Plus, how 20,000 nursing home workers avoided vaccinations, STDs dropped during the pandemic then rose to new high levels, and more. Email not displaying correctly?
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** Utilities are shutting off service as unpaid bills mount and costs rise
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A utility bill that includes late fees from Entergy, in New Orleans. (AP Photo/Matthew Hinton)

Utility companies say that time is running out for customers who ran up unpaid utility bills during the pandemic.

CNN reports ([link removed]) :

Many lower-income people have been protected from losing heat over the winter by state-based annual moratoriums. But that protection has largely ended for the season, forcing consumers to contend with utility bills that have grown even bigger as the cost of energy has skyrocketed.

The Cincinnati Enquirer adds ([link removed]) :

Officials will restart water shutoffs, a practice that was halted due to the coronavirus pandemic, for delinquent accounts beginning May 2, according to a news release. Late fees for past-due balances will also return, officials added.

Water utility shutoffs were originally set to resume on April 4, but that deadline was pushed back as a result of the billing outage ([link removed]) , said utility spokesperson Tiffaney Hardy.

Pandemic relief funds are also available through 513relief.org ([link removed]) , officials said.

In March, officials said nearly 40,000 of 240,000 residential and commercial accounts had overdue balances, adding 14,000 of those were eligible for shutoff. The utility says the number of accounts eligible for shutoff has dropped to around 3,400 customers.

“While we are returning to water shutoffs and late fees, we want all customers to know their bills don’t need to leave them in a bind,” Waterworks executive director Cathy Bailey said in a statement.

The Albany Times Union ([link removed]) reports that New York customers were more than $1.7 billion behind on paying their gas and electric bills. 700,000 Pennsylvanians ([link removed]) were behind at the last report.


** How 20,000 nursing home workers avoided vaccinations
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ProPublica investigates ([link removed]) how so many nursing home workers were able to get around mandatory COVID-19 vaccination requirements:

But with the pandemic now in its third year, thousands of workers have found a way to avoid getting vaccinated, claiming what experts say are questionable medical exemptions from a federal mandate for health care employees, which went into effect this year.

Although few reasons exist for claiming a medical exemption, nearly 20,000 nursing home workers nationwide, or about 1 in 100, have obtained them, according to a ProPublica analysis of federal data. That rate is three times that of nursing home residents, a notably vulnerable group, who didn’t get the vaccine for medical reasons.

Many of the employees claiming medical exemptions cluster in the same nursing homes: In 27 of Ohio’s more than 900 nursing homes, over 15% of employees have claimed medical exemptions — more than in any other state. And in California, where only 4% of the state’s nursing home workers are unvaccinated, 23 facilities have claimed exemptions for 15% or more of their staff.

In more than a dozen facilities, a third to a half of the staff members have said they have a medical reason to forgo getting vaccinated. Those clusters have raised questions among scientists, said Tim Leslie, a researcher at George Mason University who has studied vaccination rates.

“That suggests some level of organization to achieve that outcome,” he said.

A far larger group — 164,000 workers — has declined to get the vaccine for another reason, which can include a religious objection. The federal government doesn’t track the number of religious exemptions.

Between medical exemptions and workers who refuse the vaccine for other reasons, more than 1 in 5 nursing home workers in Montana, Wyoming and Ohio have yet to get vaccinated — the highest rates in the country, according to the CDC data.


** STDs dropped during the pandemic then rose to new high levels
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New data from the Centers for Disease Control and Prevention shows ([link removed]) :

Reported cases of sexually transmitted diseases (STDs) in the United States decreased during the early months of the COVID-19 pandemic in 2020, but most resurged by the end of that year. Ultimately, reported cases of gonorrhea, syphilis, and congenital syphilis surpassed 2019 levels, while chlamydia declined, according to new data published today by the Centers for Disease Control and Prevention (CDC).
* Reported cases of gonorrhea ([link removed]) and primary & secondary (P&S) syphilis ([link removed]) were up 10% and 7%, respectively, compared to 2019.
* Syphilis among newborns ([link removed]) (i.e., congenital syphilis) also increased, with reported cases up nearly 15% from 2019, and 235% from 2016. Early data ([link removed]) indicate primary and secondary syphilis and congenital syphilis cases continued to increase in 2021 as well.
* Reported cases of chlamydia ([link removed]) declined 13% from 2019.

The natural question that journalists will ask is “why?” Researchers say there were many factors:

* Reduced frequency of in-person healthcare services as routine visits decreased, resulting in less-frequent STD screening.
* Diversion of public health staff from STD work to respond to the COVID-19 ([link removed]) pandemic.
* STD test and laboratory supply shortages.
* Lapses in health insurance coverage due to unemployment; and
* Telemedicine practices that led to some infections not being captured in national data.


** Rape survivors required to pay for test kits
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Bonnie Price, director of the forensic nursing program at the Bon Secours St. Mary's Hospital, holds an evidence kit in the examination room at the hospital in Richmond, Va., Wednesday, Oct. 30, 2019. A nationwide shortage of sexual assault nurse examiners means that rape victims are often forced to drive from hospital to hospital to find someone trained to examine them. (AP Photo/Steve Helber)

The Kaiser Family Foundation included some head-shaking reporting ([link removed]) about how, despite the Violence Against Women Act ([link removed]) requiring states to bear the cost of rape kit exams, survivors sometimes have to pay for their own tests. Keep in mind that there are federal funds that are supposed to be used to cover these expenses. KFF reports:

KFF analysis of a sample of private insurance claims from large employers found that two-thirds (66%) of privately insured women who likely presented for a rape kit after a sexual assault were charged out-of-pocket costs for some services which are typically included in the minimum standard rape kit services as defined by the US Department of Justice. Women who were charged cost-sharing for services often included in the MFE (Medical Forensic Exams) and spent an average of $347 dollars out of pocket.

[link removed]
(Kaiser Family Foundation)

Two-thirds of the almost 1,200 medical claims the analysts examined resulted in out-of-pocket costs for survivors. Kaiser found:

For example, the majority of survivors had lab tests, pregnancy tests, and oral or injected medications such as antibioticd. Nearly half of all patients were charged out-of-pocket costs for these services. Other notable services, which were less frequently provided to survivors, also incurred out of pocket charges. This includes half (52%) of encounters that used an ambulance and almost half (47%) of those who had drug tests (data not shown). This analysis is consistent with previous research ([link removed]) which also found that many patients were charged cost-sharing on days that they received rape kits.

The 19th explains ([link removed]) why it is not only expensive, but can also be dangerous for the survivor to get a bill for those services:

Most states do not cover those additional services — like X-rays, pregnancy tests, MRIs, STI testing, prescriptions, ambulance fees and additional doctor’s visits. In addition to placing more financial burdens on survivors, those charges can endanger them.

When a charge shows up on a survivors’ insurance — or is mailed to their home — hospitals may be alerting victims’ assailant that they just sought help.

The KFF investigation found that the main problem seems to be a lack of certified Sexual Assault Nurse Examiners (or SANEs) and a lack of awareness in hospital billing departments:

Finding a place to get a rape kit from a certified SANE can be difficult. Only a fraction of hospitals in the US have a SANE, making it especially difficult to get an exam from a SANE in rural communities. In addition, there is no government sanctioned national database of SANE providers making it difficult for victims who do not interact with law enforcement or a rape crisis center to know where to go. Many survivors would likely not know that only specific providers are required to perform sexual assault forensic exams without cost-sharing.

Hospitals billing services may not know that the services should not be charged to the victim and send a bill to them for services provided.

The investigation found that depending on the state, survivors of sexual abuse may or may not get tested for STDs, pregnancies or be given free care for any injuries.

The scope of coverage required by states is particularly unclear when it comes to lab testing, drug testing, pregnancy testing, and STI testing. For example, although MFEs typically include urinalysis, some states choose to specify that they cover these services as part of the kit, but many others do not. Because the services included in a rape kit are not explicitly defined in statute or by federal regulation, it is unclear whether states consider these services a part of the forensic exam (which they are required to cover in full per VAWA) or if they mandate them through separate state laws.

[link removed]
(Kaiser Family Foundation)

Furthermore, 17 states cap how much the state will spend on services per victim. For example, Georgia, Nevada, and Pennsylvania all limit spending to $1,000 per victim. Some states cap costs for the MFE, some states cap the costs paid to the provider but make clear that the patient will not have to pick up the extra costs, and some states specify ceilings for other services, such as medication or laboratory testing. Medical costs outside of the MFE may expose survivors to cost sharing following sexual assault in any state as VAWA does not explicitly mandate coverage for these services. Variation in state requirements contributes to differences in out-of-pocket costs between states.

You can see what your state law requires ([link removed]) to be covered and what the survivor pays out of pocket here. (Scroll down to Appendix 1: State Requirements for Coverage of Services in Medical Forensic Exams)


** Time-restricting eating shows no benefit
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The researcher who led this study ([link removed]) believed passionately in the long-held theory that if you restrict all of your day’s eating in a tight window ([link removed]) of time, you will lose weight. The study found no benefit.


** Free public library access for 13- to 21-year-olds
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The Brooklyn Public Library made a remarkable offer ([link removed]) :

Brooklyn Public Library (BPL) is launching a new campaign today, titled Books UnBanned, to help teens combat the negative impact of increased censorship and book bans in libraries across the country. For a limited time, young adults ages 13 to 21 nationwide, will be able to apply for a free eCard from BPL, unlocking access to the library’s extensive collection of eBooks.

To apply for the card, teens can send a note to [email protected], or via the Library’s s teen-run Instagram account, @bklynfuture ([link removed]) . The $50 fee normally associated with out-of-state cards will be waived. Teens are encouraged to share videos, essays, and stories on the importance of intellectual freedom and the impact that book challenges and bans have had on their lives.

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