By Erin Schumaker, Carmen Paun and Daniel Payne

Presented by Arnold Ventures

Health clinics in several states received heat wave alerts this summer from a Harvard-affiliated project. | AP Photo/Peter Morgan

As wildfires, floods, heat waves and hurricanes intensify, preparation for climate disasters could mean the difference between life and death.

That’s the idea behind a climate resilience toolkit for frontline community health clinics that the Harvard T.H. Chan School of Public Health and the nonprofit Americares developed. The toolkit includes practical advice for climate disasters, including clinical guidance, tip sheets, action plans and simple-to-follow preparation checklists for providers, patients and administrators.

“We cannot simply regard climate-related natural hazards — weather events like heat waves or events like hurricanes — as random, unforeseeable events,” Dr. Caleb Dresser, a specialist in emergency medicine and director of health care solutions at Harvard Chan C-CHANGE, told Erin.

The toolkit is meant to prompt frontline health clinics to take steps before events occur, he said, “to make sure that their staff, their facilities and their patients are as prepared as possible for the predictable impacts of climate change.”

This summer, 19 clinics in California, Massachusetts, North Carolina and Texas rolled out the toolkit in an initial test run.

That provided insight into how the toolkit could help during another hot summer:

— At the beginning of each summer, clinic staff could review the checklists to ensure they’re heat-wave ready.

— If a patient comes to the clinic during a heat wave, their provider could offer a toolkit printout and counsel them on staying safe based on their personal health risk.

— During annual visits, providers could help patients in wildfire or flood zones develop individual action plans, such as packing go bags and printing out a list of their medications.

— Clinic staff could receive heat-wave alerts — piloted this year — with advance notifications about dangerous temperatures in their locations, including information about categories of people at risk for heat-related health problems and recommendations for helping them cope.

What’s next? The pilot runs through the end of disaster season — although disaster season, particularly wildfire season in the Western states, is nearly a year-round phenomenon these days, Dresser noted — likely wrapping up in November.

This fall, the team will interview clinic administrators and staff to assess how well the test run went. It’ll incorporate that feedback to better serve health care workers and patients. Harvard and Americares plan to scale up with a larger number of clinics next year.

A message from Arnold Ventures:

Same service, same price. You should be charged the same price when you receive the same medical service, no matter where you get it. But today, patients, employers, and taxpayers are charged billions because big hospital systems are buying up small physician practices. And when the logo on the door changes, you pay over 14% more for the same routine services. It's time to make site-neutral health care a reality. Learn more.

Asheville Botanical Gardens, Asheville, N.C. | Sam Oates

This is where we explore the ideas and innovators shaping health care.

An earthquake can cause your hair to stand on end or give your skin a tickle. Electric charges triggered by quakes are the cause, the Washington Post reports.

Share any thoughts, news, tips and feedback with Carmen Paun at [email protected], Daniel Payne at [email protected], Evan Peng at [email protected] or Erin Schumaker at [email protected].

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Today on ourPulse Check podcast, host Kelly Hooper talks with POLITICO health care reporter Ben Leonard about House GOP leaders' newly unveiled health care package that aims to boost price transparency and address high drug costs.

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Hospital worker pay spiked during the pandemic. | Go Nakamura/Getty Images

The upward trend in labor costs in health care — a major concern for hospitals and other providers throughout the pandemic — might be flattening, according to a new report from Fitch Ratings.

That’s good news for the providers, which have had to pay up to cope with strong demand for health workers and low supply.

The particulars: For three consecutive months, year-over-year average wage growth has slowed for health workers in hospitals and ambulatory centers, the analysis from the credit ratings agency found.

For hospital employees, hourly wage growth, year over year, has dropped from a pandemic high of 8.4 percent and a 2023 high of 5.15 percent to 3.75 percent in July.

The decelerated rate, though, is still above the average wage growth before the pandemic, 2.3 percent.

Why it matters: Providers are happy to see the shift now that pandemic relief funds have dried up and a post-vaccine rebound in patients has abated.

But slowing wage growth doesn’t mean labor costs are down by every metric.

The report found that the number of employees remains elevated compared to the time before the coronavirus arrived — suggesting higher staffing levels may be a new normal.

And, of course, slowing wage growth is not good news for health care workers coping with inflation.

A message from Arnold Ventures:

When hospitals consolidate, prices go up, and everyone loses. As big hospitals are gaming the system, patients and taxpayers are paying the price. Site-neutral payment policies would put an end to hospital consolidation, and protect Americans from more than $140 billion in overpayments every year. It’s no wonder that 85% of voters from both sides support site-neutral policy solutions. Now, Congress has the opportunity to protect patients and save taxpayer dollars. It’s time to put patients before profits and enact site-neutral health care. Learn more.

Milgram says the DEA is weighing virtual prescribing carefully. | AFP via Getty Images

The public will get more time to weigh in on whether telemedicine providers should be permitted to continue prescribing controlled substances, the head of the Drug Enforcement Administration said today.

Pandemic waivers allowed that virtual care, but the DEA moved in February to roll back the eased rules. It then delayed a final decision after an initial round of comments found substantial support for continuing to allow patients to get their medicine without an in-person visit.

Administrator Anne Milgram said Tuesday at an event attended by POLITICO’s Ben Leonard that the agency would seek additional input on how it should proceed.

She said the agency is “committed to expanding access to telemedicine” while balancing patient safety, technological advancements, lessons from the pandemic and the opioid epidemic.

The backstory: Critics, including members of Congress on both sides of the aisle, argued that the DEA’s February proposal was too restrictive.

Under that proposal, patients seeking controlled substances such as Adderall to treat attention-deficit/hyperactivity disorder, or Oxycontin for pain relief, would need to go to a doctor’s office before they could start taking the drug.

Patients who need buprenorphine for opioid use disorder, testosterone for gender-affirming care or ketamine for depression could get an initial 30-day supply via telemedicine, but would need to visit a doctor’s office to continue taking those medications.

The agency reversed course after receiving a record 38,000 comments — many of them negative — and extended pandemic rules through Nov. 11 for new patients and a year further for established ones.

What’s next? With the November date now less than two months away, the DEA may have to issue another extension of the pandemic rules.

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