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Glacier Melt Can Result in River Piracy

Fri, 04/21/2017 - 16:49


By Seth Borenstein

WASHINGTON — Scientists have witnessed the first modern case of what they call “river piracy” and they blame global warming. Most of the water gushing from a large glacier in northwest Canada last year suddenly switched from one river to another.

That changed the Slims River from a 10-foot (3 meters) deep, raging river to something so shallow that it barely was above a scientist’s high top sneakers at midstream. The melt from the Yukon’s Kaskawulsh glacier now flows mostly into the Alsek River and ends up in the Pacific Ocean instead of the Arctic’s Bering Sea.

It seemed to all happen in about one day — last May 26 — based on river gauge data, said Dan Shugar, a University of Washington Tacoma professor who studies how land changes. A 100-foot (30-meter) tall canyon formed at the end of the glacier, rerouting the melting water, Shugar and his colleagues wrote in a study published in Monday’s journal Nature Geoscience .

The term “river piracy” is usually used to describe events that take a long time to occur, such as tens of thousands of years, and had not been seen in modern times, especially not this quickly, said study co-author Jim Best of the University of Illinois. It’s different from something like the Mississippi River changing course at its delta and it involves more than one river and occurs at the beginning of a waterway, not the end.

The scientists had been to the edge of the Kaskawulsh glacier in 2013. Then the Slims River was “swift, cold and deep” and flowing fast enough that it could be dangerous to wade through, Shugar said. They returned last year to find the river shallow and as still as a lake, while the Alsek, was deeper and flowing faster.

“We were really surprised when we got there and there was basically no water in the river,” Shugar said of the Slims. “We could walk across it and we wouldn’t get our shirts wet. It was like a snake-shaped lake rather than a river.”

What had been a river delta at the edge of the Slims River had changed into a place full of “afternoon dust storms with this fine dust getting into your nose and your mouth,” Best said.

The lack of water in the Slims wasn’t because of changes in rainfall, Shugar said. They know that because it’s a river fed mostly by glacial melt, not rain, and the Alsek increased in amounts similar to what disappeared from the Slims.

The Kaskawulsh glacier covers about 9,650 square miles (25,000 square kilometers), about the size of Vermont. The front of the glacier has retreated nearly 1.2 miles (1.9 kilometers) since 1899, Shugar said.

The scientists calculate that there is only a 1 in 200 chance that the retreating glacier and river piracy is completely natural without man-made global warming. They used weather and ice observations and a computer simulation that models how likely the glacier retreat would be with current conditions and without heat-trapping greenhouse gases.

Several outside scientists praised the study as significant and sensible.

“This is an interesting study and reconfirms that climate change has large, widespread and sometimes surprising impacts,” Pennsylvania State University glacier expert Richard Alley, who wasn’t part of the study, said in an email.

Copyright 2017 The Associated Press. All rights reserved.

Copyright Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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Can Teachers, First Responders Find Affordable Homes?

Fri, 04/21/2017 - 16:04

For everyday Americans, homeownership is far from a sure thing. The mid-range American household makes just $37,040 per year while the national median home price is $254,900. That means that the average person spends 42 percent of their income on a home purchase with a mortgage, an increase of six percentage points from 2015. With today’s rising home prices and stark drops in inventory, finding affordable homes for sale is no easy feat.

Although helpful, the national numbers paint too broad of a picture on a hyperlocal subject. Just as home prices vary by market, so do wages within common occupations. Teachers and first responders, for instance, may find greater homeownership opportunity in the Midwest than on the West Coast.

Consider the following example cities with varying affordability depending on median wage data and a 31 percent debt-to-income ratio, or the recommended percent of income allocated toward housing. These calculations also assume buyers put at least 20 percent down on a 30-year fixed mortgage with a 4.1 percent interest rate. Homeowners association (HOA) dues, taxes and insurances are included.

Dayton – Affordable

In Dayton, teachers earn a median $61,810 per year. At a median list price of $129,000, 83.3 percent of Dayton homes for sale are affordable for house hunters who work in education. First responders have a lower annual median wage of $49,405 per year, but can nevertheless afford three-quarters of listings. As one of the best cities for affordable homes, buying a house in Dayton is reasonable for many professionals.

Chicago – Somewhat Affordable

Although home values vary depending on neighborhood – of which the Windy City has many – Chicago’s overall median list price is a cool $279,000. For teachers who make the median income within their field of $70,483, just over half of Chicago homes for sale fall within budget. First responders have a slightly higher median income of $75,600 per year, allowing Chicago educators to consider 55.3 percent of all Chicago’s inventory.

San Francisco – Not Really Affordable

The City by the Bay is the least affordable market for most earners – even high-earning physicians. With a median list price of $1.249 million, just 0.4 percent of listings are affordable for teachers who earn median wages of $72,340 per year. First responders face a similar issue; only 2.6 percent of homes for sale in San Francisco are affordable to them, despite holding a higher than usual median income of $100,625 per year. Doctors, who gross a seemingly comfortable living at $208,000 each year, can still only realistically afford 41.6 percent of the market. Although incomes are generally higher in West Coast markets like San Francisco, local wages fail to offset home prices.

Although unaffordable for teachers and first responders to reside in, these professionals are just as vital to San Francisco as they are elsewhere in the nation. The data is telling, but homeownership affordability isn’t the same for everyone.

To get a better idea if your community provides affordable homes based on specific public employee incomes and home search locale details, try Trulia’s Home Affordability Calculator.

Written by Jennifer Riner on behalf of Trulia.



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Will Trump Ignore Coastal Infrastructure Impacted by Sea Level Rise?

Fri, 04/21/2017 - 14:30

Coastal states are experiencing or expecting consistent, persistent inundation of coastal facilities like drinking water conveyance systems and roads. City leaders, like Miami Beach, Fla., Mayor Philip Levine, are already addressing what happens to both city and state roads with sea level rise. Sunny day flooding has plagued the concentrated barrier beach for upwards of a decade.

In coastal Massachusetts, where Senator Elizabeth Warren recently held a town hall meeting, recent studies funded through Massachusetts Coastal Zone Management (CZM) Agency grants are calling for coastal resiliency action.

In Beverly, Mass., a city of 40,000 on the shores of Salem Sound and one of the state’s 78 coastal communities, at least two low-lying wastewater pump stations and a suite of gas and electric storage, control and transmission stations are threatened by sea level rise. As part of Beverly’s 2017 grant-funded coastal resiliency planning efforts, the city actually identified several vulnerable critical assets, including public works and public safety facilities, a transit station critical to two light rail lines connecting the region to Boston and more.

Groups like Salem Sound Coastwatch, a 25-year old, non-profit coastal watershed organization, want to know how are coastal communities going to become resilient to rising seas without Federal help?

The State of Federal Coastal Infrastructure Resiliency Funding

CZM funds projects like Beverly’s waterfront resiliency assessment through its Coastal Resilience Grant Program, which relies on annual appropriations from the National Oceanic and Atmospheric Administration (NOAA). A total of $75 million in NOAA CZM and Coastal Resilience funding could soon disappear under President Donald Trump’s proposed FY2018 budget.

At the Salem, Mass., town hall, Warren said she believes in science and will fight for environmental funding. Later, she told EfficientGov:

It’s long past time for Washington to get serious about investing in infrastructure — to keep our country running, our economy growing and to confront the impact of climate change. Coastal communities live with the threat of climate change, as rising sea levels increase the likelihood of flooding and threaten drinking water supplies. I will fight for federal investment in infrastructure to protect our coastal communities as we prepare for rising sea levels.‎”

Rhode Island Senators Sheldon Whitehouse and Jack Reed, along with Rep. James Langevin stood with Warwick Mayor Scott Avedisian to discuss sea level rise threats to several Ocean State communities. According to the Providence Journal, the roads in Warwick are the most vulnerable to rising seas in the state, according to a recent assessment by the Rhode Island Division of Planning.

In January, the Senate Democrats proposed the National Oceans and Coastal Security Fund as one of three climate resiliency programs to share $25 billion in funding under their $1-trillion infrastructure plan.

Trump is currently proposed a $200 billion infrastructure plan, but the details won’t be ready until the third quarter, according to Bloomberg Politics.

Rhode Island’s study determined that 1.9 miles of the state’s roadway in Rhode Island are expected to flood at high tide with one foot of sea level rise. But the state will have to contend with 34 miles of flooded roadway with a three-foot rise, 102 miles at five feet and 175 miles of road wash out with a seven-foot rise.

To put it in perspective, the most recent National Climate Assessment from 2014 has already observed sea level rise increases of up to two feet in the Northeast.

But upon taking office, Trump dumped the previous administration’s climate action plans, which this assessment supported.

Florida Senator Bill Nelson recently brought the Senate Commerce, Science and Transportation Committee to West Palm Beach, Fla., for a field hearing on sea level rise, according to E&E News. If the administration denies climate change is a problem, it may also deny solutions like infrastructure spending to help communities with adaptation, Nelson said.

In addition to environmental groups, state leaders dealing with sea level rise also want to know how a Federal government that rejects climate change will prepare infrastructure with consistent, persistent flooding that is expected to increase.

These are all changes that are coming at us pretty fast in terms of geologic time and that we need to prepare for with adequate infrastructure to meet the needs of Rhode Island communities,” Whitehouse told his constituents.

How States & Cities Take Action

In February, the Massachusetts Seaport Economic Council recently granted $5 million in state funding to 13 coastal communities. The Bay State started funding coastal economic development through this program under a 1996 Seaport Bond Bill, and the Council was relaunched in 2015 under an executive order from Governor Charlie Baker.

Under annual appropriations to the state’s Housing & Economic Development agency, the Council awards grants for capital expenses under five categories — including coastal infrastructure — twice per year. Individual projects are capped at $1 million, and a 20 percent match by communities is required. According to Baker’s press office, the grants don’t depend on Federal funding. The state’s FY2018 allocation to the Council has not been confirmed yet.

In Florida, communities like Miami Beach are not waiting idle for waters to rise. Over the next five years, the city will spend $400 to $500 million on costly defenses like raising roads and installing numerous pump stations, according to the Architect’s Newspaper.

The city has funded $200 million of these efforts by doubling stormwater fees, and imposes fees of up to 5 percent of construction costs on developers of buildings that are more than 7,000 square feet, if they fail to get LEED Gold certified.   

Editor’s Note: Andrea Fox is a former board member of Salem Sound Coastwatch and former outreach coordinator of Massachusetts CZM.

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Can Medical Marijuana Reduce Opioid Use?

Thu, 04/20/2017 - 16:50

When Attorney General Jeff Sessions veered off script last month in Richmond, Va., and called use of marijuana to solve the heroin crisis “stupid,” he created a bit of an uproar from those that want to address the full opioid crisis, which includes use of medical marijuana to reduce addiction to prescription pain medications.

“I’m astonished to hear people suggest we can solve our heroin crisis — have you heard this? — by having more marijuana. I mean, how stupid is that! Give me a break! So we’re going to have to stand up and confront that, tell the truth here. And our nation needs to say clearly once again that using drugs is bad, it will destroy your life,” Sessions said.

Vox argued that with opioid abuse now being the number one cause of accidental death in the country, use of marijuana to treat chronic pain “certainly merits consideration by lawmakers who want to keep medical marijuana illegal at the federal and state levels.”

The Drug Policy Alliance of New York (DPA) in a paper that supports policy changes to support the use of marijuana for patients that are at-risk of becoming opioid dependent. DPA’s position is that use of medical marijuana in conjunction with opioids allows for much lower doses and reduced withdrawal symptoms from the addictive narcotic.

This position was supported by research published in the Journal of Pain in June 2016.

DPA, like many other medical marijuana supporters, cited a 2010 University of California Center for Medicinal Cannabis Research study double-blind, placebo-controlled clinical trials over a decade found inhaled marijuana as a successful first line treatment of neuropathy.

DPA also cited research published in 2012 by the Canadian Medical Association Journal which found that inhaled marijuana was successful in reducing spasticity symptoms and pain in participants with multiple sclerosis or MS.

In addition to pain management, for diseases like cancer, where many treatments create nausea, use of marijuana has been reported widely as helping patients to eat and obtain or maintain basic nutritional needs.

Late last year when Seantrel Henderson, a football player for the Buffalo Bills, faced a second suspension for violating the National Football League’s (NFL) substance-abuse rules in choosing to use medical marijuana after colon removal surgery due to Crohn’s Disease, American football lovers took note, according to The Cannabist.

Crohn’s Disease is an inflammatory bowel disease that affects upwards of 700,000 people in the United States to varying degrees. In some people, it becomes active only occasionally as a “flare.” In extreme cases, sections of intestine that could cause sepsis must be removed. Many with Crohn’s Disease take steroid-based and others medications to control the advancement of the disease, which is believed to be exacerbated by stress and environmental factors.

A 2013 study in the Clinical Gastroenterology and Hepatology Journal found that “a short course (8 weeks) of THC-rich cannabis produced significant clinical, steroid-free benefits to 10 of 11 patients with active Crohn’s Disease.”

According to The Cannabist, ballers like Henderson are also looking to the cannabidiol, or CBD, in cannabis for its analgesic and anti-inflammatory properties.

Football players want the NFL and NFL Players Association to reconsider use of medical marijuana for both pain management and anti-inflammatory properties in its substance abuse policy, according to the pro-pot website.

“We are actively looking at the issue of pain management of our players. And studying marijuana as a substance under that context is the direction we are focused on,” said George Atallah, the NFLPA’s assistant executive director of external affairs.

Henderson was ultimately suspended again, but is reportedly on the road back to playing next season.

However, not everyone fighting opioids is on the medical marijuana bandwagon — including former Speaker of the House Newt Gingrich and Massachusetts Representative Patrick Kennedy, two chief advisers of Advocates for Opioid Recovery, who spoke this week at the National Rx Drug Abuse & Heroin Summit in Atlanta about rewriting the prescription.

While Advocates for Opioid Recovery has been slammed for its interests — because it is funded by opioid manufacturer Braeburn Pharmaceuticals — drug rehab professionals are also not supportive of a pro-pot answer to opioid addiction.

“It’s trading one dependency for another,” an anonymous clinician told EfficientGov.


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What’s the Deal with Recreational Marijuana Edibles Labeling?

Thu, 04/20/2017 - 14:29

While marijuana remains prohibited under federal law, voters approved marijuana referendums in several states in the November 2016 and state legislators are grappling with how they will regulate recreational marijuana, which includes marijuana edibles.

How edibles are packaged, and even what they look like, is being considered by lawmakers in most states with relaxed marijuana laws.

Dragging Recreational Marijuana Regulations 

The last election cycle tripled the number of Americans living where recreational pot is now legal because the places where it was already legal — Alaska, Colorado, Oregon, Washington and the District of Columbia — account for less than 6 percent of the population combined. However, state governments like Massachusetts are being accused of dragging their feet.

The Bay State recently pushed back its regulatory effective date to July 1st, 2018, according to Rolling Stone’s State-By-State Guide to Legal Pot. While it’s not legal to sell or buy recreational marijuana in Massachusetts, it’s legal to possess it. The group Yes on 4 is reportedly circulating 4/20 briefing papers at the Massachusetts State House urging lawmakers not to delay because the black market will figure out a way to make marijuana edibles available.

Case in point: some budding pot companies in Maine — where marijuana retailers licenses are not yet available — are giving away free marijuana edibles and are accepting donations for “packaging and handling,” according to the Portland Press Herald.

Marijuana Edibles Labeling Controversies

Edibles have been highly controversial because high concentrations of the psychoactive ingredient THC in marijuana-infused cake, cookies, candy and lollipops may be more appealing to — or may be accidentally eaten — by children.

Pediatric accidental ingestion is a growing issue for EMS services. Colorado experienced an increased incidence of pediatric marijuana exposures, according to Howard Kim, MD at EMS World Expo in September 2016. Kim advised first responders to ask if marijuana is in the house when on pediatric calls.

While Rolling Stone reports that Nevada lawmakers are working quickly to set up recreational marijuana regulations, they aren’t treading lightly with edible labeling and packaging requirements. A bill — one of nearly two dozen proposed to regulate the state’s new cannabis industry — would ban edibles that look like candy, along with clear packaging, and also impose advertising requirements. KSNV News3LV reported the bill passed the Nevada Senate Judiciary Committee, and is up for a vote by the full Senate.

A 2014 Colorado murder case has also brought increased attention to how edibles are labeled.

Richard Kirk plead not guilty by reason of insanity, claiming that he was unaware of how consuming a marijuana edible would affect him before fatally shooting his wife Kristine in the head, according to the Denver Post. Kirk’s attorneys claimed he did not know he was high risk for marijuana psychosis due to schizophrenia in his extended family, and that he ate the edible for back pain, according to the Associated Press. The AP also noted that Denver District Judge Martin Egelhoff did not address the marijuana edibles hallucination argument earlier this month when he sentenced Kirk to 30 years in prison under a second-degree murder plea agreement.

Though a toxicology report said Kirk’s tests from the night of the murder were low at 2.3 nanograms of THC per milliliter of blood, and the state’s legal limit for stoned driving is 5 nanograms of THC per milliliter, Kristine’s parents, Marti and Wayne Kohnke, filed a wrongful death suit on behalf of the Kirks’ three sons, naming the marijuana edible’s manufacturer and store selling it .

Marijuana Edibles Labeling Continues to Evolve

Since 2014, Colorado has been regulating how marijuana edibles are labeled, and many of the stores had taken to educating their consumers. In a 2014 National Public Radio story, staff at the the Fort Collins pot shop Organic Alternatives said they hand out cannabis industry edibles education cards with every purchase and tell consumers to “Start Low and Go Slow.” Edibles could be sold up to 100 mg THC per package.

In October 2016, the state enacted new requirements, including barring the word “candy” or “candies,” including a potency statement, stamping each edible serving and package with a universal THC symbol or packaging bulk items in single serving, childproof containers, according to The Cannabist.

The state’s Department of Public Health & Environment’s marijuana informaiton website, GoodtoKnowColorado.com advises: “The effects of marijuana can take up to four hours to peak after eating or drinking it. It’s a good idea to wait at least four hours before consuming more. The standard serving size is 10 mg of THC, so don’t use more than that to start.”

In Oregon, which allows individual counties to decide to legalize marijuana, edibles must be in childproof packaging and cannot contain more than 5 mg THC per serving and more than 50 mg THC per package, according to the Oregon Liquor Control Commission, which regulates marijuana.  An additional labeling requirement is the statement: “Cannabinoid edibles can take up to 2 hours or more to take effect.”


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Colorado Now Has a Drive-Thru Marijuana Shop

Wed, 04/19/2017 - 17:00

PARACHUTE, COLO. — A business believed to be Colorado’s first drive-thru marijuana shop is set to open.

The Rifle Citizen Telegram reports that customers will be able to pull their cars into the Tumbleweed Express Drive-Thru starting Thursday, the unofficial 4/20 marijuana holiday.

The shop is located in the western Colorado town of Parachute.

Robert Goulding, a spokesman for the state Marijuana Enforcement Division, says the agency isn’t aware of any other drive-thru pot shops in Colorado.

He says the business will have to comply with regulations that apply to every marijuana shop.

That means no one under 21 will be allowed, even in the back seat of a car. Since no pot can be visible outside the shop, vehicles will drive into a bay in the former car wash to get to the sale window.

Copyright 2017 The Associated Press. All rights reserved.

Copyright Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.


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Student Program with ‘Marijuana Goggles’ Simulates Drug Impairment

Wed, 04/19/2017 - 16:50

An interactive mobile classroom outfits students with ‘Marijuana goggles’ and a tri-cycle as it sends them through a defined course to simulate different levels of visually impaired driving. They also wear the googles to test how marijuana affects their cognitive abilities.

Last year, the Appalachia High-Intensity Drug Trafficking Area and the Kentucky Army National Guard provided 18,754 students at 182 schools in 37 counties in Kentucky, Tennessee, Virginia and West Virginia with this interactive drug education and prevention program.

The non-profit Operation Unlawful Narcotics Investigations, Treatment and Education (UNITE) “On The Move!” program is made up of five components designed for 7th and 10th grade students.

Students are surveyed before the program, and then throughout using a system which provides immediate feedback to students and a summary of the students’ perceptions to schools following the program.

After entering the cozy, kid-friendly mobile classroom, students begin learning about drugs and their effects.

In addition to the tricycle course, students also get in a battery-powered go-kart operated by program staff to get a taste of what an impaired driving experience is like.

They also wear the ‘Marijuana goggles’ by Fatal Vision to test reactions in cognitive and other tests.

Small group discussions address making decisions and how good choices outweigh the consequences of bad choices.

Access the On the Move! program flyer.

Learn more at OperationUnite.org.

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Intervention for Pregnant Women with Opioid Use Disorder Shows Results

Wed, 04/19/2017 - 15:31

ATLANTA — Four healthcare providers at the University of Kentucky (UK) created the Perinatal Assistance and Treatment Home (PATHways), an intervention model presented at the National Rx Drug Abuse and Heroin Summit for its preliminary achievements in comprehensive treatment programs designed for pregnant women with opioid use disorder.

PATHways provides medical treatment and a support network to expectant mothers with opioid use disorder as it prepares them for motherhood. The program:

  • Integrates evidence-based knowledge through a comprehensive approach to perinatal opioid use disorder
  • Offers buprenorphine maintenance treatment for opioid use disorders, including neonatal abstinence syndrome
  • Brings peer support and education, legal support and prenatal and post-natal health services

Kristin Ashford, assistant dean of research in the UK College of Nursing, Agatha Critchfield, a UK HealthCare obstetrician, Michelle Lofwall, an addiction medicine psychiatrist in the UK Center on Drug and Alcohol Research and Lori Shook, a neonatologist at Kentucky Children’s Hospital created and have overseen this program for pregnant women with opioid use disorder that has served more than 150 women since 2014.

According to UK News, 77 percent of PATHways participants were admitted to labor and delivery testing negative for all illicit drug use.

The researchers also found a connection between attending prenatal sessions and illicit drug use. For each session attended, a program participant was 13 to 18 percent more likely to have a negative illicit drug urine test upon delivery or at a follow up appointment.

The organic development of this program illustrates that you don’t need a large organization with many players to make a big difference in the health of this vulnerable population,” said Sharon Walsh, director of the Center on Drug and Alcohol Research and moderator of the summit session in Atlanta.

Perinatal nurse facilitators bind the intervention model, according to the PATHways team. They educate, navigate and advocate for pregnant women with opioid use disorder participating in the program.

“Linking nurse navigation with nurse-led group care and medication therapy is really what makes the program special,” Ashford said at the summit.

Read the original story on the UKNow website.

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Light Rail to Connect Airport to Las Vegas Strip

Wed, 04/19/2017 - 14:58

CARSON CITY, NEV. — Nevada senators are green-lighting a bill that would provide the permission necessary to build high-capacity systems of transportation in Las Vegas.

Senate Bill 149 would lay the groundwork to implement a multi-billion-dollar light rail plan being considered to link McCarran International Airport with the Las Vegas Strip.

For two years, members of the Regional Transportation Commission of Southern Nevada have been drawing blueprints for the light rail as well as makeovers for pedestrian walkways.

They’re also considering transit options to connect residential neighborhoods, college campuses, Sunrise Hospital and shopping hubs.

The bill would give local officials new authority to seek tax hikes or federal grants to finance developments and explore the use of self-driving cars.

State senators voted 20-1 on Monday to pass it to the Assembly.

Copyright 2017 The Associated Press. All rights reserved.

Copyright Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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Governments are Using Data to Track & Predict Opioid Overdose

Wed, 04/19/2017 - 14:51

Data is being used by cities and governments to track overdoses and predict opioid trends.

Cincinnati Chief Data Officer Brandon Crowley presented how data is being used to track the city’s opioid epidemic last month with Socrata to deploy first responder resources and advise community outreach.

After a spike in overdoses in the summer of 2016, Cincinnati began analyzing emergency medical services (EMS) response data to identify trends and geographic points to help strategically deploy public safety officers and medical resources.

The Heroin Dashboard is a subset of Emergency Medical Services (EMS) response data which captures responses to reported heroin overdose incidents. The dataset helps the city deploy roving medics, increase public safety abnd public health response in hotspots and it also advises on trends.

For example, Crowley said the city was also able to better understand why they were exhausting their naloxone supply. It turns out EMS was having to administer double doses for a particular cut of heroin used at a particular point in time.

Thirteen months of anonymized data is shared through a visualization, including adjusted latitude and longitude coordinates, updates daily, helping to advise communities. Residents and community leaders can use the public dashboard to understand heroine overdoses in each neighborhood, and they can access the full data through the city’s Open Data Portal.

While the city has not yet implemented predictive modeling with the heroin overdose dataset, Crowley said data analysts do intend to build on it. But efforts at the state level have begun using Prescription Drug Monitoring Program (PDMP) data, which started in 2010, to predict opioid risk patterns.

Leveraging State PDMP Data

The state of Ohio has been combining data on known overdose deaths with prescription data from the Ohio Automated Rx Reporting System (OARRS), which tracks the dispensing of controlled prescription drugs to patients Ohio, to build predictive models as early detection for overdose.

A National RX Drug Abuse & Heroin Summit webinar on May 4th, featuring Chad Garner, director of OARRS along with speakers from Appris Health, will explain how PDMP data and advanced analytics can impact detection of prescription narcotic and opioid overdose deaths and review the early identification process of prevention and management of substance use disorders.

According to the 2016 OARRS annual report, the total doses of opioids dispensed to Ohio patients decreased 20. 4 percent from 793 million in 2012 to 631 million in 2016.

Nearly all U.S. states have adopted PDMP systems that support data analytics efforts to better understand and address the opioid epidemic, except Missouri. Although Missouri Senator Rob Schaaf, a physician, said that he will now support the system if the proposed state law requires doctors to use it, according to the U.S. News/Associated Press.

Ohio requires doctors to access it’s PDMP system, and the state’s Board of Pharmacy requires pharmacists to use it before dispensing medication.

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Access the Heroin Dashboard on Insights.Cincinnati-oh.gov.

Register for the May 4th webinar on 

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VW Paying for Diesel Scandal with $300M in Charging Stations

Tue, 04/18/2017 - 12:43


By Andrew Krok

When Volkswagen agreed to a landmark $15 billion settlement in the wake of its diesel malfeasance, part of that settlement involved promoting the use of next-gen propulsion technology. Now, we’re seeing it start to pan out.

Electrify America, a wholly owned subsidiary of Volkswagen Group of America, is set to invest $300 million in a network of electric-vehicle chargers. It hopes to create hundreds of stations with “non-proprietary” chargers in 11 different urban markets, including stations along popular highway corridors. It’s the first stage of a deployment meant to boost demand for electric vehicles.

“Electrify America aims to establish one of the largest, most technically advanced and customer-friendly charging networks in the US,” said Mark McNabb, CEO of Electrify America, in a statement. “Our investments will make it easier and faster for millions of Americans to charge their electric vehicles while encouraging more drivers to explore and embrace electric driving.”

Continue reading the story on CNET’s website.

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Supercomputer that Won Jeopardy to Power New York 311

Tue, 04/18/2017 - 12:33


When it launched in 2003, New York City’s 311 system received 4 million calls per year. But that number rose to 36 million calls per year in 2016.

The city’s data processing system needs upgrades, according to the city, and it has invested $24 million for artificial intelligence that can manage requests and eliminate copious searches by 311 attendants navigating various data portals.

Watson, a cognitive supercomputer by IBM that won Jeopardy in 2011, will present quick and concise answers that will keep caller wait times out of the red, hopefully by mid-2018, according to NBC in New York.

Watch the story on NBC New York.

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How Terrorist Attacks Affect Responding Police Officers

Mon, 04/17/2017 - 17:02

September 11, 2001, marks the deadliest terrorist attack on American soil. Since this date, terrorist attacks in the U.S. appear to be been on the rise. Terrorist attacks like the Oklahoma City bombing, 9/11, the Boston Marathon bombing and the Orlando Night Club shooting were so horrific we remember them like yesterday.

These domestic terrorist attacks are fresh in our minds because of the continual reporting of stories, sharing of graphic images/video and also because we are still seeking to learn from these horrific attacks to prevent future occurrences. Images capturing desperate people jumping from the Twin Towers to escape immense heat and flames to lifeless children carried from the rubble of the Murrah Federal Building in the arms of first responders are still shared. Video accounts on TV and the Internet, only to be replayed countless times thereafter. They are permanently etched in our minds to be immediately linked to the event.

Side Effects of Repeated Exposure

Repeated exposure to these graphic images, videos and accounts does not affect the social media viewer the same way it does to those who viewed them on the front lines. A once peaceful world is quickly brought into focus once the officer graduates the academy and hits the street. This reality was seen when the Boston Marathon bombing on April 15, 2013, and when Watertown, Massachusetts officers were involved in a shootout with the two bombing suspects on April 19, 2013. MBTA Transit Police Officer Dic Donohue responded as backup and upon arrival, he was shot and critically wounded.

ran the It is not fully known how the aftermath of these attacks will affect our first responders, but there will be both short and long-term effects that are physical, emotional and psychological. In fact, 20 years after the Oklahoma City Bombing, survivors are still coming forward for mental health assistance and “…nearly one in four survivors has markers for PTSD.”

The Critical Incident

Critical incidents are major stressors for law enforcement, according to a 2002 study on “Routine Occupational Stress and Psychological Distress in Police” by Liberman, Best , Metzler, Fagan, Weiss and  Marmar published by Policing.

Yet, many officers believe they are fully prepared for whatever the streets throw at them. The truth, however, remains that there is no amount of training, education or life experience that can fully prepare an officer for the critical incident which are, according to Kulbarsh, those “… abrupt, powerful events that fall outside the range of ordinary human experiences.” The critical incident has such a dynamic impact, that regular coping skills no longer suffice, leaving an officer in a downward tailspin. This can seem like a dark, lonely place leaving some to believe they are really losing it or that they may never get better. Often, the officer tries desperately to fix him or herself, often believing they are suffering alone.

First responders are required to deal with death, destruction and human misery. However, there is a difference between dealing with natural versus manmade events, even if both have life-changing outcomes. Terrorists hide behind false narratives, anti-terroristic slogans and deceptive rhetoric. They believe taking the lives of the innocent is justified because of social, religious and/or political injustice. Officer Donohue, like many first responders and survivors of these attacks, are left to pick up the pieces. Sadly, many of our heroes are unaware, at that moment; their own lives have been shattered in some way.

The Aftermath

According to the Occupational Safety and Health Administration the aftermath of the critical incident can present in numerous ways and in varying degrees and severities. This chart below is a compilation of common signs and symptoms associated with critical incident stress. However, this is not an exhaustive list.


Physical Cognitive Emotional Behavioral Fatigue Uncertainty Grief Inability to rest Chills Confusion Fear Withdrawal Unusual thirst Nightmares Guilt Antisocial behavior Chest pain Poor attention and decision making ability Intense anger Increased alcohol consumption Headaches Poor concentration, memory Apprehension and depression Change in communications Dizziness Poor problem solving ability Chronic anxiety Loss/increase appetite


The majority of first responders exposed to a critical incident experience signs and symptoms within the first 24 hours following an attack. However, about half will not experience immediate symptomology, but rather, may see noticeable changes days or even weeks after the incident. Some will even experience symptoms years after the initiating event. The lack of immediacy in symptomology can leave many confused as to what is happening or perplexed by the actual cause of the signs being presented.

It has been said that law enforcement must be right every time in regards to terrorist attacks, but the terrorist only has to be right once. The sad reality remains that even one event, like that of 9/11, leaves thousands to suffer. The aftermath still reverberates today. According to the Officer Down Memorial Page, in the 15 years since the 9/11 attacks, 181 officers have lost their lives. Of these, 72 were killed at Ground Zero and 109 have passed away due to 9/11 related illnesses. The number of deaths due to 9/11 related health issues is expected to rise.

Combating terrorism is a huge undertaking and a fight that will continue for many years. However, we must not forget to protect our first responders in any way we can. Harmful exposure to these attacks can be limited by sound mental health prior to events, training in disaster preparedness, limiting on-scene exposure, maintaining adequate sleep and limiting work shifts, providing critical incident stress debriefings and most importantly providing adequate availability to mental health practitioners and resources.

About the Author

Dr. Olivia Johnson holds a master’s in Criminology and Criminal Justice from the University of Missouri, St. Louis and a doctorate in Organizational Leadership Management from the University of Phoenix, School of Advanced Studies. Dr. Johnson is a veteran of the United States Air Force, a former police officer, and published author. As the founder of the Blue Wall Institute she trains first responders on wellness issues, suicide awareness and prevention, peer support, stress and anger management, and leadership issues. Dr. Johnson writes for several publications and is an Adjunct Professor at Lindenwood University – Belleville, Illinois.

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How to Show EMS Fiscal Stability in Grant Applications

Mon, 04/17/2017 - 14:42

Nearly all grant applications have a section requiring the explanation of your EMS organization’s sustainability. Funders want to know that when their funding of a one year or multiple-year project ends your organization will be able to continue to support the project. Sustainability is proof that a grant was a wise investment for a funder.

The sustainability plan is often the most difficult piece of an application to write and as a result often is the weakest section. Sustainability refers to the ability of administrators to maintain an EMS organization over the long term [1]. This is especially important for EMS agencies given that they serve high-need communities that require consistent and continually available services. The goal for any organization’s sustainability plan is to maintain or expand services while developing resilience to occasional, short-term economic burdens.

Why Show Sustainability?

Funders consider grant applications as investment opportunities. They want to be assured that their contribution is having a lasting effect on the community. Even for equipment purchases, like an AED or power-cot, funders want to be assured that your organization has the ability to financially support required maintenance, replace parts, and continue training necessary for optimal utilization of the funded purchase.

How to Demonstrate Sustainability

Here are four ways your EMS agency can demonstrate sustainability in grant applications.

#1 Develop a Coherent Fundraising Plan

Many EMS agencies, especially volunteer organizations, have operating budgets largely met through fundraising efforts. Due to this dependence on fundraising tough economic times hit these organizations the hardest.

A way to improve this fundraising model is to garner participation from your board members in annual fundraising drives. Studies have shown that agencies that have required participation from their board members secured over 50 percent of their operating budget from individuals within their service area [2]. A fundraising plan should be integrated into other planning efforts, such as strategic planning, program design and budget setting.

#2 Foster Relationships with Funders

Funders invest with the organizations that they have strong relationships with. Get to know local funders in your area and begin to build a relationship through constantly showing your value to the community. This can be done by offering station tours or sharing your ride-along program with the community foundation in the area. Opening your doors allows investors to see the impact of a potential investment and builds credibility.

#3 Brand Your Organization

EMS agencies depend on marketing and branding efforts to help promote and sustain their programs and services. The goal is to establish a clear and consistent message about your mission and services you provide so the organization stands out in the community.

One of the biggest pitfalls observed is not developing and defining the organizational mission. It is also important to have a consistent logo absolutely critical to have an up-to-date and informative website.

#4 Demonstrate Value and Accountability

The value of EMS is serving our community, however how do we demonstrate true value to funders that have a hard time conceptualizing our role? Evaluating sustainability is about using a “dual bottom line” that determines sustainability based on fiscal responsibility and mission impact of your services and programs [3]. Annual reports communicate these goals best and create transparency between funders and your organization.

Following these four steps will demonstrate sustainability to funders, increase grant revenue and strengthen your organization.


  1. Bowman, Woods, “Financial Capacity and Sustainability of Ordinary Nonprofits,” Nonprofit Management and Leadership, Vol. 22, No. 1, Fall 2011, pp. 37–51.
  2. Besel, K., Williams, C. L., & Klak, J. (2011). Nonprofit sustainability during times of uncertainty. Nonprofit Management and Leadership, 22(1), 53-65. doi:10.1002/nml.20040
  3. Bell, Jeanne, Jan Masoka, and Steve Zimmerman, Nonprofit Sustainability: Making Strategic Decisions for Financial Viability, San Francisco: Jossey-Bass, 2010.

About the Author

EMS1.com Columnist Rachel Stemerman is currently the Quality Assurance Officer for Orange County Emergency Services in North Carolina. She attained her Bachelor of Arts from Wesleyan University and has been freelance grant writing for both the non profit sector and EMS agencies around the country for the past 6 years. While working with EMSGrantsHelp.com Rachel has helped agencies all over the country attain funding for various projects. Currently she is in the process of attaining her Masters in Public Health Policy and Administration Management from the University of North Carolina.


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Albuquerque City Buildings Going Solar, Saving Millions

Mon, 04/17/2017 - 14:06

ALBUQUERQUE, N.M. — New Mexico’s most populous city has plans to install more than $25 million in solar panels on city buildings over the next two years.

The installations in Albuquerque will mark the first phase in fulfilling a recently set goal of generating more of the city’s energy from solar power.

Albuquerque City Councilors Pat Davis and Isaac Benton made the announcement Saturday.

They say the project’s first phase of the project is expected to save taxpayers about $20 million over 30 years.

City councilors last September passed a resolution calling Albuquerque to generate one quarter of its energy from solar power by 2025.

The first phase of the project will begin later this year.

The project will be financed through the energy savings and federal bond credits.

Copyright 2017 The Associated Press. All rights reserved.

Copyright Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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Textalyzer: New York Distracted Driving Law Advances

Mon, 04/17/2017 - 13:45

NEW YORK — Assembly Assistant Speaker Felix Ortiz, who introduced a proposed New York state law in 2016 that would enable law enforcement officers at the scene of an auto accident to use a device to determine when a driver’s smartphone was last used, said authorizing police use of textalyzer technology is as important as the breathalyzer has been to reducing drunk driving deaths.

Proponents of the legislation, dubbed Evan’s Law, are emboldened by new data and studies that show increased smartphone use while driving has a direct correlation to 2016 being the deadliest year for motor vehicle accidents  in nine years. Last year more than 40,000 Americans died in automobile accidents — an increase of 6 percent over 2015 and a 14 percent increase over 2014, according to the National Safety Council.

The New York Senate version of the bill has advanced out of its transportation committee and moved forward to the finance committee on March 21st, while the New York Assembly legislation is in the transportation committee.

A recent University of Pennsylvania study found that in-car breathalyzers for previous drunk-driving offenders have curbed drunk-driving deaths by 15 percent. Proponents say the textalyzer technology could do the same thing for deaths caused by distracted driving —  while the proposed law ensures privacy.

Supportive Studies

According to data reviewed by the Alliance Combating Distracted Driving (ACOD), the increased 2016 fatalities happened despite continued reductions in drunk driving and increased use of seat belts. ACOD said that despite a 3.3 percent increase of the number of drivers on the road, an 18-year declining trend in crashes per vehicle miles traveled (VMT) should have continued.

This study looked at the relationship between yearly crashes and VMT since 1994, and found that new crash causes emerged in 2012, which they attribute to an increase in cellphone ownership:

“The introduction and dependence of smartphones trend is more in aligned with this spike than any other factor. Distracted driving information at crashes remains almost nonexistent so its impossible to pinpoint the exact cause. We can determine that the rate increase is more profound than can be explained by a more populated roadway,” according to ACOD.

A new 90-day study by Zendrive, whose technology supports a General Motors and Life360 Driver Protect application that accesses smartphones to detect and illicit faster response to auto accidents and is racking up data on millions of miles driven for future use by insurance carriers, supports the claim that drivers distracted by smartphones are causing more accidents.

Zendrive calculated that drivers are handling their cell phones 88 percent of the time.

For its study, Zendrive tracked anonymized data from 3.1 million of its 5 million users, according to the executive summary. The company calculated the ratio between the average daily trip time and the average amount of time drivers used their phones. The rate is based on results showing cellphone use in 88 out of every 100 trips, which totaled 600 million trips with phone use in the United States during the study.

“By comparing duration to duration, i.e. apples to apples, Zendrive came up with the most direct and accurate measurement of driver distraction,” according to the summary, which also noted that Vermont had the highest level of driver phone use, and Oregon had the lowest.

A 2015 study by the AAA Foundation for Traffic Safety found that potentially unsafe levels of mental distraction occur even if drivers eyes are on the road and hands are on the wheel. Distracted driving could last as long as 15 to 27 seconds after completing a voice-activated, hands-free task, which analyzed a range of the easiest to the most complex tasks in commercially available, voice-activated systems.

Textalyzer Technology

Ben Lieberman co-founder of Distracted Operators Risk Casualties, whose son died as a result of terminal injuries sustained in an automobile accident where the driver’s cellphone logs his family subpoenaed revealed texting throughout the trip, said police could not investigate the driver’s phone in the 2011 crash due to privacy.

The result is a “nameless and faceless crime,” Lieberman said.

James Brady, chief executive officer of Cellebrite, told EfficientGov in a recent press call that the textalyzer technology could be brought to market within six to nine months of a distracted driver law passing.

The Israeli company already works with law enforcement throughout the United States on mobile data forensics. In a proof of concept, Brady said Cellbrite demonstrated that the company’s existing mobile data forensics technology could be modified. While ensuring privacy, a textalyzer device would give officers the ability to determine — within 90 seconds — if a smartphone’s applications had been used — but without revealing or reporting on any of the material content.

Privacy Exchange

“We have to fight through some bad information,” Lieberman said, noting that publications like the Washington Post and others frequently use the same erroneous quotes, such as:

“The technology may in fact be scanning through the content of people’s phones and collecting data, even if that is not apparent,” which is a statement by the New York Civil Liberties Union.

Lieberman said statements like these about the textalyzer prototype developed are absolutely not accurate.

Additional Resources

Access a National Safety Council Cell Phone Policy Kit for Employers.

Textalyzer Technology & Distracted Driving Legislation


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Report: How Smart Local Policies are Expanding Solar Power

Fri, 04/14/2017 - 16:40

Solar power grew at a record-breaking pace in 2016. The United States now has 42 gigawatts (GW) of solar photovoltaic (PV) energy capacity, enough to power 8.3 million homes and reduce carbon dioxide emissions by 52.3 million metric tons annually.1 Hundreds of thousands of Americans, especially in our cities, have invested in their own solar panels or solar projects in their communities and millions more are ready to join them.

America’s major cities have played a key role in the clean energy revolution and stand to reap tremendous benefits from solar energy. As population centers, they are major sources of electricity demand and, with millions of rooftops suitable for solar panels, they have the potential to be major sources of clean energy as well.

As of the end of 2016, 20 cities—representing just 0.1 percent of U.S. land area—accounted for 5 percent of U.S. solar PV capacity. These 20 cities have nearly 2 GW of solar PV capacity—nearly as much solar power as the entire country had installed at the end of 2010.

Access the Shining Cities report on the PennEnvironment Research and Policy Center.

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Dallas to Break Ground on Trinity River Parks & Flood Management

Fri, 04/14/2017 - 16:28


DALLAS — Following a $50 million donation from the widow of late Texas philanthropist Harold Simmons last October, the Trinity Park Conservancy soon will break ground on the largest civic project in the history of Dallas — a “Nature District” along the Trinity River Corridor roughly eleven times larger than Manhattan’s Central Park.

Harold Simmons Park will cover 115 ha (285 ac) of the Trinity River floodplain, representing the first foray into the ambitious Trinity River Corridor Project. The installation will employ innovative flood management techniques to use overflow from the Trinity River as a resource. The district was designed by acclaimed landscape architectural firm Michael Van Valkenburgh Associates (MVVA; Brooklyn, N.Y.). Planners expect construction to wrap up by 2021.

“Dallas is very fortunate to have this forward-thinking, transformational gift from Annette Simmons,” said Mayor of Dallas Mike Rawlings in a press release. “This gift changes everything. It has the ability to change the culture and image of our city in the future. And in terms of the immediate impact, it transitions us from thinking to doing. My hope is that in the near future we can begin a series of public input meetings to start building out the design of the park. By next year, we want to be building America’s next great urban park.”

Continue reading about the resiliency project.

Damage from Dallas Flooding Exceeds $2.6M

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Findings: Police Mentality, Post Ferguson

Fri, 04/14/2017 - 15:54

In collaboration with Louisiana State University, PoliceOne issued a survey that explored officers’ views related to policing in the post-Ferguson era (August 2014-June 2016) and their feelings since the ambush attacks in Dallas and Baton Rouge (July 2016-present). This survey resulted in over 3,346 responses on topics ranging from use of force to career satisfaction.

In our special coverage series, “Major Event Impact: How Ferguson and Dallas Changed Police Psychology”, PoliceOne is publishing several items as a result of the survey findings.

Data Summary

The data summary provides an overview of the data and responses collected. You’ll quickly see that the 54 percent of the respondents are line officers and 46 percent are supervisors. The information contained in the data summary is incredibly valuable to all department leaders and can be used to inform policy, procedure and training.


The infographic is a visual aid that highlights key findings from some of the main themes of the survey, including use of force, community relations and how critical incidents like Ferguson and Dallas impact officers’ mental health.

Expert Analysis

PoliceOne Contributor John Bostain looks into the issues revealed by the survey about police use of force, including officer reluctance, restraint and fear on the job. Bostain emphasizes that police officers will be safer by focusing on improved decision making and not on how to avoid using force. PoliceOne Editor-at-Large Doug Wyllie interviewed the LSU researchers about their interpretation of the survey findings, including the differences in opinion among supervisors and officers, female and male cops, as well as officers of different races. Wyllie also examines how the raw data appears to confirm the issue of de-policing and the general sentiment among cops that they are under attack.

High-profile events like Ferguson, Dallas and Baton Rouge are bound to impact officers in one way or another. It is incumbent on us to directly acknowledge and address these issues so we can move forward, and safeguard our officers and the communities they continue to nobly serve. All law enforcement officials should use these findings as a tool and discuss them among the command staff and line officers within their departments.

While continued research on the key issues — use of force, career satisfaction/morale and mental health — is needed, these findings provide a good baseline for the law enforcement profession to make informed and evidence-based decisions on policy, procedure and training.

Access the special report from PoliceOne.com.

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Millions Could Access Lower Cost Hearing Aids with OTC Reform

Fri, 04/14/2017 - 15:43

U.S. Senators Elizabeth Warren (D-Mass.), Chuck Grassley (R-Iowa), Maggie Hassan (D-N.H.) and Johnny Isakson (R-Ga.), reintroduced legislation to make hearing aids for those with mild to moderate hearing loss available over the counter (OTC). A companion bill led by Representatives Joe Kennedy III (D-Mass.) and Marsha Blackburn (R-Tenn.) was also introduced in the House of Representatives.

At an April 13th town hall meeting in Salem, Mass., Warren insisted that the host of health and social challenges people with hearing loss experience due to a lack of access to affordable hearing aids “is a problem we can fix” with regulatory reform because the technology is there.

The Over-the-Counter Hearing Aid Act of 2017 would make certain types of hearing aids available over the counter to Americans with mild to moderate hearing impairment. In addition, the proposed legislation would require the U.S. Food & Drug Administration to write regulations ensuring that this new category of OTC hearing aids meets the same high standards for safety, consumer labeling and manufacturing protections as all medical devices, providing consumers the option of an FDA-regulated device at lower cost.

Millions Go Without Due to Costs

Nearly 30 million Americans experience age-related hearing loss, including over half of adults between the ages of 70 to 79. Yet only a small share of Americans with hearing loss — around 14 percent — use hearing aids, primarily due to their high cost. Hearing aids are not covered by Medicare or most private insurance plans, and out-of-pocket costs for a single hearing aid average $2,400 – far out of reach for many consumers.

“Allowing hearing aids to be sold over the counter will help bring down costs and expand consumer choices so that millions more Americans can find affordable hearing aids,” Senator Warren said. “This bill will loosen up outdated regulations and, with the right protections in place, let the market bring great products to Massachusetts residents at far lower costs.”

“I hear from Iowans about the high cost of hearing aids, and I understand the concern,” Senator Chuck Grassley said. “If you can buy non-prescription reading glasses over the counter, it makes sense that you should be able to buy basic, safe hearing aids, too. The goal is that by making more products more easily available to consumers, competition will increase and lead to lower costs. More consumer choice and convenience are what we want to accomplish with this legislation. This won’t affect those who need professional expertise to be fitted for hearing aids or have hearing aids implanted. The over-the-counter option is for those who would benefit from a simpler device.”

The American Association of Retired People indicates that hearing aid prices range from $1,200 to $3,500, but since 80 percent of wearers need two, costs run up to $7,000.

Why Is There No Lower Cost Solution?

In a post for the Journal of the American Medical Association, Warren and Grassley addressed several factors that make hearing aids inaccessible to many adults with hearing loss.

“First, hearing aids are expensive, and Medicare and most private insurance plans do not cover the cost. Out-of-pocket costs for a single device average more than $2,000, and individuals with hearing loss in both ears may require two hearing aids to properly treat their condition. These costs are simply too high for many people to afford, so instead they go without treatment for their hearing loss,” the senators wrote.

They also discussed service fees and current audiology practices that can limit product offerings based on incentives for retailer.

Dispensers may then use proprietary software to tune the hearing aids, locking consumers in to coming back to the same retailer for any follow-up adjustments,” according to JAMA.

The American Journal of Public Health also recently published Opening the Market for Lower Cost Hearing Aids where the physician authors discuss how regulatory changes can improve the health of older Americans. Only one in seven American adults that need a hearing aid use one, they said, and it’s a 30-year trend.

Prices haven’t dropped, “despite trends of steady improvements and price reductions in the consumer electronics industry,” wrote Jan Blustein, MD, PhD and Barbara E. Weinstein, PhD in the abstract.

Read the original legislative announcement on Senator Warren’s website.

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