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THE DAILY ASTORIAN • WEDNESDAY, DECEMBER 12, 2018
Washington governor proposes plans to fi x mental health
New focus on
prevention
By MARTHA BELLISLE
Associated Press
SEATTLE — Washing-
ton Gov. Jay Inslee unveiled
on Tuesday his budget and
policy plans for fi xing the
state’s struggling mental
health system in the coming
years.
Inslee said at a news con-
ference in Burien that he
wants to change the system
from being “crisis-based”
to one that focuses on pre-
vention by providing mental
health care to more people.
“There’s too long of a
line of people trying to get
into the mental health sys-
tem,” he said.
The governor reiterated
his plan to move mental
health care away from large
institutions to smaller com-
munity-based centers. He
proposes opening housing in
communities so that people
can be treated in centers that
are closer to their families.
“I am very confi dent that
we can get this job done,”
Inslee said. “We know what
works. We know how to fi x
this problem.”
Inslee said he wanted to
invest in the troubled West-
ern State Hospital to address
safety concerns there, but
he didn’t mention the rise in
assaults at the state’s largest
psychiatric hospital.
AP Photo/Ted S. Warren
Washington Gov. Jay Inslee, center, spoke last May in
front of Western State Hospital in Lakewood, Wash.
A recent Associated Press
investigation found that
attacks by patients on staff
and other patients has been
increasing in recent years.
The 850-plus bed facil-
ity in Lakewood also lost
its certifi cation by the Cen-
ters for Medicare and Med-
icaid Services and federal
funding after it repeatedly
failed health and safety
inspections.
Workers at the hospi-
tal have said that they’re
in crisis mode and fear for
their safety as they go into
work each day. Nurses,
counselors and others who
care for patients must work
an unhealthy and unsafe
amount of overtime to keep
the wards staffed, they say.
Inslee said there was a
critical shortage in men-
tal health workers across
the state, and his remedy
would be to provide schol-
arships for people interested
in pursuing a career in that
area.
His written plan calls for
$56 million for infrastruc-
ture at Western and East-
ern state hospitals. It doesn’t
mention an increase in staff-
ing, which is what workers
want.
The governor hopes to
eventually move many of the
civil commitment patients to
community-based centers
and reserve beds in Western
State for forensic patients
who are held through the
criminal justice system.
He said they would need
to talk with communities
that are targeted to house
some of the civilly commit-
ted patients.
They need to understand,
he said, that “all of us can be
touched by mental health.”
Audit fi nds Oregon keeps vital opioid information under wraps
The state program
has little teeth
By CLAIRE
WITHYCOMBE
Capital Bureau
SALEM — Oregon is
collecting valuable informa-
tion about opioid prescrib-
ers and their patients but
state law hamstrings using
the system to confront drug
abuse, state auditors said
Tuesday.
Oregon, like all other
states, collects information
on prescriptions for con-
trolled substances like Oxy-
codone and Percocet.
But Oregon’s program
has little teeth, auditors
found.
Auditors blamed state
lawmakers, saying that con-
straints they put in place on
the program, created nearly
a decade ago, limit the pro-
gram’s “effi ciency, effec-
tiveness and impact.”
Misuse or abuse of pre-
scription drugs can lead to
abuse of illicit drugs like
heroin and fentanyl, the
audit report said.
Secretary of State Den-
nis Richardson Tuesday
released results of his audit,
focusing on the Oregon
Health Authority’s use of
the prescription system.
His auditors noted that
more seniors are hospital-
ized for opioid abuse, over-
doses and dependence in
Oregon than in any other
state.
Oregon ranks sixth for
teen drug use and is the
worst in the country for
treatment and recovery sup-
port for teens.
Colin Murphey/The Daily Astorian
The state hopes to improve a drug monitoring program
to help combat drug abuse.
Underreported
While deaths due to
prescription opioids have
declined 45 percent since
a peak in 2006, about one
Oregonian dies from an opi-
oid overdose every three
days, auditors said. Some
research suggests that
deaths from prescription
opioids are underreported
by 20 to 35 percent.
In March, Gov. Kate
Brown declared addiction a
public health crisis.
In the face of such prob-
lems, prescription monitor-
ing could provide Oregon a
wealth of information about
how opioids are prescribed
and dispensed and more
tools to prevent abuse.
It can help the state catch
patterns like doctors who
overprescribe, pharmacists
who dispense “excessive
quantities” of opioids and
problems like “doctor shop-
ping,” where a patient goes
to different doctors to get
multiple prescriptions.
But in Oregon, even
if the state fi nds “egre-
gious” examples of ques-
tionable prescribing hab-
its, the information can’t be
shared with regulatory or
enforcement agencies that
could investigate, auditors
said.
Oregon is one of nine
states that don’t make pre-
scribers or pharmacies use
drug monitoring databases
to check patient histories
before prescribing certain
drugs.
And although prescrib-
ers are required to regis-
ter with the monitoring pro-
gram, only about 77 percent
of prescribers have done so,
auditors found. There are no
repercussions in state rules
for prescribers who don’t
register, auditors said.
This year, a new state
committee reviewed pre-
scribers’
histories
for
high-volume
prescribers
and other warning signs.
That group identifi ed
160 medical profession-
als in Oregon with suspi-
cious prescribing patterns
and reached out to them
with letters suggesting more
training or education. The
professionals had no obli-
gation to take the advice or
to even respond, auditors
said.
And the committee that
detects suspicious pat-
terns can’t share its fi ndings
with state health licensing
boards.
Police also have lim-
ited access to the informa-
tion, available only with
a warrant as part of a drug
investigation.
The state’s licensed phar-
macists and prescribers
fund the prescription data-
base through annual fees
totaling about $800,000 per
year.
Red fl ags
State auditors found red
fl ags in the state’s database.
Reviewing three years
of information, auditors
found 148 people who each
received controlled sub-
stance prescriptions from 30
or more providers and fi lled
their prescriptions at 15 or
more pharmacies.
In comparison, auditors
said, the average patient in
Oregon gets prescriptions
from two providers and two
pharmacies.
Auditors recommended
changing state law to
allow the drug monitor-
ing program to analyze
data on prescriber, phar-
macy and patient practices,
and to share those results
with licensing boards and
police.
The state could also give
the state committee that
reviews prescriptions more
authority, and require pre-
scribers to check the pro-
gram’s database to review
Consult a
PROFESSIONAL
Q: What causes
bad breath?
all food eaten begins
A: Basically,
to be broken down in your
JEFFREY M. LEINASSAR
DMD, FAGD
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By GILLIAN FLACCUS
Associated Press
or cold?
you hurt,especially in
A: If a joint,
use ice; it reduces
ASTORIA
CHIROPRACTIC
for one species in one day,”
said Jason Cope, a research
fi sheries biologist at the
National Marine Fisheries
Service. “There was a lot of
avoidance, a lot of places
you couldn’t go and proba-
bly a lot of paranoia. It was
a lot of kind of walking on
eggshells.”
Improved
population
numbers mean there’s now a
buffer for such mistakes and
anglers can go to places they
haven’t fi shed in years with-
out as much worry, he said.
Key to these changes is
the recovery of the yellow-
eye rockfi sh, one of several
species of rock fi sh that were
in trouble just 15 years ago.
The combined annual
catch limit for the yelloweye
will increase from 20 met-
ric tons to 48 metric tons in
2019, although regulators
could begin to make adjust-
ments to fi shing restrictions
when the catch approaches
39 metric tons to allow room
for error.
Anglers will be able to
fi sh at greater depths and in
locations that were previ-
ously off-limits. One imme-
diate effect will see fewer
fi shing boats crowded near
the shore where anglers were
less likely to net the over-
fi shed species.
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inflammation and pain and
shortens healing time. You can get
a burn from ice just like with heat,
so don’t leave it on for more than
20 minutes. Most problems get
better more quickly with ice. Heat
feels good, but may seriously
make problems worse. As long
as there is pain and/or swelling,
continue ice; it can be done as
often as once an hour. Would you
heat a cut? No, because it would
keep bleeding —that is what
happens inside where you can’t
see it.
Q: I haven’t received
my new Medicare
card. What should
I do, everyone I
know has theirs?
Steve Putman
A: If you didn’t receive it in
the mail or lost it, here’s
Medicare Products what to do: call Medicare at
1(800)MEDICARE.
503-440-1076
Licensed in Oregon
and Washington
putmanagency@gmail.com
Remember that your new
Medicare card will come in
a plain white envelope from
the Department of Health and
Human Services.
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Tiffany Ann Phillips
Dec. 12, 1980
Jan. 4, 1998
LEO FINZI
ASTORIA
TRANSIT CENTER
PORTLAND — Federal
offi cials said Tuesday they
are increasing catch limits
for several species of West
Coast groundfi sh that were
severely depleted more than
a dozen years ago, posing a
threat to the commercial and
sports fi shing industries.
Limits for yelloweye
rockfi sh will more than
double, while substantial
increases will be allowed
for California scorpionfi sh,
bocaccio and Pacifi c Ocean
perch, the National Marine
Fisheries Service said.
Those species have recov-
ered enough to allow for the
greatest expansion of a West
Coast fi shery in years. The
formal announcement of
the revised catch limits will
be published today and the
changes go into effect on Jan.
1, the fi rst day of the new
fi shing season.
Fishing income in Cal-
ifornia, Oregon and Wash-
ington state could increase
$60 million because of the
changes, with the potential
for 900 new jobs and at least
200,000 more angler trips a
year, according to a prelimi-
nary report.
“It’ll actually allow us to
fi sh,” said Tom Marking, a
recreational fi sherman from
Eureka, California.
“Right now, there are a
lot of places you just avoid
because they’re known as
yelloweye hot spots. You just
stay away from them. If they
allow us to go to 30 fathoms
or 40 fathoms or all depths,
it’ll allow the fl eet to spread
out.”
Between 1999 and 2002,
nine West Coast ground-
fi sh stocks were declared
overfi shed as surveys docu-
mented declining numbers.
Because more than 90
total groundfi sh species share
the same habitat, anglers
fi shing for a permitted spe-
cies risked also catching
restricted fi sh and exceeding
the overall limit — a mistake
that could mean an end to the
fi shing season for that partic-
ular species. The limits dev-
astated the fi shing industry
along the West Coast. Many
businesses went under and
tensions between the indus-
try and federal regulators ran
high for years.
“Back then, one boat
could catch all the quota
mouth. Bacteria which accumulate
with food form a sticky film called
plaque which leads to gum disease.
This process creates what is known as
volatile sulfur compounds resulting
in bad breath. Poor brushing habits,
a coated tongue, strong odor foods,
smoking and heavy alcohol drinking
all contribute to bad breath. If this
is you, do something about it by
calling your dentist to schedule an
evaluation.
Q: Should I use heat
Barry Sears, D.C.
Catch limits increase for key West Coast groundfi sh species
a patient’s prescription
history.
The Capital Bureau is a
collaboration of EO Media
Group, Pamplin Media
Group and Salem Reporter.
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