This Week in Health Care

Several States Vow to Review Any FDA-Approved COVID-19 Vaccine: Concerned about political interference in the FDA’s vaccine approval process by the administration of President Trump, officials in at least six states, including California and New York, have indicated they will conduct independent reviews of any COVID-19 vaccine authorized by the federal agency.

“We want to make sure — despite the urge and interest in having a useful vaccine — that we do it with the utmost safety of Californians in mind,” said California Health and Human Services Secretary Dr. Mark Ghaly.

New York Gov. Andrew Cuomo (D) put it a little less diplomatically last month, saying, “Frankly, I’m not going to trust the federal government’s opinion and I wouldn’t recommend [vaccines] to New Yorkers based on the federal government’s opinion.”

Both of those states and another two that have signaled their intention to independently review the vaccine data, Colorado and Oregon, are governed by Democrats. But two others, Michigan and West Virginia, are governed in part or entirely by Republicans.

Some vaccine policy experts said the states’ plans could end up doing more harm than good by undermining public confidence in a vaccine, which is ultimately the best strategy for ending the pandemic.

“Do you really want a situation where Texas, Alabama and Arkansas are making drastically different vaccine policies than New York, California and Massachusetts?” said Dr. Saad Omer, who heads the Yale Institute for Global Health.

There’s plenty of reason for states to be skeptical about the FDA’s vaccine approval process. President Trump has repeatedly indicated he’d like a vaccine approved before the Nov. 3 election. And the FDA approved two treatments for COVID-19 touted by the president - hydroxychloroquine and convalescent plasm - despite a lack of evidence they were safe and effective.

But Dr. Peter Marks, who leads the division of the FDA that is responsible for approving vaccines, says the career scientists at the agency are committed to keeping “our hands over our ears to the noise that’s coming in from all sides” and keeping “our eyes on the prize.” (KAISER HEALTH NEWS)

KS Nursing Homes Now Have Metric for COVID-19 Testing: Nursing homes in Kansas have a way to determine how often to test their staff for COVID-19. An online COVID-19 dashboard maintained by the Kansas Department of Health and Environment now displays a “14-day percent positivity” metric for those facilities.

The metric consists of a color-coded map of the state’s counties, indicating each of their positive test rates. Counties shown in green have low community activity (positive test rates below 5 percent), those in yellow have medium activity (positive test rates between 5 percent and 10 percent), and those in red have high activity (positive test rates over 10 percent).

The metric stems from a rule issued by the Centers for Medicare and Medicaid Services (CMS) in August requiring routine testing of staff based on their community positivity rate. David Wright, director of the Quality and Safety Oversight Group for CMS, stated in a memo that the rule was “aimed at preventing COVID-19 from entering nursing homes, detecting cases quickly, and stopping transmission.”

“Swift identification of confirmed COVID-19 cases allows the facility to take immediate action to remove exposure risks to nursing home residents and staff,” he said. (WICHITA EAGLE, CENTERS FOR MEDICARE AND MEDICAID SERVICES)

Health in Brief

WY Hospital Association President Decries Slow CARES Act Distributions: Wyoming Hospital Association President Eric Boley told state lawmakers last week that the process for hospitals to obtain federal CARES Act money has been “cumbersome” and “taken way too long.” Among the specific problems Boley mentioned were the application process for a loan program run through the State Loan and Investment Board and federal rule changes complicating the use of CARES funding. (WYOMING TRIBUNE EAGLE [CHEYENNE])

Wheeling, WV Declares Racism Health Crisis: Spurred by recent social justice movements across the country, the City Council of Wheeling, West Virginia unanimously approved a resolution last week declaring racism a health crisis. The resolution directs the city manager to remove any racial bias from city policies and require city employees to complete bias training, among other things. (ASSOCIATED PRESS)

Oklahoma City Police Overwhelmed by Mental Health Calls: Last year the police in Oklahoma City, Oklahoma received 19,568 mental health-related calls, nearly twice as many as in 2013. Less than 14 percent of the city’s police officers have received specialized training in how to respond to such calls. (OKLAHOMA WATCH [OKLAHOMA CITY])

Hospitalizations Surge After Capacity Wanes in OK: Oklahoma posted two consecutive nights of record COVID-19 hospitalizations last week. The surge comes two weeks after the state declined to renew overflow contracts with hospitals. (TULSA WORLD)

Hospitalizations Shift to Rural Areas in OH: In April, 54 percent of COVID-19 hospitalizations in Ohio were in urban areas, with 26 percent in suburban areas, and 21 percent in rural areas. As of the end of September, 42 percent of hospitalizations were in rural areas, 34 percent were in the suburbs and 24 percent were in urban areas. (COLUMBUS DISPATCH)

-- Compiled by KOREY CLARK

Politics and Leadership

Judge Allows Early Counting of Mail-In Ballots in NJ: A federal judge ruled last week that New Jersey election officials can start counting mail-in ballots 10 days before Election Day and accept mail-in ballots without a postmark up to two days after Nov. 3, changes Democrats who control the state’s government made last month to help election officials handle the expected surge in voting by mail due to the coronavirus pandemic.

President Trump’s reelection campaign - which has sought to block efforts to increase voting by mail around the country - and Republicans in the state challenged the election changes on the grounds that they would increase the risk of election results being leaked before all votes had been cast in the state and stretch out Election Day by more than a week.

But U.S. District Judge Michael Shipp ruled that reversing the changes would not be in the “public interest,” potentially causing so much “confusion or distrust” in mail-in voting that more voters end up going to the polls and being exposed to the virus. The judge also indicated that the Republicans had failed to demonstrate the changes would cause them “immediate, irreparable harm.”

Although the case isn’t over, Shipp’s decision increases the chances the new election policies will still be in place on Nov. 3. (NJ.COM)

Appeals Court Upholds IN Mail-In Voting Restrictions: A three-judge panel of the 7th U.S. Circuit Court of Appeals unanimously upheld a lower court ruling saying Indiana’s restrictions on mail-in voting were not unconstitutional, despite the coronavirus pandemic.

The plaintiffs in the case had challenged the state’s restriction on mail-in voting to those 65 years of age or older, arguing it violated the 26th amendment of the U.S. Constitution, which prohibits the denial of voting rights based on age.

Southern District Judge James Patrick Hanlon rejected that contention, ruling that while some states had decided to allow everyone to vote by mail, Indiana had “decided otherwise.”

“The question here, however, is not whether the policy is wise, but whether it is unconstitutional,” he wrote.

The appeals panel saw things much the same way, acknowledging “the difficulties that might accompany in-person voting during this time,” but concluding it was the pandemic and not the state’s absentee voting laws that were “to blame.” (INDIANAPOLIS STAR)

Politics in Brief

‘Unprecedented’ Demand Crashes FL Voter Registration Website: Last Monday, which was supposed to have been the final day for registering to vote in Florida for the Nov. 3 election, the state’s online voter registration system went down for several hours due to an “unprecedented” volume of requests, over 1 million per hour. The state extended the registration deadline by 24 hours, during which an estimated 40,000 additional people registered. Voting rights groups have filed a lawsuit seeking to extend the deadline further. (FLORIDA TIMES-UNION [JACKSONVILLE], TAMPA BAY TIMES)

Judge Extends AZ Voter Registration Deadline: Hours before Arizona’s Oct. 5 deadline for registering to vote, a federal judge extended it until Oct. 23. U.S. District Judge Steven P. Logan cited the impact of the coronavirus pandemic on efforts to register voters in-person. (ARIZONA REPUBLIC)

-- Compiled by KOREY CLARK

Governors

Whitmer Says Trump “Complicit” in MI Kidnap Plot: One of the most contentious election seasons in memory took another harrowing and bizarre turn last week when the FBI announced it had thwarted a plot to kidnap and possibly murder Michigan Gov. Gretchen Whitmer (D).

Federal authorities filed terrorism and conspiracy charges against six of the men, while Michigan charged seven more with providing that group with material support for terrorist activities, being members of a gang and using firearms while committing felonies.

Authorities said the plot targeted the governor’s vacation home, and included plans to use an improvised explosive device (IED) and possibly blowing up a bridge near the home to slow police response.

Whitmer thanked law enforcement for their work, and condemned President Donald Trump for his often-incendiary comments that can easily been seen as offering support to white supremacist and anti-government groups.

Whitmer accused the president of “stoking distrust and fomenting anger,” while “giving comfort to those who spread fear and hatred and division.” She also noted his refusal during the September 29th debate with Democratic presidential nominee Joe Biden to condemn white supremacists, instead calling on a known supremacists group calling itself the Proud Boys to “stand back and stand by.” That, the governor said, was seen by such groups “not as a rebuke, but as a rallying cry,” and “a call to action.”

Biden also took Trump to task, referencing a tweet the president issued earlier this year to “LIBERATE MICHIGAN.” The White House pushed back, accusing Whitmer of being the one who was sowing divisions by making “outlandish allegations” against the president.

Whitmer noted in September there has been “an explosion” of threats made against her and her family this year, predominantly over executive orders she has made to mitigate the impact of the COVID-19 pandemic. The state was already underway on a $1.1 million security upgrade for the state-owned governor’s mansion in Lansing, including a new fence around the perimeter of the property.

Michigan’s is not the only gubernatorial residence undergoing a security upgrade – South Dakota, Kentucky and Georgia are all in the process of installing fencing around their governors’ mansions as well. The new fences in Georgia and South Dakota are being paid for with public money, while the one in Kentucky is being paid for by the Executive Mansions Foundation, Inc., a nonprofit based in Lexington. (DETROIT FREE PRESS, DETROIT NEWS, NEW YORK TIMES, NEW YORK POST, MINNEAPOLIS STAR TRIBUNE, LEXINGTON HERALD-LEADER, WASHINGTON POST)

Newsom Signs Major CA Conservation Order: California Gov. Gavin Newsom (D) issued an executive order last week that directs the state to preserve at least 30 percent of the state’s land and coastal water by 2030 to fight species loss and ecosystem destruction.

Under Executive Order N-82-20, state agencies are also expected to pursue actions that will use the state’s lands and waters to absorb carbon from the atmosphere. Newsom said the state’s actions are part of a larger global effort to combat climate change and to protect 30 percent of the Earth. He added that California is the first state to join 38 countries that have made similar commitments.

Governors in Brief

LA House Moves to Limit Gov’s COVID Orders: The Republican-controlled Louisiana House approved eight separate proposals to restrict or suspend Gov. John Bel Edwards’ (D) executive orders aimed at combating the COVID-19 pandemic. The measures have moved to the Senate, where committees have so far approved two of the eight proposals. (ADVOCATE [BATON ROUGE], CENTER SQUARE)

Cuomo Imposes Sanctions on NYC COVID Hot Spots: Citing a new spike in coronavirus infections, New York Gov. Andrew Cuomo (D) imposed new restrictions on parts of New York City and its northern suburbs. Cuomo’s plan overrides a proposal from Mayor Bill de Blasio that would have shut down schools and non-essential businesses in nine zip codes around the city. (NEW YORK TIMES, ALBANY TIMES-UNION)

SC High Court Blocks Funds to Private Schools: The South Carolina Supreme Court ruled against Gov. Henry McMaster’s (R) plan to use $32 million in federal COVID-19 relief money to pay for one-time tuition grants of up to $6,500 per student for about 5,000 private school K-12 students across the state. The court ruled that such use of funds is unconstitutional. (STATE [CHARLESTON])

Newsom Names First Gay Justice to CA High Court: California Gov. Gavin Newsom (D) nominated Martin Jenkins, a moderate Black former prosecutor and judge, to the state Supreme Court. If confirmed, he would become the first openly gay justice – and the third African-American - to serve on the state’s highest court. (LOS ANGELES TIMES)

-- Compiled by RICH EHISEN

Hot Issues

Business: VERMONT Gov. Phil Scott (R) allows SB 54, a bill that legalizes the retail sale of marijuana in the Green Mountain State. The measure, among several things, authorizes local governments to decide for themselves whether to allow retail sales outlets in their communities (ASSOCIATED PRESS).

Elections: The TEXAS Supreme Court rules that the elections administrator of Harris County, the state’s largest, may not send out applications for mail-in ballots to all 2.4 million of the county’s registered voters (TEXAS TRIBUNE). MICHIGAN Gov. Gretchen Whitmer (D) signs SB 757, which allows clerks in certain Wolverine State cities or townships to begin processing absentee ballots prior to election day and to notify voters of any reason their vote won’t be counted within 48 hours (CRAIN’S DETROIT BUSINESS).

Energy: CONNECTICUT Gov. Ned Lamont (D) signs HB 7006, which among several things transitions utility companies to a performance-based system, gives consumers refunds on their utility charges after 96 hours of outages and limits utility companies’ profits (WFBS [HARTFORD]).

Environment: VERMONT Gov. Phil Scott (R) vetoes HB 926, which would have made significant changes to Act 250, the state’s wide ranging environmental framework that has been in place for more than half a century. Scott supported amending the law, but said the current bill “adds new regulation and new burdens to our recreational trail networks and recreation economy.” Lawmakers will consider an override effort (VERMONT PUBLIC RADIO).

Health Care: VERMONT Gov. Phil Scott (R) signs HB 607, which will provide tuition waivers to medical students who choose to practice primary care in an underserved area of the State; HB 795, which will require the state to develop and maintain a public, interactive, Internet-based price transparency dashboard that allows consumers to compare health care prices for certain health care services across the state; and HB 663, which requires health insurance plans to cover all methods and forms of contraceptives without cost-sharing; requires school districts to make free over-the-counter contraceptives available to all secondary school students; and directs the Department of Health to coordinate with stakeholders to make free over-the-counter contraceptives available in a variety of settings statewide. (STATE NET).

Social Policy: The VIRGINIA Senate and House give final approval to SB 5029 and HB 5058, which together would bar Old Dominion law enforcement from conducting warrantless searches based only on the smell of marijuana. The measures have been sent to Gov. Ralph Northam (D) for consideration (HIGH TIMES). VERMONT Gov. Phil Scott (R) signs SB 124, a bill that enacts a moratorium on the use of facial recognition technology by police until approved by lawmakers and requires the Vermont Criminal Justice Council to craft a statewide policy for the use of body cameras. Scott also allows SB 119 – a bill that lays out specific rules for how and when law enforcement may use deadly force, including chokeholds and other normally prohibited restraints – to become law without his signature (VERMONT DIGGER).

Local Government: The District of Columbia City Council unanimously approves a measure that requires landlords to provide photographic evidence that tenants have been given notice of eviction cases against them (WAMU [AMERICAN UNIVERSITY]).

-- Compiled by RICH EHISEN

 News by the Number

19,816: The number of Amazon employees – out of its 1.3 million workers - who have tested positive for COVID-19 during the pandemic. The company said the infection rate is 42 percent lower than it expected based on “the general population rate” in the United States.

4,200: The number of children in New York who lost a parent or guardian to the coronavirus between March and July. The study by the United Hospital Fund and Boston Consulting Group says the pandemic has placed another 325,000 into or near poverty.

54 percent: The number of Americans who say political ads should not be allowed on social media.

2,100: The number of ballots sent to Los Angeles County residents that contained no provision for voting for president. The ballots instead contained a double printing of the page that contained ballot measures.

4 million: The number of voters who had already cast their ballots by October 6th. That is more than 50 times the 75,000 at this time in 2016, according to the United States Elections Project.  

63.6 million: The number of new unemployment claims filed since mid-March. Overall, 840,000 people filed for unemployment in the week that ended Oct. 2.

$9.4 billion: The decline in revolving consumer debt in August compared to July. Overall revolving consumer debt now stands at its lowest since 2017.

$1 billion: The estimated cost to build the nation’s largest publicly financed internet service in Oregon’s Multnomah County. The county was looking for ways to bridge the digital divide, but conceded the proposal is not economically feasible.

$400 million: The amount Citigroup agreed to pay federal regulators as a penalty for engaging in what the Federal Reserve and the Office of the Comptroller of the Currency called “unsafe and unsound banking practices.” 

865,000: The number of women who dropped out of the U.S. workforce from August to September, more than the 661,000 total jobs the economy added in that time. Around 216,000 men dropped out during that same period.

$240 million: The amount Georgia paid to local governments in September to make up for sales tax revenue the cities and counties were shortchanged between 2015 and 2018. State officials blamed accounting software for the error.

-- Compiled by RICH EHISEN