OHSU Rural Health Care

OHSU is working to expand rural health care.  Lithium-ion batteries are a fire risk in your home. The "2025 State of the Climate Report, a planet on the brink."

Episode Transcript

Speaker 1 (00:04):
Welcome to local voices. I'm brad Ford. OHSU is working
to use federal grants to expand rural health care. Lithium
ion batteries can be a fire risk in your home,
and OSU has helped out through a new report on
the climate that found twenty twenty four was the hottest
year in one hundred and twenty five thousand years. Boarding
and Health Sciences University is working to expand rural health

(00:26):
care in the state. OHSU President doctor Sharif Felnehal says
they're pursuing new federal grants.

Speaker 2 (00:32):
I'm encouraged by a new program, the Rural Health Transformation
Grant Program. That's program spearheaded by this administration, and that's
going to be meaningful funding in the many billions of
dollars for rural communities across the country. Oregon is a
state that has a lot of rural residing people, and
so we believe that we will qualify on the merits

(00:54):
for some of that funding. Exactly what amount that will
be and how the organ Health Authority ultimately spurs that
is an open question, which just you will be there
in case the state thinks that we can particularly use
our infrastructure in people to execute on that well, and
we hope to be able to qualify for that. So
there's a way that the state applies.

Speaker 3 (01:16):
We hope that the.

Speaker 2 (01:16):
State gets the maximum amount of funding they need, and
then as a healthcare provider, we will also work with
the state and potentially apply for some of that funding.
And all that is kind of an open question, but
I'm encouraged by that new resource for rural Americans. I'm
concerned about some of the moves around supporting people's.

Speaker 4 (01:34):
Tuition and loan forgiveness.

Speaker 2 (01:36):
Again, the grad plus loan, which was very favorable term
loan set for people to serve underserved communities that has
been eliminated, and so that increases the risk of getting
diverse and frankly rural people to enter our education programs
books that come from historically marginalized areas and do not

(01:57):
have as many resources asymmetric benefited from those programs. And
so again that's what I mentioned before about trying to
figure out how we're going to fortify that. You know,
some of these you know, funding programs out of HURSA
for education also historically have benefited minority communities and vulnerable communities,

(02:18):
and those are expiring as well, and so all of
that increases the risk that we might not meet our
thirty thirty thirty goals to the extent that we otherwise
could have. But now that we know that that's happening,
we're trying to fortify those resources in any other way
that we can. That advanced knowledge, we're trying to move
on it. I'm also concerned about HR one and its
impact on Medicaid. Medicaid disproportionately serves rural people. Some of

(02:43):
the highest Medicaid utilizing states in America or overwhelmingly rural states.
We have about a third of our patients who benefit
from the Medicaid program, again overrepresented by people of rural
communities who don't have.

Speaker 1 (02:58):
As much.

Speaker 2 (03:00):
Access to healthcare coverage other than Medicaid. And so that
is a real problem when people start rolling off of
Medicaid because of whether it's the work requirements or you know,
increase kind of bureaucratic eligibility checks or whatever it is,
the kind of final common pathway is that more people
will roll off of Medicaid. That will hurt rural communities

(03:21):
in Oregon and across the country. So privileged to be
working with the governor alongside other healthcare leaders on what
we're going to do to pick up the pieces on that, frankly,
and try to maximize what we can do to support
the Medicaid program. But you know that also presents a
really important risk, and you know, with about one hundred

(03:42):
and fifty two hundred thousand people expected to roll off
from this policy, we have to get ahead of it
as much as possible and bring whatever other resources we
can to help them.

Speaker 1 (03:51):
Reno Hammond is working to become a nurse. He is
in the LaGrande School of Nursing program. Reno says that
he's wanted to work in the medical field since he
was young.

Speaker 5 (04:00):
It's hard to pinpoint the exact moment in my life
that I decided that I wanted to be a part
of the medical community, but I think a lot of
it had to do with some of the experiences I
had growing up in rural eastern Oregon. At the age
of thirteen, my dad was life lighted to Idaho to
undergo emergency open heart surgery, and this was a time
of uncertainty and darkness in my life, and I didn't

(04:22):
even know if my dad was going to make it.
After driving up to see them. I was immediately bombarded
with love and compassion from the medical staff, and when
walking into my dad's room, I could tell that everyone
was dedicated to his well being as well as the
well being in my mom and I. This was the
beginning of a lifelong dream to join the medical community,

(04:43):
and I wanted to be the person that families could
trust and rely on to care for their loved ones
and any time of uncertainty. So, with the intention of
becoming a healthcare professional, I moved to Corvallis and I
originally attended OSU as a pre med student. Shortly after
COVID nineteen hit, it created some uncertainties about my future.

(05:04):
Although I was receiving federal loans and scholarships to assist
with my schooling, food and security became a major concern mine. Thankfully,
OSU had a student food bank that I was able
to attend weekly to get through this difficult time. And
it was also during this time that I began to
reflect on the needs of my own community in Eastern Oregon.

(05:24):
The more I reflected, the more I realized that my
community needed a public health advocate to shed light on
the disparities that were affecting adequate access to housing, food security,
and even affordable and safe health care. So with this
in mind, I switched my area of study to public
health to learn more about how I could make a
difference in my community. Near the end of my four

(05:45):
year program, I returned home and I interned at the
local health department. During this time, I had the opportunity
to learn about the importance of nursing in my community.
While assisting with community health outreach events and healthfares. Through
the health department, I realized that nurses were right there
alongside me, lending their knowledge and expertise to those who
were willing to listen. It was also during this time

(06:08):
that I realized my true calling as a future nurse.
After being accepted to the OHSU Nursing program at one
of the rural partner schools, I began to actively participate
in clinical rotations through community Connections, Hospice, Headstar, and even
at the local hospitals. I even had the opportunity to
work at the local hospital in my hometown, which had

(06:31):
previously lost access to its birthing center and ICU during
the height of COVID. As I furthered my studies and
completed my first year nursing school. I discovered the RNs
program by talking with instructors and other students. Prior to
applying to the program, I already knew that I wanted
to graduate and return to my hometown. The RNs grant

(06:54):
program gave me the financial opportunity to continue my schooling
to achieve the school. It also provided me with many
opportunities to learn about how nursing and other medical staff
can address the medical emergencies and more specifically, the community
health needs that rural communities lack compared to bigger communities
such as on the western coast, or in Portland, or

(07:16):
even in Court Vallas, in the city that I lived
in for almost four years while attending ISSUE. After graduating
from this nursing program, I plan to be an advocate
for diversity, equity, and inclusion in my community. And I
want to shed light on the disparities that exist within
the community. And I want to be a be better

(07:38):
prepared to address the issues that are present in critical
access hospitals throughout Oregon. Most importantly, I want to use
the opportunities that have been granted to me through the
ORNs program to be a beacon of light and support
for the families that are experiencing unimaginable circumstances.

Speaker 1 (07:54):
Doctor Alnahall says getting an appointment to meet a doctor
or having a procedure done can be difficult. Needs improvement.

Speaker 2 (08:01):
Access to care is a big challenge at Oiicus. You
there's no question about that. It's one of the challenges
that I heard during my interview process. I've seen that
bear out with feedback to me directly. Some of our
survey data on patient experience has shown concerns with that
about accessibility. That is something that has to change. I

(08:25):
do think some of the moves that we're making at
a big picture level will help. So the Vista Pavilion
opening will help certainly with acute care and inpatient access.
We're going to look to every possible strategy around the
deployment of artificial intelligence to help our workforce get folks
into care faster. So that's going to be part of

(08:46):
our strategy. We have to look at whether and how
we are maximizing the number of patients we see every
day without burning out our clinicians, and so where we
have those opportunities, we will make moves to ensure that
access improves. But I'm not going to pretend that access
is meeting all of its goals right now, because it's not,

(09:08):
and it's one of the most important things we have
to do in the next couple of years to improve
a which just use service to the community.

Speaker 1 (09:14):
Doctor Alohol says that they're also aware of burnout the
staff is experiencing, and they're working on solutions. Yeah, we
have really.

Speaker 2 (09:20):
Important well being programming and a chance to get briefed
recently on what we're doing not just for kind of
faculty and the folks leading clinics, but also everybody who
supports them. And part of that is making sure that
spaces and forums are available for folks to be expressing
feedback and so that we can ultimately make the work

(09:41):
environment better and more responsive to people's needs. I ultimately
think that burnout is mostly a function of the processes
that we impose on our employees, and trying to find
ways to make those processes efficient and require the least
steps as possible for rote work from our employees is

(10:03):
a really, really important part of that. So I can
speak from a perspective as a physician. We go I
went into my field, and most people in my field
go into being go into medicine because they want to
see patients. They want to diagnose, they want to treat,
they want to help, they want to heal. They don't
want to sit behind a computer and you know, click
a computer twenty times to get one test done. So

(10:24):
a lot of it's the IT systems that we have
a lot of it's the kind of bureaucracy inherent to
just getting things done in the healthcare system, between insurance
coverage and prior authorization and everything in between, you know.
And so we're going to be looking at all those
processes because we want to make sure that we make
the basic things, especially the road things easier and allow

(10:46):
people to actually do what they love to do. I
OUs you, and that goes for all parts of our mission,
not political care alone. So that's a big focus of
ours and again we have like a core of people
who focus on that well being of as your members.

Speaker 1 (11:01):
That's OHSU President doctor Shrif Alnahal discussing issues facing the
hospital and the university as they navigate challenges facing the
entire medical industry. An increasing number of products have lithium batteries, laptops, phones,
power banks, bike scooters, and vehicles, just to name a few.
Lithium batteries can also be responsible for dangerous fires. Kenton Bryan,

(11:24):
president of the Northwest Insurance Council, joins us on local
Voices Canton, these products are parts of our lives.

Speaker 4 (11:30):
Lithium ion batteries these days are used for a lot
of things, both small and large. They can be as
small as your cell phone battery, all the way up
to an e bike or e scooter, or even your car,
your motor vehicle.

Speaker 1 (11:43):
So charging batteries can overheat and start a very intense fire.
What advice do you have for people charging lithium ion batteries?

Speaker 4 (11:53):
The keys are First of all, only use the charging
equipment and or records that came with the device to
charge the device. You know, don't if you're chargers wearing out,
don't pick up a random you know brand you've never
heard of at a gas station on your way home
and start using it to charge your e scooter because
these can be less reliable and can end up starting

(12:15):
a fire. Secondly, when you're charging a device, especially if
it's a phone or something smaller, make sure it's sitting
on a hard surface, not on a pile of clothes
or on your bed. You know, don't charge things overnight,
leave them on the charger unattended. And if you're charging
a vehicle or a scooter or a bike, it's important

(12:37):
to not charge it when you're going to leave the house.
It's best to charge it outside and not inside the
garage or inside your house.

Speaker 1 (12:47):
Now, when you're done with a device or you're done
with the battery, what should you do with it?

Speaker 4 (12:52):
Do not throw your used batteries or devices in the
household trash. Take them to a local recycling or hazardous
waste facility. You can usually find those online and usually
a local landfills and even some electronics stores have the
ability to recycle used electronics and or batteries.

Speaker 1 (13:12):
Now, some really large battery systems, like if you have
a solar power unit on your house, that can store
it and then you can use it at night. What
should you think about for those large battery systems. Is
that something you can install yourself.

Speaker 4 (13:26):
You definitely should get help from a certified professional if
you're going to install a large solar storage or backup unit,
and make sure that those installations meet recognize safety standards,
including proper ventilation, fire resistant enclosures, thermal management, and compliance
with your local building and fire codes.

Speaker 1 (13:48):
Any special precautions to take with electric vehicles.

Speaker 2 (13:52):
Well.

Speaker 4 (13:52):
More and more we're seeing damage to homes as well
as vehicles from overcharging and sometimes just from meltonntioning batteries
or the vehicles themselves. So it's important to make sure
that your vehicle is being charged with a system that's
approved by the manufacturer of the vehicle. It's best to

(14:14):
charge the vehicle outside. Although some people do install these
chargers inside their garage, it's safer to have it outside
your home because if there is an overheating problem in
that a vehicle or battery starts to burn, it can
burn super intensely and it can burn for days, and
even after sometimes they think the fire is out, it

(14:36):
can re ignite. And if the vehicle is stored inside
your garage when it's charging, obviously you're putting your home
at risk.

Speaker 1 (14:44):
So does insurance cover a lithium ion battery fire like
a standard homeowners policy?

Speaker 4 (14:50):
A standard homeowner's policy usually is going to include coverage
for fire under any circumstance. But if you have an
ev A scooter that you're routinely charging it's a really
good idea to check in with your insurance company, with
your agent and make sure you're covered for that, because
there may be some restrictions in your policy on those

(15:14):
kinds of uses, and it's you don't want to find
out after it's too late that you don't have coverage.

Speaker 1 (15:20):
That's Cat and Bryan, president of the Northwest Insurance Council,
discussing the dangers of lithium batteries and how to reduce
the risk of fire. Oregon State University has helped write
an annual report on the climate. It's called the twenty
twenty five State of the Climate Report, A Planet on
the Brink. Doctor Jillian greg and the OSU College of

(15:40):
Agricultural Sciences joins us on local voices. What did the
report find about temperatures in twenty twenty four?

Speaker 3 (15:46):
Twenty twenty four was the warmest year own record, had
global average temperatures exceeding the pre industrial average by one
point five degrees celsius. So that marked the first time
that the annual a rich temperatures surpass the one point
five degrees warming threshold. A single year of one point

(16:08):
five degrees celsius is critical warning, but it doesn't actually
pass the Paris Agreements one point five degrees target because
that target was based on a twenty year average. So
we are getting closer, but we are not quite there yet.

Speaker 1 (16:27):
Is it known what's causing the increase in temperatures.

Speaker 3 (16:31):
Well, there are three known factors that can change any
planet's temperature. You could have income more incoming solar radiation,
You could have a changing the amount of reflection of
that incoming solar radiation, which we call albedo, or you
could have change in the greenhouse gases. So measurements of
all of these three factors have shown that incoming solar

(16:55):
radiation has actually been going down since nineteen fifty and
whereas greenhouse gases have been increasing, and calculations show that
the amount of warming is directly proportional to the amount
of greenhouse gases in the atmosphere, so it's a direct
physical relationship. You can put CO two and air in

(17:18):
different soda bottles and shine a light on them and
see that the bottle with the CO two warmest faster.
This is an experiment that was first performed in the
eighteen fifties by Eunice Foot in New York City Central
Park and it's been validated many times by many experience
experiments since then. So this year, the high sea surface

(17:40):
temperatures were also influenced by the El Nina weather pattern,
which was also a major driver of the record heat
in this year. However, the ten warmest years on record
have all occurred within the last decade, so from twenty
fifteen to twenty twenty four, so many of those were
not almina years.

Speaker 1 (18:03):
Have there been times when the Earth has been hotter
and is it known what caused that?

Speaker 3 (18:09):
Well, the question isn't really whether the Earth has been
warm in the past, which it has. The question is
whether humans and human agriculture which supports the human populations
have existed in those very warm time periods. So certainly,
in the last one hundred thousand years, for instance, there
have been two thermal maximums that were fifteen or eleven

(18:32):
degrees fahrenheit warmer than today. So ninety million years ago
we had the Crestaceous thermal maximum which had these co
two levels of one thousand parts per million compared to
today's levels which are four hundred and twenty two parts
per million, and the pre industrial which were only about
two hundred and eighty parts per million, and we also

(18:55):
had fifty five million years ago, we had the Paleocene
Eocene thermal maximum. The important things to remember about those
warm periods is that both of these thermal maxima were
caused by elevated CO two concentrations. Both were associated with
mass extinctions of seventy five percent or more of all species,

(19:16):
And the current rates of CO two missions that we're
experiencing now are at ten times faster rates than those
that happened for those two previous warm periods. So the
broad overview then is that temperature CO two concentrations in
sea levels have all been very constant since the beginning

(19:40):
of agriculture, which has allowed the development of human civilization
as we know it. So our practices of adding greenhouse
gases to the atmosphere are in fact warming the globe,
and the temperatures that we are headed toward have never
been experienced by humans, and they are taking far out

(20:01):
of the range of the stable climate system to which
we have adapted.

Speaker 1 (20:06):
Is it not being done to change the conditions that
are causing temperatures to rise?

Speaker 3 (20:12):
Well? The anerlyz in CO two constant concentrations was initially
only about eight parts per million per year in the
nineteen sixties, but recently it's gone up to two or
three parts per million per year. The change from twenty
twenty three to twenty twenty four was the highest on record,
at three point five parts per million in a single year.

(20:35):
So it's not just CO two. If you look at
our paper, you can see that CO two, methane, and
nitrous oxide all are on the rise, as is s
F six, which is the strongest of all greenhouse gases.
So the goal is not just for the rise in
these greenhouse gases to level off, but we need for

(20:56):
them to go back to their pre industrial levels so
that we can maintain a stable climate system.

Speaker 1 (21:04):
What could be done differently in how energy is created
so that we don't create the greenhouse gases well.

Speaker 3 (21:13):
Solar and when energy are now cheaper than building power plants,
so anything we can do to encourage the use of
renewable energy is the way to go.

Speaker 1 (21:25):
Does improving ecosystems make a difference.

Speaker 3 (21:28):
Well, plants naturally take CU two out of the atmosphere
and the process of photosynthesis, so anything we can do
to preserve natural ecosystems will help. Currently, land plants take
up a quarter of human emissions, and oceans take up
another quarter. So without these systems in place, global warming
would be accelerating at twice the rate.

Speaker 1 (21:50):
How does the food system creating food impact greenhouse gas emissions?

Speaker 3 (21:58):
Well, food weight is one of the largest contributors to
global warming, so for all of the food that we waste,
that much more must be produced and distributed throughout the world.
In addition to greenhouse gas emissions, this is one of
the biggest impacts on global warming. Also, if we could

(22:19):
eat more of a plant based diet that is lower
on the food chain, that can make a big difference.
Certainly ten percent of the energy at any trophic level
makes it to the next level, so eating a more
plant based diet will always require fewer of Earth's natural resources.
There's also the idea that animals with ruminant digestive system cows, sheep,

(22:43):
and goats use bacteria to break down cellulose, so in
that process they create methane and that methane is emitted,
which is a much stronger greenhouse gas, which also has
a large impact on a climate system.

Speaker 1 (23:00):
What's work called for specific changes in society.

Speaker 3 (23:04):
Well, in our report, we discuss climate change mitigation strategies
across three core areas, energy, nature, and the global food system.
The specific strategies we describe include scaling up renewable energy capacity,
protecting and restoring natural ecosystems, and reducing food loss and waste.

(23:25):
Like we were just discussing, we also discuss broader changes
that are needed, including the adoption of post growth economic
models that promote societal equity.

Speaker 1 (23:40):
Is the US going backwards in the progress that was
being made?

Speaker 3 (23:45):
Well. Rivocation of tax credits to encourage solar and when
and electric vehicles is unfortunate and certainly not helpful. Encouraging
the expansion of fossil fuel production is also not helpful.
All of these efforts should instead be focused on the

(24:05):
expansion of renewables. But despite these setbacks, the energy transition
seems to be going full steam ahead. Solar and wind
energy are now cheaper, and now much cheaper than building
power plants, so power companies are adding solar and wind
to make up the power that they provide.

Speaker 1 (24:28):
Now there are critics of the causes of climate change.
What is your response to them?

Speaker 3 (24:34):
Well, critics have changed their arguments through the years. The
first it was that the globe is not warming but
now it's pretty clear just looking at the data that
the globe has reached the one point five degrees celsius warmer.
Then it was that humans are not responsible, but we
clearly see that the timing and the amount of warming
is directly corresponding with the greenhouse gas emissions and the

(24:57):
industrial revolution. Interestingly, the Trump administration appointed five climate deniers
to write one hundred and fifty page report this summer
about how greenhouse gases are not important for climate change.
They gave scientists sixty days to comment on the report,
and scientists with experts in all fields came back with

(25:21):
even longer rebuttal paper. So the contrast of these two papers,
these two very current papers that came out this year,
will be very interesting for any critics to examine.

Speaker 1 (25:34):
Now it seems like such a large scale problem, right,
what can people do on an individual basis?

Speaker 3 (25:42):
Well, the big push now really is the energy transition
and everyone can be part of this. So anytime your
fossil fuel a point of clients breaks, we need to
switch to electric and this includes not only changing from
gasoline cars to electric vehicle, but also switching any of

(26:03):
our household products over to heat pumps. For instance, your heating,
your air conditioning, your water heaters, your clothes dryers, visa.
Can all be run by electric heat pumps, which are
much more cost efficient. It is also most satisfying if
you have your own rooftop solar if possible. But over

(26:25):
time all of our electricity will be coming from renewable sources.
So the sooner we can switch off of cliants is
that use fossil fuels, the sooner you'll be part of
the solution. We also need to vote, encourage others to vote,
and to keep the importance of climate change and the
energy transition forefront in all conversations.

Speaker 1 (26:46):
Now sure way that people can determine their individual carbon
footprint and where they rank in comparison to others.

Speaker 3 (26:55):
There are a number of online footprint calculators. The EPA
has one Nature Conservacy, the Conservation International, and many more
beyond that. Some of them relate to the total resources
you use and expand that to the world population to
see how many earths we would need to support the
world population. So this often comes to five or seven

(27:18):
or even more earths to be you know, so we're
way vastly over utilizing the natural resources that we have
available to us. Things that can help to bring your
footprint down include the usual suspects of driving less, more insulation,
and even the ones that we talked about having more

(27:39):
of a plant based diet.

Speaker 1 (27:42):
Is there a point when it becomes too late, when
it's gone too far to correct the problem.

Speaker 3 (27:49):
Yes. These points are called tipping points, And it's like
if you're kayaking down a river, you could always paddle
back upriver. It's harder, but you could do it, but
not if you've gone over a waterfall, then you're never
going to get able to paddle back up the river.
So the climate system, the major tipping points include the

(28:10):
melting of all of the ice on Greenland and west
antiarch ice sheets. So these are reinforcing feedback loops. So
once ice melts, it's replaced by dark land or dark
ocean would absorb even more incoming solar radiation even without
added greenhouse gases. So once these systems are in place,

(28:34):
that can lead to the melting. This less saline melt
water that adds to the ocean, which reduces ocean circulation,
which can change the climate patterns such that we have
more droughts and die back in the Amazon rainforest, and

(28:55):
therefore even less carbon removal out of the atmosphere. So
all of the systems of the Earth are connected, and
the sooner we pass tipping points, the more other tipping
points we're going to be passing.

Speaker 1 (29:10):
Doctor Greg, thanks for joining us on Local Voices. That's
doctor Jillian Greg and the OSU College of Agricultural Sciences
on the twenty twenty five State of the Climate Report,
A Planet on the Brink. Thanks for listening to Local Voices.
I'm Brad Bord. You can hear past episodes on the
iHeartRadio app under the podcast tab. Local Voices is a
public affairs presentation from iHeartRadio.