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			Monday, February 23, 2009 News Clipping Archives *Maryland / Regional* Congress seeks to have hospitals justify tax-exempt status (Baltimore Sun) Brushing up on dental care (Baltimore Sun) Sister to Sister Foundation to hold Women's Heart Health Fair (Baltimore Sun) Events, screenings, support groups and more (Baltimore Sun) Whooping cough still around (Baltimore Sun) Planning ahead: County schools are ready for emergencies (Frederick News-Post) Two companies in running to buy county nursing home (Cumberland Times-News) *National / International* In Turnabout, Children Take Caregiver Role (New York Times) Antibodies Offer a New Path for Fighting Flu (New York Times) Mo. man pleads guilty to day care molestations (Frederick News-Post) Britain releases report into tainted blood scandal (Washington Post) *Opinion* Invincible? Maybe not (Frederick News-Post) A Black Eye for Justice (Washington Post) The Deficit Hawks' Attack on Our Entitlements (Washington Post) *Maryland / Regional* Congress seeks to have hospitals justify tax-exempt status That, other measures would help define free, reduced-care guidelines By James Drew Baltimore Sun Monday, February 23, 2009 Proposals in the Maryland General Assembly to define which patients are eligible for financial assistance at hospitals are getting an unexpected push from Congress, which might soon consider legislation aimed at making nonprofit hospitals justify their tax-exempt status. The push comes on the heels of a Feb. 12 Internal Revenue Service report showing that a small percentage of America's nonprofit hospitals provide nearly two-thirds of the nation's free or reduced-price care for the poor. "I'm very disappointed," Sen. Charles E. Grassley of Iowa, who has for years pushed to examine the business practices of various nonprofits, said in an interview. "Charity care is practiced differently from hospital to hospital and community to community, and there ought to be a uniform definition. If the IRS doesn't do it, I will have to do it through legislation." The initiatives come amid a worsening economy that is expected to swell the ranks of people seeking help to pay hospital bills, and a growing debate over how much charity care nonprofit hospitals should have to offer in exchange for their tax exemptions. In response to an investigative series in The Baltimore Sun on hospital debt-collection practices, Gov. Martin O'Malley is urging lawmakers to replace voluntary guidelines crafted by the Maryland Hospital Association with a minimum standard of who is eligible for free care, commonly referred to as charity care. "These reforms mean quality hospital care does not have to add a crushing hardship to uninsured patients or their families," said John M. Colmers, secretary of the state's Department of Health and Mental Hygiene. The state agency that sets Maryland hospital rates has called for a review of the formula it uses to compensate hospitals for their costs of charity care and unpaid bills. A report by the Health Services Cost Review Commission recently said that the current formula might unwittingly create financial incentives for hospitals to classify some low-income patients as "bad debt" cases, which they can pursue through collections or court action, instead of providing them charity care. Executive director Robert B. Murray said financial incentives might be added to encourage more charity care. Grassley told The Sun that the Centers for Medicare and Medicaid Services should also investigate if lower-income patients have been harmed. A CMS spokesperson declined to comment. Four decades ago, after the Medicare and Medicaid programs were created, the federal government abolished requirements that hospitals provide free and reduced-price care to the poor to receive tax-exempt status. Since then, the IRS has used a "community benefit" standard, requiring hospitals to report how much they spend on items such as medical research, emergency care, physician training and health fairs. Grassley, the ranking Republican on the Senate Finance Committee, said the standard is vague. If the IRS doesn't restore the requirement that nonprofit hospitals provide charity care, Grassley said, he and Sen. Jeff Bingaman, a New Mexico Democrat, plan to push legislation to do so. One proposal would require nonprofit hospitals to devote at least 5 percent of their annual revenue to charity care. States could set higher standards, Grassley added. In 2007, the amount of charity care provided by Maryland hospitals was slightly above 2 percent of gross patient revenue, according to state data. The IRS has acknowledged that it has struggled to administer the "community benefit" rules, calling them "imprecise legal standards" in its recent report. The report found that 14 percent of nonprofit hospitals surveyed provided 63 percent of the aggregate charity care and unpaid bills written off, though the agency didn't recommend any policy changes and didn't identify the 489 hospitals surveyed. The American Hospital Association has countered that nonprofit hospitals do more to help the poor than any other part of the health-care industry, and it said the IRS undercounted the amount of charity care and other community benefits. In Maryland, legislation introduced by Del. Peter A. Hammen and state Sen. George W. Della, both Baltimore Democrats, would require hospitals to provide care to all Maryland residents whose incomes are less than 1.5 times the federal poverty guideline, which would equal $33,075 for a family of four. State regulators, backed by O'Malley, have recommended eligibility for a family of four with income up to $44,100. A leader of a nationwide consumer group said the proposals would "go a long way toward creating a much more fair, clear and transparent system for consumers." "It is long overdue, and the need is clear based on The Baltimore Sun's investigation," said Renee Markus Hodin, project director for Community Catalyst, a Boston-based nonprofit group. The investigative series found that Maryland, unlike some other states, lacks uniform standards and practices to determine who is eligible for free or reduced-price care at hospitals. Because hospitals have varying policies, which consider household assets as well as income, some people end up facing court judgments or get liens placed on their homes even though they have little means to pay their bills. Hospitals are required to post notices about the availability of financial assistance, but not necessarily to inform each patient about that or provide charity care applications proactively. Under Maryland's unique system in which the state sets hospitals rates, hospitals received nearly $1 billion last year - through a markup on bills that all patients pay - to cover their costs of charity care and unpaid bills. All but one of Maryland's 47 hospitals are nonprofit. In 2005, a bill to require hospitals to devote at least half of the amount of their tax exemption to free and reduced-price care died in committee in the General Assembly. The Maryland Hospital Association argues that its members justify their tax exemptions through annual filings to the IRS and touts Maryland's law requiring hospitals to also file annual reports with state regulators on how they benefit their communities. "Charity care and financial assistance is critical, but the benefit that our hospitals provide to communities is much broader than that," the group's president, Carmela Coyle, said in a recent interview. O'Malley ordered regulators last December to do an "immediate and thorough review" of hospital debt-collection practices. The report, released Feb. 13, noted the benefits of the state's rate-setting system but acknowledged that the voluntary guidelines for defining charity care might have led to overly aggressive debt-collection practices by hospitals. The Sun reported that hospital debt-collection lawsuits spiked sharply between 2003 and 2006 before falling slightly in 2007. In all, hospitals filed more than 132,000 of these suits in the past five years, winning at least $100 million in judgments and placing liens on more than 8,000 homes. Copyright 2009 Baltimore Sun. Brushing up on dental care Care in Maryland is improving, but loss of jobs, health benefits could slow recent progress By Meredith Cohn Baltimore Sun Monday, February 23, 2009 Dental student Andrew Swiatowicz stood next to the extra-large set of model teeth positioned in a corner of the National Museum of Dentistry and asked young onlookers how many times a day they should brush. Two or three, belted out the kindergartners from George Washington Elementary School in Southwest Baltimore. It seems like an obvious question, but museum officials say not every kid from the poorer parts of Baltimore and Maryland - those who rarely or never see a dentist - know the answer. A decade ago, access to care in Maryland had been among the nation's worst. That has been changing, especially since the 2007 death of Deamonte Driver, a 12-year-old from Prince George's County who died after an infection in an untreated tooth spread to his brain. With February's National Children's Dental Health Month upon them, academic, industry and government leaders can point to improvements. They formed a Dental Action Committee that has won aid for local health centers; streamlined the Medicaid program; and sent hygienists into the community to provide screenings. They've been gaining commitments from dentists to treat poor children. They worry, however, that the bad economy will set back efforts and that there will be less money for care at a time when people are losing their jobs and private health care. "The problem is huge," said Rosemary Fetter, executive director of the Baltimore dental museum, where about 60 kids got some hands-on education as well as dental screenings this month as part of an annual event. "Problems with teeth keep kids out of school, some statistics say, more than anything else." Student volunteers from the nearby University of Maryland Dental School said the children's mouths didn't look too bad during the recent visit. Many had been to dentists, as evidenced by work done on their baby teeth. The volunteers also thought they were keeping the kids' attention during the oral-hygiene lessons by using props and computers. "This is much better than a video," said Gloria Gillian, one of the kindergarteners' teachers. "It'll stick with them. They'll go home and tell their parents. And when they're in the store, they'll remind them to get floss." Kiniya Coleman, who was missing her front teeth, said she'd brush the ones she has. Classmate Nia Thompson said her mother had already taught her "everything" about brushing. "Up and down, up and down," she said. Then, while demonstrating on those giant teeth, she told her classmates, "You got to get in the back." Such events are also reaching children who aren't seeing dentists regularly, said Dr. Marc Nuger, president of the Maryland State Dental Association. And Nuger and others on the Dental Action Committee, including Dr. Norman Tinanoff, chair of the UM Dental School's Department of Health Promotion and Policy, said they can point to other successes: •The state was able to simplify its Medicaid system by reducing the number of companies serving patients to one from seven or eight. Patients and dentists will call only one number as of July 1. •Reimbursements for dentists taking Medicaid patients are increasing, which is luring more professionals to treat the poor. The first raise came in July, and two more are planned, though the recession is causing a delay. •State health workers received an extra $1.5 million to bolster care in community centers. •Dental hygienists received permission to screen more children in public health settings. •Dentists were offered training in pediatric dentistry so they could more confidently treat children. •Doctors who treat Medicaid patients will soon be compensated for providing fluoride treatments in their offices after they complete a training course. Nuger said the changes, including the single-payer system for Medicaid, have already netted almost 100 new dentists in the Medicaid system in the past two years, bringing the total to about 400. The group is looking for about 200 more. There are about 4,000 dentists in Maryland. "The new system is going to be a big plus," Nuger said. "There are some 400,000 on the Medicaid roles in Maryland, and we'd like to get more to see a dentist regularly." Nationwide, despite fluoridated water and toothpaste and increased dental visits, dental disease and cavities among preschoolers are rising, largely among poor children, according to data from the American Dental Association and the National Institute of Dental and Craniofacial Research. About a quarter of the nation's children ages 2 to 11 have never been to the dentist, though professionals recommend children see one by their first birthday. Lack of dental insurance is a prime culprit, and for every American child with insurance there are about 2.5 without. Tinanoff, of the dental school, said there is increasing interest in pediatric dentistry, but Maryland admits only six students a year due to staffing. Last year, 120 applied. That's the same number of practicing pediatric dentists in the state. He believes some of the gaps in pediatric care will continue to be filled by other dentists, doctors and hygienists. And despite the economy, he believes state lawmakers will continue funding. "I think the story of Deamonte Driver hit home," Tinanoff said. "It shocked people around the world; people couldn't believe a child in the United States could die of a dental infection. We had been working on the problem slowly, but this really brought attention." It was the reason the dental committee was created by state Health Secretary John M. Colmers, who was in office for three weeks when Deamonte died, said Harry Goodman, director of the state Department of Health and Mental Hygiene's Office of Oral Health. The biggest issue remains education, Goodman said. Many low-income families don't look for a dentist, miss appointments or don't properly care for their teeth at home, he said. The committee is looking for funding for an extensive education campaign. "Deamonte Driver was failed on both ends," he said. "He couldn't find a dentist for treatment, and he was failed on the prevention end as well. We know for the most part how to prevent disease with oral hygiene. He didn't have access to those messages. An education campaign is our greatest challenge now." in maryland A September 2007 report from the Dental Action Committee found, among other things: •Less than a third of children on Medicaid were receiving dental services in a given year •More than half of Head Start children had tooth decay, and most of it was untreated •Only half of the local health departments offered dental services, and only nine provided care to children on Medicaid •Only 19 percent of dentists provided services to children on Medicaid for information For more information or to find a dentist, call 410-767-5300 or go to fha.state.md.us/oralhealth. Copyright © 2009, The Baltimore Sun, Sister to Sister Foundation to hold Women's Heart Health Fair Health event to take place Tuesday at Baltimore Convention Center By Sophia Terbush Baltimore Sun Monday, February 23, 2009 One in four women in the United States dies of heart disease each year - more than all types of cancer combined, including breast cancer. However, studies show that only a third of American women consider themselves at risk for heart disease. To increase awareness about the risks of heart disease in women, the Baltimore chapter of the Sister to Sister Foundation is holding its fifth annual Women's Heart Health Fair tomorrow at the Baltimore Convention Center. Founded in 2000, Sister to Sister is a national nonprofit organization committed to educating women about healthy lifestyle changes that can reduce their risk of heart disease. Baltimore is one of 13 cities across the country that runs a Sister to Sister campaign. During the health fair, attendees will have access to medical, nutrition and stress-reduction tips and cooking and fitness demonstrations provided by more than 70 vendors. The University of Maryland School of Nursing and Mercy Medical Center will provide free cardiac screenings followed by on-site counseling sessions with on-the-spot results and a personalized action plan. The 15-minute screening checks several risk factors related to heart disease, including blood pressure, body mass index (BMI), cholesterol, glucose, triglycerides, waist circumference and family health history. "This is the largest event that provides free cardiac screenings, demonstrations, medical experts and service providers all in one place for a complete, pro-active experience," said Allison Buchalter, campaign director for Sister to Sister Baltimore. Last year's fair attracted 3,000 women, a turnout that Buchalter attributed to support from the business community and local government. Sister to Sister is hoping for a turnout tomorrow like last year's, but it bases its success on helping to change unhealthy behaviors, providing prevention information and increasing awareness. "If we only help or save one woman, that's a success," Buchalter said. Dr. Mandeep Mehra, head of cardiology at the University of Maryland Medical Center, which helps sponsor the yearly fair, stressed the importance of cardiac screening for women. "Heart disease typically appears about eight to 10 years later in women than it does in men, so men tend to be screened more often and earlier as a result," he said. "Traditional risk factors in men are similar in women and should be checked." Mehra said he has treated 30-year-old women with severe coronary artery disease. "Obesity, lifestyle habits, tobacco use, high blood pressure and diabetes are the key risk markers," he said. "I try to tell female patients of mine that they ought to just know their numbers." if you go The Women's Heart Health Fair will be held 8 a.m.-4 p.m. tomorrow in Hall A at the Baltimore Convention Center, 1 W. Pratt St. Online pre-registration is available at sistertosister.org. Call 410-649-7000. Copyright © 2009, The Baltimore Sun. Events, screenings, support groups and more Baltimore Sun Calendar Monday, February 23, 2009 programs Baltimore City Hall100 N. Holliday St. / Why is City Hall red? Sinai Hospital sponsors the illumination of the building in honor of the American Heart Association's national "Go Red for Women" campaign. Event runs sunset to sunrise through Saturday. Flu vaccines Anne Arundel County Department of Health will provide free flu vaccinations by appointment to residents at the Glen Burnie Health Center, 416 A St. S.W., and the Parole Health Center, 1950 Drew St. in Annapolis. A $20 donation to help defray costs is requested. Call 410-222-7343 or go to aahealth.org. Love You DayMaryland Science Center, 601 Light St. / Visitors can celebrate healthy lifestyles noon-4 p.m. Saturday. Event includes heart-healthy cooking demonstrations and activities for a healthy lifestyle and positive self-image. Event is free with paid museum admission. Call 410-685-5225 or go to marylandsciencecenter.org. Mental health and substance abuse services The Anne Arundel County Department of Health provides treatment for veterans returning from military service in Iraq and Afghanistan. Call 410-222-0117 for information about the free and confidential services. People with Arthritis Can Exercise (PACE)Laurel Regional Hospital, 7300 Van Dusen Road / Laurel Regional Hospital and the Metropolitan Washington Chapter of the Arthritis Foundation offer this program at 10 a.m. Mondays and Thursdays, ending March 5. Participants must be able to walk independently, with a device, or transfer to a straight chair from a wheelchair. Cost is $25 per person or $3 per class. Call 301-497-7914 to register. Volunteers needed5401 Old Court Road, Randallstown / The gift shop at Northwest Hospital seeks adult volunteers to assist customers in selecting gifts and personal items. Weekday and weekend hours are available; training will be provided. Call 410-521-5911. support groups Al-Anon Laurel Regional Hospital, 7300 Van Dusen Road / Group to help families and friends of alcoholics meets at 7 p.m. Fridays and Sundays. Call 410-792-7636 or 301-497-7914. Alcoholics AnonymousLaurel Regional Hospital, 7300 Van Dusen Road / Fellowship group meets at 7 p.m. Sundays. Call 410-792-7636 or 301-497-7914. BipolarLaurel Regional Hospital, 7300 Van Dusen Road / Group meets at 6 p.m. Thursdays. Call 410-792-7636 or 301-497-7914. Domestic Violence Victim Support Group7701 Dunmanway, Dundalk / The Family Crisis Center of Baltimore County offers this support group 10 a.m. and 6 p.m. Wednesdays. Topics include emotional and physical violence and how children are affected by their environment. Call 410-285-4357 to register and for more information. Mood disorder St. Joseph Medical Center, 7601 Osler Drive, Towson / Support group meets Thursday. Free. Call 410-337-1584 for time and more information. Nar-AnonLaurel Regional Hospital, 7300 Van Dusen Road / Meeting at 7 p.m. Mondays provides information and resources for friends and families of drug addicts and substance abusers. Call 410-792-7636 or 301-497-7914. Survivors of SuicideChurch of the Redeemer, 5603 N. Charles St. / Group to help families and friends meets twice a month 7:30 p.m.-9 p.m. Tuesdays. Call 410-880-2504 for more information. Survivors Offering SupportSt. Joseph Medical Center, 7601 Osler Drive, Towson / Hospital seeks survivors of breast cancer who are interested in mentoring newly diagnosed patients. Call 410-427-2513 for more information. screenings Breast and cervical cancer Franklin Square Hospital Center, 9000 Franklin Square Drive / Free screenings for women ages 40-65 who meet income requirements. 443-777-8138. Breast and cervical cancer Baltimore County Department of Health, 6401 York Road / Free screenings for women ages 40-64 without health insurance who meet income requirements. Call 410-887-3432. Copyright © 2009, The Baltimore Sun. Whooping cough still around Expert advice By Liz Atwood Baltimore Sun Monday, February 23, 2009 Whooping cough sounds like one of those old-fashioned diseases that only the heroines of Victorian novels get. But whooping cough, or pertussis, is a serious and sometimes fatal illness that has been on the rise in the United States in recent years, says Virginia Keane, associate professor of pediatrics at the University of Maryland School of Medicine and president of the Maryland chapter of the Academy of Pediatrics. What is whooping cough? A bacterial infection caused by the bacteria Bordetella pertussis. This bacteria only resides in human beings. It is passed by droplets if people cough on you. It has an incubation period of seven to 10 days. It has multiple phases. It starts like a bad cold. Then it gets much worse. You can get pneumonia and encephalopathy (a brain disorder). You can get a leukemoid reaction - that's an explosion of white blood cells. Then you get in the recovery phase. The whole thing can take six to 10 weeks. Who is susceptible? The people who are most susceptible are infants who haven't been immunized yet. When do children get immunized for the disease? The vaccine schedule is 2, 4, 6 months, 12 to 18 months. Then before preschool. Then there's another booster dose in adolescence that we ideally give at 11 years of age. Since November 2005, it's been recommended that adults get a booster every 10 years. It is combined with the tetanus shot. Can patients have reactions to the vaccine? Until 1995, we were using a whole cell pertussis vaccine that was causing high fevers and severe irritability in children. Now that we use the acellular vaccine, which is much purer, we rarely see bad side effects. If you have had whooping cough, can you get it again? Yes. Your immunity can wane. How many cases are there each year in the United States? In the 1990s we saw fewer than 1,000 cases a year. In 2004, we had a little over 25,000. Why have the number of cases been on the rise? We think that is because adults are acting as a reservoir for [the disease]. And the number of susceptible children is growing because parents are being misled by scientifically unsupported claims that vaccines are dangerous and are choosing not to have their children vaccinated. I know they think they are doing what is right for their children, but they are wrong. They are putting their own children and others at risk of getting preventable diseases like whooping cough. What is the mortality rate for whooping cough? It depends on the age group. A relatively healthy young adult is not at risk. Adults with immune deficiency might be. The ones that are at the highest risk are young infants. If they are not treated properly, the mortality rate can be around 10 percent. It depends on your age, immune status and at what point in your disease it is diagnosed. What are the signs and symptoms of the disease? It starts like a cold. But the cough gets worse and worse. You usually get a fever with it. The cough gets so bad you can't catch your breath. You can't stop, and when you try to catch your breath, it sounds like a whoop. Sometimes little children will throw up. They can turn quite blue. When should someone seek medical attention? With young babies, they seem pretty sick before they get the whoop. With adults, if you have a significant cough that hasn't gone away in three weeks, you should see your doctor. There are other causes, but pertussis is the one you should get tested for and treated for. How is it treated? It's treated with antibiotics like erythromycin, and recently we're using azithromycin - Z packs. But that's not approved for young infants. What is the best way to prevent whooping cough? The best way to prevent it is vaccinate your children early and often, and for adults in contact with children to be vaccinated every 10 years. What percentage of the U.S. population has received the vaccine? That's a moving target. Pertussis vaccine was started in the 1940s. So most adults have had some doses of it. Since 2005, it's been recommended they get their booster. If you get a tetanus shot is the pertussis vaccine in it? It should be in there. You shouldn't have to ask for it. But you should be told it is in there. Copyright © 2009, The Baltimore Sun. Planning ahead: County schools are ready for emergencies By Kristina Negas Frederick News Post Monday, February 23, 2009 Emergency personnel load a shooting victim into the back of an ambulance at the Liberty gas station off North East Street on Feb. 3. Gov. Thomas Johnson High School was placed on lock-down after the shooting, which was a few blocks from the school. School officials said they are ready in case of another emergency. When police advised Gov. Thomas Johnson High School to go into lock-down after a student was shot Feb. 3, the administration readily complied. Although the shooting occurred off school property and after dismissal, students and staff remained in lock-down for about a half hour. "That meant that no one in the building could leave and no one on the outside could enter," said Marita Loose, Frederick County Public Schools executive director of communication services, speaking on behalf of TJ Principal, Marlene Tarr. Three days later, Mount St. Mary's University went into lock-down when a bullet was discovered in the window of a dormitory. Cpl. Jennifer Bailey, spokeswoman for the Frederick County Sheriff's Office, said lock-downs in Frederick County schools are rare, occurring about four or five times a year. While the two recent incidents were unrelated, officials at both schools believe safety precautions were implemented smoothly, showing that schools know what to do in an emergency. In any school emergency, communication is vital. Each Frederick County public school is equipped with an emergency radio for reaching the police, said Clifton Cornwell, security coordinator. Cornwell said he found out about TJ's lock-down in a timely manner. "I had constant communication with the police department." To notify parents, FCPS turns to its "Find Out First" e-mail system. Members of the school community can sign up at www.fcps.org to receive e-mail alerts during an emergency. Hood College, Frederick Community College, and Mount St. Mary's also have e-mail alert systems, and along with FCPS, post information on their websites. However, the Mount's website had a problem when the school went into lock-down on Feb. 6. At first, the home page message said the alert was "only a test." "They were in the process of updating," said R. Barry Titler, the director of public safety at the Mount. In addition to an e-mail alert and a campus-wide public address system, FCC has a program called "Orange Alert," in which emergency notices and information are posted on orange paper and displayed around campus. "Nobody on campus except for security is allowed to use orange paper," said James Garofalo, FCC's chief of security operations. Cornwell differentiates between two types of FCPS lock-downs: full lock-down and partial lock-down. During a partial lock-down, the exterior of the building is locked and school continues normally inside. Parents are allowed to pick up their children, but have to show ID at the front office, he said. A partial lock-down might be put in place if something is going on in the community, such as a search for someone who has robbed a nearby bank, Cornwell said. A school is put in full lock-down, where no one can go in or out of the building, if it is considered to be safer inside the school than outside. "It could be an intruder," Cornwell said. "It could be somebody trying to get in from the outside." The key to preparing for any emergency is practice, according to Cornwell. Each Frederick County Public School has about 12 emergency drills a year, he said. "Students are used to it, so it's not such a scary thing." Additionally, school officials go through "table top" exercises to prepare for emergency situations. "We go into the schools and run through scenarios," Cornwell said. "It's not a threatening exercise, but it's more of a team-building thing." Exercise scenarios include such issues as what to do if students are on the playground when an emergency arises, Cornwell said. About four table top exercises are done each week. Titler also credits the Mount's exemplary actions to practice. "We review our plans continually and go over it every couple of months," he said. Since the lock-down, Titler said, the Mount has received calls and letter from parents, law enforcement agencies, and other schools, commending its handling of the situation. "In an emergency you always see things that you have done better," he said. "But for the most part, we did a pretty good job." Please send comments to webmaster or contact us at 301-662-1177. Copyright 1997-09 Randall Family, LLC. All rights reserved. Two companies in running to buy county nursing home By Kevin Spradlin Cumberland Times-News Monday, February 23, 2009 CUMBERLAND - The search for a new owner of the Allegany County nursing home is in the final stretch, according to sources familiar with the negotiations. North Bay Health Associates LLC, based in Miami, Fla., and Cumberland-based Allegany HealthCare Group LLC are the final contenders from an original list of 13 interested parties. The county approved in early February 2008 to advertise for the “acquisition or lease of all assets” of the Allegany County Nursing Home and Rehabilitation Center on Furnace Street. The list of 13 companies was pared to six within three months, when five companies submitted a $100,000 deposit or letter of credit. A sixth interested party remained on the short list. It’s not known if either North bay or Allegany HealthCare Group was the company that lacked either of those items. County Commissioners Jim Stakem, Dale Lewis and Bob Hutcheson appointed a three-member panel comprised of Jason Bennett, of the county finance department, acting County Administrator David Eberly and County Attorney Bill Rudd to evaluate the remaining interested parties. The evaluation process has included site visits to existing facilities managed by the candidates and interviews. The commissioners have emphasized a concern for the nursing home’s work force - nearly 160 strong - and its residents. Many of the employees are union members. The negotiations with the union have delayed the potential sale, which first was expected to be finalized by July 1, 2008, the beginning of the current fiscal year. The negotiations have centered around a long-term contract for the employees. It’s possible part of the proceeds of the sale - figured to be nearly $7 million - could go toward paying existing employees past-due wages for unpaid comp time. Contact Kevin Spradlin at kspradlin@times-news.com. Copyright © 1999-2008 cnhi, inc. *National / International* In Turnabout, Children Take Caregiver Role By Pam Belluck New York Times Monday, February 23, 2009 LANTANA, Fla. — Partly paralyzed, with diabetes and colitis, Linda Lent needs extensive care at home. But with her husband working long hours at a bowling alley, Ms. Lent, 47, relies on a caregiver who travels by school bus toting a homework-filled backpack: her 13-year-old daughter, Annmarie. Annmarie injects migraine medicine, dispenses pills, takes blood from her mother’s finger for tests and responds to seizures — responsibilities she has at times found overwhelming. At 11, she said, she felt “fed up,” thinking: “There’s no law says I have to take care of her. Why should I have to do it? Other kids, they could go out and play with friends.” Across the country, children are providing care for sick parents or grandparents — lifting frail bodies off beds or toilets, managing medication, washing, feeding, dressing, talking with doctors. Schools, social service agencies and health providers are often unaware of those responsibilities because families members may be too embarrassed, or stoic. Some children develop maturity and self-esteem. But others grow anxious, depressed or angry, sacrifice social and extracurricular activities and miss — or quit — school. “Our society thinks of children as being taken care of; it doesn’t think of children as taking care of anybody,” said Carol Levine, director of families and health care at United Hospital Fund, a health services organization that studied child caregivers. “Kids who do it well gain confidence,” Ms. Levine said, but “they may be resentful, not do as well in school and feel limited because their role is to be the caregiver.” Health organizations are increasingly “realizing the extent of what children are doing,” said Nancy Law, an executive vice president of the National Multiple Sclerosis Society. “Everything from children who become overly responsible” to “the kid who totally rebels and gets into trouble.” “This is an issue that’s growing,” she said. A 2005 nationwide study suggested that about 3 percent of households with children ages 8 to 18 included child caregivers. Experts say they expect the numbers to grow as chronically ill patients leave hospitals sooner and live longer, the recession compels patients to forgo paid help and veterans need home care. Recently, programs have been formed to help children find support. Several Florida schools now have classes and meetings regarding caregiving. Other countries do more. In Britain and Australia, the census counts child caregivers, and many of them have rights to participate in patient-care discussions and to ask agencies for help or compensation. Hundreds of programs help them, said Saul Becker, a sociology professor at the University of Nottingham. “It’s such a big issue.” Experts say that in the United States, the issue is often hidden. “It is embarrassing for grownups to admit they’re so helpless that a child is caring for them,” said Kim Shifren, a psychology professor at Towson University, who studies child caregivers and was one herself. Ms. Levine said children worried that “friends won’t understand and if some outsider sees they’re doing all this stuff there may be problems for the family.” Michael Anderson II, 12, of Boynton Beach, Fla., said, “I don’t really talk to people about it.” His mother, Iris Santiago, 43, is legally blind, anemic and has depression and hernias. Michael gives B12 injections, helps with medicine and guides her when she walks — “my seeing-eye boy,” she calls him. Some, like Alyssa Morano, 12, of Lantana, face recalcitrant patients. Alyssa’s grandmother, Willene Black, 59, who adopted Alyssa and her brother, sometimes skips medication for her diabetes, angina, anxiety and pain from disabling injuries. “If I find any in the garbage, I take it out,” said Alyssa, who shares her grandmother’s room and has even helped her put on underwear. “She lays down all the time. I can tell she’s getting kind of weaker every day.” Ms. Black, who cannot walk far or sit up long, said, “I know my limits.” But she says Alyssa tells her, “ ‘Go to your doctor, Grandma, you’re going to die.’ ” And when visiting the doctor, Ms. Black said, “When I say an answer she don’t like, like he will ask me are you doing exercise, she will say, ‘No you’re not.’ ” Programs for child caregivers face challenges because parents may fear that “you’re taking away their role as a parent” or that protective service agencies will be called, said Gail Hunt, president of the National Alliance for Caregiving. Ms. Levine said that rather than a response of “Oh, take the child out of the home,” a program’s priority should be “making the responsibilities appropriate.” Many programs simply offer children a break from their responsibilities. The Caregiving Youth Project in Florida offers the most comprehensive approach, holding weekend camps to give children breaks and teach them caregiving skills. It counsels families and conducts classes and meetings in schools. “It hasn’t been something teachers looked at, but some of the kids end up acting out at school,” said the director, Connie Siskowski. Or dropping out, like Maryangellis Rodriguez, of Boynton Beach, who quit school at 16 to care for her mother, who has multiple sclerosis. “I just did it ’cause that’s my mom,” she said. Ann Faraone, director of student intervention for the Palm Beach School District, says the project helps scores of students whose teachers had been unaware of their caregiver status. “Families don’t come forward,” Ms. Faraone said. “Now, school personnel are better equipped to deal with these children.” Experts say many child caregivers are from single-parent, low-income families, including some from foreign cultures accustomed to such roles. Others are from middle-income families whose insurance does not cover home care. Christina Powell’s family left a four-bedroom house in Virginia in 2007 for an apartment in Boca Raton, Fla., where her grandfather, Guy French, 78, struggled with dementia and bladder cancer. Her mother’s job at a yacht uniform company starts early, so Christina, 13, gives medicine, changes sheets and dresses her grandfather for chemotherapy. Initially, he was continually drunk, went naked and urinated everywhere, “like a sprinkler system,” Christina said. His chain-smoking aggravated Christina’s asthma. He was also often “really angry,” saying that “he didn’t like me,” she said. “That made me depressed. I was like, ‘I’m the one who takes care of you.’ ” Her mother, Florence French, 44, moved them out, but after Mr. French broke his hip, he joined them in their new home. Christina gave him her bed, now in their living room alongside a commode, and slept on chairs for a while. Her grandfather refused adult day care and balks at Medicaid-financed home visits. Christina, a good student who is usually upbeat, said that for months she felt, “ ‘I hate my life.’ ” Eventually, Ms. French stemmed the drinking, restricted the smoking and put her father in diapers. “It’s a hard experience, but it’s good for them to see what family means,” said Ms. French, who is planning a move to a bigger house. In their Haitian culture, she said, “We don’t put our parents in nursing homes. And I know if it’s too much for her she’ll tell me.” The Caregiving Youth Project visited, telling Christina, “ ‘You’re doing something good,’ ” she said. “I’m happier now.” Karen Harwood, the project’s care coordinator, said, “We can’t change the situation for a lot of kids, but we can help them through it.” A Caregiving Youth Project weekend camp gave Michael Anderson a chance to “get away from my mother so I can be with myself and my friends,” he said. Michael is so conscientious that he takes a premedical class at school. Sometimes Ms. Santiago, his mother, calls school with a code word so he knows she is O.K. She said she worried when Michael said that “he didn’t want to go away to college or leave.” “I don’t want him to think he was born to take care of me,” she added. At 11, Annmarie Lent said, she felt “depressed” and “under pressure.” Classmates taunted her, saying, “ ‘Your mom’s crippled.’ ” Once, she said, when she was reluctant to attend school, her parents got the police to “bring me to school in handcuffs — in my Tinkerbell pajamas.” Ultimately, she “got really aggressive,” her mother said. “She threw a cup and hit me in the head, then she smashed me across the face.” Another time, Ms. Lent said, Annmarie “took my cane away and started punching me” and beat her mother with beads, yelling,“ ‘You took my life away from me,’ that it was all my fault for becoming disabled. I was screaming. I didn’t want to die at the hands of my 11-, almost 12-year-old.” Three times, Ms. Lent said, she reluctantly had Annmarie arrested. Charged with assaulting a disabled person, Annmarie wrote, “Dear Mom, I’m so sorry for hitting you.” She spent time in detention, faced the possibility of foster care and was given a diagnosis of bipolar and attention deficit hyperactivity disorders. In time, things improved. The Caregiving Youth Project helped her get counseling, peers and letters of commendation from school and elected officials. “Sometimes I feel guilty about putting the responsibility on her,” Ms. Lent said, but “we have a very good relationship now.”. Annmarie says she realizes her mother “goes through more pain than anybody. I think she’s special for that.” Copyright 2009 New York Times. Antibodies Offer a New Path for Fighting Flu By Donald G. McNeil Jr. New York Times Monday, February 23, 2009 In a discovery that could radically change how the world fights influenza, researchers have engineered antibodies that protect against many strains of the virus, including even the 1918 Spanish flu and the H5N1 bird flu. The discovery, experts said, could lead to the development of a flu vaccine that would not have to be changed yearly. And the antibodies already developed can be injected as a treatment, going after the virus in ways that drugs like Tamiflu do not. Clinical trials to prove that the antibodies are safe in humans could begin within three years, a researcher estimated. “This is a really good study,” said Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, who was not part of the study. “It’s not yet at the point of practicality, but the concept is really quite interesting.” The work is so promising that Dr. Fauci’s institute will offer the researchers grants and access to its ferrets, which can catch human flu. The study, done by researchers from Harvard Medical School, the Centers for Disease Control and Prevention and the Burnham Institute for Medical Research, was published Sunday in the journal Nature Structural & Molecular Biology. In an accompanying editorial, Dr. Peter Palese, a leading flu researcher from Mount Sinai Medical School, said the researchers had apparently found “a viral Achilles’ heel.” Dr. Anne Moscona, a flu specialist at Cornell University’s medical school, called it “a big advance in itself and one that shows what’s possible for other rapidly evolving pathogens.” But Henry L. Niman, a biochemist who tracks flu mutations, was skeptical, arguing that human immune systems would have long ago eliminated flu were the virus as vulnerable in one spot as this discovery suggested. Also, he noted, protecting the mice in the study took huge doses of antibodies, which are expensive and cumbersome to infuse. One team leader, Dr. Wayne A. Marasco of Harvard, said it began by screening a library of 27 billion antibodies he had created, looking for ones that take aim at the hemagglutinin “spikes” on the shells of flu viruses. Antibodies are proteins normally produced by white blood cells that attach to invaders, either neutralizing them by clumping on or tagging them so that white cells can find and engulf them. They can be built in the laboratory and then “farmed” in plants, driving prices down, Dr. Marasco said. The flu virus uses the lollipop-shaped hemagglutinin spike to invade nose and lung cells. There are 16 known types of spikes, H1 through H16. The spike’s tip mutates constantly, which is why flu shots have to be reformulated each year. But the team found a way to expose the spike’s neck, which apparently does not mutate, and picked antibodies that clamped onto it. Once its neck is clamped, a spike can still penetrate a human cell, but it cannot unfold to inject the genetic instructions that take over the cell’s machinery to make more virus. The team then turned the antibodies into full-length immunoglobulins and tested them in mice. Immunoglobulin — antibodies derived from the blood of survivors of an infection — has a long history in medicine. As early as the 1890s, doctors injected blood from sheep that had survived diphtheria to save a girl dying of it. But there can be dangerous side effects, including severe immune reactions or accidental infection with other viruses. The mice in the antibody experiments were injected before and after receiving doses of H5N1. In 80 percent of cases, they were protected. The team then showed that their new antibodies could protect against both H1 and H5 viruses. Most of the flu this season is H1, and experts still fear that the lethal H5N1 bird flu may start a human pandemic. However, the other seasonal flu outbreaks each year are usually caused by H3 or B strains, so flu shots must also contain those. But there is always at least a partial mismatch because vaccine makers must pick from among strains circulating in February since it takes months to make supplies. By the time the flu returns in November, its “lollipop heads” have often mutated. Therefore, other antibodies that clamp onto and disable H3 and B will have to be found before doctors even think of designing a once-a-lifetime flu shot. It is also unclear how long an antibody-producing vaccine will offer protection; new antibodies themselves fade out of the blood after about three weeks. Dr. Marasco said that his team had already found a stable neck in the H3 and that they were “going after that one too.” They have not tried with B strains yet. To make a vaccine work, researchers also need a way to teach the immune system to expose the spike’s neck for attack. It is hidden by the fat lollipop head, whose rapid mutations may act as a decoy, attracting the immune system. As a treatment for people already infected with flu, Dr. Marasco said, the antibodies are “ready to go, no additional engineering needed.” They will, of course, need the safety testing required by the Food and Drug Administration. Antiflu drugs like Tamiflu, Relenza and rimantadine do not go after the hemagglutinin spike. Tamiflu and Relenza inhibit neuraminidase (the “N” in flu names like H5N1), which has been described as a helicopter blade on the outside of the virus that chops up the receptors on the outside of the infected cell so the new virus being made inside can escape. Rimantidine is believed to attack a layer of the virus’s shell. Copyright 2009 New York Times. Mo. man pleads guilty to day care molestations Associated Press Frederick News-Post Monday, February 23, 2009 FARMINGTON, Mo. (AP) -- A man pleaded guilty to seven sex-related charges for molesting children as young as an infant at a small day care business his wife operated out of their home. William Huck, 62, entered the plea Friday to seven charges, softly detailing his crimes in court. He had been scheduled for trial next month but agreed to plead guilty instead. The victims included five boys and two girls, ranging in age from an infant to a 5-year-old between 1998 and 2007, but authorities have said Huck admitted to molesting up to 40 children over the past three decades. Huck could be sentenced to life in prison as a sexual predator. His sentencing is set for April 17. The victims attended the day care operated by his wife at the family's home in Ste. Genevieve, a historic French settlement about 50 miles south of St. Louis. The business did not require a license because of the small number of children there at any particular time. According to police reports, the abuse happened during times when Huck's wife was away from the center. Huck, a retired railroad worker, had no criminal record. He was arrested in March 2007. Ste. Genevieve County prosecutor Tim Inman said Huck's wife cooperated in the investigation and wasn't charged. Information from: http://dailyjournalonline.com © 2009 The Associated Press. All rights reserved. Britain releases report into tainted blood scandal Associated Press By Gregory Katz Washington Post Monday, February 23, 2009 LONDON -- A report into the use of contaminated blood that infected roughly 5,000 hemophiliacs in Britain with hepatitis C and HIV called Monday for increased financial help to victims, and partly blamed U.S. companies. House of Lords member Peter Archer, who led a two-year non-governmental review into the tainted blood scandal, called it "a horrific human tragedy" and the worst treatment disaster in the history of Britain's health care system. The review committee found "a significant burden of responsibility" falls on U.S. companies that supplied contaminated products used to treat hemophilia in the 1970s and 1980s. The treatments involved the use of blood collected from thousands of donors. "Long after alarms had been founded about the risks of obtaining paid-for blood donations from communities with an increased incidence of relevant infections, such as prison inmates, this practice continued. It is difficult to avoid the conclusion that commercial interests took precedence over public health concerns," the report stated. The report's conclusion does not name any U.S. companies specifically for the tainted products, and it stopped short of blaming specific doctors. Hemophiliacs suffer from an inherited disorder that prevents blood from clotting. Roughly a third of the victims have died since becoming infected with hepatitis C and HIV, the virus that causes AIDS. Archer's committee, which gathered evidence for two years, said people who were infected should be entitled to financial and medical benefits that they are not receiving. The 200-page report also raised other concerns about medical ethics. "We are satisfied that some patients were subjected to tests without knowledge of their purpose and without their consent, a practice described by some witnesses as being treated as experimental guinea pigs," the report states. The inquiry is a nonbinding investigation that will not directly lead to criminal charges. Tainted blood scandals have been investigated throughout the world, but there had been no detailed probe in Britain until now. © 2009 The Associated Press. *Opinion* Invincible? Maybe not Frederick News-Post Editorial Monday, February 23, 2009 When you're 20-something you have the world by the tail -- you can do anything whether it's running rings around the old guys in a pickup basketball game or wearing trendy form-fitting clothes that show off a youthful frame. The insurance companies have a name for this segment of the population: "The young invincibles." A report released last week by the Centers for Disease Control and Prevention, however, casts some doubt that this group of 18- to 29-year-olds is as invincible as it seems. For starters, a third of this demographic are smokers, despite all the no-brainer evidence out there that smoking is a bad choice. Even seeing parents and other older smokers stricken with emphysema, lung cancer and heart ailments does little to deter them from puffing on the accessory they think makes them look cool and sophisticated. As to the part about looking svelte and buff? Sure, all the gym ads feature young people with those six-pack abs, and there's obviously someone buying those skimpy clothes, but according to the CDC report, a quarter of the 20-somethings are obese. It noted the obesity rates among this group has tripled in the past three decades. And about that pickup game of basketball? Nearly two-thirds of young adults reported not having regular leisure-time physical activity, according to a CNN story on the CDC's findings._ "At that age, people tend to be healthy but take it for granted," said Dr. Jennifer Shu, CNNhealth's Living Well expert. "Diabetes and heart disease start at much earlier ages now. The obesity and cigarettes can impact how young you might be when you get a serious illness." Which brings us to another point: What about insurance if a young adult becomes seriously ill? A third of people ages 20 to 24 are uninsured, said the CNN story. "They are too old to qualify for their parents' insurance, looking for work or in a job that doesn't provide health insurance." The CDC report also said: -- Almost 40 percent of adults 18 to 20 years of age, about one-third of 21- to 25-year-olds and a quarter of 26- to 29-year-olds reported using an illicit drug in the past year. -- One-fifth of young adults reported having five or more drinks in a day on at least 12 days in the past year. -- Young adults also have one of the highest rates of injury-related emergency department visits of all age groups. Something to think about for those times when you're wishing for the return of youth. Please send comments to webmaster or contact us at 301-662-1177. Copyright 1997-09 Randall Family, LLC. All rights reserved. A Black Eye for Justice Domestic violence legislation in Maryland should protect victims, not abusive officers. Washington Post Editorial Monday, February 23, 2009; A18 POLICE OFFICERS ought to be ardent supporters of legislation to take guns away from domestic abuse suspects. After all, it's the officers' responsibility to uphold the law, and abuse suspects use handguns and rifles to break it at alarming rates; half of the 75 domestic-violence-related homicides in Maryland last year involved guns. It is unconscionable, then, that the Maryland Fraternal Order of Police is pushing an exemption for police officers. The union's attempt to shield abusive officers from the consequences of their actions is an insult to countless victims of domestic violence and should be soundly rejected. The General Assembly is considering two bills that would help protect abuse victims. One would give judges the discretion to take away the guns of abuse suspects subject to a temporary protective order. The other would require judges to take away the guns of abuse suspects after a final protective order has been issued. The Fraternal Order of Police is promoting a law-enforcement-only exemption in the second bill that would give judges the discretion not to take away an officer's gun. The group argues that the bill attacks the livelihood of officers accused of domestic violence. It seems to us that if officers want to keep their guns, they should follow a simple rule: Don't abuse your significant others. Some critics claim the legislation leaves officers vulnerable to false accusations of abuse. Backers of the bills acknowledge that this happens, if infrequently. That's why an accuser must present "clear and convincing evidence" of abuse -- hardly an insignificant standard -- to persuade a judge to issue a final protective order. It's telling that many police chiefs and sheriffs have testified in support of the bills, with or without special treatment for officers. They recognize that in such potentially life-threatening situations, it's better to err on the side of protection. It may be that the officers-only exemption is a necessary concession to spring the bill from the House Judiciary Committee, which is notoriously biased toward defendants, and secure a modicum of protection for abuse victims. But that doesn't mean it's right. Copyright 2009 Washington Post. The Deficit Hawks' Attack on Our Entitlements By Robert Kuttner Washington Post Commentary Monday, February 23, 2009; A19 With the enactment of a large economic stimulus package, fiscal conservatives are using the temporary deficit increase to attack a perennial target -- Social Security and Medicare. The private-equity investor Peter G. Peterson, who launched a billion-dollar foundation last year to warn that America faces $56.4 trillion in "unfunded liabilities," is a case in point. Supposedly, these costs will depress economic growth and crowd out other needed outlays, such as investments in the young. The remedy: big cuts in programs for the elderly. The Peterson Foundation is joined by leading "blue dog" (anti-deficit) Democrats such as House Budget Committee Chairman John Spratt of South Carolina and his counterpart in the Senate, Kent Conrad of North Dakota. The deficit hawks are promoting a "grand bargain" in which a bipartisan commission enacts spending caps on social insurance as the offset for current deficits. President Obama's economic advisers devised today's White House fiscal responsibility summit to signal that the president takes the deficit seriously and to lay the groundwork for such a bipartisan deal. Originally, Peterson was slated to be a featured speaker. But Capitol Hill sources say that Democratic congressional leaders were skeptical of the strategy. The summit has been reduced to a lower-profile, half-day event; Peterson will attend but no longer has top billing, and Obama reportedly is lukewarm about the idea of a commission. Obama should indeed be wary of such a plan, and official briefings on his first budget suggest that he will drastically reduce the deficit by 2013, but without going after social insurance. What's wrong with the story of entitlements wrecking the economy? Plenty. For starters, the $56 trillion "unfunded liability" figure relies on creative accounting. Only about $6.36 trillion is the actual public debt, according to the U.S. Treasury. Most of the number Peterson cites is a combination of the 75-year worst-case projections for Social Security, Medicare and Medicaid. These three programs face very different challenges and remedies. Social Security's accounts are actually near long-term balance. The Congressional Budget Office puts the 75-year shortfall at only about one-third of 1 percent of projected gross domestic product. Social Security is financed by taxes on wages -- and since the mid-1970s, wage growth has stagnated. If median wages rose with productivity growth, as they did during the first three decades after World War II, Social Security would enjoy a big surplus. Even without a raise for working America, Social Security needs only minor adjustments. Medicare really does face big deficits. But that's because Medicare is part of a hugely inefficient, fragmented health insurance system. It makes no sense to "reform" Medicare in isolation. If we just cap Medicare, needy seniors would get bare-bones care while more affluent people could supplement their insurance out of pocket. The decent cure for Medicare's cost inflation lies in comprehensive universal health insurance so that the entire system is more efficient and less prone to inflation. You don't hear many budget hawks supporting that brand of reform. The deficit hawks' story also contends that we are sacrificing our children's future by too much (deficit) spending on the elderly. In fact, today's young adults are already falling out of the middle class because of the high costs of the investments we don't adequately finance socially -- child care, college tuition and health insurance. But fiscal conservatives seldom call for increased investment in the young. Today's young, of course, will be tomorrow's retirees, and they will need social insurance, too. The overall bottom line? The economy we bequeath to our children has everything to do with getting growth back on track and almost nothing to do with imagined future deficits. History provides a parallel. At the end of World War II, the public debt was about 120 percent of GDP -- about three times today's ratio. Yet the heavily indebted wartime economy stimulated a quarter-century postwar boom -- because all that debt went to recapitalize American industry, advance science and technology, retrain our unemployed and put them to work. We need to increase public spending and debt now to restore economic growth and then gradually reduce the debt ratio once recovery comes. Social Security has little to do with this challenge. Nor does Medicare, if we reform our overall health system. Since the early 1980s, Peter G. Peterson has been warning that future entitlement deficits would crash the economy. Yet when the crash came, the cause was not deficits but wild speculation on Wall Street. Now, with 401(k) plans swooning and health benefits being cut, Social Security and Medicare are the two bedrock programs that keep tens of millions of elderly Americans from destitution. Why perversely cut these programs to pay for the sins of Wall Street? The attack on social insurance is really an ideological assault, dressed up as fiscal high-mindedness. Robert Kuttner, co-editor of the American Prospect and a senior fellow at the New York public policy group Demos, is most recently the author of "Obama's Challenge: America's Economic Crisis and the Power of a Transformative Presidency." Copyright 2009 Washington Post. BACK TO TOP


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