Friday, January 23, 2009

News Clipping Archives

 

Maryland / Regional

O'Malley puts brakes on health care plan for uninsured (Gazette)

Troubled Hospital in Southeast Improves, Regains Accreditation (Washington Post)

Center sheds light on caregivers of Alzheimer's patients (Baltimore Examiner)

Out-of-work won’t wait for Howard’s health care plan (Baltimore Business Journal)

Somerset reaches out to homeless (Salisbury Daily Times)

Ex-nursing home worker sentenced in identity theft (Salisbury Daily Times)

Groups sue to force Md. to set new emissions standard for Baltimore trash Incinerator  (Baltimore Sun)

Burst pipe closes senior center, moves hearing (Baltimore Sun)

Attorney: Wal-Mart settles lawsuit in Md. death (Salisbury Daily Times)

Frederick County unveils new emergency alert system (Frederick County Gazette)

167th participates in bioterror drill (Hagerstown Herald-Mail)

National / International

CDC study: Kentucky has highest smoking death rate (Washington Post)

CDC Insider Named Acting Director (Wall Street Journal)

Building a Healthy Community, One Child at a Time (New York Times)

More Americans Skipping Necessary Prescriptions, Survey Finds (New York Times)

FDA: 31M lbs of peanut products recalled (Salisbury Daily Times)

Drug Impedes Body's Deadly Reaction to Flu Virus (Washington Post)

Audit: More bad accounting in veterans health care (Washington Post)

Western NY launches patient record exchange (Salisbury Daily Times)

$635 Million Is Donated to Fight Polio (Washington Post)

Opinion

Peanut recall lists expands (Carroll County Times Editorial)

Rejecting care for 'conscience' (Baltimore Sun Commentary)

Readers speak out on state employee layoffs (Baltimore Sun 4 total)

 

 

Maryland / Regional

 

O'Malley puts brakes on health care plan for uninsured

Medicaid program only partially funded

 

Gazette

Friday, January 23, 2009

 

ANNAPOLIS - The state is putting a halt to a portion of a health care expansion that won praise from advocates when it passed during the 2007 special legislative session but is too expensive to pay for in the current economic climate.

 

Gov. Martin O'Malley's $14.4 billion general fund budget leaves intact the expansion of Medicaid to eligible parents with incomes at 116 percent of the federal poverty guidelines or about $20,000 for a family of three.

 

That effort to expand coverage to the uninsured, which began July 1, had enrolled 28,000 people as of Wednesday.

 

But there is no money for expanding coverage to childless adults, John Folkemer, deputy secretary of the Department of Health and Mental Hygiene, told House and Senate committees this week.

 

Under the 2007 Working Families and Small Business Health Coverage Act, the state was to begin enrolling childless adults in the plan starting July 1, 2009, but only if there was enough money to do so.

 

'You need money on the front end, and that's what we're lacking right now,' House Health and Government Operations Chairman Peter A. Hammen said Wednesday.

 

Advocates are holding out hope that a federal stimulus bill can provide the money needed to keep the expansion which was to include 30,000 parents and about 70,000 childless adults on schedule.

 

Leaders in the U.S. House of Representatives are considering an $87 billion Medicaid stimulus package.

 

O'Malley (D) assumed $350 million in federal stimulus money in his budget plan. Most of that would go toward the $5.7 billion set aside for Medicaid and continuing the expansion of coverage to low-income parents.

 

Vincent DeMarco, president of the Maryland Citizens' Health Initiative, said he would 'strongly urge' lawmakers to fund the expansion to childless adults should the state receive more than $350 million.

 

The U.S. House of Representatives is considering raising the federal match in Medicaid funding from 50 percent to 54.9 percent, which would mean about $300 million more a year in federal money to Maryland. There could be additional federal aid if unemployment rises more than 1.5 percentage points.

 

'So we're talking about fairly significant amounts, and if the unemployment rate goes up, it could be a pretty big bump on top of that,' Folkemer said.

 

While the poor economy and state efforts to educate parents about their eligibility are driving more to enroll, the economy has hampered efforts to increase coverage elsewhere.

 

O'Malley's budget includes, for a second straight year, a $15 million subsidy for businesses with from two to nine employees to provide Medicaid coverage.

 

Between the start of the program in October and the end of last year, 106 employers had enrolled, providing coverage to 332 employees and a total of 554 people. The average premium subsidy per person is $1,129, for a total annual subsidy of more than $625,000.

 

The state expected to enroll 15,000 people each year under the program.

 

'This, of course, is not the rate that we had expected when this was first enacted,' Rex W. Cowdry, executive director of the Maryland Health Care Commission, told the Senate Finance Committee on Wednesday. 'The reason is very simple it's the economy. It should be no surprise that small businesses are particularly vulnerable, and if they're facing a decision about deciding to start offering health insurance, they're going to be hesitant.'

 

Legislators will be looking at ways to make the program more attractive to employers, but must make sure the state has the money to continue the subsidy, said Hammen (D-Dist. 46) of Baltimore.

 

'An employer doesn't want to provide a benefit to an employee, only to take it back a few years later,' he said.

 

Copyright 2009 The Gazette.

 

Troubled Hospital in Southeast Improves, Regains Accreditation

 

By Darryl Fears

Washington Post

Friday, January 23, 2009; B01

 

After a near-death experience, months of intensive care and an extreme makeover, the District's most woebegone hospital, United Medical Center, formerly known as Greater Southeast Community Hospital, is up and running again and has regained a steady pulse. The hospital announced yesterday that it has gotten its accreditation back.

 

The Joint Commission, a group that accredits health-care organizations, confirmed the hospital's announcement that it had earned accreditation slightly more than a year after losing it in December 2007. A spokeswoman for the commission said that United Medical Center passed a surprise inspection last month and that its accreditation became effective Jan. 14, a week before the hospital was notified.

 

Specialty Hospitals of America renamed the hospital and with the city's help invested $30 million in improvements and renovations. Damaged and waterlogged top-level floors were refurbished. Broken radiology equipment was replaced, and the facility was no longer on the verge of running out of food for patients.

 

The Joint Commission awards accreditation based on a hospital's performance in specific areas to assure that patients are cared for in a safe environment. It studies infection prevention and control, life safety, medication management, record of care and treatment, whether the rights of patients are observed and other factors.

 

In a statement, the hospital's board chairman and president, Eric Rieseberg, called the accreditation "a milestone" that affirmed the efforts of "thousands of people who have worked hard to restore the community's faith in our hospital."

 

David A. Catania (I-At Large), chairman of the D.C. Council's health committee, said in a statement that the notion that the hospital would be reaccredited in slightly more than a year "seemed unlikely at best, impossible at worst" and that its staff should be "commended for the phenomenal progress they have made."

 

In summer 2007, the hospital, then Greater Southeast, was on its death bed. Doctors walked off the job after they weren't paid, and the emergency room was forced to shut down for at least a day. City inspectors discovered a shortage of workers and functioning equipment so severe that patients could not be properly treated. City officials and residents feared that the only hospital east of the Anacostia River would close.

 

Throughout that year, the hospital's problems worsened.

 

The Joint Commission gave the hospital a chance to respond, but new managers brought aboard after the facility was purchased by SHA in November 2007 couldn't mount much of a defense.

 

In the past year, SHA has made numerous changes.

 

A few days before its accreditation became effective, the hospital's chief medical officer, Cyril Allen, said the change was revolutionary. "You can smell it. You can see it," he said. "The physicians are all coming back."

 

Lack of accreditation can sink a hospital's spirits. Doctors don't like working with non-accredited facilities. Allen said the hospital must overcome its bad reputation east of the Anacostia.

 

Frank G. DeLisi III, chief executive of United Medical Center, thanked the District government for providing the funding that helped the hospital rebuild.

 

"We understand that they were taking a risk in rebuilding this facility," he said, "and by receiving our accreditation, we have shown that it was a risk worth taking."

 

Copyright 2009 Washington Post.

 

Center sheds light on caregivers of Alzheimer's patients

 

By Sara Michael

Baltimore Examiner

Friday, January 23, 2009

 

Dr. Constantine Lyketsos, chairman of the psychiatry department at Johns Hopkins Bayview Medical Center, directs Hopkins' Memory and Alzheimer's Treatment Center, where he researches and cares for Alzheimer's patients. He also has turned his attention to the patients' caregivers, who serve a critical but difficult role.

 

About 5 million Americans have Alzheimer's. In Maryland, 78,000 had Alzheimer's in 2000, according to the Alzheimer's Association. Although an autopsy is the only way to diagnose the disease with 100 percent certainty, doctors are able to determine whether a person has Alzheimer's based on a series of symptoms, a patient's medical history and ruling out other causes for the condition.

 

Constantine G. Lyketsos is the director of the Memory & Alzheimer’s Treatment Center at Johns Hopkins Bayview. - Kristine Buls/Examiner

 

At the Memory Center, you focus a fair amount of attention on the caregiver. Why is that important?

The caregivers typically are faced with as may as eight, 10, sometimes 20 years of taking care of someone who is becoming progressively disabled. They lose their social networks. They get overwhelmed. They educate themselves usually pretty well, although we help with that. What we work on is teaching them how to be caregivers, how to go from husband to caregiver, from wife to caregiver. It's not an easy transition.

 

Why not?

The nature of the relationship is different in Alzheimer's. When you are caregiving for a cancer patient, caregiving is often simply helping the patient with their medical problems, getting in and out of bed. But in early Alzheimer's, you are talking about taking over decision-making, helping them stop driving, helping them make decisions about where to live, and depending on the existing relationship, you can imagine it can be very difficult.

 

Another important part is what we call respite. Respite really refers to time away from caregiving.

 

There is a range of what different caregivers need. Not everybody needs the same amount of respite. Our job is to assess their needs in the certain circumstances.

 

Is it a full-time commitment?

It can be, even when it doesn't progress. If the patient has early memory loss but can still bathe, dress, etc., they might have such poor judgment that they need to be supervised 24-7 so they don't go out in the cold or drive the car when they shouldn't.

 

Are professionals in the field paying more attention to caregivers' needs?

The clinicians have always known that. That goes back a very long time. What has changed is the appreciation that there needs to be a systematic way of supporting them in that role. And [an appreciation of] paying the clinicians to teach them and help them be in those roles.

 

Thirty years ago, the physician would just sit down with a caregiver, give them a copy of "The 36-Hour Day" [a family guide for caring for someone with Alzheimer's] and say, "Adios, come back in six months," as opposed to a much more engaged approach we take.

 

How are you more engaged with caregivers?

We spend time that involves both physicians and nurses and often a social worker. Rather than giving a diagnosis in five minutes, we do it in 20 or 30 minutes. And then we take our time to go through a checklist of supportive interventions.

 

[We ask the caregiver], "How much time away are you getting? Is that enough?" We can recognize signs of the caregiver getting overwhelmed.

 

That has to be hard to do as a caregiver.

 

It's hard to do, [and] you [feel as if you] are failing if you need help. But you miss the fact that usually the patient is doing fine and you are the one that is overwhelmed.

 

There is an important statistic to remember. Caregivers tend to get depression. That's actually very important but less interesting than the fact that they are at much higher risk of death than any other caregiver. Alzheimer's caregivers are second only to heart failure caregivers in risk of death. So any older caregiver has three to four times the risk of death related to their caregiving role.

 

What is contributing to that?

It's the chronic stress, most likely, as well as the failure of things that keep you going. Your life can become so isolated. You don't have the social network. It's the same routine every day. [That can lead to] heart attacks, bone thinning.

 

I understand more younger people are being diagnosed?

It can be in your late 40s, early 50s. We don't know why, but we think it's partly just the baby boom. You have more 50-year-olds around.

 

Another part is there is more recognition of what is going on. Even 25, 30 years ago, when a 50-year-old misbehaved, they might have been institutionalized psychiatrically and the point might have been missed that they have a degenerative brain disease like Alzheimer's.

 

How close is a cure?

It could arrive very soon. We are all hopeful for that, but it won't be likely. What we think is happening is a certain protein in the brain is depositing -- called amyloid -- through a complex cascade that eventually leads to brain damage that spreads to many parts of the brain and eventually involves most of the brain.

 

In order to cure it, what you need to do is understand how amyloid gets deposited and then all the steps in between that lead to the translation of the symptoms.

 

Right now the only way we have to identify someone who has Alzheimer's is they have symptoms. That means they have brain damage. We are developing what are called biomarkers. They could be brain imaging, MRIs, PETs, blood tests that will tell us where someone is in the cascade before there is brain damage. That will allow us to take different therapies and test them.

 

How did you get into this field? Is there a personal connection?

It was not a personal connection for me. I came to this field because I am interested in how the brain is related to misbehavior. I actually started in the HIV/AIDS field. HIV infects the brain very early, so I was interested in how does the brain infection translate to dementia, depression or mania.

 

Here's this disease, Alzheimer's, where we know brain damage is going to happen and we can study it. So I was very interested in understanding this relationship. That was 20 years ago. Now I am sticking around because it is such a huge public health problem.

 

For more on how Alzheimer's disease affects patients and their caregivers, click here.

 

smichael@baltimoreexaminer.com

 

Copyright 2009 Baltimore Examiner.

 

Out-of-work won’t wait for Howard’s health care plan

 

By Sue Schultz

Baltimore Business Journal

Friday, January 23, 2009

 

A pink slip could be a ticket for some Howard County residents to get into a health care plan that offers coverage to the county’s uninsured at a discount.

 

Howard health leaders next month plan to allow individuals who have been laid off and lost employer-backed health care benefits to enroll in a program that provides members with basic health services for a monthly fee.

 

The move, which comes as Howard’s unemployment rate is growing, will waive a requirement that prevented individuals who lost their jobs from enrolling in the Healthy Howard program for at least six months.

 

“We are trying to address the needs of people in this economy,” said Dr. Peter Beilenson, Howard County’s health officer and architect of the program. “With the rising cost of health insurance, there are those who may lose jobs and can’t afford coverage.”

 

Healthy Howard — a county-funded program launched in October, and the first of its kind in Maryland — gives uninsured residents access to primary care doctors, hospitals, specialists and prescription drugs. The program, not a health insurance plan, costs participants about $50 to $80 a month. Healthy Howard has about 120 residents enrolled this month.

 

Howard County’s unemployment rose to 3.6 percent in November, compared to 2.6 percent for November 2007. That 1 percent means about 1,500 additional workers lost their jobs during the 12-month span.

 

“We are clearly still going down in the recession,” said Richard W. Story, CEO of the Howard County Economic Development Authority. “We haven’t hit the bottom yet.”

 

Story said he expects to see the county’s unemployment rate for January rise above 4 percent.

 

The county put nearly $500,000 for the program to cover about 2,200 uninsured residents by July 2009. The program also is funded with federal dollars and grants from nonprofits.

 

Within days of its launch last October, Healthy Howard was inundated with more than 1,100 requests for coverage. Beilenson said the program closed in November to process the applications and reopened enrollment this month.

 

Beilenson said many of those residents qualifed for other government-funded programs such as Medicaid or were eligible for assistance with private health insurance plans. To qualify for the Healthy Howard, participants must be county residents between the ages of 19 and 64 and have a household income of 300 percent of the federal poverty level — or income of $63,600 for a family of four.

 

But the program has been scrutinized by one Howard County lawmaker. County Councilman Greg Fox said he questions the use of county tax dollars to fund administrative costs and health coaches for the program, He said he was unaware of the program would waive the six-month requirement.

 

“They came to use for county dollars under the premise that the requirement would be in place,” said Fox. “Now they plan to lower the bar and the standard. We might need to look at this in terms of what future dollars the county allocates and how they will be used.”

 

Beilenson said the program doesn’t plan to seek additional funding from the county to open the program to newly unemployed residents. He said the program also plans to target uninsured students and faculty at Howard County Community College, uninsured residents in government subsidized housing in the county, and contract workers without health care benefits next month to help boost enrollment.

 

All contents of this site © American City Business Journals Inc. All rights reserved.

 

Somerset reaches out to homeless

County's first Resource Fair is geared to provide education, create census

 

By Liz Holland

Salisbury Daily Times

Friday, January 23, 2009

 

PRINCESS ANNE -- Somerset County social workers hope to get an accurate count of the homeless population next week during the county's first Homeless Resource Fair.

 

The purpose of the fair is to let the homeless know what services are available to them and encourage them to come in and fill out a homeless census form, said Jenny Roser, supervisor of homeless services at the Somerset County Department of Social Services.

 

The homeless census, which is done every two years, is required for federal grants, Roser said. The better job social services officials do, the more money is available for homeless programs.

 

"It's very important that we get an accurate count," she said.

 

The fair, which is being held in cooperation with the county Health Department, will include two free Shore Transit passes for anyone filling out a survey.

 

Participants will also be able to get free haircuts from a barber who is donating his time and health screenings at the Governor's Well Mobile.

 

There also will be representatives to help with Social Security issues, birth certificates, medical assistance and food stamps.

 

Two years ago, Social Services officials counted 143 homeless people living in Somerset County by contacting people in their case loads and also by going door to door at motels and campgrounds, Roser said. This year's count is expected to exceed the 2007 census.

 

In rural areas like Somerset County, homelessness is not as visible a problem as it is in urban areas. Many live in unsuitable buildings or motels, while others stay at campgrounds.

 

As the U.S. economy worsens, Social Services officials are seeing more families coming in for help, Roser said.

 

With the rising prices of housing, food and gasoline, many people with minimum wage jobs are falling behind on their bills, which leads to eviction, she said.

 

The Homeless Resource Fair will be held Thursday from 10 a.m. to 2 p.m. at the Department of Social Services in Princess Anne.

 

Anyone who is unable to attend during those hours can fill out a census form -- and still get two free bus passes -- later that day at Social Services, or at the Somerset County Health Department in Westover or the Seton Center in Princes Anne.

 

somersetherald@dmg.gannett.com

 

410-651-1600

 

Additional Facts

If you go

 

WHAT. Homeless Resource Fair

WHEN. 10 a.m.-2 p.m. Thursday

WHERE. Somerset County Department of Social Services, 30397 Mount Vernon Road, Princess Anne

CALL. 410-677-4200

 

Copyright 2009 Salisbury Daily Times.

 

Ex-nursing home worker sentenced in identity theft

Crisfield woman to serve 5 years, pay $8K fine

 

By Earl Holland

Salisbury Daily Times

Friday, January 23, 2009

 

SALISBURY -- A former nursing assistant was sentenced to five years in prison and must pay in excess of $8,000 in restitution for stealing the identities of her patients at a Salisbury retirement community.

 

On Thursday, 27-year-old Tara C. Campbell of Crisfield pleaded guilty to two counts of theft less than $500 and one count of theft scheme greater than $500 in connection with the use of personal information from three elderly patients at the Lakeside Assisted Living at Mallard Landing Retirement Community in Salisbury.

 

Prosecutors from the Wicomico County State's Attorney's Office said at least one of the victims suffered from Alzheimer's disease and one has died since the thefts.

 

"To steal the identities of elderly people, especially one who has Alzheimer's, is unfathomable," said Paul Montemuro, assistant Wicomico County state's attorney. "It's really a terrible crime because this was when people are at their must vulnerable."

 

Montemuro said Campbell, who worked at the retirement community from October 2007 to last January, stole the victims' information and used it to apply for credit cards in their names to which she charged more than $8,600.

 

Arlene Spack, executive director of Lakeside Assisted Living, said the retirement community was "shocked and appalled" about Campbell's actions.

 

"We make it a priority to ensure that our private information of our patients remains safe and secure," she said. "As soon as we received word about the incidents, we cooperated fully with investigators on their case."

 

Wicomico County Circuit Court Judge Donald Davis sentenced Campbell to a 15-year prison term, but suspended 10 years. In addition to incarceration, Campbell will be on supervised probation for five years and must also pay restitution as part of the probation.

 

Montemuro said Davis went slightly beyond sentencing guidelines for Campbell because of her previous criminal history as well as because she had preyed upon the most vulnerable of victims.

 

"It's important for the family of an elderly person to know they can trust their caretakers," he said. "This is a really sad situation because it's a violation of that trust."

 

eholland@dmg.gannett.com

 

410-845-4633

 

Copyright 2009 Salisbury Daily Times.

 

Groups sue to force Md. to set new emissions standard for Baltimore trash incinerator

Environmental activists also threaten lawsuit against power plant in Prince George's

 

By Timothy B. Wheeler

Baltimore Sun

Friday, January 23, 2009

 

Accusing the state of failing to control industrial air pollution, environmental groups went to court yesterday to force the Maryland Department of the Environment to set new emission limits for a Baltimore trash incinerator.

 

The groups also threatened to sue Atlanta-based Mirant for allegedly spewing pollutants from one of its power plants in suburban Washington. The plant has been operating for years without a permit.

 

Activists said the actions were prompted by their frustration with the O'Malley administration for foot-dragging in dealing with pollution violations at some of the state's largest factories and power plants.

 

"We've just had it," said Eric Schaeffer, a former federal environmental regulator who now leads a Washington-based group, the Environmental Integrity Project. He said the two cases are part of a pattern in Maryland in which power plants and factories have been allowed to operate without pollution permits and up-to-date emission limits.

 

The BRESCO waste-to-energy incinerator in South Baltimore, which burns trash from Baltimore and Baltimore County, has been allowed to operate on an expired air pollution permit for more than a year, Schaeffer said. The state drafted but has not issued a new permit for the incinerator, operated by Wheelabrator Technologies. Activists say the permit would let the facility emit more pollution than the law allows.

 

Joining Schaeffer's group in filing the lawsuit in Baltimore Circuit Court were the Baltimore Harbor Waterkeeper and Clean Water Action, as well as a Crofton resident who contends that the air he breathes is fouled by the incinerator's emissions. The Chesapeake Climate Action Network joined in the letter warning Mirant that it would be sued.

 

The vast majority of Marylanders live in communities where air quality is poor, Schaeffer noted. The Baltimore and Washington metro areas, and Cecil and Washington counties, experience unhealthful levels of ground-level ozone or fine-particle pollution, or both, at certain times of year, according to federal data. Smog can cause breathing difficulties and aggravate asthma and chronic bronchitis. Particle pollution also can cause respiratory problems and has been linked to heart attacks and premature deaths among people with lung and heart disease.

 

The activists said they had no evidence that the Baltimore incinerator is violating pollution limits, but monitoring data suggests that it might be emitting excessive amounts of nitrogen oxide, a smog-forming pollutant. The permit delay might be obscuring more fundamental problems, they contend.

 

"You can't really have effective enforcement and compliance with the law unless and until you have effective permitting," said Jane F. Barrett of the environmental law program at the University of Maryland law school.

 

According to the groups, the Chalk Point power plant in Prince George's County has been burning dirty fuel oil without installing equipment to control particle pollution as required by state and federal law. The plant burned more than 187 million gallons of the oil from 2005 through mid-2007, the groups say, likely spewing more than 1,000 tons of fine particles into the air. They contend that the plant has committed 1,400 violations of the federal Clean Air Act.

 

Schaeffer said he and others have been pressing the O'Malley administration to address these and other cases of industrial and power plant pollution for two years but have gotten little or no response. The groups asked the U.S. Environmental Protection Agency last year to make Maryland tighten its oversight of air pollution or take away the state's authority to regulate it. An EPA spokeswoman said federal officials are investigating the complaints.

 

The problems are puzzling and troubling, Schaeffer said, because Maryland has taken significant steps to curb air pollution, requiring reductions from power plants with the Healthy Air Act and pushing for cleaner cars by embracing limits set by California.

 

Mirant spokeswoman Misty Allen said that the environmental groups' claims are "baseless" and that the Chalk Point power plant is in compliance with state emissions standards. The plant burns "residual" fuel oil and does not have the pollution control equipment the groups say is needed, but Allen said the plant has been operating under a consent agreement with the state for the past two years that covers that.

 

Wheelabrator spokesman Frank Ferraro said his company's incinerator is in compliance with state laws and regulations.

 

Tad Aburn, the state's chief air pollution regulator, acknowledged that his agency is late in issuing the new Baltimore incinerator permit but said it was delayed while trying to respond to complaints raised by activists. He said the permit would be issued within two weeks. He declined to discuss the Mirant plant, except to say that the agency took enforcement action against it two years ago and has asked the Maryland attorney general's office to consider further action.

 

He defended his agency's record, saying the state is seen as being aggressive in enforcing pollution laws.

 

Copyright 2009 Baltimore Sun.

 

Burst pipe closes senior center, moves hearing

 

Baltimore Sun

Monday, January 22, 2009

 

Water from a pipe ruptured by subfreezing weather caused extensive damage to a Columbia senior citizens center, forcing it to be closed for two weeks, Howard County officials said yesterday. The incident at Florence Bain Senior Center forced the relocation of tonight's county Planning Board hearing on redevelopment plans for downtown Columbia. The meeting, which begins at 6 p.m., will be moved to Wilde Lake High School.

 

Copyright 2009 Baltimore Sun.

 

Attorney: Wal-Mart settles lawsuit in Md. death

 

Salisbury Daily Times

Friday, January 23, 2009

 

An attorney representing the family of a Cecil County man says Wal-Mart has settled a lawsuit filed after the man received the wrong prescriptions from a Wal-Mart pharmacist and subsequently died.

 

Attorney Harry Barnes says it is "a favorable settlement," but says the details were sealed by a federal judge in Baltimore.

 

Sixty-six-year-old George Smith of North East died in March 2007. He became ill eight days after receiving prescriptions intended for someone else and died at Union Hospital in Elkton. Smith's two adult children sued Wal-Mart last year for $3 million, citing their severe emotional suffering.

 

Information from: Cecil (Md.) Whig, http://www.cecilwhig.com

Press Association

 

Copyright 2009 Salisbury Daily Times.

 

Frederick County unveils new emergency alert system

If crisis strikes, residents can find information online

 

By Sherry Greenfield

Frederick County Gazette

Friday, January 23, 2009

 

Frederick County has added to its arsenal of tools to prepare residents for disaster.

 

On Tuesday, the county government launched its "emergency alert" system on its site. In the event of a weather-related disaster or man-made crisis, the "emergency preparedness" link and green button on the homepage of the Web site will change to "emergency alert," accompanied by a red flashing button.

 

"We certainly hope we don't have to implement it too often," said Robin K. Santangelo, county spokeswoman and the brainchild behind the new alert system. "But if needed, this is just one more method people can use for information. We realize not everyone has access to a computer or the Internet, but people today are more computer savvy, and in an emergency this is something different they can go to."

 

In 2007, the county launched its emergency preparedness Web site. The site included media contacts in the event of an emergency, preparedness tips from the American Red Cross, and information on how businesses can prepare their employees.

 

The site will continue to carry the emergency preparedness link that will lead visitors to information and resources to help them prepare for a disaster. What is new is the green button assuring residents that no emergency situation exists.

 

But in the event of a winter snow storm or summer hurricane, the county will activate the alert system by changing the green button to red. A link with emergency information will also be made available.

 

"If there is an emergency people can go to a special page and it will have information on the inclement weather," Santangelo said. "Different county departments will be able to put things on the site and [the county's] Emergency Management can give special alerts."

 

The Frederick Board of County Commissioners signed off on the new site before it was launched this week.

 

"The new alert system is one more way that county government can communicate with our citizens about how to protect their families and businesses during emergency situations," Commissioner Jan H. Gardner (D) said. "We believe that this system will be an invaluable source of information during a crisis."

 

In case of emergency

To access Frederick County government's emergency preparedness link, go to www.co.frederick.md.us/emergency.

 

E-mail Sherry Greenfield at sgreenfield@gazette.net.

 

Copyright © 2009 Post-Newsweek Media, Inc./Gazette.Net.

 

167th participates in bioterror drill

 

By Kate S. Alexander

Hagerstown Herald-Mail

Friday, January 23, 2009

 

MARTINSBURG, W.Va. - The hull of the massive C-5 aircraft was empty save for a few boxes, and a small woven rug and folded wool blanket, fibers infested with a brown chemical.

 

Army Sgt. 1st Class Brian Burns stalked toward the rug, his head-to-toe orange Teflon-like jumpsuit crinkling with each step.

 

Behind him, Army Sgt. Dave Reeves of the 35th Civil Support Team (WMD) and Air Force Tech Sgt. Bruce Christman of the 167th Airlift Wing entered the C-5 cautiously, adrenaline fogging the plastic around their face as they talked through gas masks with air borrowed from an oxygen tank.

 

The men walked as if the substance on the rug was lethal.

 

With terrorism, Burns said they must be prepared for anything.

 

"You are literally at the will of whatever terrorist group is going to create an incident. Terrorists are only limited by their imaginations," he said. "9/11, they used aircraft literally as missile."

 

For the first time since the United States recognized bioterrorism as a threat, the Eastern Panhandle of West Virginia spent Thursday simulating how it would respond should anthrax land on its doorstep, in the hull of a West Virginia Air National Guard C-5 plane.

 

Under the direction of the Center for National Response, the 167th Airlift Wing of the West Virginia Air Guard, together with the National Guard 35th Civil Support Team (WMD), the FBI, Customs and Border Control and emergency services personnel from the Panhandle, responded to the forced landing of a C-5 after its passengers became ill from anthrax while heading home.

 

Training Specialist/Exercise Planner Floyd Burdine wrote the scenario drilled on Thursday and carefully hid the fake anthrax that Burns, Christman and Reeves respected like a ticking bomb.

 

Every move made by the men could be the difference between success or failure in an actual situation, from rinsing their hands in a bleach solution to how close they placed their gear to the rug, Burdine said as he watched the men.

 

Col. Brian Truman, vice commander of exercise operations for the 167th, said the exercise was the first time the base has coordinated with national, state and local agencies to simulate a massive regional response to a terrorist situation. Airmen in the 167th run four training exercises a year, but those rarely include multiple civilian and governmental agencies.

 

Makeshift laboratories, debriefing areas, fire engines, tactical vehicles, tents and gear filled the tarmac at the 167th during Thursday's drill.

 

Dave Underwood, senior exercise planner/analyst with the Center for National Response, said the center, a government contractor from Gallagher, W.Va., also known as The Tunnel, coordinated the multipart exercise.

 

The center also acted as evaluator for the training.

 

Underwood said members of his organization, including Burdine, played a critical role in the simulation by evaluating "the good, the bad and the ugly" that they observed in the exercise.

 

The daylong anthrax emergency exercise was designed to teach regional coordination should a terrorist emergency at the base require assistance from local hospitals, ambulance squads and state authorities.

 

The training also tested the preparedness and procedure of the agencies.

 

Burns said after six years with the 35th Civil Support Team (WMD) out of St. Albans, W.Va., he noticed areas for improvement as he and three other members worked in the hull of the C-5 to gather secure samples of fake anthrax placed on blankets and rugs like those found in the markets of Afghanistan.

 

In addition to debriefings after each stage of the simulation, Underwood said the Center for National Response will issue a detailed After Action Report to each agency with comments on the training.

 

Martinsburg City Hospital, Jefferson Memorial Hospital, Berkeley County Emergency Services, Berkeley County Emergency Ambulance Authority, Eastern Panhandle Red Cross and Shepherd University also participated in the training.

 

Copyright 2009 Hagerstown Herald-Mail.

 

National / International

 

CDC study: Kentucky has highest smoking death rate

Washington Post

Associated Press

 

Thursday, January 22, 2009

 

ATLANTA -- Kentucky and West Virginia _ where people traditionally smoke the most _ have the highest death rates from smoking, a new federal study has found. Rounding out the 10 states with the highest average annual smoking death rates were Nevada, Mississippi, Oklahoma, Tennessee, Arkansas, Alabama, Indiana and Missouri.

 

The lowest death rates were in Utah and Hawaii, according to the U.S. Centers for Disease Control and Prevention study.

 

The smoking death rate in Kentucky was about 371 deaths out of every 100,000 adults age 35 and older.

 

That was nearly one-and-a-half times higher than the national median of 263 per 100,000. And it was nearly three times the rate for Utah, which was 138 per 100,000.

 

The smoking death rates were calculated using death certificate data from the years 2000 through 2004, focusing on lung cancer and 18 other diseases caused by cigarette smoking.

 

The rates track pretty closely with the adult smoking rates in each state. Kentucky and West Virginia had the highest smoking rates in 2004 as well.

 

But obesity and other problems that trigger heart disease are also factors. Smoking, added to those problems, "is like gasoline on the fire," said Terry Pechacek, a CDC senior scientist for tobacco-related issues.

 

For every state, the annual number of smoking deaths was higher among males than females. However, rates declined in men in 49 states since the late 1990s, but declined in women in only 32 states.

 

The report is published this week in the CDC's Morbidity and Mortality Weekly Report.

 

On the Net:

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

 

© 2009 The Associated Press.

 

CDC Insider Named Acting Director

 

By Betsy Mckay

Wall Street Journal

Friday, January 23, 2009

 

The Obama administration has appointed an infectious disease and disaster preparedness expert as acting director of the U.S. Centers for Disease Control and Prevention.

 

Richard Besser, who headed the CDC's public health emergency preparedness and response functions, succeeds Julie Gerberding, who stepped down with the change in administration after six years of leading the federal agency.

 

It wasn't clear whether Dr. Besser would be Dr. Gerberding's permanent successor. An email to CDC employees Thursday said that Dr. Besser would serve as acting director until a permanent director is named and assumes the role.

 

Dr. Gerberding, who officially stepped down when President Obama was sworn in this week, was originally to be replaced temporarily by William Gimson III, the agency's chief operating officer, until a permanent successor was named. People familiar with the agency said Dr. Besser was named instead because Mr. Gimson is not a medical doctor, a qualification considered important to head the public health agency even temporarily.

 

Dr. Besser, 49 years old, is a CDC veteran with wide public health experience. A pediatrician by training, he served in the CDC's Epidemic Intelligence Service, tracking foodborne diseases, followed by several years working on infectious disease issues. He spearheaded a national campaign to prevent overuse of antibiotics, a practice which helps to spawn antibiotic resistant bugs. 

 

Most recently, he has been director of the Coordinating Office for Terrorism Preparedness and Emergency Response, which handles public health emergency preparedness and emergency response.

 

Write to Betsy McKay at betsy.mckay@wsj.com

 

Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved.

 

Building a Healthy Community, One Child at a Time

Doctor and Patient

 

By Pauline W. Chen, M.D.

New York Times

Friday, January 23, 2009

 

Like many other Americans this past Tuesday, I was moved by President Obama’s inspiring call to duty.

 

“Now, there are some who question the scale of our ambitions, who suggest that our system cannot tolerate too many big plans,” he said during his inaugural address. “Their memories are short, for they have forgotten what this country has already done, what free men and women can achieve when imagination is joined to common purpose and necessity to courage.”

 

One of the "big plans" of the Obama administration will be to revamp the nation’s health care system. But are these ambitions big enough to help the country’s smallest patients?

 

It has been hard over the last year not to feel that health care coverage for our neediest young people could have benefited from a “big plan.”

 

In May, the Commonwealth Fund, a nonprofit health policy research group, published a report that detailed striking health care disparities between states. The report found, for example, that three-quarters of children have regular medical and dental preventive care in Massachusetts, but less than half of the children in Idaho do. Whereas only 55 per 100,000 children are hospitalized for asthma in Vermont, South Carolina has a staggering hospitalization rate of 314 per 100,000.

 

More recently, the Kaiser Family Foundation summarized the role of Medicaid, the federal program that aids the poor, and the State Children’s Health Insurance Program. Roughly 30 percent of the nation’s children depend on these programs, but another 11 percent remain uninsured.

 

That’s 8.9 million American children who have no health insurance.

 

Last year, there was a big plan to try to change those numbers. But two bipartisan attempts in Congress to expand children’s health coverage withered after presidential vetoes.

 

This year, it appears that a revised and more comprehensive version of the State Children’s Health Insurance Program will likely pass, supported by the new president. After the House passed the bill last week, Mr. Obama said in a statement, “This coverage is critical, it is fully paid for and 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.”

 

I am thrilled by the prospect of better health care coverage for children. At the same time, however, I understand the concerns of critics who ask if we are just throwing more money at the larger problem: our broken health care system.

 

As the President said on Tuesday:

 

“The question we ask today is not whether our government is too big or too small, but whether it works.... Where the answer is yes, we intend to move forward. Where the answer is no, programs will end.”

 

In at least one part of the country, North Carolina, the answer has been yes.

 

Since 1991, primary care physicians, administrators and state legislators there have worked to create and support a state Medicaid program called Community Care of North Carolina. The program has not only offered high-quality, patient-centered care for the state’s neediest children and adults, but has also saved millions of dollars in health care costs.

 

Based in part on the idea that each patient should have a “medical home,” the Community Care program assigns each Medicaid patient to one of 14 community health networks. Each network in turn is organized and operated by physicians, nurses, hospitals, health departments and departments of social services.

 

Patients receive primary care and preventive health measures coordinated by the various professionals in their network, and physicians and others receive fees for their services. In addition, each network receives $3 per patient per month to help implement additional programs like after-hours office care, nurses on call and community-based care coordinators for patients with complex issues, including children with cerebral palsy or cystic fibrosis.

 

North Carolina, in conjunction with independent consulting groups, has documented the savings for state taxpayers with this innovative program. In asthma management alone, Community Care of North Carolina saved an estimated $3.5 million dollars over three years. With diabetes care, the program saved an additional $2.1 million dollars over the same time period.

 

The most striking difference, however, between Community Care of North Carolina and other state Medicaid programs is the complete absence of insurance companies. Most states partner with an insurance company to deliver care to Medicaid patients; any residual profits go to the insurance company. But in North Carolina, state Medicaid administrators and health care providers manage the program exclusively and then funnel profits directly back into patient care.

 

I recently spoke to Dr. David Tayloe, the president of the American Academy of Pediatrics and a practicing pediatrician in North Carolina. Dr. Tayloe has been actively involved with Community Care of North Carolina since its inception.

 

“We have been able to have an effective collaboration between state government and physicians,” Dr. Tayloe said to me over the phone in a deep baritone voice that accentuated his rich Southern accent. “We basically have a not-for-profit administrative program for Medicaid, and the real winners are the children and the families.”

 

I asked if there might be something different about North Carolina compared to other states, something that made it possible to run a program like Community Care.

 

“If you look at the fundamentals of the program,” Dr. Tayloe replied, “they could be adopted by other states. There’s nothing holding a state back from saying ‘We want community-based care.’ Any state Medicaid program that commits the dollars to it can do it.”

 

“We’ve done it for 17 years,” he added, “and we’ve saved a lot of money for the state. No one in our general assembly even thinks about going to another system of care anymore.”

 

I asked Dr. Tayloe what had inspired him to become so actively involved with his state’s Medicaid program. He paused to think, then talked about his father, who had practiced pediatrics in North Carolina for over 40 years, and about his own lifelong desire to care for any child that walked into his practice.

 

“With the shortage of primary care physicians in the U.S., we are at risk of allowing our system of health care to deteriorate such that our most needy and deserving children do not have access to good pediatricians,” he added via e-mail the next morning. “This is what Community Care of North Carolina is all about — paying for a system that assures patients access to the best in primary care — a real medical home.”

 

He continued, “I envision a medical system in which the poorest at-risk children have access to the best and the brightest we have in medicine — on the front lines in our communities.”

 

Dr. Tayloe’s work and his words, even via e-mail, reminded me of the President’s message I had heard on Tuesday:

 

“We have duties to ourselves, our nation and the world, duties that we do not grudgingly accept but rather seize gladly.”

 

Copyright 2009 New York Times.

 

More Americans Skipping Necessary Prescriptions, Survey Finds

 

By Roni Caryn Rabin

New York Times

Friday, January 23, 2009

 

One in seven Americans under age 65 went without prescribed medicines in 2007 as drug costs spiraled upward in the United States, a nonprofit research group said on Thursday.

 

That figure is up substantially since 2003, when one in 10 people under 65 went without a prescription drug because they couldn’t afford it, according to the Center for Studying Health System Change in Washington, D.C.

 

The current figure may be even higher because of the recent economic downturn, said Laurie E. Felland, a senior health researcher at the center and lead author of the study.

 

“Our findings are particularly troublesome given the increased reliance on prescription drugs to treat chronic conditions,” she added. “People who go without their prescriptions experience worsening health and complications.”

 

The people who were least able to afford medicine were often those who needed it most, Ms. Felland said: uninsured, working-age adults suffering from at least one chronic medical condition. Almost two-thirds of them in the survey said they had gone without filling a prescription.

 

But even those with private health insurance provided by their employers were affected: one in 10 working-age Americans with employer-sponsored coverage went without a prescription medication in 2007, up from 8.7 percent in 2003, the study found.

 

Among low-income Americans, three in 10 said they had been unable to fill a prescription because of cost, and nearly one in four adults on Medicaid or state insurance programs said they’d had difficulty affording drugs.

 

Ms. Felland said a number of factors contributed to the trend, including rising drug prices, the tendency of physicians to prescribe drugs more frequently, the introduction of expensive new specialty medications, and skimpier drug coverage that shifts a greater share of costs onto patients.

 

“Insurance coverage offers less financial protection against out-of-pocket costs than it did in the past,” she said.

 

The study was based on results from the 2007 Health Tracking Household Survey, a nationally representative telephone survey of 10,400 adults under age 65, many of whom also discussed affordability of medications for their 2,600 children. Participants were asked whether there was a time in the previous 12 months when “you needed prescription medicines but didn’t get them because you couldn’t afford it.”

 

Overall, 5 percent of children didn’t have prescriptions filled in 2007 because of cost, up from 3.1 percent in 2003, and 17.8 percent of working-age adults couldn’t afford drugs in 2007, up from 13.8 percent in 2003, the survey found. That translates into about 36.1 million Americans under 65 who were affected, according to the study.

 

Karen Davis, president of the Commonwealth Fund, a private foundation that researches health care issues, said the new study confirms previous Commonwealth studies. In 2007, nearly two-thirds of U.S. adults, or an estimated 116 million people, struggled to pay medical bills, went without needed care because of cost, were uninsured for a time or were underinsured, according to the foundation.

 

"It has become a middle class problem," she added, noting that improving health coverage is an integral part of economic recovery.

 

"It’s not enough just to help people have jobs," she said. "They need to have adequate coverage, so they can get care when they need it and pay the bills they incur when they do seek care."

 

Copyright 2009 New York Times.

 

FDA: 31M lbs of peanut products recalled

 

Salisbury Daily Times

Thursday, January 22, 2009

 

Federal health officials say the salmonella recall now involves about 31 million pounds of peanut butter and peanut paste.

 

That's a whole lot of peanut butter.

 

But consider this: The nonprofit National Peanut Board says Americans eat 700 million pounds of the gooey treat every year.

 

Peanut Corp. of America - the company that made the recalled products - isn't an industry giant. But its peanut paste is used by others to make dozens of goodies, from energy bars, to cakes, to dog biscuits. And the recall list keeps getting longer.

 

It's making the food industry nervous, although no major national brands of peanut butter are affected. Even the Girl Scouts are reassuring customers Peanut Corp. is not their supplier.

 

On the Net:

FDA recall page - http://tinyurl.com/8s3mwr

Press Association

 

Copyright 2009 Salisbury Daily Times.

 

Drug Impedes Body's Deadly Reaction to Flu Virus

 

Washington Post

Friday, January 23, 2009

 

FRIDAY, Jan. 23 (HealthDay News) -- A drug may be able to dampen part of the body's immune response so infections can be fought without a resulting overkill that may cause the person to perish, a new study says.

 

The compound sphingosine analog AAL-R, when administered directly into the lungs of mice, helped mitigate the cytokine response, a common immune reaction that can sometimes be so strong that it can harm as much as help, according to a report published in this week's issue of the Proceedings of the National Academy of Sciences. A severe "cytokine storm" can flood and clog the lung's alveoli with infection-fighting cells, making it so oxygen can no longer be properly absorbed by the body.

 

When administered to mice with the flu virus, the compound helped to temper the cytokine effect enough to prevent harm to the rodent while still allowing the body to fight the infection.

 

"Even though this compound does not kill the virus itself, the immunopathologic response was significantly impaired," study co-leader Dr. Michael Oldstone, of The Scripps Research Institute, said in a news release issued by the facility.

 

The researchers believe their findings may help prevent a much-feared pandemic of the H5N1 virus, more commonly known as bird flu, and the spreading of other deadly lung infections by helping make treatment more effective without harming the patient.

 

"We know that many of those who died in the 1918 influenza pandemic were young people, those with the strongest immune systems whose bodies mounted the strongest immunopathologic responses," Oldstone said. "Our hope is that our current research will yield answers about how to treat this kind of immune response not only in influenza, but also in other viral diseases such as hantavirus and SARS, in which pulmonary infiltration is severe."

 

They plan to study how sphingosine analog AAL-R receptors work and test combination therapy, such as adding Tamiflu to the compound, as a way to kill the virus while managing the immunopathologic response.

 

More information

The U.S. Centers for Disease Control and Prevention has more about the flu virus.

 

SOURCE: The Scripps Research Institute, news release, Jan. 20, 2009

 

© 2009 Scout News LLC. All rights reserved.

 

Audit: More bad accounting in veterans health care

 

Associated Press

By Hope Yen

Washington Post

Friday, January 23, 2009

 

WASHINGTON -- Two years after a politically embarrassing $1 billion shortfall that imperiled veterans health care, the Veterans Affairs Department is still lowballing budget estimates to Congress to keep its spending down, government investigators say.

 

The report by the Government Accountability Office, set to be released Friday, highlights the Bush administration's problems in planning for the treatment of veterans that President Barack Obama has pledged to fix. It found the VA's long-term budget plan for the rehabilitation of veterans in nursing homes, hospices and community centers to be flawed, failing to account for tens of thousands of patients and understating costs by millions of dollars.

 

In its strategic plan covering 2007 to 2013, the VA inflated the number of veterans it would treat at hospices and community centers based on a questionably low budget, the investigators concluded. At the same time, they said, the VA didn't account for roughly 25,000 - or nearly three-quarters - of its patients who receive treatment at nursing homes operated by the VA and state governments each year.

 

"VA's use, without explanation, of cost assumptions and a workload projection that appear unrealistic raises questions about both the reliability of VA's spending estimates and the extent to which VA is closing previously identified gaps in noninstitutional long-term care services," according to the 34-page draft report obtained by The Associated Press.

 

The VA did not immediately respond to a request for comment.

 

In the report, the VA acknowledged problems in its plan for long-term care, which accounts annually for more than $4 billion, or 12 percent of its total health care spending. In many cases, officials told the GAO they put in lower estimates in order to be "conservative" in their appropriations requests to Congress and to "stay within anticipated budgetary constraints."

 

As to the 25,000 nursing home patients unaccounted for, the VA explained it was usual clinical practice to provide short-term care of 90 days or less following hospitalization in a VA medical center, such as for those who had a stroke, to ensure patients are medically stable. But the VA had chosen not to budget for them because the government is not legally required to provide the care except in serious cases.

 

The GAO noted the VA was in the process of putting together an updated strategic plan. Retired Gen. Eric K. Shinseki, who was sworn in Wednesday as VA secretary, has promised to submit "credible and adequate" budget requests to Congress.

 

"VA supports GAO's overarching conclusion that the long-term care strategic planning and budgeting justification process should be clarified," wrote outgoing VA Secretary James Peake in a response dated Jan. 5. He said the department would put together an action plan within 60 days of the report's release.

 

The report comes amid an expected surge in demand from veterans for long-term rehabilitative and other care over the next several years. Roughly 40 percent of the veteran population is age 65 or older, compared to about 13 percent of the general population, with the number of elderly veterans expected to increase through 2014.

 

In 2005, the VA stunned Congress by suddenly announcing it faced a $1 billion shortfall after failing to take into account the additional cost of caring for veterans injured in Iraq and Afghanistan. The admission, which came months after the department insisted it was operating within its means and did not need additional money, drew harsh criticism from both parties.

 

The GAO later determined the VA repeatedly miscalculated - if not deliberately misled taxpayers - with questionable methods used to justify Bush administration cuts to health care amid the burgeoning Iraq war. In Friday's report, the GAO said it had found similarly unrealistic assumptions and projections in the VA's more recent budget estimates submitted in August 2007.

 

According to latest GAO report, the VA is believed to have:

 

*Undercut its 2009 budget estimate for nursing home care by roughly $112 million. It noted the VA planned for $4 billion in spending, up $108 million from the previous year, based largely on a projected 2.5 percent increase in costs. But previously, the VA had actually seen an annual cost increase of 5.5 percent.

 

*Underestimated costs of care in noninstitutional settings such as hospices by up to $144 million. The VA assumed costs would not increase in 2009, even though in recent years the cost of providing a day of noninstitutional care increased by 19 percent.

 

*Overstated the amount of noninstitutional care. The VA projected a 38 percent increase in patient workload in 2009, partly in response to previous GAO and inspector general reports that found widespread gaps in services and urged greater use of the facilities. But for unknown reasons, veterans served in recent years actually decreased slightly, and the VA offered no explanation as to how it planned to get higher enrollment.

 

On the Net:

Government Accountability Office:http://www.gao.gov

 

© 2009 The Associated Press.

 

Western NY launches patient record exchange

 

Associated Press

By Carolyn Thompson

Salisbury Daily Times

Friday, January 23, 2009

 

Doctors in western New York have a new, electronic way to access patient records with the hope of reducing medical errors and avoiding costly duplicative tests.

 

The HEALTHeLINK Western New York Clinical Information Exchange is a step toward Gov. David Paterson's goal of creating a unified statewide system where doctors can access records that are now scattered among different clinics and offices.

 

"The emergency room doctor who's never seen that patient before ever will have access to their information, their medication history, any lab work, any radiology reports," HEALTHeLINK Executive Director Dan Porreca said.

 

On a national level, President Barack Obama, during his campaign, promised a $50 billion investment to store patient records electronically. Earlier this month, Obama said he wants all of the country's medical records computerized within five years.

 

"We believe that New York is setting the standard in fulfilling the president's goal of digitizing patient health records and HEALTHeLINK is an integral component of our statewide initiative," said Lori Evans, the state Health Department's deputy commissioner of health information and technology.

 

Addressing privacy concerns, Porreca said the electronic files are more secure than paper, since only authorized people will have access to the Web-based system and to a patient's records.

 

"If it's a paper chart, you never know who's looked at that," he said. "In electronic form, we can track who's looking at what."

 

As of Wednesday evening's launch, about 500 physicians had registered for the free service, which contained more than 4 million lab results and reports.

 

The system is not meant to replace existing electronic medical record software now used by some doctors to record patient visits, but it gives doctors without such software the ability to view lab results, radiology results and transcribed reports from hospitals.

 

"What we're doing is facilitating delivery of information electronically to physicians that are taking care of patients at the point of care," Porreca said.

 

The information exchange also gives doctors the ability to "e-prescribe" — send an accurate, legible prescription directly to a pharmacy. The system will build and maintain a permanent record of a patient's medication history, resulting in fewer adverse drug interactions.

 

"What is important about this effort is we want people's personal health information to follow them wherever they are and to be available at the time they're being seen," said Dr. Michael Cropp, board chairman of HEALTHeLINK.

 

The federal government has encouraged electronic prescriptions by agreeing to increase Medicare reimbursement to participating doctors by 2 percent in 2009 and 2010. Doctors who do not adopt the practice will have their reimbursement reduced by 1 percent in 2010.

 

The not-for-profit HEALTHeLINK was established through a $3.5 million state grant and funding from the Buffalo-based Catholic Health and Kaleida Health hospital systems, Erie County Medical Center and Roswell Park Cancer Institute, along with three insurance organizations: HealthNow New York Independent Health Association and Univera Healthcare.

Press Association

 

[iCopyright] © 2009 Associated Press.

 

$635 Million Is Donated to Fight Polio

 

By David Brown

Washington Post

Thursday, January 22, 2009; A10

 

The global effort to eradicate polio, which began more than two decades ago and has suffered repeated setbacks, will receive an additional $635 million in an effort to finish the job over the next five years.

 

The money will be used to intensify vaccination campaigns in northern India and northern Nigeria, the two regions that account for more than 80 percent of the remaining cases of the paralyzing infection. In addition to those two countries, Pakistan and Afghanistan are the only others where "wild" polio virus still circulates.

 

Providing the new infusion of cash are Rotary International, the service organization that first proposed the eradication of polio and has raised $825 million toward the goal; the Bill and Melinda Gates Foundation; and the governments of Germany and Britain.

 

About $6.17 billion has been spent so far on the eradication effort. The United States has contributed $1.4 billion over the years and is the biggest single donor.

 

"If we don't do this, we will lose all the investment we have made in the past," Gates said yesterday at a Rotary conference in San Diego.

 

The $255 million Gates pledged comes 14 months after a $100 million donation his foundation made in 2007 as the virus resurged in India. Since then, he and his wife have committed themselves to eradicating malaria, a task that will be much harder than ending polio.

 

Yesterday, Gates suggested that a failure to rid the world of polio would be a major setback to progress in global public health that his foundation is spearheading.

 

"The value of this eradication initiative in energizing the global health movement can't be underestimated," he said. "It is super-important that we succeed with polio."

 

Some experts, however, have come to doubt that polio eradication is possible. The campaign has already missed two deadlines, in 2000 and 2005.

 

The number of cases worldwide last year was 1,625 -- about 500 more than in 2007 and three times the number in 2001, the best year of the campaign. Nevertheless, the incidence of the disease has been cut by 99 percent since the campaign began in 1988, when about 350,000 cases a year were recorded.

 

On a teleconference with reporters yesterday, the coordinator of the campaign at the World Health Organization said that failing to finish the job would result in returning to something close to the previous level of infection.

 

"This is an epidemic-prone disease," said R. Bruce Aylward, a Canadian physician and epidemiologist. "The idea that it can be controlled at the level where it is now is a false premise."

 

There are many reasons why eradicating polio has proved harder than eradicating smallpox, a unique achievement that was officially completed in 1980.

 

One is that the vast majority of polio infections are "silent," with about 1 in 200 causing paralysis. That means the virus can spread widely before authorities realize it is present in a population. Another is that there are three types of polio virus, and eradication must eliminate all of them.

 

The vaccine used in the global campaign consists of versions of all three strains that have been weakened so they cannot cause illness. After the vaccine is administered, the viruses briefly grow in a person's intestinal tract, providing immunity and, for several weeks, also being excreted in feces.

 

That can spread the "vaccine-derived" strains through an under-immunized population, and over time the virus can revert to a pathogenic form and cause paralysis.

 

That is what is happening with so-called type 2 polio virus. Its wild form was eradicated in 1999, but since then a vaccine-derived type 2 virus has caused more than 100 cases in northern Nigeria, where in some locales fewer than 60 percent of children are fully immunized.

 

Earlier this decade, several Nigerian states stopped mass immunization for more than a year because of internal political rivalries and suspicions about the vaccine's safety. Polio cases rose steeply, and travelers carried the disease to 20 previously polio-free countries, necessitating expensive and laborious efforts to stamp it out again.

 

The Gates foundation will provide $255 million over the next five years. Rotary will match that with $100 million. The organization, which has 33,000 clubs around the world, has raised $61 million of a $100 million pledge to match the Gates's 2007 donation.

 

Britain, the second-biggest governmental donor to polio eradication, pledged $150 million, and Germany, the fifth-biggest contributor, pledged $130 million.

 

Although no new deadline has been set, WHO has a plan for using the money over the next five years, during which it hopes eradication will be achieved.

 

Copyright 2009 Washington Post.

 

Opinion

 

Peanut recall lists expands

 

Carroll County Times Editorial

Friday, January 23, 2009

 

People worried about a growing list of products recalled because of possible salmonella contamination should visit the federal Food and Drug Administration’s Web site to check the list and look for updates.

 

On Wednesday the FDA added new products to the list. Currently, about 125 products that contain peanut butter and peanut paste that came from a Georgia plant have been recalled.

 

Major national brands of jarred peanut butter are not included in the recall, according to the FDA. But the list does include everything from energy bars to dog treats. Cookies, crackers, cereal, cakes and ice cream are also among the items on the recall list.

 

So far, almost 500 people have gotten sick, and the contamination is suspected in at least six deaths.

 

The FDA notes that many of the products involved have long shelf lives, so it is important for consumers to keep up with the recall and check the various foods that may be in their pantries.

 

The FDA Web site contains a searchable database of the recalled products. Visitors can search by brand name, UPC code or general product description.

 

The FDA is confident that the Georgia plant is the source of the salmonella outbreak. An inspection of the plant found salmonella present, and the Connecticut Department of Health says that it found the exact strain that has been sickening people in an unopened tub of peanut butter that came from the plant.

 

But because the company sends the product out to be used in the creation of so many other products, and because many of those products have long shelf lives, the FDA says it is important for consumers to check and see if any of the products that have been recalled are in their home.

 

If found, the FDA says that consumers should throw the recalled product away.

 

FDA has created a searchable list of products and brands associated with the expanded PCA recall. This list is available on the FDA website at:

 

http://www.accessdata.fda.gov/scripts/peanutbutterrecall/index.cfm

 

Copyright 2009 Carroll County Times.

 

Rejecting care for 'conscience'

 

By Diana Carvajal and Eva Moore

Baltimore Sun Commentary

Friday, January 23, 2009

 

Before this week, when an uninsured Baltimore woman needed contraception, she had an open door to affordable, confidential services. She could go to her local family planning clinic to receive comprehensive reproductive health care services.

 

But thanks to a last-minute rule change ordered by the departing Bush administration, this is no longer the case. Now, care can be denied if a doctor, a nurse - even a receptionist - has a moral objection to a woman's legal right to contraception or other sexual health services.

 

On Monday, the door closed on 17 million women in Maryland and across the nation who rely on public funds for health care. The "conscience clause" allows any employee of a federally funded clinic to abstain from participating in care for "moral" reasons. They can refuse to schedule appointments, clean exam rooms or dispense safe and effective medications. In fact, an employee is not even obligated to refer a woman to a facility that will provide care.

 

This extreme measure goes against everything that we, as physicians, have been trained to do.

 

A woman seeking reproductive health care should be entitled to information about all safe and effective options. Federal Title X funding was made available to provide affordable reproductive care such as pap smears, sexually transmitted infection testing and treatment, contraception and pregnancy options counseling. These funds provide reproductive care for women who otherwise cannot afford it.

 

As health care providers, we are, at the very least, obligated to provide all patients with appropriate referrals - even if we do not participate in or agree with the care. Our personal morality does not enter into it. For example, we cannot refuse to treat a drug user for his drug-induced heart attack just because we are morally opposed to drug use. Nor can a doctor deny a blood transfusion to a woman who lost blood in a fight, even though he or she is opposed to violence. How, then, can we allow a receptionist, doctor, nurse or janitor to turn away a women seeking birth control at a clinic that provides such services just because the employee thinks premarital sex is wrong?

 

Where else will these women go? Many uninsured women have limited options for reproductive health care services. Even worse, the very clinics that need federal funding the most could lose that funding if an employee were made to participate in the care of a woman by providing her with options or proper referral.

 

A health care facility works as a team to take care of patients - to provide every patient with the best medical care available. But under this rule, we are no longer working together. Instead, the team may be torn apart by one person's moral objections. As a result, women will be denied needed care.

 

The "conscience clause" was our former president's last effort to impose moral restrictions on a woman's right to reproductive freedom. The new administration must overturn this extreme and dangerous regulation as soon as possible. It's a simple fix. And it would protect the rights and health of millions of women nationwide.

 

When a worried and scared woman calls her local family planning clinic with no other place to go, she must not be told that health care will be withheld from her on moral grounds. What she needs to hear is, "You called the right place. We'll be glad to help you."

 

Dr. Diana Carvajal is a family medicine physician at the Johns Hopkins School of Medicine and the University of Maryland Department of Family Medicine. Her e-mail is dcarvaj1@jhmi.edu. Dr. Eva Moore is a pediatrician specializing in adolescent medicine at Hopkins. Her e-mail is emoore5@jhmi.edu.

 

Copyright 2009 Baltimore Sun.

 

Readers speak out on state employee layoffs

 

Baltimore Sun Letters to the Editor – 4 total

Friday, January 23, 2009

 

Having been involved in layoffs several times, I understand the anxiety and financial pain that go with the layoff notices the governor may be sending hundreds of state employees ("Painful cuts for budget balance," Jan. 22).

 

But I worked for the private sector, and the layoffs were the result of downturns in the business of the company I worked for. There is no such downturn in the business of the state of Maryland. In fact, during times of recession, more is demanded from government services. And we all know that any layoff of government employees will adversely affect many services to the citizens of Maryland.

 

But by law, the state budget must be balanced. So what can be done to balance the budget that would not involve layoffs of hardworking state employees and would sustain the level of service Maryland taxpayers demand?

 

I see the solution as simple: a temporary wage cut for all levels of state, city and county employees.

 

The wage cut should be based on a percentage of the government employee's wages. The higher the income, the higher the percentage of his or her wage that would be cut.

 

And here is another suggestion: Every contractor now doing business with the state should take a percentage cut in the value of the contract they are now working under.

 

If they refuse, well, memories can be long when these contractors seek additional work from the state.

 

Come on, Gov. Martin O'Malley, the citizens of Maryland hired you to think out of the box. So start doing so.

 

Ron Wirsing

Havre de Grace

 

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Gov. Martin O'Malley's threat to lay off hundreds of state employees to deal with the budget deficit shows a callous disregard for those who might be losing their jobs in this time of economic crisis.

 

The unemployment rate nationally has already topped 7 percent. Adding to that number would only mean longer lines for unemployment compensation (and add to state deficits), more people applying for food stamps or visiting already struggling food pantries. And some of these state employees might be on the verge of losing their homes. There must be a better way.

 

How about a shorter work week for all 70,000 state employees? Shaving two or four hours off everybody's payday would be better than putting hundreds of people permanently out of work.

 

And when the crisis is over, their pay could be restored.

 

State Senate President Thomas V. Mike Miller should stand his ground on this issue.

 

William Wilson

Shady Side

 

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Gov. Martin O'Malley's proposal to lay off hundreds of state employees to help achieve the required state balanced budget does not make sense during an economic recession that includes a high unemployment rate.

 

It will only worsen the unemployment problem and put new stress on state programs designed to aid those out of work.

 

A better course of action would be to repeal the law that requires Maryland to have a balanced budget.

 

Many economists believe that during times of economic slowdown, it is good policy for a government to run a deficit.

 

Deficit spending by a government can actually help to improve the economy. And a balanced budget will do no one any good if it only increases the ranks of the unemployed.

 

John Tully

Baltimore

 

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My thoughts and prayers go out to those state workers facing the prospect of being laid off.

 

These are extremely tough economic times, and I am sure our leaders in Annapolis who are working feverishly to reduce government spending don't enjoy the grim task of letting these people go. But if such dire measures need to be enforced to keep our state government operating, then so be it.

 

Perhaps, though, we can offer some consolation to those who must begin to look for work elsewhere.

 

Let's bring them into the State House and deliver their pink slips on the brand-new carpet that is part of the lavish $10 million State House renovation project that was just completed.

 

Patrick Wallis

Bel Air

 

Copyright 2009 Baltimore Sun.

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