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Where Iowa House District 30 candidates stand on the issues – Des Moines Register

Des Moines Register staff| Des Moines Register

From 2022 races to caucus action, what to watch for in Iowa politics

It's an election year: Look for no shortage of news from Gov. Kim Reynolds' and Sen. Chuck Grassley's reelection races to early Iowa caucus action.

Megan Bridgeman, Wochit

Republican Jerry Cheevers is running against Democrat Megan Srinivas to represent Des Moines' south side in the Iowa Legislature.

The two are seeking to succeed Democratic state Rep. Bruce Hunter, who is retiring at the end of his term, for the seat in the redrawn Iowa House District 30. Cheevers has run unsuccessfully against Hunter in two previous campaigns. Srinivas won June's Democratic primary, defeating Democrat Eddie Mauro.

To help voters, the Des Moines Register sent questions to all federal, statewide and Des Moines area legislative candidates running for political office this year. Their answers have been lightly edited for length and clarity.

Cheevers did not respond to the Register's request to fill out a questionnaire.

Early voting begins Oct. 19 for the Nov. 8 election.

More:A guide to voter rights in Iowa. What you need to know before you cast a ballot

Age:No response

Party: Republican

Where did you grow up? No response

Current town of residence: Des Moines

Education: No response

Occupation: No response

Political experience and civic activities: No response. Cheevers previously ran for the Iowa House in 2018 and 2020.

Age:35

Party:Democrat

Where did you grow up?Fort Dodge

Current town of residence:Des Moines

Education:

Occupation:Physician

Political experience and civic activities:

Cheevers: Did not respond.

Srinivas:I became a doctor to help my community, but so many of the challenges that my patients and neighbors face are systemic problems that I cannot solve with my prescription pad. The reason Im running is to address those issues, the social determinants of health that keep people from living the quality of life they deserve. This includes making sure people have access to the things that they need to succeed, such as food, housing, transportation, good jobs, and education. All of these factors are critical to ones health, and I will advocate for my community using this holistic approach.

More:Where Sonya Heitshusen & David Young stand on key issues in the House District 28 race

Cheevers: Did not respond.

Srinivas:We need to bolster our small businesses, especially after the economic hardship of the last few years. Ill also work for all Iowans to have access to a living wage protect pensions, including IPERS and 411, so workers enrolled in these plans remain secure in their retirement. Additionally, affordable childcare is a hurdle for many in the workforce. We must support childcare businesses in the face of rising operational costs that caused many to close over the pandemic. We can also adopt an income-based tax credit to create affordable childcare options. These upfront investments to create viable childcare options will spur economic growth for the state.

Cheevers: Did not respond.

Srinivas:As a physician, I strongly believe that an individuals healthcare decisions are their own and should only be discussed with their medical team. Ill advocate for an individuals right to abortion care. Ill also fight against efforts to remove insurance coverage for contraception and family planning. In 2017, our state stripped family planning health centers of public funding if they are affiliated with an abortion provider or even discuss abortion as a healthcare option. One of my goals is to reverse this policy and improve delivery of reproductive health services in every part of our state.

More:Where Iowa House District 27 candidates Kenan Judge & Kristen Stiffler stand on key issues

Cheevers: Did not respond.

Srinivas:We need to increase our supplemental state aid (SSA funding) to public schools to not just meet inflation, but to make up for the underfunding of the last decade. We need to change the narrative from our legislative leaders about our teachers and school staff, recognizing the critical and hard work they do rather than attacking them. We can improve teacher recruitment and retention by increasing teacher pay and creating programs to help with education loans for individuals teaching in high-need areas. We also must properly fund our public universities and community colleges. Additionally, I'll advocate to reinstate vocational curricula into schools.

More:Meet Todd Halbur & Rob Sand, running for Iowa state auditor in the 2022 election midterms

Cheevers: Did not respond.

Srinivas:

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Where Iowa House District 30 candidates stand on the issues - Des Moines Register

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What is relational health, and why is it so important? – Contemporary Pediatrics

Rebecca Baum, chief, section of Development, Behavior, and Learning at the University of North Carolina, Hillsborough, North Carolina; and Katherine Wu, MD, FAAP, Pediatric Health Care Associates in Cambridge, Massachusetts began their presentation, Promoting relational health during health supervision visits with an anecdote of a mother sitting in a pediatricians office with 2 of her children, one rather unruly. If you dont stop misbehaving, Im going to get the doctor to give you a shot, the very stressed mother warned her child.

Comical or concerning? Using the Bright Futures Guidelines, 4th edition, a book that offers principles, strategies, and tools to improve the health and well-being of children through culturally appropriate interventions, the 2 practitioners went on to explain relational health, how the pediatric HCP can promote relational health during office visits, and offered both strategies and resources for attendees.

Baum and Wu explored 4 concepts during their session: adverse childhood experiences (ACEs); toxic stress; relational health; and strength-based approach. ACEs were categorized into 3 different types; neglect, abuse and household challenges, such as substance misuse, divorce, etc) along with other adversity (bullying, community violence, etc). ACEs can increase the risk for disease, early death, and poor social outcomes, Baum stated.

Toxic stress was explained as biological processes that occur after the extreme or prolonged activation of the bodys stress response in the absence of safe, stable, and nurturing relationships (SSNRs), the crux of this conversation. With SSNRs, children, even in the face of ACEs, can still grow up to be mentally and emotionally stable adults.Relational health, in essence is what creates these SSNRs, and the focus is on finding patient, family, and community capacities that can promote these SSNRs. How to create, though? As the presenters explained, the strength-based approach shifts the focus from a deficient model (emphasizing problems and disease detection) to health promotion and disease prevention, acknowledging the patient and familys particular skills that can promote family (and particularly patient) overall well-being.

Baum and Wu then shared examples through videos of doctors and parents discussing challenges in the family that could be impacting the patient. The key takeaways here:--the clinician should echo the mothers concerns (I am sorry to hear that you are going through the challenge of a divorce right now)-- then through positive reinforcement, help the parent to strategize additional solutions to the problem (It is great that you can work with your ex-husband in that way; would it be OK if I help you explore some additional options to come up with a solution to your childs misbehaving?).

If a family is successfully executing SSNRs, it will reap positive benefits; the child will demonstrate interest and curiosity to learn new things; complete tasks; and (one of the most important), stay calm and in control when faced with a new challenge (ie, moving to a new school).

Additionally, Baum and WU shared both screening tools and resources, and offered these final suggestions:--Assess a childs level of relational health as part of pediatric health supervision visits--Support families by utilizing the common factors approach (using hope, empathy, lay language, support; ask the family for permission to delve further with questions; and partner with family for solutions)--Provide prevention and treatment counseling and guidance to children and adolescents and their parents/families--Refer to local parent/child services when relationships are strained--Advocate for effective opportunities for focusing on relational health in schools, communities, and hospitals--Incorporate relational health in medical school curricula

ReferenceBaum R, Wu K. Promoting relational health during health supervision visits. 2022 AAP National Conference & Exhibition. October 9, 2022. Anaheim, California.

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How to improve the prior authorization process for Medicare Advantage – Medical Economics

Study looks at how prior auths help and hurt health care - and how they can be made better

A study from the University of Colorado and Johns Hopkins University on the prior authorization process for Medicare Advantage plans identified several areas for improvement.

The study, published in JAMA, examined the benefits and problems with prior authorizations, which 99% of MA plans use for at least some medical services. The goal of prior authorization is to ensure appropriate use criteria are met and the right care is provided to the patient to reduce unnecessary spending. This also can benefit the patient through reduction in premiums and lower out-of-pocket costs through better care allocation and reduced denials. The study also notes that when applied to medications, prior auths can provide an additional level of safety review.

On the other hand, patients must content with inappropriate denials due to omissions or errors in the medical record, or inappropriate application of clinical practice guidelines. An HHS report in 2018 found that 56% of audited MA contracts inappropriately denied prior auth requests. Approximately 75% of audited denial appeals were successful, raising concerns that MA plans were denying services and payments that should have been approved, according to the report.

Prior auths can also cause delays in care, which for serious conditions, can cause possible harm to the patient, according to the report. Prior auths create a substantial administrative burden, with 93% of physicians reporting care delays and 82% reporting abandonment where the patient does not follow through because of prior authorization policies, and can contribute to physician burnout.

Because of these issues, the report notes that calls for reform have resulted in Congressional bills to establish requirements for MA plans with respect to the timeliness and efficiency of prior auths.

The report outlines the following proposed measures that may help improve the use of prior authorization in Medicare:

Plans should use an electronic-based prior authorization process with time-bound requirements for initial and appeal decisions.

Plans should be mandated to report guidelines used to make prior authorization decisions and seek input from respective medical societies and stakeholder groups on an annual basis.

In addition, to expand the congressional legislation, the following proposed measures could be considered:

The relative benefits and costs of prior authorization should be reviewed by the CMS at the procedure level. Such review could consider evidence from other care rationing mechanisms, including price. All else equal, unnecessary care is less of a concern in clinical scenarios for which demand is inelastic and there is little price sensitivity (eg, high-cost chemotherapy when there is not a lower-cost alternative). In such cases, restrictions on access due to prior authorization will introduce little change in wasteful or unnecessary care while still generating additional administrative costs.

Medicare Advantage insurers should report approval and denial rates annually to the CMS based on beneficiary sociodemographic characteristics and by procedure type so that the CMS can monitor whether prior authorization policies may be increasing disparities in access to care.

Drawing upon MA insurersubmitted data on denial rates, the CMS should audit the denials of plans with high-denial rates. Setting thresholds for audit could be based on a comparison with other MA plans, as well as in consultation with patient, caregiver, clinician, and insurer stakeholders.

The authors conclude that by improving transparency and accountability of the process, prior authorization can better function as a tool to improve high-value care for Medicare beneficiaries.

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Is the doctor’s office heading for extinction? – Medical Economics

Survey shows that alternative sites for care are gaining popularity with consumers

When it comes to where Americans prefer to receive their care, retail clinics, virtual health, and community centers are all growing in popularity, according to a survey from the Deloitte Center for Health Solutions. These changes reflect patient preferences to have health care be more similar to other consumer retail experiences.

There is a growing desire to use retail clinics, and this is especially true among underserved populations, according to the survey. Only 10% of consumers have used a retail clinic in the past year, but many more say the would be likely to or maybe would use retail clinics for preventive care (55%) or mental health care (47%). Black, Asian, and Hispanic respondents were more likely than White respondents to use retail clinics, and urban respondents were more likely than rural ones.

Virtual care, which became popular during the worst months of the pandemic, continues to be popular with patients. Nearly three in four consumers with Medicaid (74%) or HIX plans (73%) would use virtual health for mental health visits, and nearly two-thirds of all consumers would use virtual visits for preventive care.

According to the report, health care organizations looking to stay relevant need to take several steps. They should create more access points and include opportunities to address the drivers of health. They need to develop diverse care teams, ensure care continuity, and invest in virtual health technology and training.

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Taubman to Conclude CEO and Dean Terms In December 2023 – URMC

Mark B. Taubman, M.D., URMC CEO and Dean of the School of Medicine and Dentistry, has decided not to seek reappointment upon completion of his terms as CEO and Dean. The 72-year-old URMC leader will hand over the reins on December 31, 2023 or later if a successor has not been identified, as announced by University of Rochester President Sarah Mangelsdorf at todays Board of Trustees meeting.

I have been honored to lead this great institution and am proud of the significant advances we have achieved, particularly over the past two years, Taubman said. With so many of the goals of our strategic plan either accomplished or well underway, the time feels right to begin succession planning to assure our Medical Center is structured for a strong and vibrant future.

Taubman racked up many firsts during his tenure. In 2015, he became the first to serve as both Dean of SMD and URMC CEO. He was the first to create and implement an integrated strategic plan for URMC that stretched across all three missions, re-invigorating the foundations for core patient care, research, and education activities, and significantly boosting commitments to diversity and inclusion efforts. He led a strong and successful faculty leadership recruitment focus, and assured a renewed emphasis on financial agility by establishing the Medical Centers first integrated financial model to recognize its interdependent missions and ensure support for the academic enterprise.

More recently, his steady and reassuring leadership was essential to the Universitys response to the COVID-19 pandemic. He also worked with Monroe County public and health officials to structure a coordinated community plan, and dedicated Medical Center resources to build tools and infrastructure to support screening, testing and eventually equitable distribution of vaccine within the Rochester community and surrounding regions.

Mark has been a visionary leader and a thoughtful, supportive colleague to me and to so many others across the institution, Mangelsdorf said. The fact that he is providing us with ample notice of his future plans so that we can thoughtfully organize and conduct a search for his successor is just another indication of his commitment to the ongoing work of the University and the Medical Center. I am not only grateful for Marks past service; Im also glad that we can count on his continued service for the next 15 months.

Taubman said that he will actively work to conclude many important initiatives currently underway. These include developing local solutions to our nations health care worker shortage, improving the Medical Centers financial performance and growing the research mission. He will also stay focused on finalizing expansion and modernization plans for Strongs Emergency Department and inpatient areas, opening the first phases of UR Medicines Orthopaedics and Physical Performance Center, and lay plans for the future growth of the UR Medicine health system.

A board-certified cardiologist, Taubman came to the Medical Center as chief of the Cardiology Unit and Paul N. Yu Professor in Cardiology in February 2003. He became chair of the Department of Medicine and Charles E. Dewey Professor of Medicine in May 2007, and served in that role until being named as dean. He briefly served as acting CEO in 2010 while former CEO Bradford Berk, M.D. recovered from an injury.

Taubman graduated from the New York University School of Medicine and completed his residency and cardiology fellowship training at the Brigham & Womens Hospital. He held academic appointments at Harvard Medical school, Childrens Hospital Boston, and Mt. Sinai School of Medicine. Prior to being recruited to the University of Rochester, he was director of cardiovascular research at Mt. Sinai.

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Becher promoted to Chief Medical Officer at Community Care of West Virginia – My Buckhannon

Buckhannon, W.Va. Dr. Kimberly Becher has been promoted to Chief Medical Officer at Community Care of West Virginia (CCWV), joining the leadership team with more than a decade of experience in the medical industry.

Becher joined CCWV in 2014 as a family physician at Community Cares health center location in Clay.

Kimberly has an extensive background in the medical field and has shown immense passion for her community and issues that face our rural patients, announced Patricia Collett, chief operations officer of Community Care of West Virginia. I am confident that she will make an excellent and vital addition to our leadership team.

Becher has held several leadership positions at the university, state, and national level. As a medical student, she was a member of the American Academy of Family Physicians (AAFP) Commission on Governmental Advocacy. She was selected as a resident spokesperson for the AAFPs 2012 visit to the White House. She served as a resident on the board of directors of the AAFP from 2013 to 2014 and as the New Physician Delegate to the AAFP Congress of Delegates in 2018.

I have dedicated my career to bettering the health and lives of West Virginians and I am excited to take my responsibility to the next level so that we can continue to grow and deliver services that best serve our patients and their whole health needs, said Becher.

Becher acquired her undergraduate degree in biology from Denison University in Granville, Ohio, in 2002. She received her medical degree from Marshall University Joan C. Edwards School of Medicine in 2011 where she also completed her family medicine residency and served as one of the departments chief residents. Between her undergraduate studies and medical school, Dr. Becher carried out breast and colon cancer research at the University of Cincinnati.

As we continue to grow and expand our services, Dr. Becher has the vision and expertise to lead us into this next phase as our new chief medical officer, stated Collett.

Becher grew up in West Virginia and is an active member of her community. She has served as a volunteer physician at the Marshall Medical Outreach homeless clinic and as a volunteer at the Health Sciences and Technology Academy of West Virginia University summer camp. She also served on the Mountaineer Food Banks board of directors from 2018 to 2021 and continues to be on the Clay Senior and Community Services board.

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