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			Thursday, January 15, 2009 News Clipping Archives Governor plans to lay off hundreds of state workers (Baltimore Sun) O'Malley: State layoffs likely (Annapolis Capital) City sets rule against individual cigar sales (Baltimore Sun) Howard making head way on Healthy Howard (Baltimore Examiner) Our Say: North county hospital expansion a major milestone (Annapolis Capital) Peanut butter crackers recalled amid possible salmonella link (Baltimore Sun) Maryland health advocates push to keep Medicaid expansion (Baltimore Examiner) House votes to expand health insurance program to 4 million more children (Baltimore Sun) House Votes to Expand Child Health Insurance (Washington Post) Md. stores stop selling Elmo toy due to excessive lead paint (Baltimore Sun) Finding Havens for the Homeless (Washington Post) Same old (toxic) story (Baltimore Sun) Missed opportunity (Baltimore Sun) Obama pick for EPA chief to assess coal ash disposal sites (Baltimore Sun) Bay cleanup effort must tackle harmful chemicals (Baltimore Sun) Viewpoint: Non-native oysters may endanger human health (Baltimore Sun) A Vaccine's Unintended Consequences (Washington Post) Dangerous Cribs, Drugstore Doctors and Rising S.T.D.’s (New York Times) Study Finds Drug Risks With Newer Antipsychotics (New York Times) Governor plans to lay off hundreds of state workers O'Malley, legislature faced with closing $1.9 billion budget shortfall By Gadi Dechter and Laura Smitherman Baltimore Sun Thursday, January 15, 2009 Gov. Martin O'Malley is planning to lay off hundreds of state workers and is asking for other labor concessions to help close a nearly $2 billion budget gap projected for the fiscal year that begins in July. That warning came hours before the Maryland General Assembly convened yesterday with ceremonial speeches pledging "One Maryland" unity. But signs of discord soon surfaced between the Democratic governor and lawmakers, who must ratify the budget, revealing tensions aggravated by economic woes that are sure to grow as the 90-day session unfolds. When he submits his budget next week, O'Malley will ask the legislature to approve between 500 and 1,000 layoffs, aides said, in an executive branch work force of more than 70,000. But Senate President Thomas V. Mike Miller objected, arguing that local governments should shoulder more budget cuts instead. "State employees can only do so much," Miller said. "Most of the counties haven't had any furloughs. They haven't had any layoffs, and they've gotten pay increases. ... Everybody's got to pay their fair share ... and that means the counties are going to have to step up just like the state." The O'Malley administration has also been negotiating with labor unions representing tens of thousands of state workers, asking workers to pay more for their health care benefits. But the largest union, whose members have already been furloughed, is balking at the requests. As lawmakers and lobbyists swarmed back to Annapolis, many eyes were fixed on Washington and hope for a federal bailout for the state. Inside the ornate House and Senate chambers, politicians pledged their commitment to public service but left the real work to the days ahead. In addition to the budget, the talk was about looming legislative battles on police spying, urban sprawl, climate change and the death penalty. "We have never been so needed as we are today," O'Malley told a packed House chamber. "So we're going to step up." By law, Maryland must maintain a balanced budget. O'Malley has already had to hack hundreds of millions from his current $14 billion operating budget to compensate for plummeting tax receipts amid a global economic meltdown. During a radio interview recorded yesterday morning, he held out hope that "very serious layoffs" might be lessened if President-elect Barack Obama persuades Congress to send hundreds of millions in stimulus money to Maryland through a bailout program. Federal money is a "huge variable" and could improve the bleak budget outlook, he said. Most state agencies will see neither increases nor reductions to their budgets, O'Malley said, though he plans to ask for a $25 million to $30 million increase for higher education that would allow Maryland's public universities to keep tuitions frozen for a fourth consecutive year. Miller, however, said he did not believe a tuition freeze could be sustained, another potential area of conflict between the governor and legislature. Miller and House Speaker Michael E. Busch, both Democrats, said they would consider tapping a $366 million reserve fund in the comptroller's budget to plug part of the $1.9 billion projected revenue gap. O'Malley said such a move could spare local governments from some, but not all, cuts in state funding. Republicans, far outnumbered by Democrats in both chambers, said they hope to be included in budget discussions, and they vowed vigilance against any tax increases. The American Federation of State, County and Municipal Employees, the largest union for state employees, has been in negotiations with O'Malley's administration in recent days. Maryland director Patrick Moran said union members oppose layoffs and shifting health care costs and he is confident the two sides will achieve a "middle ground" settlement. "Our union is fighting tooth and nail to maintain health care benefits and to make sure we do not have budgets balanced on the backs of state employees who provide essential services every day to the people of Maryland," Moran said. Miller predicted an "extremely contentious" legislative debate over an O'Malley-backed bill to strengthen state efforts at curbing urban sprawl. It could be opposed by local governments worried about preserving their land-use authority, but Miller said that, ultimately, "we're going to pass some meaningful legislation." Busch predicted that another of O'Malley's priorities - a bill limiting State Police authority to spy on political activists - would become law. The governor's legislation will address a Maryland State Police surveillance program that included troopers infiltrating peaceful protest groups and wrongly labeling dozens of activists as terrorists in a police database. Col. Terrence B. Sheridan, the State Police superintendent, has called the operation, which began in 2005 under a different superintendent, "disconcerting" and said his agency has abandoned the practice. State Sen. Jamie Raskin and Del. Sheila E. Hixson, both Montgomery County Democrats, plan to jointly sponsor anti-spying bills, said Del. Samuel I. Rosenberg, a Baltimore Democrat. Rosenberg, who plans to co-sponsor the House measure, said the bill likely will "be more extensive" than the governor's, in that it asks for tight controls on when information gathered by police can be forwarded to federal databases. The opening day came with its usual pomp. As expected, Busch was re-elected unanimously by the House of Delegates to his leadership post. Miller, among the longest-serving legislative presiding officers in the nation, was chosen president by a vote of 44-3, with three Republicans voting against. Noticeably absent was recently indicted Baltimore Mayor Sheila Dixon, who did not join the county executives in opening day festivities. Dixon spokesman Ian Brennan said the mayor - who faces felony theft and perjury charges - had planned to travel to Annapolis but changed her schedule. At a City Hall news conference, Dixon said last week's indictment has had no impact on her plans to push city initiatives in Annapolis, listing tougher gun control legislation as a priority. Baltimore Sun reporters Julie Bykowicz and Annie Linskey contributed to this article. Copyright 2009 Baltimore Sun. O'Malley: State layoffs likely Md. counties also should brace for cuts as General Assembly session begins By Liam Farrell Annapolis Capital Wednesday, January 14, 2009 As the General Assembly opened today, Gov. Martin O'Malley kicked off the morning with bad news for state employees: They face layoffs unless the federal government steps in quickly to help struggling states. Cutting raises, cost-of-living increases and making employees pay more for health benefits also are being discussed, Mr. O'Malley told reporters shortly before the session opened in Annapolis. His budget is set to be released next week. "Eventually, you get to a point where you can cut no further without cutting real priorities," Mr. O'Malley said. "We have to submit a budget that is intellectually honest … There is really no guarantee (federal help) will pass in time." One of the only bright spots of the session will be education funding, which the governor said will be one of the few areas to see a budget increase. During several events on the eve of the session yesterday, Mr. O'Malley and other legislators emphasized the beneficial results of the record education funding from the past two years, including Education Week ranking Maryland as the best school system in the nation. "There is a correlation between that investment in education and the fact that we have a lower unemployment rate in the state (than other parts of the country)," House Speaker Michael E. Busch, D-Annapolis, said at yesterday's annual Democratic party luncheon. "The number one issue in creating jobs and keeping people in the workforce … is an educated workforce." Education will be the "strong horse" pulling the state through its current economic swamp, the governor said. "That's an economic asset to have a school system, to have colleges that are as high-performing as ours," he said. Beyond education, however, counties had better brace for cuts. "Local aid to counties will have to be cut, reflecting the downward revenue trend," Mr. O'Malley said. "In the past we were able to totally hold counties harmless as we corrected our mistakes at state government … This is a different sort of problem and all levels of government are going to be hurt." During a meeting with the House and Senate Republican caucuses, both the governor and leaders of the minority party indicated a need to work together in the coming weeks. Republicans have been advocating for steep budget cuts for years, but Democrats have been largely resistant, defending the taxes as necessary to keep progressing on issues such as education. "We will meet you halfway," House Minority Whip Christopher Shank, R-Washington told the governor. "Dissent and disagreement does not necessarily need to be personal … (and) it also ultimately means a better policy outcome for all of us." Besides the hope of bipartisanship, the session will be heavily defined by a hope that the federal government will step in and help the budget problems of states. One of the lines that garnered the largest applause at the Democratic luncheon yesterday was from U.S. Rep. Chris Van Hollen of Montgomery County, who promised that Maryland would not face the fiscal crisis on its own. "We are all looking forward … to working together to get things done," he said. "Help is on the way." Copyright 2009 Annapolis Capital. City sets rule against individual cigar sales Cheap smokes would have to be sold by fives, to discourage kids By Annie Linskey Baltimore Sun Thursday, January 15, 2009 Saying she wants to put cigars out of the reach of young adults, Baltimore Mayor Sheila Dixon announced a new city rule that inexpensive cigars must be sold in packets of five or more. "Single cheap cigars are becoming quite popular," Dixon said at a City Hall news conference. "These products are addictive and deadly." Single cigars often cost as little as 50 cents at city corner stores, and people often empty them and refill them with marijuana. The new regulation, which will go effect Oct. 1, includes cigars that cost $2.50 each or less. Violators could receive a warning and then a fine of up to $1,000. The city's health commissioner, Dr. Joshua M. Sharfstein, proposed a draft of the regulation in May. He noted yesterday that the new rule makes cigar sales consistent with the regulations requiring cigarettes be sold in packs of 20. Dixon said she will also introduce a City Council bill banning individual cigar sales. Young adults in the city are "sensitive to price," Dixon said, and requiring the cigars be sold in packets would drive up the consumer cost of the product, putting it beyond their means. Bruce C. Bereano, a lobbyist for the Maryland Association of Tobacco and Candy Manufacturers, questioned the mayor's motives, saying he believes she is really trying to ban all smoking in the city. He said that only the General Assembly, which has twice failed to pass bans on selling individual cigars, has the authority to make such rules. "The notion that they are trying to sell to kids is absurd," Bereano said. National research cited in the regulation suggests that people are trying cigars at a younger age. The study found that in 2005, people who had tried cigars first did so at the age of 21.1. In 2006, that figure dipped to 19.9. And a 2007 study by public health researchers at Johns Hopkins University found that nearly 24 percent of Baltimoreans ages 18 to 25 had smoked cigars within the previous 30 days. Bereano said the industry has filed a lawsuit to stop similar legislation in Prince George's County. Copyright 2009 Baltimore Sun. Howard making head way on Healthy Howard By Josh Kowalkowski Baltimore Examiner Thursday, January 15, 2009 Howard officials now said they're on track for enrolling about 2,000 residents in the first year of the Healthy Howard Access Plan, a first-of-its kind program in the nation to provide benefits for uninsured residents. "We are getting people insured in every part of the county," said Health Officer Dr. Peter Beilenson, who told the County Council at a meeting this week that 123 residents are either qualified or enrolled in the plan for January, almost double the amount reported just a week ago. Beilenson this month announced a new strategy to more effectively reach those who are uninsured with a goal of signing up 150 to 200 a month. Officials now are specifically targeting: » Contracted and contingent employees who work for the county and don't receive benefits; » Other contracted employees from a database of employers; » Subsidized housing residents; » Howard Community College staff and students; » Parents of children in the Maryland Children's Health Insurance Program, which provides insurance for children up to the age of 19 and pregnant women of any age who meet income guidelines. Residents in subsidized housing, for example, have been responding after county officials personally delivered letters informing them of the health program, Beilenson said. More than 20,000 adults do not have health insurance in Howard County, and about 12,000 could still qualify under Healthy Howard, Beilenson said. About 1,100 residents will receive insurance through existing programs but who didn't qualify for Healthy Howard. Some council members, like Greg Fox, are still skeptical about the county's plan to target specific residents. However, Beilenson deflected any criticism by saying council members should realize the benefit of having residents with insurance and not just those signed up for Healthy Howard. "You should take pride that this county is doing something about this," he said. Liddy Garcia-Bunuel, director of Healthy Howard Inc., the nonprofit administering the Healthy Howard Access Plan, cautioned against a rush to judgment. "This is a program that's the first of it's kind," she said. "We are learning every month how to continue to move forward." Councilwoman Courtney Watson agreed that judgment should be reserved at this time. "We need to keep moving this program forward until we see where we are after a year," she said. For more on stories on Healthy Howard, visit www.baltimoreexaminer.com. Copyright 2009 Baltimore Examiner. Our Say: North county hospital expansion a major milestone Annapolis Capital Wednesday, January 14, 2009 On Monday, Baltimore Washington Medical Center opened the first section of its new, eight-story patient tower. This is a landmark event for north county and for health care across the region. What began 44 years ago as a modest community facility - and was known for most of its history as North Arundel Hospital - has been stepping into a different league entirely in the last few years, and BWMC officials are justifiably proud. This expansion is the latest big step. It will improve the already-formidable professional standing of the hospital, rated a couple years ago as one of the top 100 in the country. It will create more than 100 new jobs. And it will provide better health care for area residents just as the region braces for a wave of growth from expansion at Fort George G. Meade. Once the first phase of the transition is completed next month, the new $117 million tower will house spinal, urological and vascular surgery patients. It will make more complex surgeries possible. Units moving into the building include the outpatient infusion program, the wound and hyperbaric oxygen program, and clinical care. A steady stream of patients will come from the hospital's burgeoning Emergency Department, one of the busiest ERs in the state, expanded as part of this project. And in September, BWMC will open its first obstetrics center, giving expectant moms a choice closer to home than facilities in Annapolis or Baltimore. The hospital, which is part of the University of Maryland Medical System, will now be better positioned to handle the demand for health care in growing west county as well as established communities. Hospital officials expect to attract new doctors and see more medical practices offering services there. Among the thousands of area residents who toured the building during Sunday's open house, one man offered a particularly trenchant observation: The improvements are great, and he wants his doctor to get privileges at the hospital so he doesn't have to travel as much for his care. There's plenty of credit to share for this achievement. Jim Walker, the recently retired president and chief executive officer of the hospital, and his successor, Karen Olscamp, have helped the facility weather an economic downturn. Dr. Larry Linder, chief medical officer and senior vice president, and the hospital staff should be applauded for the smooth transition. Bruce Seeley, BWMC's director of facilities engineering, made sure the construction had the minimum impact on ongoing patient care. And the community deserves a share of the praise. Almost 10 percent of the project was funded through donations. As Baltimore Washington Medical Center moves into this new era, you can look forward to reading more about the expansion's impact on the community. Congratulations to all those who contributed to this. Copyright 2009 Annapolis Capital. Peanut butter crackers recalled amid possible salmonella link Associated Press By Sue Lindsey Baltimore Sun Thursday, January 15, 2009 ROANOKE, Va. - A peanut butter maker that sells bulk supplies to institutions issued a nationwide recall as officials on Wednesday reported two more deaths associated with a salmonella outbreak. Its client Kellogg Co. later asked stores to stop selling a variety of peanut butter crackers. Lynchburg-based Peanut Corp. of America issued the recall late Tuesday for 21 lots of peanut butter made since July 1 at its plant in Blakely, Ga., because of possible salmonella contamination. The company supplies peanut paste to Kellogg, which on Wednesday asked stores nationwide to pull peanut butter crackers sold under the Austin and Keebler brands. Kellogg, based in Battle Creek, Mich., said it hasn't found problems or received complaints about those products. "We are taking these voluntary actions out of an abundance of caution," Kellogg CEO David Mackay said in a release. The national salmonella outbreak has sickened more than 430 people in 43 states. Health officials in Minnesota and Idaho reported Wednesday that one death in each state had been linked to the outbreak. Another death in Minnesota and two in Virginia were confirmed Tuesday. All five were adults who had salmonella when they died, though their causes of death haven't been determined. The U.S. Centers for Disease Control and Prevention said the salmonella outbreak may have contributed. Peanut Corp. of America said none of the peanut butter being recalled is sold through retail stores. Its peanut butter is made for 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. However, the products being pulled from shelves by Kellogg are sold directly to consumers. They include Austin and Keebler toasted peanut butter sandwich crackers, peanut butter and jelly sandwich crackers, cheese and peanut butter sandwich crackers, and peanut butter-chocolate sandwich crackers. Customers and stores are asked to hold onto the Kellogg products, but not eat them, until an investigation is complete. FDA compliance officer Sandra Williams said Kellogg's move is known as a stop-sale order and isn't as serious as a recall. Neither Williams nor a Kellogg spokesman could say how many units were involved, but Williams said, "It's a very large volume." Kellogg spokesman Darryl Riley said federal investigators visited company facilities this week. The Peanut Corp. 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. Health officials had recommended nursing homes, hospitals, schools, universities and restaurants discard containers of peanut butter linked to the outbreak. The peanut butter was in containers between 5 and 50 pounds. "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 phone and in writing, the company said. Kellogg said it gets peanut paste from several suppliers. The Georgia Department of Agriculture so far has found nothing in samples tested from Peanut Corp.'s Blakely plant, spokesman Arty Schronce said Wednesday, but added the testing process can take several days. Authorities have declined to identify the five people who died. But Virginia Health Department spokesman Phil Giaramita said Wednesday the cases there involved an adult over 65 in southwestern Virginia and a younger adult in the northwestern part of the state. Health officials said a man in his 70s who had numerous underlying health conditions was the second person to die in Minnesota, where 13 people have been hospitalized. The Idaho death occurred in the fall. The CDC said it appears most people became ill between Sept. 3 and Dec. 31 but mainly after Oct. 1. King Nut recalled the peanut butter over the weekend in the seven states where it distributed it. King Nut president Martin Kanan had said he didn't want to wait for Peanut Corp. to act. He did not immediately return a message Wednesday seeking comment on the wider recall. Besides the Georgia plant, Peanut Corp. of America has plants in Suffolk, Va., and Plainview, Texas. Georgia agriculture officials have one to three inspectors at the Blakely plant and more people working on the case at the department's Atlanta headquarters, Schronce said. He said peanut butter plants in the state are inspected once or twice a year and more frequently if problems are found. Associated Press writers Doug Glass in Minneapolis, Kate Brumback and Mike Stobbe in Atlanta, David Aguilar in Detroit and Thomas J. Sheeran in Cleveland contributed to this report. Copyright 2009 Associated Press. All rights reserved. Maryland health advocates push to keep Medicaid expansion By Sara Michael Baltimore Examiner Thursday, January 25, 2009 President-elect Barack Obama's economic stimulus package could include Medicaid matching funds for states, which could ease some of Maryland's costs for the expansion. "It's working," Vincent DeMarco, president of the Maryland Citizens Health Initiative, said of the state's recent Medicaid expansion. But even with proposed federal dollars to help states fund Medicaid, Maryland's expanded health care coverage could be in jeopardy as state lawmakers grapple with a hefty budget deficit, health advocates say. Since July 1, more than 25,000 people have enrolled for benefits after they were expanded to cover parents making less than 116 percent of the poverty level, which is about $20,400 for a family of three. Previously, an adult had to make less than half of the poverty guidelines to qualify. Starting this July, health care coverage will be expanded even more to cover nonparent adults making that less than 116 percent the poverty level. But with Maryland facing a $1.9 billion deficit, the expansion could be threatened, health advocates said. "Everything is on the table," said Del. Dan Morhaim, D-Baltimore County, who supports Medicaid expansion. "There's nothing sacred right now, and nothing should be, and each thing needs to be defended." The expansion plan is expected to cost $38 million in fiscal 2009 and grow to nearly $280 million by 2013. Expanding Medicaid reduces the amount of uncompensated care in the state's hospitals, DeMarco said. That reduces the burdens on insured residents, who are left covering those costs, he said. "This is a money saver," he said. Maryland AARP Director Joe DeMattos said he recognized the economic crisis, but said cutting Medicaid would be a poor decision that would affect many Marylanders. "It's not the right time to end this new outreach to those without coverage in Maryland," he said. The latest expansion would help cover adults over 50 who are too young to receive Medicare, but make too much money to qualify for Medicaid, DeMattos said. "These folks will be very well-served by the extension that goes into place in July," he said. It's hard to estimate how many people would be covered under this expansion, he said, but it would likely be in the "high tens of thousands." "It's too soon," DeMattos said, "to pull the rug out for those other Marylanders whose lives could be positively changed." Copyright 2009 Baltimore Examiner. House votes to expand health insurance program to 4 million more children Tribune Washington Bureau By Noam N. Levey Baltimore Sun Thursday, January 15, 2009 WASHINGTON - Congressional Democrats pushing to overhaul the nation's health care system - a major priority of President-elect Barack Obama - notched an early legislative victory yesterday as the House easily passed a bill to expand federally funded health coverage for children. The measure, which would cover an additional 4million children and nearly halve the number of uninsured youngsters in the country, came more than a year after President George W. Bush vetoed similar bills, effectively blocking any growth in the State Children's Health Insurance Program. This year, with Democrats controlling Congress and the White House, there appear to be no real obstacles to the planned expansion, expected to cost nearly $33 billion over the next 4 1/2 years. The bill sailed through the House, 289-139, and is expected to win swift passage in the Senate before Obama signs it into law soon after taking office next week. "This is a new day in Washington," Rep. Frank Pallone Jr., a New Jersey Democrat and a leading champion of the bill, said yesterday on the House floor. "Soon we will have a new president who has committed himself to reforming our nation's health care system so every American can access affordable and quality health care," he said. "The bill … makes a down payment on that promise." Shortly after the vote, Obama issued a statement praising passage of the measure. "In this moment of crisis, ensuring that every child in America has access to affordable health care is not just good economic policy, but a moral obligation we hold as parents and citizens," he said. "I hope that the Senate acts with the same sense of urgency so that it can be one of the first measures I sign into law when I am president." Democrats had hoped to expand the program after they took control of Congress in 2007. But they were rebuffed by Bush, who twice vetoed legislation citing concerns that it would expand government-run health care. House Republicans renewed that critique yesterday and lambasted the legislation - which Democrats brought to the floor without regular committee hearings - for allowing states to provide health coverage to children in families whose incomes are significantly above the federal poverty line. "We believe that the SCHIP bill should follow the original intent of the law, that is to cover children in low-income, working families," said Virginia Rep. Eric Cantor, the No. 2 Republican in the chamber. The federal poverty line for a family of four was $21,200 in 2008. Family insurance premiums, meanwhile, averaged about $12,680 for a family of four, according to the Kaiser Commission on Medicaid and the Uninsured. Most of the 7 million children now enrolled in SCHIP programs nationwide come from families that earn less than twice the poverty line, although several states have opened the program to families making more. Copyright 2009 Baltimore Sun. House Votes to Expand Child Health Insurance By Shailagh Murray and Ceci Connolly Washington Post Thursday, January 15, 2009; A06 The House easily approved an expansion of government health coverage for low-income children yesterday, a top priority for President-elect Barack Obama and the first in a series of stalled measures expected to move quickly through the Democratic Congress as President Bush leaves office. Obama hailed the 289 to 139 vote and nudged the Senate to act with the "same sense of urgency so that it can be one of the first measures I sign into law when I am president." The president-elect vowed as a candidate to provide health coverage to every child, and the expansion of the State Children's Health Insurance Program, known as SCHIP, is a major step toward that goal. "In this moment of crisis, ensuring that every child in America has access to affordable health care is not just good economic policy, but a moral obligation we hold as parents and citizens," Obama said. The House legislation would cost nearly $33 billion over 4 1/2 years and would be funded in part by a cigarette tax increase of 61 cents to $1 per pack. Bush vetoed two similar bills in 2007, objecting to the tax increase and the expansion of government health care. The Senate Finance Committee will take up a similar measure today, with floor action expected to begin next week. On Friday, the House passed two bills aimed at closing the pay gap between men and women. Both measures are opposed by Bush and supported by Obama, and both have been long stuck in the Senate because of formidable Republican opposition. With their new, much larger margin of at least 58 votes, Senate Democratic leaders hope to approve the measures in the coming weeks. Other GOP-blocked initiatives that could move quickly would lift restrictions on federal stem cell research, a step Obama could take administratively after his inauguration, and would grant full congressional voting rights to the District of Columbia's delegate. The House bill would provide health insurance to an additional 4.1 million children and parents, including legal immigrant children and pregnant women, who currently must wait five years before becoming eligible for the program. A total of 11 million individuals could now receive coverage. House Speaker Nancy Pelosi (D-Calif.), a champion of the equal-pay and children's health measures, called the bills a signal of the House's commitment to taking care of "women and children first," saying Democratic leaders are especially eager to rush the health bill into law. "At a time of economic crisis, nothing could be more essential than ensuring that children of hard-working families receive the quality health care that they deserve," Pelosi said. In a policy statement, House Republicans outlined their objections, chiefly that the measure would place a new burden on states already struggling to meet soaring Medicaid costs and would permit states to enroll children from households with incomes of up to $80,000. "Increasing the amount of federal tax dollars flowing to states that consciously choose to provide benefits to children of these higher-income families before enrolling already eligible poor and low income children is the wrong policy and sends the wrong signal," the statement said. Republicans also object to the tobacco tax as an unstable revenue source. Opponents of the bill asserted that the steady decline of smokers in recent years would have to be reversed in order to meet funding estimates for the children's health program over the coming decade. But the American Cancer Society estimates that the proposed tax increase would prevent more than 900,000 smoking-related deaths and discourage nearly 1.9 million children from taking up smoking. GOP critics also believe that Democrats are underestimating participation in the program, and thus its price tag, especially as more people lose private health insurance because of the economic downturn and become eligible for government support. "Couple that with a drop in revenue from decreased smoking and the gap between program spending and revenue becomes staggering," the policy statement said. A major Republican flashpoint is the House's move to include immigrant children and pregnant women in the program. Sen. Charles E. Grassley (Iowa), the ranking Republican on the Finance Committee, said their addition would violate a 100-year-old law that requires the sponsors of new immigrants to pledge that the individuals will not become a financial burden to taxpayers. "I feel very strongly that if you sign a contract with the government that brings people over here and you promise that they're not going to cost the taxpayers anything, you ought to keep your word to the taxpayers," Grassley said. The Senate version of the bill does not give states the option of covering immigrants, but Finance Committee Chairman Max Baucus (D-Mont.) has said he supports adding the provision, and many Senate Democrats concur. Copyright 2009 Washington Post. Md. stores stop selling Elmo toy due to excessive lead paint By Liz Kay Baltimore Sun Thursday, January 15, 2009 Elmo's Take-Along Card GameBig Lots Stores Inc. and Dollar General Corporation have ceased selling Elmo's Take-Along Card Games, a card game and backpack set, in Maryland stores after a Maryland Attorney General's office investigation revealed high levels of lead paint. The state department of the environment tested the toys and discovered the high lead paint levels, and Attorney General Douglas Gansler followed with a letter to the two companies. Both stores agreed to stop selling the toys and to offer refunds to anyone who brings the toys back for a return, as well as post information in the store about the recall. The Sesame Street toy was mentioned in several news reports last year about excessive lead paint levels in toys. According to a 2007 Hartford Courant article, the toy contained almost 10,000 parts per million in the Red Elmo bag. The federal recall standard of 600 parts per million. Update: the AG's office has also alerted the Consumer Product Safety Commission about their findings. Since these items showed up at the dollar store, it's all got to make you ask: what do people do with returned recalled toys? According to this Christian Science Monitor Q&A that answers the question about where recalled toys go: "... historically only about 6 percent of recalled toys are returned. For those that do come back, Mattel sells or reuses the zinc and some of the resins they contain, and then recycles as many of the other components as possible, sending the lead to companies that specialize in the safe disposal of hazardous materials. But what of the 94 percent of the recalled lead-tainted toys that don’t make it back to Mattel? Many of them, no doubt, found a comfortable home with a child somewhere long before word of the recall – ignored or missed by parents – got out. Of the remaining toys, some of those that were recalled in the summer of 2007 ended up on auction websites like eBay and business-to-business sites like Made-in-China.com – and then eventually into the hands of unwitting consumers, many of them overseas." Copyright 2009 Baltimore Sun. Finding Havens for the Homeless Population Within D.C.'s Security Zone Encouraged to Stay in Shelters By Petula Dvorak Washington Post Thursday, January 15, 2009; B01 From the steam grates of Pennsylvania Avenue to the porticoes of the city's grand buildings, homeless Washingtonians who live inside the nation's tightest security zone are being encouraged to decamp during the inauguration for shelters in the city's outer neighborhoods. The security sweeps will probably begin Monday. Buses will make one-way trips to two of the District's largest shelters, which will remain open round-the-clock, said D.C. Council member Tommy Wells (D-Ward 6). "Everyone has to be out of the perimeter by then," Wells said. Although everyone is required to be out, homeless people, like all residents, could line up to watch the festivities on the Mall or the parade route. They must, however, follow the bans on large duffel bags and suitcases. The issue is how to avoid making people feel like they are being "carted off," Wells said. In years past, U.S. cities grappling with sizable homeless populations rounded them up in mass arrests, bought them one-way bus tickets to nearby states or gave them movie passes to keep them out of sight during such events as the Olympics or political conventions, said Michael Stoops, executive director of the National Coalition for the Homeless. It wasn't until the 2002 Olympics in Salt Lake City, where officials opened shelters and welcomed homeless people with warm food, that a more humane precedent was set, Stoops said. The District plans to follow that city's lead and open all of its shelters for 24 hours during the inauguration, offering warm beverages, food and live television feeds of the day's ceremonies, said Mafara Hobson, spokeswoman for Mayor Adrian M. Fenty (D). "We'll be open all day. We'll make it a day of celebration, a fun place to stay away from the crowds," said David Treadwell, executive director of the Central Union Mission shelter in Logan Circle. The city's Interagency Council on Homelessness has been meeting for weeks about how to do this well. It created a brochure for outreach workers about how to help people find shelter safely. And it added a page for police officers from out of town, particularly those unaccustomed to dealing with such urban issues as homelessness. "We are trying to work with the homeless, to get them to shelters and help them," said Sgt. Robert Lachance of the U.S. Park Police. "The Park Police has no plans to push anybody out." The downtown Business Improvement District estimated this spring that 125 people are sleeping in the streets in the downtown area. Free shuttle buses will run to shelters at St. Elizabeths Hospital and on New York Avenue. They will stop running Tuesday, when people will be urged to stay in the shelters, Wells said. "If any of those people want to come back into town for the events, there is nothing preventing them from taking a Metrobus back." But many homeless people are not so mobile. They are the ones with mountains of stuff sometimes precariously tied to shopping carts, strollers and luggage carts. The city will offer free storage to those who are hampered by their worldly possessions. Until Saturday, city workers will help them place their possessions in a storage shed donated by the Office of Property Management, where the items will be locked up until the inauguration is over. These are the people who remain in the greatest danger as the weather gets colder and the city is engulfed in the chaos of thousands of visitors, Treadwell said. "This is the group I'm worried about: the people who live in the alleys and doorways of downtown Washington," he said. "They will be disrupted, and the little routine they've built up is often the key to their survival." Such groups as the Salvation Army's Grate Patrol are a safety net. The patrol delivers meals to people who sleep on the street rather than in shelters. Volunteers know them by name, where they sleep, what kind of blankets they have and how they are doing. Once the security perimeter goes up, the volunteers plan to find those people. "I've been sitting there with maps and the Secret Service Web site, trying to figure out where all our people are going to go and how we can continue our meal program," said Leslie Wooley, who helps organize the Grate Patrol's meal deliveries. The group might find a central location to distribute food. But that might change, too. It's all changing. "The fact is, everyone is going to be terribly inconvenienced. The housed, the unhoused," Wells said, sighing after a brutal day of District traffic. "Already, getting around town is difficult." Copyright 2009 Washington Post. Same old (toxic) story Our view: Latest coal ash disaster underscores the need for federal intervention; state regulations such as Maryland's can't solve the problem alone Baltimore Sun Editorial Thursday, January 15, 2009 If the experience in Gambrills, where wells serving more than 80 homes were found to be contaminated by chemicals leaching from a coal ash dump, weren't enough to demonstrate the need to regulate these growing environmental hazards, the recent problems of the Tennessee Valley Authority have surely sealed the deal. Last month, about 5.4 million cubic yards of coal plant sludge escaped a containment pond and spread across 300 acres near the Kingston Fossil Plant in East Tennessee. As was the case in Maryland, drinking water supplies were poisoned with lead, arsenic, chromium and other highly toxic substances. Admittedly, the scale of the two events is not the same. The cost to clean up the Tennessee spill is expected to reach hundreds of millions of dollars, which will dwarf the $45 million Constellation Energy Group has agreed to spend to make things right in Anne Arundel County. Here, the money is being used not only to contain the mess but to connect homes to public water and pay for any health problems or property losses stemming from the ash dump. The Maryland Department of the Environment has chosen to adopt new standards for landfills that handle coal ash - although the fledgling program is woefully underfunded. But the two incidents in Maryland and Tennessee are hardly isolated events. Environmental groups estimate that there are more than 1,300 coal ash disposal sites in the country. A high percentage are in facilities such as a pond or former gravel pit with no lining to prevent groundwater contamination. The U.S. Environmental Protection Agency has studied the problem and concluded - well, not much. The agency has found ample evidence of pollution, but when it comes to devising regulations to protect human health? So far, nothing. It's not easily solved. Society can't just wish away the millions of tons of waste produced each year by coal-fired power plants. Some forms of coal ash can be recycled into building materials, but that's not a complete solution. Landfills and waste ponds continue to be used as industrial dumps, and the public water supply deserves to be protected now. States like Maryland can adopt their own forms of regulation, but that's not going to solve a national problem and might even make it worse if mountains of ash end up getting shipped to states with lax environmental standards. The EPA must take this on before another dam breaks or waste dump floods and more communities are put at risk. Copyright 2009 Baltimore Sun. Missed opportunity Our view: Anne Arundel should promote, not discourage, pollution-curbing septic systems Baltimore Sun Editorial Thursday, January 15, 2009 When the Anne Arundel County Council recently rejected legislation that would increase the use of pollution-curbing septic systems in homes, it missed an opportunity to improve the health of the Chesapeake Bay. And for a county that sits on two major rivers that flow to the bay, it was a pass-the-buck moment. Improving the health of the Severn and Magothy rivers and their tributaries should be in the county's interest. The dirtier the rivers, the less inviting the county shoreline and the greater the likelihood that the value of miles of waterfront property will suffer. The legislation sponsored by Councilman Jamie Benoit of Crownsville would have required Arundel residents who live within environmentally sensitive areas to upgrade failed septic systems with ones that reduce pollution-causing nitrogen. The county is sensitive to the problem of septic systems - it previously required these ecologically friendly ones in new homes. The Benoit bill was an effort to take advantage of state grants that help pay for these more costly systems. But Anne Arundel is the only jurisdiction in the state that puts a condition on homeowners who receive the state grants. Families who took advantage of the grant program and subsequently expanded their homes would have to repay the grant to the county. That's a mighty deterrent. The administration of County Executive John R. Leopold, who raised concerns about the financial costs of requiring the upgrades, refused to modify or remove the expansion clause. Officials say there are plenty of takers for the grants as it is, and the council voted down the measure. Anne Arundel has 40,684 septic systems, the most in the state. And on many days, the waterways in the county fail the smell test - an overabundance of bacteria from waste foul the water for recreational users. That should be reason enough for the county to find another way to encourage replacement of failing septic systems and not penalize homeowners who want to do the environmentally correct thing. Copyright 2009 Baltimore Sun. Obama pick for EPA chief to assess coal ash disposal sites Baltimore Sun Thursday, January 15, 2009 WASHINGTON President-elect Barack Obama's pick to head the Environmental Protection Agency vowed yesterday to immediately assess hundreds of coal ash disposal sites at power plants across the country in the wake of two spills in Alabama and Tennessee. Testifying at her Senate confirmation hearing, Lisa Jackson said the agency also will reconsider ways to regulate the ash and how it is stored, something the EPA recommended in 2000 but did not act upon. Coal ash ponds storing waste created by burning coal are not subject to federal regulations. Oversight of the ponds and landfills varies by state. Jackson said the agency's decisions will be based on science and the law and not politics. Her statement was the clearest signal yet that the Obama administration plans to take the EPA in a different direction. "Science must be the backbone of what EPA does," said Jackson. "EPA's addressing of scientific decisions should reflect the expert judgment of the agency's career scientists and independent advisers." Copyright 2009 Baltimore Sun. Bay cleanup effort must tackle harmful chemicals By Ruth Berlin Baltimore Sun Thursday, January 15, 2009 The Maryland Department of the Environment says Chesapeake Bay striped bass more than 28 inches long are contaminated with polychlorinated biphenyls, or PCBs - industrial chemicals that can damage children's nervous systems. Maryland fish advisories say children should not eat large rockfish that run in springtime, and no one should eat local rockfish more than twice a month. In fact, Maryland and Virginia have posted health warnings for 23 kinds of bay fish and shellfish. A National Oceanic and Atmospheric Administration study found half the bay bottom is degraded by PCBs, mercury or pesticides. Two-thirds of its tidal rivers and streams are listed under the Clean Water Act as "partially or fully impaired" by toxic chemicals. Severn River catfish have tumors at four times the rate considered a sign of heavy contamination. The Chesapeake Bay Program has pledged to achieve "a Chesapeake Bay free of toxics." Its staff developed a strong action plan that could meet that goal if governments followed through. But they have not. Out of $1.1 billion spent on bay restoration in 2007, less than one-half of 1 percent went to reduce toxic pollution. Until recently, a toxics subcommittee led by a full-time coordinator carried out the bay program's toxics initiative. That committee was disbanded and the coordinator was reassigned, leaving no one to implement the plan. This dangerously complacent attitude toward known risks makes no sense. The Chesapeake Bay Program was created in 1983 because of concern about nutrients from fertilizers and sewage, which choke the bay. Nutrients are the program's main focus, and they should be. But chemical contamination is more serious than anyone knew in 1983. The toxics subcommittee identified more than a dozen chemicals that are widely used, have serious potential effects and accumulate in the bodies of bay creatures. New detection methods have found toxic pollutants throughout the bay. Researchers recently found the herbicide atrazine, the country's most common farm chemical, in 100 percent of bay water samples. It can cause deformities in frogs, and is linked to health problems at all levels of the food chain. After 25 years, the bay program is barely halfway to its nutrient reduction goals. The Chesapeake Bay Foundation has filed suit against the Environmental Protection Agency demanding a cleanup of nutrient pollution. But the Clean Water Act requires the states to work toward eliminating all pollutants that impair our troubled waters, including toxic chemicals. The loss of a healthy ecosystem harms us all. That's why the Maryland Pesticide Network hopes President-elect Barack Obama will follow through on commitments to cleanse the Chesapeake Bay of harmful chemical pollution. At a minimum, the new administrator of the EPA should make sure the toxics initiative is properly staffed. Mr. Obama should work with Congress to ensure that some federal money for Chesapeake Bay restoration is targeted at toxic chemicals remediation. Full enforcement of the Clean Water Act can and should become a key element of his environmental legacy. Copyright 2009 Baltimore Sun. Viewpoint: Non-native oysters may endanger human health By Sharon Nappier Baltimore Sun Thursday, January 15, 2009 As federal and state officials move toward a decision next year on whether to introduce non-native oysters into the Chesapeake Bay, I have some advice: Don't do it. Action is clearly needed to restore the bay's oyster population, which is estimated to have fallen to less than 1 percent of its size during the 1800s. But recently published research I conducted while studying at the Johns Hopkins Bloomberg School of Public Health strongly suggests that the introduction of non-native oysters into the bay may present greater public health consequences for consumers than native oysters. The Army Corps of Engineers and officials in Maryland and Virginia, who are starting work on a final environmental impact statement that will be published this spring, need to consider those consequences as they weigh various strategies for oyster restoration in the bay. There are risks associated with eating oysters - especially oysters that have been exposed to fecally contaminated water. Oysters are filter-feeding bivalves that accumulate and retain pathogens, such as viruses, bacteria and protozoa, for long periods. Studies have shown that non-native Crassostrea ariakensis oysters can help to filter or clean the bay's waters. However, it has been proposed that these oysters be harvested for human consumption. If so, the ecological benefits provided by the oyster's filtration efficiency may have harmful repercussions for the health of consumers. The large bay region receives fecal pollution, capable of contaminating oyster-harvesting waters, from various sources - including leaky septic systems, sewage overflows and numerous nearby chicken and cattle farms. Our study aimed to assess these questions: If the oyster-harvesting waters became contaminated, would non-native oysters accumulate viruses? And if so, would the oysters retain the viruses for long periods? We looked at viruses, such as the norovirus and the hepatitis A virus, because they contribute to more than 80 percent of oyster-associated intestinal illnesses. We exposed both the non-native and native oyster species to human and nonhuman viruses for 24 hours at varying salinities found in the bay's oyster-harvesting waters. After that, oysters were placed in clean water tanks for one month to simulate the process frequently used to purge oysters of harmful pathogens. Our analysis showed that non-native oysters were statistically more likely to harbor human viruses than native oysters, and if exposed to contaminated water, non-native oysters may contain multiple virus types. Unlike native oysters, the ability of non-native oysters to harbor viruses was not driven by the salinity of the water. Additionally, we found that non-native oysters may have a wider range of habitat in the bay, and in those habitats it is possible the non-native oyster will be able to accumulate and retain human pathogenic viruses. The Army Corps of Engineers and state officials need to consider these findings - and the questions they raise about the public health risks associated with consumption of non-native oysters - as they decide whether to introduce the species into the bay. In their draft environmental impact statement, those officials acknowledged such a move "is very controversial and deviates significantly" from all prior oyster restoration efforts in the bay. As a citizen and a scientist, I believe it is simply not worth the risk. Sharon Nappier is a research assistant professor at Drexel University in Philadelphia. The oyster research was published in the November issue of the American Society of Microbiology's peer-reviewed research journal Applied and Environmental Microbiology. Her e-mail is snappier@drexel.edu. Copyright 2009 Baltimore Sun. A Vaccine's Unintended Consequences By Rob Stein Washington Post Thursday, January 15, 2009 When a new vaccine was approved in 2000, experts hoped it would protect children against a common bacteria that causes a variety of illnesses, including meningitis. They were not disappointed. The vaccine, known as Prevnar, has resulted in a sharp drop in cases. The question was: Would it also reduce cases in adults? A new study led by Lee Hamilton of the University of Pittsburgh says the answer is yes. An analysis of data collected at eight centers around the country between 1998 and 2005 by the federal Centers for Disease Control and Protection found that overall there was a 30 percent drop in pneumococcal meningitis caused by strains of the bacteria Streptococcus pneumoniae. The study, in today's New England Journal of Medicine, found that, as expected, the biggest drop occurred in children under age 2, among whom cases fell by 64 percent. But there was also a 54 percent drop in cases among the elderly--presumably because the fall in infections among children meant fewer kids were spreading the pathogen to adults. The news, however, is not all good. At the same time, there was a 60 percent increase in strains of the bacteria not covered by the vaccine. The reduction in those covered by the vaccine probably created a void that the other strains filled, the researchers speculated. Perhaps even more worrisome, there was an increase in the number of cases caused by strains of the bacteria resistant to antibiotics. That's probably because as the other strains became more common and doctors started treating them with antibiotics they developed more resistance. None of this means that children should not continue to receive the vaccine. Quite the opposite. But it does mean that doctors should be as judicious as possible about using antibiotics to minimize the chances that the antibiotic resistant strains will become more common. The findings give impetus to drug makers to speed the development of new versions of the vaccine to cover more strains. And that work is already underway. Copyright 2009 Washington Post. Dangerous Cribs, Drugstore Doctors and Rising S.T.D.’s Morning Rounds By Roni Caryn Rabin New York Times Wednesday, January 14, 2009 S.T.D. Rates Increasing in the U.S. According to the Centers for Disease Control and Prevention, rates of infection with chlamydia and syphilis increased in the United States in 2007, the latest year for which data are available, The Los Angeles Times reports. For several years, rates of gonorrhea infection have held study. Chlamydia infections, which can cause infertility in women, now top 1.1 million in the U.S., the highest figure since record-keeping began. The Doctor Will See You in Aisle 12 Walgreen Co. plans to launch a network of pharmacies, in-store clinics and health centers that will be marketed to corporate and government employers, The Wall Street Journal reports. Participating employees would be able to get checkups, preventive care, dentistry and optometry services, as well as discounted prescriptions. F.D.A.: Asthma Drugs Not Linked to Suicide Officials at the Food and Drug Administration say data submitted by drug makers do not show an association between asthma medications and suicide, The Associated Press reports. Since the studies were not designed to detect such an association, however, the agency will continue to examine possible links to behavioral problems. Baby Cribs Recalled Due to Suffocation Hazard The makers of Stork Craft baby cribs is recalling more than a million cribs in Canada and the United States because of a potential suffocation hazard, USA Today reports. The U.S. Consumer Product Safety Commission says the metal brackets used to support the mattress and mattress board can crack and break. The cribs were sold at major retailers like Kmart, Wal-Mart and J.C. Penney. D.C. Families Turning to State Health Insurance for Children The economic crisis is driving many Washington, D.C., area families to turn to their states for children's health insurance, The Washington Post reports, and large numbers of these families are qualifying for coverage as employers cut jobs and benefits. Requests are up sharply even in the affluent suburbs of Virginia and Maryland. Copyright 2009 New York Times. Study Finds Drug Risks With Newer Antipsychotics By Benedict Carey and Roni Caryn Rabin New York Times Thursday, January 15, 2009 The popular drugs known as atypical antipsychotics, prescribed for an array of conditions, including schizophrenia, autism and dementia, double patients’ risk of dying from sudden heart failure, a study has found. The finding is the latest in a succession of recent reports contradicting the long-held assumption that the new drugs, which include Risperdal, Zyprexa and Seroquel, are safer than the older and much less expensive medications that they replaced. The risk of death from the drugs is not high, on average about 3 percent in a person being treated at least 10 years, according to the study, published Thursday in The New England Journal of Medicine. Nor was the risk different from that of the older antipsychotic drugs. But it was significant enough that an accompanying editorial urged doctors to limit their prescribing of antipsychotic drugs, especially to children and elderly patients, who can be highly susceptible to the drugs’ side effects, including rapid weight gain. In recent years, the newer drugs, which account for about 90 percent of the market, have become increasingly controversial, as prescription rates to children and elderly people have soared. Doctors use the drugs to settle outbursts related to a host of psychiatric disorders, including attention deficit disorder and Alzheimer’s disease. Most are not approved for such use. After an analysis of study data, the Food and Drug Administration required that all antipsychotics’ labels contain a warning that the drugs were associated with a heightened risk of heart failure in elderly patients. The new study, an analysis of more than 250,000 Medicaid records, is the first to rigorously document that risk for the newer drugs in adults over 30 without previous heart problems. In the study, researchers at Vanderbilt University and the Nashville Veterans Affairs Medical Center analyzed Tennessee Medicaid records for 276,907 people ages 30 to 74. About a third of them began taking an antipsychotic medication in the period studied, from 1990 to 2005, either a newer atypical or an older drug. Two-thirds made up a control group. The researchers excluded patients with heart disease or other problems that might put them at higher risk of cardiac failure. Antipsychotic drugs can affect heart rhythm in some vulnerable people. They found 478 sudden cardiac deaths among those taking the drugs, about twice the rate of the control group. The risk — equivalent to 3 deaths for every 1,000 patients taking the drugs for a year — was about the same whether people took the newer or older medications. The higher the dose of the drug, the study found, the higher the risk of sudden death. “The implication of this study is that physicians need to do a very careful cardiovascular evaluation prior to prescribing these drugs,” especially if there are alternative treatments, said the lead author, Wayne A. Ray, a professor of preventive medicine at Vanderbilt and the Nashville veterans’ hospital. “Then, if they’re used, to pay careful attention to using the lowest possible dose.” Dr. Ray’s co-authors were Dr. Cecilia P. Chung, Dr. Katherine T. Murray, Kathi Hall, and C. Michael Stein, all of Vanderbilt. In 2005, government-sponsored researchers reported that three of four new antipsychotic drugs tested were no more effective than an older, far less expensive drug in treating schizophrenia — the disorder for which they were originally approved. In 2006, doctors working on the same large study reported that the drugs were no more effective than placebos for most elderly patients being treated for dementia-related psychosis. Since then, several review articles have come to similar conclusions, and raised concern about a far more common side effect: weight gain. “When it comes to treating kids, these cardiac events are going to be rare,” said Dr. Jon McClellan, a psychiatrist at the University of Washington. “But heart problems due to obesity are not rare, and the public-health implications of kids on these drugs gaining 10 to 15 pounds are much greater.” Copyright 2009 New York Times. BACK TO TOP


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