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RI State Profile and Policy Report

Rhode Island State Profile and Policy Report

Heart Disease and Stroke Burden

Table of Contents

Rhode Island - State Deaths for Heart Disease and Stroke

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

  • 2,718 Rhode Islanders died from heart disease in 2006 (28 percent of total deaths in Rhode Island).

  • 421 Rhode Islanders died from stroke in 2006 (4.3 percent of total deaths in Rhode Island).
    Source: National Vital Statistics Report, 2009.

Rhode Island - State Risk Factors for Heart Disease and Stroke

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Rhode Island - 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 Rhode Island’s estimated medical costs to treat heart disease, hypertension and stroke based on 2003 Medical Expenditure Panel Survey data.   

Rhode Island Annual Cost of Hypertension, Heart Disease and Stroke 

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

Hypertension 

$.15 billion

Heart Disease          

$.24 billion

Stroke                     

$.06  billion

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

Rhode Island - Estimated 2007 Medicaid Treatment Costs for Cardiovascular Diseases
 

Based on Rhode Island'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 used to estimate the Medicaid costs below. 

 Heart Disease

 $18 million

 Hypertension

 $64 million

 Stroke

 $37 million

 Congestive Heart Failure

 $7.9 million

 

Funded CDC Heart Disease and Stroke Prevention Program in Rhode Island

The Centers for Disease Control and Prevention funds Rhode Island's Heart Disease and Stroke Prevention program to increase control of high blood pressure and cholesterol; increase awareness of the signs and symptoms of heart attack and stroke and the importance of promptly calling 911; improve emergency response; improve quality of care; and eliminate related health disparities.  These efforts are informed by monitoring heart disease, stroke and related risk factors statewide.

Rhode Island State Highlight - Heart Disease and Stroke Prevention Program

  • The Rhode Island Department of Health is launching the Heart Safe Communities project, a population-based initiative to improve community coronary care and advance chain of survival and emergency systems change priorities in collaboration with the American Heart Association. 

State Laws and Policies

Public Awareness of Heart Disease and Stroke

RI H 7396/RI S 2092 (Resolution Chapter No. 2010-70/Resolution No. 2010-58 ) - Recognizes February 5, 2010 as “National Wear Red Day.”

RI H 5341 (2009, adopted) - The House of Representatives of the State of Rhode Island and Providence Plantations, proclaims February 6, 2009 to be "Go Red For Women" Day, and urges all citizens to show their support for women and the fight against heart disease by commemorating this day with the wearing of the color red. By increasing awareness and empowering women to reduce their risk for cardiovascular diseases, we can save thousands of lives each year.

SB3095 (2008) - This Senate of the State of Rhode Island and Providence Plantations hereby recognizes June of each year as "Aphasia Awareness Month" in the State of Rhode Island. Aphasia is most often the result of stroke or brain injury.

HB7330/SB2247 (2008) - This Senate of the State of Rhode Island and Providence Plantations, in recognition of the importance of the ongoing fight against heart disease and stroke, hereby proclaims February 1, 2008, to be “Go Red for Women” Day and urges all citizens to show their support for women and the fight against heart disease by commemorating this day with the wearing of the color red. By increasing awareness and empowering women to reduce their risk for cardiovascular disease, we can save thousands of lives each year.

HB7077 (2006) - This House of Representatives of the State of Rhode Island and Providence Plantations hereby proclaims February 2006 to be "American Heart Month" in the State of Rhode Island. We furthermore recognize the critical importance of supporting aggressive programs that aid in the ongoing fight against heart disease.

HB7953/Public Law 06-R 187 (2006) - This House of Representatives of the State of Rhode Island and Providence Plantations, along with the American College of Emergency Physicians and American Heart Association, recognize the week of May 14 – 20th as "National EMS Week" in celebration of the outstanding service EMS teams provide to our community, and in recognition of their commitment to the fight against heart disease and stroke, join us in honoring the EMS providers who dedicate themselves to the service of their community.

Prevention of Risk Factors (Nutrition, Physical Activity, Tobacco and other Hazards)

Tobacco Control

Rhode Island's state employee tobacco cessation program meets all three of the 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; YES
3) Counseling and medication coverage for at least two quit attempts annually; YES 

  • Rhode Island also has a cigarette excise tax and quit line.  The cigarette excise tax in Rhode Island is $3.46.

  • Rhode Island's state Medicaid tobacco cessation program covers over-the-counter and prescription products, therapy, counseling and social support. A statewide public program is also available; coverage may vary from other programs. 

  • Rhode Island state law requires all health plans to cover nicotine replacement therapies in combination with four hours of cessation counseling.  Normal deductibles and coinsurance apply.

HB7906 (2008) - Vehicle exhaust is hazardous to human health. Studies have linked pollution from vehicles to increased rates of cancer, lung and heart disease, asthma and allergies, urban smog and climate change. Fine particulate matter in diesel exhaust is particularly harmful to children and seniors. Tiny particles can lodge deep within human lungs, where they can trigger asthma attacks and stunt lung growth in children, and contribute to chronic obstructive pulmonary disorder and heart attacks in seniors. As a result, after July 1, 2008, no person shall dispose of any of the covered electronic products in a manner other than by recycling or disposal as hazardous waste.

Increase Early Detection and Treatment of Heart Disease and Stroke

HB8319 (2008) - That this House of Representatives of the State of Rhode Island and Providence Plantations hereby honors Dr. Marc S. Weinberg on receiving the Distinguished Eagle Scout Award. For the past two decades, his clinical research interest has focused on the prevention of protein leaking out of the kidney, which by lessening this powerful risk factor, decreased the likelihood for the development of kidney failure and heart disease. This finding is significant by preventing the progression of hardening of the arteries, also known as arteriosclerosis.

State Employee Health and Wellness

  • A 2008 bill (H. 8330) proposed to provide a standard $7,000 per year stipend to elected state legislators, to cover purchase of health insurance.  The legislator would have been permitted to keep any amount not needed or used for health insurance, or it may be "banked" in an HSA account if eligible.  The plan was rejected in the 2008 session; it received some criticism from think-tanks, which noted that costs of individual coverage was "around $5,500."

  • State Workers Retiring Early Because of Health-Insurance Costs - (ProJo news, 8/17/08)

  • "More members of General Assembly paying part of health cost -- voluntarily"  - The public spotlight placed on their free health-care benefits has prompted several more state lawmakers to offer to pay 10 percent of the cost of the premiums costing up to $16,233 a year for family coverage. The number of $13,508-a-year lawmakers paying a portion of their health insurance premiums now stands at 26 of 113. Others either get it for free, or they get a $2,002 waiver payment for giving it up.   (Providence Journal, 5/5/08.) 

  • Judge's ruling stymies Carcieri plan on health costs 11/6/07)  - A Superior Court judge has thrown a proverbial monkey wrench in the Carcieri administration’s mid-contract attempt to raise by as much as seven-fold the copays that members of the largest state employees union pay for certain medical expenses, such as emergency room visits from $25 to $150, for urgent care visits from $10 to $75, for visits to specialists from $10 to $25 and for prescription drugs from the current $5/$12/$30 range to $7/$25/$40.  (ProJo news,

  • In spring 2003, the governor proposed to impose a cost-shared premium for state employees for the first time. Legislators examined alternatives.

  • The state spent about $4 million in 2004 on health-care benefits for 372 part-time state employees, an analysis of state payroll data shows. 

DOMESTIC PARTNER BENEFITS AND TREATMENT 
Rhode Island 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 

RI HB 5173/ SB 60 (2011, enacted, Chapter 86,Public Law No. 206) – Directs the department of health to develop a cardiovascular disease screening and lifestyle intervention pilot program housed in one of Rhode Island's six core cities, Pawtucket, Providence, Woonsocket, Newport, West Warwick or Central Falls. Requires the program to be based on the federal WISEWOMEN program administered by the Centers for Disease Control and Prevention. Directs the department to prepare an annual report and submit it to the legislature by January 3rd, each year summarizing the scope and reach of the pilot program, including a fiscal analysis and recommendations outlining the benefits and cost of expanding the pilot program throughout the state after the program has been in existence for three years. The pilot program expires July 1, 2014. Implementation of the women's cardiovascular screening and risk reduction pilot program is subject to appropriation. 

Address and Eliminate Disparities 

 No policy listed at this time

 

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

Public Law Chapter 356/5-50-12/HB6470 (2007) - Every health club registered with the Department of the Attorney General pursuant to this chapter shall have at least one automated external defibrillator (AED) on the premises. The AED will at all times be deployed in a manner in which it best provides accessibility to staff, members and guests. At least one employee per shift must be properly trained by the American Heart Association or comparable state recognized agency in cardiopulmonary resuscitation (CPR) and AED, and must be on duty during hours of operation.

HB7886/SB2220 (2006) - On or after July 1, 2006, the director of the Department of Health shall purchase and distribute automated external defibrillators to every public high school in the state of Rhode Island. The Department of Health shall also be responsible for providing training in cardiopulmonary resuscitation (CPR) and automated external defibrillator use for all personnel who may be responsible for using the defibrillators which have been provided. Each high school shall have the option to decline the automated external defibrillator and participation in the training program. If a public high school in the state of Rhode Island already has an activated external defibrillator, then the state will purchase one for the middle school in their community.

SB2550 (2006) - On or after July 1, 2005, the director of the Department of Health shall purchase and distribute automated external defibrillators to every municipally operated senior citizen center in the state of Rhode Island. The Department of Health shall also be responsible for providing training in cardiopulmonary resuscitation (CPR) and automated external defibrillator use for all senior citizen center personnel who may be responsible for using the defibrillators which have been provided. Each senior citizen center shall have the option to decline the automated external defibrillator and participation in the training program.

HB7952/Public Law 06=R 186 (2006) - This House of Representatives of the State of Rhode Island and Providence Plantations, along with the American College of Emergency Physicians and American Heart Association hereby recognize the week of May 14-20th as "National EMS Week" in Cranston, R.I. We celebrate the outstanding service provided by the Cranston EMS Team to our community, and recognize them for their commitment to the fight against heart disease and stroke. We urge all Rhode Islanders to join us in honoring the EMS providers who dedicate themselves to the service of our community.

Public Law Chapter 246 (2006) - This law appropriates $130,000 from general revenues to be reserved exclusively for the Southeast and New England Health Safe Community Foundation/Michael Montelone Foundation to provide automated external defibrillators to high schools and athletic fields.

Public Law 23-6.2 (2000) - On or after September 30, 1998, the Rhode Island Municipal Police Academy, after consultation with the coalition for public safety defibrillators, shall provide two (2) defibrillators for distribution to each and every city or town in the state, one defibrillator to the State House, one defibrillator to each campus of the University of Rhode Island, one defibrillator to Rhode Island College, and one defibrillator to each campus of the Community College of Rhode Island. On or after July 1, 1999, thirty-five (35) defibrillators shall be provided to the Rhode Island state police. The Rhode Island Municipal Police Academy will, in consultation with the Coalition for Public Safety Defibrillation, also provide training in cardiopulmonary resuscitation and automated external defibrillator use for all law enforcement personnel serving the municipalities and agencies referenced in this section to which automated external defibrillators have been provided.

Stroke Systems of Care

State of Rhode Island General Laws Chapter 23-78 (2004) - The Rhode Island General Assembly further finds that the establishment of a stroke task force will ensure that state-of-the-art information on stroke education, prevention, and treatment is available to healthcare providers and patients. This task force will serve as a consensus group designed to coordinate efforts in stroke treatment and prevention, including bringing additional monies to the state to fund improvements. The task force shall advise the Rhode Island General Assembly, the governor, and director of the Department of Health and have the following duties: (1) undertake a statistical and qualitative examination of the incidence and causes of stroke deaths and risks; (2) receive and consider reports and testimony; (3) develop methods to publicize the profile of stroke burden and its preventability in Rhode Island; (4) identify research-based strategies that are effective in preventing and controlling risks for stroke based on the science available; (5) determine the burden that delayed or inappropriate treatment has on the quality of patients’ lives; (6) study the economic impact of early stroke treatment; (7) research and determine what constitutes high quality for stroke; (8) evaluate the current system of treatment; (9) research and determine the most appropriate method to collect data; (10) identify best practices on stroke care in other states and at the federal level; (11) research and obtain any public or private funding available to improve stroke prevention and/or treatment in Rhode Island; (12) complete and maintain a statewide comprehensive stroke prevention and treatment plan; (13) develop a registry of all Ischemic and Hemorrhagic Strokes that occur within the state; and (14) identify and facilitate specific commitments to help implement the plan and all task force activities.


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