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			Wednesday, July 15, 2009 News Clipping Archives *Maryland / Regional* Swine flu vaccine likely by October (The Gazette) Lyme disease cases rise as West Nile virus falls (Salisbury Daily Times) Board discusses veteran care problems (Salisbury Daily Times) Health clinic signs lease in Rockville (The Gazette) Keeping body in fridge is legal, officials sayKin did not report death, stored Glen Burnie grandmother in freezer (Baltimore Sun) *National / International* Choosing Safer, Sustainable Seafood (Baltimore Sun) A New Understanding of Glaucoma (New York Times) Senate committee passes health care bill (Frederick News-Post) *Opinion* Gone but not forgotten (Carroll County Times Commentary) Evaluating Hospitals (New York Times Letter to the Editor) Hospital causes pain for family (Carroll County Times Letter the Editor) *Maryland / Regional* Swine flu vaccine likely by October Maryland confirms a second H1N1 death By Marcus Moore The Gazette Wednesday, July 15, 2009 The federal government expects to have a vaccine developed by the fall to combat the national spread of the H1N1 virus, commonly known as swine flu, health officials said Thursday morning during a summit at the National Institutes of Health in Bethesda. Obama administration officials are preparing for the worst and suspect that swine flu could come back stronger in October, when an illness could spread more easily. "What we can't do is wait until October, then decide that we have a very serious problem on our hands," Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, told a crowd of local health officials and government leaders. The World Health Organization declared swine flu a national pandemic in late June. On Thursday, Novavax Inc., a biotechnology firm in Rockville, announced a joint venture with Cadila Pharmaceuticals in India to develop the swine flu vaccine. Under the joint venture, CPL Biologicals Pvt. Ltd, the first round of swine flu vaccine would be available by October. Also on Thursday, Sebelius announced that some $350 million in grants - including $260 million for states and another $60 million for hospitals to prepare for the expected rise in the number of flu patients - would be available. The summit was the first of many to help states prepare for the flu's possible comeback, according to the Department of Health and Human Services. "Preparation is the message today," Janet Napolitano, secretary of the U.S. Department of Homeland Security, told reporters, adding that it's a "shared responsibility amongst all of us." Maryland had 686 confirmed cases of swine flu in 11 counties and Baltimore city as of the end of last week. Two swine flu-related deaths have been reported in the state. Nationally, 170 people have died from the virus. Swine flu first turned up in the state in April, when schools were closed in Baltimore, Anne Arundel and Montgomery counties because of suspected cases. Last month, state health officials said they needed volunteers and federal aid to combat swine flu. Despite state and local health departments performing well during this spring's outbreak, "I think we lack bench strength," Maryland Health Secretary John M. Colmers said at the time. For state information on the swine flu, go to www.dhmh.maryland.gov/ swineflu. The federal government has also launched a Web site, www.flu.gov. Staff Writer Sean R. Sedam contributed to this report. Copyright 2009 The Gazette. Lyme disease cases rise as West Nile virus falls By Jordan Allen Salisbury Daily Times Wednesday, July 15, 2009 SALISBURY -- Six years ago, West Nile virus sent a scare through Maryland as mosquito numbers soared and brought the cases of infected humans up with it. Since then, the virus has been on the decline, along with reported cases. But where West Nile dropped off, Lyme disease has picked up in its place. Lyme disease is spread by the black-legged tick (also known as the deer tick), and is becoming more common in Maryland and Delaware. The Centers for Disease Control and Prevention reported the number of Lyme disease cases in Maryland nearly doubled between 2006 and 2007, rising to 2,576 people infected. The Maryland Health Department recorded about 2,200 cases in 2008. Incidents of West Nile virus, on the other hand, have declined since its peak of 73 cases in 2003. In 2008, the CDC reported only 14 cases of the virus in the state. West Nile virus is a potentially serious illness, transferred to humans by mosquitoes, with the greatest chance for infection during the summer months and early fall. Dave Schofield, assistant program manager of mosquito control for the Maryland Department of Agriculture, said the number of cases of West Nile virus on the entire East Coast have been in a state of steady decline. "Basically it's cyclic," Schofield said. "You have years where it keeps going up, then it crashes." Entomology professor Michael Raupp of the University of Maryland said West Nile virus cases drop when one stage of the epidemic cycle is broken. The virus is passed to mosquitoes after feeding on an infected bird. The insects then feed on humans and horses, spreading the virus to both. "There was a huge die-off of crows and other susceptible birds, so that portion of the epidemic cycle dropped out," Raupp said. Another factor in the drop-off of cases could simply be fewer humans are susceptible to the virus, Raupp said. Larry Lembeck, an MDA entomologist, said West Nile virus first appeared in New York in 1999 and spread across the country. When it hit the mid-Atlantic in 2003, people had not yet built up immunity to the virus, he said. "When a disease comes into an area, nothing is used to it yet; there are no antibodies," Lembeck said, adding that people have now built up antibodies to West Nile virus, though it will flare up occasionally like any other virus. Wicomico and Somerset county health departments reported no cases of West Nile virus in the past two years. Taking up the torch But as West Nile virus cases go down, Lyme disease continues to thrive. Lyme is caused by a bacterium transferred to humans by the black-legged tick. Tick eggs are laid in the spring and hatch in the summer, when they feed on small animals, most typically the white-footed mouse. When the tick feeds on a mouse carrying Lyme, it carries the disease in its blood and remains infected for the remainder of its life. The ticks then grow older, and the next year, feed on larger animals, such as deer and humans. While deer do not become infected, they transport the ticks and maintain the population. Most cases of Lyme disease in humans occur in late spring and summer when tick feeding is most active, according to the CDC Web site. In 1999, there were 899 cases of Lyme disease. By 2006, that number grew to 1,248 before doubling the following year. Raupp said no one knows for sure why the tick population is up this year, but a convincing hypothesis was developed by Rich Ostfeld, an animal ecologist at the Cary Institute of Ecosystem Studies in New York. Ostfeld's hypothesis involves mast-consuming animals, or animals that eat acorns. The critical players are ticks, white-footed mice and white-tailed deer. The mast hypothesis states high acorn production means more food for mice, meaning more mice on which ticks can feed. The tick population, in turn, rises and increases the chance to pass on Lyme. Basically, he said, anything that increases the mouse population has the potential to increase human cases of Lyme disease. "As far as I know, the hypothesis hasn't been tested in Maryland, but I have every reason to believe it would apply to any oak forest ecosystem in which there is a Lyme disease risk," Ostfeld said. He said the high fall acorn production links to increased risk of Lyme disease two summers later. If the theory is correct, this means in Maryland there was increased acorn production in fall 2005, more mice for ticks to feed on in summer 2006, leading to the doubled occurrences of Lyme disease in 2007. Ticks bear several other serious diseases besides Lyme. But some, such as Rocky Mountain spotted fever, aren't found in Maryland because they are regional to a different area of the country. Ostfeld said other diseases, such as ehrilichiosis, may be under reported because they don't have debilitating or deadly side effects like Lyme disease. So far this summer, the Wicomico County Health Department reported 14 suspected cases of Lyme, and Somerset reported eight, about the same as last year. "But that's not an increase over a typical summer," said Brandy Wink, administrative deputy health officer for Wicomico County Health Department. Raupp said the season for Lyme disease starts in June, then peaks in July and August before declining once more. "We're right on the front edge of a wave," Raupp said. "I have two people in my family that are being treated for Lyme disease right now so we're all seeing it." Additional Facts Symptoms Prevention Other diseases Lyme disease Side effects of Lyme disease are a circular bull's-eye shaped rash (appearing three-30 days after tick bite), fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes. If left untreated, the infection can also cause loss of muscle tone in the face, meningitis, shooting pains, heart palpitations, dizziness, and joint pains. In addition, up to five percent of untreated patients may develop chronic neurological complaints months to years after infection. These include shooting pains, numbness or tingling in the hands or feet, and problems with concentration and short term memory. West Nile virus Side effects of West Nile virus for rare serious cases include high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis. These symptoms may last several weeks, and neurological effects may be permanent. Most people (four out of five cases) experience no symptoms at all. -- CDC WEST NILE VIRUS: Use insect repellent with an EPA-registered active ingredient, wear long sleeves and pants (especially at dusk and dawn when mosquitoes are most active), get rid of mosquito breeding sites by emptying standing water from flower pots, buckets and barrels, pet dishes and bird baths. Drill holes in tire swings so water drains out. Keep children's wading pools empty and on their sides when they aren't being used. LYME DISEASE: Avoid wooded, bushy areas with high grass, walk in the center of nature trails, wear long pants, sleeves and socks, wear light colored clothing to more easily detect ticks on your body, use repellent with an EPA-registered active ingredient. If a tick is attached to your skin for less than 24 hours, the chance of getting Lyme disease is greatly reduced. -- CDC Mosquitoes can transfer encephalitis, West Nile virus, dengue fever, malaria and yellow fever. Ticks can transfer Lyme disease, Rocky Mountain spotted fever, Colorado tick fever, tularemia, Q fever, human granulocytic and monocytic ehrilichiosis, babesiosis, relapsing fever and tick paralysis. -- Somerset County Health Department Copyright 2009 Salisbury Daily Times. Board discusses veteran care problems Advisory Board touches on VA clinic operation hours, communication issues By Greg Latshaw Salisbury Daily Times Wedesday, July 15, 2009 SALISBURY -- Maryland Lt. Gov. Anthony Brown believes Veterans Affairs clinics on the Eastern Shore should make more of an effort to treat patients outside a 9 a.m.-5 p.m. schedule. "That's where I really hope we can make a difference in Maryland," Brown said Tuesday, presiding over a meeting of the state's Veteran's Behavioral Health Advisory Board held at Salisbury University. Outpatient clinics in Cambridge and Pocomoke City typically treat patients during normal operation hours, which are Monday through Friday from 8 a.m.-4:30 p.m., said Karen Windsor, the nurse manager at the Cambridge location. The facilities offer basic health care services, including mental health counseling and primary care. Brown, a colonel in the U.S. Army Reserves and an Iraq war veteran, supports the clinics being more flexible to treat patients who work during the day and would otherwise need to schedule time off work. The lieutenant governor is the chairman of the state's advisory board, a group commissioned by the General Assembly to recommend solutions for gaps in veterans' care. Their work comes as military reports indicate a rise among Army soldiers at risk for suicide, drug and alcohol abuse and post-traumatic stress disorder. At Tuesday's meeting, Lawrence Towles of Deal Island spoke of hurdles servicemen and woman face after being discharged and returning during a recession. "The biggest complaint I find among veterans today is a lack of communication," Towles, a former Army specialist, told the Advisory Board. Towles, who was enlisted in active duty for five years, believes that help should be "one call away." He also identified the long distances Eastern Shore veterans must drive for hospital care, often to the VA hospital in Baltimore. Brown, before Tuesday's meeting, said a shortage of mental health providers for veterans is a growing problem in rural areas. "It's one of our greatest unmet needs," he said. Officials from the VA also struggle to connect veterans with the number of services that are already available, Brown said. The VA is linking to Facebook and Twitter as a way to reach younger troops. Additionally, he touted a Web site called Network of Care, a "Web-based community" that links veterans to a number of different services. Salisbury University President Janet Dudley-Eshbach began Tuesday's meeting by commending veterans for their sacrifice but noting that they don't get all the help they deserve. "Probably not enough attention is paid to their needs," she said. For help, veterans can contact: 1-877-770-4801 from 8 a.m. to 4:30 p.m. or visit www.veterans.maryland.gov Copyright 2009 Salisbury Daily Times. Health clinic signs lease in Rockville By Melissa J. Brachfeld The Gazette Wednesday, July 15, 2009 People who need medical attention but are unable to afford it will soon be able to get that care in downtown Rockville. Community Ministries of Rockville is under contract to create a permanent health clinic at 12 North Washington St., said Agnes Saenz, executive director. The shopping center is owned by Federal Realty Investment Trust, which also leases the retail component of Town Square, located diagonally across the street. Nonprofit Community Ministries has been operating its Mansfield M. Kaseman Health Program for the five years out of temporary locations. Named for the man who founded and served as director of the organization for 26 years, the program serves the elderly, homeless, uninsured, underinsured and poor in the county. "We are delighted to be able to expand our health services into a full-time clinic," she said, adding there are some 128,000 uninsured people in the county and at least 8,000 of them reside in Rockville. "The need here is great." The Kaseman Health Program, which will be renamed the Mansfield Kaseman Health Clinic when it opens in its new location, provides initial diagnosis, referral, prevention, counseling, training and education to its patients. It offers chronic care and medication, but is not designed for urgent care, Saenz said. Buildout on the clinic, which will be located on the ground floor of the shopping center, is set to begin at the end of this month and is expected to be done by October, Saenz said. It will be open 40 hours a week and include eight examination rooms, each approximately 10 feet by 10 feet, and a waiting area. The project will cost approximately $500,000, including build-out of the site and equipment, she said. The clinic is being designed by Planit Design Associates of Germantown and will be built by Spectrum Inc. General Contracting of Vienna, Va., she added. Community Ministries is receiving funding for the clinic through a bond bill from the state, as well as Montgomery Cares, the Healthcare Initiative Foundation, the City of Rockville and Capital Information Technology Services. The program is currently open 12 hours a week at Crusader Lutheran Church on Veirs Mill Road in Rockville in partnership with Montgomery Cares, which provides primary health care to medically uninsured, low-income adults, Saenz said. It is so popular that the waiting period to get an appointment is four to six weeks long, she said. "Having a permanent medical site will make a big difference in the quality of life for county residents," she said. When the clinic opens, Community Ministries should be able to serve about 100 adults per week compared to the 30 patients that are seen now, Saenz said. The organization also hopes to add more wellness education classes and programs and eventually offer behavioral health services. The Rev. Sandra Cox Shaw, pastor of Crusader Lutheran Church, said the health program is "outstanding" and the community will benefit from a permanent clinic. "I'm very thrilled for them because they have such great programs," she said of Community Ministries. Mayor Susan R. Hoffmann said the clinic is "definitely needed" in Rockville. "We're delighted to have this service in the city," she said. "It's a good location, there's plenty of parking and I think it will work very well." Copyright 2009 The Gazette. Keeping body in fridge is legal, officials say Kin did not report death, stored Glen Burnie grandmother in freezer By Andrea F. Siegel Baltimore Sun Wednesday, July 15, 2009 Anne Arundel County prosecutors said it is legal to not report a death and to put the body in a freezer - as was discovered in a Glen Burnie apartment over the weekend - leading legislators in the county's delegation to consider a new round of efforts to make it against the law. On Friday night, police were called to an apartment in the 7400 block of Furnace Branch Road because the body of Doris Lea Cooke, 83, who had been ailing and bedridden for years, was in the freezer. Police were told that the grandmother died several weeks ago in the apartment she shared with family members and that they stored her body in the freezer. State law requires health care and other professionals to report a death. The legislature rebuffed efforts to have that requirement apply to individuals a decade ago. "We are going to see if we can do something about it," said Del. Theodore J. Sophocleus, a lawmaker from Linthicum. "I am going to introduce it again." Added Sen. James E. DeGrange of Glen Burnie: "It's certainly worth exploring again to see if it needs to be revived and needs to be addressed. We certainly will be taking a look at it." The attempt to pass legislation 10 years ago came after a father buried his daughter in the woods in Severn, horrifying the community. In 1999, Anne Arundel County prosecutors could find no law under which to prosecute 25-year-old Richard "Prince" Marshall, who led police to the place where he had secretly buried his 4-year-old daughter, Zaira, in a trash bag after she died accidentally eight months earlier. "There was nothing at that point on the books that they could do with it, other than [a charge for] littering," Sophocleus said. Similarly, there does not appear to be a law broken by storing Cooke's body in the freezer, said Kristin Fleckenstein, spokeswoman for the Anne Arundel County state's attorney's office. Police spokesman Justin Mulcahy said the investigation is continuing and detectives are awaiting results of an autopsy to determine the cause of death. Copyright © 2009, The Baltimore Sun. *National / International* Choosing Safer, Sustainable Seafood By Tara Parker-Pope New York Times Wednesday, July 15, 2009 Shopping for fish these days is tough. Sure it’s good for your heart and brain, but how do you know if it’s low in mercury and other toxins? And once you settle on a healthful fish, is buying it also good for the planet? Seattle food writer Kim O’Donnel wades through the murky waters of fish consumption over at True/Slant with “Sustainable Seafood 411,” a helpful primer on choosing earth-friendly, safer fish. Here are her suggestions. Choose: Low on the food chain seafood like sardines, anchovies, clams, mussels and oysters. These have “shorter life spans, reproduce more readily and as a result are more resilient to fishing pressure.” Wild salmon from Alaska and smaller albacore tuna from the Pacific Northwest and British Columbia, which are both relatively well-managed fisheries. A variety of fish to reduce your exposure to contaminants common to one particular type. Eat less: Big predatory fish like swordfish, tuna, shark and salmon (exceptions noted above). High-on-the-food-chain fish accumulate the most toxins. Don’t eat: Yellowfin, bluefin and big eye tuna. They are overfished and nearing extinction. Imported farmed shrimp. Environmental standards are inconsistent and unregulated. Farmed salmon. Often sold as Atlantic salmon, you’re buying fish raised in crowded and unhealthful conditions. Freshwater eel. No more unagi at the sushi bar. It’s almost fished to extinction. Another great resource is the Monterey Bay Aquarium, which offers helpful pocket cards and a new iPhone app to help you make better seafood choices. You can even take a test to find out if your favorite sushi dishes are sustainable. And don’t miss Martha Rose Shulman’s Recipes for Health collection of recipes using safe, sustainable seafood. Copyright 2009 The New York Times Company. A New Understanding of Glaucoma By Peter Jaret New York Times Wednesday, July 15, 2009 For years, glaucoma was defined as elevated pressure within the eye that leads to vision loss. And for years experts knew there were glaring gaps in that definition. Many people with abnormally high intraocular pressure never develop glaucoma. As many as one in three people who do get the disease have normal or even low pressure. As researchers have tried to resolve those contradictions, a new paradigm for understanding glaucoma has emerged. Glaucoma isn’t simply an eye disease, experts now say, but rather a degenerative nerve disorder, not unlike Alzheimer’s or Parkinson’s disease. “All three of these diseases affect aging populations and involve selective loss of certain populations of neurons,” said Dr. Neeru Gupta, a professor of ophthalmology and director of the glaucoma unit at the University of Toronto. “Parkinson’s affects motor control. Alzheimer’s affects cognition. Glaucoma disrupts vision. But the closer we look, the more they seem to have in common.” Even the official definition of glaucoma, a disease that accounts for more than eight million cases of blindness worldwide, has changed. Today, diagnosis is based on just two features: visible damage to the optic nerve, which leads from the retina at the back of the eye to the brain, and loss of peripheral vision, which can be measured by a simple test in an eye doctor’s office. “Intraocular pressure is nowhere to be found in the definition, which shows you how the field has changed,” said Dr. Stuart McKinnon, an associate professor of ophthalmology and neurobiology at Duke University School of Medicine. Researchers still recognize high pressure within the eye as a leading risk factor for glaucoma. And ophthalmologists still use the familiar screening test that shoots a puff of air at the front of the eye to measure pressure and screen for the disease. But since about 30 percent of people with the disease have normal or low pressure, there’s obviously something else at work. What’s clear is that glaucoma begins with injury to the optic nerve as it exits the back of the eye. The damage then spreads, moving from one nerve cell to adjoining nerve cells. “In glaucoma, we’ve shown that when your retinal ganglion cells are sick, the long axons that project from the eye into the brain are also affected, resulting in changes that we can detect in the vision center of the brain,” Dr. Gupta said. The phenomenon, called transynaptic damage, occurs in Alzheimer’s and Parkinson’s disease as well. Experts are still deciphering what causes initial injury to the optic nerve. Although elevated intraocular pressure clearly increases the danger, some researchers suspect that steep fluctuations in pressure may be even more damaging. “A structure in the optic nerve called the lamina cribosa is designed to act like a trampoline, going up and down in response to normal changing pressure,” said Dr. Rohit Varma, director of the glaucoma service at Keck School of Medicine at the University of Southern California. “But if those fluctuations become extreme enough, they may end up injuring the optic nerve.” Another culprit may be perfusion pressure, or the difference between pressure within the eye and overall blood pressure. Low perfusion pressure occurs when pressure within the eye is high and systemic blood pressure is low. “When perfusion pressure drops, there’s not enough blood flow getting to the optic nerve and the retina,” Dr. Varma said. Lack of adequate blood flow may damage not only the optic nerve but also supporting tissues around it. Then again, some people may have optic nerves that are simply more or less vulnerable to a variety of stresses, experts say. That possibility has led to a search for drugs to protect susceptible nerves from injury. Several promising candidates are under investigation, including a drug called memantine (Namenda), which is now approved to treat Alzheimer’s, and riluzole (Rilutek), used to treat Lou Gehrig’s disease. There is growing optimism that what works for one neurodegenerative disease, as these examples suggest, may be helpful for others. For researchers trying to understand the details of what goes wrong in such disorders, glaucoma may offer an easier model to study than a brain disease like Alzheimer’s. The optic nerve is the only nerve that can be examined visually, by peering through the pupil. And the visual system is a relatively compact structure that researchers already understand in great detail. For now, the only treatments available for glaucoma work by lowering pressure in the eye, either by decreasing the production of fluid or increasing its outflow. Even in patients with normal intraocular pressure and early signs of the disease, lowering pressure has been shown to significantly slow the progression of nerve damage. Most antiglaucoma drugs are delivered as eye drops, which may need to be used once or several times a day. When drops aren’t enough, laser treatments and surgery can be used to allow excess fluid to flow out of the eyes. Despite effective treatments, many people suffer some preventable loss of peripheral vision. One problem is that the disease too often goes undetected. About half of the estimated 2.2 million Americans with glaucoma are not aware that their vision is at risk because they have not been tested, surveys suggest. The longer the disease goes untreated, the greater the loss of vision. Worldwide, an estimated 60 million people have glaucoma, and that number is expected to reach 80 million by 2020. Another hurdle is getting patients who know they have glaucoma to take their medicine. “Glaucoma is typically diagnosed before patients notice any vision problems,” said Dr. Robert C. Cykiert, clinical assistant professor of ophthalmology at the Langone Medical Center at New York University. “So telling them they could go blind if they don’t use their eye drops is like telling someone with high cholesterol that they could have a heart attack if they don’t take a statin. A lot of people don’t take the threat seriously enough.” A 2003 study found that half of patients in a health maintenance organization never filled their initial prescription for eye drops. One in four patients failed to refill their prescriptions a second time, another survey found, even though eye drops need to be used every day to be effective. While scientists search for better treatments for glaucoma, the second-leading cause of blindness, people can take action to give themselves the best chance: get a regular glaucoma screening exam, and if glaucoma is diagnosed, take the treatment regimen seriously. Your sight depends on it. Copyright 2009 New York Times. Senate committee passes health care bill Associated Press Frederick News-Post Wednesday, July 15, 2009 WASHINGTON — The Senate health committee has passed legislation to revamp health care, becoming the first congressional committee to act on President Barack Obama’s goal of overhauling the system this year. The Health, Education, Labor and Pensions Committee voted 13-10 along party lines to pass a $600-billion measure that would expand coverage to nearly all Americans by requiring individuals get insurance and employers to contribute to the cost. The bill would provide federal aid to families and individuals making less than four times the poverty level, or about $88,000 for a family of four. Massachusetts Sen. Edward Kennedy, the chairman, wasn’t there for the milestone vote. He’s being treated for brain cancer. Copyright 1997-09 Randall Family, LLC. All rights reserved. *Opinion* Gone but not forgotten By Tom Zirpoli, Columnist Carroll County Times Commentary Wedesday, July 15, 2009 The recent closing of the Rosewood Center in Owings Mills, where at least 13,000 individuals with developmental disabilities have been housed during a span of a hundred years, is cause for celebration. But closing a facility and securing community-based placements does not guarantee a safer or improved quality of life for Marylanders with disabilities. In 1975, Congress passed the first national law mandating a public education for children with developmental disabilities. Thus, school-aged children were provided with significantly better options than staying at home or being placed in a state residential setting. Mandating that all children had a fundamental right to attend school, regardless of their ability, was the right thing to do. As a result of mandatory education, many of these children were found to be wrongly diagnosed. And through the miracle of an education, many overcame their disabilities and went on to live healthy and productive lives. At about the same time, the horrible conditions for people with disabilities living in some of our nation’s large institutions were starting to come to light. Finally, the 250,000 children and adults, many living in squalor conditions in state institutions, with some housing up to 5,000 individuals, were getting long-overdue attention. As a result, the deinstitutionalization movement encouraged states to move adults with disabilities from large residential institutions to smaller community placements such as group homes, alternative living units (small group homes) or even into their own apartments and homes. Almost 40 years of research has demonstrated that the simple act of changing a person’s environment can make a significant and positive change in their development and behavior. For the majority of individuals with disabilities, the transition from institution to community-based homes has been nothing short of life-changing. However, doing the right thing does not always produce the right result; at least not for everyone. And doing the right thing without proper monitoring and support can lead to negative results. As I wrote in an article in 1986, moving adults with disabilities from large state residential facilities to community homes is doomed to fail without the proper long-term supports and funding. As previously stated, placement is an important variable related to quality care for individuals with disabilities. But placement is not the only variable; it is merely the first step in a process of community integration. Having observed the conditions in many state-operated facilities and community-based programs, I would argue, in fact, that placement is not even the most important variable when it comes to safety and quality of care of individuals with developmental disabilities. Rosewood may be closed, but more than 18,000 adults with developmental disabilities in Maryland are on waiting lists for services. At the same time, some individuals who have secured community placements are not any safer or happier than they were in state-operated facilities. While we should certainly celebrate the closing of Rosewood and other state institutions for people with developmental disabilities, we must be diligent and ensure that we are not replacing them in underfunded community placements. The result is the same or, in some cases, worse. Tom Zirpoli writes from Westminster. His column appears on Wednesdays. E-mail him at tzirpoli@mcdaniel.edu. Copyright 2009 Carroll County Times. Evaluating Hospitals New York Times Letter to the Editor Wednesday, July 15, 2009 To the Editor: Re “Cutting Hospital Infections to Cut Costs” (letters, July 10): Readers could infer from one of the letters that hospitals know when The Joint Commission is coming for a visit. Joint Commission surveys are unannounced. The Joint Commission expects hospitals and other health care organizations to always be in compliance with its standards. The letter refers to The Joint Commission as a “regulatory” organization. As the nation’s largest accreditor of more than 16,000 health care organizations, The Joint Commission works with many state and federal regulatory bodies to improve patient care. However, The Joint Commission is not itself a regulatory body that can close facilities or issue fines. Paul M. Schyve Senior Vice President Health Care Improvement The Joint Commission Oakbrook Terrace, Ill., July 10, 2009 Copyright 2009 The New York Times Company. Hospital causes pain for family Carroll County Times Letter to the Editor Wedesday, July 15, 2009 Editor: As a parent you have to always believe that when your child is sick, you are doing the right thing by taking them to the hospital where doctors and nurses you trust will help you get the best possible care. While at the hospital, you put faith in what the doctors are telling you because they are trained professionals and take every precaution to ensure they are looking at all the options and have your best interest at heart. This was not the case at Carroll Hospital Center when eight different doctors attempted to care for a little girl, age 11, with a virus. The doctors jumped to conclusions and determined without cause and without confirmed lab evidence that this child had been sexually abused, which caused the viral infection. This may seem like an innocent mistake, but it is anything but that. For the four days in the hospital, the little girl was poked and prodded (like no little girl should be), she was questioned repeatedly and even provided details about how to be safe next time. The authorities were called in, smaller siblings questioned and the parents’ worst nightmare of wondering what horrible human being did this to their child. All aspects of a life is questioned: a coach, a teacher, a neighbor, a family member? The thoughts and the pain were endless. In the end, labs showed the little girl was completely negative. But during that time, was any other option pursued? Will she ever know what the virus actually was and where it came from? No. Because no one looked at other options. Did the hospital or any of the eight doctors ever follow up to see how the little girls was? If she was in a safe home after all? No. Always know what is going on with your children — at the doctor’s, at the hospital — ask a lot of questions, understand what is being pursued and what may not be. It can happen to you unless someone steps up to look at the process. Find out what went wrong in the process and assist to try to save another little girl/boy from this happening again. Dee Stutz, Westminster Copyright 2009 Carroll County Times. BACK TO TOP


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