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How nurse-led triage connects DC 911 callers to the right care – McCourt School of Public Policy

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Researchers from Georgetown University, American University and The Lab @ DC found that placing a nurse in a 911 call center reduced stress on the County’s emergency services.

According to DC’s Office of Unified Communications (OUC), the District’s 911 call center is one of the busiest in the country, historically ranking behind New York City, Chicago and Los Angeles. In 2023, OUC received more than 1.7 million 911 calls for service, including more than 3,000 calls requiring CPR instructions.

Dr. Rebecca Johnson, assistant professor at Georgetown University’s McCourt School of Public Policy, and Dr. Ryan T. Moore, assistant professor at American University’s School of Public Affairs (AU SPA), collaborates with District Government researchers at The Lab @ DC. , where they were both selected, to evaluate the effectiveness of a unique project that connects 911 people with non-life-threatening symptoms to appropriate care.

Proper Care, Currently a nurse on duty. (Credit: DC Office of Communications)

Under Proper care, Now program, a dispatcher at a District 911 call center or a Department of Fire and Emergency Medical Services (FEMS) first responder transfers non-emergency calls to paramedics over the phone, advising callers of Where can I find care nearby or arrange for non-emergencies? transport. Eligibility for a nurse triage call is determined by an approved list of chief complaints, including indigestion, sunburn and flu-like symptoms.

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The DC government aims to help conserve resources for serious emergencies and reduce pressure on an already overstretched system by effectively triaging emergency and non-emergency callers.

Johnson, who joined the investigative team Proper care, Now In the fall 2019 program, he was asked to participate in this project based on his experience in administrative data analysis and research experience in the complex American health care system. As a data scientist at The Lab @ DC, Johnson obtained and analyzed administrative data from agencies across DC Government to evaluate program effectiveness. He and his colleagues later produced a report to help local leaders and policy makers understand the impact of the program and the benefits provided to the residents of the District.

«I bring the lessons I learned from my work at The Lab @ DC to my McCourt course, such as using the challenges I’ve faced and management information as inspiration for problem groups to evaluate the learning of my students,» said Johnson, who teaches data science. in the McCourt School’s Master of Science in Data Science for Public Policy program and is a member of the McCourt School’s Massive Data Center.

Dr.  Rebecca Johnson won the title

Dr. Rebecca Johnson is an assistant professor at Georgetown University’s McCourt School of Public Policy and a data scientist at The Lab @ DC.

Moore, a senior social scientist at The Lab @ DC since 2016, helped design and develop the nursing intervention study from the beginning.

“This is an exciting project; demonstrates the tremendous societal impact that deep, meaningful collaborations between policymakers and academics can have when we join forces for high-quality research,» said Moore, who teaches statistical methods and data science in the Department of Government at AU SPA in partnership with the AU Center for Information Science.

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Dr.  Ryan T. Moore headline

Dr. Ryan T. Moore is an assistant professor at American University’s School of Public Policy and a senior social scientist at The Lab @ DC.

Strong results after nurse-led assessment of 911 calls

After analyzing the program’s impact on callers from April 2018 to January 2019, Johnson, Moore and co-researchers found that the number of calls that resulted in an ambulance dispatch dropped from 97% to 56%, and those resulting in ambulance transport decreased from 73% to 45. %.

Emergency department visits within 24 hours of calling 911 decreased among Medicaid beneficiaries from 29.5% to 25.1%, and the number of callers who visited a primary care physician the core rose from 2.5% to 8.2%.

Short-term results suggest that nurse-led screening of non-emergency calls can safely connect callers to appropriate, timely care. The potential long-term impacts on emergency department and primary care visits or Medicaid costs remain unclear and will be the subject of future research.

Nature Human BehaviorA leading peer-reviewed scientific journal, published the research team’s study in May 2024. Co-authors include Drs. Kevin Wilson, Dr. David Yokum and Dr. Chrysanthi Hatzimasoura, former members of The Lab @ DC, and Dr. Robert Holman, DC FEMS longest serving medical director, who was instrumental in launching the research study.

«Academic journal articles are never very motivating for us, but the publication of our findings in a prominent journal should give the District’s residents confidence that important decisions about their city are informed by the best available methods. science,» said Sam Quinney, director of The Lab. @DC.

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Since its launch in 2018, the Proper care, Now The program has evolved from a pilot effort into a successful program delivering impressive results in the District. Six years ago, Dr. Holman said dispatchers and DC FEMS first responders fielded about 75,000 non-emergency 911 calls and directed about 35,000 callers to appropriate care, such as emergency clinics. basic and urgent, self-care. , telehealth or home visits by non-executive EMS personnel rather than emergency departments.

Learn more about how paramedics improve care at the County’s 911 call center here.

#nurseled #triage #connects #callers #care #McCourt #School #Public #Policy

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10th Circuit refuses to restore family planning subsidies in Oklahoma | Center for Constitutional Responsibility

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(CN) – A three-judge panel of the Tenth Circuit on Monday denied Oklahoma’s request to return millions of dollars in Fund X, which the federal government withdrew after the state Department of Health refused to give patients the number of the landline that was coming. provides information about abortion.

Oklahoma had requested the first order requiring the US Department of Health and Human Services to restore the funds, which are intended to help provide family planning services to low-income and rural residents. On Monday, a federal appeals court upheld a lower court’s decision that denied the request, finding that Oklahoma was unlikely to succeed in its case.

By 2021, Schedule X recipients are mandated by HHS to provide “unbiased, factual information and informal counseling” about all prenatal options and “referrals about all options upon request.”

Oklahoma followed the requirement at first, but only after a decision by the United States Supreme Court Dobbs v. Jackson Women’s Health Organization allowed the state’s abortion ban to begin, Oklahoma stopped referring patients to facilities that provide abortions. The federal Department of Health and Human Services told the state it could meet that need by providing patients with a national hotline that provides unbiased information about all pregnancy options, including abortion. At first Oklahoma agreed, but shortly thereafter stopped following the policy, causing HHS to withdraw Fund X from the state.

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Oklahoma argued that requiring it to provide the phone number violates the Weldon Amendment, a federal law that bars HHS funds from going to state agencies that discriminate against health care organizations because of denial. abortion or abortion. The state continued to argue that its health department should be considered a health care facility and that providing a phone number would result in a referral for an abortion.

In a 2-1 decision, the Tenth Circuit disagreed.

«The hotline provided an opportunity to provide neutral information about abortion,» United States Circuit Judge Robert Bacharach, a Barack Obama appointee, wrote in the majority. «Oklahoma rejected the choice of a national telephone number, but did not question the neutrality of the information provided.»

US Circuit Judge David Ebel, appointed by Ronald Reagan, joined Bacharach’s opinion.

But U.S. Circuit Judge Richard Federico, a Joe Biden appointee, argued in a dissenting opinion that requiring Oklahoma to provide a phone number is tantamount to forcing it to provide withdrawal benefits. belly. He argued that Oklahoma offers informal counseling about all pregnancy options available in the state, so the only reason a patient would need to be given a phone number would be to get information about abortion. belly.

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«If a patient desires information about non-abortion options, they will not need to be sent to a national hotline,» Federico wrote. On the other hand, if the patient requests a referral, the Oklahoma provider will assume that it is only to review the option of terminating the pregnancy, which the OSDH determined would be contrary to Oklahoma law and policy.

The panel also rejected Oklahoma’s argument that the ordinance violates the Constitution’s Spending Clause, which the Supreme Court has held requires that Congressional conditions for obtaining federal funds not be it is clear. Oklahoma argued that the Title X statute was vague because it did not include a requirement for abortion counseling, but the court found that the statute gave HHS the authority to impose subsidy requirements and that Oklahoma he was clearly aware of the need when he received help. .

The Center for Constitutional Accountability, a liberal advocacy group that filed an amicus curiae brief supporting HHS’s position, issued a press release celebrating the ruling, praising the Tenth Circuit for «rejecting the effort of Oklahoma to twist the U.S. Constitution against reproductive rights.»

«Today’s decision is a victory for reproductive rights, the power of federal agencies to carry out their duties, and the text and history of the Constitution,» said the Center for Accountability’s Appellate Counsel. Constitutional Law Miriam Becker-Cohen said.

Oklahoma, however, has argued that the HHS decision wrongly removes important family planning funding for low-income and rural residents, which Judge Federico said in his dissent.

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«Weighing against HHS’s interest is the fact that the elimination of assistance to OSDH reduces access to health care for those who need it most: patients who visit OSDH clinics for health care because, due to resources or geography, is the only option available to them,» wrote Federico.

#10th #Circuit #refuses #restore #family #planning #subsidies #Oklahoma #Center #Constitutional #Responsibility

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The Biden Administration’s proposal addresses maternal mortality, an unsafe community

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The Biden-Harris administration unveiled a series of new policy proposals last week that would require hospitals to implement initiatives to improve maternal health and support communities in need.

The proposal introduces new measures for maternity care, such as expanding Medicaid coverage after delivery and implementing new hospital standards. These major changes in health care policy can have significant effects on maternal health outcomes. The proposal comes at a time when threats to abortion care are at the forefront of national debate, with many states imposing restrictive laws that restrict access to reproductive health services.

As journalists, we can help the public understand how these changes may affect them or their communities, as well as the potential long-term effects of these policy changes. Here are some ways we can review policy proposals for our audience:

Story ideas

  • Assess how these policy changes will affect local hospitals and health care providers.
  • Discuss with local health officials and hospital management how the proposed changes will be implemented; and/or consult with obstetricians, pediatricians, and other medical professionals about the practical implications of new hospital standards and the expansion of Medicaid coverage.
  • Compare maternal health outcomes in states with 12 months of continuous Medicaid and CHIP eligibility.
  • Consider highlighting personal stories of new mothers who may benefit from longer Medicaid or formerly incarcerated individuals who are now eligible for Medicare.

Included in this plan are other strategies aimed at reducing health disparities within the incarcerated and indigenous population, which are briefly highlighted below.

Key recommendations are outlined

Increasing postpartum Medicaid coverage. For children under 19 on Medicaid or CHIP (health insurance for low-income families), the plan ensures that they remain covered for a full year at a time. This means less paperwork and more consistent care for nearly 40 million children. According to the Kaiser Family Foundation, as of August 2022, nearly 37.8 million children are enrolled in Medicaid (in including Medicaid expansion CHIP), about half of those children in states with 12 months of continuous eligibility and half of states without the policy. This extends the process beyond the usual 60 days postpartum, which is an opportunity to improve access to care for new mothers.

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Improving hospital conditions, including maternity care. The proposal outlines changes to how hospitals and surgery centers are paid for outpatient care. This change may affect the types of services provided by these services and the costs associated with them. Medicare spending will reach $944 billion by 2022, which is 21% of the nation’s total health care costs. Medicare covered 65 million people by 2022, and enrollment is expected to reach 78 million by 2030 due to aging.

Also, starting in 2025, there will be a $2,000 cap on out-of-pocket costs for prescription drugs under Medicare Part D. This is due to part of the Affordable Care Act, which President Biden’s law to reduce the cost of drugs, and it could benefit the elderly who spend a lot of money to buy drugs. This is important because in 2021, the 1.3 million Part D enrollees without low-income subsidies had out-of-pocket spending of $2,000.

The proposal also creates new requirements for maternity services, including requiring hospitals to invest in staff and care delivery. This document does not specify what this looks like, but the aim is to ensure that hospitals are prepared to provide emergency obstetric services. This is very important considering that in 2021, the maternal mortality rate in the US was 32.9 deaths per 100,000 births, which is much higher than in other developed countries. Hospitals that do not meet the requirements can be removed from the Medicaid and Medicare programs.

Health care for the incarcerated. The proposal redefines «protection» to remove barriers that prevent formerly incarcerated people from enrolling in and maintaining Medicare coverage. This includes extending eligibility for the special enrollment period to those on parole, probation or house arrest. Contact advocacy groups focused on prison reform for ideas on how these policies can address health disparities.

To support Indian Health Service (IHS) and tribal services. The proposed plan supports IHS and tribal services by increasing Medicare payments for essential, high-cost drugs, including cancer drugs, in IHS and tribal hospital inpatient departments. This project supports Cancer Moonshot’s mission to prevent cancer and improve cancer care for underserved populations.

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The comment period for the proposed legislation is open until Sept. 9. To learn more, review the full proposed rule and fact sheets on the Federal Register and CMS websites.

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#Biden #Administrations #proposal #addresses #maternal #mortality #unsafe #community

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Lower capital gains tax, cuts in food benefits: What the 2025 plan could mean for your wallet in a Trump presidency

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Former Republican presidential candidate President Donald Trump speaks at a campaign rally June 22, 2024, in Philadelphia. Trump is seeking to distance himself from a major federal government overhaul planned by some of his administration officials.

Chris Szagola | AP

#capital #gains #tax #cuts #food #benefits #plan #wallet #Trump #presidency

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