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			Friday, January 30, 2009 News Clipping Archives *Maryland / Regional* Senate OKs expansion of child health insurance (Baltimore Sun) O'Malley sets leaner course for Maryland (Baltimore Sun) Md. Offers Child-Care Inspection Data Online (Washington Post) Counting the homeless (Carroll County Times) Anti-steroid program launches second phase for parents (Baltimore Examiner) *National / International* New Look at Food Safety After Peanut Tainting (New York Times) Army taking peanut items off its shelves (Baltimore Sun) What’s driving up health-care costs and how can we stop it? (Daily Record) Medicare-Payment Fix Weighed (Wall Street Journal) Bad peanuts found before salmonella outbreak (USA Today) Congress to hold hearings on peanut product recall (Newsday.com) *Opinion* The challenge of charity (Baltimore Sun Commentary) Don’t get sick (Cumberland Times-News Editorial) *Maryland / Regional* Senate OKs expansion of child health insurance Tribune Washington Bureau By Noam N. Levey Baltimore Sun Friday, January 30, 2009 WASHINGTON - President Barack Obama and his congressional allies took a modest step toward reshaping the nation's health care system yesterday as the Senate passed legislation to expand health insurance for children. But rather than building momentum for the sweeping health care reform that Obama has promised, the victory on Capitol Hill - a largely party-line 66-32 vote - marked a rocky start for what many hope will be the biggest reform campaign in a generation. "To start out the year on this note does not bode well for future health care discussions, including health reform," Sen. Orrin G. Hatch, a Utah Republican, warned colleagues as the Senate debated the children's health insurance bill, which would enlarge the current program for helping children of the so-called working poor. Like Wednesday's battle over the economic stimulus package, expansion of the State Children's Health Insurance Program became engulfed in a partisan struggle. The stimulus debate also showcased several skirmishes among interest groups, despite the consensus that seemed to be developing among many around health reform last year. Business and consumer groups scuffled over federally subsidized health insurance for jobless Americans in the stimulus package. Insurers faced off with privacy advocates over access to patients' electronic health records, which the stimulus bill would promote. And foreshadowing what will likely be a much larger debate, Republicans rebelled at Democratic moves to expand the federal government's role in providing health insurance. Just nine GOP senators backed the children's health insurance bill yesterday, nine fewer than backed similar legislation in 2007. The current bill - which parallels one approved in the House two weeks ago - would cover an additional 4 million children at an estimated cost of nearly $33 billion over the next 4 1/2 years. SCHIP, as the program is called, helps states provide health insurance for families that earn too much to qualify for Medicaid, the federal medical insurance program for the poor, but not enough to buy private insurance. In the past, the program has enjoyed extensive bipartisan support, though Democrats and Republicans have differed over how much families could earn before their children became ineligible. State rules vary, but some cover children in families with incomes more than twice the federal poverty line, which is $21,200 for a family of four. In Maryland, state officials and health care advocates cheered the Senate's passage of the program, saying it would extend coverage to more needy children. The SCHIP expansion is expected to mean $184 million for Maryland this year, $18 million more than state officials had budgeted for the program, according to estimates from the state Department of Health and Mental Hygiene. Today, about 110,000 children are enrolled in Maryland's program, which covers children in families earning up to three times the poverty limit, or $66,200 for a family of four. "This reauthorization will ensure us the ability to continue this program and allow for modest growth," said John M. Colmers, secretary of the Maryland Department of Health and Mental Hygiene. At a time when the economy is faltering, the kind of protection it affords children is essential." The legislation includes expansion of health care to legal immigrant children. While this is new in the federal legislation, Maryland has been providing coverage to such residents for years, using state money. Now, the state can use matching federal funds to provide that coverage, said Vincent DeMarco, president of Maryland Citizens Health Initiative. "That's wonderful," he said. "It's good for Maryland and it's also good for legal immigrant children elsewhere who haven't had it before." DeMarco said the legislation is a sign that the new administration will place health care expansion and reform in the forefront. "It is a wonderful symbol that this is going to be one of the first actions of the Obama administration," he said. "This is a sign of change in Washington." Baltimore Health Commissioner Joshua M. Sharfstein called SCHIP "a pillar of access to care for kids in Baltimore." "Strengthening the program is just a great step forward," he said. "It sends a really strong message that we are in a different world where the country's leaders are really supporting critical public health issue." Advocates of overhauling the whole health care system had hoped broad support for SCHIP would pave the way for similar consideration of the larger health care issues. But the largely party-line votes on SCHIP and the stimulus raised the prospect that the health care overhaul promised by Obama this year may soon become a one-party exercise. Several senior Democrats seemed unconcerned by that possibility. "You try to get bipartisan support," said Rep. Henry A. Waxman, a California Democrat who chairs the powerful House Energy and Commerce Committee. "But if they don't want to be for it, that's their choice. They'll have to answer to their voters." Other Democrats noted that bipartisan discussions about broader health legislation are continuing. "This is going to work out well," said Senate Finance Committee chairman Max Baucus, a Montana Democrat and one of the leading architects of planned heath reform legislation. Baucus and other Democrats have been meeting regularly with Senate Republicans to talk about health care reform for months, as have a host of interest groups, including insurers, doctors, hospitals, business leaders and consumer advocates. "Health care reform will be on a different track," said Ron Pollack, head of Families USA, an influential consumer group that has led efforts to build consensus around the current reform campaign. With control of the White House and commanding majorities in the House and Senate, Democrats need only a handful of GOP votes in the Senate to push through their agenda. But many advocates believe that major health care reform will need substantial GOP support to endure, much as Medicare has since it passed four decades ago with substantial bipartisan support. In contrast, the Medicare drug benefit, which Republicans pushed through in 2003 on a largely party-line vote, has been fiercely debated since and remains a top target for some Democrats. "Nobody wants ... to see reform get repealed," said Karen Ignagni, president of America's Health Insurance Plans, an insurance industry lobbying group that has been intensely involved in the current health reform talks. Baltimore Sun reporter Kelly Brewington contributed to this article. Copyright 2009 Baltimore Sun. O'Malley sets leaner course for Maryland In Assembly speech, he vows to save social programs, tuition freeze By Laura Smitherman and Gadi Dechter Baltimore Sun Friday, January 30, 2009 Gov. Martin O'Malley charted a course for the state through a national recession yesterday, pledging to protect safety net programs, freeze college tuition and eradicate childhood hunger. The Democratic governor laid out the vision in his third State of the State address before a joint session of the General Assembly, which must approve many of his plans. In a 30-minute speech, O'Malley said he "never felt more energized" despite bleak economic times, and repeatedly invoked President Barack Obama's name, drawing applause in the overwhelmingly Democratic legislature. "Our great challenge for this session is to redouble our efforts, doing all we can to stand up for Maryland families and to power through the other side of this recession ahead of every other state," O'Malley said. "The very good news is that we actually have a president and a Congress who, rather than looking at government as the enemy, are committed to moving us forward." The governor insisted that Maryland remains "strong enough to overcome the very challenging times at hand," and used his platform to reach out directly to worried voters a year before he faces re- election. He ticked off his accomplishments and read letters from two Marylanders in financial straits who sought help from the state. In a nod to the coming political season, he has announced plans to hold a series of town hall meetings to discuss the state economy and the public education system. O'Malley's campaign committee also used the occasion to send an e-mail to supporters yesterday, calling attention to his redesigned Web site that gives people "better tools" to speak out through posting opinions on the governor's legislative agenda and other issues. Republicans, who hold a minority of seats in the House and Senate, faulted the tone and content of the speech. Senate Minority Leader Allan H. Kittleman described the address as "the most partisan speech I have ever seen from the State of the State." Del. Warren E. Miller, a Howard County Republican, called the address "heavy on partisan rhetoric, light on relief for our taxpayers." O'Malley came into this legislative session needing to close a $2 billion budget shortfall. He has proposed a budget that would be balanced, in part, by laying off 700 state workers and reducing aid to school districts. The proposed layoffs are opposed by labor unions and Sen. President Thomas V. Mike Miller, who said yesterday: "That's not going to happen on this watch." O'Malley told state employees in a letter this week that he hopes layoffs won't be necessary. "I know this has many of you worried about your families' well-being and your future," he wrote. The reduced education funding drew the ire of delegations from Baltimore City and Prince George's County, which would receive $23 million and $35 million less, respectively, in school aid under O'Malley's budget for the next fiscal year. At one point, lawmakers had discussed the possibility of walking out of yesterday's speech in protest but were mollified after O'Malley appeared receptive this week to eventually reversing changes in education funding formulas. In his address, the governor repeated his hope that a federal stimulus package moving through Congress would enable the state to avoid many painful cuts. He told lawmakers that he expects the final budget they consider in April to be better than the one he submitted to them. "Why?" O'Malley said. "Two reasons. Barack ... Obama." House Minority Leader Anthony J. O'Donnell accused the governor of relying on a Washington bailout funded with borrowed money, rather than seizing an opportunity to reform Annapolis spending habits. By tapping reserves and using other budget gimmicks, O'Malley is "doing the exact opposite of what experts are telling him to do," said O'Donnell, a Southern Maryland Republican, in a response broadcast on public television. The General Assembly could push for deeper reductions in state spending than O'Malley has proposed. Miller, the Senate president, has said that he plans to ask county governments to share the cost of teacher retirement benefits, an escalating burden on the state. "Some of us, I believe, are even more fiscally responsible than the governor, and we're going to demonstrate that when we get his budget," Miller said. Yesterday, Miller circulated a memo to committee chairmen and vice chairmen, telling them to "exercise greater caution" than in recent years when considering bills that require spending increases. He also urged a reduction in the establishment of task forces and commissions, which eat up the time of legislative staff members already laboring under a statewide hiring freeze. Although O'Malley postponed this week the latest round of cuts to the current year's budget before the Board of Public Works, citing the anticipated federal stimulus, Comptroller Peter Franchot predicted that more cuts would be needed before the fiscal year ends in June as the economy declines further. "We're going to be right back in the soup at the end of the year if we don't cut back," said Franchot, the state's chief tax collector, who sits on the board. For much of his address, O'Malley noted milestones reached during his administration, such as a decline in homicides statewide and the implementation of programs aimed at helping homeowners facing foreclosure. He took aim at companies such as Wells Fargo that he said "continue to ignore the crisis." He also laid out plans that would help residents weather the economic downturn. His budget would direct a record $132 million to energy assistance to help residents pay their heating bills, and he reiterated his proposal to extend unemployment benefits to part-time employees. But O'Malley saved the most pointed rhetoric to plug his efforts to abolish the death penalty and to become the first state to commit to eradicating child hunger by 2015. He defended his proposal for a fourth year of no tuition increases at state universities as not being motivated by poll-driven electoral politics. "Is the fight for affordable college about politics?" he asked. "You're darn right it's about politics. ... It's about the politics of opportunity. It's about the politics of posterity." House Speaker Michael E. Busch praised the address for its "positive, optimistic" tone. Marylanders "need reassurance that people are working to try and resolve their problems," he said. By custom, a number of politicos attended the speech, including former Govs. Marvin Mandel and Parris N. Glendening and Rep. Donna Edwards. Local leaders such as Baltimore Mayor Sheila Dixon filled the gallery overlooking the legislative chamber. Dixon called O'Malley's speech "very upbeat" but wondered whether the governor was "depending too much" on Obama. She said O'Malley seemed to be counting too heavily on federal aid to prop up the state's operating budget. "I hope he's not being too optimistic," she said. Baltimore Sun reporter Julie Bykowicz contributed to this article. Copyright 2009 Baltimore Sun. Md. Offers Child-Care Inspection Data Online Reports Give Parents Details on Services By Donna St. George Washington Post Friday, January 30, 2009; B01 Maryland parents will now be able to peruse inspection reports from child-care homes and centers across the state with a new online records system that advocates and officials say will bring another layer of accountability to day-care decision making. The new system is designed to allow parents to make more informed choices as they seek out care for their children. Maryland joins at least 22 other states in posting online inspection and complaint records, in part or in full. Virginia has had such a system since 2005, and the District is considering one. "We think it's very important that more states do this," said Linda K. Smith, executive director of the National Association of Child Care Resource & Referral Agencies. "We do not think it's fair that parents are forced to make choices without all the facts." With the online search site, parents can see whether inspectors have noted problems with supervision, safety measures, cleanliness, discipline, rest-time practices, training and other issues. The new system went up Dec. 31 but is getting finishing touches and has not been formally announced. "We want to make sure parents have access to information about the compliance record, which is an indication of how well these programs meet state regulations in terms of safety and health as well as early-learning requirements," said Rolf Grafwallner, assistant state superintendent for early childhood development. Child-care providers in Maryland have mixed opinions about the new system, with some raising questions about accuracy and limitations. Each online report gives yes-or-no indicators of problems in 50 broad areas of regulation. But no details are included, so it can be difficult to assess a problem's severity. Parents seeking more information must phone or write licensing officials. "It's very vague," said Jennifer Nizer, president of the Maryland State Child Care Association, which represents child-care centers in the state. "There needs to be a little more information than yes or no." Nizer said one child-care provider who had a chipped countertop was cited in the system under building safety, which could have suggested a far greater hazard. The lack of specificity, Nizer said, "leaves a lot of possibilities open that could be much worse than what it really was." Virginia has taken a more detailed approach. Its online records include descriptions of problems found: an unlocked medicine cabinet; an ungated pool; a caregiver chatting on a cellphone; missing health records; and in one case children restrained with snap belts and cords. The records also include the corrective action to be taken. In Virginia, "it's been incredibly well-received," said Marianne McGhee of the Department of Social Services, who counted more than 75,000 hits for licensed children's facilities last January alone. "We get comments from parents and caretakers; they get excited that they don't have to just go by word of mouth on a facility. " After more than three years online, Virginia's child-care providers "have some appreciation for it," although many wish minor problems were not posted, said Marie Mosby of the Virginia Alliance of Family Child Care Associations. "They realize it's necessary for the safety of the children and for the parents' satisfaction." The District went online Monday with lists of child-care providers. Spokeswoman Mafara Hobson said that adding inspection reports was "a strong possibility" for the site. A previous effort to post online inspection records was sidelined when the city transferred child-care licensing from one agency to another, she said. Smith, the national child-care advocate, argues that more information is better for parents. "You have to trust parents to understand a minor from a major violation," she said, noting that many states have worried about liability and whether parents will misinterpret inspection reports. "Parents understand this more than people give them credit for," she said. Research shows that inspectors become more precise and careful in their assessments when they are posted online, Smith said. This, she said, is good for parents and providers. "Inspectors got better with their jobs," she said. "It was not that parents all of the sudden got inundated with information they didn't understand." Maryland officials said it would not be feasible to include more detailed reports until state inspections are conducted electronically. A pilot program is planned, officials said. The state has more than 2,700 licensed child-care centers and nearly 9,000 home day-care centers. Still, the state did not wish to provide the level of detail Virginia has and was concerned about the timeliness of the information, Grafwallner said. "If you post the information while the situation is, in reality, resolved, it appears online that this is still an issue," he said. Grafwallner said inspection reports are "just one piece of information that is helpful for the parents when they compare programs," suggesting that parents also rely on observation and discussions with care providers. The state's new system was developed at virtually no cost, Grafwallner said, because it was built with software the state already uses to help parents locate child care. Copyright 2009 Washington Post. Counting the homeless By Kyle Nosal Carroll County Times Friday, January 30, 2009 Jeanie Calp asks Sean Truitt some questions for the 2009 Carroll County homeless survey Thursday morning at the Westminster branch of the Carroll County Public Library. By Erica Kritt, Times Staff Writer James Rumpff has been homeless for 20 years. He and his wife, who did not wish to be identified, live in a camper near Union Bridge without electricity or running water. Most people in Carroll County would say there are no homeless in the county, the couple said Thursday at a soup kitchen in Westminster, but they probably just aren’t looking closely enough. The auditorium at St. Paul’s United Church of Christ in Westminster was packed with homeless people who were eating lunch Thursday, when the Circle of Caring Homeless Board counted Carroll’s homeless residents, from Debbie Hunker, who has only been homeless since November, to Douglas “Hippy” Saunders, who hasn’t had a permanent address for 15 years. Every other year, the county is required to count the homeless living in Carroll for the U.S. Department of Housing and Urban Development. HUD requires the numbers for communities to have proper statistics to help with planning and to make sure there are accurate resources. The data collected Thursday can also be used in applying for grants to show need in Carroll. “In order to get grants, we need numbers,” said Jenny Graybill, job readiness program manager for Human Services Programs Inc. Graybill was out Thursday conducting surveys. The count Thursday mostly took place in Westminster, where all those who live in the six shelters run by HSP were counted. The surveys were completed at a soup kitchen and the Westminster library. Graybill said most of the surveys are conducted in Westminster, because most of the homeless live there so they can access more services. Community aid programs such as North East Social Action Program in Hampstead and ESCAPE Ministries in Eldersburg were given surveys for their clients to fill out, according to Graybill. Graybill said she also relies on word-of-mouth to find places other homeless people might be located. “For the most part, they come to the soup kitchen,” she said. Graybill said volunteers surveyed about 15 people at the soup kitchen at St. Paul’s, including Russell Van Scyoc. Van Scyoc said he lives in a tent in the woods of Westminster, relying on blankets to keep him warm and food stamps to keep him fed. Van Scyoc was incarcerated for eight years. After he was released from prison he couldn’t get a job, he said. Now he is finding odd jobs and hoping to parlay a painting gig into renting an apartment. Van Scyoc hopes participating in the survey might result in more jobs or transportation in the county. Stephen Fasick, who is staying at the cold weather shelter in Westminster, said it’s also hard to get a job without the money to buy nice clothes. “I can’t keep a stable job because I don’t have a stable place of residence,” he said. Graybill was unsure how many people were surveyed. The surveys not only asked if a person was homeless, but where they were residing, how long they had been homeless and where they lived before becoming homeless. The survey also asked about gender, race and marital status. Graybill said the information will be put into a secure database where county workers can access the information. Rita Zimmerman, a member of the Circle of Caring Homeless Board and deputy director of the county’s Department of Citizen Services, said there has been an increase over last year of people staying at the cold weather shelter, but she said she doesn’t think there will be a huge increase in the amount of homeless in Carroll County. “There may be a few [more], but it’s usually held steady,” she said. Reach staff writer Erica Kritt at 410-857-7876 or erica.kritt@carrollcountytimes.com. By the numbers January 2007 Homeless Count Are these all the homeless in the state, or are you just looking at neighboring areas. If so, you should make that clear. - Carroll County: 174 - Baltimore County: 634 - Howard County: 175 - Frederick County: 221 - Maryland: 9,606 Copyright 2009 Carroll County Times. Anti-steroid program launches second phase for parents By Sara Michael Baltimore Examiner Friday, January 30, 2009 The next phase of an anti-steroid program looks to parents to spread the message of the dangers of performance enhancers. St. Joseph Medical Center's Powered by Me! program launched phase two of PASS aimed at reducing steroid use among teens. "Parents play a critical role in teaching their children to play their sport safe, fair and free of all drugs," program director Mike Gimbel said in a statement. The first phase of PASS, Physician Awareness of Steroids and Supplements, reached out to doctors to look out for the signs and symptoms of steroid use. They were provided with small cards listing the symptoms to make it easier to review during a checkup. In the latest phase, Parents Awareness of Steroids and Supplements, Powered by Me! will be distributing 15,000 refrigerator magnets to 24 Baltimore County public high schools. The magnets are printed with information to help parents start a discussion about steroids and energy drinks. The Baltimore County PTA will help in handing out the magnets. There also will be a Web site featuring information for families, a message from Baltimore Oriole second baseman Brian Roberts, and a pledge for children and coaches to sign vowing to play fair and sober. A public service announcement will be sent to media and school systems. "We can not be truly successful in the battle against performance-enhancing drugs without the participation of parents," said Rep. Elijah Cummings, D-Baltimore, said in a statement. "The Powered by Me! PASS program is absolutely critical in keeping parents educated about the warning signs and risks of steriod abuse, providing our community the necessary armor to keep our children safe." Copyright 2009 Baltimore Examiner. *National / International* New Look at Food Safety After Peanut Tainting By Gardiner Harris and Pam Belluck New York Times Friday, January 30, 2009 Christopher Meunier, 7, had not been sick since he was a toddler, but in late November, he suddenly had a high fever and bloody diarrhea and started vomiting. “He was just in screaming pain,” said his mother, Gabrielle Meunier of South Burlington, Vt. “He said, ‘It hurts so bad, I want to die’ — something you don’t expect to hear out of a 7-year-old’s mouth.” Hospitalized for six days, Christopher had salmonella poisoning, making him one of more than 500 people sickened across the country after eating peanut butter or peanut products made at a Peanut Corporation of America plant in Blakely, Ga. The Food and Drug Administration has charged that the company knowingly shipped contaminated products to some of the largest food makers in the country from a plant that was never designed to make peanut butter safely, causing one of the most extensive food recalls in history. The company responded that it disagreed with some of the agency’s findings and that it had “taken extraordinary measures to identify and recall all products that have been identified as presenting a potential risk.” Food scares have become as common as Midwestern tornadoes. Cantaloupes, jalapeños, lettuce, spinach and tomatoes have all been subject to major recalls in recent years. And a growing list of manufacturers and trade associations joined consumer advocates in begging for stricter regulations — calls that the Bush administration largely rejected. A clutch of legislative proposals this year would offer fixes to the system, and people offering those measures expect President Obama to support them because, as a candidate, he repeatedly promised reforms. “Far too often, tainted food is not recalled until too late,” Mr. Obama said last year. “When I am president, it will not be business as usual when it comes to food safety. I will provide additional resources to hire more federal food inspectors.” Nearly all of the proposed legislation under consideration would require companies like the Peanut Corporation of America to lay out specific plans for manufacturing safely and testing routinely. The bills would require that test results and other records be made available to government inspectors upon demand, and would provide additional money for more intense inspections of domestic and foreign food factories. Some would also fix the patchwork system by which outbreaks are detected. Senator Richard J. Durbin, Democrat of Illinois, and Representative Rosa DeLauro, Democrat of Connecticut, also propose creating a food agency independent of the F.D.A. so that food would receive single-minded attention. At present, at least 12 federal agencies regulate food safety. The battle between those who would strengthen the F.D.A. and those who would break it up will be an important fight this year. “I think I can prevail on the president to take a fresh look at this,” Mr. Durbin said. “We can no longer forgive or explain what’s happening with food safety in this country.” Neither the White House nor the Health and Human Services Department would comment on Thursday. But the peanut case, critics say, demonstrates just how badly the system needs fixing, starting with the patchwork surveillance system that is the first indicator that something has gone wrong. Cases like Christopher’s are reported to local health departments, which in turn are to report them to the Centers for Disease Control and Prevention. By mid-November, the disease centers had seen enough cases of a similar strain of salmonella to be concerned. “The numbers were not necessarily significant initially — one here, one there,” said Lola Russell, a disease centers spokeswoman. “Over time, those numbers began to grow.” By mid-December, the Minnesota Department of Health, known as among the best in the nation, had received reports of nine people with salmonella poisoning. As a result, the department’s Team Diarrhea, a group of graduate students who work nights, started calling patients and their caregivers to ask about their food choices . “We had a lot of peanut-butter eaters,” said Carlota Medus, a state epidemiologist. “But none of the brand names were matching up well.” Other states were reporting similar cases, but as in Minnesota, no one could figure out the shared food. The process is fraught with uncertainty. State health officials ask people what they remember eating in the days before they became ill. Poor memories and bad records hamper these efforts, and officials are often sent on fruitless pursuits. Delay is part of the problem. More than two weeks generally pass between the time someone is diagnosed with an illness and the result of a stool sample test is passed on to federal officials. Last year, the F.D.A. announced a recall of tomatoes, only to discover near the end of the outbreak that the problem had actually been with jalapeños. Tomato growers, who saw much of their crop destroyed and endured millions in losses, were outraged. With the illnesses involving peanut butter, an initial suspect was chicken. “The chicken was actually a red herring,” said Ms. Russell of the C.D.C., a diversion that resulted from an outbreak of illness among people who had eaten chicken at an Ohio restaurant as well as peanut butter at a school cafeteria. Then on Dec. 22, a nursing home in northern Minnesota reported a cluster of cases. Investigating outbreaks in nursing homes is both more challenging and easier than elsewhere — easier because the facilities have set menus, harder because patients are often unable to say what menu choices they ate. Then another nursing home reported illnesses. On Dec. 28, a Minnesota elementary school reported two children who had become ill. The holidays prevented state workers from talking to school cafeteria workers, but the health department was able to track down the school’s food supplier. Everyone seemed to be eating peanut butter. Finally, a state health worker asked the nursing homes if they still had jars of the suspect peanut butter. One did, and on Jan. 9, that peanut butter tested positive for salmonella. The state announced that King Nut peanut butter, sold only to institutions, was the culprit. King Nut’s product was made by the Peanut Corporation of America. The F.D.A. then descended on the Georgia plant with a team of inspectors. It used authority granted under a 2002 bioterrorism law to demand records that inspectors from the Georgia Agriculture Department, which had inspected it twice before without finding serious violations, had not been given access to. The records showed that on 12 occasions from 2007 to 2008, tests of peanut products made at the plant were contaminated by salmonella. Each time, retests came up clean. But F.D.A. officials said the initial tests should have led plant officials to quarantine their product and clean their facility — neither of which occurred. Sheryl Gay Stolberg contributed reporting. Copyright 2009 New York Times. Army taking peanut items off its shelves Military acts after salmonella sickened more than 500 in U.S. Associated Press Baltimore Sun Friday, January 30, 2009 WASHINGTON - Amid concerns about contamination, the Army said yesterday that it is removing some peanut butter items from warehouses in Europe, the most recent in a growing list of recalled peanut products linked to a national salmonella outbreak. The Army recall does not affect Meals Ready to Eat, but will affect another kind of military ration called Unitized Group Rations-A, which provide a complete 50-person meal. In the civilian world, more than 430 kinds of cakes, cookies and other goods have been pulled off store shelves in what the Food and Drug Administration is calling one of the largest product recalls in memory. Yesterday, Giant Food added Nature's Promise All Natural Trail Mixes to the list, voluntarily recalling products that contain peanuts supplied by the Peanut Corp. of America, the company that owns the Georgia processing plant at the center of the investigation. More than 500 people have gotten sick during the U.S. salmonella outbreak, and at least eight might have died. Federal inspectors reported finding roaches, mold, a leaking roof and other sanitary problems at the Blakely, Ga., peanut processing plant. Managers at the plant continued shipping peanut products even after they were found to contain salmonella, the FDA said. The company shipped the food items after retesting them and getting negative results. Peanut Corp. expanded its recall Wednesday to all peanut goods produced at the plant since Jan. 1, 2007. The company makes just 1 percent of the peanut products sold in the United States, but those products are ingredients in hundreds of foods, from ice cream, to Asian-style sauces, to dog biscuits. Major national brands of peanut butter are not affected. A senior lawmaker in Congress and Georgia's agriculture commissioner called for a criminal probe of the company, but the FDA said that would be premature while its own food safety investigation continues. The company says it is cooperating fully with the government and has stopped all production at the plant. Peanut Corp. said in a statement that it "categorically denies any allegations that the company sought favorable results from any lab in order to ship its products." Stewart Parnell, the firm's president, said the recall was expanded out of an abundance of caution. "We have been devastated by this, and we have been working around the clock with the FDA to ensure any potentially unsafe products are removed from the market immediately," Parnell said. Most of the older products in the expanded recall have probably been eaten already. Officials said they see no signs of any earlier outbreaks from those goods. The recall covers peanut butter, peanut paste, peanut meal and granulated products, as well as all peanuts - dry and oil roasted - shipped from the factory. FDA officials could not quantify the amount of products being recalled. Officials recommend that consumers check the FDA Web site, which lists all of the products being recalled, and toss out any that are named. Salmonella had been found previously at least 12 times in products made at the plant, but production lines were never cleaned after internal tests indicated contamination, FDA inspectors said in a report. In most states, food producers are not required to alert health regulators if internal tests show possible contamination at their plants. Products that initially tested positive for salmonella were retested. When the company got a negative reading, it shipped the products. That happened as recently as September. A month later, health officials started picking up signals of the salmonella outbreak. Michael Rogers, a senior FDA investigator, said it is possible for salmonella to hide in small pockets of a large batch of peanut butter. That means the same batch can yield both positive and negative results, he said. The products should have been discarded after they first tested positive. Separately, senior congressional and state officials called Wednesday for a federal probe of possible criminal violations at the plant. The company's actions "can only be described as reprehensible and criminal," said Rep. Rosa DeLauro, a Connecticut Democrat who oversees FDA funding. "This behavior represents the worst of our current food safety regulatory system." In Georgia, the state's top agriculture official joined DeLauro in asking the Justice Department to determine whether the case warrants criminal prosecution. "They tried to hide it so they could sell it," said Georgia Agriculture Commissioner Tommy Irvin. "Now they've caused a mammoth problem that could destroy their company, and it could destroy the peanut industry." Copyright 2009 Baltimore Sun. What’s driving up health-care costs and how can we stop it? By Jim Cronin Daily Record Friday, January 30, 2009 Recent studies by Towers Perrin and Hewitt Associates both project 2009 health-care cost increases to be around 6 percent nationally. Although that is less than the double-digit increases we’ve seen in recent years, 6 percent still may sound like a lot. I don’t blame people for wondering, perhaps angrily, why health-care costs continue to rise. As a local executive for a national health insurer, however, I know that there are real, structural reasons these costs increase every year and that addressing the causes of health-care inflation is a daunting task. A big part of the increase in health-care costs this year is inflation, which most experts say will run 5.6 percent, fueled by the dramatic increase in energy costs for much of the year. When you take overall inflation into account, the real increase in health care is minimal. Besides inflation, there are a number of trends that continue to drive health-care costs up despite the best efforts of employers, consumers, health-care professionals and insurance companies to cut them: * Unhealthy lifestyles. There continues to be an increase in conditions such as diabetes, heart disease and some cancers related to unhealthy lifestyles and obesity. The total bill for delivering health care in our country would decline dramatically if more Americans adopted healthy habits. * An aging population. The population is aging and the elderly tend to need and use more health-care resources. Because of its older demographics, the aging of the population affects Baltimore County more than most other places here. * The economy. Several studies have shown that many people with chronic conditions stop taking or take smaller doses of medication or forgo other care because they can’t afford it. This results in greater overall costs when patients deteriorate and need more expensive treatments. * Use and overuse of medical technology. New technologies improve medical care but also drive up the cost of providing that care. For example, in what has become known as the “medical arms race,” many medical practices invest in expensive imaging machines, and once a group owns one, there is a tendency to use it more rather than refer patients to lower-cost facilities. It will be a challenge to slow or reverse these trends in the short term. There are, however, some actions that employers and employees can take today to “act locally” and reduce the cost of their health care. For example, businesses can offer employees incentives to shift to the combination of a high-deductible health plan and a health savings account. A recent study of employers offering UnitedHealthcare plans indicated that an HSA program provides a 10 percent to 12 percent cost savings over a four-year period, in part due to greater use of preventive care. Employers can encourage workers to use generic drugs, which usually have the same components as brand-name drugs but cost less. And employers can study employees’ usage of benefits to identify and provide wellness programs to address the most prevalent issues. There is no quick solution, but employers can take action to help lower the cost of health care. And in the process, employers and their employees will play an important role in making quality health care more affordable and accessible for all. Jim Cronin is CEO of UnitedHealthcare of Maryland. His e-mail address is jim_p_cronin_jr@uhc.com. Copyright 2009 Daily Record. Medicare-Payment Fix Weighed By Jacob Goldstein Wall Street Journal Friday, January 30, 2009 As leaders in Congress and the Obama administration look to expand health-insurance coverage while controlling costs, they are considering changing the way doctors are paid for treating patients covered by Medicare. Critics of the current system, in which most doctors are paid for each procedure they perform, say it creates a financial incentive for unnecessary treatments. Alternatives such as paying a fixed annual rate for each patient have been criticized for giving providers an incentive to withhold potentially helpful treatments. In search of a middle road, policy makers and some private insurers may opt to make a single, blanket payment for such things as implanting an artificial hip or providing a few months of cancer treatment, which currently can involve many separate billable procedures. Health and Human Services Secretary nominee Tom Daschle has said he supports episode-based payments because they could lead to "better outcomes and lower cost, and far less hassle for providers." A white paper published last fall by Max Baucus, the Montana Democrat who is chairman of the powerful Senate Finance Committee, said moving Medicare toward bundled payments for hospitalized patients could improve efficiency and encourage doctors to do a better job coordinating patient care. Medicare, the federal health-insurance program for the elderly, has long used lump-sum payments for hospitals. Before Medicare could make a large-scale shift to bundled payments for physicians, congressional approval would be required. But a new Medicare pilot program splits a single lump sum between the hospital and physicians who care for the patient. Some insurers in the private sector are also experimenting with bundled payments. But for all the enthusiasm about bundled payments, bringing them into widespread use in the fragmented health-care world would be tricky. Doctors could be forced to give control over a large portion of their incomes to hospitals, which in some cases would be responsible for coordinating distribution of bundled payments. "It's hugely worrisome to us," said Lawrence Martinelli, an infectious-disease specialist in private practice in Lubbock, Texas. "There's concern about not only how much you're going to get paid, but whether you can negotiate a contract where you can at least break even." Dr. Martinelli is a member of the Infectious Diseases Society of America, which last year wrote an open letter arguing that bundling physician and hospital payments together could "limit Medicare beneficiaries' access to necessary specialty care." To avoid creating an incentive for doctors and hospitals to cherry pick the healthiest patients, payments could be higher for those with a higher risk of complications. And there would have to be a check against doctors and hospitals denying care when doing so would be the cheapest option, but not in the best interest of the patient. Proponents argue that well-designed bundled payments could remedy a central problem in the existing payment system: Doctors who provide subpar care are reimbursed for treating problems that better care might have prevented, while doctors who prevent serious complications see no financial benefit. In an episode-based payment system designed by Bridges to Excellence, a nonprofit group that is trying to realign health-care incentives, doctors and hospitals treating heart-attack patients would receive a fixed payment that would not increase if a patient had to be readmitted to the hospital a few days after being sent home. "You're forcing the delivery system to think about the stuff that everybody complains is not happening," says François de Brantes, the group's chief executive. "Don't discharge the patient without coordinating with the treating physician, because that's going to lead to a readmission." Medicare recently launched its own pilot project at a handful of hospitals that negotiated with doctors and submitted bids to receive bundled payments for a few procedures, including hip and knee implants and coronary-bypass surgery. Write to Jacob Goldstein at jacob.goldstein@wsj.com Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved. Bad peanuts found before salmonella outbreak USA Today Associated Press Friday, January 30, 2009 WASHINGTON (AP) — Weeks before the earliest signs of a national salmonella outbreak that now has been traced to peanuts from a Georgia processing plant, peanuts exported by the same company were found to be contaminated and were returned to the United States, The Associated Press has learned. The rejected shipment — coming over the U.S. border across a bridge between New York and Canada — was logged by the Food and Drug Administration but never was tested by federal inspectors, according to the government's own records. The chopped peanuts from Peanut Corp. of America in Blakely, Ga., were prevented by the FDA from being allowed back into the United States in mid-September because the peanuts contained an unspecified "filthy, putrid or decomposed substance, or is otherwise unfit for food," according to an FDA report of the incident. It was not immediately clear whether the date on the government's record, Sept. 15, was when the unspecified importer rejected the shipment or when the FDA refused it. It also was not known whether the peanut shipment ultimately was destroyed or sent somewhere else. The FDA said it could not provide details about the incident. Peanut Corp. of America didn't immediately respond to AP's request for comment. Federal inspectors previously reported they found roaches, mold, a leaking roof and other sanitation issues at the company's processing plant in Blakely believed to be the source of the outbreak. Members of Congress noted that the timing of the discovery of the adulterated peanuts came just weeks before the first clear signs of the salmonella outbreak that has sickened more than 500 people in the United States and may have killed at least eight. The FDA has since ordered recalls of a long list of products containing nuts from Peanut Corp. "The FDA failing to follow up after this incident, does that mean that products that are not good enough for a foreign country are still good enough for the USA?" asked Senate Agriculture Committee Chairman Tom Harkin, D-Iowa. "That's a double standard that has deadly consequences for our citizens." Harkin plans hearings on the outbreak and has proposed an overhaul of the nation's food inspection network. The House Energy and Commerce Committee, led by Rep. Henry Waxman, D-Calif., announced oversight hearings in the House will begin Feb. 11. The head of the House appropriations panel that oversees FDA funding, Rep. Rosa DeLauro, called the discovery of the bad shipment in September "a perfect example of the patchwork system." "Why was it able to get exported in the first place?" said DeLauro, D-Conn. "That also begs the question, how many contaminated products are getting through our borders every single day? If the FDA discovered that there was an issue with this product inspection, why didn't they follow up on it? Why didn't they take a closer look at this facility?" DeLauro said she wants the Justice Department to investigate the salmonella outbreak, and also is pressing for major changes in food safety oversight. The government recorded the peanuts' seizure in the FDA's Oasis system, designed to prevent shipments into the United States of unsafe foreign products. In this case, it caught peanuts coming back into the U.S. after they were rejected abroad. According to the government's database, the FDA did not analyze a sample of the adulterated peanuts. The records show conflicting information about whether the FDA has a record of an analysis of the peanuts from a private lab. The seizure of the peanuts in September is significant because it came just before the salmonella outbreak, said Caroline Smith DeWaal, director of the food safety program at the Center for Science in the Public Interest in Washington. "It strikes me that if FDA was paying attention to this information, that they might have gone and done an inspection of the plant in September instead of waiting until after the products were associated with a major outbreak," she said. DeWaal said she thinks "the question for the agency is how did they use it when it happened." The incident was among nearly 1,400 around the country in September in which the FDA refused to allow shipments into or back into the United States, often because products are not approved for sale in the U.S. or were improperly labeled. In a few cases in September, the FDA actually detected salmonella on items coming into the U.S. The rejected peanut shipment was stopped at a border crossing, apparently in Alexandria Bay, N.Y., suggesting the chopped peanuts had been sent originally to Canada. Canadian government officials told the AP they could not confirm the shipment. Canada this week recalled several products as a result of the outbreak. The country is working with the FDA to trace back possible distribution of the products, said Garfield Balsom, spokesman for the Canadian Food Inspection Agency Office of Food Safety and Recall. Copyright 2009 The Associated Press. All rights reserved. Congress to hold hearings on peanut product recall Staff and Wire Reports Newsday.com Friday, January 30, 2009 A congressional committee will hold hearings into the cause of the tainted peanut product that as of Wednesday had sickened 530 persons in 43 states, including 20 in New York, and one Canadian province, and been linked to eight deaths. Rep. Henry Waxman (D-Calif.), chairman of the House Energy and Commerce Committee, will conduct the hearings into the cause of the salmonella outbreak the week of Feb. 11, The Associated Press reported. Also yesterday, the U.S. Army learned it was not immune from the impact of a massive expanded recall of peanut product and ingredients originating from the Peanut Corp. of America's Blakely, Ga., facility federal investigators say is the outbreak source. As many more firms yesterday began recalling product, the U.S. Army said it was removing some peanut butter items from warehouses in Europe. The move doesn't affect Meals-Ready-to-Eat, but another kind of military grub called Unitized Group Rations-A, which provide a complete 50-person meal. The expansion, announced Wednesday, now covers peanut butter, peanut paste, peanut meal and granulated products, as well as all peanuts - dry and oil roasted - shipped from the factory, dating back to January 2007. More than 430 kinds of cakes, cookies, candy, ice cream, pre-prepared dinners and other goods - even three brands of dog treats - had already been pulled from store shelves before what the FDA Wednesday called one of the largest product recalls in memory. Waxman is expected to invite victims of the outbreak to tell their stories, as well as put under oath the owners - the Parnell family - of the Peanut Corp. of America. Two private labs now under scrutiny in the outbreak, J. Leek Associates Inc., and Deibel Labs Inc., are also expected to be called to testify. It was not clear if other affected manufacturers will also be called. Meanwhile, a third lawsuit was filed on behalf of a victim against PCA yesterday. Seattle attorney Bill Marler, a 15-year veteran in litigating food-borne illness cases, filed in the U.S. District Court of California, Northern District, on behalf of the Trone family of Crescent City, Calif. The suit alleges that up to and including Christmas Day, Bryson Trone, 3, ate peanut butter cracker sandwiches made with PCA's peanut butter product. He fell ill Dec. 26, and when symptoms worsened, was admitted to the hospital, where he remained for 5 days. While hospitalized, he tested positive for the strain of Salmonella Typhimurium associated with the PCA outbreak. Marler has also filed suit on behalf of a Vermont couple whose 7-year-old son was similarly sickened and tested positive for the strain, while a Minnesota lawyer has filed on behalf of the family of Shirley Mae Almer, 72, who died Dec. 21 after consuming peanut butter at a nursing home in the state. Latest list of recalled items These companies yesterday pulled products as part of the expanded recall of all peanut products from Peanut Corp. of America's Blakely, Ga., plant dating back to January 2007. The items were removed from store shelves because each product contains peanuts supplied by PCA and has potential to be contaminated with salmonella bacteria. GIANT/MARTIN SUPERMARKETS: Recalls another peanut-based product - ice cream sundae cones. UNCLE EDDIES VEGAN COOKIES: Uncle Eddies Vegan Peanut Butter Chocolate-Chip Cookies, both 12 oz. bags and 3.75 oz. individually wrapped. THE STOP & SHOP SUPERMARKET CO.: Announced it has recalled various Natures Promise All Natural Trail Mixes. FIELDBROOK FOODS CORP.: Select ice cream sundae cone packs that contain granulated peanuts, including certain varieties of America's Choice, Artic Classic, Big Y, Bon, Byrne Dairy, Carnival, Cub Foods, Dolly Madison, Econo, Food Club, Flavorite, several Food City and Giant Eagle varieties, Grande, Greens, Hill Country Fare, Hagan, Hood, Ice Girl, IGA, Kay's, Key Food, Krasdale, Lowes, Market Basket, Meijer, Pathmark, Price Chopper, Pricerite, Publix, River Valley, Redners, Richfood, Roundy's, Shop 'n Save, Shoprite, Shurfine, Shurfresh, Stater Bros, Stop & Shop, Sundae Shoppe, Tops, United Dairy, Valu Time, Velvet, Weis, Winn Dixie. COUNTRY MAID INC.: Expand its previous recall of 2-pound packages of Classic Breaks peanut butter cookie dough to include more lot numbers. The dough was available for distribution through fundraising groups between Aug. 20, 2007 and Jan. 9, 2009, in 32 states, including New York. WEGMANS FOOD MARKETS INC.: All code dates of peanut-covered doughnuts, peanut butter cookies and chocolate peanut butter tarts that were sold in Wegmans' stores in New York, Pennsylvania, New Jersey, Virginia and Maryland. WELLS' DAIRY, INC.: Recalling all Blue Bunny No Sugar Added Reduced Fat Bunny Tracks ice cream and one lot of Blue Bunny Personals Bunny Tracks. Copyright © 2009, Newsday Inc. *Opinion* The challenge of charity By Richard Lawrence, Colleen McCahill and Audrey Rogers Baltimore Sun Commentary Friday, January 30, 2009 Many people in Baltimore want to do something to help the homeless residents of our city. But as we at St. Vincent de Paul Catholic Church have learned, some ways of helping end up doing more harm than good. Ten years ago, our church acquired the park that lies at the foot of the Jones Falls Expressway. In an agreement with the city, the Baltimore Archdiocese and the Maryland Historic Trust, we agreed to keep the park as a park. When it became private, we allowed homeless people to sleep there. Now, 12 to 18 people sleep in the park on any given winter night. Others visit during the day. And many people come to the park to donate food or clothing. Our park has become a visible sign of homelessness in Baltimore. Although we believe not one person should sleep on the street, we cannot tell someone with no housing options to move on. However, our small parish has paid a dear price. We relinquished our only green space and tolerate trash and crowds. It would be far more comfortable to post "No Trespassing" signs, replant grass and flowers, and reclaim our property. However, we find ourselves challenged to live a Christianity that cannot ignore the world's brokenness, and challenged to find meaning in a faith that reaches out to those in despair. Mayor Sheila Dixon sees the human dimension of homelessness and has committed resources to it. Moreover, Ms. Dixon reached out through her Division of Homeless Services to partner with us in addressing the needs of the homeless in the park. Since the partnership started last year, our volunteer staff has identified more than 100 people who frequent the park, ascertaining the needs of many and linking them to services. Through Baltimore Homeless Services and others, 12 people are now housed and another dozen have housing vouchers. There are many who care. Our Daily Bread provides a midday meal. The Salvation Army, Loyola University students, Bridgeway Community Church in Columbia and New Psalmist Baptist Church in Baltimore bring suppers. Our Lady of the Fields Catholic Church provides a hot supper every Friday in our church hall. The St. Vincent de Paul Society placed a collection bin in the park to keep donated clothing clean and dry. We also have a free clothing program. Epic Church of Canton co-funds a portable toilet. We pay for a part-time liaison who enlists people living in the park to help keep it clean. Parishioner volunteer teams regularly remove mildewed and dirty discarded clothes, wet bedding and uneaten food. We posted a sign noting that only authorized donations are permitted. But cold weather, media coverage and the spirit surrounding Christmastime produced a tsunami of food and clothes brought by people who ignored our sign and our efforts. Such donations may seem to be a perfect solution for leftover food or clothes, but excess food draws rats, and the "feel good" response enjoyed by donors is not necessarily shared by park residents - who, although they gratefully receive, tell us of their feeling of being "fed like dogs." Every month, hundreds of pounds of ruined clothes go to the city incinerator. This surplus and waste contributes not to the health and well-being of those in the park, but to the erosion of their dignity. We beg good-hearted people to continue to be generous while becoming more discerning. More effective than bringing food or clothing to the park would be to support the agencies that give directly to the homeless and help them to a better life: Health Care for the Homeless, Our Daily Bread, the Salvation Army, the St. Vincent de Paul Society, Beans and Bread, Helping Up Mission, the Maryland Food Bank and the new United Way Fund. Finally, we urge residents to get their faith communities involved with us as active members of the Archdiocesan Beyond the Boundaries program and the Baltimore Regional Initiative for Genuine Equality (BRIDGE), organizations committed to inclusionary, affordable housing. Nobody belongs on the street in America. We are our brother's keeper. The Rev. Richard Lawrence is pastor of St. Vincent de Paul Catholic Church. Colleen McCahill is president of the church's Parish Council. Audrey Rogers is coordinator of the St. Vincent de Paul Park Working Group. Copyright 2009 Baltimore Sun. Don’t get sick Cumberland Times-News Editorial Friday, January 30, 2009 Consider this a reprieve, of sorts. If you meant to get a flu shot but didn’t, it’s not too late. The flu season is just arriving, and flu vaccine is still available. Flu kills about 36,000 Americans each year, and for those who contract it but survive, the experience is far but pleasant. About 200,000 Americans are hospitalized each year because of the flu. The flu season usually peaks in November, December and January, but that hasn’t happened until February for the last two winters. The vaccine is recommended for all children between 6 months and 18 years old, anyone 50 years and older, women who will be pregnant during flu season, anyone who has long-term health problems or a weakened immune system and anyone who is caring for someone who fits any of the above at-risk categories. Just because you haven’t already been vaccinated against the flu doesn’t mean it’s too late to do so. Contact your primary care physician for a flu shot or call the Allegany County Health Department, which still has a limited supply of vaccine, at (301) 759-5090. PharmaCare of Cumberland also offers vaccinations; call its “Option Care” line at (301) 723-2240. The idea that flu shots make people sick is a myth. The flu itself is what does that. Copyright © 1999-2008 cnhi, inc. BACK TO TOP


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