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			Wednesday, January 14, 2009 News Clipping Archives Swimmers lose access to hotel pool (Hagerstown Herald Mail) Health takes a dive (Hagerstown Herald Mail) Families Seeking Insurance For Kids (Washington Post) O'Malley's budget proposal to include layoffs (Baltimore Sun) State leaders looking for federal money to close budget deficit (Daily Record) UnitedHealth to set up new pay-rate database (Baltimore Sun) Va. company recalls peanut butter nationwide (Hagerstown Herald Mail) Open-plan offices lead to stress, flu and raised blood pressure, study finds (Corporate Fitness and Wellness Today) Woman who rehabilitated foxes gets criminal charges (Montgomery Gazette) House Set to Pass Child Health Bill (Washington Post) CDC Confirms Salmonella Link (Washington Post) Sexually Transmitted Disease in America (Washington Post) Swimmers lose access to hotel pool By Andrew Schotz Hagerstown Herald-Mail Wednesday, January 14, 2009 WASHINGTON COUNTY - A group of area residents doesn’t like the Plaza Hotel’s new pool policy: For guests only. Dozens of people from the community, many of them senior citizens, have used the pool in recent years as paying members of an “adult health club” at the hotel. But the arrangement ended last month because it didn’t meet a state health code that requires, among other things, lifeguards for public pools. The Washington County Health Department first told the Halfway hotel in 2001 it couldn’t offer public pool access without meeting certain regulations, department spokesman Rod MacRae said. The hotel was supposed to stop, but the health department learned this past November the program was still going on, MacRae said. Erma Renner, the hotel’s general manager, said she disbanded the club in the middle of December. Some swimmers, such as Dr. Richard Young, are upset and either don’t want to go elsewhere or say they can’t. Young, 87, who lives north of Hagerstown, questioned why lifeguards are needed to protect community swimmers, but not hotel guests, calling it “a question of semantics.” He said he paid $35 a month to swim at the hotel. Swimming was helpful exercise after he tore cartilage in his knee two years ago, he said. Jill Keefer of Halfway said she swam at the Plaza Hotel on and off for about 14 years. It was a good place for therapy for arthritis or a knee replacement, she said, but Keefer was there for recreation. Young, Keefer and nine others signed an protest letter to the editor of The Herald-Mail blasting the health department. “Hydrotherapy is a great asset for body building and outweighs the ‘brain therapy’ being exerted by our local health officials,” the letter says. “If change is not made, these 200+ people can rot and die peacefully at home from poor health, thanks to our health department.” MacRae said it was up to hotel management to decide how to follow the law. “We did not close the pool,” he said. Under state law, hotel pools are generally “semipublic,” said Pamela Engle, chief of the Division of Community Services within the Maryland Department of Health & Mental Hygiene. A semipublic pool has lesser requirements than a public, or “recreational,” pool, which must have a lifeguard on duty and meet more stringent water-quality standards. MacRae said that by charging the public a fee to swim there, the Plaza Hotel had in effect operated a recreational pool without telling the health department. Renner said she tried to phase out the club in November by cutting off new membership and letting current members finish the time for which they paid. But when some club members complained further, Renner stopped the program entirely in December, she said. The Clarion Hotel & Conference Center in Hagerstown had a similar membership system for community use of its pool. Co-owner Lata Milner said she and her husband ended the program when they bought the hotel last year. Some people weren’t happy, but it created safety, security and liability concerns, she said. “There’s plenty of public pools around,” she said. Keefer said community swimmers haven’t given up on using the Plaza Hotel pool again and hope the state representatives they’ve contacted can help change the law. Or maybe, she said, some swimmers can get lifeguard certification, qualifying them to watch over the group. Copyright 2009 Hagerstown Herald-Mail. Health takes a dive Hagerstown Herald Mail- Letter to the Editor Wednesday, January 14, 2009 To the editor: Under a very silly and complex ruling (COMAR10.17.01) our health officials have prevented over 200 individuals from exercising their bodies to relieve pain and increase their strength and vitality at a local wonderful swimming pool. This all boils down to a question of semantics such as "public swimming pools," "semipublic pools" and "recreational pools" as delineated in the COMAR. When translated into English it means the following. If you pay for a room at a hotel, you can swim in the pool unattended by a lifeguard. You could swim alone but you couldn't possibly drown as per the health department. On the other hand, when a group of people pay a small fee for the purpose of exercising their weary bones and muscles, a lifeguard is required. And usually five to 15 people are always present to look after each other. We can or will probably drown. Baloney. The Plaza Hotel in Hagerstown deserves a sincere vote of thanks for providing these senior citizens an opportunity to utilize the wonderful pool facility in their hotel over the past many years and with a perfectly clean record of no casualties. If the health department is really interested in the health of its citizens, I would feel that they would change COMAR 10.17.01 and enhance the lives of these individuals who have lost a valuable resource to improve their bodies. Hydrotherapy is a great asset for body building and outweighs the "brain therapy" being exerted by our local health officials. If change is not made, these 200-plus people can rot and die peacefully at home from poor health, thanks to our health department. Richard A. Young, M.D. Hagerstown © 1996–2008 The Herald-Mail Company. Families Seeking Insurance For Kids Downturn Forcing Parents to Get Aid By Chris L. Jenkins Washington Post Wednesday, January 14, 2009; B01 Rising unemployment and the sinking economy are driving sharp increases in the number of Washington area families seeking state health insurance for their children, and more of these families are qualifying for coverage, records show. The increases are particularly pronounced in the region's largest and wealthiest jurisdictions as employers cut benefits and eliminate jobs. In Fairfax County, for instance, requests for the state's insurance program for children, Family Access to Medical Insurance Security (FAMIS), were up 16 percent between November 2007 and November 2008. In Alexandria, caseloads increased 20 percent, and in Loudoun, they were up 16.5 percent. Overall, caseloads in Northern Virginia shot up 18 percent during that period, from 19,299 to 22,692, compared with 7 percent for the rest of the state. In Maryland's Washington suburbs, caseloads for the state's insurance plan for children have increased about 4 percent, from about 45,000 to 47,000. Not only are caseloads up, but the number of people applying for such coverage has increased substantially too. Last week, the Virginia Department of Medical Assistance Services reported that the number of people applying for FAMIS increased an average of 24 percent a month in 2008 over 2007, from 5,073 a month to 6,291. This included a 40 percent increase in applications in September and October 2008 over the same two months in 2007. In addition, the number of applications approved increased 10 percent statewide from 2007 to 2008. In Maryland, where eligibility levels are more generous than in Virginia, officials in Montgomery, Prince George's and Howard counties said they have seen an increase in applications for the Maryland Children's Health Program (MCHP) as well. For instance, the number of people applying for the program in Montgomery County increased almost 16 percent in October 2008 from a year earlier, from 3,977 to 4,599. The District does not keep separate statistics on the number of children enrolled in its program, officials said. "These generally seem to be people who, when times were good, didn't need this kind of help, but now with the economic downturn and loss of a job, now they may need it," said Sandy Ovuka, public assistance program manager for the Fairfax County Department of Family Services. Social services officials and advocates for the poor say the numbers reflect the worsening recession and the larger problem of millions of uninsured Americans. There is a direct correlation between the increase in the number of children seeking state-sponsored coverage and the number of adults who lose their jobs or can no longer afford employer-sponsored coverage, national studies have found. Although more families are finding that they qualify for coverage for their children, many of the parents still make too much money to qualify for government-sponsored coverage, such as Medicaid, for themselves. The increase in requests for assistance also burdens already stretched state budgets. Each state runs a children's health insurance program paid for by a combination of local and federal dollars that covers families whose annual income is too high to qualify for Medicaid. Generally known as the State Children's Health Insurance Program (SCHIP), the eligibility requirements are usually much more generous than publicly financed health insurance for adults who are not elderly or disabled. In Virginia, a family of four making less than $42,400 a year -- or 200 percent of the federal poverty level -- is eligible for the insurance, although some states add money to expand the coverage to a broader group. In Maryland, a family of four making up to $63,600 qualifies for some health care aid for their children. Expanding SCHIP is a top priority of president-elect Barack Obama. And with an Obama administration, congressional Democrats hope to succeed in expanding SCHIP where they failed with President Bush; they begin today by taking up debate on whether to expand the program from 6 million children to 10 million. Congress passed a program expansion twice, only to have the bills vetoed by Bush, who said that the measures expanded coverage to families that made too much money. Caseworkers and advocates for the poor said that in many cases the new enrollees are children in families where one parent has lost a job, decreasing the family's income to a level that qualifies them for state help. "We also get a lot of cases where people can no longer afford their health plans," said Meredith McKeen, a program manager for Northern Virginia Family Service. "Circumstances are changing very quickly." For years, Fawn Miller's family received health insurance through her $31,000-a-year job at a financial services company near Tysons Corner. Her husband, Richard, makes $36,000 a year as a contract truck driver but doesn't receive health benefits. So when she lost her job as an administrative assistant in October, the family lost her income and benefits. The couple's three children, ages 9, 11 and 14, have qualified for FAMIS, although neither adult has coverage. The parents don't qualify for Medicaid, and Miller cannot afford COBRA coverage, the federally sponsored insurance program for the recently unemployed. "When I walked in, I still didn't think I'd be eligible, I thought we would make too much," said Fawn Miller, 38, referring to the FAMIS program. She said this was the first time she or Richard, 45, had ever been on public assistance. "We're hoping things look up in the coming months, but I admit it's been an odd situation. We're not really poor, but we kind of are." Nationally, experts have raised concerns about the rising unemployment rate's impact on health-care coverage. On Friday, the Kaiser Family Foundation released a report estimating that now that the unemployment rate has reached 7 percent, an additional 2.6 million people nationwide might become uninsured. The report estimated that Medicaid and SCHIP enrollment could increase by 2.4 million. If the unemployment rate hits 10 percent, the report estimates, Medicaid and SCHIP enrollment would increase by 5.4 million. "We found that people who are getting SCHIP for their children are people who have never had any public assistance before and never dreamed that they would ever have to do that," said Diane Rowland, executive vice president for the Kaiser Family Foundation. Joe Antos, a researcher in health-care and retirement policy at the American Enterprise Institute, said that the number of families needing public health-care coverage if they become unemployed depends partly on how long the recession lasts. An increase in public health-care enrollees "is certainly plausible, but many of them are going to have to figure out how to apply," he said. "In many cases, people who have never looked for these kinds of services don't even know they exist or that they would be eligible." Copyright 2009 Washington Post. O'Malley's budget proposal to include layoffs State needs to make up a nearly $2 billion budget shortfall By Gadi Dechter Baltimore Sun Wednesday, January 14, 2009 Facing a nearly $2 billion budget shortfall in fiscal 2010, Gov. Martin O'Malley said this morning that he will ask the legislature to approve layoffs of state workers as part of a budget proposal he will submit next week. An administration source said the number of layoffs proposed would be between 500 and 1,000. The Maryland General Assembly begins its 90-day legislative session later today. O'Malley, a Democrat, said his administration has also been asking labor unions for "health care concessions" such as asking state workers to contribute more toward their health benefits, but he told reporters that federal bailout money could prevent the need for such actions. During the taping of a radio program in Annapolis, O'Malley offered additional hints about his strategy for presenting a balanced budget during a national economic meltdown that has already required him to hack hundreds of millions from the state's current $14 billion operating budget. Most state agencies will see no increases to their budgets, or reductions, O'Malley said, though he plans to ask for a $25 million to $30 million increase to higher education that would allow Maryland's public universities to extend a three-year tuition freeze into a fourth. Earlier, Senate President Thomas V. Mike Miller said he did not believe a tuition freeze could be sustained, setting up a potential area of conflict between the governor and legislature, which must approve O'Malley's budget. Budget discussion and debate are likely to dominate this year's legislative session, and as lawmakers returned to Annapolis they repeatedly invoked hope that President-elect Barack Obama will send budget-strapped states hundreds of millions in stimulus funds. Miller said he hoped that the amount of a federal stimulus package to states would be known before the session adjourns, so that lawmakers can lessen budget cuts accordingly. Miller and House Speaker Michael E. Busch, both Democrats, said they hoped to tap a $366 million reserve fund in the comptroller's budget to plug part of a $1.9 billion projected revenue gap. But even with such fund transfers, they said, major cuts next year would affect state aid to local governments. Busch and Miller both pledged to maintain funding for about 25,000 Marylanders currently enrolled in Medicaid coverage under a law passed in 2007. Copyright 2008 Baltimore Sun. State leaders looking for federal money to close budget deficit By Andy Rosen Daily Record Wednesday, January 14, 2009 ANNAPOLIS — Gov. Martin O’Malley and many lawmakers are hoping for federal help in closing a projected $1.9 billion budget deficit during Maryland’s 90-day General Assembly session, which starts Wednesday. Republicans and Democrats gathered with their respective caucuses at public events and discussed how they hoped to reckon with declining state revenue that has left projected spending for fiscal 2010 out of whack. Democrats, who control both chambers of the General Assembly, are hoping to get money from the federal government. Congress is working on a stimulus package that may help state governments pay for infrastructure, health care and other costs. That may help the state maintain some spending that otherwise could be cut. Gov. Martin O’Malley said Tuesday that he plans to introduce a budget by the end of the month with $1.9 billion in spending cuts. He said public education is one of the only things that will grow in his budget, while most components will have to make do with what they have for fiscal 2009, or potentially less. The enthusiasm among Democrats for stimulus spending was clear as U.S. Rep. Chris Van Hollen, who represents Maryland’s 8th District, addressed the state party at a legislative luncheon. “Help is on the way for the states,” Van Hollen said, drawing a standing ovation from the assembled crowd. Maryland House Speaker Michael E. Busch, D-Anne Arundel, said at the party luncheon that he believes stimulus spending will help keep the severity of state spending cuts to a minimum. He pointed out that the state’s budget troubles are a result of wider economic trouble that has caused the state’s two main revenue sources — the personal income and sales taxes — to fall well short of expectations. “Through no fault of our own, we’re in a national recession,” Busch said. “And we are hopeful that part of that stimulus package is going to come back to Maryland and keep our priorities and programs where they are today.” In an afternoon briefing, Republicans questioned whether the state’s budget trouble was entirely beyond the General Assembly’s control. House Minority Leader Anthony J. O’Donnell, R-Calvert and St. Mary’s, said he believes that some of the more than $1 billion in tax increases that were passed during a special session in 2007 may have hurt the economy or further slowed tax receipts. Republicans are studying potential tax relief proposals, and argued Tuesday that a decreased tax burden could help the economy. Budget and Management Secretary T. Eloise Foster, who addressed the Republican group, said her department is contemplating some federal help as it crafts its 2010 budget, but is trying not to assume too much while the fate of the stimulus remains up in the air. O’Malley said he expects the state’s aid to local governments to be hit by budget reductions. He said in previous discussions over the budget, when the state was seeking to close a $1.7 billion gap in 2007, he attempted to keep local governments safe from cuts because that deficit had to do with planned state spending, rather than economic circumstances beyond Maryland’s control. “This is a different sort of problem,” he said, “and all levels of government are going to be hurt.” Copyright 2009 Daily Record. UnitedHealth to set up new pay-rate database By Chicago Tribune Baltimore Sun Wednesday, January 14, 2009 CHICAGO - Ending a practice doctors say underpaid them and led to higher costs for patients, UnitedHealth Group agreed yesterday to pay $50 million to establish a new database that will be used to determine rates for patients who choose physicians outside of the insurance giant's network. Consumers know the so-called network as the preferred list of doctors. Patients can get discounts or lower-priced care if they find a doctor within the network. But allegations against the Minneapolis-based health insurer by New York Attorney General Andrew Cuomo said a UnitedHealth subsidiary known as Ingenix Inc. was rigged to limit payments to doctors and, therefore, forced consumers to pay more. Cuomo also alleged that there was a conflict of interest because UnitedHealth owns the database. When consumers visit an out-of-network physician, health plans are known to pay 80 percent of the reasonable and customary rate charged by doctors often in the same geographic area. The patient then pays the rest, which often totals less than what the doctor charges. Cuomo and doctor groups say a new nonprofit database will establish reasonable and customary rates. UnitedHealth provides health benefits to 26 million Americans. But because other health plans use the Ingenix database, Cuomo and the American Medical Association say the impact is much broader. "During these tough economic times, this agreement will keep hundreds of millions of dollars in the pockets of over 100 million Americans," Cuomo said in a statement. Chicago Tribune. Va. company recalls peanut butter nationwide Hagerstown Herald-Mail Wednesday, January 14, 2009 LYNCHBURG, Va. (AP) -- A peanut butter maker that sells bulk supplies to institutions issued a nationwide recall of peanut butter from one its plants because of possible contamination with salmonella. Lynchburg-based Peanut Corp. of America company issued the recall late Tuesday for 21 lots of peanut butter made at a plant in Blakely, Ga., plant on or after July 1. The company said none of the peanut butter being recalled is sold through retail stores. Its peanut butter is made for bulk distribution to institutions, food service industries and private label food companies. The company said the peanut butter is sold under the brand name Parnell's Pride and by the King Nut Co. as King Nut. Health officials on Tuesday confirmed the deaths of two people in Virginia and one in Minnesota associated with a national salmonella outbreak that has sickened more than 400 people in 43 states. The health officials had recommended nursing homes, hospitals, schools, universities and restaurants discard specific containers of peanut butter linked to the outbreak. The recall was issued after an open container of King Nut peanut butter in a long-term care facility in Minnesota was found to contain a strain of salmonella. "We deeply regret that this has happened," Stewart Parnell, owner and president of Peanut Corp. of America, said in a news release. "Out of an abundance of caution, we are voluntarily withdrawing this produce and contacting our customers." Customers were notified by telephone and in writing, the company said. The Centers for Disease Control has said the outbreak may have contributed to the three deaths. Two adults in Virginia and an elderly woman in Minnesota had salmonella when they died, though health officials said the causes of death hadn't been determined. Besides the Georgia plant, Peanut Corp. of America has plants in Suffolk, Va., and in Plainview, Texas. © 2009 The Associated Press. All rights reserved. Open-plan offices lead to stress, flu and raised blood pressure, study finds By Marc Onigman Corporate Fitness and Wellness Today Tuesday, January 13, 2009 They were hailed as the workplaces of the future more than 100 years ago, but open-plan offices are making us 'shockingly' sick, experts have found. The noise, overcrowding and invasion of privacy can raise workers' blood pressure and lead to stress, exhaustion and flu, they claim. Academics found that employees' lack of personal space can make them feel insecure and aggressive, reducing their concentration span and lowering their productivity. Dr. Vinesh Oommen, a public health expert at Queensland University of Technology, in Brisbane, Australia, reviewed all past research into how open-plan workplaces affect workers. He said: 'The evidence we found was absolutely shocking. In 90 per cent of research, the outcome of working in an open-plan office was seen as negative. Open-plan offices caused high levels of stress, conflict, high blood pressure and a high staff turnover. 'Everyone can see what you are doing on the computer and hear what you are saying on the phone, and there is a feeling of insecurity. 'There is also a higher chance of workplace conflicts - sitting so close to someone each time their phone rings, you can get irritated. Most of us can relate to that.' Workers react by becoming territorial and putting up photos and cards at their workstation, the study found. But money-saving employers favour vast rows of desks over traditional smaller rooms. And managers believe that they encourage 'interaction' to get creative juices flowing, the study revealed. Dr Oommen called on bosses to abandon their 'one size fits all' mentality. He said: 'The research found that the traditional design was better - small, private, closed offices. 'The problem is that employers are always looking for ways to cut costs. 'But having a office environment that promotes health and high productivity would be more beneficial to employers in the long run.' Open-plan offices became popular in America after mechanical engineer Frederick Winslow Taylor promoted his 'scientific management' design for ultra-efficient mass production in the 1890s. Clerical workers were lined up in rows in large rooms and tasks were divided into repetitive acts, allowing an uninterrupted flow of work and close supervision by managers, who often had their own office. Copyright 2009 The Stone Hearth Fitness Newsletters. Woman who rehabilitated foxes gets criminal charges Harriett Crosby did not have permit to care for wildlife, accused of assaulting officer By Erin Donaghue Montgomery Gazette Wednesday, January 14, 2009 Criminal charges have been filed against a Cabin John woman who was nursing two red foxes back to health in her home in December when they were confiscated by the Maryland Department of Natural Resources and euthanized. The charges, which encompass violations of both criminal and natural resources law, include two counts of possession of a dangerous animal; possession of natural Maryland wildlife without a permit; four counts of failure to obey a lawful order of a police officer and second-degree assault, according to Sgt. Ken Turner, a spokesman for Natural Resources Police. A preliminary hearing is scheduled for Feb. 10 in Montgomery County District Court. Harriett Crosby, 63, was rehabilitating the two foxes, one of which was sick and one of which was injured, when a Natural Resources officer knocked on her door in response to a call from a concerned resident last month. Crosby was given a written citation which gave her 45 days to obtain a permit to rehabilitate wildlife - which she did not have - or to get rid of the foxes. However, a few days later the officer returned to confiscate the foxes. They were euthanized the same day. Crosby's nephew, Brett Kimberlin, obtained an injunction from a judge to halt the euthanasia, though the foxes were dead before the message reached the Montgomery County Humane Society. According to DNR, it is a violation to remove wildlife from the wild without a permit. Those who attempt to rehabilitate wildlife can often do more harm than good if they are not properly trained, according to DNR officials. Turner would not provide details pending trial, but said Crosby allegedly assaulted the police officer who was confiscating the foxes. Crosby is not licensed to rehabilitate wildlife through DNR, though she has taken a certification course and has rehabilitated animals in the past, she has said. The older fox, who she called Munchkins, had been injured, while the younger fox was believed to have been poisoned, she said. Crosby hoped to release the animals back into the wild after they were well enough to survive on their own. The officer returned to confiscate the foxes after conferring with a biologist in the group's Wildlife and Heritage Services division, which deals with wildlife, Turner said. The officer realized after issuing the written violation that because foxes are at high-risk for carrying rabies, they posed a public safety risk, Turner said. "We don't enjoy being placed in a very difficult situation like this due to the wrongdoing of an individual who removes wildlife from the wild and puts them into captivity," Turner said after the incident. "It's a terrible position." The Department of Health and Mental Hygiene issued the order to euthanize the foxes in order to test them for rabies, according to Capt. Mike Wahl of the Montgomery County Police's Animal Services Division. Animals must first be euthanized to test for the virus. Crosby said she was devastated by the foxes' deaths and may pursue a lawsuit. Kimberlin, who was with his aunt when the foxes were confiscated, said Crosby did not assault the officer. He said Crosby was attempting to drive the animals to a wildlife rehabilitator when the officer pulled her out of her car and told her to kneel on the ground and put her hands on the vehicle. "She never assaulted them, they assaulted her," Kimberlin said. "… He was pulling her out of the car and wrestling her and she was trying to break free." Copyright © 2009 Post-Newsweek Media, Inc./Gazette.Net. House Set to Pass Child Health Bill Some Complain It Falls Short of Obama's Vow of 100% Coverage By Shailagh Murray and Ceci Connolly Washington Post Wednesday, January 14, 2009; A15 The House is poised to give Barack Obama a quick legislative victory by approving a bill to expand a health insurance program for children, making a down payment on the president-elect's promise to provide coverage to every child in the country. The bill, scheduled for a vote today, would expand the State Children's Health Insurance Program, a popular initiative created during the Clinton administration that helps children living at or near the poverty line who fall outside the Medicaid system. The House bill carries an estimated cost of $33 billion over 4 1/2 years and would extend coverage to an additional 4.1 million children, on top of the 7 million who are currently enrolled. It would be paid for primarily through a 61-cent-per-pack increase in the federal cigarette tax. In 2007, President Bush twice vetoed similar legislation, objecting to its broader reach and its reliance on the tobacco tax hike. Bush's unwavering position was cheered by conservatives but caused political problems in 2008 for Republican candidates in more moderate states and districts. Obama vowed as a candidate that one of his first acts in the White House would be to sign the long-stalled bill. It will not be ready on Inauguration Day, but congressional leaders hope to complete work well before the program's March 31 expiration date. The one remaining sticking point concerns the fate of recently arrived legal immigrant children and pregnant women. They are currently required to wait five years before applying for coverage. The House bill would give states the option of allowing legal immigrants into the program. The Senate version, released Monday afternoon by Finance Committee Chairman Max Baucus (D-Mont.), would maintain the status quo, although Baucus said he looks forward to an opportunity to support addition of the immigrant provision as the bill moves forward. Some supporters of the expansion, while urging quick action, said it nevertheless falls short of Obama's campaign pledge to guarantee health care for every American child. "This is certainly not the promise to cover every child that the president-elect ran on," said Susan Gates, general counsel at the Children's Defense Fund, who said the legislation would still leave as many as 5 million children with no insurance and millions more with intermittent or partial coverage. Rep. Diana DeGette (D-Colo.), a proponent of the House bill, conceded the gap but said it would shrink significantly. "This is going to get money to states so they can insure the children of the working poor who are losing their jobs," DeGette said. "The great majority of American people believe we should give kids health insurance." GOP opposition does not appear to have softened. A Jan. 12 letter to Obama and House Speaker Nancy Pelosi (D-Calif.), signed by 122 House Republicans, spelled out four areas of concerns with the House bill: its failure to address serious Medicaid shortcomings; the immigrant provision; the potential threat to private health coverage; and unspecified "budget gimmicks" that would fund the expansion. Advocates for the bill, while cheering its revival, fear that an early victory could take pressure off Obama and congressional Democrats to go further. "I am concerned there will be a sense we're done with this and move on to the next issue," said Irwin Redlener, a Columbia University professor and president of the Children's Health Fund. When Bush vetoed similar bills in 2007, he called the legislation a move toward "government-run health care." Like many conservative Republicans, Bush has promoted private-sector-based incentives to expand coverage. John Goodman, president of the conservative National Center for Policy Analysis, said one option would be to give parents a refundable $1,000 tax credit for each child they could prove was insured. The Senate Finance Committee will debate a similar bill tomorrow, estimated to cost $31.5 billion over 4 1/2 years, that does not include the state option on legal immigrants. It does add a state option for pregnant women. Senate floor action could come next week. Sen. Olympia Snowe (R-Maine), a longtime supporter and a member of the Finance Committee, said the panel will seek to move the bill quickly, although it also has a primary role in crafting another urgent measure, the economic stimulus package. "Hopefully we can work it through," Snowe said of the lingering disputes. The expansion comes at a critical time for states, which are seeing a spike in applications for government assistance and a decline in tax revenue as a result of the economic downturn. As of November, at least 43 states were facing budget deficits totaling about $140 billion, according to a report by the liberal advocacy group Families USA. Copyright 2009 Washington Post. CDC Confirms Salmonella Link Peanut Butter Made in Lynchburg May Be Source of Outbreak By Michael Birnbaum Washington Post Wednesday, January 14, 2009; B03 The Centers for Disease Control and Prevention confirmed a link yesterday between peanut butter and a salmonella outbreak that has sickened more than 400 people in 43 states. Two people in Virginia and one in Minnesota who died recently were found to have the bacterial infection, but health officials cautioned that it was not clear whether the infection was the cause of death or whether any of the dead had eaten peanut butter. Phil Giaramita, a state Department of Health spokesman, said those who died in Virginia were adults in the western part of the state. Five cases of salmonella infection have been reported in Virginia since the weekend, bringing the total in the outbreak to 17, but it was not clear whether the five were recent. The other 12 were diagnosed Dec. 13 or earlier. A Minnesota nursing home resident in her 70s died after contracting the illness, according to state health officials, but it was not clear whether salmonella was the direct cause of death. Maryland Department of Health spokesman John Hammond said the state has received reports of seven cases of salmonella infection with a matching genetic strain, but nothing in recent days. "It is a complex, widespread outbreak," said Lola Russell, a CDC spokeswoman. Health officials are urging nursing homes, hospitals, schools and restaurants to throw away containers of peanut butter that have been linked to the 43-state salmonella outbreak. The peanut butter, manufactured by Lynchburg-based Peanut Corp. of America and distributed by King Nut Cos. of Solon, Ohio, was recalled by the distributor Sunday. It was distributed to food-service providers and not sold directly to consumers. King Nut has challenged the link to its peanut butter, saying that it could not have been the source of a nationwide outbreak because it only does business in seven states. Minnesota officials found a match this weekend between samples from an open King Nut container and the strain of salmonella bacteria that has made people sick nationwide. And a Minnesota health department spokesman said that all of the patients in that state had consumed peanut butter, with most eating the same brand. King Nut raised the possibility that the salmonella had come from another source because it had been found in an open container, not a sealed one. The Associated Press contributed to this report. Copyright 2009 Washington Post. Sexually Transmitted Disease in America By Jennifer Huget Washington Post Wednesday, January 14, 2009 The U.S. Centers for Disease Control and Prevention yesterday released a report on the state of sexually transmitted disease (STD) in 2007. It paints a pretty grim picture. Consider: * There are about 19 million cases a year; half of them among people ages 15 to 24. And that figure only represents the three "reportable" STDS -- gonorrhea, chlamydia and syphilis. Infections such as genital herpes and human papillomavirus aren't included in the tally. * Chlamydia has reached an all-time high, with more than 1.1 million cases recorded. But while this bacterial infection is easily treated with antibiotics in its early stages, the disease rarely causes symptoms and often goes undiagnosed, potentially leading to infertility and pregnancy complications. Officials think the actual number of cases in the U.S. is closer to 2.8 million. * Syphilis had been beaten back to an all-time low number of cases in 2000, after which its incidence remained steady until 2006, when the number of cases rose by 15.2 percent. Worse yet: its transmission from mothers to babies rose in 2007 for the second year in a row. * Syphilis appears to make the AIDS-causing human immunodeficiency virus (HIV) more readily transmitted from person to person. * Gonorrhea cases had been cut by 74 percent from 1975 to 1997, but since then has remained stable. There's growing concern that gonorrhea is developing resistance to the antibiotics used to treat it. * Though only 12 percent of the U.S. population is black, 70 percent of gonorrhea cases and almost half of all cases of chlamydia and syphilis occur among black people. * The CDC estimates STDs cost the U.S. healthcare system as much as $15.3 billion annually (in 2007 dollars). The CDC says changing these trends will require increased screening, testing and treatment, behavioral interventions and education efforts at the local, state and federal levels. That will cost money. And in this economic climate, there's not much money to spare. Copyright 2009 Washington Post. 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