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PA State Profile and Policy Report

Pennsylvania State Profile and Policy Report

Heart Disease and Stroke Burden

Table of Contents

Pennsylvania - State Deaths for Heart Disease and Stroke

  • More than 1 out of 4 deaths in Pennsylvania are due to heart disease.

  • 33,744 Pennsylvanians died from heart disease in 2006 (26.9 percent of total deaths in Pennsylvania).

  • 7,151 Pennsylvanians died from stroke in 2006 (5.7 percent of total deaths in Pennsylvania).
    Source: National Vital Statistics Report, 2009.

Pennsylvania - 2007 State Risk Factors for Heart Disease and Stroke

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Pennsylvania - 2003 State Costs for Cardiovascular Disease

In October 2007, the Milken Institute, an independent research group, released a study, An Unhealthy America: The Economic Impact of Chronic Disease. The study details the economic effects of treatment costs resulting from chronic disease in the United States. Below is a breakdown of Pennsylvania’s estimated medical costs to treat heart disease, hypertension and stroke based on 2003 Medical Expenditure Panel Survey data.

Pennsylvania Annual Cost of Hypertension, Heart Disease and Stroke 

Treatment Expenditures (Direct Costs)-Total annual medical cost.

Hypertension 

$1.50 billion

Heart Disease          

$2.94 billion

Stroke                     

$.78 billion

Source: Milken Institute, An Unhealthy America: The Economic Impact of Chronic Disease, October 2007. 

Pennsylvania - Estimated 2007 Medicaid Treatment Costs for Cardiovascular Diseases
 

Based on Pennsylvania's Medicaid population, economic estimates for 2007 were projected using Medical Expenditure Panel Survey data.  Medicaid spending has grown rapidly in recent years, placing a significant burden on state budgets.  To help states estimate the financial impact of cardiovascular diseases among their Medicaid beneficiaries, the Centers for Disease Control and Prevention (CDC) and RTI International developed the Chronic Disease Cost Calculator, which was sued to estimate the Medicaid costs below. 

 Heart Disease

 $174 million

 Hypertension

 $622 million

 Stroke

 $360 million

 Congestive Heart Failure

 $77.5 million

 

Pennsylvania State Funded Heart Disease and Stroke Prevention Program

Pennsylvania State Highlight - Get With the Guidelines Hospital Project

  • From February 1, 2007-June 30, 2007, the Heart Disease and Stroke Program (HDSP) has partnered with the American Heart Association (AHA)/American Stroke Association (ASA) to encourage hospitals to participate in the AHA/ASA Get With the Guidelines (GWTG) web-based hospital quality health improvement program.  The four participating hospitals are located in counties where the age-adjusted mortality rates for cardiovascular disease significantly exceed the state rate.  GWTG is based on AHA/ASA and American College of Cardiology prevention guidelines for heart disease and stroke.  The goal of GWTG is to save lives and maximize the quality of life for patients through improved outcomes and a reduction in recurring cardiovascular events. 

WISEWOMAN - The CDC funds the WISEWOMAN program, which provides low-income, underinsured and uninsured women ages 40 to 64 with access to preventive health services by screening for high blood pressure, high cholesterol and diabetes.  The program also provides lifestyle interventions that are tailored to each woman's heart disease and stroke risk factor screening results and links participants to free and low-cost community-based nutrition, physical activity, and quit smoking resources. 

  • Pennsylvania uses "A New Leaf...Choices for Healthy Living" to help women develop a healthier diet, increase physical activity, and be tobacco free. The program serves health care provider sites under the umbrella of the Alliance of Pennsylvania Councils, beginning with two health centers in medically underserved areas of Philadelphia, maintained by the Philadelphia Department of Public Health.

State Laws and Policies 

Public Awareness of Heart Disease and Stroke

PA HR 36 (2011, adopted) - Recognizes February 4, 2011, as "Wear Red Day." Encourages all citizens to show their support for women and the fight against heart disease by wearing red.

PA HR 57 (2011, adopted) -
Recognizes the month of February 2011, as "American Heart Month" to emphasize the importance of the ongoing fight against heart disease. Encourages all citizens to acknowledge the importance of calling 9-1-1, learning cardiopulmonary resuscitation and being trained to use a AED to increase survival rates from cardiac arrest.

PA HR 220/ SR 99 (2011, adopted) - Recognizes May 2011, as "American Stroke Month” and encourages all citizens to familiarize themselves with the risk factors associated with stroke, recognize the warning signs and symptoms, and the importance of dialing 9-1-1 immediately.

PA SR 21 (2011, adopted) - Recognizes Friday, February 4, 2011, as "National Wear Red Day" and encourages all citizens to show their support for women and the fight against heart disease by wearing red.

PA SR 22 (2011, adopted) - Recognizes February 2011, as "American Heart Month" and encourages all citizens to learn to use automated external defibrillators and make healthy lifestyle choices that will increase survival rates from cardiac arrest.

PA HR 158/SR 69 (2011, adopted) -
Recognizes April 6, 2011, as "National Start! Walking Day" and encourages all citizens to show their support for the fight against heart disease by walking at work.

PA HR 137 (2011, adopted) -
Recognizes April 8, 2011, as "National Start! Walking Day" and encourages all citizens to show their support by walking to fight against heart disease.

PA SR 236 (2010, adopted) - Recognizes the month of February 2010 as “American Heart Month.”

PA HR 598/PA SR 240 (2010, adopted) - Recognizes February 5, 2010 as “Wear Red Day” to show support for women and the fight against heart disease.

PA HR 683 (2010, adopted) - Recognizes May 1, 2010 as “Childhood Stroke Awareness Day.”

PA HR 782/PA SR 310 (2010, adopted) - Recognizes the month of May 2010 as “Stroke Awareness Month.”

PA HR 909 (2010, adopted) - Recognizes the month of October 2010 as “Sudden Cardiac Arrest Awareness Month.”

PA HR 4 (2009) - Recognizes February 6, 2009, as "Wear Red Day for Women" in Pennsylvania and encourages all citizens to wear red to raise women's awareness of cardiovascular disease.

PA HR 54 (2009) - Designates the month of February 2009 as "American Heart Month" in Pennsylvania and urges all citizens to recognize the critical importance of tools and skills that will increase survival rates from cardiac arrest so that thousands of lives can be saved each year..

PA SR 112 (2009, adopted) - The Senate recognizes May 2009 as "National High Blood Pressure Education Month" in Pennsylvania in an effort to bring awareness to this life-threatening condition and educate the citizens of this Commonwealth on healthy ways to reduce the risk of high blood pressure and return high blood pressure to a normal level.

SR228 (2008)/HR14 (2007) - The Senate recognizes the month of February 2008 as "Women's Heart Awareness Month" in Pennsylvania and urges all citizens to spread the message that cardiovascular disease is the number one health threat for women and men.

SR227 (2008) - The Senate, in recognition of the importance of the ongoing fight against heart disease and stroke, designates February 1, 2008, as "Wear Red for Women Day" in Pennsylvania and urges all citizens to show their support for women and the fight against heart disease by wearing red on this day.

HR564 (2008) - The House of Representatives designates February 7 through 14, 2008, as "Congenital Heart Defect Week" and February 14, 2008, as "Congenital Heart Defect Day" in Pennsylvania.

SR117 (2007) - The Senate supports the American Stroke Association's Power to End Stroke campaign and urge residents of this Commonwealth to learn the warning signs, symptoms and risk factors associated with stroke in order to reduce the devastating effects of stroke on our population.

SR58 (2007) - Brain injury prevention [including stroke prevention] can be achieved through community education and a public awareness campaign. The Senate designates the month of March 2007 as "Brain Injury Awareness Month" in Pennsylvania.

HR471 (2007) - The House of Representatives designates the month of November 2007 as "Pulmonary Hypertension Awareness Month" in Pennsylvania and urges the residents of this Commonwealth to learn more about pulmonary hypertension and recognize the seriousness of this disease and the meritorious work of the Pulmonary Hypertension Association to find a cure.

HR185 (2005) - The House of Representatives designates the month of May 2005 as "Stroke Awareness Month" in Pennsylvania and encourages all citizens to ask their doctors about stroke prevention and warning signs.

Prevention of Risk Factors (Nutrition, Physical Activity, Tobacco)

Tobacco Control

Pennsylvania's state employee tobacco cessation program meets two of the three CDC guidelines that include:

1) Coverage for at least four counseling sessions of at least 30 minutes; YES 
2) Access to smoking cessation agents, including prescriptions and nicotine replacement; NO
3) Counseling and medication coverage for at least two quit attempts annually; YES 

  • Pennsylvania also has a cigarette excise tax and quit line.  The cigarette excise tax in Pennsylvania is $1.35.

  • Pennsylvania's state Medicaid tobacco cessation program covers over-the-counter and prescription products, therapy, counseling and social support.

PA HR 692/PA SR 283 (2010, adopted) - Recognizes April 7, 2010 as “National Start! Walking Day.”

PA HR 194 (2009) - Recognizes April 8, 2009, as "National Start! Walking Day" in Pennsylvania.


Increase Early Detection and Treatment of Heart Disease and Stroke

HB471 (2005) - This bill establishes the Cardiovascular Disease Advisory Committee. The Committee shall (1) Advise the department on how to raise awareness on prevention of cardiovascular disease and stroke among the public, the health care community and policymakers using all available data. (2) Identify evidence-based best practice education strategies for the public to identify risk factors associated with the cardiovascular disease and stroke and to identify symptoms at onset. (3) Identify and review evidence-based best practice health promotion and disease prevention strategies related to cardiovascular disease and stroke for implementation in Pennsylvania, with the goal of reducing death and long-term disability among Pennsylvanians. (4) Identify limitations and problems associated with existing laws, regulations, programs and services related to cardiovascular disease and stroke and propose feasible changes. (5) Examine evidence-based current and alternative treatment options available for treating different types of cardiovascular disease and stroke. (6) Review data collected by the Department of Health pursuant to section 2127 to identify areas of improved outcomes, including reduced secondary stroke events. The Department of Health shall establish and maintain a Statewide stroke database that compiles stroke care information and statistics relating to strokes in this Commonwealth and shall make information and statistics available to the public on the Department of Health's Internet website.

Pennsylvania Code 19.271 Section 108. (1984) - Block grants.—(a) Appropriation.—The following sums set forth in this act, or as much thereof as may be necessary, are hereby appropriated from the block grant (BG) funds to the named agencies of the Executive Department of the Commonwealth for the purposes, and under the restrictions, for which the funds are provided for the fiscal year beginning July 1, 1984. Preventive Health and Health Services Block Grant.—The Preventive Health and Health Services Block Grant (PHHSBG) is for the provision of preventive health and other health services related to emergency medical comprehensive public health, hypertension, fluoridation, health education, risk reduction, home health, rape crisis and rodent control.

State Employee Health and Wellness

  • Pennsylvania: (2006) Offers a United Health Care CDHP option. In 2009 it features 100 percent coverage for preventive care services (PEBTF members have up to $500 maximum for single members/$1,000 for family per year).

  • Pennsylvania:  As of July 1, 2009, all enrollees and covered spouses that complete the 2009 Health Assessment will save half of the employee contribution or 1 percent of the gross base salary contribution. Based on an average salary of $46,000, an employee would see savings of $460 a year.

  • Pennsylvania proposal seeks health insurance savings.  Hoping to save money for his state on health-care costs—and to hold down local property-tax rates used to pay for benefits—Pennsylvania Gov. Edward G. Rendell is proposing to bring all school employees under one insurance plan. Education Week 9/27/07. article. 

  • Pennsylvania: has posted a detailed pharmaceutical Preferred Drug List for 2007 for all active state employees.  The system has been administered by ExpressScripts since 2004.  The program maintains a separate prior authorization list that allows use of some non-preferred drugs.

  • Pennsylvania in 2007 announced plans for the Pennsylvania Employees Benefit Trust Fund (PEBTF) to withhold payment for “never events."  The PETBF, anticipates that this action will stimulate performance improvements that can reduce the number of unnecessary infections and other complications.

DOMESTIC PARTNER BENEFITS AND TREATMENT 
Pennsylvania has "a law, policy, court decision or union contract that provide state employees with domestic partner benefits."  Normally health care is covered by the term "benefits." (Human Rights Campaign, 05/06). 

Improve Quality of Care and Access to Care

HR580 (2007) - The House of Representatives of the Commonwealth of Pennsylvania designates February 1, 2008, as "Peripartum Cardiomyopathy Awareness Day" in Pennsylvania and urges all residents to recognize that peripartum cardiomyopathy is a serious women's health threat; and be it further resolved that the House of Representatives urges the National Institutes of Health to recognize "Peripartum Cardiomyopathy Awareness Day" and to seek appropriate funding for research aimed at obtaining a better understanding of this high-risk condition of pregnancy; and be it further resolved that the House of Representatives challenges all women to take charge of their cardiovascular health and take the necessary preventive steps to healthy lives and pregnancies.

Address and Eliminate Disparities

HR59 (2007) - The House of Representatives designates March 17, 2007, as "Latino Health Month" in Pennsylvania. The House of Representatives acknowledges and affirms the importance of all Pennsylvanians' health, and the unique health needs of Latinos and the opportunities in addressing these disparities [including those related to hypertension and cholesterol]. The House of Representatives designates all possibly feasible special attention and resources to address the unique health needs of Latinos through promising and best health practices.

HR213 (2007) - The House of Representatives recognizes the month of April 2007 as "National Minority Health Month" in Pennsylvania to address health disparities [including those in cardiovascular disease] and promote sustained improvements in the health status of all residents of this Commonwealth.

Emergency Medical System (EMS) and Automated External Defibrillators (AED)

Pennsylvania Code 1003.21 (2000) - An ambulance attendant shall have the authority to provide the following Basic Life Support (BLS) services if trained to do so. Other BLS skills taught in a course in advanced first aid sponsored by the American Red Cross, can be used provided the ambulance attendant has received training to perform those skills in a course or in an equivalent training program approved by the Department, and is able to document having received the training.

Pennsylvania Code 567.11 (1987) - The operating suite shall be adequately equipped with age appropriate equipment for the types of procedures to be performed and the recovery area shall be adequately equipped for the proper care of postanesthesia recovery of surgical patients. All equipment and supplies shall be age and size appropriate for the patients treated. The following equipment shall be available in the operating suite and recovery area. (1) suitable surgical instruments customarily available for the planned surgical procedure; (2) emergency call system; (3) airways, breathing bag and device for the provision of positive pressure rescue breathing; (4) cardio-pulmonary drugs and intubation equipment; (5) cardiac monitor and defibrillator; (6) resuscitator including oxygen and suction equipment; (7) tracheostomy and necessary pulmonary reexpansion supplies.

Pennsylvania Code 33.340/33.340a (1988) - A dentist who possesses an unrestricted permit issued under this subchapter shall ensure that the dental office in which the permitholder administers general anesthesia, deep sedation, conscious sedation or nitrous oxide/oxygen analgesia on an outpatient basis contains a defibrillator, among many things. 

Stroke Systems of Care

PA HR 354 (2011, pending, House Health Committee)Would promote awareness of atrial fibrillation and would urge the Secretary of Health to prioritize atrial fibrillation and implement programs, evaluation, assessment and policy changes to reduce the burden of this costly, progressive disease.


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