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DR. LEWIS: “Knee-Jerk Reactions Will Harm Tennessee’s Children”

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“Knee-Jerk Reactions Will Harm Tennessee’s Children”

An Op-Ed from Dr. Terri Lewis of Tennessee

In recent days, the contingent of state legislative anti-vaxxers successfully browbeat the Tennessee Department of Health into cancelling childhood vaccine outreach programs – not just for COVID19, but for all routine childhood immunization programs.

On face, it appears that the TN Dept of Health, responsible for public health in 89 of Tennessee’s 95 counties excluding major metropolitan areas where local agencies wield more authority, will no longer conduct public outreach for any preventable childhood communicable disease.

‘Don’t ask, don’t tell’ seems to be the new public health strategy.

Tennessee lags behind the nation in all measures of disease prevention through vaccination. As of July 13, the number of fully vaccinated Tennesseans for COVID settled at 2,599,234 or 38.06% of the population. Overall, Tennessee ranks 33rd among the 50 states with a childhood vaccination rate of 79.9% against a population of 6,944,260. Tennessee currently meets HP2030 targets for 2 out of 3 vaccination-related measures for 24-month old children.

But there are significant gaps.

Many of Tennessee’s children have not completed the entire series of vaccines for preventable illnesses in the last decade. Minority children are less likely to be fully immunized. Some parents refused any and all routine immunizations.

Progress toward meeting vaccination rates for children up to the age of 24 months is located on theTNDOH website [1].

As concerning is the announcement by Dr. Tim Jones, Chief Medical Officer, that henceforth, no vaccination efforts will be conducted for routine childhood vaccines, with the HPV vaccine particularly singled out.

No outreach includes “pre-planning” for flu shots events at schools and back to school vaccines, and by inference, routine immunizations for infants, toddlers, teens and college students. Responsibility for back to school vaccines will become the responsibility of the Tennessee Dept of Education, not the TNDOH.

The elements of a successful outreach effort are well documented.

First, parental and community education and messaging around the safety, efficacy, and importance of childhood immunization is essential to ensure that children receive the full complement of preventive vaccines. With the gap in health insurance coverage for children this is an important function of the TNDOH at the county level across the state.

Second, there must be ready access to immunizations at every opportunity. The percent of children without health insurance increased from 5.2% in 2018 to 5.7% in 2019, with Hispanic children most represented in the childhood insurance coverage gap [2]. By fall of 2020, 9% of Tennessee children were uninsured, more than twice the level at the same time in 2019, according to the Vanderbilt Center for Child Health Policy[3]. Brief periods of being uninsured can have long-term effects on the health of children and their achievement in school… children who lose their insurance miss important immunizations and go months with major unaddressed problems…” [J. Zickafoose, MD, MS, Monroe Carrell Children’s Hospital at Vanderbilt]. Children who fall into the coverage gap are least likely to receive preventive care.

Third, reliable and readily accessible immunization records that provide a non-duplicated reflection of on-time immunizations are important for ensuring an accurate personal history for personal health management. This responsibility lies with health providers, not the Tennessee Department of Education. Lack of health coverage will magnify the negative impact of the childhood coverage gap where the health system fails to conduct routine outreach.

Finally, preventable childhood diseases are on the rise with the reduction in vaccination rates. Uninsured children are particularly vulnerable. When compared with privately insured children, uninsured children have more health disadvantages including need for medical or dental care; greater severity of illness, more hospitalizations and higher mortality rates; more vaccine-preventable disease; and higher rates of chronic illness such as asthma and diabetes [4].

The announced actions that resulted decisions to termination vaccine program leadership and cease immunization program outreach will have harmful effects resulting in tangible, measurable harms to Tennessee’s children and youth.

I strongly encourage the re-examination of these knee-jerk reactions to pressures exercised from certain sectors of the population.

[1] https://www.tn.gov/content/dam/tn/health/documents/cedep-weeklyreports/2020-24-Month-Old-Survey.pdf

[2] https://www.aappublications.org/news/2020/12/01/researchupdate120120

[3] https://www.vumc.org/health-policy/tennessee-poll-uninsured-kids-covid19-2020

[4] https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/Uninsured_children/state/TN

Dr. Terri Lewis

Silver Point, TN

Global Immunization Action Network Team

https://www.giant-int.org/

 

 

 

@TheTNHoller

VIDEO: LIGHTS FOR LIBERTY ACROSS TENNESSEE

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Tennesseans across the state gather to protest the Trump administration’s inhumane treatment of refugees and immigrants at the border, especially children.

VIDEO: ARMING TEACHERS BILL HIGHLIGHTS (Heads to House & Senate Committees Wednesday)

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Last week HB 1380 – a bill from Ryan Williams (R-Cookeville) to allow teachers to arm themselves in Tennessee’s schools – passed out of the K-12 subcommittee, despite every single witness who testified making a case in opposition, including a teacher, a student, a former teacher, and 3 representatives from law enforcement.

Watch the Highlights:

The Senate version is SB1399 by Sen. Mike Bell (R-Riceville).

The two measures are scheduled to be heard on the same day this week: Wednesday, April 10th.

The bill, as amended, allows the carrying of loaded, concealed weapons by school employees with permits. The names of the employees would be kept confidential, though it appears neither the school nor the state would be held liable for any of the employee’s actions in relation to a shooting incident.

Law enforcement witnesses included Brink Fidler, a former Metro Nashville plainclothes officer, Sheriff John Fuson of Montgomery County, representing the Tennessee Sheriffs Association, and Colonel Dereck Stewart of the Tennessee Highway Patrol.

They all were concerned about training and allowing teachers to teach and law enforcement to handle those duties.Sheriff Fuson also pointed out the issue of responding officers differentiating between well-intentioned  school employees and an active shooter.

House Education Committee chair Rep. Mark White (R-Memphis) said he talked to authorities at a Kentucky school in the aftermath of a shooting there, who said arming teachers “would’ve been the worst thing they could to.”

Rep. Williams responded that Parkland’s authorities thought differently.

Rep. Iris Rudder (R-Winchester) felt it was a “discussion worth having” and helped it pass to full committee, while Rep. John Mark Windle (D-Livingston) asked why Tennessee wouldn’t pay for School Resource Officers everywhere with the $1 Billion surplus.

The bill is before the house and senate committees Wednesday. Holler at your reps.

Rep. Byrd Co-Sponsored Child Rape Bill Hits House Floor Today (yes, seriously)

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Another one from the You-Couldn’t-Make-This-Up-If-You-Tried file…

HB 0283, a bill being carried by Rep. Littleton (R-Dickson) in the house and Senator Dawn White (R-Murfreesboro) in the senate, will be voted on in the house today.

The summary of the bill states:

“Criminal Offenses – As introduced, increases the punishment for a conviction of aggravated rape of a child from 15 to 60 years in prison and a fine of up to $50,000 to life in prison without the possibility of parole. – Amends TCA Title 39, Chapter 13 and Title 40, Chapter 35.”

The bill is being co-sponsored by a long list of reps… including the one and only Rep. David Byrd, who as a reminder has apologized on tape to 1 of 3 women who accuse him of molesting them when they were in high school, and who was removed from his education subcommittee chairmanship just last week.

The week prior Byrd’s son was forced out of his coaching spot in Jackson for “inappropriate communication” with a minor.

Let’s just say Rep. Byrd has some nerve coming anywhere near this bill. Feel free to holler at him HERE and let him know.

And feel free to holler at Speaker Casada and Governor Lee and let them know it’s time to call for Byrd’s resignation.

TN ED REPORT: “100% FOR CHARTERS, 2.5% FOR TEACHERS” #StateOfTheState

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Andy Spears owns the public policy consulting firm Spears Strategy which provides policy and advocacy consulting to school systems, non-profits, and parent groups. Spears holds a Ph.D. in Public Administration with an emphasis in education policy. Over the past 15 years, he has worked in public policy roles in state and local government in Kentucky and Tennessee. Follow @TheAndySpears for his take on politics and policy and subscribe to the TN ED REPORT HERE.

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Tonight, Governor Bill Lee outlined his proposed budget for 2019-2020. Lee’s budget doubles the fund for charter school facilities to $12 million. This amounts to a benefit of $342 per student (there are roughly 35,000 Tennessee students in charter schools).

Meanwhile, he announced a meager improvement to teacher salaries of around 2% – $71 million. This amounts to $71 per student.

So, charter schools — which serve only 3.5% of the state’s students — will see a 100% increase in available facility funding from the state while teachers will see only a 2% increase in pay.

If the two investments were equal and funded at the rate granted to charter schools, there would be a $342 million investment in teacher salaries. That’s roughly a 10% raise. A raise that’s desperately needed as Tennessee leads the nation in percentage of teachers with little to no classroom experience. We also have one of the largest teacher wage gaps in the Southeast.

As one Nashville teacher pointed out, Nashville – and the entire state — have a failed business plan:

I’m starting a business and looking for workers. The work is intense, so the workers should be highly skilled. Experience preferred. Starting salary is 40k with the opportunity to get all the way to 65k after 25 years of staying in the same position. See how dumb that sounds?

Now, those are numbers for Nashville. Some teachers around the state have to teach for 10 years before they even hit $40,000. Still, the point is clear: The value proposition for teachers in our state is not very good. Unfortunately, Governor Lee’s first budget is not doing much to change that. It’s the status quo. A nominal increase that will likely not entirely make it into teacher paychecks.

Tennessee’s numbers when it comes to both investment in schools and educational attainment are disappointing. Continuing along the same path means we’ll keep getting the same results.

The bottom line: Money matters.

 

 

Dems Meet Gov. Lee To Plead For Medicaid Expansion – Children’s Hospitals Against GOP Block Grant Idea

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This week a group of Democratic state representatives met with Governor Lee to implore him to reconsider his stance against expanding Medicaid in Tennessee, as most states already have.

Studies show the states that have expanded Medicaid have seen better health results, economic benefits, and fewer rural hospital closures.

Tennessee is losing $26 Billion over 10 years by not accepting billions in federal Medicaid expansion dollars that would cover hundreds of thousands of Tennesseans, including 30,000 veterans, and as a result currently leads the country in rural hospital closures per capita. The 13th rural Tennessee hospital just announced closure in Celina this week, and Democrats held an emotional press conference in the state capitol about it on Monday.

The group of Democrats calls itself the House Democratic Caucus Medicaid Expansion Task Force. They weren’t sure what kind of impact they had on Governor Lee, but said they’ll continue to try.

The general feeling was that the Williamson County-based governor doesn’t seem to understand how desperate for care some Tennesseans are, many of which don’t have another year or two left to wait for a new plan.

They did however say one thing Lee agreed with was preserving the provision of the Affordable Care Act that guarantees the protection of those with pre-existing conditions from discriminatory insurance company practices, which a Republican lawsuit in Texas seeks to undo.

From Rep. Gloria Johnson:

“We will try to continue the conversation, but it’s going to take the people rising up. The current Block Grant bill the Republicans have only takes current TennCare and turns it into block grants, probably serving fewer people than we even do now.”

The Block Grants proposal is something Tennessee Republicans are starting to push hard, with Senate leader Jack Johnson talking to the Tennessean about it this week.

Medicaid expansion is popular in Tennessee.

Block Granting Medicaid is not popular in America:

President Trump is trying to find a way to provide states like Tennessee with a block grant waiver, since they are currently illegal. Even if the president does manage to push that legislation through, it would instantly trigger lawsuits.

Meanwhile the details of the Tennessee Republicans’ Block Grants plan are “vague”, and nobody seems to be sure how it would solve the problem of covering MORE people who aren’t currently covered.

If anything the opposite would be true. The non-partisan Congressional Budget Office estimates recent Republican block grant proposals could cut Medicaid spending by as much as a third over the next decade. The cuts would start small, growing larger over the years.

Rep. Gloria Johnson also had this to say about Block Grants:

“Any waiver will instantly be challenged in court. This is not a good faith solution. This is folks who know they are getting hammered and want to appear as if they are doing something.”

It should also be noted that Children’s Hospitals, which rely heavily on Medicaid, are extremely against Block Grants, which they say would lead to cuts in coverage. Jim Kaufman, vice president of public policy for the Children’s Hospital Association, explained that proposals to simply block grant or shift costs to the states are the wrong way to go:

“Block grants cause cost-shifting that further burdens the financially strapped state budgets.  Instead, children’s hospitals want to improve access to care while reducing costs.”

And as Republican Senator John Chafee said in opposition to Medicaid block grants back in 1996:

“As states are forced to ration finite resources under a block grant, governors and legislators would be forced to choose among three very compelling groups of beneficiaries.

Who are they? Children, the elderly, and the disabled. They are the groups that primarily they would have to choose amongst. Unfortunately, I suspect that children would be the ones that would lose out.”

Just this week House Minority Leader Kevin McCarthy was heard on a phone call explaining to donors that health care issues like this are the reason Republicans got shellacked in November, and that the pre-existing conditions issue was a particular weakness.

Republicans claim to be the ones protecting the provision, but since they are also suing to undo the provision at the same time nobody seems to be buying it.

Even if you aren’t covered by Medicaid, you probably know someone who would be affected by block granting Medicaid.

To encourage Governor Lee to start listening, holler at him HERE.

“More War!” – All 7 TN GOP Congressmen Vote to Keep Fueling Humanitarian Nightmare in Yemen

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In another bipartisan rebuke of Trump’s foreign policy in the Middle East, the House passed a bill yesterday to halt U.S. involvement in Yemen’s civil war, where the United States has been lending our support to a Saudi Arabian war effort that has created the worst humanitarian crisis in recent memory.

All 7 Republican Congressmen from Tennessee: Mark Green, Tim Burchett, Phil Roe, John Rose, Scott Desjarlais, David Kustoff, and Charles Fleischmann voted against the bill.

Both Democratic congressmen – Jim Cooper and Steve Cohen – voted for it.

18 Republicans voted with the Democrats to stop American assistance in the Yemeni war.

According to a Worldwide Threat Assessment report, Of the nearly 29 million people in the country, about 22 million — nearly 76 percent of the population — need some form of humanitarian assistance. Among them, 16 million don’t have reliable access to drinking water or food, and more than 1 million Yemenis now suffer from cholera.

Dave Harden, a former US official leading humanitarian development response to Yemen, told Vox:

“The only losers are the people — their grave suffering presents generational risk to Yemen’s future.”

Democratic Rep. Jim Mcgovern had this to say about the vote:

“Nearly all of the bombs that have fallen say the same thing, `Made in the United States of America’. They fall on weddings. They fall on hospitals and on homes. They fall on funerals, refugee camps and school buses. It is an aerial bombing campaign that hammers civilians every single day.”

Last year, a bomb that originated in the U.S. landed on a school bus in Yemen, killing 40 children.

The vote is yet another bipartisan rebuke of President Donald Trump’s foreign policy. The resolution would force the administration to withdraw troops from involvement in Yemen, in a rebuke of Trump’s alliance with the Saudi-led coalition.

Previously the Senate had passed a similar bill, but it was stopped in the house of representatives which was then controlled by the Republicans. If the senate were to take up this bill, it would land on the President’s desk.

This new resolution was introduced by Rep. Ro Khanna (D-California), who said in a statement:

“Today is historic. This is the culmination of several years of legislative efforts to end our involvement in the Saudi war in Yemen. I’m encouraged by the direction people are pushing our party to take on foreign policy, promoting restraint and human rights and with the sense they want Congress to play a much larger role.”

Meanwhile the Saudi government still refuses to acknowledge its role in the murder of Washington Post columnist Jamal Khashoggi despite all the evidence, and President Trump has still stopped short of blaming or taking action against Saudi Arabia for it.

In related news, there are many questions about the president and his family’s financial ties to Saudi Arabia, and what role that may be playing in these foreign policy discussions.

As the President himself once said:

“Saudi Arabia, I get along with all of them. They buy apartments from me. They spend $40 million, $50 million. Am I supposed to dislike them? I like them very much.

Holler at Mark Green, Tim Burchett, Phil Roe, John Rose, Scott Desjarlais, David Kustoff, and Charles Fleischmann and let them know if you feel their vote to perpetuate this war flies in the face of human decency.