Hepatitis A cases surge in Colorado, El Paso County

Hepatitis A infections are surging this year across Colorado - with dozens of people most recently exposed at a Colorado Springs homeless shelter.

Across the state, one person has died and at least 57 people have tested positive for the liver disease this year - more than double Colorado's typical annual caseload, said Dr. Rachel Herlihy, the Colorado Department of Public Health and Environment's state epidemiologist.

El Paso County ranks as the hardest hit, with 12 cases so far this year, said Shannon Rowe, a county epidemiologist. Half of those people infected needed to be hospitalized, and all are recovering.

The surge comes as several other states deal with outbreaks of the virus, which is found in fecal matter and is spread through sex or through contaminated food or water. Poor hand washing is often to blame.

Related:

ACLU sues Colorado Department of Corrections over lack of Hepatitis C treatment

"What Colorado is experiencing is sort of mirroring what's happening across the country, and even actually in Western Europe, other parts of the globe as well," Herlihy said.

Some outbreaks, such as one San Diego, ran rampant through homeless communities.

In Colorado and El Paso County, most cases involved men having sex with men, or people visiting adult bookstores or adult arcades, health officials said.

Few of the infected people here have been homeless. But one who was recently forced El Paso County health officials to swiftly open two temporary clinics to halt its spread.

Last week, county health officials gave vaccination and immunoglobulin shots to 62 people exposed to a person with hepatitis A who stayed at the Salvation Army's homeless shelter, 709 S. Sierra Madre St.

That person had recently been in San Diego, though lab tests have yet to confirm whether that person's infection was linked to the outbreak there, Rowe said.

County health officials remain concerned that not everyone possibly exposed at the shelter received prophylaxis shots.

They are working with several homeless service providers to help them identify symptomatic clients. For example, the city's two largest homeless shelters have been asked to screen visitors for signs of the illness.

"We're trying to hit it from all the angles we can," said Danielle Oller, a county health department spokeswoman.

Health officials also are urging other residents to get vaccinated - especially those at higher risk for the disease. They include anyone in those affected populations, people with chronic liver disease or people traveling to places where the disease is common.

"It is a vaccine that is given now routinely to all children - but not all adults, because that recommendation has only been in place for a number of years," Herlihy said. "So we do know there is a substantial proportion of the adult population in Colorado that is quite vulnerable to infection."

The disease can damage the liver, and it can be deadly.

Symptoms include jaundice, fatigue, severe stomach pain, nausea and diarrhea. They typically don't show for two weeks to nearly two months after a person becomes infected - meaning people exposed to the disease can spread it without knowing they're sick. That makes controlling the virus difficult, Herlihy said.

Hepatitis A differs from hepatitis B and C in that it is not chronic - meaning people can recover and gain immunity from it.

The last time so many people in El Paso County were infected was in 2013, when 17 cases were reported. Eleven of those people were sickened in an outbreak tied to contaminated pomegranate seeds.

Trump seeks new health chief after Price resignation

WASHINGTON (AP) — President Donald Trump is seeking a new health secretary to take the place of Tom Price, ousted after an outcry over flying on costly private charters for official travel.

The Health and Human Services chief oversees a $1 trillion department, with 80,000 employees and jurisdiction over major insurance programs, advanced medical research, drug and food safety, public health, and disease prevention.

The administration will also have to contend with renewed scrutiny of Cabinet members' travel. Following news reports about Price, the House Oversight and Government Reform Committee launched a governmentwide investigation of travel by top political appointees.

Trump has named Don J. Wright, a deputy assistant secretary of health, to serve as acting secretary.

Mentioned as a possible permanent successor to Price is Seema Verma, a protege of Vice President Mike Pence. She now leads the Centers for Medicare and Medicaid Services, an HHS division that runs health insurance programs covering more than 130 million Americans.

Verma's immediate challenge is to manage the 2018 open enrollment season under the Obama-era Affordable Care Act, which Trump and the GOP-led Congress have been unable to repeal.

Another possible HHS candidate is FDA Commissioner Scott Gottlieb, who won some bipartisan support in his confirmation and is well known in policy, government and industry circles.

Price, 62, a former GOP congressman from the Atlanta suburbs, resigned Friday afternoon. His pattern of costly trips triggered investigations that overshadowed the administration's agenda and angered his boss. Price's regrets and a partial repayment couldn't save his job.

Price became the first member of Trump's Cabinet to be pushed out in a turbulent young administration that has seen several high-ranking White House aides ousted. He served less than eight months.

On Friday Trump called Price a "very fine person," but added, "I certainly don't like the optics" around his travels.

Price said in his resignation letter that he regretted that "recent events have created a distraction."

Privately, Trump had been telling associates in recent days that Price was overshadowing his tax overhaul agenda and undermining his campaign promise to "drain the swamp" of corruption, according to three people familiar with the discussions who spoke on condition of anonymity.

Price's repayment of $51,887.31 for his own travel costs did not placate the White House. The total travel cost, including the secretary's entourage, could amount to several hundred thousand dollars.

An orthopedic surgeon turned politician, Price rose to Budget Committee chairman in the House, where he was known as a fiscal conservative. When Price joined the administration, Trump touted him as a conservative policy expert who could write a new health care bill to replace the Obama-era Affordable Care Act.

But Price became more of a supporting player in the GOP's futile health care campaign, while Vice President Mike Pence took the lead, particularly with the Senate. The perception of Price jetting around while GOP lawmakers labored to repeal the Obama health law — including a three-nation trip in May to Africa and Europe— raised eyebrows on Capitol Hill. Price flew on military aircraft overseas.

But House Speaker Paul Ryan, R-Wis., said Friday that Price had worked hard to help that chamber pass its plan before the GOP effort reached an impasse in the Senate. "I will always be grateful for Tom's service to this country," he said.

Democrats were glad to see Price go. Some urged Trump to appoint an HHS secretary who would reach out to them.

"I hope President Trump learns from this mistake, and looks to appoint someone who can work in a bipartisan way to strengthen health care for all Americans," said Rep. Frank Pallone, D-N.J.

Price used private charter flights on 10 trips with multiple segments, when in many cases cheaper commercial flights were available. His charter travel was first reported by the news site Politico.

The controversy over Price was a catalyst for Congress launching a bipartisan probe of travel by political appointees across the administration. The House oversight committee has requested travel records from the White House and 24 federal departments and agencies.

Initially, Price's office said the secretary's busy scheduled forced him to use charters from time to time.

But later Price's response changed, and he said he'd heard the criticism and concern, and taken it to heart.

___

Associated Press writers Jonathan Lemire and Catherine Lucey contributed to this report.

Make Happiness a Priority with 3 Strategies

Happiness is a combination of how satisfied you are with your life and how good you feel on a day-to-day basis, according to research compiled by Happify. While it varies from person to person, approximately 40 percent of happiness is controlled by your thoughts, actions and behaviors, meaning we are largely in control of our own happiness.

For most people, happiness is something we have to work at. It’s easy to dwell on the negative things around us or in our own lives, but part of being happier is recognizing that hardships and working through them are a part of life. At the core, happiness requires investment on your part – it’s imperative to take an active role in being happier.

Here are a few simple ways you can increase your happiness.

Focus on the good.

Concentrating on the good things in your life is an easy way to increase your happiness. Think about past experiences, future goals or plans and savor the moment you’re in. Dr. Fred Bryant, a professor at Loyola University Chicago, coined the term “savoring, ” in his research. He illustrated how people who regularly savor the moment are happier. This can be as simple as counting the times you smile or laugh in any given day. It might surprise you how quickly these moments add up throughout the day!

Find gratitude and optimism.

The practice of gratitude can increase happiness levels by around 25 percent, according to one study. Being thankful makes us recognize the kindness of the people around us. Thanks to genetics, some people do tend to be more optimistic than others, but did you know, the act of thinking about your future in a more positive light will lead to greater happiness? If you believe your goals are within reach, you’re more likely to reach them. Feeling hopeful and thankful are powerful contributors to your overall happiness.

Practice happiness.

There are a number of activities and simple exercises you can practice each day to increase your happiness instantly and over time. Start with a simple practice, like journaling. Digitally or by hand, think back on three things that make you happy each day. If you need some inspiration, check out The Five Minute Journal, which asks “What could I have done better today?” This simple question can push you to take a deeper look at how you can improve your own happiness. Giving back or to others can help solidify your own personal happiness too. The act of giving a loved one a gift or spending time doing community service in your neighborhood makes us feel more connected to the world around us and strengthens our relationships and bonds.

Throughout life we will have moments of higher levels of stress and lower levels of happiness; the key to being a happier person is realizing that positive feelings will ebb and flow and turning to your happiness toolbox for help. Happiness is based on a number of factors, some we are in control of and others that are circumstantial. But if you prioritize the practice of happiness, you will inevitably experience happiness. For added peace of mind, give this blog post a read.

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Resources:

PODCAST

“What makes a good life? Lessons from the longest study on happiness.”

Listen in as psychiatrist Robert Waldinger shares three lessons learned from the study and gives advice on how to be happier.

https://www.ted.com/talks/robert_waldinger_what_makes_a_good_life_lessons_from_the_longest_study_on_happiness

BOOK

The Happiness Advantage: The Seven Principles of Positive Psychology That Fuel Success and Performance at Work. 

For more on the power of positivity, particularly as it relates to your work life, consider Shawn Achor’s book.

https://www.amazon.com/Happiness-Advantage-Principles-Psychology-Performance/dp/0307591549

ACTIVITY

The benefits of giving back are two-fold: to whom you’re giving and yourself. If you’re in need of inspiration and would like to spend more time in your community, find an organization or charity near you.

Call a Certified Broker In Colorado

We can help all along the way! Insurance is important and complicated. That’s why we still offer a state-wide network of confidential experts who are trained to assist you, at no additional charge. Our certified Brokers and Assistance Network teams are qualified to help you understand your options for coverage.  Jo Anne Bly 719-434-2015, Licence Broker for Connect For Health Colorado.

Learn More

Colorado Tax Subsidiary Credit Save $$$

Are you leaving money on the table?

Are you one of thousands of Coloradans who qualify for the monthly savings but don’t know it? Even if you make as much as $45,000 a year ($98,000 for a family of four) you can access financial help to lower your monthly premiums. You can quickly check to see if you qualify for savings. Open Enrollment starts November 1. Likely you’ve heard that costs for premiums will be going up for 2018. The good news is that financial help increases right alongside those premiums, making it more important than ever to check to see if you qualify.  Please call me I can help you, as I am a Certified Health Insurance Broker for Connectforhealthco.com  719-4342015, Jo Anne Bly

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No ACA Repeal and Replace under 2017 Reconciliation Process – What’s Next? On September 26, Senate Republican leadership determined the Graham-Cassidy bill, which would repeal and replace parts of the Affordable Care Act (ACA), did not have enough support to bring up for a vote by the Senate. This bill was the Senate’s final attempt to repeal and replace the ACA under the fiscal year 2017 reconciliation rules, which expire on September 30. The budget reconciliation process was the preferred option by the Republican-led Congress to pass legislation to repeal and replace parts of the ACA. While the House passed a bill back in May, the Senate was unable to pass any legislation even with the 51 vote threshold for a reconciliation bill (versus 60 votes for non-reconciliation bills). Since more than two of the 52 Republican Senators opposed the various repeal and replace bills, none garnered the required votes to pass. Because authority for the budget reconciliation is derived from the current fiscal year’s budget resolution, the Senate parliamentarian ruled that the 2017 reconciliation process must conclude by the end of the federal government’s fiscal year, September 30. What’s Next for the ACA and Health Care Reform? Before Senate Republicans focused their efforts on the Graham-Cassidy bill, the Senate Health, Education, Labor and Pensions (HELP) Committee held bipartisan hearings to discuss “actions Congress should take to stabilize and strengthen the individual health insurance market” in 2018. With the 2017 reconciliation deadline passing, it’s possible bipartisan efforts will now resume since Republicans do not have enough votes to pass a bill without Democratic support. Republican leadership in Congress could also start the reconciliation process over again for the 2018 fiscal year. Restarting the reconciliation process would require a 2018 budget resolution with the appropriate instructions for reconciliation to pass both chambers of Congress, then 2018 bills would need to be drafted and voted on in both chambers. An identical bill must pass both chambers before the President can sign into law.

?No ACA Repeal and Replace under 2017 Reconciliation Process – 

What’s Next

On September 26, Senate Republican leadership determined the Graham-Cassidy bill, which would repeal and replace parts of the Affordable Care Act (ACA), did not have enough support to bring up for a vote by the Senate. This bill was the Senate’s final attempt to repeal and replace the ACA under the fiscal year 2017 reconciliation rules, which expire on September 30.

The budget reconciliation process was the preferred option by the Republican-led Congress to pass legislation to repeal and replace parts of the ACA. While the House passed a bill back in May, the Senate was unable to pass any legislation even with the 51 vote threshold for a reconciliation bill (versus 60 votes for non-reconciliation bills). Since more than two of the 52 Republican Senators opposed the various repeal and replace bills, none garnered the required votes to pass. Because authority for the budget reconciliation is derived from the current fiscal year’s budget resolution, the Senate parliamentarian ruled that the 2017 reconciliation process must conclude by the end of the federal government’s fiscal year, September 30.

What’s Next for the ACA and Health Care Reform?
Before Senate Republicans focused their efforts on the Graham-Cassidy bill, the Senate Health, Education, Labor and Pensions (HELP) Committee held bipartisan hearings to discuss “actions Congress should take to stabilize and strengthen the individual health insurance market” in 2018. With the 2017 reconciliation deadline passing, it’s possible bipartisan efforts will now resume since Republicans do not have enough votes to pass a bill without Democratic support.

Republican leadership in Congress could also start the reconciliation process over again for the 2018 fiscal year. Restarting the reconciliation process would require a 2018 budget resolution with the appropriate instructions for reconciliation to pass both chambers of Congress, then 2018 bills would need to be drafted and voted on in both chambers. An identical bill must pass both chambers before the President can sign into law.

Congress at Crossroads After Another GOP Healthcare Failure

WASHINGTON (AP) — Congress is at a crossroads after Republicans' stinging failure to repeal Barack Obama's health care law. But what's next — more partisan conflict or a pragmatic shift toward cooperation?

Unless Republicans and Democrats in Congress can work together, and bring along an often unpredictable President Donald Trump, political conflict over health care may spread. Bipartisan talks on legislation to stabilize shaky insurance markets are on again, but time is short and there's no guarantee of success.

Congress also has yet to renew funding for programs that traditionally enjoy broad support, such as children's health insurance and community health centers, despite approaching deadlines.

Feelings were raw Tuesday after Senate GOP leaders announced they would not take their latest "repeal and replace" bill to the floor for lack of support. Some lawmakers said it's still possible to bridge the partisan gap on a limited set of priority issues.

Sen. Lamar Alexander, R-Tenn., said he would resume efforts to reach a bipartisan deal with Sen. Patty Murray, D-Wash., to stabilize markets for individual insurance policies that 18 million people rely on. More than half of those consumers are covered under the health law.

Alexander is chairman of the Senate Health, Education, Labor and Pensions Committee; Murray is the top Democrat on the committee. Alexander runs the risk of being accused by some fellow Republicans of trying to "bail out Obamacare."

Murray is under pressure from fellow Democrats not to make concessions to Alexander, who is seeking changes that would make it easier for states to get waivers from some of the law's requirements, potentially leading to plans with lower premiums.

"I'm still concerned about the next two years, and Congress has an opportunity to slow down premium increases in 2018, begin to lower them in 2019, and do our best to make sure there are no counties where people have zero options to buy health insurance," Alexander said in a statement.

Sen. Ron Wyden, D-Ore., who has worked with Republicans on a range of health care issues, said cooperation is the only way to avoid creating needless problems for constituents.

"You recognize the opportunities that are in front of you," said Wyden, the top Democrat on the Senate Finance Committee, which oversees health care funding. "My hope is we can come together."

Wyden's list includes renewing the Children's Health Insurance Program for 9 million kids, whose funding expires this week, as well as short-term action to stabilize the Affordable Care Act's insurance markets, by guaranteeing subsidies for copayments and deductibles. Experts say that could cut expected double-digit premium increases in many states by about half.

The missing ingredient seems to be leadership, say outside observers.

Neither Trump, nor House Speaker Paul Ryan nor Senate Majority Leader Mitch Connell has given clear approval for a bipartisan approach. Some governors have called for a health care reset that would involve both parties working together on a limited agenda, but their suggestion hasn't been embraced in Washington.

"The question is whether you can you forge a coalition that doesn't include either the hard right or the hard left," said GOP health economist Gail Wilensky. "I have not been able to answer who would provide the leadership for such an effort. Neither the leadership in the House or the Senate has embraced the notion of trying to forge a bipartisan coalition, and it is very hard to move legislation without that."

Rep. Richard Neal, D-Mass., said Trump at a meeting with lawmakers raised the possibility of seeking a deal with Democrats. There's no hint what that might entail.

If anything, Democrats have been moving to the left after Sen. Bernie Sanders, I-Vt., relaunched his "Medicare for all" plan recently. Under Sanders' plan, government would pay for medical services, replacing employers and insurers. Some liberal activists argue that support for "single-payer" should be a qualifying test for Democratic candidates in 2018 and beyond.

Other Democrats say single-payer would lead to political defeat, because of the massive tax increases required.

"It's not going to happen," said former Rep. Henry Waxman, D-Calif., one of the main authors of the Obama law. "You can talk about it, and plant a flag, and say that's where you'd like to go, but in the meantime people need their insurance coverage."

Wednesday is the deadline for insurers to sign contracts to offer policies for 2018 on the health law's markets. Sign-up season starts Nov. 1. About half the 18 million Americans with individual policies get no subsidies under the health law. Without congressional action some are facing premiums that rival a mortgage payment.

Saturday is the deadline for Congress to act on children's health insurance and community health center funding. Brief delays are not expected to cause disruptions, but a protracted holdup would.