EDITORS: Steve Robison, lead author of the study, is available for interviews after 11 a.m. today. To set up an interview, call 971-246-9139 or email PHD.Communications@state.or.us.

November 16, 2018

Contact: Jonathan Modie, 971-246-9139, phd.communications@state.or.us

High-dose flu vaccine reducing hospitalizations in seniors, study shows

Researchers examined vaccine with four times antigen level of typical vaccine

PORTLAND, Ore.—High-dose influenza vaccine reduces hospitalization for the virus among Oregon seniors, a new Oregon Health Authority study has found.

The study of more than 144,000 seniors, ages 65 and older, living in the Portland metropolitan area showed that high-dose flu vaccine was 31 percent more effective at preventing senior flu-related hospitalizations than the standard-dose flu vaccine during the 2016-2017 season, according to the study appearing in the scientific journal Vaccine.

A high-dose vaccine contains four times the antigen of a standard flu vaccine. Antigens are the molecular structures on the surfaces of viruses that trigger the body’s immune response. Seniors typically have a weaker immune response to standard influenza vaccines than younger adults, and benefit from vaccines that are high-dose or "adjuvanted" specifically for seniors.

Putting another chemical, an adjuvant, into the vaccine helps create a stronger reaction to the antigen of the vaccine. Seniors should get a vaccine that is intended to boost their immune response.

Steve Robison, epidemiologist in the Oregon Immunization Program, is the lead study author. Co-author is Anne Thomas, M.D., public health physician in the Acute and Communicable Disease Prevention Section. They say protecting vulnerable seniors during flu season each year is a constant challenge.

"Seniors are at greater risk of severe illness from flu," Thomas said. "What’s more, typical flu vaccine doses aren’t adequately protective for many seniors. We wanted to know whether a widely used high-dose flu vaccine would benefit a large population of seniors, particularly in reducing hospitalizations."

For their study, Robison and Thomas focused on seniors who reported receiving a flu vaccine by Dec. 11, 2016, which is roughly four weeks before the typical onset of substantial local flu disease activity. It also ensured that seniors who received the vaccine had enough time to achieve full "seroconversion," which is when flu antibodies develop and become detectable.

The study population consisted of 78,602 seniors who received high-dose flu vaccine and 65,705 seniors who received the standard vaccine dose.

Robison and Thomas found that senior use of high-dose flu vaccine, compared with standard-dose vaccine, was associated with a "substantial reduction in the risk of hospitalization" with laboratory-confirmed influenza.

"The message is: do not give the standard flu vaccine to seniors. Give the high-dose vaccine or adjuvanted vaccine," Robison said. He said that while the adjuvanted vaccine was not addressed in the study, it also is a good alternative to the standard-dose vaccine for seniors.

Robison explained that because adult influenza is not a reportable disease in the United States, only limited data on actual amounts of disease exist. However, due to funding from CDC’s Emerging Infections Program, the OHA’s Acute and Communicable Disease Prevention program tracks influenza hospitalizations in the Portland metro area.

"We are fortunate here in Oregon to have accurate data on flu hospitalizations," Robison said. "Coupled with a strong immunization registry in our state, we have the ability to use our hospitalization and vaccination data to figure out how well vaccines are working. In this case, our study tells us at least one of these vaccines may be working better than we think."

The study is available on the Science Direct website at www.sciencedirect.com/science/article/pii/S0264410X18313197?dgcid=author.

It’s not too late to get a flu shot. Local flu clinics can be found by using the flu vaccine finder tool at http://www.flu.oregon.gov/. The Centers for Disease Control and Prevention also is promoting National Influenza Vaccination Week on its website at https://www.cdc.gov/flu/resource-center/nivw/ to highlight the importance of flu vaccination.

# # #

November 15, 2018

Contact: Jonathan Modie, 971-246-9139, phd.communications@state.or.us (media inquiries)

Marisha Childs, 971-673-0389, isha.childs@dhsoha.state.or.us">marisha.childs@dhsoha.state.or.us (meeting information and accommodation)

Nurse Staffing Advisory Board Acuity Subcommittee meets November 21 in Portland

What: A public meeting of the Nurse Staffing Advisory Board's Acuity Subcommittee.

Agenda: Overview of the acuity cross-walk, subcommittee members’ discussion and questions. The agenda is available on the OHA’s nurse staffing website.

When: November 21, 3-4:30 p.m. No public comment period is offered.

Where: Portland State Office Building Room 368, 800 NE Oregon Street, Portland; or by conference call at 877-336-1829, access code 2075141.

Background: The Nurse Staffing Advisory Board's acuity subcommittee advises the Oregon Health Authority on acuity measuring and how acuity is measured on a nurse staffing survey. Board members serving on the subcommittee will review the acuity cross-walk and advise OHA for future nurse staffing surveys.

For more information, see the OHA nurse staffing website at http://www.healthoregon.org/nursestaffing.

# # #

Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:

• Sign language and spoken language interpreters
• Written materials in other languages
• Braille
• Large print
• Audio and other formats

If you need help or have questions, please contact Marisha Childs at 971-673-0389, 711 TTY or isha.childs@dhsoha.state.or.us">marisha.childs@dhsoha.state.or.us at least 48 hours before the meeting.

November 15, 2018

Contacts: Saerom England, 971-239-6483, om.y.england@dhsoha.state.or.us">saerom.y.england@dhsoha.state.or.us (media inquiries)

Daphne Peck, 503-373-1985, c.info@state.or.us">herc.info@state.or.us (meeting information or accommodation)

Chronic Pain Task Force meets December 5 in Lake Oswego

What: A public meeting of the Health Evidence Review Commission's Chronic Pain Task Force

When: December 5, 9 a.m. to noon

Where: Crowne Plaza hotel, Plaza 2 & 3, 14811 Kruse Oaks Drive, Lake Oswego. The public also may attend via a listen-only conference line by calling 888-204-5984, participant code 801373.

Agenda includes: Review opioid tapering evidence evaluation by Oregon Health & Science University’s Center for Evidence-based Policy; review results of CCO survey of implementation of previous back and neck pain coverage changes and implementation of other potential coverage changes related to chronic pain; review and discuss potential alternatives to task force proposal; public comment will be accepted for 30 minutes starting at about 11 a.m.

For more information about the meeting, visit the committee’s website at https://www.oregon.gov/oha/HPA/DSI-HERC/Pages/Meetings-Public.aspx. The meeting agenda and materials will be available one week before the meeting.

# # #

Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:

• Sign language and spoken language interpreters
• Written materials in other languages
• Braille
• Large print
• Audio and other formats

If you need help or have questions, please contact Daphne Peck at 503-373-1985, 711 TTY or c.info@state.or.us">herc.info@state.or.us at least 48 hours before the event. Written comments are also welcome at C.info@state.or.us">herc.info@state.or.us.

November 15, 2018

Contact: Jonathan Modie, 971-246-9139, phd.communications@state.or.us

OHA reminds public to practice safe food handling with parody ‘Salmonella’ Twitter account

Oregonians encouraged to keep food safety in mind this holiday season

Nothing ruins a holiday gathering quite like an unwelcome guest, particularly when that guest is a bout of food poisoning.

That’s what the Oregon Health Authority hopes to help Oregonians avoid this holiday season by sharing prevention messages through Salmonella, a parody Twitter account personifying the salmonella bacteria.

Through his tongue-in-cheek tweets, Salmonella (inadvertently) highlights ways Oregon cooks can make their kitchens less welcoming to the illness-causing contaminant.

In his messages, Salmonella enthusiastically tells people that using the same cutting board for both raw meats and vegetables is a great way to invite him to dinner; cooking stuffing inside the turkey appeals to his sense of living dangerously; and not to believe the nay-sayers—eating raw cookie dough really is a great way to get sick.

"We want people to know salmonella can have serious consequences for your health," said Emilio DeBess, DVM, state public health veterinarian and an Oregon Health Authority salmonella expert. "But you can keep it off your menu by taking simple steps as you prepare your food."

Each year 400 to 500 cases of salmonella are reported in Oregon. The Centers for Disease Control and Prevention estimates salmonella causes 1.2 million illnesses, 23,000 hospitalizations and 450 deaths in the United States each year.

OHA offers the following tips for preventing food poisoning at home:

• Wash hands and surfaces often.
• Don’t cross-contaminate.
• Cook foods to the proper internal temperature.
• Refrigerate foods promptly.

Although cases of salmonella are most common during the summer months, food is often a central part of holiday preparations, making Thanksgiving and the winter holidays a good time to raise the subject.

Children, older adults, people with weakened immune systems and pregnant women are especially vulnerable to foodborne illnesses and should take extra precautions to practice safe food handling.

Popular social media platforms handle billions of messages each day and are effective ways for people to share information. Robb Cowie, OHA communications director, said the Salmonella social media campaign offers a new way of getting attention for an important public health issue.

"If health experts always deliver food safety messages in the same way, we run the risk that people will tune them out," Cowie said. "Social media can help spread the word, but it means we have to take a different approach. Our intent with Salmonella’s light-hearted tone is to reach more Oregonians and warn them: Don’t take Salmonella lightly. He can ruin your holiday—or worse."

Through the campaign, the Salmonella parody account will respond to Oregon-based audiences posting on social media about preparing or consuming food and deliver a timely food safety message. In its first 72 hours, Salmonella has reached nearly 50,000 Oregonians.

Using social media to deliver public health messages is an emerging health communications practice and similar campaigns have shown positive results. In its "Melanoma Likes Me" campaign, Melanoma Patients Australia created a Twitter persona for Melanoma to reach young Australians, the group most at risk for the lethal cancer. Over the summer of 2014-2015 the campaign reached 2 million people and helped generate a 1,371-percent increase in unique visits to the Skincheck mobile site, a site that helped users check their moles and marks for signs of cancer.

Oregonians can follow Salmonella at @SalmonellaOR.

For more information on safe food handling practices, visit the Oregon Health Authority website at https://www.oregon.gov/oha/ph/HEALTHYENVIRONMENTS/FOODSAFETY/Pages/tips.aspx.

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November 13, 2018

Contact: Danna Drum, 971-673-1223, um@state.or.us">danna.k.drum@state.or.us (meeting information or accommodation)

Conference of Local Health Officials meets November 15 in Eugene

What: The annual public meeting of the Conference of Local Health Officials (CLHO)

Agenda: Committee appointments; update on the Environmental Public Health Modernization Plan; Tobacco Reduction Advisory Committee recruitment; update on Tobacco Prevention and Education Program funding work group; presentation on Family Connects home visiting program; 2020-24 State Health Improvement Plan engagement update.

Agenda is subject to change. The meeting agenda and related materials will be posted on the CLHO website at http://www.oregonclho.org/about/clho-meetings/ before the meeting date.

When: Thursday, November 15, 9:30-11 a.m. The meeting is open to the public. No conference call option is available for the public.

Where: Lane County Health & Human Services (Charnelton) Building, Room 530, 151 W. Seventh Ave., Eugene

The Conference of Local Health Officials provides recommendations to the Oregon Health Authority on foundational capabilities, programs and any other public health program or activity under ORS 431.147 (ORS 431.340).

# # #

Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:

• Sign language and spoken language interpreters
• Written materials in other languages
• Braille
• Large print
• Audio and other formats

If you need help or have questions, please contact Danna Drum at 971-673-1223, 711 TTY or um@state.or.us">danna.k.drum@state.or.us at least 48 hours before the meeting.

http://bit.ly/2B3p0jz

November 8, 2018

Contacts: Janet Zeyen-Hall, 503-945-6938, janet.l.zeyen-hall@dhsoha.state.or.us (meeting information or accommodation)

OHA to hold technical forum on CCO 2.0 rates, risk adjustment, member enrollment

As the Oregon Health Authority (OHA) works to develop contracts for the next five years of the Oregon Health Plan (OHP) and coordinated care, the agency is seeking public comment on member enrollment, the risk adjustment process, and rate setting methodology.

OHA is using a request for application or RFA process to award coordinated care organization (CCO) contracts for 2020-2024. In an RFA, all qualified candidates are awarded a contract, meaning there is not a target number of coordinated care organizations (CCOs) the state is aiming to contract with. Because OHA has not set a target number of CCOs, members may find multiple CCOs serving their area where previously only one was available. Similarly, members currently enrolled in a CCO may find that their CCO has not applied for or been awarded a contract during the 2020 cycle.

Potential changes in CCO membership affect capitation rates paid to CCOs (which is the amount paid to CCOs per member per month), and potentially the CCO’s risk profile. The risk profile changes may result in a CCO having a different mix of members with different diseases, which would result in higher needs or lower needs depending on the changes.

The combination of an unknown number of CCOs and the potential for shifts in membership between CCOs means that OHA must develop an approach for member enrollment and rate development that takes these scenarios into consideration.

Values guiding OHA’s decision-making include: maintaining continuity of care for OHP members, allowing member choice, equitable opportunity for procurement, and CCO financial viability.

Member enrollment

OHA will discuss why an enrollment policy is needed for CCO 2.0 and the factors affecting member enrollment and will seek public comment on the approach currently under consideration to address multiple procurement scenarios.

This approach includes offering open enrollment in areas of the state where there is a change in CCO availability and adjusting the auto-assignment process for members who do not select a plan when multiple plans exist in their service area.

Risk adjustment and rate setting

OHA will seek public comment on how to set capitation rates used to build global budgets for the new contracts that meet actuarial requirements and achieve the goal of a sustainable rate of growth. OHA will share draft rate methodology adjustments to the current rate development process.

OHA also will share how it aims to apply health-based risk adjustment to the CCO capitation rates in a fair manner when shifts in membership occur. The approach currently under consideration is a risk corridor option. A risk corridor protects the CCO and OHA from over- and under-paying for services when membership changes.

What: OHA public meeting to seek public comment on member enrollment approaches, rates and risk adjustment for the 2020-2024 CCO contracts

When: Monday, November 19, 8-11 a.m.

Where: Department of Consumer and Business Services meeting room 260, Labor and Industries Building, 350 Winter St NE, Salem

The public can also join remotely through a telephone conference line at 888-251-2909, participant code 2450162; or by joining a live-stream of the meeting at https://join-noam.broadcast.skype.com/dhsoha.state.or.us/e9ace54942c648c083e7e2324a96ecc3/en-US/.

Public comment: Public comment will be taken at specified times during the meeting. Those unable to attend the meeting can submit public comment to OHA at CCO2.0@dhsoha.state.or.us until November 28.

Agenda:

• 8-9 a.m.: Welcome; presentation of member enrollment approach; public comment.
• 9-11 a.m.: Presentation of rate and risk adjustment approaches; public comment; adjourn.

OHA will post supplemental materials for the meeting on November 14 on the CCO 2.0 page on the OHA website.

# # #

Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:

• Sign language and spoken language interpreters
• Written materials in other languages
• Braille
• Large print
• Audio and other formats

If you need help or have questions, please contact Janet Zeyen-Hall at 503-945-6938, 711 TTY, janet.l.zeyen-hall@dhsoha.state.or.us, at least 48 hours before the meeting.

http://bit.ly/2JQ2dui

November 8, 2018

Contact: Allyson Hagen, 503-449-6457, allyson.hagen@state.or.us (media inquiries)

Pete Edlund, 503-931-8873, .m.edlund@dhsoha.state.or.us">peter.m.edlund@dhsoha.state.or.us (meeting information or accommodation)

CCO Metrics Technical Advisory Workgroup meets November 15

What: The regular public meeting of the Oregon Health Authority’s CCO Metrics Technical Advisory Workgroup

When: Thursday, November 15, 1-3 p.m.

Where: Five Oak (formerly Lincoln Building), Suite 850 Mary Conference Room, 421 SW Oak St., Portland. Attendees can also join remotely through a webinar at https://attendee.gotowebinar.com/register/8490046551954092803. Conference line: 888-398-2342, participant code 5731389.

Agenda: Welcome and introductions; updates; extended eCQM/CQMR update; review smoking cessation survey; TAG input on oral health measures; Metrics & Scoring Committee workplan – where TAG can impact; adjourn.

For more information, please visit the committee's website at http://www.oregon.gov/OHA/HPA/ANALYTICS/Pages/Metrics-Technical-Advisory-Group.aspx.

# # #

Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:

• Sign language and spoken language interpreters
• Written materials in other languages
• Braille
• Large print
• Audio and other formats

If you need help or have questions, please contact Pete Edlund at 503-931-8873, 711 TTY, .m.edlund@dhsoha.state.or.us">peter.m.edlund@dhsoha.state.or.us, at least 48 hours before the meeting.

November 8, 2018

Media contact: Delia Hernández, 503-422-7179, phd.communications@state.or.us

Health advisory for water contact at Sunset Bay State Park Beach lifted November 8

Testing shows fecal bacteria levels have subsided

The Oregon Health Authority (OHA) today lifted a public health advisory for contact with marine water at Sunset Bay State Park Beach located in Coos County. The health authority issued the advisory November 7, after water samples showed higher-than-normal levels of fecal bacteria in ocean waters.

Results from later samples taken by the Oregon Department of Environmental Quality (DEQ) showed lower bacteria levels. Contact with the water no longer poses a higher-than-normal risk. However, officials recommend staying out of large pools on the beach that are frequented by birds, and runoff from those pools, because the water may contain increased bacteria from fecal matter.

State officials continue to encourage other recreational activities at all Oregon beaches, suggesting only that water contact be avoided when advisories are in effect.

Since 2003 state officials have used a U.S. Environmental Protection Agency grant to monitor popular Oregon beaches and make timely reports to the public about elevated levels of fecal bacteria. Oregon state agencies participating in this program are OHA, DEQ and the Oregon Parks and Recreation Department.

For more information, visit the Oregon Beach Monitoring Program website at http://www.healthoregon.org/beach or call 971-673-0440, or call the OHA toll-free information line at 877-290-6767.

# # #

November 7, 2018

Media contact: Delia Hernández, Oregon Health Authority, 503-422-7179, phd.communications@state.or.us

Health advisory issued November 7 for water contact at Sunset Bay State Park Beach

The Oregon Health Authority issued a public health advisory today for higher-than-normal levels of bacteria in ocean waters at Sunset Bay State Park Beach, located in Coos County.

Water samples indicate higher-than-normal levels of fecal bacteria, which can cause diarrhea, stomach cramps, skin rashes, upper respiratory infections and other illnesses. People should avoid direct contact with the water in this area until the advisory is lifted. This applies especially to children and the elderly, who may be more vulnerable to waterborne bacteria.

Increased pathogen and fecal bacteria levels in ocean waters can come from both shore and inland sources such as stormwater runoff, sewer overflows, failing septic systems, and animal waste from livestock, pets and wildlife.

While this advisory is in effect at Sunset Bay State Park Beach, visitors should avoid wading in nearby creeks, pools of water on the beach, or in discolored water, and stay clear of water runoff flowing into the ocean. Even if there is no advisory in effect, officials recommend avoiding swimming in the ocean within 48 hours after a rainstorm.

Although state officials advise against water contact, they continue to encourage other recreational activities (flying kites, picnicking, playing on the beach, walking, etc.) on this beach because they pose no health risk even during an advisory. Neighboring beaches are not affected by this advisory.

The status of water contact advisories at beaches is subject to change. For the most recent information on advisories, visit the Oregon Beach Monitoring Program website at http://www.healthoregon.org/beach or call 971-673-0440, or 877-290-6767 (toll-free).

Since 2003 state officials have used a U.S. Environmental Protection Agency grant to monitor popular Oregon beaches and make timely reports to the public about elevated levels of fecal bacteria. Oregon state organizations participating in this program are the Oregon Health Authority, Department of Environmental Quality, and Parks and Recreation Department.

# # #

November 6, 2018

Contact: Jonathan Modie, 971-246-9139, PHD.Communications@state.or.us

Public Health Advisory Board meets November 15 in Portland

What: The regular public meeting of the Public Health Advisory Board

Agenda: Review PHAB membership, leadership; review PHAB committee membership; hear updates on state health improvement planning; implementation of public health modernization by local public health authorities; legislative issues; review Oregon’s public health response to opioids.

When: Thursday, November 15, 2-5 p.m. A public comment period will be held at the end of the meeting.

Where: Portland State Office Building, Conference Room 1B, 800 NE Oregon St., Portland. The meeting is also available remotely by webinar at https://register.gotowebinar.com/rt/4888122320415752707, or by telephone at 877-873-8017, access code 767068#.

Oregon’s Public Health Advisory Board provides guidance for Oregon’s governmental public health system and oversees the implementation of public health modernization and Oregon’s State Health Improvement Plan.

# # #

Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:

• Sign language and spoken language interpreters
• Written materials in other languages
• Braille
• Large print
• Audio and other formats

If you need help or have questions, please contact Kati Moseley at 971-673-2284, 711 TTY or ina.moseley@state.or.us">katarina.moseley@state.or.us at least 48 hours before the meeting.

November 6, 2018

Media contact: Allyson Hagen, 503-449-6457, allyson.hagen@state.or.us

HERC Health Technology Assessment Subcommittee meets November 15 in Wilsonville

What: A public meeting of the Health Evidence Review Commission’s Health Technology Assessment Subcommittee

When: November 15, 1-4 p.m.

Where: Clackamas Community College Wilsonville Training Center, Rooms 111-112, 29353 SW Town Center Loop E, Wilsonville. The public also may attend via a webinar at https://attendee.gotowebinar.com/rt/66781424960174850, or by a listen-only conference line at 1-888-204-5984, participant code 801373.

Agenda includes: Review of public comments on newer interventional procedures for GERD; extended stay centers: Patient characteristics and appropriate procedures -- the initial evidence review will discuss specific types of surgeries including total knee replacement, mastectomy, transurethral resection of the prostate (TURP), hysterectomy, and bariatric surgery (laparoscopic banding, sleeve gastrectomy). For the extended stay center topic no final conclusions will be drawn about these procedures as the subcommittee plans further discussion in February.

For more information about the meeting, visit the committee’s website at https://www.oregon.gov/oha/HPA/DSI-HERC/Pages/Meetings-Public.aspx. The meeting agenda and materials will be available one week before the meeting. 

# # #

Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:

•         Sign language and spoken language interpreters

•         Written materials in other languages

•         Braille

•         Large print

•         Audio and other formats

If you need help or have questions, please contact Daphne Peck at 503-373-1985, 711 TTY or c.info@state.or.us">herc.info@state.or.us at least 48 hours before the event. Written comments are also welcome at C.info@state.or.us">herc.info@state.or.us.

November 1, 2018

Contact: Allyson Hagen, 503-449-6457, allyson.hagen@dhsoha.state.or.us

(media inquiries)

Jon McElfresh, 503-385-3075, esh@dhsoha.state.or.us">jonathan.p.mcelfresh@dhsoha.state.or.us (meeting information or accommodation)

Health Care Workforce Committee meets November 7 in Wilsonville

What: A public meeting of the Health Care Workforce Committee.

When: Wednesday, November 7, 9:30 a.m. to 12:30 p.m. A 15-minute public testimony period will begin at 12:15 p.m.

Where: Clackamas Community College Wilsonville Training Center, Room 111/112, 29353 SW Town Center Loop E, Wilsonville

The public can also follow the presentation by webinar and listen to the meeting by telephone. Register for the webinar at https://attendee.gotowebinar.com/register/991476200528257795 or call the conference line at 877-411-9748, access code 730407. Phone will be muted during public testimony.

Agenda: Introductions; approval of September meeting summary; discussion of bylaw changes for new members, OHPB and OHA updates, update on 2019 Health Care Workforce Profile, update on Health Care Workforce Needs Assessment, Update on Health Care Provider Incentive Fund recommendation protocol, recommendations on improving strategies to increase the health care workforce, discussion of potential priorities for 2019-2021, discussion of election of HCWF chair and vice-chair for 2019, public comment, and adjourn.

For more information, please visit the committee’s website at http://www.oregon.gov/oha/HPA/HP-HCW/Pages/Meetings.aspx.

# # #

Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:

• Sign language and spoken language interpreters
• Written materials in other languages
• Braille
• Large print
• Audio and other formats

If you need help or have questions, please contact Jon McElfresh at 503-385-3075, 711 TTY, esh@dhsoha.state.or.us">jonathan.p.mcelfresh@dhsoha.state.or.us, at least 48 hours before the meeting.

# # #

November 1, 2018

Contact: Allyson Hagen, 503-449-6457, allyson.hagen@state.or.us (media inquiries)

Jennifer Uhlman, 503-739-5267, .m.uhlman@dhsoha.state.or.us">jennifer.m.uhlman@dhsoha.state.or.us (meeting information or accommodation)

Health Aspects of Kindergarten Readiness Technical Workgroup meets November 5

What: A public meeting of the Oregon Health Authority’s Health Aspects of Kindergarten Readiness Technical Workgroup

When: Monday, Nov. 5, 10 a.m. to 1 p.m. Public comments will be taken at about 10:10 a.m.

Where: Clackamas Community College Wilsonville Training Center, Room 111, 29353 SW Town Center Loop E., Wilsonville. Attendees can also join remotely by webinar at https://register.gotowebinar.com/register/8436454157336541697 and telephone conference line at 877-810-9415, participant code 1773452.

Agenda: Welcome, introductions; public comment; affirm components of recommendation to Metrics and Scoring Committee; finalize measurement strategy proposal; next steps: final report and presentation to Metrics and Scoring Committee; summary and reflections.

For more information, please visit the committee's website at https://www.oregon.gov/oha/HPA/ANALYTICS/Pages/KR-Health.aspx.

# # #

Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:

• Sign language and spoken language interpreters
• Written materials in other languages
• Braille
• Large print
• Audio and other formats

If you need help or have questions, please contact Jennifer Uhlman at 503-739-5267, 711 TTY, .m.uhlman@dhsoha.state.or.us">jennifer.m.uhlman@dhsoha.state.or.us, at least 48 hours before the meeting.

November 1, 2018

OHA recommends CMS lift termination track after Unity Center fixes deficiencies

Legacy Emanuel, Unity’s parent, was set to lose certification

PORTLAND, Ore.--The Centers for Medicare & Medicaid Services is making a final determination regarding the federal agency’s certification of Unity Center for Behavioral Health in Portland, after the psychiatric hospital fixed deficiencies found during Oregon Health Authority investigations into safety issues.

The recommendation to lift the CMS "termination track" set to expire at the end of day Oct. 31 means Unity can continue receiving federal reimbursement for services provided to Oregon Health Plan clients until CMS issues its final decision. The determination will consider recommendations from the OHA Public Health Division Health Facility Licensing and Certification Program. The program’s surveyors inspect CMS-certified health facilities on behalf of the federal agency to ensure compliance with CMS’s Conditions of Participation.

"In recommending that the termination be rescinded, OHA surveyors informed CMS that Unity has sufficiently implemented an acceptable Plan of Correction that will allow it to meet CMS Conditions of Participation," said Dana Selover, M.D., manager of OHA’s Health Care Regulation and Quality Improvement Section, which administers the Health Facility Licensing and Certification Program. "The Plan of Correction has additional steps that the facility will use moving forward to ensure that patients will receive a level of care that meets state and federal standards."

A termination track is a period in which a health facility must correct deficiencies before CMS terminates the facility’s certification, effectively ending Medicare and Medicaid reimbursement for services.

In late August CMS had extended its termination track for Unity from Sept. 11 to Oct. 31 after the hospital implemented a plan to end an "immediate jeopardy" designation that had been placed on it in July. CMS concluded at the time that it would be difficult for the hospital to make necessary corrections by Sept. 11, but Unity was making progress and CMS wanted to provide additional time to develop and implement those corrections.

Unity was placed on the termination track in mid-May after OHA surveyors, on a site visit as part of a complaint investigation, found that an "immediate jeopardy" situation existed and that the facility was out of compliance with several conditions of participation. This determination followed observations, interviews with staff members and reviews of records that uncovered numerous hazards in the physical environment, and lack of patient supervision and clear protocols for response to medical emergencies. Hazards found during the survey reflected actual harm to patients, patient attempts at self-harm and suicide attempts.

The immediate jeopardy classification was removed several days later, after Unity submitted an abatement plan. However, in late July during another Unity site visit, OHA surveyors determined a second immediate jeopardy situation existed after finding continued hazards in the physical environment, continued lack of assessment and observation of patients at risk of harm. Surveyors remained at the hospital until an acceptable, written immediate jeopardy abatement plan was developed and implemented.

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http://bit.ly/2yGi4aA

October 31, 2018

Contact: Allyson Hagen, 503-449-6457, allyson.hagen@state.or.us

Oregon Health Policy Board meets November 6 in Portland

What: The monthly meeting of the Oregon Health Policy Board

When: November 6, 8:30 a.m. to noon

Where: OHSU Center for Health & Healing, third floor Rm. 4, 3303 SW Bond Ave, Portland

Members of the public can call in to listen by dialing 888-808-6929, participant code 915042#.

Agenda: welcome; minutes approval; public testimony; OHPB liaison updates, CCO 2.0 potential legislative concepts review, Healthcare Workforce Committee membership possible vote, health care provider incentive program update, HOWTO Grant Program briefing, health care workforce needs assessment discussion

For more information on the meeting, visit the board’s meeting page.

# # #

Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:

• Sign language and spoken language interpreters
• Written materials in other languages
• Braille
• Large print
• Audio and other formats

If you need help or have questions, please contact Jeff Scroggin at 541-999-6983, 711 TTY, ey.scroggin@dhsoha.state.or.us">jeffrey.scroggin@dhsoha.state.or.us, at least 48 hours before the meeting.

FOR IMMEDIATE RELEASE

Contact: Robb Cowie, Oregon Health Authority, 503-421-7684, obb.cowie@state.or.us">robb.cowie@state.or.us

Oregon kicks off data-driven review of state’s criminal justice, behavioral health systems

SALEM, Ore.--The state of Oregon began work today on a data-driven approach to address challenges in how the state responds to people in the criminal justice system who have mental illnesses and substance addictions.

Oregon’s Behavioral Health Justice Reinvestment Steering Committee met to officially launch the state’s participation in the federally funded Justice Reinvestment Initiative. The committee will focus on developing a statewide policy framework to support local governments in improving recidivism and health outcomes for people who repeatedly cycle through both the public safety and health systems.

The Council of State Governments (CSG) Justice Center, a national nonprofit organization, will assist Oregon in this effort with funding from the U.S. Department of Justice’s Bureau of Justice Assistance and The Pew Charitable Trusts.

"We know that when we make meaningful change in behavioral health treatment and addiction recovery, we lift a burden off of our prisons, our hospitals, and our law enforcement," said Governor Kate Brown, who served as CSG’s national president in 2017. "Oregon successfully used justice reinvestment to slow prison growth and expand programs that help people succeed outside of prison. By focusing on the intersection of the behavioral health and criminal justice systems in this new model of reinvestment, we can continue to improve both health and public safety."

During the meeting CSG Justice Center staff presented analyses highlighting how a small number of people can account for a large percentage of annual jail admissions. For example, Clackamas County has a population of just over 400,000 residents. In 2017, 6 percent of people booked into the county jail accounted for almost 20 percent of all booking events. The analysis showed that this group of 569 people, who cycled in and out of the jail throughout the year as many as four to 15 times, accounted for 2,848 separate admissions.

"The criminal justice system was designed to prevent, protect against and prosecute criminal offenses. It was not designed to treat mental illness or substance addiction," said Oregon Health Authority Director Patrick Allen, who serves as co-chair of the Behavioral Health Justice Reinvestment Steering Committee. "The best way to support people with behavioral health needs is to connect them to treatment in their local communities. The Justice Reinvestment process will allow us to develop solutions that better promote individual recovery while preserving community safety."

The criminal justice information presented by the CSG Justice Center staff will be matched with Medicaid and Oregon State Hospital data by the Oregon Health Authority and Oregon’s Integrated Client Services. The goal is to quantify the population of people who have frequent contact with Oregon’s criminal justice system and determine this population’s complex health care needs, what types of services they are currently receiving, and the related impacts and costs on the criminal justice and health systems.

"Law enforcement officers often face tense interaction with people with behavioral health problems. Too often, these people end up in our jails and emergency rooms," said Senate President Peter Courtney. "Adjusting how we use our resources can get them the help they need. We can end the cycle and change lives."

"Studies have shown that a small percentage of people make up a disproportionate share of the costs to these systems," said Senate Republican Leader Jackie Winters, who is a member of the Behavioral Health Justice Reinvestment Steering Committee. "By identifying this population of people, we can develop proactive strategies to improve results and their quality of life at a lower cost."

In July Governor Brown, former Supreme Court Chief Justice Thomas Balmer, Senate President Courtney, Senate Republican Leader Winters, House Speaker Tina Kotek, House Minority Whip Duane Stark, Oregon Health Authority director Allen, Oregon Department of Corrections director Colette Peters and Oregon Association of Counties president, Polk County Commissioner Craig Pope, formally requested support from the U.S. Department of Justice’s Bureau of Justice Assistance and The Pew Charitable Trusts to use a behavioral health Justice Reinvestment approach to address challenges in the state’s criminal justice and behavioral health systems.

"Nearly every day members of law enforcement come into contact with people who are struggling with mental illnesses or substance addiction," said Marion County Sheriff Jason Myers, co-chair of the Behavioral Health Justice Reinvestment Steering Committee. "Our officers have received training to help them recognize who needs treatment, but we also need to have appropriate community-based services available to help when someone is in crisis. A statewide behavioral health strategy for people in the criminal justice system will help officers better respond to the needs of their communities and keep Oregon’s citizens safe."

More than 30 states have successfully used the Justice Reinvestment approach to date, with each state tailoring the process to help address particularly challenging issues within their criminal justice systems. Policy packages that states pass have often had significant impacts on controlling criminal justice spending, averting growth in prison populations and increasing public safety. While improving access to and the quality of community-based behavioral health treatment are often critical pieces of these Justice Reinvestment approaches, Oregon is the first state to focus its Justice Reinvestment efforts entirely on the intersection of the criminal justice and behavioral health systems.

"People battling mental illnesses and substance addiction need resources and opportunities to succeed," said Rep. Mitch Greenlick, chair of the House Committee on Health Care and a member of the Behavioral Health Justice Reinvestment Steering Committee. "This project will also help identify barriers to housing, transportation and employment for people at the intersection of the criminal justice and behavioral health systems."

Local perspectives will be critical to properly defining the challenges that Oregon’s project will address. Committee members will work to ensure that the statewide strategies ultimately identified are designed to improve client outcomes and reduce costs at the local level.

A strength of this project is its level of engagement with county and tribal government officials. The CSG Justice Center team has already traveled to 27 counties and three tribal nations to meet directly with local officials, including sheriffs, district attorneys, community corrections officers and behavioral health treatment providers.

The CSG Justice Center will assist throughout this process by collecting and analyzing data and supporting the steering committee in developing appropriate policy options to improve health outcomes and reduce recidivism. CSG Justice Center staff will collect input from stakeholders in the behavioral health and criminal justice systems throughout the state to inform the process and identify solutions.

"Oregon’s behavioral health treatment practitioners have strong capacity, but services are not equally accessible to all, especially in rural and remote areas," said House Minority Whip Stark, who will serve on the Behavioral Health Justice Reinvestment Steering Committee. "The behavioral health Justice Reinvestment approach will help us identify and understand the gaps in access to treatment and programming services."

The Behavioral Health Justice Reinvestment Steering Committee will present a series of policy proposals to the Oregon Legislature during its 2019 session. In addition to Allen, Myers, Greenlick, Stark and Winters, members of the steering committee include: Kevin Barton, Washington County District Attorney; Suzanne Chanti, Lane County Circuit Court Judge; Julia Delgado, director of programs, Urban League of Portland; Jim Doherty, Morrow County Commissioner; Andi Easton, vice president of government affairs, Oregon Association of Hospitals and Health Systems; Lee Eby, Clackamas County Jail Captain; Janie Gullickson, executive director, Mental Health Association of Oregon; Eric Guyer, director, Jackson County Community Justice; Claire Hall, Lincoln County Commissioner; Silas Halloran-Steiner, director, Yamhill County Health and Human Services; Sandra Hernández Lomelí, Youth Programs director, Latinos Unidos Siempre (L.U.S.) youth organization; Bob Joondeph, executive director, Disability Rights Oregon; Cheryle Kennedy, chairwoman, The Confederated Tribes of Grand Ronde; Allison Knight, Lane County public defender; Belinda "Linda" Maddy, Department of Public Safety Standards and Training crisis intervention training coordinator, Crisis Intervention Teams Center for Excellence; Angel Prater, executive director, FolkTime; Steve Sanden, executive director, Bay Area First Step; Paul Solomon, executive director, Sponsors, Inc.; Abbey Stamp, executive director, Multnomah County Local Public Safety Coordinating Council; Elizabeth Steiner Hayward, State Senator, District 17; Heidi Steward, assistant director, offender management and rehabilitation, Oregon Department of Corrections; Nan Waller, Multnomah County Mental Health Court Judge; and Shannon Wight, deputy director, Partnership for Safety and Justice.

"The justice system is on the frontlines of the problems we face as a society, and every day too many people end up before us as a result of mental illnesses or substance addiction," said Supreme Court Chief Justice Martha Walters. "If we’re going to truly make a difference in the lives of people who struggle with these issues, we must develop common priorities and coordinated approaches. This new committee will help facilitate discussion between complex systems that aren’t used to engaging with each other on a regular basis."

Conversations about enhanced coordination between Oregon’s behavioral health and criminal justice systems initially began in May, when the Oregon Criminal Justice Commission and Oregon Alcohol and Drug Policy Commission hosted a statewide public safety forum facilitated by the CSG Justice Center. Participants discussed how to increase access to and the effectiveness of behavioral health treatment in localities across the state and how to improve information and data sharing across behavioral health and criminal justice agencies.

The CSG Justice Center serves policymakers at the local, state and federal levels from all branches of government. It provides practical, nonpartisan advice and evidence-based, consensus-driven strategies to increase public safety and strengthen communities. For more information, visit the CSG Justice Center website at http://www.csgjusticecenter.org/.

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October 30, 2018

Tri-County Regional Behavioral Health Collaborative meets November 6 in Portland

What: The kickoff meeting of the Tri-County Regional Behavioral Health Collaborative

Agenda: Describe the Regional Behavioral Health Collaborative and its focus on peer-delivered services and substance use disorder; discuss the current state of peer-delivered services and substance use disorder, and attributes of the desired peer delivery system; discuss challenges, opportunities and resources for specific focus areas: medical, public safety, communities of color, children, youth, families, and rural communities

When: November 6, 1-4 p.m. The meeting is open to the public. A public comment period will be held at the end of the meeting.

Where: Mercy Corps Action Center, 45 SW Ankeny St., Portland

The Tri-County Regional Behavioral Health Collaborative brings together multiple sectors across the Portland metro area to collectively address and prevent behavioral health challenges with a focus on peer-delivered services and substance use disorder activities that can make an impact in 12 to 24 months.

For more information, see the RBHC website at https://www.oregon.gov/OHA/HSD/BHP/Pages/Regional-Collaboratives.aspx.

# # #

Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:

•         Sign language and spoken language interpreters

•         Written materials in other languages

•         Braille

•         Large print

•         Audio and other formats

If you need help or have questions, please contact Summer Boslaugh at 503-753-9688, 711 TTY or email .h.boslaugh@dhsoha.state.or.us">summer.h.boslaugh@dhsoha.state.or.us at least 48 hours before the meeting.

http://bit.ly/2CSKReP

Oct. 30, 2018

Oregon to launch data-driven review of state’s criminal justice, behavioral health systems

SALEM, Ore.--State leaders from all three branches of government will hold a press conference Wednesday, Oct. 31, at 12:30 p.m., to announce a new project to help address challenges in how the state responds to people in the criminal justice system who have mental illnesses and substance addictions.

Following the press conference, Oregon’s Behavioral Health Justice Reinvestment Steering Committee will hold its first meeting at the State Capitol, Hearing Room C, 900 Court Street NE, Salem, from 1 to 4 p.m. This meeting will officially launch the state’s participation in the federally funded Justice Reinvestment Initiative.

During the meeting, the Council of State Governments Justice Center staff will present analyses highlighting how a small number of people can account for a large percentage of annual jail admissions. For example, Clackamas County has a population of just over 400,000 residents. In 2017, 6 percent of people booked into the county jail accounted for almost 20 percent of all booking events. The analysis showed that this group of 569 people, who cycled in and out of the jail throughout the year as many as four to 15 times, accounted for 2,848 separate admissions.

The criminal justice information presented by the CSG Justice Center staff will be matched with Medicaid and Oregon State Hospital data by the Oregon Health Authority and Oregon’s Integrated Client Services.

Oregon is the first state to focus its Justice Reinvestment efforts entirely on the intersection of the criminal justice and behavioral health systems.

What: Press conference on Oregon’s Behavioral Health Justice Reinvestment Project

Who: Oregon Health Authority Director Patrick Allen

Senate President Peter Courtney

House Health Care Committee Chairman Mitch Greenlick

Marion County Sheriff Jason Myers

Supreme Court Chief Justice Martha Walters

Senate Republican Leader Jackie Winters

Where: State Capitol Press Room, 900 Court Street NE, Salem

When: Wednesday, Oct. 31, 12:30 p.m.

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http://bit.ly/2OY4gSZ

Correcting location on SE Harney Drive

October 29, 2018

Media contact: Jonathan Modie, OHA, 971-246-9139, phd.communications@state.or.us

Metals in air near Precision Castparts not likely to harm health, report says

OHA public health assessment also finds low risk from compounds in soil, water

PORTLAND, Ore.--Measured concentrations of metals and other chemicals in air, soil and water near Precision Castparts Corp. in southeast Portland are not likely to harm health, according to an Oregon Health Authority public health assessment.

The findings, released today by the Environmental Health Assessment Program at the OHA Public Health Division, reflect conditions since 2016, since they are based on environmental samples collected in 2016 and 2017.

The public health assessment found that levels of metals including arsenic, cadmium, chromium, and nickel detected near the metal components manufacturer’s Southeast Harney Drive facility were below levels that would be expected to harm public health.

However, the report found that a quantifiable evaluation of potential health effects from previous exposures to the metals and other chemicals was not possible due to a lack of historical sampling data from before 2016. Other limitations the report cited were uncertainties about how well the available monitoring data represents typical ongoing exposures, uncertainties about potential effects in sensitive populations, and an inability to differentiate between emissions from Precision Castparts and those from other sources.

"Based on currently available science, guidance from federal agencies, and DEQ’s environmental monitoring data, we concluded that the risk to the health of people living and working in the area since 2016 is low," says Susanna Wegner, Ph.D., OHA public health toxicologist who led the Precision Castparts assessment. "What we are unable to say confidently is the extent to which people were exposed, or whether their health may have been harmed, before air, soil and water samples were collected starting that year."

The public health assessment is available on the Public Health Division website at http://healthoregon.org/pccpha.

The Precision Castparts assessment was launched in June 2016 following a request by the community group South Portland Air Quality, whose members were concerned about short- and long-term health effects from the company’s emissions. OHA’s Environmental Health Assessment Program conducted the assessment with input from an advisory committee composed of people living near the facility.

OHA evaluated potential health risks from metals based on air monitoring and soil testing the Oregon Department of Environmental Quality performed in 2016 and 2017. The assessment also looked at results of monitoring for metals, polychlorinated biphenyls (PBCs), polycyclic aromatic hydrocarbons (PAHs) and other chemicals in surface water, sediment and crayfish tissue in nearby Johnson Creek that DEQ and Precision Castparts conducted in a series of monitoring efforts performed between 2009 and 2017. Precision Castparts’ testing focused on water and sediment.

OHA toxicologists say people can safely eat up to five meals of crayfish per month (a total of 40 ounces per month for adults) from Johnson Creek.

Concerns about health risks associated with emissions from Precision Castparts and other manufacturing companies, including Bullseye Glass Co. in southeast Portland and Uroboros Glass in north Portland, swelled in February 2016. That’s when results from a U.S. Forest Service study first emerged showing that moss from trees located near these facilities and tested between 2013 and 2015 contained high levels of metals.

The Agency for Toxic Substance and Disease Registry (ATSDR), OHA’s federal partner in health assessments, has historically certified such evaluations to ensure they follow national health risk assessment guidelines and respond to a community's health concerns. However, in early 2018 ATSDR updated its criteria for certifying public health assessments, allowing only assessments of Superfund sites to go through the certification process. Precision Castparts is not a Superfund site.

Because the community expected the report would be certified, the OHA Environmental Health Assessment Program allocated $5,000 to hire, in consultation with the community advisory committee, an external consultant who will conduct a third-party review of the assessment in the absence of the ATSDR certification or review.

"We have ensured the Precision Castparts public health assessment follows ATSDR methodologies for health risk assessment, and we have written it as if it were being certified," Wegner said. "The external consultant will help provide an additional measure of technical review and will provide technical assistance to the community as they develop their comments on the draft document."

The OHA Environmental Health Assessment Program will schedule a community meeting the week of Nov. 25 at a location to be determined to discuss the findings of the Precision Castparts public health assessment. Meeting information will be shared publicly when details are confirmed.

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EDITORS: Schedule an interview with Dr. Debra Furr-Holden at 971-246-9139, PHD.Communications@state.or.us

October 26, 2018

Place Matters presenter: Managing alcohol outlet density can reduce youth violence

Debra Furr-Holden says doing so provides ‘sweet spot’ between public health, economic development

PORTLAND, Ore.—As communities in states like Oregon look for ways to spur growth, they must remain watchful of the public health risks associated with the density that can accompany that growth, says Debra Furr-Holden, Ph.D., of Michigan State University.

"As density goes up—and we can say this with national data—so do some of the major public health problems, like youth violence," said Furr-Holden, a featured speaker at the 2018 Oregon Place Matters Conference in Portland. "The goal is to find that balance, that sweet spot, between public health and economic development."

The Place Matters Conference, a biennial event aimed at addressing the leading drivers of chronic disease and health care costs, is Monday and Tuesday, Oct. 29 and 30, at the Oregon Convention Center, 777 NE Martin Luther King Jr. Blvd. Nationally recognized speakers and conference sessions will cover a variety of strategies employed in Oregon and around the country for making health accessible to all people. The Oregon Health Authority Public Health Division's Health Promotion and Chronic Disease Prevention Section sponsors the event.

Furr-Holden’s plenary on Monday, Oct. 29, is titled "Building Successful Community: Academic Partnerships in Alcohol Control."

Furr-Holden, director of the MSU’s Flint Center for Health Equity Solutions, funded by the National Institute on Minority Health and Health Disparities, contends one sweet spot between public health and economic development is addressing the proliferation of liquor stores in high-poverty neighborhoods. She co-authored a study published in the Journal of Community Psychology in July that investigated the relationship between liquor store density and life expectancy, finding that liquor store density is associated with higher levels of community disadvantage and higher rates of violence.

"What we found is there are multiple factors you have to take into account, which includes things like zoning," Furr-Holden explained. "You need to have a reasonable separation between people and certain types of businesses. People are aghast at having a strip club in a residential neighborhood, but they have no issues with an alcohol outlet, which have much more detrimental impacts on communities. People don’t see what the big deal is or what the harm is."

Furr-Holden says a powerful tool for states to make their own links between crime and alcohol outlet density is the National Incident-Based Reporting System, which tracks crime incidents reported by law enforcement agencies around the country. She says states such as Oregon—one of 17 that control the sale of distilled spirits through government agencies at the wholesale level—can use the system "for evaluation and monitoring and understanding what’s working in the programs they’re implementing."

"Oregon has good data and good data systems for tracking crime and alcohol outlets," says Furr-Holden, who is examining Oregon among other states. "The lion’s share of the state has been the beneficiary of pretty good policies so far."

For information about the 2018 Oregon Place Matters conference, visit the conference website at https://beattygroup.cvent.com/2018OregonPlaceMatters.

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October 26, 2018

Health advisory for water contact at Sunset Bay State Park Beach lifted October 26

Testing shows fecal bacteria levels have subsided

The Oregon Health Authority (OHA) today lifted a public health advisory for contact with marine water at Sunset Bay State Park Beach located in Coos County. The health authority issued the advisory October 25, after water samples showed higher-than-normal levels of fecal bacteria in ocean waters.

Results from later samples taken by the Oregon Department of Environmental Quality (DEQ) showed lower bacteria levels. Contact with the water no longer poses a higher-than-normal risk. However, officials recommend staying out of large pools on the beach that are frequented by birds, and runoff from those pools, because the water may contain increased bacteria from fecal matter.

State officials continue to encourage other recreational activities at all Oregon beaches, suggesting only that water contact be avoided when advisories are in effect.

Since 2003 state officials have used a U.S. Environmental Protection Agency grant to monitor popular Oregon beaches and make timely reports to the public about elevated levels of fecal bacteria. Oregon state agencies participating in this program are OHA, DEQ and the Oregon Parks and Recreation Department.

For more information, visit the Oregon Beach Monitoring Program website at http://www.healthoregon.org/beach or call 971-673-0440, or call the OHA toll-free information line at 877-290-6767.

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http://bit.ly/2PmSbGq

October 25, 2018

Health advisory issued October 25 for water contact at Sunset Bay State Park Beach

The Oregon Health Authority issued a public health advisory today for higher-than-normal levels of bacteria in ocean waters at Sunset Bay State Park Beach, located in Coos County.

Water samples indicate higher-than-normal levels of fecal bacteria, which can cause diarrhea, stomach cramps, skin rashes, upper respiratory infections and other illnesses. People should avoid direct contact with the water in this area until the advisory is lifted. This applies especially to children and the elderly, who may be more vulnerable to waterborne bacteria.

Increased pathogen and fecal bacteria levels in ocean waters can come from both shore and inland sources such as stormwater runoff, sewer overflows, failing septic systems, and animal waste from livestock, pets and wildlife.

While this advisory is in effect at Sunset Bay State Park Beach, visitors should avoid wading in nearby creeks, pools of water on the beach, or in discolored water, and stay clear of water runoff flowing into the ocean. Even if there is no advisory in effect, officials recommend avoiding swimming in the ocean within 48 hours after a rainstorm.

Although state officials advise against water contact, they continue to encourage other recreational activities (flying kites, picnicking, playing on the beach, walking, etc.) on this beach because they pose no health risk even during an advisory. Neighboring beaches are not affected by this advisory.

The status of water contact advisories at beaches is subject to change. For the most recent information on advisories, visit the Oregon Beach Monitoring Program website at http://www.healthoregon.org/beach or call 971-673-0440, or 877-290-6767 (toll-free).

Since 2003 state officials have used a U.S. Environmental Protection Agency grant to monitor popular Oregon beaches and make timely reports to the public about elevated levels of fecal bacteria. Oregon state organizations participating in this program are the Oregon Health Authority, Department of Environmental Quality, and Parks and Recreation Department.

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http://bit.ly/2yzAvOi

October 25, 2018

OHA publishes statewide acute opioid prescribing guidelines

The Oregon Health Authority today released the Oregon Acute Opioid Prescribing Guidelines, in an effort to help clinicians working in surgical, dental, primary care, emergency and urgent care settings make evidence-based prescribing decisions when treating pain.

Opioid painkillers are powerful medications that come with risks. While they’re effective in treating acute, non-cancer pain, high doses and long-term use could lead to dependence, abuse, overdose and death. In Oregon, five people per week die of opioid-related overdoses.

The guidelines, developed in consensus with an external workgroup representing public health, health care and coordinated care organization leaders, build on Oregon prescribing guidelines for chronic pain, published in 2016. The acute prescribing guidelines focus on acute pain management for patients who are new to opioids. They are not intended for those who currently receive opioids nor for those with a history of substance use disorder.

Common examples of relevant clinical situations include: wisdom teeth extractions, sports injuries and post-surgical pain management. It is common practice for patients to be prescribed 30-day prescriptions in these settings. The new guidelines advise that the lowest effective dose of short-acting opioids be prescribed for no more than three days in most cases.

"While opioids are effective medications in acute pain management, many people do not use all of the pills that are prescribed by their doctors after an acute event," said Katrina Hedberg, MD, state health officer at OHA. "What this tells us is that patients may not need as many pills as we think, and other forms of pain management may be safer and just as effective. It also tells us that there are many excess pills sitting in medicine cabinets, which could be misused or stolen."

The guidelines could also help prevent patients with acute pain from becoming dependent on opioids long term. According to a 2017 analysis by the Centers for Disease Control and Prevention, 30 percent of those who receive an initial 30-day prescription of opioid painkillers remained on opioids a year later.

In general, the guidelines advise against using opioids as the first-line therapy for mild to moderate pain. If opioids are deemed appropriate and likely effective for the patient, the guidelines emphasize the following principles:

• Evaluate the patient.
• Assess history of long-term opioid use or substance use disorder.
• Check the Prescription Drug Monitoring Program, which tracks prescribed controlled substances such as opioids and benzodiazepines.
• Provide patient education.
• Prescribe the lowest effective dose of short-acting opioids for no more than three days in most cases and no more than seven days in cases of more severe acute pain.
• Provide follow-up and reassess pain, healing and function.
• Implement, monitor and document pain management practices to ensure care safety and quality.

The full guidelines can be found on the OHA website at https://www.oregon.gov/oha/PH/PREVENTIONWELLNESS/SUBSTANCEUSE/OPIOIDS/Documents/Acute-Prescribing-Guidelines.pdf.

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http://bit.ly/2OQaNPF

October 23, 2018

Contact: Jennifer Uhlman, 503-739-5267, .m.uhlman@dhsoha.state.or.us">jennifer.m.uhlman@dhsoha.state.or.us (meeting information or accommodation)

Health Aspects of Kindergarten Readiness Technical Workgroup meets October 26

What: A public meeting of the Oregon Health Authority’s Health Aspects of Kindergarten Readiness Technical Workgroup

When: Friday, October 26, 9:30 a.m. to 12:30 p.m. Public comments will be taken at approximately 9:45 a.m.

Where: Clackamas Community College Wilsonville Training Center, Room 111, 29353 SW Town Center Loop E., Wilsonville. Attendees can also join remotely by webinar at https://attendee.gotowebinar.com/register/8040650860888895234 and telephone conference line at 877-810-9415, participant code 1773452.

Agenda: Welcome, introductions; public comment; outline of workgroup's final report; stakeholder input updates; CCO attestation metric; measurement strategy discussion; summary and next steps.

For more information, please visit the committee's website at https://www.oregon.gov/oha/HPA/ANALYTICS/Pages/KR-Health.aspx.

# # #

Everyone has a right to know about and use Oregon Health Authority (OHA) programs and services. OHA provides free help. Some examples of the free help OHA can provide are:

• Sign language and spoken language interpreters
• Written materials in other languages
• Braille
• Large print
• Audio and other formats

If you need help or have questions, please contact Jennifer Uhlman at 503-739-5267, 711 TTY, .m.uhlman@dhsoha.state.or.us">jennifer.m.uhlman@dhsoha.state.or.us, at least 48 hours before the meeting.

http://bit.ly/2q9dehs

EDITORS: Schedule an interview with Charles Brown at 503-422-7174, PHD.Communications@state.or.us

October 22, 2018

Place Matters presenter: Active transportation improves health equity

Charles Brown says ideas like ‘complete streets policies’ can reduce crime

PORTLAND, Ore.— For Charles Brown, active transportation investments—which emphasize creation of facilities that allow people to be physically active while getting from one place to another—improve the health of our communities and promotes social justice.

"Achieving health equity—or achieving equity period—doesn’t mean there are winners and losers," says Brown, a senior researcher with the Alan M. Voorhees Transportation Center and adjunct professor at the Edward J. Bloustein School of Planning and Public Policy, both at Rutgers University. "There can be winners and winners. But we can’t all be winners if we’re not giving people what they need to enjoy a full, healthy life."

Brown, a featured speaker at the 2018 Oregon Place Matters Conference in Portland later this month, believes at the heart of the active transportation concept is a larger goal of making all places equitable and accessible, which creates health for everyone.

"One of the things you’re going to hear me emphasize during my talk is the importance of recognizing people in a place, and that nothing matters more than the people in that place," he says, "and how our differences can be used to strengthen that place and turn it into a place that allows everyone to live their lives how they see fit."

That includes removing barriers to mobility, a term that includes walking, bicycling, skateboarding, taking public transit or using e-bikes or e-scooters.

Place Matters, a biennial conference addressing the leading drivers of chronic disease and health care costs, is Oct. 29-30 at the Oregon Convention Center, 777 NE Martin Luther King Jr. Blvd.

Nationally recognized speakers and conference sessions will cover a variety of strategies employed in Oregon and around the country for making health accessible to all people. The Oregon Health Authority Public Health Division sponsors the event through its Health Promotion and Chronic Disease Prevention Section. Brown’s plenary on Monday, Oct. 29, is titled "Justice or Just Us: Creating a Shared Vision for Equitable Places."

Brown has published research on the link between social factors and access to opportunities that allow people to be healthy. He recently co-authored a study published in the journal Health & Place that examined how violent crime affects the amount of time people walk during the day and at night for recreation and transportation on a typical day. It showed "even if people walk more in high-crime areas because of nearby destinations and lack of alternatives, crime may still have an adverse effect on walking, meaning that people in those neighborhoods would have walked even more if not for high crime."

"Complete street policies" and "Crime Prevention Through Environment Design (CPTED)" practices are noted strategies that improve safety and mobility, Brown says. Where "complete streets" ensures that all streets are designed, operated and maintained "with all users in mind," CPTED takes it a step further to ensure that the physical design and maintenance of infrastructure deters crime instead of serving as a conduit for it, Brown says.

"Too often crime is attributed to individual behavior instead of the socio-political context that allows crime to flourish, particularly in low income and communities of color," he says.

For information, visit the 2018 Oregon Place Matters Conference website at https://beattygroup.cvent.com/2018OregonPlaceMatters.

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October 19, 2018

Low levels of cyanotoxin detected in Siltcoos Lake near Florence

People who draw water directly from the lake, use in-home treatment, should find alternative drinking source after harmful algae bloom found

The presence of cyanotoxins caused by harmful algae blooms is prompting the Oregon Health Authority to recommend that people who draw water directly from Siltcoos Lake use an alternative drinking source for vulnerable family members and pets.

OHA environmental health officials say low levels of cyanotoxins, produced by cyanobacteria found in harmful algae blooms, were discovered in the water body located about seven miles south of Florence off U.S. Route 101 (Oregon Coast Highway) in Lane and Douglas counties.

Public drinking water advisory levels are very different from levels used for recreational advisories. This is because the amount of water people incidentally swallow while recreating (swimming, water skiing, etc.) is much lower than when people use it as a primary source of drinking water. Therefore, separate advisories are issued for drinking water or recreational use as data warrant. Private intakes and in-home treatment systems are not tracked or regulated by OHA Drinking Water Services, so advisories for these systems are not issued.

Cyanotoxin levels at Siltcoos Lake are well below OHA recreational use values for human exposure. As a result, a recreational use health advisory was not issued. Because toxins have not been found in finished or treated drinking water, a drinking water advisory from the city also is not necessary. However, analyses of raw water from samples taken weekly by the South Coast Water District at the agency’s drinking water intake within the lake show a level of toxin above drinking water values for vulnerable populations, including children younger than 5, pregnant and nursing women, the elderly and those with compromised immune systems. The levels can be a health issue for people who are not on a public drinking water system.

South Coast Water District is monitoring Siltcoos Lake because prior sampling confirmed the presence of cyanotoxins above drinking water advisory values in the lake water. Individuals on private intakes and using in-home treatment systems will be notified when toxin levels in the raw (lake) water are confirmed to be below drinking water advisory values.

For information about cyanobacteria, cyanotoxins, exposures or illnesses (people or pets), health advisories and other related topics, contact the Oregon Health Authority at 971-673-0440, the toll-free information line at 877-290-6767, or visit the Harmful Algae Blooms website at http://healthoregon.org/hab and select "Algae Bloom Advisories."

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October 19, 2018

Public health modernization funds fuel new approaches to prevent, fight infectious disease outbreaks

Evaluation report shows effects of $5 million legislative investment

The Oregon Legislature’s $5 million public health modernization investment is allowing counties to partner with each other and share staff resources so they can better prepare for and respond to communicable disease threats, a new state report found.

The 2017 investment, $3.9 million of which went toward funding communicable disease control efforts at eight regions of local public health departments, also is improving health equity work such as identifying populations disproportionately affected by infectious diseases, according to the Oregon Health Authority’s Public Health Modernization Interim Evaluation Report.

The OHA Public Health Division used the remaining $1.1 million in legislative funds to improve collection and reporting of population health data, including enhancing a database that tracks immunizations. It also went to local public health departments to provide technical assistance such as training on best practices for improving childhood immunization rates and communicable disease reporting.

"In the first six months of the Oregon Legislature’s modernization investment, we have seen important changes in how we deal with communicable diseases on a regional level," said Oregon Public Health Division director Lillian Shirley. "We know that these diseases don’t stop at the county line during an outbreak, and neither should we when we’re working to prevent and fight them."

For example, local public health departments have developed formal policies such as memoranda of understanding and cross-jurisdictional agreements, to create or expand inter-governmental partnerships so they can coordinate and share staff, data, and public information documents during an outbreak. Additionally, they have been able to hire additional regional epidemiologists, infection prevention specialists and communicable disease investigators, who can be quickly deployed to respond to public health emergencies.

"This allows counties to support neighboring jurisdictions with fewer resources to conduct routine investigations," Shirley said.

Specific examples:

• Deschutes, Crook and Jefferson counties are working together to prevent disease outbreaks among people living in long-term care facilities. They also are actively monitoring communicable diseases at the regional level to identify and respond to emerging diseases sooner and provide outbreak response assistance across counties when needed.
• Lane, Benton, Lincoln and Linn counties are collaborating to increase immunization rates across multiple population groups. And Lane County Public Health is working with a hospital system to prevent hospital readmission by implementing a pneumococcal vaccination policy for eligible patients upon hospital discharge.
• Washington, Clackamas and Multnomah counties are funding a full-time Oregon Health Equity Alliance position to ensure equity expertise and meaningful community engagement; and Clackamas County created Health Equity Zones to geographically tailor local health equity interventions.

Health equity work has improved on a regional level, too, the report notes. Local public health departments are working with tribes, regional health equity coalitions and other partners on assessments that ensure health equity and community engagement are incorporated into communicable disease prevention strategies. One health department used funds for translation services to ensure better access to communicable disease risk communications.

"This evaluation report shows that we are making progress in our work to build a modern public health system, but there’s a lot more to be done," Shirley said.

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