How you will know if Oregon is bending the health care cost curve?

Dr. John McConnell of OHSU’s Department of Emergency Medicine is the person who leads the evaluation of health care data for Oregon in the affordable care act era. He spoke at the Oregon Institute of Occupational Health Sciences (formerly CROET) this week.

Oregon is testing a new model of health care delivery named Coordinated Care Organizations (CCOs) that is funded by a $1.6B grant from the Department of Health and Human Services.  Oregon’s pledge is that it guarantees to reduce the rise in Medicaid health care costs from 5.4% per year as it is now, to 3.4% per year.  This is called ‘bending the curve’ and it is experiments like this that are designed to change the model for delivering health care in ways that will save money … and if we don’t bend that curve by 2017 … Oregon has to pay back some of those grant funds to the federal government.  And the CCOs get paid less if they fail to produce the changes, so they have an incentive to cut costs.  Dr. McConnell and his team are collecting the health care cost data to answer that question.  Oregon’s 16 new CCOs in Oregon are identified in the map of Oregon in the picture below.

How will coordinated care organizations bend the curve?  By ‘thinking different.’  Here are 4 facts about the Oregon experiment(s) from Dr. McConnell’s presentation:

  • Each of the 16 CCOs is independent so Oregon is essentially conducting 16 different experiments under the CCO umbrella.
  • CCOs have the freedom to pay for services that would have been refused by regular Medicaid – like for Emergency Medical Technicians (paramedics) to treat a non-urgent problem when they arrive at a person’s home instead of bringing the patient to the Emergency Room where the same treatment is many times more expensive but no more effective.  Before CCOs(and anywhere outside Oregon), the paramedics had to take the person to an Emergency Room to be paid for their services.
  • Oregon’s $1.6B CCO experiment is the largest in the affordable care act’s portfolio of grants
  • There are over 30 quality measures (called metrics) to be sure that health care effectiveness and satisfaction does not decline under this CCO experiment.  If the quality metrics decline, the federal government will shut down the experiment in the CCO where it was failing to protect the patients.

To learn more about this CCO experiment and how the quality metrics play out, click here to go to Dr. McConnell’s website.

Dr. McConnell’s talk was co-sponsored by the Oregon Health Workforce Center (OHWC), because the OHWC is playing a part in bending the curve by developing and disseminating prevention programs designed to improve health and safety and wellness and well-being in industry where half of the 3+ million Oregonians work.  The OHWC is federally funded, but not funded by the large grant to Oregon.  Nonetheless, the OHWC is one of many organizations that can play an important and possibly pivotal role in bending the curve.

What’s New at the Toxicology Information Center

The entrance to our TIC and outreach area. Look for our new name here soon!

Fall is the season of change: summer’s heat and dryness yields to cool, foggy dampness as the sun lowers its arc over the horizon. And with the changing weather comes a shift in the types of calls received by our Toxicology Information Center (TIC). As people seal up their homes and workplaces from the cold and wet, we begin to hear more about indoor air quality (IAQ) issues; in particular, ailments associated with stuffy air and mold growth.

Here are a few tips to avoid these problems: first, have your heating and air conditioning (HVAC) system checked and maintained annually by a qualified specialist. Clogged or dirty filters, standing water, and poorly functioning combustion units are a primary source for IAQ complaints. Moreover, poorly functioning HVAC systems can become a dangerous source of carbon monoxide, which is an insidious and far too common cause of serious illness, debility and death every Fall and Winter in the United States.

Second, now is a good time to check for structural problems that can lead to dampness and water intrusion into the home or workplace. Standing water in basements and subfloor areas, increased humidity from poor air exchange (kitchens and bathrooms in particular), and water-soaked structural materials are all good places for mold to grow. Mold is a problem of dampness, so correction of these problems will prevent ailments associated with indoor mold growth.

And finally, take care of your own health and well being during this time of decreasing daylight. Now is a good time to get your flu shot. And seasonal affective disorder is a common, but treatable ailment that reduces our happiness and productivity. Get adequate exercise, eat a healthy diet, make sure you get enough sleep, and if necessary, use a ‘happy light’ to increase your sense of well-being and reduce depression.

Do you have questions for our TIC or Occupational Health and Safety Information Center? Contact the TIC Director, Fred Berman, Ph.D. You can also submit questions directly though CROETweb  or to Dede Montgomery.

CROETweb topic: Indoor Air Quality
CROETweb topic: Mold

Climate Change as a Public Health Issue

Jeff Bethel, Ph.D., Assistant Professor of Epidemiology at OSU’s College of Public Health and Human Sciences.

Many within the public health community are discussing climate change. We see this in communications shared by the Environmental Protection Agency, Centers for Disease Control, American Public Health Association, and as recently expressed by Time Magazine in an article Rebranding Climate Change as a Public Health Issue.

Oregon Health Authority’s Public Health Division sponsored a well-attended talk this week on How does climate change impact public health? Speakers Kathie Dello from the Oregon Climate Change Research Institute, and Jeff Bethel, Ph.D., from Oregon State University’s College of Public Health and Human Sciences shared findings and data. Access this talk as a recorded webinar here.

While there are knowledge and research gaps, they reported that environmental scientists and the public health community should prepare for significant impacts in Oregon and the Pacific Northwest. Increases in summer temperatures and in extreme weather events will not only impact the public, these changes will also significantly affect outdoor workers, firefighters, and emergency responders. Increases in biological allergens, air pollution and infectious diseases will pose particular concerns to vulnerable populations, but they will certainly impact all those who work in public health and healthcare.

While this remains a significant environmental issue, with wide impacts to various species of plants and animals – perhaps to some, the specific talking points about people make the threats feel closer to home. And it builds individual commitment to take steps to reduce the consequences.

Learn more about the Climate Change and Public Health Program at Oregon’s Public Health Division.

Centers for Disease Control and Prevention – Climate and Health Program
Environmental Protection Agency – Climate Change and Human Health
Oregon Environmental Council – Climate Protection


Employment Relationships and Worker Well-being

Today’s (November 15) Symposium, co-sponored by the Oregon Institute of Occupational Health Sciences (formerly CROET) and the Portland State University Occupational Health Psychology program, dealt with the changing employment relationship (job loss, downsizing, working under contract) and worker well-being.

Speakers addressed the improving employment climate in urbanized areas contrasted with the persistent unemployment in the more rural areas of Oregon, the impact of job insecurity on health and steps to reduce those health effects, relationships with employees and steps to build positive relationships with employees, and best practices to use with temporary and contract workers.

The symposium, held at Portland State University’s University Inn, will be available for review on the CROET’s Outreach and Education site later in the month:

You can find presentations from prrevious symposia listed at this site, today.

Today’s Symposium: It’s your lucky day

We are busy here this morning kicking off our fall symposium. Perhaps you meant to to join us and weren’t able to? We invite you – on the spur – to join us by webinar as our guest and at no charge.

Simply visit now or later this morning. Sign in as guest (enter your name) and choose “enter.” You will join us live. And if you miss us today, keep in mind the webinar will be posted within the next couple of weeks.

Here’s the agenda, in case you are interested:

8:30 – 9:00 AM    Registration, Networking and Refreshments
9:00 – 9:15 AM    Welcome and Introduction
9:15 – 10:15 AM   Oregon’s Economy and Workforce Nick Beleiciks, Workforce and Economic Research, Oregon Employment Department
10:15-10:30 AM    Break
10:30-11:30 AM    Keynote Presentation: Job Insecurity and Relationships with Employee Safety and Well-Being Tahira Probst, Ph.D., Professor, Department of Psychology, Washington State University Vancouver
11:30 -12:30          Lunch (provided)
12:30 – 1:30 PM     Employer-Employee Relationships
Berrin Erdogan, Ph.D., Professor, School of Business Administration, Portland State University
1:30-1:45 PM         Break
1:45-2:45 PM         Temporary, Contract and Independent Workers
John Ferguson, CPCU, ARM, Underwriter Manager, SAIF Corporation, Salem, Oregon
2:45-3:30 PM         Panel: Questions, Answers and Discussion
All Speakers and Participants


Institute Scientists Present at OR OSHA and OR Workers’ Compensation Events

Dr. Steven Shea and Dr. Fred Berman trade notes at the Oregon Workers’ Compensation Conference.

This season of health and safety conferences has been keeping Oregon Institute of Occupational Health Sciences  personnel busy. Recently, Institute director Steve Shea spoke to attendees at Oregon OSHA and Oregon Workers’ Compensation Division conferences on how sleep disruption adversely affects worker health and safety, and Toxicology Information Center Director, Fred Berman, spoke to OR OSHA attendees on the toxicology of acids and bases.

Dr. Shea emphasized how sleep and circadian rhythms (the body clock) interact to coordinate the optimum function of the body’s organs, and disruption and de-synchronization of sleep/circadian functions caused by irregular or non-standard work schedules can increase the prevalence of diseases such as cardiovascular disease, diabetes, poor mental health and cancer. If you’ve missed out on hearing Dr. Shea present on sleep, you can watch the webinar from our June ’13 symposium.

Michael Wood addresses staff at Oregon OSHA all staff meeting.

Dr. Berman spoke to OR OSHA personnel about the hazards and adverse consequences from exposure to caustic acidic and alkaline substances, including hydrofluoric acid and sodium hydroxide. Acids and bases are frequently encountered  in the workplace. Improper storage and handling of these substances is one of the issues commonly encountered by Oregon OSHA personnel.

CROETweb Topic: Acid and Bases
CROET calendar of events


Motivating Others and Giving Back: Step up now for GOSH 2015

CROET’s Dr. Ryan Olson at GOSH 2013.

At recent industrial hygiene and safety association meetings we have talked about the graying of our profession. As we plan for future events, we challenge ourselves to mentor and enlist others. A phone call or personal conversation can do a lot to encourage someone to try something new and assure them that this is not a closed club!

So…what’s up for 2014? Planning for the 2015 Oregon Governor’s Occupational Safety and Health Conference, for one. Planning for the 2014 Northwest Occupational Health Conference, for another. Both planning committees are committed to bring in new and fresh faces, as we move ahead in safety, health and wellness.

What can you do?

  1. If you are a member of any Oregon Chapter of the American Society of Safety Engineers (ASSE) – personally invite someone newer in the profession to an upcoming meeting.
  2. If you have been an industrial hygienist more years than you can count – personally invite someone newer in the profession to share a cup of coffee or a telephone call about educational and leadership opportunities in our local arena.
  3. If you supervise a safety and health professional new to the area or the profession – encourage them to attend a local meeting or participate in conference planning as part of their career growth and development. Give them names of others in the field to share ideas and advice.
  4. If you come to safety and health from a research perspective – make a commitment to attend a local ASSE or industrial hygiene meeting to learn more about what’s happening on the ground, and make connections in the field.
  5. Remind younger people looking for career advice that the fields of safety and industrial hygiene are smart, fulfilling choices.

CROET’s Megan Parish with students at GOSH 2013.

Motivated yet? Join the planning team of GOSH 2015! Our first meeting is scheduled for January 8, 2014 from noon to 3pm in Wilsonville. This is a great opportunity to give back to the profession, network and make new friends. Contact us to learn more.

What are you doing to add to the growth, diversification and success of our profession?

TWH at American Public Health Association in Boston

The four NIOSH-funded Total Worker Health (TWH) Centers presented a symposium Monday at the American Public Health Association meeting, in Boston (pictured below).

The Centers described part of their research programs. The following results were of particular interest:

  • Research showed that worker participation in a TWH process resulted in increased program sustainability, presented by Glorian Sorensen of the Harvard TWH Center
  • Studies indicated that worker participation was necessary for effective integration of TWH, presented by Laura Punnett of the University of Massachusetts of Lowell of the CPH-NEW (New England) TWH Center
  • A survey of over 6000 businesses in Iowa showing that small businesses reported a striking lack of Occupational Safety and Health programs among smaller employers, reported by Jim Merchant of the Iowa TWH Center
  • A comprehensive literature review revealed only 15 published reports of research studies of TWH intervention programs, although 14 of the 15  improved between 1 and 19 organizational or behavioral risk factors for accidents or chronic health diseases indicating broad effectiveness of the programs, reported by Kent Anger of the Oregon TWH Center

Click to learn more about TWH and the Oregon Healthy Workforce Center.



Oregon Institute of Occupational Health Sciences Holds Science Retreat

The Oregon Institute of Occupational Health Sciences (formerly CROET) faculty held a Science Retreat on Wednesday, October 30, to discuss their mission and research themes, and to learn from the OHSU Foundation about ways that the Institute can gain philanthropic support.

Led by Director Steve Shea, PhD, the Retreat began with a discussion about why we are committing our careers to occupational health and safety.  Why do we do what we do.  Faculty conducting basic mechanistic research, clinical research, applied research and education and outreach all had different reasons, but basically they are about improving health and safety of Oregon workers, and those beyond Oregon.

The research themes revolve around (a) changing organizations and individual behavior in the workplace; (b) exposures: consequences and prevention); (c) injury, treatment, recovery and prevention; (d) sleep and circadian rhythms; (e) strategies and solutions for vulnerable workers. Each theme is focused on prevention and/or recovery.  Faculty are studying mechanisms through basic research, simulations in the laboratory, interventions in the workplace.  Many of the themes are being studied through integrated programs from basic mechanistic work at the molecular and cellular level, in animal subjects, and in clinical and human research.  This is translated to education and outreach that is designed to disseminate information and support it’s use in the Oregon workplace, and to bring back information on needs in the workplace to inform the research.  Much of the faculty’s research can be generalized to the world at large.

Details can be found on the Institute’s (formerly CROET) website:

Events and Connections

ProtectEar in the exhibit hall in Medford.

Fall is always a busy time for CROET outreach staff as we connect with so many of you in events around Oregon. And what great conferences and educational events we have attended this year!

Kudos to Oregon OSHA, Central Oregon Safety and Health Association, Southern Oregon Chapter of ASSE, Pacific Northwest Chapter of the American Industrial Hygiene Association and all of the companies and organizations that support these events. Still ahead we look forward to the Oregon Workers’ Compensation Educational Conference and the Western Pulp, Paper and Forest Products Safety and Health Conference.

Many of you learned a bit more about our transition to our new name, the Oregon Institute of Occupational Health Sciences, our current research including that with the Oregon Healthy Workforce Center, new Oregon FACE resources and more! Stay in the loop between conferences by following this blog, signing up for our monthly e-newsletter, and following us on Twitter and Facebook. And visit our calendar to see where we are and what we are up to. Thanks for your support!


Michael Wood welcomes attendees in Redmond.


2013 Distinguished Industrial Hygienist, Kermit McCarthy, in Seaside.


The key to Oregon OSHA’s Conference successes.


Dede Montgomery talks about sleep in Medford.


Oregon OSHA’s terrific conference team.


Joe Hurrell and Kent Anger.



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