Medical / Health

Saturday, March 26, 2016

'Full Spectrum': One Way to Attract Doctors to the North Coast

Posted By on Sat, Mar 26, 2016 at 11:35 AM

It’s no secret Humboldt County has a doctor shortage. The lack of both primary care physicians and specialists has a variety of causes, and a host of impacts on the community.

And efforts to recruit and retain doctors are met with mixed results; the shortage continues, but once in a while, you get a success story like Kelvin Vu.

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Monday, March 21, 2016

St. Joseph Pushing for Trauma Center Certification

Posted By on Mon, Mar 21, 2016 at 2:23 PM

David O'Brien. - SUBMITTED
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  • David O'Brien.
St. Joseph Health President David O’Brien will address the Humboldt County Board of Supervisors tomorrow morning to provide an update on the hospital’s efforts to become a certified Level III trauma center.

The hospital has never before sought trauma certification, but is now applying for the designation. Trauma centers in the United States are generally split into five levels, with the Level 1 being an all-inclusive center that is a regional resource and Level 5 being a facility that performs initial evaluations and stabilizations before transferring patients to higher levels of care elsewhere.

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Humboldt County Grand Jury: 'Be Wise, Immunize'

Posted By on Mon, Mar 21, 2016 at 12:03 PM

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In its first report of the year, the Humboldt County Civil Grand Jury took a look at the county’s low vaccination rates, noting we currently rank 54th out of the state’s 58 counties when it comes to kindergartners and seventh graders.

The grand jury hones in on transportation as a major barrier to getting the county’s little ones all their shots, and also urges the Humboldt County Office of Education to take on an oversight role for school’s reporting of vaccination rates, including the posting of those rates to a data website, www.shotsforschool.org. The grand jury report has been met with ridicule in some circles, as it seems to ignore the fact that there are lots and lots of people in Humboldt who just don’t believe in vaccinations, but the recommendations also seem to have some merit.

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Saturday, March 12, 2016

'Magical Efficiency': Update on Local Palliative Care Initiative

Posted By on Sat, Mar 12, 2016 at 2:39 PM

Michael Fratkin. - TOBIN PHOTOGRAPHY
  • Tobin Photography
  • Michael Fratkin.
Palliative care doctor and founder of ResolutionCare Michael Fratkin was recently interviewed by Telemedicine Magazine, and the Q-and-A reveals some of the inner workings of Fratkin's operation since it launched last year. 

The Journal wrote about Fratkin's startup in 2014, when he was still finding support and funding for his vision to provide in-home end-of-life care as well as health care provider training via telemedicine. In his most recent interview, Fratkin discusses the difficulties of trying to provide palliative care under a standard healthcare business model, and explains how the timing and technology provided the perfect launch for his program. 

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Wood Pushes Soda Tax Amid Busy Health Week

Posted By on Sat, Mar 12, 2016 at 8:41 AM

Assemblyman Jim Wood, in October, asking Gov. Jerry Brown to pass statewide medical marijuana reforms. - PHOTO BY GRANT SCOTT GOFORTH
  • Photo by Grant Scott Goforth
  • Assemblyman Jim Wood, in October, asking Gov. Jerry Brown to pass statewide medical marijuana reforms.
Really want that Double Big Gulp? Well, come next year, you’ll have to pay an extra $1.28 for it, if North Coast Assemblyman Jim Wood has anything to say about it.

Kicking off what’s proven to be a busy week for Wood and health news, the assemblyman introduced a bill that would impose a 2-cent-per-ounce tax — dubbed a health impact fee — on sugar-sweetened beverages, including sodas and energy drinks. Revenue from the fee — projected to be as much as $2.3 billion per year — would then be doled out in grants to cities, counties and nonprofits to fund childhood obesity and diabetes prevention efforts, and oral health programs.

While the fee will be imposed at the distributor level, it seems a safe bet it will be passed along to consumers.

The bill has already drawn the ire of Californians for Food and Beverage Choice, an arm of the California Beverage Association, which killed similar legislative efforts in 2014 and 2015. “The last thing that hard-working Californians need is another tax, which will only make it even more difficult to make ends meet in one of the most expensive states in the nation,” Bob Acherman, executive director of CalBev, told the Los Angeles Times.

But Wood believes the last thing Californians need is to drink more soda.

“The number of children being diagnosed today with adult-onset-diabetes is frightening, particularly when you consider that the disease was almost nonexistent in children three decades ago,” the assemblyman and dentist said in a press release. “Despite this alarming trend and the decades-long pleas from healthcare practitioners, California has made little to no financial investment to counter the problem. As the eighth largest economy in the world, I find this unacceptable.”

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Saturday, February 27, 2016

John Jaso: Humboldt's Dreadlocked Baseball Hero Talks Concussions

Posted By on Sat, Feb 27, 2016 at 12:50 PM

John Jaso, swinging for the Oakland Athletics. - SUBMITTED
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  • John Jaso, swinging for the Oakland Athletics.
Humboldt-grown pro baseball player John Jaso is the subject of a fantastic article that came out this week on VICE Sports. In it, Jaso’s former teammate Fernando Perez (a World Series champ and he’s a better writer than me? Sigh) talks with Jaso about playing catcher, diva pitchers, being a Moneyball player and the debilitating concussions he suffered two years in a row.

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Sunday, January 24, 2016

Yurok Tribe Declares Emergency After Rash of Suicides

Posted By on Sun, Jan 24, 2016 at 10:04 AM

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The Yurok Tribe has declared a state of emergency after seven young tribal members took their own lives over an 18-month span.

The tribe is working with tribal, state and federal agencies and developing a "broad, collaborative plan to identify the root causes of this epidemic," according to a press release. All of the suicides were committed by tribal members between the ages of 16 and 31, and all took place in or near Weitchpec, an isolated community in north-eastern Humboldt County, north of Hoopa.

The tribe's declaration comes on the heels of a year when Humboldt County recorded the most suicides its seen in at least five years, with 41 people having taken their own lives within the county's borders. Per-capita, Humboldt's suicides rates in 2015 were nearly three times the state average of 10.2 per 100,000 residents. Officials have pointed to a variety of factors that may contribute to the high numbers, including high rates of drug and alcohol abuse, poverty and challenges accessing mental health services.

See the full press release from the Yurok Tribe copied below:


Yurok Tribe declares State of Emergency

The Yurok Tribal Council is working with Tribal, state and federal agencies to address an alarming increase in the number of suicides committed by young Yurok people.

In the last 18 months, seven Tribal members, ranging in age from 16-31, took their own lives. In response to this perplexing pattern, the Tribal Council issued an emergency declaration on December 28. The Tribe is also developing a broad, collaborative plan to identify and resolve the root causes of this epidemic.

“My heart goes out to all of the people, directly or indirectly, impacted by this tragedy,” said James Dunlap, Chairman of the Yurok Tribe. “We are doing everything we can to answer the community’s call for a culturally appropriate response to this crisis.”

All of the suicides happened near Weitchpec, a small, isolated community of only 150 individuals, located on the east side of the Yurok Reservation. The culturally significant site sits just above the confluence of the Klamath and Trinity Rivers, in one of the most remote and rugged parts of the United States. Residents there have almost no cell or internet coverage. Many family homes do not yet have electricity. Getting groceries requires an hour-long drive and transportation is difficult due to the fact that there is only one paved road.

In early December, the Tribal Council received a petition, signed by approximately 200 upper Reservation residents, informing the governing body of the recent rise in suicides. The document also contained a call to action.

“(Yurok youth) love their home and most want to stay here, but the lack of training opportunities, jobs, or even recreational facilities invites unhealthy behaviors and feelings of despair. The people in this community need to feel that someone cares about what's happening here.  They urgently need your attention and your help," stated the signed letter.

The Yurok Tribe’s headquarters are in Klamath, CA, near the mouth of the Klamath River. Klamath is a small town in the far northwest corner of the state. The only paved road, connecting the east and west sides of the rural reservation, was washed away in the 1960s and the state highway was never replaced. Driving from one side of the reservation to the other takes about two hours, including a long stint on a dirt road that is sometimes covered in snow. The Tribe has a small office in Weitchpec, where a limited quantity of social, health and cultural services are available. The majority of the Tribe’s therapeutic resources are in Klamath, but those services are also spread thin.

“By far, the Tribe’s need for healing resources outweighs our current capacity,” Chairman Dunlap said.

The Yurok Tribal Council is working on a plan, involving health officials within the Tribe and representatives from several outside entities, to provide help for at-risk youth and young adults. In addition to state and federal representatives, the Tribe is coordinating with the Indian Health Service, United Indian Health Services and California Rural Indian Health Board. The Humboldt County Department of Health and Human Services has also played in instrumental role in this important endeavor, which is still at the beginning stages.

“I would like to thank all of the agencies and individuals that have stepped up to assist us in our time of need,” Chairman Dunlap said.

At a community meeting on Saturday, January 10 in Weitchpec, local residents identified potential root causes of the recurring instances of self-harm and solutions to prevent the problem from further escalating. Numerous members of the upper reservation community stated that the geographic isolation, lack of positive activities and the scarcity of job opportunities, in combination with historical and ongoing trauma, are causing many local youths to feel hopeless. Participants of the meeting also emphasized that easy access to illicit drugs, brought in by an onslaught of out-of-town illegal marijuana growers, was another big part of the problem.

Securing funding to build recreation center, hiring cultural mentors and increasing access to mental health professionals were among the suggested responses to the complex dilemma. Local community members also articulated a need to abolish all of the cannabis farms.

Suicide is a major concern all over Indian Country. The suicide rate among American Indian/Alaskan Natives, ages 15-34, is 19.5 per 100,000 people, which is 1.5 times higher than the national average for that age group, according to the Centers for Disease Control. The CDC also says that these rates are likely underreported by 30 percent, a result of coroners writing the incorrect ethnicity on death certificates. Among the adolescents and young men living in the Weitchpec area, the rate is hundreds of times higher than that of other American Indians/Alaskan Natives. Indian Health Services, the main healthcare provider to Native American residents, is regularly underfunded. IHS’ per capita health care expenditure is only about $3,000 per person, whereas the national average is $9,255, according to the CDC.

The Yurok Tribe is the largest Tribe in California and has more than 6,000 members. While Weitchpec is sparsely populated, it is considered the primary cultural hub. It is where many of the Tribe’s traditional ceremonies take place.

“Every Yurok has a real connection with the Weitchpec area and a very real connection to this heartbreaking crisis. We will continue doing everything we can until we have fully addressed this heart-wrenching calamity,” concluded Chairman Dunlap. 


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Thursday, January 14, 2016

Local Harm Reduction Team Becomes Authorized Naloxone Distributor

Posted By on Thu, Jan 14, 2016 at 11:34 AM

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The Humboldt Area Center for Harm Reduction (HACHR) took a step toward helping reduce local overdose and infection rates yesterday, as a physician has agreed to carry a prescription for Naloxone and bulk syringes. HACHR would not disclose the name of the physician, but spokesperson Michelle Ellis said they were lucky to find someone who was "really concerned about hepatitis C rates." Humboldt County has the fifth highest infection rate in the state for the disease, which is primarily transmitted through intravenous drug users sharing needles.


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Saturday, January 2, 2016

How to Ditch Your Pills in Humboldt

Posted By on Sat, Jan 2, 2016 at 11:00 AM

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... the short answer is, you can't. Not if they're opiates, or another controlled substance. Despite a growing local and national epidemic of prescription pill abuse, stringent guidelines from the Drug Enforcement Administration have made it nearly impossible for those in Humboldt who want to dispose of their leftover medications  to do the right thing. 

If you bring your pills back to the pharmacy where you got them, you may well get a firm refusal and a flyer directing you to the Humboldt Waste Management Authority. HWMA does accept most medications, if they've been repackaged in a clear plastic bag without identifying information. But they cannot accept any controlled substances, including opiates, steroids and others that have made the DEA's list

Brent Whitener, operations manager at HWMA, says he "loses money" on the medications that he does accept. Unlike aluminum or glass, there is no (legal) resale market for medications. But the facility continues to accept them because Whitener doesn't want them to end up in the waterways via the sewer, or decomposition in landfills. When enough have accumulated at the plant, they are incinerated. A few times a year, HWMA will host a drop-off day where people can bring their medications, and a law enforcement officer will stand by to book controlled substances in as evidence. Whitener says that every time this happens, 12 to 20 pounds of pills go into the hands of law enforcement.

"I’m trying to get out of the business," he says. "The DEA is making it extremely difficult to accept medications just because, inadvertently, controlled substances may be in there."

Whitener says pharmaceutical manufacturers should pay for the disposal of their products. Currently, the DEA recommends putting medications in a bag with kitty litter or coffee grounds before putting them in the garbage. Whitener says this is an ineffective idea and only ends with toxic substances in the wastestream and waterstreams. In the meantime, he has worked with the county to get medication disposal bins installed where people can bring their controlled substances. 

The bins, which will feature a double lock system, will be installed in two Eureka locations where people can safely and anonymously bring their controlled substances for disposal. The cost of purchasing the bins came from a Drug Free Communities grant and a California Healthcare Foundation grant, in partnership with the Regional Opioid Safety Coalition, is covering the pickup and disposal costs. The total cost was $9,490.

Michael Weiss, program services coordinator at the Humboldt County Department of Health and Human Services, says Humboldt Allies for Substance Abuse Prevention (ASAP) "has been working for the last six months to identify community partners and locations for medication disposal bins." 

"Opioid safety and overdose prevention are top issues in Humboldt County," he adds in an email. " DHHS Public Health’s Community Health Assessment identifies drugs and alcohol as top causes of preventable morbidity and mortality, and overdose deaths are a contributor to this. Currently there is no location for the disposal of controlled substances in Humboldt County, and providing one will reduce the availability of these medications in the community."

While ASAP continues to search for someone to pick up and dispose of the drugs, Whitener says re-educating the public will be a crucial step in fixing this gap. 

"The battle I’m fighting is that I’ve taught people in the county that you can take your medications to me," he says.

For now, don't.
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Saturday, December 19, 2015

MediCal Expansion May Bring Better Addiction Treatment to Humboldt

Posted By on Sat, Dec 19, 2015 at 12:09 PM

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Drug and alcohol related fatalities comprised 20 percent of all Humboldt County deaths over the last three years, but the number of those seeking help often exceeds the amount of treatment available. A change in the state's MediCal program may change that, opening up access to treatment for many low-income residents. 

A key component of the MediCal program's federal "drug waiver," which will get rolling in 2016, is flexibility. Prior to this expansion of the Affordable Care Act, treatment providers were limited in the types of care they could offer to MediCal patients. Currently, no inpatient residential program in Humboldt County accepts MediCal as a form of payment. Residential programs, with a structured environment, can be crucial in addressing the holistic needs of patients who may also struggle with housing insecurity, mental illness and making lifestyle changes that support recovery. The county's outpatient program (which features group and individual therapy) does accept MediCal, but it does not include detox services. For many patients, detox, which involves the withdrawal from the substance or substances of abuse, is the first hurdle in getting clean. The county's lone detox program, which is privately run through Alcohol Drug Care Services, accepts subsidies for some patients from the county but does not accept MediCal. Nancy Starck, legislative and policy manager at the Humboldt County Department of Health and Human Services, says that might be changing.

"It could be a great opportunity to address a big need in our county," she says. "We're exploring opting in to the waiver as a Northern California Region, for economy of scale. A small county like ours can't expand these services alone."

For the first time, the county may also cover reimbursement for case management. Case management allows social workers to address all the needs of a client (housing, mental illness, employment), connect clients to services and track progress over a greater length of time.

"We think integrating these new services into the Medi-Cal health plan makes the most sense for holistic patient care," says Starck.

A county report on this option adds that opting into the waiver is voluntary, and  "a number of the small, rural northern counties have agreed to meet as a region to explore several ACA and managed care issues and opportunities, including a regional approach to Drug MediCal." Medi-Cal for the eight northernmost counties of California is all managed under the Partnership Healthcare Plan, and Starck said that the counties may work regionally to address this common issue. Existing treatment programs, specifically Alcohol Drug Care Services, may also get a boost from this funding. 
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