CSG Midwest
For patients who develop sepsis, the ability of a health professional to recognize it early on can mean the difference between life and death, or between full recovery and permanent organ damage. For doctors and nurses, though, early recognition of this condition (caused by the human body’s response to an infection) can be difficult.
“The symptoms are like those for the flu and many other diseases,” says Kelly Court, chief quality officer at the Wisconsin Hospital Association. “So you need to get the entire clinical team at a hospital to think sepsis when evaluating a patient, because early detection is so important.”
Four years ago, that early detection did not take place in a case that led to the tragic death of a 5-year-old girl in Illinois. The girl, Gabby Galbo, died from sepsis after a tick bite caused a bacterial infection.
Gabby’s Law (SB 2403), signed into law this summer after receiving unanimous legislative approval, puts in place new statewide requirements for hospitals, which will now have to establish and then periodically implement evidence-based sepsis protocols — for example, a process for screening and early recognition, identification of the infectious source, and guidelines for how to administer fluids and deliver antibiotics to patients. Direct-care staff in Illinois’ hospitals will have to receive periodic training on these protocols.

Some states are implementing policies to increase the use of long-acting reversible contraception, known as LARCs, among Medicaid enrollees. LARCs--intrauterine devices, or IUDs, and subdermal contraceptive implants--are highly effective forms of birth control, with pregnancy rates of less than 1 percent within the first year. A five-year Colorado pilot program documented a 48 percent reduction in the state's teen birth and abortion rates.

An article in today's Kaiser Health News suggests that a President Trump could dismantle much of the Affordable Care Act without Congressional action. For instance, just a stroke of his presidential pen could eliminate subsidies to persons between 100 and 250 percent of the poverty level. On the other hand, Clinton's proposals to support and build on the ACA would seem to require Congressional action. 

Voters in Colorado will head to the polls this November not only to cast their ballots for the next president of the United States, but also to determine whether they will become the only state in the nation to adopt single-payer health care.

More than 20 legislators from 16 states--many of them in key leadership positions on health or budget committees that deal with Medicaid in their home states--attended a CSG policy academy in Washington D.C. on September 21-23, 2016, to learn how states are making reforms in their Medicaid program that pursue the health "triple aim": improving the quality of care for individuals, improving the health of populations, and reducing per capita costs of health care.

CSG Midwest
Before the night she suffered a severe allergic reaction that took her life nine days later, 13-year-old Annie LeGere had grown up with only minor allergy symptoms. There was no reason for her, her family or her health providers to believe she should have a prescription to an epinephrine autoinjector, the emergency treatment that can save lives in cases of anaphylaxis (a serious allergic reaction, most commonly to food).
But what if the first people often to respond to a medical emergency (including in Annie’s case) — local police officers — could carry these autoinjectors and be trained on how to administer them? The minutes saved by administering the drug on-site rather than in an emergency room could be the difference between life and death.
In Illinois, these officers now will have the opportunity, thanks to a bill passed this year (HB 4462) known as Annie’s Law. One of the leading proponents of HB 4462, Illinois Sen. Chris Nybo, worked closely on the measure with Annie’s family, which has created a foundation in her name with the goal of preventing future tragedies.
CSG Midwest
Right now in Iowa, it’s no sure bet that a child in need of mental health services is going to get them. Instead, access can depend on where his or her family happens to live. “There is no statewide system or network of care in place, and over the long term, we need to develop it because there are clear gaps,” explains Anne Gruenwald, president and CEO of Four Oaks, a Cedar Rapids-based nonprofit agency that provides a range of services for children in need.
“When you have those gaps, needs go unmet, or we have to rely on our adult system of care — and that’s not always a good fit.” Iowa appears to be taking some important first steps, thanks to the recommendations of a work group formed by the Legislature in 2015 and actions taken by lawmakers during their 2016 session. 

States are increasingly turning to community paramedicine to help fill the gap in the health care workforce. States have been experimenting with community paramedicine programs for the last five years or more. Expanding the role of licensed or certified emergency medical technicians—or EMTs—and paramedics to provide non-emergency preventive health care services directly to patients in their communities can be cost-effective and make up for health care work force shortages. 

Voters in Colorado will face a choice on the ballot this November regarding medical aid in dying for the terminally ill. The “Colorado End of Life Options Act,” or Initiative 145, is a proposal that would allow physicians to prescribe life-ending medications to adult Colorado residents who have a terminal illness with a prognosis of six months to live or less.

While technology has been a key component of medicine in the modern era, healthcare is moving towards more personalized treatments that are based on enormous amounts of data that are collected and managed in complex computer systems. Will equitable access to healthcare in the future mean not just access to medical professionals, but also access to these promising technologies that can aggregate information from multiple sources, and provide support for treatment planning?