons who can handle and benefit from community settings perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life,” according to the U.S. Department of Justice Civil Rights Division.

Justices additionally found “confinement in an institution severely diminishes the everyday life activities of individuals, including family relations, social contacts, work options, economic independence, educational advancement and cultural enrichment.”

The ruling amounted to the declaration of a new era in mental health care — one to which the state of Illinois did not respond quickly or well.

“In some areas, the state did a poor job of implementing Olmstead,” said Christine Kahl, the executive director of Peoria’s South Side Office of Concern, a charitable organization that finds permanent housing for people with mental illness. “It didn’t plan well enough how to put all these people into community-based living and many of them became reinstitutionalized in nursing homes.”

The “new” institutions with the archaic-sounding name of Institutes for the Mentally Diseased (IMDs) were just a new designation for nursing homes.

“We moved from institutions to zone centers to nursing homes in Illinois,” Kennedy said. “All we were doing was creating a different kind of warehousing or institutionalization of people.”

And courts became involved again. A class action lawsuit in Illinois settled in 2010, now known as the Williams Consent Decree, mandated that the state help find homes in the community for institutionalized individuals with mental illness who want to live in the community.

According to the opinion handed down by the court, the decree “respect(s) the individual’s choices and focus(es) on the individual’s strengths as well as their needs. The State proposes not only to expand the current system of care, but to create a number of recovery-oriented system enhancements in both services and housing, designed to assure that each person choosing to move from an IMD has the best opportunity for a successful transition to community living.”

Regional mental health service organizations were required to find ways to comply with the new directives, known as Assertive Community Training, or ACT, and help individuals in nursing homes find housing in the community. Services and medical care also had to be maintained.

Emergency housing, such as shelters, and non-emergency permanent housing were mandated. Employment training and schooling also became parts of mental health treatment and recovery.

The ACT intensive outpatient service ultimately represented a shift from the idea of just providing sustaining care — keeping people stable and out of the hospital — to providing avenues for individuals to support themselves and improve.

“We assist in forming a self-sustaining life where those with mental illness can maintain employment or schooling and have enough money to live and go out to do something fun on Friday night, just like everybody else,” said Cindy Gilmer, the vice president of clinical services at the Human Service Center.

The Center’s ACT team serves 175 people annually with an average caseload of 10 or less per ACT specialist, according to the center. The team is comprised of a master’s-level licensed manager, a master’s-level team leader, 20 recovery specialists, two nurses, psychiatrists and support staff.

“It’s a smaller staff-to-client mix, so there’s more intensive case management,” Gilmer said.

The Human Service Center also operates a peer-run, drop-in center, Brighter Days Ahead, for individuals with mental health or substance abuse recovery issues, or both. The center is located in an old house in the North Valley.

Kahl’s South Side Office of Concern is primarily focused on finding permanent housing for individuals who are able to live independently in the community. The group operates the New Hope Apartments, home to 84 residents, Glendale Commons and other community-based residences.

“We work in partnership with (the Human Service Center),” Kahl said. “We provide housing, and they provide some of the services.”

Unique to the local service offerings, the Human Service Center places a premium on lived experiences for its employees. The center seeks people who have suffered from mental illnesses and recovered to help those still in need.

“We look at years of lived experience as equivalent to education in some instances,” Kennedy said.

The practice makes clients more comfortable with the people facilitating their care, and the job can be more than just a paycheck for those who are able to help others through difficult periods of their lives.

“We know people can get well,” Gilmer said. “We know a majority of people with major mental illness actually want to work.”

Scott Hilyard can be reached at 686-3244 or Follow him on Twitter @scotthilyard. Matt Buedel can be reached at 686-3154 or Follow him on Twitter @JournoBuedel. 

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POLITICO Health reporter Brett Norman dies at 43

Brett Norman and his family are pictured. | Contributed Photo

Brett Norman is pictured with his sons Owen (left) and Everett and his wife journalist, Kate Dailey. “Brett was a kind and generous colleague, but more importantly he always put his family first,” one POLITICO colleague recalled. | Courtesy of Kate Dailey

Mourned by colleagues, Norman helped build the health team at POLITICO.

Brett Norman, a POLITICO health care reporter, died Saturday. He was 43 and had pancreatic cancer.

He is survived by his wife, journalist Kate Dailey; sons Everett, 4, and Owen, 2; his mother, Jean Norman; and his brother, Daniel Norman.

Story Continued Below

Norman reported on the Affordable Care Act, bioethics and the pharmaceutical industry. He joined POLITICO in July 2011.

“He covered all the craziness surrounding the launch of Obamacare – and he broke the story that the very same HHS official who made a mess out of later went on to make a mess out of Brett had fun with that one,” POLITICO Editor Carrie Budoff Brown, POLITICO Pro’s Editorial Director Marty Kady, and Executive Editor for Health Care Joanne Kenen emailed the staff.

Norman also wrote about bioethical issues such as organ transplantation, and complicated policy issues surrounding the pharmaceutical industry.

At the time of his diagnosis in late 2016, he was working on a project about overprescribing drugs to foster kids as a Rosalynn Carter Mental Health Journalism Fellow. It was a project he did not get to finish but it mattered to him deeply.

Norman was a talented reporter, a caring colleague, and a valued member of the POLITICO Health Care Team family. He was thoughtful, smart, and had a delightfully wry wit.

“Brett was a kind and generous colleague, but more importantly he always put his family first. It was obvious how much he loved Kate and his boys,” said his fellow POLITICO health reporter Sarah Karlin-Smith, with whom he shared the pharmaceutical beat and the weekly Prescription PULSE newsletter. “I’d like to think there will always be a bit of his spirit in every one of my bylines.”

Before POLITICO, Brett was a science writer at Rockefeller University. He got his start in journalism covering cops, courts and local government at the Pensacola News Journal. At the paper, he was twice part of teams named as finalists for the Pulitzer Prize for public service.

Norman, who lived in Washington, was a graduate of the University of Chicago and the Columbia University Graduate School of Journalism. He was born in Iowa, but considered Pensacola, Florida, his home town. On his Twitter profile, he called himself a “Floribamian.”

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Avicii, struggling with health and fame, tried to walk away from it all two years before he died

It was a decision that shook the electronic dance world, and one Tim Bergling, then 27, did not take lightly.

Before Bergling, the Swedish DJ and producer known as Avicii, announced his retirement from touring just five years after his 2011 song “Levels” launched his meteoric rise, he had to break the news to the people closest to him. He had to explain to friends, handlers and business associates why, to attain happiness, he had to change his definition of success.

Then he had to explain to his fans.

“Two weeks ago, I took the time to drive across the U.S. with my friends and team, to just look and see and think about things in a new way,” the musician wrote in an emotional letter on his website in 2016. “It really helped me realize that I needed to make the change that I’d been struggling with for a while.”

He was grateful for the opportunities and comforts of his lucrative career, he wrote. But the lifestyle was exhausting, leaving too little for the “life of a real person behind the artist.” Avicii had canceled tour dates in 2014 after having his gall bladder and appendix removed, and had been hospitalized twice in the preceding two years for acute pancreatitis, according to Billboard.

He did leave the door open for a possible return to the electronic dance music scene.

“I will however never let go of music,” he concluded. “One part of me can never say never, I could be back … but I won’t be right back.”

Perhaps more than ever, those words resonated with his fans Friday. They were devastated by the news that Avicii, 28, was found dead in Muscat, Oman. The cause of his death has not yet been released.

His fans’ unyielding devotion had made Avicii reluctant to retire from touring. “Wake Me Up,” “Hey, Brother” and “Levels” are among the biggest songs of the decade, having been streamed on Spotify more than a billion times. In 2012 and 2013, Avicii was nominated for two Grammy Awards for best dance recording.

“I was nervous when I made the announcement, mainly that I would look ungrateful,” Avicii told the Hollywood Reporter shortly after announced his retirement. “But I’ve gotten so many supportive texts from friends in the industry, other DJs, other artists. The fan response has been incredible. And even the press response has been incredible. So yeah, it’s been a lot better than I expected.”

Fans on Friday wrote heartfelt tributes on their social-media accounts and shared vibrant videos of the times they saw him perform live. Some said that even after Avicii announced his retirement, they’d hoped they would see him on stage again.

Geffen Records president Neil Jacobson, who first worked with Avicii on “Levels,” described to Variety the DJ’s ability to entrance his audience.

You want to go lose your mind? Go to a middle of pit of a festival crowd for an Avicii concert. He understood the ebb and flow of a show, of a set, of how to get people to dance; how to know when to let them down. How to know when to bring them back up, and bring them back down again. Then you’d end up crying three-quarters of the way through the show and you didn’t know why. That’s what he did. That was his talent.

On Saturday, Avicii’s former manager Ash Pournori said on Instagram that the DJ and producer was “raw talent. You were one in a billion.”

But Avicii’s decision to leave the limelight conveyed the pressures he felt as the face of electronic dance music, an industry he helped bring to prominence. A documentary about the DJ released six months ago, “Avicii: True Stories,” provides an unvarnished look at Avicii’s rise to fame, according to a Variety review. The film reveals how managers and agents can risk a star’s health and friendship to maximize the star’s publicity and profitability, and includes moments when Avicii — who around this time was the world’s sixth-highest-paid DJ, making about $19 million a year — is dreading his next plane ride or headline set.

“Young people can learn from this movie,” Levan Tsikurishvili, the director and a longtime friend of Avicii’s, told Variety in September. “That life can look exciting and glamorous on Instagram and social media, but you don’t really have any idea what’s going on behind that.”

Health scares made things harder. Before his gallbladder and appendix surgeries in 2014, he learned at age 21 that he had acute pancreatitis, which he said was in part caused by excessive drinking, Billboard reported.

“To me it was something I had to do for my health,” he said about the decision to quit touring, according to Billboard. “The scene was not for me. It was not the shows and not the music. It was always the other stuff surrounding it that never came naturally to me. All the other parts of being an artist. I’m more of an introverted person in general. It was always very hard for me. I took on board too much negative energy, I think.”

But that didn’t mean he wanted to forgo success, Tsikurishvili told Variety. Avicii worked so hard during his years touring that a documentary scene shows him working from his hospital bed.

“But I think he didn’t really know from the beginning [at age 19] what it means to be that successful,” Tsikurishvili said. “No one knew that he could be that successful. It has been a weight for him. He’s had to find himself.”

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