Capsules

New Executive Order Bans Conversion Therapy

On July 15, Governor Tim Walz signed Executive Order 21-25, protecting Minnesotans from conversion therapy. Conversion therapy, also known as “reparative therapy,” refers to a counseling practice that seeks to change a patient’s gender or sexual orientation. Every leading medical and scientific association including the American Medical Association, American Academy of Pediatrics, and National Education Association have strongly rejected conversion therapy for minors, citing its harmful effects on the long-term mental health. “Our kids deserve to grow up in a state that values them for who they are – not one that tries to change them,” said Governor Walz. “This Executive Order aims to protect young and vulnerable Minnesotans from the cruel and discredited practice of conversion therapy and affirms that the LGBTQ+ community is an integral part of One Minnesota.” The Executive Order restricts the practice of conversion therapy in Minnesota by directing state agencies in a number of ways including:

• Requiring that HMOs and health plan companies do not cover conversion therapy
• Pursuing administrative remedies against those companies that engage in unfair business practices related to conversion therapy.
• Rulemaking as necessary to restrict coverage of conversion therapy.
• Preparing a report on the public health impacts of conversion therapy.
• Not paying for conversion therapy services through Minnesota Health Care Programs such as Medicaid and pursuing recovery for payment of conversion therapy services.
• Pursuing civil enforcement actions against health care providers who are engaged in discriminatory practices related to conversion therapy.

Dr. Angela Kade Goepferd, chief education officer and medical director of the Gender Health program at Children’s Minnesota, was invited to the signing to talk and said “Banning conversion therapy helps us send the message to LGBTQ kids that there isn’t anything wrong with who they are; that the way they love others and identify their genders isn’t’ something to be fixed or changed. But more than that, it gives us the opportunity to boldly step into a space of loving and celebrating LGBTQ kids and all of the ways that their ability to reimagine identity and relationships enhances the world for all of us,”.

U of M Study Highlights Disparities in Financing Medical Education

A study just published in JAMA Network Open, a team including members of the HealthPartners Institute, former faculty and Arman Shahriar, Varun Sagi and Lorenzo Gonzalez, all fourth-year students at the University of Minnesota Medical School, found that nearly 40 percent of all funds used to pay for medical school are expected to come from family or personal sources and scholarships. The prevalence of these sources, however, varies widely by race and socioeconomic status. “Financing a four-year medical education requires upwards of a quarter-million dollars, and this amount has been rising faster than inflation since the 1960s. Prior to this study, little was known about how students pay for medical school, so we set out to shed light on this opaque subject,” Shahriar said. Using data from more than 29,000 medical students who responded to the 2017 to 2019 Association of American Medical Colleges (AAMC) Matriculating Student Questionnaire. The study found that:

• Nearly 25 percent of all medical students come from the top five percent of household incomes (greater than $270,000 in 2019). For comparison, only three to four percent of students from the lowest three income quintiles rely primarily on family or personal funds. 
• Family or personal financing was more prevalent among Asian students and white students and was least prevalent among Black students. Black students graduate with the highest debt burden of any racial group.”
• Between high- and low-income students, scholarships were distributed much more evenly than family or personal funds. The heavier reliance on loans among low-income students suggests an inadequacy of current scholarship amounts to offset the large deficit in family or personal funds.

“Knowing that scholarship funds are finite, individual medical schools should work to ensure that scholarships are awarded through holistic review with ample consideration of economic background,” Shahriar said. “As medicine works toward improving its socioeconomic, racial and ethnic diversity, the last thing we want is for family wealth to be influencing educational quality.” Future work will better examine how financing methods have evolved over time for various subgroups, linking matriculant financing plans with debt at the time of graduation and beyond.

Program in Human Sexuality Rebrands as the Institute for Sexual and Gender Health

Early this month, The Program in Human Sexuality (PHS) achieved the status of an Institute in the Department of Family Medicine and Community Health at the University of Minnesota Medical School. With this elevated status, PHS is announcing a rebranding and subsequent name change. The Program in Human Sexuality is now the Institute for Sexual and Gender Health (ISGH). This name change reflects the academic excellence and clinical growth built over the past 50 years. The Institute for Sexual and Gender Health’s clinical enterprise serves thousands of individuals, couples and families throughout the Midwest. Their research and educational endeavors influence international, national and local policy. Routinely collaborating with organizations, such as the World Health Organization, the World Association for Sexual Health and the Centers for Disease Control and Prevention, ISGH faculty work to raise awareness of sexual rights as an inherent part of universal human rights based on freedom, dignity and equality. Debuting with the new name is a symbol intended to highlight ISGH’s multidisciplinary approach to sexual and gender health: 

• Develop, provide and promote evidence-based best clinical care. 
• Advance groundbreaking discovery through bio-psycho-social gender and sexuality research. 
• Advocate for sex and gender rights.

“The elevation of the Institute for Sexual and Gender Health from a program to an institute is overdue,” said James Pacala, MD, MS, head of the Department of Family Medicine and Community Health. “This group has been at the forefront of progress on every significant issue regarding sexual and gender health for the past 50 years. The institute will advance its proud legacy into the next 50 years.”

Trellis Releases Report on Aging and Health Equity Issues 

Assessment on Access to Title III Services for Native Americans and Minority Older Adult Populations. Compiled by SDK Communications + Consulting the report provides a compelling snapshot of the ways different systems come together to create inequities for Black, Indigenous, and People of Color (BIPOC) elders aging in their communities. It looks at several key elements of health status, including nutrition, transportation, caregiver support services, special access needs and ability to obtain to legal services. While the White population in Minnesota outnumbers all other ethnicities by an over three to one margin, the percentage of chronic and age related health concerns his much higher percentage wise in the, Black, Asian, Hispanic and Native American populations. The report concludes with several suggestions for addressing the core problems. As Minnesotans are aging and the population becoming more diverse, concerns addressed in the report will multiply over the next decade. By 2030, 15 percent of all older adults in the Twin Cities will be people of color. That’s almost 95,000 people in pure population numbers, and equivalent to half of the total Twin Cities older adult population in 2000. In total, this means that Trellis’ work to provide Title III funding in more equitable ways will happen as both the needs for aging services and the needs for elevating equity in the field of aging are accelerating, likely far beyond the pace of funding. The Older Americans Act Title III funds that Trellis administers are intended to help low income and minority adults age in their communities. The results of this assessment show that broader inequities in income, health, housing and more make the work to fund Title III services a critical first step in helping BIPOC elders age in their communities – but only a first step. Part of this first step will be revising the Trellis Request for Proposals (RFP) process to be more transparent and accessible. A new RFP for some Title III services will be released next month.

Regions Expands Inpatient Mental Health Bed Capacity

Early this month Regions Hospital announced plans to expand its inpatient mental health services by adding 20 beds to its current 100-bed, on-campus inpatient mental health building. Regions is the east metro’s largest provider of inpatient mental health services, serving 3,300 patients a year and operating at an average of 97 percent capacity. The project, which will entail converting existing shell space from a 2012 expansion, is expected to be completed by the end of the year and help serve an additional 600-plus patients annually. The additional capacity will allow mental health patients to receive treatment and recover more quickly in a supportive, healing environment while opening Regions Emergency Center beds for patients with various health care needs. “Many who experience a mental health crisis need the lifesaving care of a hospital and a safe place where they can receive intensive treatment,” said Christine Stanson, MD, medical director of inpatient mental health for HealthPartners. “Expanding inpatient mental health services at Regions will help us provide care to the growing number of people experiencing crises.” In addition to a leading inpatient program for patients with suicidal ideation, Regions provides a wide range of comprehensive mental health programs. Other services include Regions Emergency Center, serving about 9,000 patients experiencing mental health crises each year, The Lee and Penny Anderson HeroCare Program, a specialized care program for veterans, military members and their families, DayBridge, a partial-hospitalization program for adults who need intensive therapy but can safely continue living in their communities and residential services such as Afton Place, Safe House and Hovander House.  “Regions is a destination hospital for great care,” Regions President Megan Remark said. “Our community relies on us to be there when they need us, and to create an environment that fosters hope and healing. We are proud to continue to make investments to meet the needs of our community.”  

Hennepin Healthcare Announces Reopening of East Lake Clinic

In a joint statement with Hennepin County, plans were revealed for a phased reopening of the South Minneapolis Human Services Center at 2215 E Lake Street. The building had sustained damage during the George Floyd protests. One of the phases includes the renovation of 10,000 square feet on the sixth floor to become the new home of the East Lake Clinic, whose former building was much more significantly damaged in the protests and had been closed since. Tentatively starting in October 2021 and continuing throughout the year the building will reopen with services scheduled by appointment. “After a difficult year, reopening the Hennepin Healthcare East Lake Clinic will allow us to offer a trauma healing model of care, co-located with critical county services and community support, to a neighborhood that we have been proud to serve for more than a decade and plan to serve for many years to come,” said Jennifer DeCubellis, CEO, Hennepin Healthcare. The Center had been a vital community asset providing a wide range of social services including access to health insurance; food and child care assistance, direct financial support and many related services. Tenants Briva Health and Seward Pharmacy will continue to operate in this space. Besides reopening the East Lake Clinic, new partnering organizations will be added to include the Office of Multicultural Services, a mental health center, and adult probation services. “The goals of the co-location are to provide efficient, effective service and care, create a safe and welcoming space for residents and provide easy access to services,” said Hennepin County Commissioner Angela Conley.

CDI Quality Institute Recognized by CMS

CDI Quality Institute, a non-profit affiliate of RAYUS Radiology, has been qualified as a Provider-led entity (PLE) for the Medicare Appropriate Use Criteria (AUC) Program within CMS. PLE designation is granted to a select group of organizations nationwide tasked with providing real-time clinical guidance to treating physicians ordering diagnostic imaging procedures. Only 22 federally qualified organizations nationwide hold this designation. The Quality Institute is supported by more than 250 sub-specialty trained radiologists and top specialists within RAYUS’ nationwide network. Since its inception in 2003, the Quality Institute has helped define quality measures to ensure patients receive the right test at the right time, reduce unnecessary care – and lower costs.