Robert Carmon had a rough start to life. Shortly after birth he developed asthma, a chronic disease that causes inflammation in the lungs and difficulty breathing. His attacks were so severe as an infant that his parents rushed him to the emergency room practically every week. They were terrified he might die. Today, at age 7, Robert’s asthma has stabilized.
The number of Medicaid-insured children treated in Connecticut emergency rooms for behavioral health crises rose 20 percent between 2014 and 2016, mirroring a national trend – despite efforts to provide non-ER treatments. In 2014, Connecticut ERs recorded 12,100 Medicaid-insured youth visits compared to 14,448 in 2016, according to a study of Medicaid-eligible patients ages 18 and younger commissioned by the Child Health and Development Institute of Connecticut (CHDI). Most of the children who go to emergency rooms with behavioral health issues go to one of five hospitals, according to data collected by consultant Beacon Health Options, which manages behavioral health care for the state’s Medicaid population. Connecticut Children’s Medical Center in Hartford saw the most behavioral health-related ER visits, with 3,962 visits by Medicaid-insured youth in 2016. Yale New Haven Hospital and Yale New Haven Children’s Hospital had a combined total of 2,263 visits, followed by St.
Various violations that jeopardized patient safety, including two that preceded patient deaths and several involving the improper use of restraints, have taken place at Connecticut hospitals, according to the most recent hospital inspection reports released by the state Department of Public Health (DPH). The reports, which can be found in C-HIT’s Data Mine section, cover inspections that took place at hospitals between 2016 and this year. Some of the violations resulted in injuries to patients, while others showed lapses in protocols and procedures. Bridgeport Hospital was cited for 26 violations, including an incident in which a patient with a diagnosis of an ovarian mass suffered a burn during surgery. Hartford Hospital was cited for 60 violations, including two violations that preceded patient deaths.
With Connecticut children testing positive for lead at consistently high numbers, and millions of dollars thrown at the problem with tepid results, lawmakers may finally be stepping up to seek an effective solution. The Banking Committee is considering a bill that would create a task force to study better ways to finance the removal of the toxin from thousands of homes around the state. The task force would also investigate how to enforce abatement measures, including rental property inspections, and look into increasing workforce training in the specialized process needed to remove lead. State Department of Public Health (DPH) numbers from 2015, the latest available, show more than 72,000 children under the age of 6 testing positive for some level of lead in their blood. More than 900 children were at levels two to four times the baseline at which a child is considered poisoned.
On a snowy Saturday morning in January, Selvin, 13, and his mother were in the basement of the First and Summerfield United Methodist Church in New Haven, to support a friend in sanctuary. As they sat there, the boy tried to push away thoughts of how it would be when ICE came to take away his own mother, who is also under a deportation order. “I’m going to be alone with my little brother and my dad,” Selvin said. “Sometimes I feel I don’t want to talk to anybody. I just go to my room, lock the door, and I feel depressed.”
Selvin – whose family asked that his last name be withheld – is among thousands of immigrant children in Connecticut and nationally feeling the effects of prolonged stress, which can become so toxic it can damage the developing brain.
About half of Connecticut hospitals—15 out of 31—will lose part of their Medicare payments in 2018 as a penalty for having relatively high rates of patients who acquired preventable injuries and infections while hospitalized. The hospitals are among 751 nationwide that will lose 1 percent of their Medicare reimbursements in this fiscal year. The penalties are part of the Centers for Medicare and Medicaid Services’ (CMS) Hospital-Acquired Condition Reduction Program, which is part of the Affordable Care Act. The program penalizes hospitals with the highest rates of patients who got infections from hysterectomies, colon surgeries, urinary tract catheters and central line tubes. It also tallies those who suffered from blood clots, bed sores or falls while hospitalized.
The state’s efforts to direct children in mental health crisis away from emergency rooms, to other services, have fallen short, with major hospitals reporting staggering increases in patient visits since 2013: Up 32 percent at Connecticut Children’s Medical Center, and 81 percent at Yale New Haven Hospital. The children’s hospital (CCMC) reported nearly 3,300 visits last year – 275 a month, on average — with the average length of stay increasing to 15 hours from less than 12 in 2013. “I wish I could say we had made a lot of progress, but we haven’t,” said Dr. Steve Rogers, medical director of the emergency department’s (ED’s) behavioral health unit. “Unfortunately, I think it’s only going to keep trending this way.”
Similarly, Yale saw ED visits by children ages 15 and younger rise from fewer than 750 in 2013 to more than 1,350 in 2016 — and the numbers are running even higher this year, said Dr. Claudia Moreno, medical director for psychiatric emergencies in Yale’s children’s emergency department. At times, she said, all ED beds are full, and children wait on hallway gurneys.
Connecticut doctors and health care workers are battling childhood obesity by helping low-income families make healthier food choices, and coaching busy parents on fast but healthy ways to feed their children. Children are more likely to be obese if they grow up in low-income families, the U.S. Centers for Disease Control and Prevention (CDC) reports. And when parents work long hours at low-wage jobs, that can contribute to childhood obesity as well, according to health experts, because time-squeezed parents struggle to provide home-cooked meals and family activities. Colleen Shaddox explores how teens in New Britain learn how to make healthy food choices. The CDC defines obesity as “having excess body fat,” and says it is affected by genetic, behavioral and environmental factors.
The rates of asthma-related emergency room visits and hospitalizations dropped in many Connecticut communities, the latest data from the state Department of Public Health show. Overall, 58 percent of communities saw a decrease in the age-adjusted rate of emergency room visits, while 63 percent saw a decrease in the rate of hospitalizations for asthma, according to a C-HIT analysis of the data. Some 36 percent saw improvement in both areas. The data compares age-adjusted rates for each town for 2005-2009 and for 2010-2014 per 10,000 people. Meanwhile, the state’s overall rate for emergency room visits in 2014 was lower than recent years but still was higher than it was 10 years ago.
Despite national debate on whether doctors should use social media, some physicians are forging ahead, using platforms such as Twitter to interact with colleagues, expand their knowledge and even connect with patients. Dr. Nick Bennett, the infectious disease and immunology medical director for Connecticut Children’s Medical Center in Hartford, said he benefits professionally from Twitter. He created his account, @peds_id_doc, a few years ago to see what Twitter was about, and he’s remained a loyal user. Bennett started by following health-related accounts and live tweeting from conferences. He also joined Twitter chats – conversations that use hash tags to link tweets.