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April Edition 2021

Inside This Issue

From Questions to Confidence: Understanding COVID-19 Vaccines By Michael Teneriello, M.D., FACOG, Texas Oncology Austin Central

Focusing on Awareness, To Help Communities Overcome Hesitancy Toward The COVID-19 Vaccines See pg. 10

INDEX Legal Matters....................... pg.3 Mental Health...................... pg.6 Healthy Heart....................... pg.8 Age Well................................ pg.13

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or the past year, the pandemic has felt out of our control, and in many ways that’s true. However, COVID-19 vaccines bring new hope – and opportunity for us all to do our part to slow the spread of the virus. As vaccines continue to become available, it’s important to understand how they work, why they’re safe for current cancer patients and survivors, and what to expect at your vaccination appointment. How COVID-19 vaccines work As of spring 2021, there are three COVID-19 vaccines approved under the U.S. Food and Drug Administration’s (FDA) emergency use authorization. Here’s what you should know. • The technologies and techniques used in the COVID-19 vaccines have been studied by scientists and researchers for decades. • The Moderna and Pfizer-BioNTech vaccines use the body’s own immune system to produce a special type of protein, called a “spike protein,” to prevent infection with

COVID-19. • The Janssen/Johnson & Johnson COVID-19 vaccine is different in that it uses a modified version of an adenovirus to deliver a message

as part of clinical trials. As a cancer patient, you may have heard about or participated in a clinical trial focused on innovative new cancer therapies or procedures. Before COVID-19 vaccines were authorized by the FDA, data from large-scale clinical trials confirmed that the benefits of the vaccines are safer than becoming infected with COVID-19. While the process was swift, no steps were skipped. The science is clear: COVID-19 vaccines are safe and recommended for most people, including patients with cancer. What to expect when you get the COVID-19 vaccine Every patient with cancer responds to treatment a little differently – the same is true of COVID-19 vaccines. Here’s what you should know before you’re vaccinated: • Patients with cancer should talk to their physician before getting the vaccine. Immunocompromised patients may have a diminished response to all three vaccines. • Everyone is asked screening questions before getting the vaccine. • For the Moderna and Pfizer-BioNTech vaccines, two

The science is clear: COVID-19 vaccines are safe and recommended for most people, including patients with cancer.

Paralyzed Veteran Learns to Ski During Pandemic See pg. 12

to our cells. That message allows the body to mount an immune response to the COVID-19 virus spike antigen. The adenovirus can’t grow inside our cells or cause illness other than flu-like symptoms. • While you may experience side effects such as arm soreness, headache, fatigue, or mild fever, you cannot get COVID-19 from the shots. Why COVID-19 vaccines are safe All vaccines go through rigorous and lengthy processes, including evaluation by an independent review board, before reaching the FDA’s stringent scientific and regulatory process. For example, COVID-19 vaccines were administered to patients

see Vaccines...page 14

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Legal Matters Who Is Going to Cover Covid Hospitalizations – Commercial Health Plans or Workers’ Compensation

By C. Ryan Morgan, J.D. Tish R. Pickett, J.D. Polsinelli, PC

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ommercial health plans are delaying and even denying reimbursement for COVID-19 hospitalizations — especially high-dollar inpatient stays. Plans are attempting to defer these claims to workers’ compensation on the health plans’ assertion that COVID-19 is a work-related illness. Some hospitals defer to health plans, as it relates to these types of claims, because it is plausible that patients could have contracted COVID-19 at work and because workers’ compensation is typically primary for coordination of benefits purposes. But workers’ compensation is notoriously complex, and hospitals may not understand the nuances of the program

enough to know when it is appropriate to challenge this type of health plan denial. Failing to appeal these denials may impact hospital reimbursement, as well as a hospital’s accounts receivable days, known as “AR days,” depending on the number of COVID hospitalizations and the corresponding amount in open balances. A. Demystifying Workers’ Compensation With a Brief Overview It is important to have a general understanding of workers’ compensation coverage. Workers’ compensation is a state-mandated insurance program that protects employers and employees from financial loss when employees suffer job-related injuries and illnesses. Virtually all employers, even small employers, must maintain workers’ compensation coverage. If an employee suffers an occupational injury or illness, an employer through its workers’ compensation carrier may provide missed wage replacement, temporary and permanent disability, death benefits, and supplemental benefits. But one

of the basic benefits in all states is medical and hospital benefits. Each state regulates workers’ compensation coverage differently, which is a critical factor with respect to COVID-19 and whether a health plan may delay or deny payment. In some states, employer premiums for workers’ compensation policies are experience-rated, meaning that employers that file more claims pay more in premium. B. States’ Response to Classifying COVID-19 as an Occupational Illness When it comes to COVID-19 as an occupational illness, states have responded differently. On one hand, 17 states and Puerto Rico have extended workers’ compensation coverage to include COVID-19 as a work-related illness. Within this group of states, there are varying degrees of coverage. The majority of these states have established COVID-19 workers’ compensability presumptions for various types of workers. In these states, if a designated worker contracts COVID-19,

it is generally presumed that the worker acquired the virus during the course of employment thus eligible for workers’ compensation, including medical and hospital benefits. But employers can dispute this presumption and produce evidence to the contrary, if done so within a certain amount of time under state law. Hospitals are often left out of this decision-making process, which is unfortunate because hospitals may have additional information about where the worker contracted COVID-19. On the other hand, some states still consider COVID-19 an “ordinary disease of life,” similar to a cold or the flu, which means the virus is not covered by workers’ compensation. Still other states have taken no action to clarify whether COVID-19 hospitalizations and treatments should or should not be covered by workers’ compensation. Workers’ compensation see Legal Matters...page 14

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All of Dell Med’s Class of 2021 Matched to Residencies Across the U.S., 40% Entering Primary Care Professions

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embers of the 2021 graduating class of Dell Medical School at The University of Texas at Austin learned today that all of them “matched” and will join residency programs following graduation this May. Among the 47 fourth-year students set to graduate, 19 (about 40%) will enter primary care fields including internal medicine, pediatrics, family medicine, obstetrics and gynecology. The matches were revealed this morning, when graduating medical students across the country opened emails revealing where they would spend the next stage of their medical careers. While Dell Med students are headed for academic medical centers across the country, 32% will stay in Texas. Eight of them will remain in Travis County, where they will continue to learn from Dell Med faculty as part of residency programs jointly led with its academic medical partner, Ascension Seton. Graduating during a global

pandemic has added special meaning to the medical school experience for many. “It’s bittersweet,” said Dekoiya Burton, who earned both M.D. and MBA degrees during his four years as a student. “This pandemic has been so hard for medical education and for health care providers, but graduating is such a celebratory and exciting time. Although there’s a ton of uncertainty and grief, our dreams of becoming physicians are coming true,” said Burton, who learned today that he will embark on a combined internal medicine and pediatrics residency at University of Cincinnati Medical Center – Ohio. Stepping Up to Fill a Growing Gap in the Medical Profession The concentration of graduating students planning to specialize in primary care is expected to help address the shortage of primary care physicians in the U.S., which the Association of American Medical Colleges predicts will grow to between 21,100 and 55,200

by 2032. Additionally, students matching to residencies in the Austin area means more care providers across the community. In 2012, 218 medical residents were providing care in Travis County community clinics and hospitals. That number has since grown to 320 residents in 2020. “Local residency matches among Dell Med students means that Travis County will continue to benefit from the investment in the community it made when voting to create this medical school way back in 2012,” said Sue Cox, M.D., executive vice dean of academics and chair of the Department of Medical Education at Dell Med. How Match Day Works A rite of passage for most

fourth-year medical students, the Main Residency Match system of the National Resident Matching Program (NRMP) connects more than 44,000 applicants and 34,000 training positions every year. Based on a computerized mathematical algorithm, the system considers preferences of both applicants and program directors to produce the best possible outcome for filling training positions available at U.S. teaching hospitals, according to the NRMP. All participants follow the same rules and adhere to the same deadlines. Applicants and programs get to consider all options before making decisions. Not everyone matches, but for those who do, match results are see Match...page 14

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Mental Health Behind the Pandemic, An Epidemic Worsens By Lauren Rouse

While the world focuses on the coronavirus pandemic, the ongoing opioid epidemic in America has gotten worse

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ocial Drug overdoses have increased drastically during the COVID-19 pandemic. Provisional data released from the Centers for Disease Control and Prevention (CDC) and the National Center for Health Statistics (NCHS) indicates more than 81,000 deaths occurred from drug overdoses in the United States between June 2019 and May 2020, which is the largest number of drug overdose deaths ever recorded in the nation for a 12-month period. The report also noted that the rise in overdose deaths during this period was primarily driven by synthetic opioids, with state and local data reporting overdoses were linked to “illicitly manufactured fentanyl.” Texas, although not initially seen as a high opioid misuse state, reported a greater than 50 percent increase

and Aging and chair of the Texas A&M Health Opioid Task Force. Physical distancing and avoiding contacts outside of the home could inadvertently lead to higher numbers of people using substances alone without others to perform life-saving measures like administering naloxone or calling for help in case of an overdose. Additionally, the fear of contracting COVID-19 could deter bystanders from administering life-saving measures or the user from reaching out to health care providers for help. The response to mitigate the COVID-19 pandemic has also involved shelter-in-place recommendations, travel restrictions and physical distancing guidelines, adding additional hurdles to treatment that people with opioid use disorder already face. The opioid epidemic didn’t go away when the coronavirus pandemic began, but access to many treatment options did. Getting treatment for

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April 2021

in synthetic opioid deaths in this 12-month period. The unknowns and challenges that come with a pandemic can cause many people to become stressed and overwhelmed with strong emotions, according to the CDC. This increased stress can cause anger, sadness, worry, frustration and physical reactions such as headaches, stomach pains or skin rashes, worsening mental health conditions, and increased use of drugs, alcohol and tobacco. “It is not surprising that there is a convergence of these two public health crises, and generally negative impacts on both mental and physical health, especially for older adults who may become more socially isolated,” said Marcia G. Ory, PhD, MPH, founding director of the Texas A&M Health Center for Population Health

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opioid use disorder has always been complicated, often requiring daily visits to receive medication, such as methadone, that control cravings and maintain sobriety under the supervision of a clinician. During the pandemic, many such programs have remained shuttered, even as overdoses are on the rise. “Many patients suffering from opioid use disorder lost their main source of continuity, not only for medication and treatment, but also the community of people that supports them during recovery,” said Joy Alonzo, M. Engineering, PharmD, clinical assistant professor at the Texas A&M Irma Lerma Rangel College of Pharmacy and co-chair of see Mental Health...page 13


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April 2021


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Healthy Heart

MARINE MILITARY ACADEMY

During Move More Month this April, Fit in Walking: Morning, Noon or Night By Verónica Sánchez, The American Heart Association

REPARE FOR COLLEGE

CONQUER LIFE!

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alking is one of the most versatile forms of exercise, because you can do it just about anytime, anywhere. During the Heart Walks in November, we encouraged participants to “walk where you are.” Just because we weren’t gathering in large groups didn’t mean you couldn’t be physically active in your own neighborhood.

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This April, during Move More Month, the American Heart Association is reminding Houstonians

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few minutes, so don’t overdress. • Bring your lunch or pick a route where you can grab a quick healthy meal at the end of your walk. Is working out after work your idea of happy hour? • Have a light snack about an hour or two before you leave so you don’t experience an energy dip and talk yourself out of walking. • Pick a route without heavy traffic because rush hour can increase air pollutants. • Do some shoulder rolls and other warm-ups to release the stress of the day before heading out. • If it’s already dark, wear reflective clothing or carry a light. Every Step Counts Most adults should try for at least 150 minutes (2.5 hours) a week of moderate intensity activity. 30 minutes

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to sit less and stay in motion no matter where you are. Here are some tips to get your walk on. Like to move as soon as your feet hit the floor? • Before you go to bed, get your walking clothes and shoes ready so it’s easy to put them on quickly and head out the door. • Eat a piece of fruit or a few spoonfuls of yogurt for a quick fuel-up. • Walking to your favorite jams may help get you moving. Just make sure you can still hear traffic. • If it’s still dark, wear reflective clothing or carry a light. • Be sure to stretch a bit at the end of your walk. Is lunchtime the only break in your busy day? • Schedule your lunchtime walk in your work calendar. Think of it as an important appointment. • Recruit some coworkers to join you virtually. You can keep each other on track. • In cooler weather, you might need a jacket, hat, or gloves. If you’re walking briskly, you’ll heat up in a April 2021

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of brisk walking on at least five days a week is one way to meet this goal. And, for every one hour of vigorous exercise you complete, you can gain back two hours of your life! Staying physically active while we’re in a period of social distancing is so important to maintain our good health. Walking helps lower blood pressure, maintain cholesterol and diabetes, and it also lowers the risk for cardiovascular disease, such as potentially having a heart attack or stroke. You can also soak up some Vitamin D on a sunny day. Any activity is better than none. Even light-intensity activity can offset the serious health risks of being sedentary. Physical activity is linked with better sleep, memory, balance, and cognitive ability, as well as less risk of weight gain, chronic disease, dementia, and depression. For more information on how to Move More this April, go to heart.org/ en/healthy-living/fitness/walking


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Street Medicine, Other Homeless Health Initiatives Receive Permanent Support $2 Million Gift from John Paul and Eloise DeJoria’s Family Foundation Will Create Dell Medical School Chair to Improve the Health of People Experiencing Homelessness

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entral Texans without homes are getting a permanent health champion at Dell Medical School at The University of Texas at Austin. Austin philanthropists John Paul and Eloise DeJoria and their family foundation have given $2 million to create an endowment that will provide ongoing support for Dell Med’s faculty leader and programs improving health for people experiencing homelessness or housing insecurity, as well as other vulnerable populations. Tim Mercer, M.D., MPH, assistant professor of population health and internal medicine, leads the school’s work to develop long-term, sustainable approaches to caring for those without homes in partnership with CommUnityCare Health Centers and Integral Care. Mercer practices as a primary care physician for CommUnityCare’s Health Care for the

Homeless program. “People experiencing homelessness and other vulnerable populations require innovative care models to address their health and social needs,” Mercer said. “JP and his family get this, and we are so humbled and grateful for their support. This endowment will allow Dell Med to make a permanent commitment to taking responsibility for the health and well-being of this population in our community.” Mercer and his team lead the federal grant-funded Mobile, Medical and Mental Health Care Team (“M3 Team”) serving people experiencing chronic homelessness who have a chronic medical condition, serious mental illness, and substance use disorder. Additionally, with his team at CommUnityCare, they collaborate with Austin Public Health and the Ending Community Homelessness

CommUnityCare nurse Taylor Frank and Integral Care social worker Tony Nunez check in with a patient living under an I-35 overpass.

Coalition (ECHO) to test, treat — and now vaccinate — this population for COVID-19, while ensuring people have a safe place to quarantine and recover. Last week, Dell Med began vaccinating people at the Austin Resource Center for the Homeless (ARCH) in collaboration with CommUnityCare Health Centers and Austin Public Health. The JP’s Peace, Love & Happiness Family Foundation Endowed Chair will support the continuation and expansion of Dell Med’s street medicine programs, research, and training the next generation of doctors skilled at caring for vulnerable populations. The chair will be based in the school’s Department of Population Health and is a lead gift for UT Austin’s annual day of giving, 40 Hours for the Forty Acres, on March 30-31. “At one time in my life I was homeless; I know what it’s like,” said DeJoria, who lived in his car while

building his business empire. “The American dream happened for me. True success is doing something for someone else and asking nothing in return — success unshared is failure. My family and I wanted to invest in a permanent position to help people in need, and UT and Dr. Tim Mercer are the perfect partner for this.” The foundation previously gave gifts of $100,000 and $250,000 to Dell Med to support health care for people experiencing homelessness, including COVID-19 treatment, testing and contact tracing. And it donated 20,000 surgical masks and 1,000 rapid COVID-19 tests to aid mobile testing teams caring for people without homes, as well as meals for vaccination staff at UT Health Austin, the clinical practice of Dell Med. “To improve health for everyone in our community, we must develop and scale new, nonconventional ways to see Street Medicine...page 14

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Focusing on Awareness, Access And Trust To Help Communities Overcome Hesitancy Toward The COVID-19 Vaccines

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t’s vital to all of us to build community immunity to COVID-19, particularly to protect those most at risk. A key to achieving community immunity is ensuring that everyone receives a vaccine against this virus as soon as it’s available to them – to protect not just themselves, but their loved ones, friends and neighbors as well. We know that some individuals and communities have expressed hesitancy and concerns about the vaccines. As a national health ministry with a Mission to serve all with special attention to the most vulnerable and marginalized populations, Ascension has a sacred responsibility to provide our patients and the communities we serve with access to reliable and accurate information, resources and care to help them meet their health needs. When making important decisions, we rely on the people and sources we trust – especially when it

comes to healthcare, and especially when the amount of information available can be overwhelming. As healthcare providers, our patients trust us with their care and well-being. The individuals we serve also trust us to help improve the overall health of the community, educate them on healthy behaviors, increase accessibility and eliminate barriers to care. We also have a responsibility to be proactive and go out into the community to build relationships with community partners and organizations that can help us to raise awareness and provide access. All of these responsibilities come together in highlighting the importance of the COVID-19 vaccine and making it available and accessible to all. There is an art and a science to the work of educating our communities about public health matters. It’s important that we listen to our communities and create opportunities

to better understand the questions and reservations our patients, associates and communities may have, and address them appropriately, combining the latest medical science with the most appropriate and engaging means of communicating with each audience. It’s essential that we engage directly with our communities to build awareness and opportunities for access to information about COVID-19 vaccines. Ongoing outreach and trust-building efforts will be vital to ensure that vulnerable and marginalized populations have access to the vaccine when it’s available to them. Our clinical leaders are working closely with our marketing and communications, patient experience, language services, and community outreach teams to create accessible messaging and materials to help educate our patients, communities and our own associates about COVID-19, about the vaccines, and why we believe it’s so important to get vaccinated. To help guide this work, Ascension is analyzing the data we have so we can identify those at high risk for serious COVID-19 cases and proactively encourage them to get vaccinated. Even before vaccines became available, we established system-wide vaccine operations, vaccine equity, and community outreach and engagement

Dr. Joseph Cacchione, Executive Vice President of Clinical & Network Services, Ascension

teams tasked with identifying and developing strategic, comprehensive and community-focused plans and solutions to increase awareness and provide access to the COVID-19 vaccines. Since then, our sites of care have been working in close alignment with local and national health authorities to engage communities and make COVID-19 vaccines available, with some even establishing mobile and large-scale vaccination clinics to help reach eligible healthcare professionals, established patients, community members, essential workers and those who are most vulnerable. We’re also working to leverage long-standing community connections and relationships see Vaccine Hesitancy...page 14

HELP US BUILD A HEALTHIER AUSTIN

Access to nutritious food is essential for a healthy, thriving community. Learn about how we’re leading the fight against hunger at centraltexasfoodbank.org. April 2021

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Austin Medical Times

Paralyzed Veteran Learns to Ski During Pandemic Paralyzed Veteran Regains Excitement and Adrenaline of Being an Athlete During Pandemic

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rmy Veteran Thomas “Nate” Turner, Jr. grew up participating in just about every sport you can think of. He was a four-sport varsity letterman at a very large Texas high school and went on to Midwestern State University where he participated in both football and track. But one horrible summer day, Turner’s life drastically changed. In 2012, Turner was cooling off with friends and family at a nearby lake. One second, he was enjoying the breeze on a swing. The next, Turner was crashing to the ground, shattering his L-1 vertebrae, damaging his spinal cord, and losing all feeling and function from the waist down. After two surgeries and two weeks in the hospital, Turner moved to a rehabilitation hospital where he spent the next three weeks learning how to walk again. He regained most of the feeling in his legs but lost nearly all the plantar flexion in both feet. “I can no longer run, jump, or even stand on my tippy toes,” said Turner, who

served as an Army counterintelligence special agent from 2001 to 2007 and deployed to Iraq in support of Operation Iraqi Freedom. “I am what you call a walking paraplegic.” After his injury, Turner and his wife moved back home to the Houston area. There, he was introduced to the Spinal Cord Injury Clinic at the Michael E. DeBakey VA Medical Center. “During my orientation, I met Recreation Therapist JeMarques Handy and was told that if there was anything athletic that I needed or wanted, he was the person to contact,” said Turner. “I had been riding a recumbent trike regularly but needed something a little more comfortable and challenging.” “VA Recreation Therapy promotes wellness through leisure and physical activity,” said Handy. “Mr. Turner was a pleasure to work. He is an avid cyclist and I am glad to see him explore and excel at other adapted sports. Our Recreation Therapy department strives to encourage and support all

Veterans, no matter where they are in their physical therapy journey.” After a VA Cycling Clinic, Handy introduced Turner to a more advanced tadpole recumbent trike. “My wife and I went on a trip to the Grand Canyon and took the trike with us. I got to ride on some beautiful trails and then some off-road mountain trails in Colorado Springs with a cousin,” said Turner. “The trike gave me new-found adrenaline rush and sense of freedom as I was zooming down the mountain. The Army Veteran Nathan Turner skiing in Breckenridge, CO trike is definitely something that I with his wife and son. Turner learned to ski during the pandemic. am very, very grateful for and can’t thank JeMarques and the Houston VA Sports Clinic or search the App store enough.” for “Veterans Winter Sports Clinic” and After the successful riding sign-up before March 1. adventure, Turner turned his focus to A world leader in rehabilitation, skiing, discovered an adaptive bi-sit-ski, the National Disabled Veterans Winter and signed up for lessons. Sports Clinic provides nearly 400 “This was the first time since I profoundly disabled Veterans with broke my back that I felt the excitement training and rehabilitation every year. and adrenaline of being an athlete. I was Veterans with traumatic brain injuries, hooked on adaptive skiing from that spinal cord injuries, visual impairments, point on. I told my wife that I wanted to amputations, and other severe disabilities go skiing every year,” said Turner, who are challenged to overcome perceived is looking forward to participating in limitations through adaptive skiing, sled VA’s National Disabled Veterans Winter hockey, scuba diving, rock wall climbing, Sports Clinic. education, and other activities. While VA was forced to cancel For more information about this year’s event because of the the National Disabled Veterans COVID-19 pandemic, a virtual event Winter Sports Clinic, VA adaptive will take place March 29 – April 2. sporting events, call Central Texas VA Download the app at Veterans Winter 512-823-4000

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Age Well, Live Well Nutrition Habits for Healthy Aging By Chelsea Couch, CHES Texas Health & Human Services

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ational Nutrition Month is a great time to learn about older adults’ changing nutritional needs and the eating habits that are so important to healthy aging. Nutrients are compounds in food that are vital to living. They help the body heal, regulate chemical process and provide the body with energy. As we age our metabolism slows, and we lose the ability to absorb nutrients as well as when we were younger. As a result, nutrient recommendations will change. Experts recommend that older adults get more calcium, potassium, vitamin D and vitamin B12. Eating a variety of fruits and vegetables as well as fortified foods can help you get the recommended amounts of these nutrients. If you have trouble getting enough of these nutrients through the foods you eat, you can talk with your doctor about supplements. Healthy eating is not only about the foods you eat but also habits like controlling portions, reading nutrition labels, substituting for healthier options and other practices.

Mental Health

Continued from page 6 the Texas A&M Health Opioid Task Force. Alonzo states that although the federal government has attempted to ease restriction to access medications, the guidelines are ambiguous and not uniformly implemented, creating a burden on patients. Additionally, the in-person individual and group therapy that is so important to maintain recovery from opioid use disorder (OUD) have moved online or are not currently available. “People are isolated due to the pandemic and are not engaging in treatment online. Not everyone has Wi-Fi, a computer or phone to access telehealth,” Alonzo said. “If you are alone and have no access to your support network, you are at much greater risk of relapse, and if you start to use alone, you are at greater risk of an overdose.” Patients can still only receive methadone for OUD treatment through a federally licensed opioid treatment program. Some regulatory measures have changed to allow patients to receive a supply of

Learning about nutrition and aging can help you make nutritionally sound choices and practice healthy eating habits. The United States Department of Agriculture’s MyPlate provides nutrition information and recommendations for all ages. To learn more, visit myplate.gov. The Texas Health and Human Services Texercise initiative has a variety of free resources that engage older Texans in healthy lifestyle behaviors, including physical activity and eating habits. Texercise also provides several nutrition fact sheets highlighting topics such as sodium reduction, reading food labels and portion sizes to help Texans improve their everyday routines. Tracking the foods you eat is one way to start identifying the eating habits you want to move away from and which

take-home methadone, instead of coming to the facility every day. Another medication used to treat OUD, buprenorphine—which is regulated under a separate Drug Enforcement Administration prescriber licensing measure known as an X-waiver—has also undergone regulatory revisions. Although the X-waiver requirement still exists, the prescriber-to-patient, face-to-face requirements have been relaxed, reducing the number of times the patient has to come to the clinic to get the medication. There has been no provision for the lack of psychosocial supports which typically accompany the medication treatment and ensure that patients maintain recovery, which remains a huge concern. The result on patient outcomes of the new regulations is unknown, and access to care continues to be a challenge. The CDC has provided a list of recommendations for expanding essential service prevention and response activities to health care providers, public health departments, community education programs and others. Recommendations include guidelines to: “expand the provision and use of naloxone and overdose

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you want to adopt. To download the Texercise Daily Food Log, learn more about being healthy, access Texercise nutrition fact sheets and order a free copy of the Texercise handbook, visit texercise.com. COVID-19 impacted the nutritional health of many people through limiting access to healthy food options — congregate meal sites closed, for example, and transportation to grocery stores became limited. The good news is that there are resources to help people access healthy food options. • The Supplemental Nutrition Assistance Program assists people with buying the food they need for good health. During the COVID-19 pandemic, Texas HHS piloted a program that allows Texans to purchase groceries online using

SNAP benefits. To learn more about SNAP, how to apply and how to purchase food online, visit yourtexasbenefits.com. • Area Agencies on Aging provide older adults, their families and caregivers with nutrition services, like home and congregate meals. To connect with the nearest AAA and learn about available nutrition services, call Texas HHS at 800-252-9240. • Aging and Disability Resource Centers are part of the No Wrong Door System and help streamline access to long-term services and support for the whole family. To learn more about the full range of available long-term supports in Texas, call Texas HHS at 855-937-2372.

prevention education; expand access to and provision of treatment for substance use disorders; intervene early with individuals at the highest risk for overdose; and improve detection of overdose outbreaks due to fentanyl, novel psychoactive substances (e.g., fentanyl analogs), or other drugs to facilitate an effective response.” Learning how to recognize adverse patterns of behavior, evidenced-based screening techniques, and referring to appropriate treatment resources are key, Alonzo said. “Especially now, we have to see risk for opioid use disorder as a serious medical condition that requires medical intervention, not punitive intervention.” Through the Opioid Task Force and the EMPOWER TeleECHO Clinic program, Texas A&M faculty, staff and student ambassadors are able to educate the community and health care practitioners about the opioid epidemic and harm reduction strategies. “Our goal as a task force is to not only reach underserved areas, but any clinician, practitioner or community member in need of additional education and training

which will equip individuals with the knowledge, skills and expertise necessary to prevent opioid overdoses, thereby combatting the opioid epidemic in their local communities,” said Chinelo Nsobundu, RN, DrPH, CHES®, program manager for the center’s Opioid Task Force activities. EMPOWER (Enhancing Mental Health Practice, Organization and Workforce through Education and Readiness) enables providers from all disciplines and locations to build their expertise and increase their workforce capacity to implement high-quality, evidence-based care around opioid use disorder prevention, screening, treatment and recovery. By moving medical knowledge, not patients, patients can be treated where they are, rather than where specialists practice. “It is critically important for anyone in the health care field to reach out to those who may be at risk for or suffering from substance use disorder, including OUD,” Alonzo said. “All the issues regarding mental and behavioral health have been amplified during the pandemic, and it will take everyone in health care to increase access to care for those affected.”

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Vaccines

Continued from page 1 vaccine shots, given several weeks apart, are needed to provide the best protection against the virus. Both shots are given in the upper arm. The Janssen/Johnson & Johnson vaccine is given as a single dose. • Everyone who gets a COVID-19 vaccine is required to be monitored

Legal Matters

Continued from page 3 laws were difficult to navigate prior to the pandemic, which makes the recent patchwork of legislation and executive orders classifying COVID-19 as an occupational illness even more difficult to understand. As a result, health plans may accidentally or intentionally delay or deny reimbursement. It is important for hospitals to review all claims when health plans seek to delay or deny payment for COVID hospitalizations. C. Takeaways It is complicated to determine if a patient’s stay is covered by workers’ compensation when faced with a health

Match

Continued from page 4 binding. Who’s Coming to Dell Med Next Year? As Dell Med sends its graduating students to medical institutions across the country, it will also welcome new physicians pursuing medical

Street Medicine Continued from page 9

transform care delivery,” said Dean Clay Johnston, M.D., Ph.D. “We so appreciate the DeJorias’ vision and support.” In 2011, DeJoria, co-founder of John

Vaccine Hesitancy Continued from page 10

with churches, faith communities, neighborhood centers and organizations that also work directly with vulnerable and marginalized populations. So far, across our national ministry, our sites of care have administered more than 550,000 doses of the COVID-19 vaccine. As healthcare providers, it’s April 2021

Austin Medical Times on-site for a minimum of 15-20 minutes after each shot. • If you have a history of allergic reactions after getting shots, contact your primary care physician to discuss whether the vaccine is safe for you. • You will receive a vaccine card. Keep it in a safe place for your records and share a copy with your oncologist. Texas Oncology encourages plan that attempts to delay or deny payment. If faced with this scenario, hospitals should consider the following: • Understand your state workers’ compensation laws and the coverage available for COVID-19 hospitalizations. Determine if the state where the hospital is located designates COVID-19 as an occupational illness and whether the patient’s occupation falls within the state’s definition of a “covered worker.” • If the patient is not eligible for coverage under workers’ compensation, then the hospital should appeal the health plan’s delay in or denial of reimbursement. In addition, the hospital should

patients and their families to get vaccinated as soon as possible. Talk to your physician if you are unsure about getting the vaccine based on your personal health history. It’s understandable to have questions and concerns. Your physician can provide evidence-based guidance from leading infectious disease experts and discuss whether COVID-19 vaccines are right for you. Together, we can slow the spread of COVID-19. consider contacting the patient’s employer to jointly assess whether to dispute any state presumptions that a worker contracted COVID-19 on the job. • If workers’ compensation denies all or part of a claim, the hospital should submit the remainder of the bill to the health plan. • As an employer, the hospital should understand whether its own workers’ compensation policy is experience-rated. If so, the hospital may want to be more diligent about ensuring the hospital’s health plan or health plan administrator does not inappropriately delay or deny claims based on workers’ compensation coverage.

residencies. “We are pleased we retained several of our own students, and excited to welcome a diverse group of new colleagues from outstanding schools across the nation including Yale, UT Southwestern, Baylor, Dartmouth, University of North Carolina, and many other prestigious institutions,” said Jonathan MacClements, M.D., associate dean of graduate medical

education at Dell Med. “We are thrilled that they will be calling Austin their new home.” In 2020, Dell Med hit two major milestones, earning full accreditation by the Liaison Committee on Medical Education and graduating its first class. Its next celebration is set for May 20, when the fourth-year students who matched today will graduate. 

Paul Mitchell Systems and Patrón Spirits International, joined other billionaires — now about 200 — in signing the “Giving Pledge” to give half of their wealth to make the world a better place. The DeJorias hope their gift to Dell Med will inspire others to support this work and other efforts in the Austin

community to protect, heal and house people struggling with homelessness. Gifts of all sizes can be made to support Dell Med’s ongoing COVID-19 testing, treatment and vaccination efforts for Central Texans without homes.

also vital that we live and lead by example. Since December, we’ve been working with our marketing and communications team to highlight individuals across our ministry who have gotten their COVID-19 vaccine and shared their experiences and reasons for being vaccinated. In this way, others in the community know we walk the talk and are committed to the safety of all. Across our national health system, we’ve vaccinated 60% of our associates. But we still have work to do to make sure

everyone has the opportunity to get the vaccine they need. There are three main reasons to get the COVID-19 vaccine: your personal health; the health of family members and loved ones, especially those most vulnerable; and community health. Focusing on those three commitments can help us to achieve community immunity, stop the spread of this deadly virus, and help us return to normal.

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Austin Medical Times is Published by Texas Healthcare Media Group, Inc. All content in this publication is copyrighted by Texas Healthcare Media Group, and should not be reproduced in part or at whole without written consent from the Editor. Austin Medical Times reserves the right to edit all submissions and assumes no responsibility for solicited or unsolicited manuscripts. All submissions sent to Austin Medical Times are considered property and are to distribute for publication and copyright purposes. Austin Medical Times is published every month P.O. Box 57430 Webster, TX 77598-7430


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April 2021


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