Fire Pit Fridays
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Maryland’s Cardin, other Democrats, push to include dental coverage under Medicare
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Led by Maryland Sen. Ben Cardin, Senate Democrats are renewing a push to include dental care benefits under Medicare.
“Oral health is integral to overall health and well-being,” Cardin said Wednesday at the year’s first hearing of the Senate Finance Committee’s health care subcommittee, which he chairs. “It can make worse an underlying health condition, impacting overall healthcare costs. It can impact a person’s ability to get a job and be well enough to work. It impacts a person’s ability to go to school, impacting the local and national economy.”
“It seems to me the solution is clear,” said Sen. Elizabeth Warren, D-Massachusetts. “It’s time to expand Medicare to cover dental care.”
Medicare currently does not cover dental costs in most cases. As of 2019, nearly half of Medicare beneficiaries, or 24 million people, did not have dental coverage, according to a study by the Kaiser Family Foundation (KFF). The average out-of-pocket spending for those with Medicare coverage was $874 in 2018.
Medicaid beneficiaries have optional and limited services for dental care.
Earlier this month, Cardin and Sen. Bob Casey, D-Pennsylvania, introduced legislation allowing Medicare to cover dental, vision, and hearing services and increasing the federal investment in Medicaid covering these services.
Cardin has been an outspoken proponent of accessible dental health coverage, often referring to the case of Deamonte Driver, a 12-year-old from Maryland whose difficulty receiving Medicaid eligibility prevented him from getting the proper dental care that would have saved his life.
“What would have initially cost $80 for a tooth extraction ended up costing hundreds of thousands of dollars, and, tragically, Deamonte Driver lost his life,” Cardin said. “So, that really struck home. A person in my community that I represented, that we could have that kind of outcome.”
In February, Cardin, Sen. Debbie Stabenow, D-Michigan, and Rep. Nanette Diaz Barragán, D-California, reintroduced legislation that would significantly expand dental insurance coverage available to children nationwide through the Children’s Health Insurance Program (CHIP).
As of Jan. 1, Maryland’s adult Medicaid beneficiaries became eligible for dental coverage, including regular checkups as well as emergency procedures under the Maryland Healthy Smiles Dental Program.
In 2019, two states had no dental coverage under Medicaid, 15 had “limited” coverage, and 13 had only emergency coverage, according to a study by the Center for Health Care Strategies.
The American Dental Association estimated $4 million in savings per year to Maryland’s Medicaid budget by expanding dental coverage to adults.
Emergency visits for dental problems that could have been avoided by regular check-ups cost taxpayers, hospitals, and the government, according to research by the American Dental Association.
“There are more than 2 million emergency hospital room visits in America for oral health conditions,” Marko Vujicic, chief economist and vice president of the Health Policy Institute at the American Dental Association, said at the Senate hearing. “If you do the math, that’s about one every 15 seconds. This is heartbreaking, but as an economist, I also want to highlight that this costs our healthcare system upwards of over $2 billion per year.”
Other witnesses named workforce diversity and size, geography, and education as barriers to dental care across the United States.
“It is well established that a person’s healthcare and trust in the medical community improve when they are seen by a provider of their own choice,” said Cherae Farmer-Dixon, dean of the Meharry Medical College School of Dentistry in Nashville.
Only 4% of dentists are Black, according to data from the American Dental Association.
Farmer-Dixon pleaded with Congress to find a solution to the limited diversity in dentistry, stating that the job of educating a diverse workforce should not lie solely in the hands of the Meharry School and Howard University in Washington, both HBCUs.
By MICAELA HANSON
Capital News Service
Wider access to overdose-reversing drug could ease deadly toll of opioid crisis, experts say
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An FDA panel last month approved over-the-counter use of the nasal spray naloxone – commercially branded as Narcan, and it could be available at stores and online retailers by late summer.
“Having these types of treatments is important for people that are not able or ready to stop using drugs,” Eric Weintraub, who heads the addiction research and treatment division at the University of Maryland School of Medicine, told Capital News Service. “It’s basically keeping people alive.”
Over-the-counter access to Narcan will help Marylanders who face a drug supply that is increasingly dangerous and lethal, Weintraub said.
Fentanyl was involved in 81.4 percent of all fatal overdoses in Maryland from November 2021 to November 2022, according to the state’s Opioid Operational Command Center.
The national number of deaths involving synthetic opioids – primarily fentanyl – has also been rising, with opioid overdoses claiming more than 70,000 lives nationwide in 2021. That death toll has increased 97-fold since 1999, according to the U.S. Department of Health and Human Services.
Before the FDA approval, some state laws and standing orders allowed people to get naloxone without a prescription at a pharmacy. Various advocacy groups and government agencies have also distributed the spray for free in dozens of states.
Wednesday’s decision addresses the “dire public health need” of the opioid epidemic and improves access to life-saving treatment, FDA Commissioner Dr. Robert Califf said in a statement.
Naloxone’s approval is the latest initiative that Maryland health officials say could help curb the state’s opioid crisis.
Multiple bills in the Maryland General Assembly this legislative session look to improve fentanyl testing and increase penalties for distributing fentanyl-like substances. Manufacturing, selling, or distributing fentanyl in the state currently carries a $20,000 fine and 20 years of prison.
Weintraub said that Maryland has “always been a leader” in helping people struggling with substance use disorders.
But he added that naloxone’s approval sends a loud message supporting harm reduction strategies, which look to meet people who use drugs “where they’re at” when mitigating overdoses, according to the National Harm Reduction Coalition.
Since 2017, Maryland residents have been able to get naloxone without an additional prescription from pharmacies.
But overdose response programs, which often distribute the life-saving drug for free, need a sign-off from a medical prescriber or must provide training before administering naloxone, according to Zach Kosinski, a harm reduction director with the Behavioral Health System Baltimore.
Offering over-the-counter treatment could “change the game” for how response programs provide access to naloxone in Maryland, Kosinski added.
The Maryland Department of Health will share additional information about the availability of over-the-counter naloxone in Maryland as more details are finalized, according to Michael Coury, a spokesperson for the Opioid Operational Command Center.
Improved naloxone access could also help reduce stigma around substance use disorders in the state, Kosinski said. A person may be more willing to get naloxone at a grocery store or gas station than through an overdose response program because it affords them more privacy, he added.
“On the flip side, there’s no requirement that places that now will legally be able to sell it over the counter actually will, so stigma could also contribute to retailers not carrying it,” Kosinski said. “People who use drugs are already shopping at all of these establishments in every way that anyone who’s not using drugs is, and all this would do is make those stores a safer place.”
In a statement Wednesday, Robert Kramer, the CEO of the Gaithersburg-based company that manufactures Narcan, Emergent BioSolutions, also emphasized the need for community collaboration in setting up widespread naloxone access.
“With leaders across government, retail, and advocacy groups, we must work together to continue increasing access and availability, as well as educate the public on the risks of opioid overdoses,” Kramer said.
Shenandoah Apple Blossom Festival® welcomes Victoria Chuah, Miss Virginia 2022 to festival
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Shenandoah Apple Blossom Festival® President, Sharen Gromling, is pleased to welcome Ashburn, Virginia native and reigning 2022 Miss Virginia, Victoria Chuah, to the Festival this spring. She is no stranger to the Shenandoah Apple Blossom Festival®, as she was Miss Apple Blossom 2019.
Victoria obtained her Bachelor and Master Degrees of Science in Computer Science from the University of Pittsburgh in May 2022, graduating Summa Cum Laude with honors in four years. She was featured on the Morgan Stanley billboard in Times Square and is one of their incoming software engineers.
Victoria was selected Miss Virginia 2022 in Roanoke, VA, on June 25, 2022, and was the recipient of $22,500 in scholarships. She was also awarded the overall Social Impact Award with her initiative 4A: Awareness & Advocacy for Adults with Autism, inspired by her 19-year-old brother Luke, who lives with autism. As Miss Virginia, she is using her voice to advocate the need for Home Life Community – community developments for adults on the autism spectrum, providing services and long-term support plans for them to thrive.
Victoria was awarded a $10,000 “Women in Stem” scholarship at Miss America in December.
She also serves as the ABC Spokesperson for promoting healthy choices and substance abuse prevention to students in Virginia’s elementary schools as part of Virginia Alcoholic Beverage Control Authority’s Miss Virginia School Tour program.
As part of her year of service, she makes personal appearances to promote local businesses and non-profits. She is the keynote speaker at various events across the Commonwealth, participating in fundraising events and conferences. Her advocacy within these diverse arenas offers schools the opportunity to target the programs that best meet the needs of their students.
Victoria will visit many festival events when returning to our springtime homecoming. Among those events are the Coronation, presented by Morgan Orthodontics, and the Hang 10 Car Wash Firefighters’ Parade on May 5. She will then ride in the Glo Fiber Grand Feature Parade at 1:30 p.m. on May 6.
Tickets to Festival events are available at www.thebloom.com/events.
Shenandoah University, Valley Health partner to tackle region’s nursing shortage
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Shenandoah University, in collaboration with Valley Health and the Virginia Hospital and Healthcare Association (VHHA), is working to tackle the region’s nursing shortage through a program that will enhance the training of aspiring nurses and create a sustainable pipeline of new healthcare
NextGen Nurses program will draw upon the expertise of semi-retired and retiring nurses to help train the next generation of nurses before they leave the profession. The program, which is designed to provide a replicable model that can be used throughout the state, will create a reliable source of new nurses in the Shenandoah Valley by increasing regional opportunities to meet clinical training requirements through preceptorship and simulation.
This project was funded in part by GO Virginia, a state-funded initiative administered by the Virginia Department of Housing and Community Development (DHCD) that strengthens and diversifies Virginia’s economy and fosters the creation of higher-wage jobs in strategic industries.
The NextGen Nurses program is funded by a $496,000 GO Virginia Economic Resilience and Recovery Grant.
“Shenandoah University is grateful to have the support and financial backing of GO Virginia and the Department of Housing and Community Development for such a vital program during a critical period for health and nursing care in Virginia and across the country,” said Lisa Levinson, M.S.N, acting dean of the Eleanor Wade Custer School of Nursing. “We’re proud to partner with Valley Health on such an important endeavor to facilitate an increased nursing workforce in the region. We aim to ultimately improve the quality of life in the Northern Shenandoah Valley and provide a model to be followed across the state to help address the nationwide nursing shortage.”
The pandemic exacerbated workforce shortages in the healthcare sector, including an exodus of nursing professionals and a shortage of clinical trainers for nursing students.
As part of the NextGen Nurses program, Shenandoah University’s highly skilled faculty in the Eleanor Wade Custer School of Nursing – which boasted one of the state’s highest National Council Licensure Examination (NCLEX) first-time pass rates (97.47%) for the 2021-22 academic year – will develop a series of scalable, relevant and easy-to-use educational on-demand modules designed to accelerate training for retired nurses, and other eligible nurses, to become clinical preceptors.
“Clinical training is one of the most pressing concerns in contemporary nursing education, making this NextGen Nurses program all the more important,” said Shenandoah University Provost Cameron McCoy, Ph.D. “We are grateful for the continued partnership of Valley Health, GO Virginia, VHHA, and DHCD as we collectively improve nursing education in the Shenandoah Valley. At Shenandoah University, our nursing faculty are perpetual innovators and, as such, are exceptionally well positioned to lead and partner in the development of these essential modules.”
Valley Health, with the assistance of the Virginia Department of Health, will recruit and onboard nurses who no longer work full-time at the bedside to complete the SU-developed training modules before being employed as clinical preceptors.
“This academic-practice partnership with Shenandoah University is an important element in our broader workforce development strategy,” said Theresa Trivette, DNP, Valley Health chief nurse executive. “It is critically important that we draw upon the knowledge of our most experienced nurses in the region to help train and support our newest nurses to assure we are able to continue providing the highest quality of care for our community.”
Additionally, NextGen Nurses will increase opportunities to use simulation as a supplemental option in clinical preceptorships. Shenandoah has hired a director of the clinical simulation and obtained the necessary equipment to create a simulation lab capable of fulfilling up to 25% of the 500 clinical hours required for aspiring nurses. The simulation lab will reduce the need for SU’s School of Nursing preceptorships by 25%, relieving some of the burden on local healthcare providers to serve as preceptors and/or clinical sites, a role that has become more challenging due to the growing workforce shortages.
The NextGen Nurses program aims to hire 35 retired or retiring nurses as clinical preceptors by June 2024.
“GO Virginia Region 8 is thrilled to provide funding for the NextGen Nurses project, addressing critical workforce shortages exacerbated by COVID-19,” said Chris Kyle, GO Virginia Region 8 chair. “Region 8 will benefit from this project, which will help rebuild capacity in the health care system as we continue to focus on this critical health care shortage in our region. We embrace the opportunity for replicable projects in the region, knowing economic prosperity will expand from high-paying career pathways. Everyone should celebrate this win!”
About Shenandoah University
Shenandoah University was established in 1875 and is headquartered in Winchester, Virginia, with additional educational sites in Clarke, Fairfax, and Loudoun counties. Shenandoah is a private, nationally recognized university that blends professional career experiences with wide-ranging education. With approximately 4,200 students in more than 200 areas of study in six different schools, Shenandoah promotes a close-knit community rich in creative energy and intellectual challenge. Shenandoah students collaborate with accomplished professors who provide focused, individual attention, all the while leading several programs to be highly nationally ranked. Through innovative partnerships and programs at both the local and global level, there are exceptional opportunities for students to learn in and out of the classroom. Shenandoah empowers its students to improve the human condition and to be principled professionals and leaders wherever they go. For more information, visit su.edu.
About Valley Health
Valley Health is a nonprofit health system serving a population of more than 500,000 in the Northern Shenandoah Valley of Virginia, the Eastern Panhandle and Potomac Highlands of West Virginia, and western Maryland. As a healthcare provider, employer, and community partner, Valley Health is committed to improving the health of the region. The system includes six hospitals, more than 70 medical practices and Urgent Care centers, outpatient rehabilitation and fitness, medical transport, long-term care, and home health. For more information, visit valleyhealthlink.com.
Laurel Ridge Community College Workforce Solutions to begin offering in-demand ITIL 4 certification from PeopleCert
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Laurel Ridge will begin offering ITIL 4 Foundation, an internationally recognized in-demand IT management certification, beginning this June. Students taking the ITIL course will learn the skills they need to lead and manage an IT business service through every stage.
Additionally, the fast-paced, four-week online course will prepare students for the ITIL 4 Foundation exam. It is being offered by Laurel Ridge Community College Workforce Solutions with certification provided through PeopleCert, the global leader in assessing and certifying professional skills.
“Our college is the heartbeat of workforce development, and we are the direct line to providing the skilled workforce local employers need,” said Laurel Ridge Marketing Director Guy Curtis. “The IT realm in organizations, especially in a post-pandemic and hybrid working world, needs so many skilled people, and training in ITIL 4 will meet their needs while also creating long-term careers for our graduates – with average annual salaries for entry-level workers starting at almost $110,000.
“With the number of tough-to-fill jobs in the market, we are inviting more people to gain education and training and move forward in their working lives. And, with the need for IT service management skills on the rise across the nation, ITIL is a great foundation course to obtain management skills, which lay the foundation for other stackable credentials.”
ITIL was originally developed by the British government to improve performance in IT services and has been adopted by IT professionals and organizations in multiple industry sectors worldwide, helping to increase business value through digital and IT services.
“This program is ideal for students currently working as it enhances their current skills and can help them launch a new career and become more marketable in the workforce,” Curtis said. “One of our core values – a passion for lifelong learning – is about the need for individuals to keep pursuing new opportunities, to grow and keep pace with the in-demand skills of today.
“And, with ITIL recognized by both the G3 and the FastForward grant programs as a training course resulting in industry credentials for high-demand professions in the region, this makes it more affordable for students to subsidize their next career move.”
FastForward grant funding covers two-thirds of the tuition costs for Virginia residents, and the G3 program pays for costs not already covered by grants and other financial aid for qualified students. Learn more at laurelridgeworkforce.com/ITIL.
As Virginia budget negotiations drag on, here’s what hangs in the balance
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In normal years, Virginia’s budget plan is supposed to be pretty much done by April, except for any late changes recommended by the governor.
But for the second year in a row, the politically split General Assembly is heading into spring under a cloud of uncertainty over when the budget will get done and what will be in it.
According to House Appropriations Chairman Barry Knight, R-Virginia Beach, budget negotiators are taking a deliberately cautious approach to getting a better feel for the status of the broader economy.
‘Buckle up’: Youngkin budget proposal includes another $1B in tax cuts
“We are taking our time and being very deliberate with the stock market volatility, revenues softening some and to see if the bank situation doesn’t proliferate,” Knight said in an email Wednesday, referring to possible ripple effects of the failure of Silicon Valley Bank this month.
Lawmakers are set to return to Richmond on April 12 to take up vetoes and legislative amendments from Gov. Glenn Youngkin. If there’s no budget to vote on by then, the next big deadline is June 30, when the state’s current budget year ends.
Some legislators have pointed out that the General Assembly technically isn’t required to pass a budget this year. Because the state is approaching the middle of its two-year budget cycle, lawmakers are modifying an existing plan, not creating an entirely new budget.
Still, several key priorities won’t get funded if the two parties can’t come to an agreement over the next few months. Here are a few of them:
For a second year in a row, Youngkin and his Republican allies have made broad tax cuts a top priority, and Democrats have again been trying to use their negotiating power to lock in more targeted relief that would help lower-income Virginians.
Democrats have made clear Youngkin’s proposal to cut the corporate tax rate from 6% to 5% is a non-starter for them. But they’ve expressed more openness to broader forms of relief for individual taxpayers, such as raising the standard income tax deduction.
Signs of strength or weakness in state revenues could be a major factor in determining how much tax relief is feasible because Youngkin has indicated he will only pursue tax cuts the state can comfortably afford.
Legislators have also floated the idea of doing another round of one-time tax rebates instead of making more structural tax cuts meant to be long-term. As part of last year’s bipartisan budget deal, the state sent out millions of tax rebate payments worth up to $250 per person.
Mental health investments
Following years of financial and staffing strain that culminated in five of Virginia’s state-run mental hospitals closing to new admissions in July 2021, Youngkin this December laid out a broad package of $230 million in reforms to the government behavioral health system.
While some of the aims in the governor’s “Right Help, Right Now” proposal can be achieved by consolidating current programs, said Virginia Department of Health Chief Operating Officer Christopher Lindsay, the numerous amendments to the current budget would be a “significant contributor” to those goals, which are generally backed by both parties. Those include money for a school-based mental health pilot, the expansion of local crisis centers that provide an alternative to hospitals for people seeking help, and higher Medicaid reimbursement rates for certain behavioral health providers.
Both budgets would also increase pay for staff at the state’s community services boards, the locally based bodies that are the primary providers of behavioral health and developmental disability services in Virginia. The House calls for an extra $37 million, and the Senate an extra $50 million.
Virginia, like other states, is suffering from teacher shortages, with many policymakers pointing to low pay as one driver of the vacancies. A 2019 report from the state’s legislative watchdog agency found Virginia ranked 33rd among the states in average salary for K-12 public teachers.
The House and Senate are proposing even bigger raises for public school teachers than the existing budget. Under the current budget, teachers get 5% raises, while this year’s amendments would push those up to 7%. Both chambers are also recommending that $50 million in proposed teacher performance bonuses be redirected to other goals, with the House specifically putting that money toward bigger salary bumps and calling for a workgroup to set “appropriate metrics” for teacher compensation.
Help with Richmond’s massive sewer project
Both the House and the Senate are backing a request from Youngkin to put $100 million toward the city of Richmond’s ongoing struggle to fix its 19th-century combined sewer overflow system, which routes storm runoff and sewage through the same pipes. CSO systems, which were built over a century ago in many historic East Coast cities, including Richmond and Lynchburg, cause sewage overflows into waterways whenever heavy rainfall overwhelms the network.
Lynchburg has almost completed its CSO conversion, and Alexandria’s is in full swing. But with an estimated cost of over $1.3 billion, Richmond’s project far outstrips its counterparts in both price and complexity, and the high percentage of residents living below the poverty line has limited the city’s ability to cover costs through rate increases.
Hiring more reading and literacy specialists
After sharp drops in reading test results during the pandemic, both chambers have proposed hiring more literacy coaches and reading specialists to help students. House and Senate amendments would allocate $6.7 million to expand the state’s literacy program, which currently covers students up to grade 3 through eighth grade. Both also call for the hiring of more reading specialists, with the Senate proposing more than $27 million and the House almost $14 million for the initiative.
Increased funding for the state’s Business Ready Sites Program
One of Youngkin’s biggest spending priorities was $450 million to boost the state’s supply of economic development sites that could make the state more attractive to big employers looking for somewhere to build.
That funding became a sticking point for budget negotiators late in the regular session, according to the Richmond Times-Dispatch, and it remains unclear how legislators will resolve their differences.
School security grants
Both budgets call for ramped-up spending on school security. The Senate is proposing an extra $50 million in grants for that purpose, while the House is suggesting $12 million be diverted from the Lottery Fund for school security grants, $8 million go toward hiring more school resource and school security officers and $1.5 million go toward security renovations at two elementary schools in Newport News, including Richneck Elementary, where a 6-year-old shot his teacher in January.
Statewide housing needs assessments
While their numbers differ, the House and Senate budgets both provide funding for a statewide housing needs assessment. As home prices rise faster than inflation and many areas of the state see ongoing shortages of affordable housing, the two chambers backed legislation this session to direct the Department of Housing and Community Development to conduct a comprehensive review of the state’s housing stock and need every five years. The Senate proposes $400,000 for the effort, while the House proposes $500,000.
An inland port in Southwest Virginia
Both budgets include substantial new funding for the Virginia Port Authority to begin the process of building an inland port in Southwest Virginia’s Mount Rogers Planning District.
The state currently has an inland port in the northern Shenandoah Valley, and proponents of adding a second logistics hub in Southwest Virginia say it could increase the flow of cargo and boost business development in the area.
The House budget includes $55 million for the project. The Senate budget allocates $10 million.
Jury duty pay
Lawmakers passed a proposal this session to raise jury duty pay from $30 per day to $50 per day after initially considering compensation as high as $100 per day.
Youngkin signed the bill setting the new amount at $50, but nearly $1.4 million in new funding to help the courts system cover those costs depends on the budget being approved.
by Sarah Vogelsong, Virginia Mercury
Virginia Mercury is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Virginia Mercury maintains editorial independence. Contact Editor Sarah Vogelsong for questions: firstname.lastname@example.org. Follow Virginia Mercury on Facebook and Twitter.
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