Friday, April 10, 2009

News Clipping Archives

 

Maryland / Regional

Therapy called better than group homes (Baltimore Sun)

Md. health centers get $4.3 million in stimulus funds (Baltimore Sun)

Area Gets Funds for Care of Children (Washington Post)

2008 Tuberculosis Cases Increase In Maryland; Drop Seen In Baltimore City (Medical News Today)

Medicare may pay for doctors’ mark-ups of diagnostic tests (Daily Record)

Balto. County Council considers allowing creameries on farmland (Baltimore Sun)

Fox rabid; dog's owner sought (Baltimore Sun)

State budget headed for final passage (Baltimore Sun)

Homeless shelter clears roadblock (Annapolis Capital)

Virginia funeral home accused of atrocious conditions (Annapolis Capital)

Health system honors doctors (Cumberland Times-News)

Lt. Governor Brown Launches Maryland Veterans Network Of Care Portal (ZAMP Bionews)

 

National / International

Food Safety Efforts Have Stalled in Recent Years, CDC Says (Washington Post)

CDC: US food poisoning cases held steady in 2008 (Washington Post)

No salmonella found in New York pistachio plant (Hagerstown Herald-Mail)

Ethanol use could raise cost of U.S. food aid (Baltimore Sun)

FDA reversal OKs morphine painkiller for dying (Washington Post)

Free clinics fill medical void (USA Today)

Obama Pledges New Data System for Veterans (Washington Post)

Veteran Issues In The News (Washington Post, New York Times, CBS Evening News and Associated Press)

Electronic Health Record (Associated Press)

Childhood eczema is a growing problem (Orlando Sentinel)

New records plan streamlines vets' care (Washington Times)

 

Opinion

City hospital at risk (Baltimore Sun)

Caring for the Dead (Baltimore Sun)

 

 

 

 

 

Maryland / Regional

Therapy called better than group homes

 

By Brent Jones

Baltimore Sun

Friday, April 10, 2009

 

Advocates for Children and Youth released a study Wednesday that says that more than 40 percent of children sent to group homes would be better served by Multisystemic Therapy, an intense, family-based intervention program. The percentage is twice as much as the state sends to such therapy.

 

The sample for the study included 35 children between the ages of 11 and 17, advocates said. After a review of court records, pre-disposition investigation reports, placement and treatment histories and other documents within the juvenile court files, the study found that 15 of the children were eligible for the therapy, advocates said. It is designed to strengthen parent skills and improve decision-making in kids through in-home therapy. The therapist talks to the youth, parents and others in the household about structure and behavior. The program is supported by the Department of Juvenile Services, which is more than doubling the number of eligible families from a year ago to at least 200 statewide. Advocates for Children and Youth says that number should be closer to 400.

 

Copyright 2009 Baltimore Sun.

 

Md. health centers get $4.3 million in stimulus funds

 

By Kelly Brewington

Baltimore Sun

Friday, April 10, 2009

 

 Maryland's struggling community health centers are getting $4.3 million in federal stimulus money so they can offer primary care to thousands more needy people.

 

The federal money is going to more than a dozen groups that operate community health centers in Maryland. U.S Rep. John Sarbanes visited one program - Baltimore's Highlandtown Community Health Center - Thursday morning to present its parent company, Baltimore Medical System, with a check for $571,742.

 

Baltimore Medical System, the city's largest network of health centers, will use the money to treat an additional 1,500 uninsured patients at its seven health centers in Baltimore and Baltimore County.

 

Last year, Baltimore Medical System served about 11,000 uninsured patients, out of a total patient load of 45,000. But the uninsured figure is expected to grow rapidly this year, as job losses caused by the recession leave many without health insurance. Baltimore Medical System's clinics receive 60 calls a day from new patients, twice the number from six months ago, said Jay Wolvovsky, Baltimore Medical System's chief executive officer.

 

"Baltimore Medical System is very grateful to the president and to Congress for recognizing the additional burden that safety net providers are going to feel from the change in the economic environment," he said. "We will use this money toward good purposes."

 

Copyright 2009 Baltimore Sun.

 

Area Gets Funds for Care of Children

Stimulus Targets Struggling Families

 

By Chris L. Jenkins

Washington Post

Friday, April 10, 2009; B01

 

Virginia, Maryland and the District will receive more than $73 million in federal stimulus funds to expand and improve child-care and immunization programs for low-income families, the Obama administration announced yesterday.

 

The money is part of a two-year, $2 billion initiative passed by Congress in February that gives states more money to help low-income families struggling with rising child-care costs. The money can be used to expand the number of child-care vouchers offered, pay agencies more for their services or help states deliver these services more efficiently, officials said.

 

In a statement, Vice President Biden said that the child-care money issued under the American Recovery and Reinvestment Act was designed to help moderate-income families weather the poor economy.

 

"Parents are worried about finding a job or keeping the job they have, and they shouldn't have to worry about affording quality child care," Biden said. "Safe, affordable, high-quality child care gives working parents the peace of mind they need to be stable, dependable employees."

 

He added that the money for immunizations would increase the availability of certain vaccines and funnel more money to programs that provide those services.

 

Experts said that states probably will use the money conservatively, as the allocation is designed to last only two years, and many states don't want to be saddled with programs they can no longer afford. Virginia will receive about $43 million; Maryland, almost $28 million; and the District, about $2.9 million.

 

Marianne McGhee, a spokeswoman for the Virginia Department of Social Services, which has more than 8,100 children on its waiting list for child-care vouchers, said the state has not decided how the money will be spent but is not considering any program changes that could not be sustained once the stimulus money runs out.

 

"Ultimately, our focus remains on increasing the capacity of the child-care program, support to families hard hit by the economic downturn, and quality of care provided," she said.

 

Kristin Yochum, deputy chief of staff for the District's Office of the State Superintendent of Education, said the city planned to use the money to improve its child-care tracking system, among other changes, and potentially increase reimbursement rates to child-care providers.

 

The stimulus money represents a change from how child care was funded under the Bush administration. A 2007 study by the Office of Management and Budget found that in 2006, 150,000 fewer children nationwide were receiving child-care assistance than in 2000 because of flat federal funding. Subsequent budgets added $200 million a year. Advocates said the $2 billion was a first step toward erasing past shortages.

 

"This increase was desperately needed. . . . There have been just enormous gaps," said Joan Entmacher, director for family economic security at the National Women's Law Center, a Washington-based think tank. "For years [funding] was flat, then followed by very small increases."

 

Michael Thompson, president of the Thomas Jefferson Institute for Public Policy, said the money is primarily designed to get struggling families though the recession. "It's important that people realize that this stimulus money is temporary," he said.

 

Copyright 2009 Washington Post.

 

2008 Tuberculosis Cases Increase In Maryland; Drop Seen In Baltimore City

 

Medical News Today

Friday, April 10, 2009

 

Tuberculosis, the infectious lung disease that the American Lung Association was founded to fight, remains active in Maryland. In 2008, there were a total of 278 cases of TB throughout the state, up from 270 cases in 2007.

 

While the majority of localities saw their TB numbers increase or stay the same, Baltimore City was one of six localities in Maryland where the number of tuberculosis cases decreased.

 

Baltimore City's cases dropped sharply, from 47 in 2007 to 32 in 2008.

"The Baltimore numbers show how we can protect people and defeat TB with awareness and attention to strategies that work," said John M. Colmers, Secretary of the Maryland Department of the Health and Mental Hygiene (DHMH). "What Dr. Josh Sharfstein and his department have done to inhibit the spread of TB is an example for all local health departments, hospitals and clinics."

 

Today, on World TB Day, the American Lung Association in Maryland commends both Baltimore City and Baltimore County for their efforts to stop the spread of tuberculosis. Baltimore County's TB cases declined as well, from 31 cases in 2007 to 20 cases in 2008.

 

"Proper detection, diagnosis and treatment of tuberculosis are important for patient health and public safety," said Dana Lefko, Manager of Mission Services and Advocacy for the American Lung Association in Maryland. "The methods in place in Baltimore City and Baltimore County are achieving results. That work must continue and grow in order to keep Marylanders safe from tuberculosis."

 

March 24 is World TB Day, which commemorates the day in 1882 when Dr. Robert Koch announced the discovery of Mycobacterium tuberculosis, the bacterium that causes TB. Tuberculosis is transmitted through the air when someone with active TB in the lungs coughs or talks, and it is usually spread in close living quarters. Anyone inhaling air containing TB bacteria may become infected, which is referred to as latent TB infection. Only active TB disease causes symptoms and can be spread to other people; latent TB infection does not cause symptoms and cannot be transmitted but can lay dormant in the body for years and become active disease when the body becomes vulnerable due to other illness, chemotherapy or other stressors.

 

In 1919, when the American Lung Association in Maryland was founded, TB was killing 1 in 4 Americans. That rate has dropped significantly in the United States, but each year, 9 million people around the world become sick with TB. An estimated 2 billion people worldwide - one third of the world's population - are infected with TB, and more than 2 million of them die annually of the disease.

 

"TB is a stubborn disease that has produced illness and early death for centuries. Though far less common now, TB demands strong public health protections," said Frances Phillips, DHMH Deputy Secretary for Public Health. "Preventing the spread of this serious disease is the day-today work of public health investigators, nurses and doctors in every city and county statewide. With increased international travel and the development of drug resistant forms of TB, this public health work becomes even more essential."

 

In the United States, there were 12,898 cases of TB reported in 2008, which is a 3.8 percent decline since 2007. The Centers for Disease Control Advisory Council for the Elimination of Tuberculosis declared in 1989 that their goal was to eliminate tuberculosis in the U.S. by 2010.

 

That goal will not be reached. It will take 96 years to eliminate TB in America if the current annual rate of decline in TB incidence continues.

 

"We need to remain vigilant in the fight against TB," said Lefko of the American Lung Association. "It is critical to keep this communicable disease under control so it does not spread.

 

Quick, accurate diagnoses and consistent, effective treatment are needed if we are going to eliminate tuberculosis in the United States."

 

Now in its second century, the American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease. The regional American Lung Association of the Atlantic Coast, working in Maryland as the American Lung Association in Maryland, serves communities in Maryland, North Carolina and Virginia. For information, visit http://www.marylandlung.org.

 

As a public health department, the Maryland Department of Health and Mental Hygiene's goal is to improve the health status of every Maryland resident and to ensure access to quality health care. We are responsible for helping each person live a life free from the threat of communicable diseases, tainted foods, and dangerous products. To assist in our mission, we regulate health care providers, facilities, and organizations, and manage direct services to patients where appropriate. For information, visit http://www.dhmh.state.md.us

 

Source

American Lung Association

 

Article URL: http://www.medicalnewstoday.com/articles/145576.php

 

Copyright 2009 MediLexicon International Ltd.

 

Medicare may pay for doctors’ mark-ups of diagnostic tests

 

Barry F. Rosen and Christopher P. Dean

Daily Record

Friday, April 10, 2009

 

Physicians often recommend certain diagnostic tests for their patients. Sometimes the “technical” components of these tests are performed with someone else’s equipment, including mobile units, and with someone else’s technologists.

 

Sometimes the “professional” components of these tests are interpreted by someone other than the physician ordering the test. In these situations, the question arises whether the ordering physician should re-bill these technical and professional services at the “wholesale” price that the ordering physician is paying for these services, or whether the ordering physician may mark up that price.

 

Physicians ordering and re-billing diagnostic tests in late 2007 and early 2008 for Medicare patients were caught in a quagmire, because the Centers for Medicare and Medicaid (CMS) issued new ”final” mark-up rules, postponed those rules and distributed new “proposed” rules during that time.

 

However, a new, easier-to-implement “anti-mark-up rule” went into effect Jan. 1, 2009, and health care providers should now carefully review their arrangements under this new rule.

 

CMS’ 2009 anti-mark-up rule states that, except for two important exceptions discussed below, Medicare should pay a physician the lesser of (1) the wholesale price he or she pays for the technical and/or professional component of a purchased diagnostic test billed by the ordering physician, or (2) the Medicare Physician Fee Schedule.

 

Accordingly, absent an exception, the physician billing for an ordered test may only bill his or her wholesale cost, using a reasonable methodology to determine that cost. The calculation of wholesale cost may be difficult because suppliers may be charging the ordering physician on a monthly basis and not per test.

 

Moreover, the new rule states that such wholesale cost must exclude any amounts the performing physician is paying the ordering physician for leasing diagnostic equipment or space from the ordering physician.

 

Furthermore, if the ordering physician does not disclose when billing Medicare that the diagnostic tests were purchased, then the ordering physician is subject to the False Claims Act.

 

However, as noted above, there are two important exceptions to the 2009 rule that will result in Medicare paying a mark-up.

 

The two exceptions are the same practice rule and the same office rule, and both exceptions recognize the importance of cost-effective, in-office diagnostic testing. Under either exception, the ordering physician may purchase a diagnostic test, bill for the test, and Medicare will pay the lower of (1) the marked-up (or retail) price for the diagnostic test, or (2) the Medicare Physician Fee Schedule.

 

Same practice rule

The same practice rule allows an ordering physician to bill for a diagnostic test performed by someone who is in the same practice as the ordering physician. To satisfy the same practice rule, the physician performing the diagnostic test must perform 75 percent or more of his or her services on behalf of the ordering physician’s group.

 

Interestingly, the 75 percent rule may be satisfied retroactively or prospectively. This means that the ordering physician may take into account the performing physician’s services in the prior 12 months or reasonably anticipate the performing physician’s services for the next 12 months.

 

For anti-mark-up rule purposes, the performing physician for the professional component of a diagnostic test is the physician performing the interpretation. For the technical component, the performing physician is the physician supervising the diagnostic test.

 

In many cases, general supervision of the diagnostic test is sufficient for Medicare, which means that the procedure is furnished under the physician’s overall direction and control, but the physician is not required to be present during the procedure.

 

Same office rule

If the same practice rule cannot be satisfied, an ordering physician may still bill and collect a marked-up amount of a purchased diagnostic test if the ordering physician qualifies for the same office rule.

 

For the same office rule to apply, the performing physician must perform the technical and/or professional component in the ordering physician’s office. For a diagnostic test to be performed in the ordering physician’s office, the office must be one in which the ordering physician provides substantially the full range of patient care services.

 

In addition, ordering physicians who offer a full range of services in an office with the same street address as the performing physician may also bill and mark up the technical component of a purchased diagnostic test, if the ordering physician leases diagnostic space and equipment in the performing physician’s office.

 

However, the space and equipment must be leased and used exclusively by the ordering physician for the block of time when the test billed by the ordering physician is performed.

 

If the performing physician also performs the professional component in the leased space during the block of time, then the ordering physician may also bill and mark up the professional component.

 

While compliance with the anti-mark-up rule will likely result in compliance with other applicable statutes, such as the federal Stark law, a separate analysis must also be done to confirm such a conclusion on a case-by-case basis.

 

Barry F. Rosen is the chairman and CEO of the law firm of Gordon, Feinblatt, Rothman, Hoffberger & Hollander LLC, and he can be reached at 410-576-4224 or brosen@gfrlaw.com. Christopher P. Dean is an associate in Gordon, Feinblatt’s Health Care Practice Group, and he can be reached at 410-576-4221 or cdean@gfrlaw.com.

 

Copyright 2009 Daily Record.

 

Balto. County Council considers allowing creameries on farmland

Measure recommended in wake of controversy in Long Green area

 

By Mary Gail Hare

Baltimore Sun

Friday, April 10, 2009

 

A dispute over land use among neighbors in Long Green Valley has prompted the Baltimore County Council to draft legislation to permit creameries to operate in agricultural zones.

 

The measure, recommended by the county Planning Board and set for introduction April 20, may settle the debate, waged in court and before the council, between land preservationists who say the law would open the door to factory operations in their midst, and farmers who insist that they must diversity to stay in business.

 

The conflict centers on the creamery that Bobby Prigel has built - but has yet to open - at his Bellevale Farm, a dairy operation on about 260 acres, and his plans to sell organic products made from milk his cows produce.

 

Several Long Green residents insist that a commercial enterprise has no place in a valley where numerous farms, including Prigel's, are permanently safeguarded from development through preservation programs.

 

Others disagree. "If you deny this farmer the right to earn a living, no one will put their land in preservation," Mickey White, a Hydes dairy farmer, said at a council hearing Monday night. "Maybe we should charge people to look at our farms, rather than sell our products. How can we survive, when we are getting $1 for a gallon of milk?"

 

The issue drew a standing-room-only crowd to council chambers, and about 40 people addressed officials.

 

Carol Trela, secretary of the Long Green Valley Association, called the proposed legislation "a Trojan horse that will open the gates of destruction on the conservation zone. It is a license for farmers to do as they wish."

 

Gary Bowers, a neighbor, said Prigel "is moving into 21st-century agriculture. It is hard to believe a farmer would be denied the opportunity to sell his goods."

 

A county zoning administrator has twice upheld Prigel's right to operate the business, and last month the Baltimore County Circuit Court ruled in his favor. Many residents have rallied to Prigel's cause and have planned a benefit next month to help him defray $100,000 in legal costs.

 

Council members said they will take the next week to study the issue and possibly visit Prigel's farm and the 10,000-square-foot creamery. Councilman T. Bryan McIntire, who represents the district, said he is still gathering information.

 

"I am listening to all the people," he said. "This issue has brought terrible dissension to a lovely and loving valley. I will have to decide what is best for the county as a whole."

 

Council Chairman Joseph Bartenfelder, who, as a farmer, likely will recuse himself from the vote, said he will continue to search for a reasonable compromise.

 

The council will accept additional public comment at its April 14 work session.

 

Copyright 2009 Baltimore Sun.

 

Fox rabid; dog's owner sought

 

By Jonathan Pitts

Baltimore Sun

Friday, April 10, 2009

 

A rabid fox was found dead near where a dog was attacked by a fox in a northern Harford County park last weekend, and officials are attempting to find the dog's owner. Harford County Health Department officials said an unidentified man was walking a dog near the boardwalk in Eden Mill Park in Pylesville on Sunday when a fox attacked the dog. Officials later found a dead fox nearby that tested positive for the rabies virus. It was the first recorded case of rabies in a fox in Harford County in a year, according to Bill Wiseman, a Health Department spokesman. "We're urgently looking for the dog's owner because, on the slight chance that the fox's saliva contacted an open wound on the owner or contacted his eyes, nose or mouth within a couple of hours of the attack, he might have contracted the virus," Wiseman said. "And if the rabies virus goes untreated, it is lethal." Officials learned of the attack when the dog's owner mentioned it to a park employee Sunday, but the man did not give his name or describe the dog.

 

Copyright 2009 Baltimore Sun.

 

State budget headed for final passage

Bill cuts tax break for new car purchases, includes Bon Secours grant

 

By Laura Smitherman

Baltimore Sun

Friday, April 10, 2009

 

Maryland residents would not get a state tax break when buying a new car under budget legislation nearing final passage - as they would under a federal law meant to jump-start the slumping auto market.

 

The bill, finalized by a cross-chamber conference committee Friday morning, now heads to the House of Delegates and Senate for final passage as lawmakers race to finish before the session adjourns at midnight on Monday. The House is expected to take up the bill first, on Saturday.

 

As part of the $14 billion operating budget and a companion measure, lawmakers also decided to throw a $5 million lifeline grant to Bon Secours Hospital but not until the struggling hospital's board devises a long-term plan to solve its financial problems.

 

And lawmakers resolved disagreements over funding for stem-cell research, cutting Gov. Martin O'Malley's proposal by $3 million to $15.4 million, averting a much larger proposed reduction. The committee also restored $2 million in tax credits for the biotechnology industry that O'Malley has championed.

 

Under the tax provisions, lawmakers did extend federal tax breaks for unemployment insurance and the earned income tax for low-income residents to be counted on state income tax returns. But they decided against the titling tax break, which would cost $10 million, as they worked to build a roughly $100 million fund balance that could be tapped if the economy deteriorates.

 

"This is one of the few benefits we'd be going back to taxpayers with," said Del. Sheila E. Hixson, chairwoman of the Ways and Means Committee and a Montgomery County Democrat, before the committee decided to decouple from federal law on the titling tax.

 

Sen. Ulysses Currie, chairman of the Budget and Taxation Committee and a Prince George's County Democrat, responded by warning that the economy could worsen and lawmakers needed to build a budget cushion in case state tax revenues take a dive.

 

"I understand," Hixson said.

 

The state titling tax break would have been about $96 on the purchase of a $20,000 car, though taxpayers will still get the federal benefit of about $350.

 

Maryland's budget must be balanced, and lawmakers have cut a number of programs, frozen state agency budgets and denied state workers raises. Lawmakers did work to preserve about $180 million for Program Open Space, under which state and local governments purchase land for preservation and recreation, by funding the majority of projects through bonds.

 

Copyright 2009 Baltimore Sun.

 

Homeless shelter clears roadblock

Adjacent businesses say 'not in my backyard'

 

By Ryan Justin Fox

Annapolis Capital

Friday, April 10, 2009

 

An effort to build a new and badly needed homeless shelter in Annapolis has cleared another hurdle after a city board rejected an attempt by a neighbor to block construction.

 

The five-member city Board of Appeals earlier this week denied an appeal by local attorney Michael Roblyer who challenged the city planning and zoning director's ruling that allows the planned shelter to be built on Hudson Street near the Annapolis National Guard Armory.

 

Annapolis Area Ministries officials are hoping to move the Light House shelter operations from its current cramped facility on West Street to a new center that would be built on 1.4 acres in the commercially zoned area packed with an assortment of businesses.

 

Plans for the building call for a first-floor office and administrative space and a second and third floor for residential use. The new center will allow the Light House to expand its staff and serve an estimated 1,500 people per year, according to its Web site.

 

Jon Arason, city planning and zoning director, ruled in January that the City Code allows for the facility to include residential uses on upper floors since the ground floor is designated for nonprofit office use.

 

Roblyer, whose offices are across Willow Avenue from the proposed homeless shelter, challenged Arason's interpretation of the residential use described in the building's plan.

 

"It's a basically a dormitory and not a 'dwelling unit' as (laid out in the city zoning code)," Roblyer said.

 

Both Arason and the shelter's attorney, Alan Hyatt, said the code allows for a broad determination for the residential usage in the business and commercial enterprise zone.

 

The Board of Appeals disagreed with Roblyer and upheld Arason's zoning determination during a standing-room only public hearing Tuesday night at City Hall.

 

Other neighboring business and property owners were restricted to testimony specifically addressing the zoning determination. Potential neighbors still aren't happy.

 

"We're not against homeless shelters, we're really not," said Tim Mealey, owner of Mealey's Signs on Willow Street next to the planned shelter. "But it, unfortunately, has a negative impact (on surrounding properties)."

 

Mealey said he's been trying to lease space for the past six months, but interested businesses have voiced concern about the homeless shelter being built next door.

 

"Like they said at the (Tuesday Board of Appeals) meeting, 'There's nothing wrong with a homeless shelter as long as its not in my backyard,' you know," Mealey said.

 

This is not the first time the new Light House facility has faced a challenge. Last month, the City Council threatened to pull the plug on more than $210,000 in financial breaks to build the new center.

 

Aldermen eventually agreed to waive $123,550 in construction and permit fees. Shelter officials said the project would have potentially been derailed if the city voted against waiving those fees.

 

Baltimore-based architects Cho Benn Holback and Associates have agreed to design the new shelter for free. David Avedesian and John Bruno of Annapolis Developers, the owner representatives managing the design and construction of the new center, also are donating their services to the project, according to the shelter's Web site.

 

Shelter officials also will receive a $400,000 capital grant from the city to build the new facility.

 

The new building will include a day center for the chronically homeless, emergency residential shelter for individuals and families, and a resource center for education and employments training and health and social services.

 

Officials also said they are planning to provide more programs for homeless people, including financial literacy workshops, job training, legal counseling and employment referrals.

 

Elizabeth Kinney, who is helping lead the fundraising effort for the new shelter, said nearly $1.7 million already has been donated for the new building.

 

The fundraising campaign's goal is $8.5 million, officials said. Shelter officials said they hope to start construction this summer and open the new Light House next year.

 

Barring an appeal of the board's decision to county Circuit Court, construction of the shelter will move forward.

 

Copyright 2009 Annapolis Capital.

 

Virginia funeral home accused of atrocious conditions

 

Associated Press

Annapolis Capital

Monday, April 6, 2009

 

WASHINGTON (AP) — A funeral home that helps handle veterans awaiting burial at Arlington National Cemetery left corpses in an unrefrigerated garage, hallways and on makeshift gurneys, according to a former embalmer who has given his photographs and notes to authorities, The Washington Post reported Sunday.

 

"It was disturbing and disrespectful and unethical," said Steven Napper, a retired Maryland trooper who worked at the funeral home for nine months. "I never could have imagined what I saw there or the things we were asked to do."

 

Napper said he saw as many as 200 corpses not properly cared for while working at National Funeral Home in Falls Church, Va., from May until he quit in February. National Funeral Home also embalms and stores bodies for four other funeral homes in the D.C. region that are all part of Houston-based Service Corporation International, the world's largest funeral services conglomerate.

 

The Post reported that Napper's documentation as well as the observations of three other employees and a grieving son have sparked an investigation by the Virginia Board of Funeral Directors and Embalmers. The newspaper also reported that several people said a board investigator had interviewed them in recent weeks.

 

Lisa Hahn, the board's executive director, told the Post she could not confirm a current probe or talk about allegations.

 

Service Corporation International's Virginia Funeral Services is investigating the allegations, but has found its facilities comply with laws and regulations, company president J. Scott Young said in a statement. No employee brought any such conditions to the company's attention, he said.

 

"Our company is committed to treating all human remains with the utmost dignity and respect at all times," he said.

 

Photos in a video on the Post Web site show several coffins stacked on a rack in what Napper said was an unrefrigerated garage. Another photo shows a body wrapped in a white sheet on top of a cardboard box.

 

A message left by The Associated Press for Napper at a listed home number was not immediately returned Sunday.

 

In 2003, Service Corporation International reached a $100 million settlement with hundreds of families over allegations involving two Florida cemeteries, including digging up graves and burying people in the wrong places.

 

Ronald Federici saw a lukewarm cooler overflowing with exposed bodies when his Army colonel father's body was taken to National in December.

 

"The stench was disgusting," Federici of Clifton, Va., told The Associated Press Sunday. He described seeing about 1 to 2 inches of feces and urine on the floor.

 

Federici immediately reported his observations to officials at Alexandria's Demaine Funeral Home, which was to handle his father's embalming. They told him it was a misunderstanding. He later took his complaints to the state and in a Jan. 2 letter, National Funeral Home's general manager told Virginia officials that the conditions Federici spoke of didn't exist.

 

Federici said he'd like to see the company be fined or shut down, "because obviously they didn't learn from the $100 million settlement a few years ago."

 

"They need to make a public statement and make public reparation for this kind of egregious and vile behavior," he said.

 

Copyright 2009 Annapolis Capital.

 

Health system honors doctors

 

Associated Press

Cumberland Times-News

Wednesday, April 8, 2009

 

ROCKY GAP — Four area physicians were recognized by the Western Maryland Health System at its gala held at Rocky Gap Lodge & Golf Resort on Friday.

 

Mark Nelson, cardiovascular surgeon for the WMHS Heart Institute, was honored as the 2009 Physician of the Year.

 

The Lifetime Achievement Award, which honors an outstanding physician with more than 20 years of service to the community, went to both Robert Dawson and Elm-aslias Menchavez.

 

Radiation oncologist Scott Watkins was the inaugural recipient of the Immediate Impact Award. This recognition is for a physician who has been with WMHS for less than five years and has already made a significant difference in the community.

 

Joining the WMHS Heart Institute at its inception nine years ago, Nelson has performed more than 2,000 cardiac surgeries there. The cardiac surgery program has become nationally recognized for quality and receives the highest praise from patients and their families.

 

Nelson grew up in Frostburg, where he attended Beall High School and graduated from Frostburg State University. He received his medical degree from the University of Maryland School of Medicine and completed his internship and residency in surgery at the West Virginia University Hospitals in Morgantown. He also did his clinical and research fellowships in cardiothoracic surgery there.

 

Nelson came to WMHS from the Iowa Heart Center in Des Moines. He is certified by the American Board of Surgery and the American Board of Thoracic Surgery.

 

During his 45 years in practice, pediatrician Dawson has cared for three generations of area families and made an indelible mark in the community.

 

He was born in Cumberland and graduated from Central High School in Lonaconing. A graduate of the University of Maryland School of Medicine, he did his internship and residency at Mercy Hospital in Baltimore and returned to the University of Maryland for his fellowship in pediatrics. Dawson joined Children’s Medical Group in 1964 and is board-certified in pediatrics.

 

Dawson has been a mentor to countless other physicians. He is involved in medical student education with the Western Maryland Area Health Education Center, providing a rotation site for the University of Maryland, St. Francis, WVU and other regional schools.

 

He has served in leadership roles in the hospitals’ medical staffs and many professional organizations. He currently serves on the WMHS Board of Directors and the Board of Trustees for Memorial Hospital.

 

Menchavez has been caring for patients in Western Maryland since 1976. He is a graduate of the Cebu Institute of Medicine in the Philippines and is board-certified. He completed internships and pediatric residencies at Cebu Velez General Hospital and at Newark Beth Israel Medical Center in New Jersey, where he also completed his fellowship in pediatrics and neonatology.

 

He also has inspired his son, pediatrician Celestino Menchavez, to carry on the tradition of compassionate care.

 

A native of Grantsville, Watkins joined the WMHS Regional Cancer Center in 2005. Previously, he was the section chief of radiation oncology at the WVU Hospitals in Morgantown, where he also was the medical director for the radiation therapist education program.

 

Watkins did his radiation oncology residency at Albert Einstein/Temple University’s Hospital in Philadelphia and completed an internship in Family Medicine at WVU Hospitals. He received his medical degree at the West Virginia School of Medicine and his undergraduate degree from McDaniel College in Westminster. Watkins is board-certified in radiation oncology by the American Board of Radiology.

 

Since Watkins joined WMHS, both intensity modulated radiation therapy and image-guided radiation therapy are available locally.

 

Physicians nominated for these awards must inspire others to a higher level of care, demonstrate clinical ex-cellence, have compassion for patients, be committed to meeting community medical needs, work as a team member and exemplify the WMHS core values. This year, there were 168 nominations for 65 different physicians who provide care at WMHS.

 

Four physicians were honored by the Western Maryland Health System for their commitment to their patients, colleagues and the community. From the left are Barry Ronan, president and chief executive officer at WMHS; Drs. Elmaslias Menchavez, Mark Nelson and Robert Dawson; and M. Kathryn Burkey, chairwoman of the WMHS Board of Directors. Dr. Scott Watkins was the fourth physician to receive an award.

 

Copyright © 1999-2008 cnhi, inc.

 

National / International

Food Safety Efforts Have Stalled in Recent Years, CDC Says

 

By Lyndsey Layton

Washington Post

Friday, April 10, 2009; A03

 

Efforts to reduce the number of food-borne illnesses in the United States have stalled in the past three years, and some illnesses are on the upswing, giving new urgency to efforts to reform the nation's food safety system, the Centers for Disease Control and Prevention reported yesterday.

 

"We need greater effort at all stages of movement of food in the food chain from farm to table" to prevent bacterial contamination, said Robert Tauxe, deputy director of the CDC's Division of Foodborne, Bacterial and Mycotic Diseases.

 

Several factors are fueling the trend, including the intricacy of the U.S. food chain, the changing nature of the contaminating bacteria and the rise in imported food, Tauxe said. Bacteria that used to be associated mainly with meats and poultry have recently shown up in fresh produce, posing new risks, he said. Examples include E. coli 0157 in spinach and salmonella in peanuts and pistachios.

 

"It reflects the complexity of the problem, with many different foods becoming potentially contaminated, including more fresh produce. It reflects that fact that pathogens like E. coli 0157 and salmonella can spread in the environment and contaminate a number of different foods, some of which we have not seen in the past," Tauxe said. "And the food industry is also complicated and changing, with a variety of different arenas and components from all over the world."

 

Children younger than 4 are particularly vulnerable to food-borne bacteria, while adults older than 50 are the most likely to be hospitalized and die from bacterial exposure, the study found. Children can become infected simply by sitting in a shopping cart next to raw meat or, in non-food-related cases, from living with pet turtles or reptiles or from attending day-care facilities where other children or care providers have not adequately washed their hands after using the bathroom, Tauxe said.

 

The bacteria in question are generally found in the intestines and feces of animals. When consumed in food by humans, they can cause diarrhea and cramps. Most healthy adults recover within days, but the bacteria can cause serious and sometimes deadly illness in children, the elderly and those with compromised immune systems.

 

"We had been moving in the right direction. We had been reducing some of these key food-borne illnesses, and something potentially significant has stopped that progress or reversed that progress," said Erik D. Olson, director of food and consumer product safety at the Pew Charitable Trusts, which is advocating for tougher food safety requirements for industry and stepped-up oversight by government regulators. "In some cases, like salmonella, we're double the [2010] national objective. That says we've got a pretty serious issue here."

 

The CDC has been collecting data since 1996 from 10 states on the people with infections caused by eight bacteria and two parasites found in food. The study, reported in the CDC's Morbidity and Mortality Weekly Report, found that the rate of infection for several bacteria had been dropping until about 2004, when the numbers began rising again or leveled off. They include salmonella, vibrio, E. coli 0157, listeria and campylobacter.

 

Preliminary 2008 data show that infection rates for five food-borne illnesses currently exceed the national goals set by the CDC for 2010. The rate of salmonella infection was more than twice the national goal, and that data did not include the current national outbreak of salmonella illness linked to peanut products. That episode began in late 2008 and peaked in the early months of 2009, sickening nearly 700 people and killing nine.

 

The Food and Drug Administration, which is responsible for overseeing the safety of most food in this country, has been under fire for years on Capitol Hill and among health advocates for being too lax. The agency is widely considered to be understaffed and underfunded, deficiencies highlighted repeatedly by the Government Accountability Office.

 

As fresh produce increasingly became a new source of food-borne illnesses, the FDA provided little or no oversight, the GAO found in a report last year. The agency inspected less than 1 percent of the fresh produce imported between 2002 and 2007, it had no formal program devoted to fresh produce, and it had conducted no scientific work to understand contaminants such as E. coli 0157 because it did not have research money, the GAO found. In fiscal 2007, the agency spent about 3 percent of its food safety budget on fresh produce, the GAO reported.

 

The agency did not act even after an outbreak of E. coli 0157 illness from spinach decimated spinach growers and the leafy greens industry lobbied the FDA, asking regulators to require growers to take preventive measures to minimize bacterial contamination.

 

The crisis came to a head during the ongoing outbreak of salmonella illness linked to peanuts, which captured national attention and prompted a pledge by President Obama to elevate food safety and revamp the FDA. It also spurred about half a dozen bills now pending in Congress to reform food safety.

 

David Acheson, director of food safety and security at the FDA, said his agency is moving ahead with new tactics to try to prevent outbreaks and to react more quickly when they occur. "This has to be addressed with a proactive, dynamic approach to new strategies to protect American consumers," he said.

 

Among other things, the FDA is hiring more than 150 inspectors and scientists to boost its capabilities and is joining with public health officials in six states in a pilot project to create "rapid response" teams to speed investigations once an outbreak occurs, Acheson said.

 

Obama's nominee to head the agency, Margaret Hamburg, is awaiting Senate confirmation. Her deputy, Joshua Sharfstein, started work last month and has pushed a more aggressive posture in the way the agency is handling a new salmonella scare connected to pistachios.

 

Copyright 2009 Washington Post.

 

CDC: US food poisoning cases held steady in 2008

 

Associated Press

Washington Post

By Mike Stobbe

Thursday, April 9, 2009

 

ATLANTA -- Americans didn't suffer more food poisoning last year despite high-profile outbreaks involving peppers, peanut butter and other foods, according to a government report released Thursday. Rates of food-borne illnesses have been holding steady for five years. They had been declining from the mid-1990s until the beginning of this decade, due mainly to improvements in the meat and poultry industry, some experts say.

 

But produce-associated food poisonings have been increasing, and the nation is no longer whittling down food-borne disease, government officials said.

 

"Progress has plateaued," said Dr. Robert Tauxe of the U.S. Centers for Disease Control and Prevention, a co-author of the report.

 

The report looks at the occurrence of about ten leading food-borne illnesses in ten states that participate in a federally-funded food poisoning monitoring system. CDC officials believe it's nationally representative, based on the sample's mix of geography and demographics.

 

The research appears in this week's issue of a CDC publication, Morbidity and Mortality Weekly Report.

 

Salmonella remained the most common cause of food poisoning, triggering more than 7,400 lab-confirmed illnesses in those states. That translates to a rate of about 16 cases for every 100,000 people. There has been no significant change in the salmonella rate in recent years, CDC officials said.

 

Campylobacter and shigella, two kinds of bacterial infections, were the second and third most common food-borne illnesses, occurring at rates of about 13 and 7 per 100,000, respectively.

 

The researchers don't address how many people died.

 

Experts say the report's numbers are lower than reality because only a fraction of food poisoning cases get reported or confirmed by laboratories.

 

An estimated 87 million cases of food-borne illness occur in the United States each year, including 371,000 hospitalizations and 5,700 deaths, according to an Associated Press calculation that used the CDC formula and current population estimates.

 

There were geographic variations in disease rates among the states, the CDC found. The highest rates of salmonella occurred in Georgia and New Mexico, campylobacter was most common in California and E. coli thrived best in Colorado.

 

Those variations were no doubt influenced by some specific outbreaks that caused more illnesses in some states than others, said Elliot Ryser, a professor of food science at Michigan State University.

 

Prominent food-borne illness outbreaks in 2008 included:

*A salmonella outbreak linked to hot peppers and tomatoes from Mexico that sickened more 1,400 Americans. It was the nation's largest outbreak of food-borne illness in a decade, and was first identified in New Mexico and Texas.

 

*A peanut-related salmonella outbreak _ which started last year _ caused at least 690 confirmed illnesses in 46 states and was linked to nine deaths.

 

*A salmonella outbreak attributed to Honduran cantaloupes sickened 51 people in 16 states.

 

Better testing and surveillance has improved the government's ability to detect food-borne disease outbreaks, Ryser said.

 

Outbreaks account for just a fraction of cases in the ten states last year, however. For example, only 7 percent of the salmonella cases were tied to identified outbreaks, the CDC report said.

 

The food supply is safer today than it was 50 or 100 years ago, thanks to advances like pasteurization and cleaner water, said Tauxe, deputy director of the CDC's Division of Foodborne, Bacterial and Mycotic Diseases.

 

But to the public, food poisoning may seem to be getting worse because of large outbreaks in the last several years, experts say.

 

That's due in part to better testing and surveillance that have improved the government's ability to detect multistate outbreaks. Other factors: Food poisoning is occurring in certain foods _ like peanut butter _ that in the past were not thought to be a risk. And government and company inspectors have at times failed to protect consumers from contamination in food processing plants.

 

Government investigators and food industry officials have been under increasing pressure to fix what is perceived as a broken food system. The U.S. Food and Drug Administration has hired more than 150 additional inspectors and more than 30 additional scientists and consumer safety officers in the past year, FDA officials said during a Thursday teleconference with reporters.

 

On the Net:

The CDC publication:http://www.cdc.gov/mmwr

(This version CORRECTS number of years that illness rates have held steady.)

 

© 2009 The Associated Press.

 

No salmonella found in New York pistachio plant

 

Associated Press

Hagerstown Herald-Mail

Friday, April 10, 2009

 

FRESNO, Calif. (AP) -- New York officials say they found no traces of salmonella in a Long Island pistachio processing plant whose sister company sparked a nationwide recall of the nut last week.

 

New York State Agriculture Commissioner Patrick Hooker said Friday that inspectors received negative results on nine environmental swabs of Commack, N.Y.-based Setton International Foods, Inc. and eight sample tests of company food products.

 

The probe was conducted in tandem with an investigation into Setton's sister firm in California, where federal food safety officials found traces of the bacteria inside the plant earlier this week.

 

Setton Pistachio of Terra Bella, Inc. has temporarily closed after recalling more than 2 million pounds of potentially tainted nuts.

 

© 2009 The Associated Press. All rights reserved.

 

Ethanol use could raise cost of U.S. food aid

 

Baltimore Sun

Friday, April 10, 2009

 

WASHINGTON - The increased use of ethanol could cost the government up to $900 million for food stamps and child nutrition programs, a congressional report says.

 

Higher use of the corn-based fuel additive between April 2007 and April 2008 accounted for about 10 percent to 15 percent of the rise in food prices during that time, the nonpartisan Congressional Budget Office said. That translates into higher costs for food programs for the needy.

 

The CBO said other factors, such as high energy costs, had an even greater impact on food prices during that period. Ethanol's impact on future food prices is uncertain, the report says, because an increased supply of the crop could eventually lower food prices.

 

About one-quarter of corn grown in the United States is now used to produce ethanol, and overall consumption of ethanol in the country hit a record high last year, exceeding 9 billion gallons, according to the CBO. Nearly 3 billion bushels of corn were used to produce ethanol in the United States last year - an increase of almost a billion bushels over 2007.

 

As the use of ethanol has greatly increased, several groups, including food retailers, meatpackers and restaurants, have opposed tax breaks and federal mandates for the fuel, saying it adds to their costs that are passed on to consumers.

 

Copyright 2009 Associated Press.

 

FDA reversal OKs morphine painkiller for dying

 

Associated Press

By Malcolm Ritter

Washington Post

Friday, April 10, 2009

 

NEW YORK -- A liquid morphine painkiller given by family caregivers to dying patients can remain on the market, federal regulators have decided after hearing protests over their decision to remove it. The Food and Drug Administration had announced last week that it was ordering manufacturers to stop making 14 medications including the liquid morphine. All were developed so long ago they had never received FDA approval.

 

But on Thursday, the FDA's Dr. Douglas Throckmorton told The Associated Press the morphine liquid will remain on the market until it's replaced by an approved version or some equivalent therapy.

 

The reversal was welcomed by experts in hospice care and pain relief. One doctors group had told the FDA that last week's order would "cause extreme suffering for many patients who are nearing the end of life."

 

The order has not changed for the other painkillers, at least for now, said Throckmorton, deputy director of the agency's Center for Drug Evaluation and Research.

 

The agency said last week that the unapproved drugs might be unsafe, ineffective or poor quality. The order gave manufacturers 60 days to stop making those products.

 

The liquid morphine is highly concentrated. Other approved forms of liquid morphine are more dilute, and Throckmorton said the FDA had thought the other forms could take the place of the concentrated form.

 

But reaction from hospice experts and others "helped us understand" that some patients need the unapproved version, Throckmorton said.

 

In interviews, experts said they didn't have firm numbers on how many patients use the concentrated liquid. But Dr. Diane Meier, director of the Center to Advance Palliative Care at the Mount Sinai School of Medicine in New York, estimated that it may be at least 2 million Americans a year.

 

She called Thursday's decision "fabulous.... It's incredibly refreshing and makes me hopeful about our government."

 

The high morphine concentration is crucial, she and others said. It allows caregivers to rapidly relieve pain by placing just a few drops in the mouth of a person who has trouble swallowing, perhaps because of confusion, lethargy or other conditions.

 

The more dilute morphine requires much more liquid, which could make an impaired person choke or sputter, or refuse to take the medication, experts say.

 

Caregivers can administer the concentrated solution at home, where morphine shots often aren't a good option. Without the concentrated liquid, families could end up calling 911 to rush their loved ones to an emergency room for morphine shots, which would be expensive and against patient wishes, said Dr. Porter Storey, executive vice president of the American Academy of Hospice and Palliative Medicine.

 

Storey called the FDA reversal "a really important step in the right direction," showing "an amazing level of responsiveness we're not used to seeing in our government officials."

 

But Storey said he was still concerned about the other painkillers ordered off the market, products containing morphine, hydromorphone or oxycodone.

 

While approved medications with those ingredients remain on the market, Storey noted that opiate painkillers are in short supply. So rather than removing the unapproved versions all at once, exacerbating the problem, he suggested the FDA proceed more slowly.

 

In a letter to the FDA earlier this week, Storey's organization said the painkillers covered by last week's order "have been used safely and effectively for decades."

 

Throckmorton said the FDA is open to getting additional information about the other painkillers, and would discuss them with experts in hospice and palliative care.

 

But Storey said that in a later phone call with physicians and pharmacists, the FDA said that the order against the other painkillers would stand.

 

Further shortfalls in painkiller supply could spell trouble for chronic pain patients such as 62-year-old Ora Chaikin in New York City, said her physician, Dr. R. Sean Morrison at Mount Sinai.

 

Chaikin takes an unapproved version of the drug Dilaudid _ hydromorphone _ when her joint pain flares, which is typically on most days. She said she needs that medication "just to be able to walk, to be able to do daily activities (like) putting a coat on."

 

Although approved versions of the drug are available, the FDA order makes Morrison worry about their supply.

 

"It's already hard to get them," he said.

 

On the Net:

FDA statement on original order:http://www.fda.gov/bbs/topics/NEWS/2009/NEW01983.html

 

FDA background information:http://www.fda.gov/cder/drug/unapproved_drugs/narcoticsQA.htm

 

FDA web page on unapproved drugs:http://www.fda.gov/cder/drug/unapproved_drugs/default.htm

 

© 2009 The Associated Press.

 

Free clinics fill medical void

 

By Marisol Bello

USA Today

Friday, April 10, 2009

 

WEST CHESTER, Pa. - By his analysis, Edward Boyer should be dead.

 

Boyer, who lost his health insurance with his factory job last May, is an insulin-dependent diabetic who says he can't afford his medicine. He has a new job, working part-time in the kitchen of a chain-store restaurant, but can't afford insurance, he says.

 

A month ago, things looked grim. He had enough insulin to last a few days and didn't have $200 for a refill.

 

That's when a friend, also diabetic, told him about Community Volunteers in Medicine, a clinic in this suburb 36 miles west of Philadelphia.

 

The clinic provides free medical and dental services and medicine for the working poor - people who have no insurance but earn too much to qualify for federal or state programs.

 

"They kept me alive," says Boyer, 28, of Coatesville.

 

More Americans losing their jobs and health insurance are turning to volunteer-run free clinics and government-funded community health centers for free or low-cost medical care. The safety net is being strained as demand grows and budgets shrink.

 

For every 1 percentage point rise in unemployment, the number of uninsured people increases by 1.1 million, according to Families USA, a health-reform advocacy group. The U.S. unemployment rate is 8.5%.

 

"That's placing a major-league burden on health centers," says Tom Van Coverden, CEO of the National Association of Community Health Centers.

 

Community health centers are funded by states and the federal government and provide services to the poor, regardless of insurance. Patients receive free services or pay on a sliding scale based on their income.

 

In 2008, the country's 1,200 community health centers treated 7 million uninsured patients, up 3% from 6.8 million in 2007.

 

Van Coverden says the recession is likely to drive the number of uninsured up by 30%.

 

Free clinics are charity organizations that provide services to people who can't afford insurance or don't qualify for government health programs. They rely on donations and volunteer medical staff to care for 4 million patients a year, says Nicole Lamoureux, executive director of the National Association of Free Clinics.

 

Community health centers and free clinics treat a small portion of the estimated 46 million Americans the U.S. Census estimates have no insurance.

 

Among the challenges clinics and health centers face:

•In West Chester, Community Volunteers in Medicine treated 332 patients in February, up 26% from February 2008. The cost of care was up 21%. At the same time, the clinic was about $100,000 behind in fundraising for its $1.8 million annual budget.

 

•Ohio's 40 free clinics treated 56,000 uninsured patients in 2008, up from 43,000 in 2007. Marjorie Frazier, executive director of the Ohio Association of Free Clinics, expects the number to increase in 2009. In January, one clinic in Cleveland closed because it lacked funding. Ohio, one of the few states that helps pay for free clinics' operations, is cutting funding. Its two-year allocation for 2008 and 2009 was $2.1 million; for 2010 and 2011, proposed funding is $1.5 million.

 

•California's 800 community health centers saw increases of up to 20% in uninsured patients in the past six months. The state, facing a $42 billion budget shortfall, is eliminating payments for some services for poor adults, including dental care. As a result, the centers will lay off 1,000 dentists and other staff, leaving as many as 400,000 people without dental care, says Chris Patterson, spokesman for the California Primary Care Association.

 

Community health centers are getting a lifeline, though. They will receive $2 billion in federal stimulus funding for staffing, equipment and construction of new centers.

 

In Carrboro, N.C., Piedmont Health Services will receive $686,000 in stimulus money that will keep the center from laying off 19 of its 235 medical, dental and pharmacy workers, says CEO Brian Toomey.

 

Free clinics, which won't get any of that money, are stepping up fundraising. They are appealing to donors who want to contribute to charities that provide care for those who need it most in the troubled economy, says Maureen Tomoschuk, CEO of Community Volunteers in Medicine.

 

Anthony Hicklen hopes the donations keep coming. The owner of a janitorial business, Hicklen says he can't afford private insurance and has been going to the clinic since 2003.

 

This year, the clinic's volunteer doctors diagnosed him with prostate cancer. The clinic helped him join a state program for the poor that will pay for his surgery this month.

 

"The clinic is the only answer for a lot of people," Hicklen says. "This is a lifesaver for me. I'm 55 years old and I would like to see a few more years."

 

Find this article at:

http://www.usatoday.com/news/health/2009-04-09-freeclinics_N.htm

 

Copyright 2008 USA Today, a division of Gannett Co. Inc.

 

Obama Pledges New Data System for Veterans

 

By David Brown

Washington Post

Friday, April 10, 2009; A02

 

President Obama said yesterday that his administration will create an electronic record for veterans that will "contain their administrative and medical information from the day they first enlist to the day that they are laid to rest."

 

Research has shown that the handoff of medical information -- between individuals and hospital systems -- can be dangerous. Incomplete, incomprehensible or misunderstood data can contribute to medical error or substandard care.

 

While the Defense Department's hospitals and the Veterans Affairs medical system have electronic records, they are not seamlessly connected -- a problem Obama said he is determined to solve.

 

"Currently, there is no comprehensive system in place that allows for a streamlined transition of health records between DOD and the VA," the president said during a briefing at the Eisenhower Executive Office Building that was attended by the secretaries of those two departments as well as patients and practitioners from Washington area hospitals and military and VA facilities.

 

"I can't tell you how many stories that I heard during the course of the last several years . . . about veterans who were finding it almost impossible to get the benefits that they had earned despite the fact that their disabilities or their needs were evident for all to see," he said.

 

Obama has made electronic record-keeping a key feature of his health-care reform effort. There is evidence that electronic medical records reduce errors and waste.

 

A problem, however, is how the military and VA hospital systems, which use different software, will be able to communicate with each other. While the White House gave no details about how that will be accomplished, integration is the goal.

 

"I'm asking both departments to work together to define and build a seamless system . . . with a simple goal: When a member of the armed forces separates from the military, he or she will no longer have to walk paperwork from a DOD duty station to a local VA health center. Their electronic records will transition with them," Obama said.

 

The VA has a highly regarded system that allows a practitioner in any veterans hospital to retrieve data, look at X-rays and even review diagnostic videos. VA hospitals are officially "paperless." Military hospitals, however, use paper and electronic records.

 

"This new approach incorporates a transition strategy by maintaining a seamless access to all clinically relevant data from both systems, while concurrently building 'common services' between the two," said Cynthia Smith, a Pentagon spokeswoman.

 

In his remarks, Obama noted the toll of traumatic brain injury and post-traumatic stress disorder on veterans of the wars in Iraq and Afghanistan. He said his 2010 budget contained the largest single-year increase in VA funding in 30 years, with substantial increases for mental health screening and treatment.

 

Copyright 2009 Washington Post.

 

Veteran Issues In The News

 

Washington Post, New York Times, CBS Evening News and Associated Press

Friday, April 10, 2009

 

Budget said to contain "substantial" mental healthcare funding boost for VA.

The Washington Post (4/10, A2, Brown) notes that in his remarks Thursday, President Barack Obama "noted the toll" of traumatic brain injuries (TBI) and post-traumatic stress disorder (PTSD) on Iraq and Afghanistan veterans. He "said his 2010 budget contained the largest single-year increase in VA funding in 30 years, with substantial increases for mental health screening and treatment."

 

        Obama budget increases spending on veterans by $25 billion. The New York Times (4/10, A16, Alvarez), which says the President's "announcements are part of a larger effort to improve services for veterans," points out that Obama's "budget for 2010 increases spending for veterans by $25 billion and funnels more money into programs for those who suffer mental-health problems" and traumatic brain injury (TBI).

 

        Pace of 2009 Army suicides seen as dwarfing previous record. The CBS Evening News (4/9, story 9, 4:00, Couric) reported, "The US military is facing a crisis in the ranks" as "more soldiers than ever are taking their own lives. The Army is investigating 13 suspected suicides this month alone. That's 54 so far this year. If that pace keeps up, the number for all of 2009 will dwarf the record 143 last year." Correspondent David Martin interviewed Army Vice Chief of Staff Gen. Pete Chiarelli said, "We saw the number goes up the last four years. We should have been more proactive...in attacking this problem." But, according to Chiarelli, "Fort Campbell has most aggressive suicide prevention program in the Army, but that has not stopped what he calls a horrible spike, 11 suicides at this one base since the first of the year, one during his visit." Lt. Col. Tom Kunk, who "is the first to be notified whenever a suicide occurs" there, said that the "one common thread" in suicides "is relationship problems."

 

        US military making "broad effort" to better treat head injuries. The AP (4/10, Hall) reports, "Every soldier who's gone to war in the past year paused before leaving to take" a series of brain tests. And now that "some of these troops have returned, they're taking a fresh round of tests" that became mandatory in all branches of the US military last year. The tests are "part of a broad effort by the military to better treat head injuries." Funding for such treatment "is expected to increase under" President Obama, "who said Thursday his new military and veterans affairs budget will focus on diagnosing brain injuries and psychological disabilities that have gone untreated."

 

Copyrights 2009 Washington Post, New York Times, CBS Evening News and Associated Press.

 

Electronic Health Record

 

Associated Press

Friday, April 10, 2009

 

The AP (4/10) reports, "President Barack Obama on Thursday promised a more efficient record system to ease delays" in healthcare "for wounded veterans, as the government copes with more than 33,000 military personnel injured in wars in Iraq and Afghanistan." Under the new system, an "electronic record would follow a service member in the military and then later in the Veterans Affairs Department's medical system." The White House "said the program being undertaken by the Pentagon" and the VA will be the "next leap to delivering seamless, high-quality care, and serve as a model for the nation." Reuters (4/10) and the Star and Stripes (4/10, Shane) publish similar stories.

 

Copyright 2009 Associated Press.

 

Childhood eczema is a growing problem

 

By Linda Shrieves

Orlando Sentinel

Friday, April 10, 2009

 

Michelle Stevens first noticed the red, blotchy patches on her toddler's feet after he started walking. Every time Noah walked outdoors in their grassy backyard, the blotches appeared.

 

Before long, the itchy patches - signs of eczema - began popping up on Noah's legs and in the crease of his arms. Even in his sleep, Noah scratches his arms and legs, making the rashes worse.

 

For parents whose children have childhood eczema, a condition that often goes away during puberty, the battle often feels like the Eleven Year Itch.

 

Although generations of Americans have lived with itchy, scratchy skin, pediatricians estimate that today nearly one in 10 babies has eczema. And the condition - which results in red rashes on the sides of their necks, on the backs of their knees and inside their elbows - appears to be becoming more common.

 

Stevens, who is editor of an Orlando parenting magazine, had no idea childhood eczema was so common - until she asked for advice on a mom's blog. Within days, 70 moms had posted tips.

 

What's behind the growing number of eczema cases? Allergies, some doctors say.

 

"As a society, we're getting cleaner," says Dr. Kenneth Beer, a West Palm Beach dermatologist. "There's some evidence to suggest that because of all this hyper-hygienic dusting and cleaning, children's immune systems don't get exposed to enough things. Instead, their immune systems go into overdrive."

 

Eczema, also known as atopic dermatitis, is a chronic inflammation of the skin. Although it's often difficult to pinpoint exactly what kids are allergic to, some likely culprits include dust mites, pollen, pet dander, molds, environmental chemicals or food allergies.

 

Today, physicians are attacking childhood eczema with a multipronged approach, including a daily moisturizing routine, hypoallergenic soaps and detergents, antihistamines and occasional use of steroid creams or antibiotics.

 

Although eczema cannot be cured, "you can do an awful lot to keep [eczema] from getting worse," Beer says.

 

To reduce the itching, try antihistamines. Some pediatricians suggest parents try over-the-counter antihistamines such as Benadryl.

 

"With eczema, there is an itch-scratch cycle. Children itch, so they scratch, which makes the rash worse and makes the skin itch even more," says Dr. Joan Younger Meek, who leads the pediatric residency program at Arnold Palmer Hospital for Women & Children. "The allergy medicine can break the itch-scratch cycle and allow the skin to respond to the steroids or the moisturizers."

 

And though many parents shy away from steroid creams, doctors believe they're valuable when used occasionally.

 

"Topical steroids are used when there is very bad inflammation, irritation and the child cannot sleep at night," says Dr. Tad Nowicki, an Orlando pediatrician. "Then we use them only for a short time and go back to moisturizers."

 

Eczema is also sensitive to the weather. The cold dry air of winter bothers eczema patients, and many patients can't tolerate wool clothing.

 

Summer - or hot, humid weather - can bring other challenges for eczema patients. Heat and perspiration may aggravate their blotchy patches, resulting in a type of prickly heat. But a little sun exposure sometimes helps clear up red, scaly patches, Beer says.

 

For many kids and their parents, there's good news: Childhood eczema is often a temporary condition. Most outgrow it by puberty.

 

But they may spend a lifetime with sensitive skin. "When I see a child with eczema, I always ask the mother: 'Do you have dry skin? Do you have to use lotion a lot?'" Nowicki says. "We may not remember, but many of us probably had eczema as children."

 

Indeed, eczema is part of what doctors call "the allergic triad," which includes eczema, asthma and allergic rhinitis (also known as hay fever). Although you don't inherit eczema, you might be more likely to have eczema if one parent has eczema or hay fever or asthma, there's about a 50 percent chance that the child will have one or more of the diseases, according to the National Eczema Association.

 

Although the condition may be triggered by an allergy, children rarely need to see a specialist. "Pediatricians or family physicians can treat the vast majority of children with eczema," says Meek. "Referral to a specialist, such as a dermatologist or an allergist, should be considered in children with severe asthma who do not respond to the usual treatments."

 

For many families, finding the solution is a matter of trial and error. Michelle Stevens has tried oatmeal baths, moisturizing Noah after every bath, and eliminating scented detergents. Now, she has stopped feeding him dairy products to see if that's triggering his symptoms.

 

"It's very frustrating," she says. "I wonder what other allergies he does have. For instance, we have two dogs. Am I going to find out that he's allergic to the dogs?"

 

Linda Shrieves can be reached at lshrieves@orlandosentinel.com or 407-420-5433.

 

Copyright © 2009, Orlando Sentinel.

 

New records plan streamlines vets' care

 

By Joseph Weber and Sean Lengell

Washington Times

Friday, April 10, 2009

 

President Obama on Thursday introduced a plan to streamline the medical records system for wounded veterans, vowing better treatment for the more than 33,000 military personnel injured in Iraq and Afghanistan.

 

The plan calls for an electronic database designed to easily transfer the medical records of military personnel from the Defense Department to Veterans Affairs (VA). A lack of a compatible computer system has led to a six-month backlog in providing VA services.

 

"We have a sacred trust with those who wear the uniform of the United States of America, a commitment that begins with enlistment and must never end," Mr. Obama said at a White House event to introduce the plan.

 

"But we know that for too long we've fallen short of meeting that commitment. Too many wounded warriors go without the care that they need."

 

The proposed "Joint Virtual Lifetime Electronic Record" program would create a unified lifetime medical records system for military personnel and veterans that would be used "from the time they enlist until they are laid to rest," the president said to the applause of about 120 people at White House event.

 

Joe Violante, the national legislative director for Disabled American Veterans, who was at the White House event, said Mr. Obama also reiterated a promise to get the additional money for veterans through advanced appropriations so officials could plan better.

 

"I'm really excited to see him keep the promise," said Mr. Violante, a retired Marine. "I think he is really paying attention to what the needs are."

 

VA and Defense officials for years have acknowledged the problem, and more than two years ago initiated a program called "seamless transition" to assist seriously injured troops who are leaving active duty and filing medical claims with the VA.

 

The new program will be part of the Defense Department's health care budget of $47 billion for fiscal 2010, which begins Oct. 1, the White House said.

 

The VA's overall budget is set to grow by $25 billion during the next five years, the White House said.

 

Mr. Obama said the funding increase is the biggest in the past three decades and that the additional help will go to those "who gave up so much but signed up to give more."

 

More than 1.6 million troops have deployed in support of the Iraq and Afghanistan wars.

 

There are more than 23 million veterans overall in the United States, and almost 5.5. million people sought health care at a VA facility last year.

 

Mr. Obama, flanked by Defense Secretary Robert M. Gates and Secretary of Veterans Affairs Eric Shinseki at the White House event, said the military men and women he met during his visit this week to Iraq inspired him "all over again."

 

The president mentioned two soldiers whom he met in Baghdad - Spc. Jake Altman and Sgt. Nathan Dewitt - both severely injured but returned to battle.

 

"Today, they're both back alongside their fellow soldiers in their old units," Mr. Obama said.

 

Mr. Shinseki testified on Capitol Hill in January that he was working to reduce a six-month delay in paying veterans' disability claims and that a paper-less system would not be in place before 2012.

 

Copyright 2009 Washington Times.

 

Opinion

City hospital at risk

Our view: Bon Secours needs $5 million to stay afloat while it seeks a new business model for serving the poor; the state should throw it a lifeline

 

Baltimore Sun Editorial

Friday, April 10, 2009

 

Maryland hospitals are sharing the pain as people who have lost jobs and health insurance in the economic downturn find it harder to pay medical bills. Some institutions have had to cut services, lay off employees and reduce subsidies paid to doctors and nurses to keep them on staff.

 

Bon Secours Hospital, a venerable West Baltimore institution since 1881, has been especially hard hit. Most of the hospital's clients are poor and rely on Medicare and Medicaid to pay for health care. Many patients with chronic illnesses - such as diabetes, kidney disease and asthma - lack health insurance that would allow them to see a primary care physician for regular check-ups and preventive treatment.

 

As a result, patients often put off seeing a doctor until their symptoms are acute, then rush to the emergency room for treatment. The losses the hospital sustained caring for such patients came to $22 million last year. That was on top of substantial deficits in previous years. Clearly, this situation can't go on indefinitely.

 

Bon Secours CEO, Dr. Samuel L. Ross, says the hospital needs a new business model if it hopes to continue serving its indigent clients. Not only must it develop new revenue streams and improve operating efficiency but also recruit more permanent medical staffers and reduce its dependence on expensive contract workers.

 

To boost revenues, the hospital is considering new services it could offer to the state, such as an acute-care psychiatry unit. It also wants to partner with the state department of corrections to provide health care to inmates. And it wants to work with the Maryland Department of Health and Mental Hygiene, Medicaid, foundations and other stakeholders to come up with a strategy to make primary health care more widely available so that Bon Secours' doctors and nurses can concentrate on patients who really require hospitalization.

 

None of this is going to happen overnight. That's why Bon Secours is seeking a one-time, $5 million grant from the state to stay afloat long enough to reorganize its operations and implement a new business model. That's a lot of money even in flush years, and this year isn't one of them. Nevertheless, we urge lawmakers to seriously consider granting this request in the budget now being debated.

 

If the hospital were forced to close, thousands of residents could be left without community health care and several hundred hospital workers would lose their jobs. No matter how tough times are, that's not an acceptable option.

 

 

Copyright 2009 Baltimore Sun.

 

Caring for the Dead

 

Baltimore Sun Letter to the Editor – 3 total

Friday, April 10, 2009; A16

 

Regarding the April 5 front-page story "I Never Could Have Imagined," which described the mishandling of bodies, some of which were improperly stored for months:

 

If families were aware that they could care for their own departed, this might never have happened. Throughout time, families have cared for their loved ones at death. People died at home, and their bodies were cared for at home.

 

The deceased were respectfully attended to by those who loved them best.

 

In 45 states, including Maryland and Virginia, families still have the right to care for their own departed. Families can wash and dress the body. Embalming is not generally required by law. The remains can be kept cool with dry ice. Family members are allowed to transport the body, and they can bury on private land, or they can take the body directly to a crematorium and witness it being put into the crematory chamber. No special vehicle is required, and a body in a pine box can fit into most small station wagons or any minivan.

 

There are psychological, social, ecological and financial advantages to caring for our own departed. This is a way to guarantee that our departed loved ones are treated with dignity.

 

Elizabeth Knox

Executive Director

Crossings: Caring for Our Own at Death

Takoma Park

 

*****

 

I am glad that The Post reported what's happening in some funeral homes, including how dead bodies were left lying amid pools of leaking fluid. The legal requirement that a hospital release a body only to a funeral home worries me, especially as a Muslim.

 

Traditionally, in Muslim countries and according to Islamic law, a body must be buried as soon as possible. When a person dies, relatives converge on his or her home immediately, view the body, accompany it until burial and recite prayers throughout. The body is given a bath under a white shroud with privacy and respect maintained at all times, and it is wrapped in another shroud for burial. Usually, the body is in a grave within 24 hours. The issue of stench, decomposition or infection usually does not arise. In this day and age, where cost and finances govern everything, I would prefer to have loved ones deal with my body when I die rather than have strangers desecrate it for their profit.

 

Anila Jahangiri

Charlottesville

 

****

 

Kudos to reporter Josh White and staff researcher Julie Tate, and to whistleblower Steven Napper for helping us make an informed family decision.

 

As the wife of a retired Army full colonel, I have attended several funerals at Arlington National Cemetery, and I was profoundly impressed with the dignity of a funeral with "full military honors." I have campaigned for both of us to be interred at Arlington.

 

I have wondered what happens to bodies when they await burial for two or three months and naively assumed that they would be in cold storage at some military facility. Now that I know that we could be stowed in a garage and sprinkled with industrial deodorizer before the coffin is closed, I have second thoughts.

 

Unless someone steps in to stop this deplorable desecration, I will tell my children to find an alternative final resting place and have the priest sprinkle us with holy water.

 

Mary Kay Downes

Centreville

 

Copyright 2009 Baltimore Sun.

 

Lt. Governor Brown Launches Maryland Veterans Network Of Care Portal

 

ZAMP Bionews

Friday, April 10, 2009

 

Maryland Lt. Governor Anthony G. Brown joined representatives of the public mental health industry and veterans affairs as Maryland became the first state in the nation to launch a “Network of Care” Website devoted to the state’s veterans. The Maryland Veterans Network of Care portal is an on-line resource that provides simple and fast access to information on local, state and national behavioral health services available to veterans. The portal is part of Network of Care online community.

 

“We ask a great deal of our military families and our veterans and for that we owe them a debt of gratitude. When we saw men and women falling through the cracks of a large and out dated federal VA system, we didn’t point fingers. We chose to act,” Lt. Governor Brown said. “Maryland’s Commitment to Veterans initiative is a national model for what states can do to improve veteran services, especially behavioral health services. We are proud to be the first state in America to launch the Veterans Network of Care portal. We hope that other states follow our example and make veterans health a leading priority.”

 

Last year, the O’Malley-Brown administration introduced to the General Assembly one of the most comprehensive veterans packages in the nation. The cornerstone of the package was the Veterans Behavioral Health Initiative that set aside $2.3 million for behavioral health services for veterans of Iraq and Afghanistan. The initiative provides funding for four regional resource coordinators who help direct behavioral health services to veterans in need. The administration introduced a bill this year that will expand the Veterans Behavioral Health Initiative to include all veterans. Brown is working closely with leaders in the General Assembly to protect funding for this program.

 

“Many veterans do not sign up for services through the VA, and their families don’t know where to turn for help,” said Department of Health and Mental Hygiene Secretary John M. Colmers. “The Veterans Network of Care portal is a comprehensive Website that includes information to help veterans find and sign up for these services.”

 

Studies show that as many as one out of three veterans returning from Iraq and Afghanistan suffers from mental health problems, including traumatic brain injury and post-traumatic stress disorder. Of those veterans, more than two out of three do not receive the proper medical attention that is necessary. Other studies have found that today’s returning veterans have a significantly higher rate of suicide than veterans from previous conflicts.

 

“The Veterans Network of Care portal will serve as a bridge between federal, state and local services available for veterans. As a unique, new outreach and information hub it will serve all of Maryland’s veterans regardless of their geographic location,” said Maryland Department of Veterans Affairs Deputy Secretary Wilbert Forbes.

 

Found at http://www.mdveterans.networkofcare.org, Maryland’s Veterans Network of Care portal builds on the success of the state’s Network of Care site which launched last year. It is hosted by the Department of Health and Mental Hygiene (DHMH), with assistance from the state Mental Health Association, National Alliance on Mental Illness-Maryland, On Our Own of Maryland and the Maryland Association of Core Service Agencies. DHMH is in the fourth year of a five-year $13.7 million federal grant to implement transformation initiatives in mental health care.

 

The Network of Care community allows consumers to have a lead role in addressing their needs for behavioral health services, and also allows them to store medical records, advance directives and personal wellness plans in a password-protected personal folder. The site also contains a library of mental health articles, links to support and advocacy organizations, and reports on legislation.

 

“This is a flexible system that can be updated within 24 hours,” said Renata J. Henry, DHMH Deputy Secretary for Behavioral Health and Disabilities. “It is compatible with the 2-1-1 system and is available to anyone, including providers and those who staff crisis response systems.”

 

The Network of Care online community was developed by Trilogy Integrated Resources. California’s Network of Care system was showcased by the President’s New Freedom Commission in 2003 as a model program to help transform mental health care in the nation and is recognized as a leading force in the transformation of mental health care from a system that relied primarily on clinical treatment to one that empowers an individual to make decisions regarding his or her care.

 

v “We were so proud to be able to work with both the veterans and mental health leadership of Maryland to develop this remarkable resource for our returning soldiers,” said Trilogy president Bruce Bronzan. “Maryland now has the most advanced and comprehensive, locally-based information resource for veterans and their families in the country.”

 

More information about Maryland’s main Network of Care Web site is available by clicking on “Maryland” found through the “Mental/Behavioral Health” link at http://www.networkofcare.org.

 

Source: Maryland Department of Health and Mental Hygiene

 

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