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About East Oregonian : E.O. (Pendleton, OR) 1888-current | View Entire Issue (Jan. 11, 2019)
A8 OFF PAGE ONE East Oregonian Friday, January 11, 2019 2019: Health care providers are a ‘key resource’ Continued from Page A1 right sources — olive oil and lean chicken, for exam- ple, instead of bacon and sausage. Guenther said the time of day people eat is important as well. Many people make the mistake of skipping breakfast or lunch every day, leading them to over- eat unhealthy foods later or snack after dinner. “Eat more earlier in the day and less in the evening,” she said. Both Guenther and Treadwell said planning ahead is an important part of eating healthy. Diets fall apart when there aren’t healthy ingredients around the house or meal prep for days when there isn’t time to cook. “If someone wants to work on increasing their vegetable intake, for exam- ple, they need to come up with a plan,” Guenther said. “How are they going to do that? If they say, ‘I’m going to eat this much,’ how does that fit into their day? Will it be snacks? Or with dinner?” For people planning to increase or decrease certain foods in their diets, there are plenty of resources. Ore- gon State University’s Food Hero website, for example, features a large collection of healthy recipes searchable by ingredient. And Good Shepherd Health Care Sys- tem in Hermiston just put together a new cookbook called “Shepherd’s Pie.” Kathy Thomas, wellness coordinator for Good Shep- herd, said the cookbook’s recipes were submitted by staff and reviewed by the hospital’s wellness commit- tee and a registered dietician to make sure each recipe selected was healthy, practi- cal for a family on a budget and passed “the delicious taste test.” The cookbook is ded- icated to Jared Bowling, who was Good Shepherd’s head chef and nutrition ser- vices manager for more than Staff photo by Kathy Aney A student in Hermiston Head Start’s healthy cooking class gives a sample of overnight oatmeal to her son. The recipe includes blueberries, apples and yogurt. 10 years before his death. Thomas said the first order, selling at $15 apiece, is almost sold out. The money goes toward the Agape House’s backpack program to send food home on the weekend with school chil- dren who might otherwise go hungry. Good Shepherd also offers a variety of classes and one-on-one options around healthy eating. They can be found at http://www. gshealth.org/classes-events. Quitting smoking As some people try cut- ting back on foods that are harmful to their body, oth- ers are focusing on quitting another harmful substance: tobacco. Dr. Tom Jeanne, deputy health officer for the Ore- gon Health Authority, said the OHA does see a spike in calls to its quit line this time of year. The department is taking advantage of reso- lution season to run adver- tisements reminding people that the state has resources to help them quit smoking. They can call 1-800-QUIT- NOW (1-800-784-8669) 24 hours a day or visit www. quitnow.net/oregon for guidance. “In Oregon we know nearly three out of four people who smoke want to quit,” he said. Many of them have tried before but relapsed. Nico- tine is “highly addictive,” Jeanne said, and those try- ing to quit can easily be trig- gered by smelling cigarette smoke or seeing someone else using. There is hope, he said, even for people who have tried and failed to quit in the past. Millions of people have quit eventually. Jeanne said some peo- ple do manage to power through on their own, but using a combination of counseling and FDA-ap- proved products such as nicotine patches doubles a person’s chances of quitting permanently. Tobacco ces- sation tools are covered by all health insurance provid- ers in Oregon. “They really do raise people’s chances of quitting for good,” he said. Health care providers are also a “key resource,” Jeanne said. It is important for people trying to quit to talk to their doctor, who can give them advice about what options will work best and help them make a quit plan. Smoking kills 8,000 Ore- gonians a year and worsens chronic diseases in many more. Jeanne said the bene- fits of quitting are longterm, but also immediate: After 12 hours, a smoker’s carbon monoxide levels go down to the level of a nonsmoker’s, and after just one year their risk of coronary heart dis- ease is cut in half. Doctors: Wrote 3.1 million opioid prescriptions in 2016 Continued from Page A1 Under the program, retail pharmacists report prescrip- tions of controlled sub- stances, such as Oxycontin and Xanax, to the state within 72 hours of dispensing them. The state maintains three years of prescription data. The issue of prescriptions has been central to govern- ment efforts to reduce the number of overdose deaths attributed to opioids. In 2016, Oregon doctors wrote 3.1 million opioid pre- scriptions at a rate 13 per- cent higher than the national average. That year, 312 Oregonians died from an opioid over- dose, a rate of about 7.6 per 100,000 people, according to the National Institute on Drug Abuse. Nationally, the rate was 13 people in 100,000. Oregon legislators in 2017 revised the state’s prescrip- tion reporting system to flag doctors who prescribe high volumes of opioids or pre- scribe conflicting drugs. State auditors examining the system found instances of Oregonians “doctor shop- ping.” Nearly 150 people were identified as each get- ting prescribed drugs from at least 30 different doctors. That led auditors to ques- tion how the state deals with those doctors identified as improperly prescribing opioids. “Questionable prescribing habits seen within the data, even those that are egregious, cannot be elevated to any regulatory or enforcement entities to directly look into those situations,” auditors said in their audit released in December. Auditors recommended that a state review committee get authority to require pre- scribers to justify practices deemed “concerning” and to collaborate with licensing boards and police. The state committee con- fidentially reviews prescriber, pharmacy and patient pre- scriptions, according to the Oregon Health Authority. It also developed criteria defin- ing risky prescribing. When the committee spots a suspicious pattern, it typi- cally writes to the doctor. A sample letter that state audi- tors reviewed said it was an “invitation to explore” the state’s resources and “review your prescribing practice.” The doctors don’t have to acknowledge the letter, or take any more training or education, auditors said. The information can’t be shared with medical licens- ing boards. Those licensing boards can obtain the state’s infor- mation if they certify the information is needed for an investigation. According to the Health Authority, state licens- ing boards in the last three months of 2018 requested drug monitoring information 109 times. Department offi- cials couldn’t recall a time when they denied a request for such information from the board and said the requests are increasing. Police can obtain the mon- itoring program’s data with a court order. By the time Oregon legis- lators established the state’s prescription drug monitor- ing program in 2009, Oregon was behind dozens of other states already operating sim- ilar programs. Rob Bovett, former Lin- coln County district attor- ney who at the time lobbied on behalf of law enforce- ment groups, helped lead the charge to create the monitor- ing program. The law was the result of “a lot of bargaining and com- promise” between advocates and the ACLU of Oregon and the Oregon Medical Associa- tion, Bovett said. Police and prosecutors wanted to tackle prescrip- tion drug abuse at the source, Bovett said. “Oregon law enforcement doesn’t just want tools to go after people for drug abuse,” Bovett said. “They prefer that drug abuse drop because they’ve got plenty to keep them busy and we just, quite frankly, don’t have enough of them.” Gary Schnabel, the exec- utive director of the state’s Board of Pharmacy from 1999 to 2014, said the board floated the idea of the state monitoring controlled sub- stance prescriptions for years before the legislation was passed. He got the idea while at a national conference and learned what other states were doing. “It was the very begin- nings of the opioid crisis, and it was a way to actually monitor opioid use,” Schna- bel said. The point was to identify people using more than a cer- tain amount — whatever pro- gram administrators thought was appropriate — and let doctors know. Pharmacists hoped the program could prevent issues like doctor shopping by hav- ing doctors intervene when they found a patient had mul- tiple prescriptions for the same or conflicting drugs. But they didn’t want to share the database with police or investigators. “The only people who (would have) access to that data were the patient them- selves, or the patient’s phy- sician,” Schnabel said. Shutdown: So far, effects have been minor Continued from Page A1 If a rental provider agrees to participate in the program, they will receive a portion of the rent from a public hous- ing agency (such as Umatilla County Housing Authority), which receives the funds from HUD. The tenants pay the rest of the rent. So far, the effects have been minor. Some paper- work processing has been stalled because no one is staffing the USDA office, Stradley said, but they have reserve funds that have got- ten them through the first three weeks of the shutdown. But he said if the shut- down does not end and the USDA can’t give out rental assistance, in February it will affect people renting proper- ties in Boardman, Hermiston and Umatilla. If HUD can’t deposit funds for Section 8 housing, he said, there will be 300 families across four counties without funding. He said the residents will be the last to feel the impact. “We’ll do everything we can,” he said, adding that he does not foresee any evictions for that rea- son. But he said that with those in Section 8 housing, effects may be felt sooner, because the housing author- ity doesn’t own or manage the properties. “Depending on how indi- vidual owners want to treat it, I imagine some will be understanding,” he said, “and some will want their rent, and be entitled to it.” Federal agencies including the Umatilla National For- est, the U.S. Fish and Wild- life Service and United States Department of Agriculture have all been closed. Services including the McNary Dam and the National Weather Service were deemed essen- tial, and employees have con- tinued to work. The Oregon Energy Fund announced on Thursday that it may be able to help fur- loughed employees get emer- gency funding for utility bills. They said they don’t provide direct funding, but they dis- tribute funds to partner agen- cies that may be able to help workers. Federal employ- ees can reach the nonprofit at 971-386-2124 or at Ore- gonEnergyFund.org to see if they are eligible. Regina Baltrusch, a pub- lic information officer for the U.S. Army Corps of Engi- neers, said the three princi- pal appropriation bills for fiscal year 2019 which sup- port funding for the corps were passed by congress and signed into the law before fis- cal year 2019 began, on Oct. 1, 2018. “These bills together virtually cover all Direct Funded USACE activities and an overwhelming major- ity of the reimbursable work for the remainder of this fis- cal year,” Baltrusch wrote to the EO in a statement. “Nobody else would have access to it.” The state association rep- resenting doctors and the ACLU of Oregon resisted at first, Schnabel said. The ACLU of Oregon worried the program would invade patient privacy and could be susceptible to data breaches. Some health care providers also voiced privacy concerns, legislative records show. “They thought it was inva- sive,” Schnabel said of the Oregon Medical Association. “They thought it might get physicians in trouble, thought it might be punitive against the physician for prescribing. They just didn’t trust it.” Courtni Dresser, director of government relations for the Oregon Medical Associ- ation, said the group never opposed the program. The monitoring system was cumbersome at first, said Dr. Amy Kerfoot, an Oregon Medical Association trustee who represents the associa- tion at the governor’s Opioid Epidemic Task Force. In recent years, the associ- ation urged reforms to make it easier for doctors to use the monitoring data, Dresser said. In 2017, state lawmak- ers created the special com- mittee to review prescrib- ing practices of controlled substances. The bill was sponsored by state Rep. Knute Bue- hler, R-Bend, a surgeon, and supported by the medical association. The committee advises the Health Authority on inter- preting prescription informa- tion and training prescribers. State law requires commit- tee members be licensed health care practitioners with at least five years’ experi- ence prescribing controlled substances. The following year, Gov. Kate Brown asked the Legis- lature to mandate registration in the prescription program. Kerfoot testified in favor, as did other health care groups like the Oregon Pri- mary Care Association. “Requiring practitioners to register with the Prescrip- tion Drug Monitoring Pro- gram is another important step in the right direction,” Kerfoot told lawmakers in a letter. She said the program would be “a powerful tool to help providers rethink pre- scribing decisions that had been automatic in the past, but maybe should not have been for many patients.” In an interview, Kerfoot acknowledged that the med- ical association was con- cerned that doctors would become more liable for their prescribing decisions. “You never want to have a legislative body sending out what a physician is lia- ble for when they don’t yet have the background on the patient, the indications, the rationale behind it,” Kerfoot said. “They want prescribing to be safe, but prescribing is a tool that should be available to the people who need to use it — qualified physicians and pharmacists.” But that law created no consequence for not signing up and doesn’t require pre- scribers to access the data- base before prescribing a controlled substance. In 2017, roughly 40 per- cent of prescribers were reg- istered with the program, according to the Oregon Health Authority. By late 2018, after state outreach efforts, 83 percent of pre- scribers were registered. Additionally, only retail pharmacies must submit pre- scription data to the state. That leaves out pharmacies in long-term care facilities and residential treatment facili- ties, auditors said. There are 143 institutional pharmacies licensed in Ore- gon, according to the Board of Pharmacy. Of those, 56 are pharmacies in long-term care facilities. Those facilities often care for patients with chronic ill- nesses or disabilities, rather than patients with acute pain like a back injury. Reporter Claire Withy- combe: cwithycombe@ eomediagroup.com or 971- 304-4148. Withycombe is a reporter for the East Orego- nian working for the Oregon Capital Bureau, a collabo- ration of EO Media Group, Pamplin Media Group, and Salem Reporter.