What’s in store for city’s mental health care

LOOK FOR PHASED-IN REOPENINGS OF CHICAGO’S MENTAL HEALTH CLINICS: The mayoral transition plan released by Chicago Mayor Brandon Johnson last week does not include a timeline for reopening the 14 shuttered mental health clinics, a key part of Johnson’s health plan during his campaign.

While Johnson previously hinted at reopening all of Chicago’s 14 shuttered mental health clinics in the 2024 budget, the transition report calls for the reopening to occur in “phases.” Stay tuned.

The transition report also says the city should “expand non-police crisis response and integrate it with sustained crisis-prevention services,” a nod to the Treatment Not Trauma ordinance championed by Ald. Rossana Rodriguez-Sanchez, 33rd. That bill proposes some 911 emergency calls be answered by mental health professionals without police officers.

Rodriguez-Sanchez told Crain’s last month she plans to hold a hearing on the ordinance this summer and is working with the administration on a revised plan to be introduced later this year. Read more.

Meanwhile, in Washington, D.C., the issue of mental health professionals as first responders is being litigated. The American Civil Liberties Union, the ACLU of D.C. and the law firm of Sheppard Mullin are representing a local community organization in a legal challenge to the District of Columbia’s practice of sending police officers rather than mental health providers to respond to mental health emergencies. The lawsuit alleges “that the disparity in how the district responds to physical and mental health emergencies violates the Americans with Disabilities Act and the Rehabilitation Act.”

HCSC’s SMITH SEES $22.1M IN COMPENSATION: Health Care Service Corp. CEO Maurice Smith saw his pay nearly double to $22.1 million in 2022, according to the Chicago-based company’s financial records obtained by Crain’s in a Freedom of Information Act request. Smith’s salary was about $1.5 million in 2022, up 12% from the year before, but a $20.6 million bonus skyrocketed his total pay.

The CEO’s take was one of many big raises at the parent company of Blue Cross & Blue Shield of Illinois as revenues and profits rose following the worst of the COVID-19 pandemic.

Milton Carroll, executive board chair and an energy industry executive, was the next highest-paid leader at HCSC, taking home $9.4 million in 2022, up 5% from the year before. Following Carroll was Executive Vice President of Commercial Markets Dr. Opella Ernest, who saw her pay rise 34% to $7.7 million.

HCSC spent at least $12 million in 2022 on now former executives. Jeffrey Tikkanen, formerly an executive vice president and special adviser, and Stephen Hamman, former president of Blue Cross & Blue Shield of Illinois, were paid $7 million and $5 million, respectively.

Altogether, the 10 highest-paid employees at HCSC received a combined $70 million last year, up 27% from 2021. Read more.

CRITICS SKEPTICAL THAT NEW ALZHEIMER’S DRUG WILL HELP MINORITIES: With only 20 Black participants among 859 people infused with the recently fully approved Alzheimer’s disease drug lecanemab, some wonder whether the expensive drug will simply aggravate racial disparities in elder care, Kaiser Family Foundation Health News reports.

In a clinical trial involving nearly 1,800 early-stage Alzheimer’s patients, the drug slowed progression of the disease somewhat in those who got biweekly infusions, compared with those given a placebo. The lack of data on how the drug was tolerated by Black patients, along with the findings that those receiving lecanemab were twice as likely as placebo recipients to suffer hemorrhaging or swelling in the brain concerns some, KFF reports.

Others, the article states, say any positive impact it has won’t benefit lower-income patients, who tend to be diagnosed too late for the drug to be effective, and usually receive care in settings ill-equipped to handle the drug’s stringent requirements.

“The most likely consequence of this medication is to take resources and attention away from addressing basic supports for older adults with cognitive impairment,” Maria Glymour, chair of the Department of Epidemiology at the Boston University School of Public Health, told KFF. The money spent on expensive drugs like lecanemab would be better invested in fighting diseases like high blood pressure and diabetes, which hasten dementia, and on community-based services for older adults, she said.

Minorities are often underrepresented in research, but this study had an additional barrier, said Carey Gleason, a clinical neuropsychologist at the University of Wisconsin School of Medicine & Public Health. Many Black volunteers in the trial “screened out,” she said, because PET scans showed relatively low levels of amyloid in their brains. Lecanemab works by removing amyloid, so the trial organizers excluded patients — regardless of their Alzheimer’s symptoms — if their PET scans were negative.

A spokesperson for Eisai, lecanemab’s manufacturer, said the company worked to enroll a diverse population but that amyloid levels “differed among racial and ethnic groups.” She added, “If individuals do not have elevated amyloid, they do not have Alzheimer’s disease.”

However, there is no research to suggest the drug would not work in Black people, Carl Hill, chief diversity, equity and inclusion officer for the Alzheimer’s Association, told KFF. The Chicago-based association is raising awareness of the drug through churches and grassroots groups, Hill said.

HOSPITALS TO SHARE IN $9B IN 340B REMEDY: The Centers for Medicare & Medicaid Services would pay 340B-eligible hospitals $9 billion to offset payment cuts the Supreme Court deemed unlawful, the agency said in a proposed rule issued Friday.

CMS cut Medicare 340B payments by roughly 30% for most outpatient drugs from 2018 through Sept. 27, 2022. The Supreme Court ruled in June 2022 that CMS did not have authority to reduce reimbursement because it didn’t gather data on what hospitals pay for outpatient drugs.

CMS proposed a $9 billion lump-sum payment dispersed at the end of 2023 or by early 2024 to each of the some 1,600 affected 340B-covered hospitals that was paid less due to the now-invalidated policy. Providers and other stakeholders have 60 days to submit a comment on the proposal, which CMS plans to finalize by Nov. 1. Read more.

The Chicago-based American Hospital Association, among other stakeholders, has lobbied to preserve the 340B program, which continues to face a number of legal and regulatory threats.

“After more than five years of litigation and a unanimous Supreme Court victory, the AHA is extremely pleased that 340B hospitals will finally be paid back what they deserve so they can continue providing care to their patients and communities,” AHA President and CEO Rick Pollack said in a statement. “We are especially gratified that HHS agreed with the AHA’s position that these hospitals must be promptly repaid in full with a single lump-sum.”

More than 30 hospitals in the Chicago area participate in the 340B program, according to 340Bhealth.org.

BIDEN ADMINISTRATION MOVES TO RESTRICT SHORT-TERM HEALTH INSURANCE: The Health & Human Services, Labor and Treasury departments unveiled a proposed rule Friday that would restrict short-term policies to three-month terms, Crain’s sister publication Modern Healthcare reports.

The move would restore the regulations in place before 2018, when President Donald Trump’s administration issued a rule enabling consumers to keep short-term plans for up to 364 days and to renew them for up to three years. The new draft regulation to rein in short-term, limited-duration health insurance is part of a slate of health policy initiatives President Joe Biden announced Friday.

“Today’s announcement protects patients from junk health insurance” HHS Secretary Xavier Becerra said in a news release.

Illinois currently allows for six months of short-term insurance and an enrollee cannot purchase a new short-term plan from the same issuer within 60 days of the termination of a previous short-term plan, according to Healthinsurance.org.

POLICE INVESTIGATE TWO NEWBORN DEATHS AT DAYCARE CENTER IN NORTHWESTERN MEMORIAL CAMPUS: Chicago police are investigating the deaths of two newborn infants found in a bathroom at a child care center located on the Northwestern Memorial Hospital campus in Streeterville. Police were called to the 400 block of East Ontario Street at about 6:58 p.m. on Thursday to assist emergency medical personnel, a CPD statement said.

An on-scene witness discovered two female newborns unresponsive inside the daycare bathroom, the statement said, and both newborns were transported to Lurie Children’s Hospital where they were both pronounced. The statement said Area Three detectives are investigating.

An emailed statement from daycare operator Bright Horizons said that a staff member at the Bernice E. Lavin Childhood Education Center “experienced a medical emergency that resulted in the unanticipated delivery of newborn twin babies. All children and families enrolled at the center are safe and none were involved in the incident.”

“We will be providing emotional and mental health support to all members of our center team and families,” the Bright Horizon’s statement said. “We ask for support and respect for everyone involved at this time as we grieve together and work to support each other and any ensuing investigation.”

A statement from Northwestern Medicine notes that “an emergency medical situation involving a daycare employee occurred last night at the daycare facility on the Northwestern Memorial Hospital campus. No daycare children were involved or impacted by the situation. The Chicago Fire and Police departments were called. We are working with CPD regarding this incident and unable to comment further at this time.”

AT A GLANCE

Chicago-based private-equity firm Shore Capital announced the formation of Empower Aesthetics last week. The Shore Capital company is a new national aesthetics platform headquartered in Austin, Texas.

“Empower will provide the tools, support and strategy needed to empower aesthetics practices to reach new heights while maintaining the highest quality of care,” the statement said. “Together, Empower and Shore will explore opportunities for growth through new partnerships and business development in the medical aesthetics space.”

“Shore has a significant history of success in the health care industry, and we plan to apply the same principles to enable Empower to grow bigger, stronger and faster through partnerships with top-tier providers and training the next generation of talent,” Logan Pitts, vice president at Shore Capital, said in the statement.

The National Association for Home Care & Hospice filed a lawsuit Thursday against the Centers for Medicare & Medicaid Services and the Health & Human Services Department over reductions in home health payment rates, Modern Healthcare reports.

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The association is challenging a 3.9% payment cut that went into effect this year and an additional 5.7% cut CMS proposed last week for 2024. The reductions stem from overpayments CMS said it made to home health agencies following the introduction of a new payment model in 2020.

“We have done everything possible to get Medicare to understand the disastrous consequences of its actions,” NAHC President William Dombi said in a news release. “We have presented hard facts, deep legal analyses and extensive data to Medicare that demonstrate the errors in its policies to no avail. As a last resort, we have filed this lawsuit to protect Medicare beneficiaries and the home health agencies that care for them.”

Horizon Therapeutics last week announced data that reinforces previous findings about the durability and efficacy of its gout therapy, Krystexxa injections with methotrexate. The findings, published in ACR Open Rheumatology, showed Horizon’s Krystexxa used with methotrexate lowered urate levels and was sustained over time, the statement said.

“Given the damage that uncontrolled gout can cause to bones and joints, as well as its significant impact on a person’s daily life, it is crucial to provide data that demonstrates how a co-treatment approach can quickly lower a patient’s serum urate level and sustain it over time,” Dr. Brian LaMoreaux, senior medical director at Horizon said. “As clinicians, when we commit ourselves to improving the quality of care provided to people who live with uncontrolled gout, we’re also working to improve their quality of life.”

OSF HealthCare will open primary care locations in Peru and Granville, in the Illinois Valley region, today, following the recent closure of St. Margaret Health in Peru. OSF is advising patients of St. Margaret’s to obtain their medical records on their website. OSF said in a statement that St. Margaret Health will no longer accept requests over the phone or by message and that, due to volume, patients should expect to wait at least 30 days for their records.

A new report by the Brushwood Center at Ryerson Woods, in Riverwoods, details how health equity, climate justice and the environment are deeply interconnected issues. In a Crain’s opinion piece, Catherine Game, executive director of Brushwood, says there is an enormous importance to time spent in nature on human health, “with documented benefits to cardiovascular disease, depression, stress and anxiety, and of particular developmental importance for children.

“Yet, there is unequal access to green spaces, both in terms of proximity as well as safety and feelings of belonging. In Lake County, nearly half of Black/African American survey respondents and 31% of Hispanic/Latino respondents expressed concerns about access, safety or maintenance to visiting parks or open spaces compared to 21% of white respondents. Nearly one quarter of Lake County identifies as Hispanic or Latino, and in parts of the county this percentage is greater than 50% of residents, but these individuals are excluded from decision-making processes relevant to their environment and health due to language barriers, including a lack of resources available in Spanish.” Read more.

In a separate Crain’s opinion piece, former Crain’s Chicago Business editor Robert Reed suggests that Chicago Mayor Brandon Johnson should check out the debate in Evanston over how nonprofits might be made to pay for the impact they have on public resources. Reed said some Evanston residents and politicians “are backing a controversial cash-generating program that’s already working in other municipalities.”

Called payment in lieu of taxes — or PILT — it could be used for large, land-owning nonprofits like colleges and medical centers, to support services from public safety to garbage pickups. Such institutions’ tax-exempt status allows them to enjoy city services without paying taxes to support them, Reed writes, but nothing is stopping Johnson from taking a “hard, calculated look at these institutions.” Read more.

PEOPLE ON THE MOVE

Kim Bruffy has been promoted to principal at architecture firm Kahler Slater, where she is the national director of business development for the firm’s health care market. The firm said in a statement that, with over 30 years of business development, project management and interior design experience, she has contributed directly to our significant growth within the health care and Mid-Atlantic markets.