Tuesday, March 24, 2009

News Clipping Archives

Maryland / Regional

 

O'Malley: Stimulus will help Marylanders keep health coverage (Daily Record)

County to lose $13 million in state aid (Annapolis Capital)

Grow It, Eat It: Maryland's Food Gardening Network Show/Hide details (Annapolis Capital)

How safe is our food? (Carroll County Times)

In Good Health - Colon cancer still a killer (Frederick News-Post)

Army to test Odenton wells (Baltimore Sun)

Triple Killer Dies in Apparent Suicide at Supermax Prison (Washington Post)

St. Joe's, cardiology group probed (Baltimore Sun)

Council OKs Dixon proposal for 275-bed shelter (Baltimore Sun)

Book Dealers Told to Get The Lead Out (Washington Post)

Va. Hospital Treats the Whole Person (Washington Post)

Familiar faces (Cumberland Times-News)

Delaware's infant mortality rate falls (USA Today)

 

National / International

 

Workers feel the brunt of health insurance woes (Washington Post)

FDA Ordered to Rethink Age Restriction for Plan B (Washington Post)

Blacks Suffer More Early Heart Failure (Washington Post)

Alzheimer's cost triple that of other elderly (Washington Post)

Census Bureau Will Try an Ad Campaign To Reach Minorities (Washington Post)

Vaccination: Vaccine Delays in Poorer Nations Raise Health Risks for Infants (NewYork Times)

USDA shield guarantees inspected meat (Carroll County Times)

 

Opinion

 

Regulating Carbon (Washington Post)

Misfire in Maryland (Washington Post)

 

 

Maryland / Regional

 

O'Malley: Stimulus will help Marylanders keep health coverage

 

By Danielle Ulman

Daily Record

Tuesday, March 24, 2009

 

Maryland will use $1.5 billion in federal stimulus money to shore up the state’s health care system, allowing thousands of newly insured residents to keep their coverage, Gov. Martin O’Malley said Monday.

 

The health care money constitutes the largest portion of Maryland’s $3.9 billion boost from the American Reinvestment and Recovery Act, and the state expects it to save or create thousands of jobs in the industry, provide preventive care, address the needs of underserved children and support community clinics.

 

Under the governor’s Working Families and Small Business Coverage Act, the state has signed up more than 33,000 people for health care coverage, and another 20,000 people are eligible to take part. So far the federal resources will cover an additional 53,000 people.

 

“We actually do have a considerable amount of help coming to Maryland for these next two years to shore up that safety net of health care to make sure that people who are in need of health care in these challenging times are able to receive it,” he said. “Sometimes in our state people don’t know that they’re eligible.”

 

O’Malley spoke at the Belair-Edison Family Health Center in Baltimore at the start of “Cover the Uninsured Week,” a statewide awareness campaign led by the Department of Health and Mental Hygiene, hospitals and community clinics to enroll even more people into health care coverage programs.

 

“I do wish we will come soon to a day where we don’t have to celebrate ‘Cover the Uninsured [Week]’ because everybody will be insured, but until that day happens, we’ll put our shoulders to the wheel and do what we can to make life better for everyone,” said John Colmers, DHMH secretary.

 

Vincent DeMarco, president of the Maryland Citizen's Health Initiative, said he was pleased with the governor’s plans for health care coverage, although efforts to expand coverage to adults without children will likely have to wait.

 

“It’s going to happen,” he said. “It may not happen this year, but I know the legislature is committed to it.”

 

Some have suggested that the state is improperly using money from the federal stimulus to plug budget gaps, but O’Malley disagreed that there was anything wrong with using the money that way.

 

About 80 percent of the state’s budget goes toward health care, education and public safety, O’Malley said, noting that using money from the American Reinvestment and Recovery Act to pay for programs in those areas is “not inconsistent with the purpose” of the stimulus. He suggested that those curious about where the money will be spent should look at the state’s Web site, http://recovery.maryland.gov.

 

“The largest investment in the [American] Recovery and Reinvestment Act is the investment in the health of our people,” he said. “It’s going to allow us as a state to continue to be able to safeguard, defend and protect the health of some of our most vulnerable families in our state.”

 

U.S. Sen. Benjamin Cardin, D-Md., said Congress and President Barack Obama are working to invest in the country, and said that in Maryland the governor has already invested in making the state’s health care situation better, although more needs to be done.

 

“But let me make this clear, this is a down payment, governor,” Cardin said, “because we need to have universal health care in America.”

 

Copyright 2009 Daily Record.

 

 

 

 

 

County to lose $13 million in state aid

State budget debate begins tomorrow

 

By Liam Farrell

Annapolis Capital

Tuesday, March 24, 2009

 

A House committee has cut Gov. Martin O'Malley's proposed operating budget below the fiscal 2007 spending level, leaving Anne Arundel County with nearly $13 million less in state aid next year.

 

Full House deliberations begin tomorrow on the House Appropriations Committee's proposed cuts, which weren't finalized until after 10 p.m. Friday.

 

Legislative leaders said the General Assembly has cut or transferred $825 million across the fiscal 2009 and fiscal 2010 budgets. The result: a $13.9-billion general fund budget that falls 2.7 percent and is about $300 million less than the final budget from then-Gov. Robert L. Ehrlich Jr.

 

"It was a very challenging undertaking," said House Speaker Michael E. Busch, D-Annapolis. "We think we put forth a very fair and efficient budget without raising any tax or fees."

 

Counting federal stimulus funds, Anne Arundel County would lose about $12.8 million, including reductions in highway user revenue and income tax distribution. After a substantial revenue loss announced on March 11, the budget committee was forced to look to the counties to make up a worsening fiscal situation.

 

Aid to Queen Anne's County would be cut by $1.5 million under the House plan.

 

Del. Norman Conway, D-Wicomico, the chairman of the House Appropriations Committee, said the local income tax cut was a

 

"last resort" after revenue estimates were revised downward by $1.2 billion.

 

"It was very, very clear we had no other route to follow," he said. "We were at the door of local governments."

 

Other options were unpalatable, Busch said.

 

For example, cutting local police aid or the disparity grants that help poorer jurisdictions would have been less equitable than the income tax reduction.

 

"We didn't want to do it," he said. "We did everything we could to protect the local governments."

 

The committee's actions were on the county's radar, said David Abrams, a spokesman for County Executive John R. Leopold.

 

Anne Arundel is facing its own budget shortfall, which is approaching $150 million.

 

"Nothing is for sure and we are just awaiting the final verdict (from the state)," Abrams said. "If it becomes the final answer, certainly our budget shortfall will be higher."

 

State employees fared well, as hundreds of proposed layoffs and a 1 percent reduction in pay never came to fruition. The American Federation of State, County and Municipal Employees held a rally on Lawyers Mall last night, chanting, "They said give back, we said fight back."

 

"It has been one tough year … but we are tougher," said Patrick Moran, the state director of AFSCME. "Now is not the time for us to step back."

 

At the rally, O'Malley pledged he would do all he can to protect workers.

 

"So long as there is breath in my body, and I have the trust of the people of Maryland to do this job … I will be doing it for you," he said.

 

But how long the state work force or anyone else can remain relatively unscathed is still an open question. Although the budget committee wanted an ending fund balance of $250 million, the cushion is far less, coming in at just $51.2 million.

 

Once the House wraps up its work, the Senate will make its own cuts and the differences will be sent to conference committee. The General Assembly session is scheduled to end on April 13, but can be extended if there is an impasse on the spending plan.

 

Copyright 2009 Annapolis Capital.

 

 

 

 

 

Grow It, Eat It: Maryland's Food Gardening Network Show/Hide details

 

Annapolis Capital

Tuesday, March 24, 2009

 

Today     7:00 pm - 8:00 pm

The Anne Arundel County Master Gardeners will be offering a series of free presentations to get you started on a journey to grow your own healthy vegetables. March 24 - Vegetable Garden Basics will help get you started. Classes will begin at 7:00 PM and last until 8:00 PM. For more information, annearundelcountygrowiteatit@gmail.com. To register, 410-222-6757.

 

Contact: 410-222-6757 or visit annearundelcountygrowiteatit@gmail.com

Location: St. Margaret's Parish Hall. at the intersection of St. Margaret’s Rd. and Plea , St. Margaret's 21401 . n/a

 

Copyright 2009 Annapolis Capital.

 

 

 

 

 

How safe is our food?

 

By Erica Kritt

Carroll County Times

Sunday, March 22, 2009

 

BALTIMORE - In the winter, a crisis struck the country.

 

Salmonella infections traced to peanuts broke out across the U.S.

 

People wondered if the peanut butter in their pantry or the peanut-flavored cracker in their child’s lunchbox could possibly kill them. While most of the furor was happening in January and February, the first cases of salmonella infections related to peanut products started in September.

 

In November, the Centers for Disease Control and Prevention recognized that there were 13 infections in 12 states. Not until January did officials realize the outbreaks were related to peanut butter or peanut products from a Georgia processing plant.

 

As of March 15, the CDC reported that 691 people had been infected, including 10 Marylanders. The outbreak has also been linked to nine deaths.

 

Millions of Americans are infected with foodborne illnesses each year, and thousands die. But health officials say the United States has one of the safest food systems in the world, with numerous regulations in place providing safety checks before food reaches consumers.

 

Detecting an outbreak

 

The CDC reported that in 2006 there were 623 confirmed foodborne outbreaks. In 2005, there were 410 confirmed outbreaks, and in 2004, there were 519.

 

Dr. Alan Brench, chief of food defense for the State of Maryland, said that those were only the confirmed cases and that there are fluctuations each year depending on climate.

 

“That number is not really changing. What’s getting better is our ability to communicate. Since Sept. 11, 2001, you have a lot more connectivity of agencies,” he said.

 

Brench said science is also improving with genetic fingerprinting.

 

Health officials have been able to access a national database that has the genetic codes of disease-causing bacteria that were found in infected humans or food. This helps public health officials from all over the country find if bacteria they are seeing in their area are related to other illnesses around the country.

 

Brench said this can help researchers discover the root of a problem more quickly, but an outbreak still takes a while to show signs.

 

He said it could take a while for the CDC to spot a growing outbreak from several states.

 

For example, spinach typically takes 40 to 50 days to grow, then is pulled from the field, washed and picked in less than a day, he said. It takes one to five days to get to the grocery store.

 

“It can sit on the supermarket shelf 10 days or more,” he said. “You buy it, and it sits in your fridge two to three days.”

 

After eating the spinach, it could take another couple of days for a person to get sick. Then, if a person reports the illness, it can take another five days to determine the cause.

 

“It’s difficult to know whether you’ve got an outbreak. By the time you get sick enough, it’s two or three days down the road,” Brench said. “If it is an outbreak, the numbers will climb with time.”

 

Nationally, about 5,000 people die each year from foodborne illness, and approximately 76 million become ill, but Brench said that number needs to be put into perspective.

 

He said a lot of the people who die of foodborne illnesses have compromised immune systems or another primary condition they are battling.

 

Brench said people should also consider the number of times people eat and drink and don’t get sick. He said the average person probably eats and drinks eight times a day. That adds up to approximately a trillion eating events in America each year.

 

“When you look at it, we have amongst the safest food supplies in the world, but it’s all subject to abuse,” Brench said.

 

In order to combat that abuse, the federal government has a number of inspections and regulations in place.

 

Food safety system

 

Food inspections are performed by various government agencies.

 

The U.S. Department of Agriculture handles all meat, poultry and processed eggs. According to Amanda Eamich, a spokeswoman for the Food Safety and Inspection Service of the USDA, an inspector must be present at all times of slaughter.

 

About 7,800 inspectors who work in more than 6,200 establishments across the country. The inspectors examine each animal before and after the slaughter to ensure it is healthy and clean.

 

The animals are viewed at rest and in motion.

 

At Bullock’s Country Meats in Westminster, Mondays are slaughter days, and an inspector is present each week to make sure the animals are healthy and treated humanely.

 

Eamich said the laws on humane treatment ensure animals are not exposed to any undue stress and have enough water in their pens.

 

“The slaughter operation is a very clean operation,” said Doug Zepp, co-owner of Bullock’s. “There’s a half-a-dozen guys on the kill floor with the federal inspector.”

 

Bullock’s store manager Larry Mickley said that after slaughter, the meat is hung for 10 days to two weeks to tenderize it before it is brought to the store to be sold.

 

The Food and Drug Administration handles processed foods and imported foods, excluding meat and poultry.

 

According to the FDA, the agency regulates $417 billion worth of domestic food and $49 billion worth of imported food each year.

 

Brench said the food safety system is three-tiered with the USDA and FDA on the federal tier. Underneath the federal tier is the state, with its laws and regulations, and on the bottom tier is the county.

 

A state can have its own food safety laws and regulations, but they have to be stricter than federal rules. The same holds true for counties, Brench said, which must have stricter rules than the state.

 

Brench said Maryland has four distinct duties. The first is keeping the state law books up to date with federal law changes and working with the state legislature when it changes a law. Then there are those who review plans for new food service operations or changes in a previous operation.

 

The state office also works with all the county health departments to make sure that all inspectors work and follow the same laws and interpret the laws in the same way. The state is also responsible for inspecting all manufacturing plants.

 

“At the local level or state level, [state inspectors] can walk into any food facility to inspect,” Brench said.

 

Brench said his department also gets contracted by the state to perform inspections for the FDA.

 

Each county is responsible for inspecting any retail location that sells food.

 

Andrea Hanley, supervisor of community hygiene at the Carroll County Health Department, said all businesses are inspected unannounced, but some organizations are inspected more often than others.

 

The county health department will also inspect a restaurant if it receives a complaint. A facility will be immediately closed if a critical item is not corrected immediately or the critical violation couldn’t be corrected in an allotted period of time.

 

Brench said a facility cannot reopen until it has fixed the critical items it was cited for violating.

 

Consumer responsibility

 

In order to create a safe food system, Brench said consumers also have a role to play.

 

He said not all of the state and county inspectors can be everywhere all the time, so receiving reports from consumers who have seen things they don’t think are proper can help.

 

Eamich said the same is true for the USDA. Reporting can help the organizations make sure food sold to Americans is safe.

 

The other part of food safety is making sure that food is properly cooked and handled.

 

“Eating raw meat is not a good idea,” Brench said.

 

He said food should have a kill step, which means cooking, irradiating or chilling food to the proper temperatures that kill bacteria.

 

“Most things have a kill step,” Brench said. An exception would be raw oysters, which Brench said kill a few people a year.

 

Other health initiatives to make sure bacteria stays off food is to make sure it is clean and people who are preparing the food have washed their hands.

 

Reach staff writer Erica Kritt at 410-857-7876 or erica.kritt@carrollcountytimes.com.

 

To prevent contamination

 

To prevent contamination of food at home, the Partnership for Food Safety Education suggests these steps:

 

1. Clean. Wash your hands with warm water and soap for at least 20 seconds before and after handling food, after going to the bathroom, touching animals or changing diapers.

 

Wash cutting boards and utensils used to prepare foods before moving on to the next food. Wash and rinse all vegetables and fruits.

 

2. Separate. Keep raw meat, poultry, seafood and eggs separate from other foods in your grocery shopping cart, grocery bags and in your refrigerator. Use one cutting board for fresh produce and another for raw meat, poultry and seafood. Never put cooked food on a plate that held raw meat, poultry, seafood or eggs.

 

3. Cook. Use a food thermometer to make sure bacteria has been killed.

 

- Roasts and steaks should be cooked at a minimum of 145 degrees.

 

- Poultry should be cooked at a minimum of 165 degrees.

 

- Ground meat should be cooked to a minimum of 160 degrees.

 

- Fish should be cooked to a minimum of 145 degrees.

 

- Eggs should be cooked until the yolk and white are firm.

 

4. Chill. Refrigerate foods quickly to slow down the process of bacteria growth and always keep the refrigerator at 40 degrees or below. The freezer should be at 0 degrees or below.

 

For more information and temperatures, visit www.fight bac.org.

 

If you suspect a problem with food, call the Carroll County Health Department at 410-857-5000.

 

Health Department inspections

 

There are three types of food retailers that the Carroll County Health Department inspects. Each retail type determines the frequency upon which the establishment is inspected.

 

High-priority facilities: A facility that uses a combination of procedures when preparing food, which would include cooking, hot holding, cooling and reheating; and any facility that serves an at-risk population (the elderly, very young, people with compromised immune systems)

 

Example: Nursing home, restaurant where food is made on site

 

Times inspected per year: Three

 

Moderate-priority facilities: A facility where there is not a lot of food preparation and that usually only holds foods for four hours.

 

Example: Some fast-food restaurants, sub shops

 

Times inspected per year: Two

 

Low-priority facilities: Handles commercially packaged potentially hazardous food or handle food that is not potentially hazardous.

 

Example: Gas stations that sell milk and eggs, some bakeries (depending on the menu)

 

Times inspected per year: One

 

 

Staff Illustration with CDC photos

Calicivirus, top left, salmonella, top right, and E. coli, bottom, are three common foodborne illnesses

 

Copyright 2009 Carroll County Times.

 

 

 

 

 

In Good Health - Colon cancer still a killer

 

By Ashley Andyshak

Frederick News-Post

Tuesday,  March 24, 2009

 

March is Colorectal Cancer Awareness Month. Many of you over age 50 may already get regular colonoscopies, and if you do, keep it up. If not, please take note: colorectal cancer is the second leading cause of cancer death in both Maryland and the U.S. as a whole.

 

According to the American Cancer Society, 149,000 new cases and 50,000 deaths were reported in 2008. Of those, nearly 3,000 new cases and 1,000 deaths were reported in Maryland.

 

If you read the main story on this page today, you'll see the mention of a well-educated man (with two doctoral degrees) who died of colon cancer because he didn't get regular checkups. This disease can affect anyone.

 

Colorectal cancer rarely produces symptoms in its early stages. By the time people begin to notice blood in their stool or a change in bowel movements, abdominal cramps, pain, or anemia, their cancer may already be in the advanced stages.

 

According to ACS, it takes 10 to 15 years for a polyp (non-cancerous tumor) to develop into colorectal cancer. Routine screenings can catch this cancer in its early stages, allowing for more successful treatment and a greater chance of survival.

 

ACS recommends that people begin routine screenings at age 50, or even earlier for those with a personal or family history of colon cancer. Those with a history of inflammatory bowel disease or women with ovarian or endometrial cancer should also begin screenings before age 50.

 

There is good news: the death rate from colorectal cancer has been dropping for more than 20 years, according to ACS. This is likely due to more people getting regular screenings and early treatment.

 

The most common and well-known test for colorectal cancer is the colonoscopy. The test uses a flexible tube and light to look inside the colon to find cancer or pre-cancerous polyps. The test takes about 30 minutes, and often times doctors can remove any small polyps during the procedure.

 

To see if you qualify for a free colorectal screening, call the Frederick County Health Department at 301-600-3362. For more information on colorectal cancer, visit www.co.frederick.md.us/cancerprevention  or cancer.org.

 

Copyright 1997-09 Randall Family, LLC. All rights reserved.

 

 

 

 

 

Army to test Odenton wells

Nearby monitoring wells show unhealthy levels of chemicals

 

By Timothy B. Wheeler

Baltimore Sun

Tuesday, March 24, 2009

 

The Army plans to test residential and business wells in Odenton after groundwater samples there showed elevated levels of toxic chemicals in an area adjacent to Fort Meade, officials said Monday.

 

Mary Doyle, a spokeswoman for the Army base, said the military hopes to test all wells within one mile of a pair of monitoring wells, near the Odenton MARC station, where contaminants have been found at up to 10 times levels considered safe to drink.

 

The testing is being done under orders from the Environmental Protection Agency, which said in a letter that the chemicals are "an unacceptable risk to human health" if they are being consumed in drinking water.

 

Elin Jones, a spokeswoman for the Anne Arundel County Health Department, said that none of the chemicals was found at an unsafe level in the eight drinking-water wells tested last year.

 

Those drinking water wells, within a half-mile of the train station, might be tapping a shallower aquifer. The tainted monitoring wells are more than 200 feet deep.

 

But the new test-well results showing a sudden increase in contamination have prompted EPA to order expanded sampling of residents' wells.

 

Henry Sokolowski, who oversees federal facility cleanups for EPA's Mid-Atlantic office in Philadelphia, said the Army also has been directed to investigate whether any toxic vapors are seeping into basements or foundations of buildings in the Odenton area.

 

The three chemicals found in the test wells - carbon tetrachloride, perchloroethylene and trichloroethylene - are frequently used as cleaning solvents. All are considered potential human carcinogens because they cause tumors in animals.

 

EPA officials say the contamination could be coming from a closed landfill on the edge of the base or from a site on the base where a laundry once operated. The Army spokeswoman said it has never been proven that the contamination in the test wells came from Fort Meade. But she said the Army is cooperating with federal, state and local civilian authorities to determine its extent.

 

The issue is to be discussed at a meeting of Fort Meade's Restoration Advisory Board at 7 p.m. Thursday on the base, at the Directorate of Information Management, Building 1978. Information: 301-677-9365.

 

Copyright 2009 Baltimore Sun.

 

 

 

 

 

Triple Killer Dies in Apparent Suicide at Supermax Prison

Mentally Ill Man In Legal Battle For Treatment

 

By Ruben Castaneda

Washington Post

Tuesday, March 24, 2009; B02

 

A thrice-convicted killer whom Maryland officials considered too dangerous to be treated at the state's secure psychiatric hospital for the criminally insane died in an apparent suicide yesterday at the Supermax prison in Baltimore, corrections officials said.

 

Guards conducting a routine check found Kevin G. Johns, 25, in his cell and hanging from a bedsheet, said Harry J. Trainor Jr., one of Johns's defense attorneys. Guards were required to check on Johns every 15 minutes, Trainor said.

 

According to a statement by the state Department of Public Safety and Correctional Services, Johns's body was found about midnight. Emergency medical personnel were summoned, but efforts to revive Johns were unsuccessful. Paramedics pronounced Johns dead at the scene, the statement said.

 

An internal investigation is being conducted by the Department of Public Safety and Correctional Services, and Maryland State Police also are investigating, officials said. An autopsy by the state medical examiner's office is pending, officials said.

 

Johns, who has been incarcerated at the Supermax since 2004, was the subject of a legal battle over where he should be held and what level of treatment he should receive.

 

Last June, Harford County Circuit Court Judge Emory A. Plitt Jr. issued a ruling that allowed state officials to keep Johns in the Supermax facility, rather than transferring him to the Clifton T. Perkins Hospital Center in Jessup, the state's secure psychiatric facility for the criminally insane.

 

The state Department of Health and Mental Hygiene had filed court papers arguing that Johns was too dangerous to be held at Perkins. According to court papers, Johns had bipolar disorder and hallucinations.

 

Defense attorneys had argued that state law required that Johns, of Baltimore, be transferred to Perkins, because he was found not criminally responsible for the most recent killing he committed. Trainor said yesterday that a defense motion asking Plitt to reconsider his ruling was pending.

 

"Had Kevin received the care and treatment that the statute requires, I seriously doubt this would have happened," Trainor said.

 

State officials said they would not comment beyond the statement that was released.

 

Last June, state health and corrections officials said they were developing a plan to treat James in the prison system. But Sharon Weidenfeld, an investigator for Johns's defense team, said when she last visited Johns on Dec. 24, he was not on medication, which she called "vital to him staying alive."

 

Doctors and social workers visited Johns, who sometimes agreed to see them and sometimes did not. Johns said he had attempted suicide in the past few months by trying to hang himself but was saved by guards, Weidenfeld said.

 

Johns "knew more than anybody else that he needed treatment," Weidenfeld said. "He wanted it. He was looking forward to it."

 

Johns committed the first killing in 2002, when he strangled and cut an uncle who, according to court records, had sexually abused him. Johns was sentenced to 35 years in prison.

 

In 2004, Johns strangled a teenage cellmate at a state prison in Hagerstown. He was sentenced to life without parole for that killing and sent to the Supermax in Baltimore. In February 2005, Johns strangled Philip Parker Jr., 20, on a prison bus outside Baltimore as two corrections officers sat nearby.

 

Copyright 2009 Washington Post.

 

 

 

 

 

St. Joe's, cardiology group probed

Hospital, Midatlantic involved in business, legal disputes

 

By Stephanie Desmon and Robert Little

Baltimore Sun

Tuesday, March 24, 2009

 

The federal agency responsible for investigating Medicare fraud and other health law violations, and whose probe of St. Joseph Medical Center led to a leadership shake-up last month, has ordered a group of cardiology specialists affiliated with the hospital to hand over business records.

 

Midatlantic Cardiovascular Associates, a dominant cardiology practice at hospitals in the Baltimore area, received a subpoena from the Department of Health and Human Services in June - the month the agency made a similar demand of St. Joseph, according to documents shared with The Baltimore Sun and sources connected to the hospital.

 

Officials at St. Joseph, which markets itself as one of the region's top heart hospitals, declined to say whether Midatlantic is the unnamed "physician group" whose relationship with the hospital is, according to hospital officials, at the center of the federal investigation. Midatlantic Chief Executive Robin T. Levy issued a statement saying, "It is not appropriate for Midatlantic Cardiovascular to comment on an ongoing investigation at any medical institution."

 

But state and federal court records show that the relationship between Midatlantic and the Towson hospital has been contentious for the past decade. The clash has spawned lawsuits and harsh words. In one lawsuit, some patients and employees at St. Joseph alleged that for business reasons, Midatlantic strong-armed patients into using only its cardiac surgeons, sometimes compromising their care. In another, a group of surgeons that had long done nearly all heart surgeries performed at St. Joseph alleged that Midatlantic's tactics forced it to fold.

 

As the dispute has escalated, St. Joseph's revenue from cardiac surgery has declined while that at rival Union Memorial has accelerated. Early last year, St. Joseph hired away two of Midatlantic's top doctors, derailing the physician group's $25 million deal to be acquired by Union Memorial's parent company, MedStar Health, and prompting a threat from Midatlantic's then-CEO to "destroy" the doctors, court records show.

 

Midatlantic, formed in the early 1990s, is the dominant cardiology group in the Baltimore region, with 57 cardiovascular specialists who see patients at most hospitals in the area. Through its collective size and the role that cardiologists play in the early part of a heart patient's treatment, Midatlantic makes most of the patient referrals to cardiac surgeons in the area and as such holds considerable sway over when and where patients have cardiac surgery.

 

Fees from cardiac surgery are critical to the bottom lines at St. Joseph and Union Memorial and can account for about one-third of each institution's annual billings. Last year at St. Joseph, cardiac surgery billings amounted to nearly $78 million.

 

Midatlantic officials once called St. Joseph their "flagship" hospital, but the Towson medical center has seen its total billings for cardiac surgery decline by 20 percent since 2006, according to records from state regulators. Those records also show a significant increase in billings at Union Memorial. In fiscal 2006, Union Memorial had just over half the level of billings as St. Joseph for heart surgery. Two years later, it surpassed its rival.

 

Federal investigators also have sought records from Union Memorial, according to sources. Hospital spokeswoman Debra Schindler said, "No one has made any allegation of any wrongdoing by Union Memorial Hospital." She declined to comment further.

 

Three top executives at St. Joseph - including the chief executive officer and the chief operating officer - took administrative leave last month to "avoid a conflict of interest during the investigation," and an outside restructuring team was brought in to help ensure that the hospital is complying with federal law. A St. Joseph spokeswoman said Midatlantic's doctors continue to see patients and have privileges at the hospital.

 

While primarily a cardiology practice, Midatlantic began employing surgeons in 2000, after its efforts to merge with a group of cardiac surgeons at St. Joseph failed and spawned a lawsuit that continues today. According to that lawsuit, before Midatlantic hired its own surgeons it referred some $10 million in annual surgery business to other medical practices.

 

At issue in the failed merger was Midatlantic's once-novel business model, under which all of its physicians share equally in the practice's earnings. Cardiac surgeons typically earn much more than cardiologists, and the surgeons at St. Joseph at the time were unwilling to share the costs of Midatlantic's nonsurgical practice and thus take a significant pay cut. In the three years that followed, the annual salaries of two surgeons who declined to join Midatlantic dropped from $1.12 million to just over $550,000, according to court records, ostensibly because they were not getting as many referrals from Midatlantic.

 

Today, at least four surgeons work for Midatlantic performing surgeries at St. Joseph, Union Memorial and Sinai Hospital in Northwest Baltimore. ( Johns Hopkins Hospital and the University of Maryland Medical Center, the area's other cardiac centers, have their own cardiologists and surgeons.)

 

"Midatlantic has held and exercised power over each of these hospitals by threatening, either explicitly or implicitly, to move its patients to other hospitals if the hospital does not accede to Midatlantic's demands," attorneys for the St. Joseph surgeons wrote in papers filed in their case, which is awaiting trial in Baltimore County Circuit Court.

 

In court, Midatlantic has denied that it holds any untoward influence, and other doctors say that the disputes stem largely from frustration with the practice's success.

 

Dr. Luis Mispireta, former chief of cardiac surgery at Union Memorial who retired in 2003, called Midatlantic the "1,000-pound gorilla" in cardiac care in the Baltimore region. "Some people are going to look at that and feel intimidated," he said. "I don't think you can blame the gorilla for that."

 

In declining to discuss the federal investigation, St. Joseph officials have said repeatedly that the matter does not relate to the quality of patient care. The lawsuits concerning Midatlantic, on the other hand, contain allegations that the business disputes have compromised patient care.

 

One lawsuit contends that a patient was wrongly told that his requested surgeon, who was not affiliated with Midatlantic, was unavailable, and that he was directed instead to a less-experienced Midatlantic surgeon. The patient was injured, and sued. The lawsuit includes allegations from St. Joseph nurses that other patients were steered to Midatlantic surgeons after requesting someone else. A jury awarded the patient $5 million from Midatlantic and two of its doctors after finding that the patient was defrauded, though an appeals court determined last March that the jury saw evidence it should not have and sent the case back for a new trial.

 

In an affidavit in a third case, former Midatlantic employee Dr. Mark Midei, who now heads the heart catheterization lab at St. Joseph, alleged that a complicated procedure he was supposed to perform was about to be given to a Midatlantic doctor who had never done one. Midei alleged that the doctor was doing Internet research to learn how to perform it. Midei contended that he was allowed to perform the procedure only after his lawyer stepped in.

 

Midatlantic sued St. Joseph, Midei and his colleague, Dr. Stephen Pollock, who also left the practice in January 2008 to work at the hospital, after the doctors' departure derailed the proposed merger with MedStar. Midei called Hank Yurow, then chief executive of Midatlantic, to tell him that he would be moving to St. Joseph, and Yurow "erupted in a volcano of vitriol," according to Midei's affidavit.

 

"I will spend the rest of my life trying to destroy you personally and professionally," Midei said Yurow told him. "I will sue you back to the stone age." In a separate affidavit, Pollock told of a similar conversation.

 

Yurow did not respond to Sun messages, but in a deposition he admitted making those remarks and said, "I am still embarrassed about that comment."

 

Copyright 2009 Baltimore Sun.

 

 

 

 

 

Council OKs Dixon proposal for 275-bed shelter

Part of mayor's 10-year plan to end homelessness in the city

 

By Annie Linskey

Baltimore Sun

Tuesday, March 24, 2009

 

Baltimore Mayor Sheila Dixon's 10-year plan to end homelessness received a boost Monday evening when the City Council unanimously approved her proposal for a 275-bed shelter on Fallsway.

 

Dixon stressed that the new facility is part of a broader goal. "Our whole thrust is, how can we eliminate poverty in this city?" Dixon said.

 

City Councilman William H. Cole IV said the project "is giving homeless people in this city an opportunity they have never had before."

 

The measure garnered support from City Councilman Bernard C. "Jack" Young, who had previously been an outspoken opponent of the facility. "I can't stop it," he said. But he added that he would prefer to have smaller shelters spread throughout the city.

 

A recent survey found about 3,400 homeless people in the city, an increase of 12 percent over two years, said Diane Glauber, who is in charge of homeless services for the city. The increase, she said, is because of better counting and the faltering economy.

 

"We're seeing an increase of people who are seeking shelter service for the first time," Glauber said. "We've had people in our shelters who used to donate to shelters."

 

The city is lobbying for $2 million in state funding for the project, which will be called the Harry and Jeanette Weinberg Housing Resource Center. Dixon expects construction to begin in May.

 

Copyright 2009 Baltimore Sun.

 

 

 

 

 

Book Dealers Told to Get The Lead Out

Libraries Resist Ban on Potentially Toxic Books

 

By Michael Birnbaum

Washington Post

Tuesday, March 24, 2009; HE01

 

Rachel Merrill, mother of three, was holding innocuous-seeming contraband in her hand at an Arlington Goodwill store earlier this month: a 1971 edition of "Little House on the Prairie." This copy of the children's classic had just become illegal to resell because of concerns that some old books contain lead in their ink.

 

Legislation passed by Congress last August in response to fears of lead-tainted toys imported from China went into effect last month. Consumer groups and safety advocates have praised it for its far-reaching protections. But libraries and book resellers such as Goodwill are worried about one small part of the law: a ban on distributing children's books printed before 1985.

 

According to the Consumer Product Safety Commission, the agency charged with enforcing the act, lead in the books' inks could make its way into the mouths of little kids. Goodwill is calling for a change in the legislation even as it clears its shelves to comply, and libraries are worried they could be the next ones scrubbing their shelves.

 

Parents like Rachel Merrill are concerned, too. She home-schools her children and says that new books are just too expensive.

 

"We eat organic food, and I'm very careful about that kind of stuff," she said. "But to me, it seems like the law's written way too broadly."

 

Scientists are emphatic that lead, which was common in paints before its use was banned in 1978, poses a threat to the neural development of small children. But they disagree about whether there is enough in the ink in children's books to warrant concern. Some even accuse the safety commission of trying to undermine the law by stirring up popular backlash.

 

"On the scale of concerns to have about lead, this is very clearly not a high priority," said Ellen Silbergeld, a MacArthur scholar and professor of public health at Johns Hopkins University who is considered one of the leading experts on lead poisoning.

 

"It doesn't take a tremendous amount of intelligence to figure out what the highest-risk sources of lead are," Silbergeld said. "This is a way of distracting attention from their failure to protect children from the clear and present dangers of lead. I think this is just absurd, and I think it's disingenuous." She said that toys, poorly made jewelry and other trinkets were cause for much more alarm.

 

The legislation, which passed with strong bipartisan support, was a reaction to lead's being discovered on and in thousands of imported toys, mostly from China, in 2007. It restricts lead content in products designed for children age 12 and younger to 600 parts per million by weight; the threshold drops to 300 parts per million in August of this year. Items as varied as bikes and jewelry are affected.

 

So are books such as "Madeleine," "Goodnight Moon" and "Corduroy."

 

Lead was phased out of printer's ink following the 1978 paint ban; lacking a firm date for when it effectively disappeared, the safety commission has ruled that the toxic metal might be found in any book printed before 1985.

 

"The information we have found so far is that the ink used to have lead in it," said Joe Martyak, a spokesman for the commission and the chief of staff to its acting chairwoman, Nancy Nord. "They took the lead out of it sometime around 1980 or so." He said that tests of some old books have shown lead levels above 300 parts per million.

 

Implementation of the new law has libraries and secondhand bookstores reeling. Although they could pay to have each old book tested, the cost ($300 to $600 a book, according to the American Library Association) makes that impractical.

 

The commission has advised libraries not to circulate old books while the agency reviews the situation. But few libraries have complied, and they complain that they have received contradictory information from the commission.

 

"We're talking about tens of millions of books," said Emily Sheketoff, executive director of the Washington office of the American Library Association. "You've got the commission playing games with the libraries.

 

"It's hard enough to get kids to read," she said. "We don't want parents to think, 'Oh, there's something wrong with this book; I don't want to take it home from the library.' "

 

Children are more vulnerable than adults to damage from ingesting lead. Experts agree that fetuses and toddlers younger than 2 are at the most risk, but the threat remains for several years. Specialists say that lead poisoning can cause IQ loss and developmental delays, difficulty in focusing and increased aggressiveness. Children have to ingest the lead, not just touch it, but as anyone who has cared for toddlers knows, most toys and even books will wind up in their mouths sooner or later.

 

"Lead poisoning among children is one of the most intractable problems in pediatric history," said David Rosner, co-director of the Center for the History and Ethics of Public Health at Columbia University. "At present there's a whole body of science that says there's no threshold, there's no level of exposure that's safe. . . . The only long-term answer is to say, 'If we know there's lead there, keep it away from kids.' "

 

Rosner thought that the effort to take pre-1985 books out of circulation might seem like overkill to parents who grew up reading the old books themselves. "Unfortunately, the latest science doesn't really jibe with [their] understanding of what danger is," he said. He said the commission might be taking an aggressive stance in this case because "they've been burnt a number of times for not going far enough."

 

The commission says that it is understaffed and overtaxed by the new areas it must police.

 

"The agency is really stretched to the limit as to what we are doing about this new law," Martyak said. But he said that the agency has been given very little leeway. He cited new restrictions on children's bikes that have also caused a backlash: There was enough lead in the tire valves to push them over the enforcement limit, even though there might not be lead anywhere else in the bike.

 

"Whether you consider that common sense or not, that's the way the law is written," he said.

 

In the District, libraries have been waiting for more information about the rules before they decide whether to pull their old children's books.

 

"Children's collections are a little different from our regular adult collections," said Nancy Davenport, interim director of library services at the District of Columbia Public Library. Children's books stay on the shelf longer because they remain popular, she said. "You could walk into almost any children's library and you'd see the same books that you just adored when you were a kid."

 

In the District, the law means that more than a sixth -- 110,000 of 650,000 -- of the children's books on the shelves might have to be removed. And in these tight financial times, replacing those books could be a serious problem.

 

"I don't know that there is an urban system in this country that is expecting a budget bonanza," Davenport said.

 

In secondhand stores such as Goodwill, the law has already begun to take effect. Local outlets have been slowly scouring their shelves of old children's books and other products, such as cribs, strollers and car seats, that could run the risk of violating the law. The books are piling up in a warehouse in Arlington.

 

"It is never Goodwill's goal to knowingly sell dangerous merchandise," said Brendan Hurley, a spokesman for Goodwill of Greater Washington. "We are, of course, concerned about how this will affect retail sales."

 

That means that books such as "Theodore Turtle," "Bunnicula" and "Dominic" -- copies of which, worn with time and the attentions of countless children, were on the shelves of an Arlington Goodwill store earlier this month -- will no longer be available in old editions.

 

That will disappoint parents such as Rachel Merrill, who lives in Arlington.

 

"On these shelves I know I've found four or five books that are classics," she said, ones she said she couldn't have afforded if they were new.

 

Copyright 2009 Washington Post.

 

 

 

 

 

Va. Hospital Treats the Whole Person

 

By M.J. McAteer

Washington Post

Tuesday, March 24, 2009; HE06

 

At Fauquier Hospital in Warrenton, a patient doesn't have to worry about getting stuck with a chatty roommate: All 86 of the hospital's rooms are private. Restricted visiting hours are a thing of the past, too: Family and friends can drop by any time, day or middle of the night.

 

Fauquier patients can order decidedly non-institutional dishes such as breakfast burritos, brick-oven pizza, Mongolian stir fry and desserts that are to die for, although the hospital probably wouldn't care to put it that way. And if a patient is accustomed to dinner at 8 or likes to sleep until 10, the concierge will take note and try to oblige.

 

Because of those and other features, Fauquier has been given "designated" status by Planetree, a nonprofit that promotes a more humanistic approach to health care. Planetree, which takes its name from the type of tree under which Hippocrates sat to teach his medical students, was founded in 1978 and now has 140 hospital affiliates, mostly in the United States; of those, eight have the "designated" label.

 

Other organizations serve as similar resources for health-care institutions, but Planetree was "the pioneer," says Rick Wade, a spokesman for the American Hospital Association. "The public doesn't know about Planetree," he says, "but health-care people know it means a commitment to a certain kind of internal culture. Before Planetree, hospitals were all about getting patients well, but not about what the patient was experiencing. Now 80 percent of the nation's hospitals are making some effort at patient-centered care."

 

Planetree addresses topics as diverse as patient education, social support, nutrition, spirituality and building design. Changing the culture of a very large hospital can be extremely difficult, Wade says, so most Planetree affiliates tend to be small- to medium-size facilities looking for a way to stand out. "Planetree doesn't market itself to hospitals," Wade says. "Hospitals come to Planetree."

 

Fauquier Hospital chief executive Rodger Baker was first impressed with Planetree when he attended a talk about the organization's philosophy and its vision of hospitals as "sacred healing places."

 

In the late '90s, when Fauquier was planning a $60-million-plus expansion and renovation, Baker sought advice from the organization, made site visits with staff to facilities using the patient-centered approach and, in 2000, paid the $15,000 fee for his hospital to become an affiliate. That gave him access to the organization's educational and professional resources as the hospital worked on implementing Planetree's 10 core components of patient-centered care. Planetree tracked Fauquier's progress; in October 2007, it judged the hospital to have met 45 specific standards for patient care and support staff, and gave it the "designated" label.

 

Baker estimates that such architectural features as private rooms with built-in sleeping accommodations for family members, carpeted corridors and additional windows added 10 to 20 percent to the cost of the construction project. Those extra expenses were worth it, he says, because the Planetree approach as a whole has resulted in improved market share and higher patient and employee satisfaction; as a result, no additional fees have been levied on patients or insurers.

 

The design differences at Fauquier are obvious. In waiting areas, lamps have replaced overhead lighting; halls have been carpeted to keep down noise or are finished in faux wood for a warmer feel. Community artwork hangs on the walls. "We try to look more like a hotel," Baker says.

 

Barriers between patients and staff, such as those sliding-glass windows that close nurses off from patients and the public, have been removed. Elevators for patients and the public are separate: No one really wants to be seen in a hospital johnny. No constant paging over the intercom system, either; instead, unobtrusive music plays all the time.

 

"Planetree," Wade says, "has had a tremendous impact on how hospitals are being designed and built, even if they aren't Planetree."

 

Family-Friendly Features

Changes extend beyond the physical structure to the human factor.

 

Consider one of the most common patient complaints: being asked the same question over and over by different staff members. That could be exhausting and infuriating for the patient.

 

Now, Baker says, computerized records have helped eliminate redundant questions, and the hospital strives to maintain a continuity of caregivers.

 

Elizabeth Mullen, who goes to Fauquier's infusion center for weekly chemotherapy treatment for breast cancer, volunteered about a year ago to serve on a patient advisory council for the hospital.

 

The first issue she broached was the infusion center's "ridiculous" and "redundant" process for registration. "It's a real burden when you aren't feeling well to have to register twice," she says. Within about a month, the hospital responded to her complaint, and now chemo patients register just once.

 

As for patient meals, the attitude used to be, "This is what you're going to eat, and this is when you're going to eat it," says Vernon Rhea, Fauquier's director of nutrition. Now, "within dietary constrictions," patients can pick from about 50 items or order from the Bistro on the Hill, the hospital's cafeteria -- and get a meal any time the kitchen is open.

 

Patients at Fauquier are urged to educate themselves about their condition and become partners in their treatment. The hospital has a clinician sit with patients to go over their medical charts, explaining such notations as "SOB": med-speak for "shortness of breath."

 

Some changes mean that patients aren't separated from family and friends, unless they want to be. In the emergency department, the near and/or dear can accompany the patient to one of 33 private treatment rooms. If the patient is admitted, a companion can sleep over on the fold-out couch provided in every room. "They make it very easy for families to stay," Mullen says.

 

Courtesies extend to outpatients, too. When Stanley Orr needed medical attention for a kidney stone in January, he told the hospital's concierge, Lisa M. Spitzer, that his wife was worried about driving them home in snowy conditions. Spitzer arranged for someone to chauffeur them -- at no charge.

 

It's not yet clear how the Plane-tree sensibility will affect either the hospital's medical outcomes or its bottom line, but Wade says he believes that patient-centered care leads to "fewer complications, fewer readmissions, improved outcomes and greater productivity."

 

Measures of Success

On the federal government's Hospital Compare Web site (http://www.hospitalcompare.hhs.gov), 76 percent of patients who had stayed overnight at Fauquier said "yes" when asked whether they would definitely recommend using the hospital. (The national average was 68 percent.)

 

Of 75 hospitals within a 100-mile radius of downtown Washington, only four scored higher than Fauquier: Johns Hopkins in Baltimore (80 percent), Anne Arundel Medical Center in Annapolis (79 percent), Winchester Medical Center in Virginia (79 percent) and Inova Fair Oaks in Fairfax (78 percent); Virginia Hospital Center in Arlington tied Fauquier at 76 percent.

 

Planetree's principles extend to better treatment of staff. Fauquier holds regular retreats for all staff to build teamwork. Employee benefits include a $10-a-month health club membership and a 20 percent discount at the Bistro.

 

Fauquier hopes to duplicate the success of Griffin Hospital in Derby, Conn., Planetree's flagship facility. The once-struggling hospital has posted growth in both inpatient and outpatient volumes far outstripping that of other hospitals in the state. At the same time, it has made Fortune magazine's list of 100 Best Places to Work for seven years.

 

If the experience at Griffin is prescriptive, the prognosis for Fauquier Hospital's future health should be promising.

 

Copyright 2009 Washington Post.

 

 

 

 

 

Familiar faces

 

Cumberland Times-News

Tuesday, March 24, 2009

 

It is difficult to know how many hundreds of children Dr. Thomas Hunt has helped over his more than four decades of volunteering at the League for Crippled Children.

 

As the League celebrates its 75 anniversary this year, Hunt has a unique distinction. He is the longest-serving of dozens of orthopedic surgeons who have volunteered for the nonprofit organization over the years.

 

Last Friday, Hunt was back at it again. The Baltimore pediatric orthopedic surgeon, whose official status is retired, conducted yet another one of the hundreds of clinics he has held in his 44 years of service to the League.

 

Hunt and his physician colleagues have become familiar faces in Cumberland over the years. Chartered in 1934, the League was founded to provide free care to “all crippled children in the county whose families were unable to pay for treatment necessary to assure such children useful, happy lives,” Hunt wrote in a 2004 reflection.

 

More than 30,000 children have been served by the League at clinics held at least once a month in Cumberland.

 

Currently, four pediatric orthopedic surgeons take turns giving clinics. Patients from birth to 21, most of them from Maryland, West Virginia or Pennsylvania, are referred through a variety of sources — schools, doctors and other agencies. The League also has a full-time speech pathologist and a contract physical therapist.

 

It is a wonderful service that would not have been possible but for the generosity of the many physicians who have participated in the program. Dr. Hunt and all of those physicians have earned the genuine gratitude of the community.

 

Copyright © 1999-2008 cnhi, inc.

 

 

 

 

 

Delaware's infant mortality rate falls

 

Associated Press

USA Today

Tuesday, March 24, 2009

 

DOVER, Del. (AP) — Delaware health officials say the state's infant mortality rate has fallen, but are worried that the recession could adversely affect children's health.

 

Officials released the information Monday in the annual Kids Count in Delaware report.

 

It indicates that the infant mortality rate in Delaware was 8.8 deaths per 1,000 births in 2002-2006, the latest period for which statistics are available. That's a decline from 9.2 deaths per 1,000 live births in 2001-2005.

 

The national rate for 2002-2006 is 6.8 deaths per 1,000 live births.

 

But Janice Barlow, policy analyst for Kids Count in Delaware, says Delaware's economic problems will have a negative effect on next year's report and possibly later years.

 

Copyright 2009 The Associated Press. All rights reserved.

 

National / International

 

Workers feel the brunt of health insurance woes

 

Associated Press

By Ricardo Alonso-Zaldivar

Washington Post

Tuesday, March 24, 2009

 

WASHINGTON -- American workers _ whose taxes pay for massive government health programs _ are getting squeezed like no other group by the nation's health insurance woes.

 

While just about all retirees are covered, and nearly 90 percent of children have health insurance, workers now are at significantly higher risk of being uninsured than in the 1990s, the last time lawmakers attempted a health care overhaul, according to a study to be released Tuesday.

 

The study for the Robert Wood Johnson Foundation found that nearly 1 in 5 workers is uninsured, a statistically significant increase from fewer than 1 in 7 during the mid-1990s.

 

The problem is cost. Total premiums for employer plans have risen six to eight times faster than wages, depending on whether individual or family coverage is picked, the study found.

 

"The thing I think is interesting is how many workers are newly uninsured," said Lynn Blewett, director of the State Health Access Data Assistance Center at the University of Minnesota, which conducted the research. "In the last couple of years we've seen a deterioration of private health insurance."

 

About 20.7 million workers were uninsured in the mid-1990s. A decade later, it was 26.9 million, an increase of about 6 million, the study found.

 

In the 1990s, there were eight states with 20 percent or more of the working age population uninsured. Now there are 14: Alaska, Arizona, Arkansas, California, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina and Texas.

 

Yet workers continue to pay the bill for covering others. Their payroll taxes help support Medicare, which covers the elderly. Income taxes and other federal and state levies pay for covering the poor and the children of low-income working parents. But government provides little direct assistance to help cover workers themselves.

 

"There really aren't safety-net programs for adults," Blewett said.

 

The study comes as the Obama administration is scrambling to maintain support for a health care overhaul this year in the face of record federal deficits. A program like President Barack Obama's, which would commit the nation to coverage for all, is estimated to cost about $1.5 trillion over 10 years. Yet the U.S. health care system, already the world's costliest, is also considered one of the most wasteful.

 

"I don't think we can delay action beyond this year," said Dr. Risa Lavizzo-Mourey, president of the Robert Wood Johnson Foundation, which sponsored the study and provides extensive financing for health care research. "It's clear that we are at the brink."

 

For the Ramer family of Denver, Iowa, it's already too late. Husband Jim, a truck driver for a road-building company, died of a heart attack in 2005 at the age of 59. He was uninsured and trying to cope with diabetes, a chronic disease that requires prescription drugs and follow-up medical care to keep under control.

 

His wife, Cindy, 58, works full time caring for mentally disabled people as a certified nursing assistant. But the nursing home that employs her canceled its medical coverage several years ago because it had become too expensive. Ramer is now uninsured and hasn't had a regular checkup in about three years. Instead, she goes to health fairs for bone-density measurements and other screening tests.

 

"I don't think it's fair that I'm caring for people and helping them with their health care, and I don't have adequate, affordable health care of my own," said Ramer. "I'm not asking for a handout. I'm just asking for something I can afford, and won't have all these restrictions that they'll cover this and won't cover that." Ramer says she can afford to pay about $100 to $150 a month.

 

If anything, the situation for workers appears to be worse than is reflected in the report. It analyzed Census data through 2007, the latest year available. But that before the economy tumbled into recession.

 

On the Net:

Robert Wood Johnson Foundation:http://www.rwjf.org

 

© 2009 The Associated Press.

 

 

 

 

 

FDA Ordered to Rethink Age Restriction for Plan B

Judge Says Politics Influenced Policy on the Contraceptive

 

By Rob Stein

Washington Post

Tuesday, March 24, 2009; A02

 

A federal judge ordered the Food and Drug Administration yesterday to reconsider its 2006 decision to deny girls younger than 18 access to the morning-after pill Plan B without a prescription.

 

U.S. District Judge Edward R. Korman in New York instructed the agency to make Plan B available to 17-year-olds within 30 days and to review whether to make the emergency contraceptive available to all ages without a doctor's order.

 

In his 52-page decision, Korman repeatedly criticized the FDA's handling of the issue, agreeing with allegations in a lawsuit that the decision was "arbitrary and capricious" and influenced by "political and ideological" considerations imposed by the Bush administration.

 

"These political considerations, delays and implausible justifications for decision-making are not the only evidence of a lack of good faith and reasoned agency decision-making," he wrote. "Indeed, the record is clear that the FDA's course of conduct regarding Plan B departed in significant ways from the agency's normal procedures regarding similar applications to switch a drug from prescription to non-prescription use."

 

FDA lawyers are reviewing the decision, said Rita Chappelle, an agency spokeswoman, who declined to comment further.

 

Critics of the FDA's decision hailed the ruling.

 

"We're very excited," said Suzanne Novak, a senior staff lawyer for the Center for Reproductive Rights, which filed the lawsuit. "The message is clear: The FDA has to put science first and leave politics at the door."

 

Opponents of Plan B condemned the judge's order.

 

"This ruling puts politics above women's health, and intrudes into parents' ability to protect their minor daughters," said Wendy Wright of the group Concerned Women for America. She also questioned the drug's effectiveness.

 

"Making the morning-after pill easy to get has not resulted in fewer pregnancies or abortions, as advocates promised it would," Wright said. "Pregnancy counselors report more young women relying on it as a regular form of birth control -- even though the drug has not been tested to discover what happens when it is used multiple times."

 

Plan B consists of higher doses of a hormone found in many standard birth-control pills. Taken within 72 hours of unprotected sex, it has been shown to be highly effective at preventing pregnancy.

 

With strong support from women's health groups and family planning advocates, Barr Pharmaceuticals, which makes Plan B, asked the FDA in 2003 to allow the drug to be sold without a prescription so women would not have to obtain a doctor's order to get it.

 

Conservative Congress members and advocacy groups opposed the request. They questioned the drug's safety and argued that wider availability could encourage sexual activity and make it easier for men to have sex with underage girls. They also maintain that Plan B can cause the equivalent of an abortion.

 

The FDA delayed its decision for three years despite endorsements of nonprescription sales by its outside advisers and internal reviewers, leading to intense criticism that the agency was allowing politics to influence the decision.

 

When the agency eventually approved nonprescription sale in August 2006, proponents were disappointed that the drug was limited to women age 18 and older. The FDA said that there was too little safety data to approve the drug for teenagers younger than 18 and that pharmacists would be unable to enforce the age cutoff. The requirement also meant that women must show proof of their age when buying the drug, which made it more difficult for some women, such as illegal immigrants.

 

In his ruling, Korman detailed repeated interference by "political actors" in the agency's handling of Plan B, including the long delay in approving the drug and the ultimate decision to act only after some senators tried to apply pressure by blocking confirmation of acting FDA commissioners. The agency's justification for its final decision "lacks all credibility," Korman said.

 

"The court has vindicated our claim that the Bush administration's FDA was playing political games with women's health," said Nancy Northup, president of the Center for Reproductive Rights. "The judge's opinion makes clear that the FDA should have put medical science first and left politics at the lab door."

 

Susan F. Wood of George Washington University, who resigned from the FDA because of the agency's delays, noted that several officials involved in the decision are either still at the agency or in other key government positions, including Janet Woodcock, who heads the FDA's drug approval office, and Steven Galson, now acting surgeon general and assistant secretary of health. But Wood and others said they are confident that the new leadership at the agency will make Plan B widely available after reviewing the case.

 

"I think FDA is now in a position where it can make a fair decision because of the change in leadership and the commitment by everyone involved to make science-based decisions," Wood said. "This is a chance for the agency to demonstrate it is back on track."

 

President Obama recently announced plans to name former New York City health commissioner Margaret A. Hamburg as FDA commissioner and Baltimore Health Commissioner Joshua M. Sharfstein as her deputy. He also issued an order he said was designed to insulate scientific decisions throughout the government from political influence.

 

Plan B remains the focus of intense debate, particularly over whether pharmacists who oppose its use on moral grounds should be required to sell it.

 

Copyright 2009 Washington Post.

 

 

 

 

 

Blacks Suffer More Early Heart Failure

 

Associated Press

By Mike Stobbe

Washington Post

Tuesday, March 24, 2009; HE04

 

One in 100 black men and women develop heart failure before age 50, according to one of the first long-term studies to look at the life-threatening condition in younger adults.

 

The research, published in the New England Journal of Medicine, suggests blacks in that age group suffer the condition at a rate 20 times that of whites. However, the findings are based on a very small number of cases, the authors said, so more study is needed.

 

Heart failure, which occurs when the heart loses its ability to pump sufficient blood through the body, is often fatal.

 

"Usually this is a disease of the elderly," said Kirsten Bibbins-Domingo, a physician who is one of the study's authors. "When this disease happens in 30- and 40-year-olds, it's quite dramatic."

 

The researchers looked at data from more than 5,100 people who were ages 18 to 30 at the time they joined the study more than 20 years ago. Over the years, 27 people developed heart failure by age 50, all but one of them black. Five died, all of them black.

 

At the outset, blood pressure levels and weights were similar regardless of race, said Bibbins-Domingo, an epidemiologist at the University of California at San Francisco.

 

But the researchers found that a disproportionate number of blacks developed high blood pressure in young adulthood and went on to suffer heart failure. Blacks also were more likely to develop diabetes and chronic kidney disease, and to suffer an impairment in the heart muscle's ability to contract.

 

Researchers told those who received a diagnosis of high blood pressure to see their doctors about it. But 10 years into the study, the condition was untreated or poorly controlled in three out of four black patients who had received the diagnosis.

 

Copyright 2009 Washington Post.

 

 

 

 

 

Alzheimer's cost triple that of other elderly

 

Associated Press

By Lindsey Tanner

Washington Post

Tuesday, March 24, 2009

 

CHICAGO -- The health care costs of Alzheimer's disease patients are more than triple those of other older people, and that doesn't even include the billions of hours of unpaid care from family members, a new report suggests.

 

Compared with people aged 65 and older without Alzheimer's, those with the mind-destroying disease are much more often hospitalized and treated in skilled-nursing centers. Their medical costs also often include nursing home care and Medicare-covered home health visits.

 

That all adds up to at least $33,007 in annual costs per patient, compared with $10,603 for an older person without Alzheimer's, according to a report issued Tuesday by the Alzheimer's Association.

 

The numbers are based on 2004 data and include average per-person Medicare, Medicaid and private insurance costs.

 

Costs likely have grown since then as the U.S population has aged and the number of Alzheimer's diagnoses has risen, said Angela Geiger, the Alzheimer's Association chief strategy officer.

 

According to the group's report, nearly 10 million caregivers _ mostly family members _ provided 8.5 billion hours of unpaid care for Alzheimer's patients last year.

 

"All of these statistics paint a really grim picture of what's going to happen ... unless we invest in solutions" to delay or prevent the disease, Geiger said.

 

This week a Senate committee will hear from an independent coalition of experts that has been working on a strategy for dealing with the growing Alzheimer's population.

 

An estimated 5.3 million Americans have the disease; by next year nearly half a million new cases will be diagnosed, according to the Alzheimer's Association.

 

As the disease progresses, people lose the ability to care for themselves and need help with eating, bathing, dressing and other daily activities. Eventually, they may need help with breathing and swallowing.

 

From 2000 to 2006, while deaths from heart disease, stroke, breast and prostate cancer declined, Alzheimer's deaths rose 47 percent.

 

Geiger said those trends reflect improved treatments for other diseases, while there are no treatments that can slow or prevent Alzheimer's.

 

On the Net:

Alzheimer's Association: http://www.alz.org

 

© 2009 The Associated Press.

 

 

 

 

 

Census Bureau Will Try an Ad Campaign To Reach Minorities

Economic Downturn Complicates Count

 

By Ed O'Keefe and Steve Vogel

Washington Post

Tuesday, March 24, 2009; A04

 

Amid fears that millions of people may be overlooked during next year's census, the Census Bureau will launch a $250 million promotional campaign to encourage participation in the decennial head count, especially among hard-to-reach minority groups in urban areas.

 

More than half those funds will go for advertising across traditional and social media, and nearly a quarter will be devoted exclusively to Asian, black and Hispanic outlets.

 

"A year from now, the populace will have seen and heard more ads in national and local media than in any prior census," the Census Bureau's acting director, Thomas L. Mesenbourg, told a House Oversight and Government Reform subcommittee.

 

The agency will also hire 2,000 temporary employees by the end of June to coordinate efforts with more than 10,000 local organizations and corporations to help encourage greater participation. Companies including General Mills and Target and civil rights groups including the NAACP will encourage their customers and members to fill out census forms next year.

 

All of this is necessary to help boost participation levels among the nation's undercounted groups, mostly ethnic minorities in economically depressed areas. How the bureau decides to advertise could prove crucial to next year's count, said Stacey Cumberbach, New York City's census coordinator.

 

"While the census is a federal responsibility, there must be earlier and ongoing communication and accountability to local governments and communities," she said at yesterday's hearing, noting that 55 percent of New York residents responded to the 2000 census questionnaires, compared with 66 percent nationally.

 

But any attempt at coordination with local governments may be adversely affected by their tight budgets, according to Robert Goldenkoff of the Government Accountability Office. He also noted that the bureau could encounter many people who refuse to answer questions because of their general distrust of government or fear of revealing their immigration status.

 

At a forum last week sponsored by the Brookings Institution, census officials and other experts also warned that increases in foreclosure and joblessness would make it harder to accurately count the population during the 2010 census because more Americans are moving out of their homes and into shelters or other locations where they may be more difficult for census workers to find.

 

Arturo Vargas, executive director of the National Association of Latino Elected and Appointed Officials, said minority populations are more likely to be affected because they are being hit harder by job losses and foreclosures. "Another undercount of the Latino community, of which there has been in every single census, simply represents a failed census," Vargas said.

 

Research done by the Census Bureau shows that many Hispanics "believe answers can be used against them," according to Frank A. Vitrano, a division chief at the bureau who oversees planning and coordination for the 2010 count. Hispanics also tend to be overrepresented among groups that know little or nothing about the census and its purposes, he said.

 

Copyright 2009 Washington Post.

 

 

 

 

Vaccination: Vaccine Delays in Poorer Nations Raise Health Risks for Infants

 

By Donald G. McNeil Jr.

New York Times

Tuesday, March 24, 2009

 

Many infants in poor and middle-income countries get their vaccines weeks later than doctors recommend and therefore face increased risks of sickness and death, according to a new study in The Lancet.

 

Researchers at the London School of Hygiene and Tropical Medicine studied health surveys from 45 countries, mostly in Africa and Latin America. Globally, vaccination rates have risen sharply over the last 20 years, and child mortality has dropped below 10 million a year for the first time, thanks largely to measles shots, according to the United Nations Children’s Fund.

 

In the first nine months of life, the World Health Organization recommends vaccines for tuberculosis, diphtheria, tetanus, whooping cough, polio and measles.

 

The study’s authors said that Egypt, Kyrgyzstan, Peru and Rwanda did particularly well and that Chad, Nigeria and Yemen did particularly poorly. In the slowest countries, at least a quarter of all children got shots between two months and five months late.

 

Besides the obvious risk that a child will die during the delay, there are some theoretical risks with vaccines being newly introduced, an editorial accompanying the study said. The Hepatitis B vaccine under consideration can protect against infection from the mother only if given within seven days of birth, but a vaccine given now that also should be introduced in the first week, the BCG tuberculosis vaccine, was often delayed. And a new vaccine against rotavirus has a recommended cutoff date of 12 weeks, meaning it might be denied to many children.

 

Copyright 2009 The New York Times Company

 

 

 

 

 

USDA shield guarantees inspected meat

 

By Michael R. Bell

Carroll County Times

Tuesday, March 24, 2009

 

Consumers buy meat because they like its taste and flexibility for being prepared in a variety of ways for just about any occasion. Wholesomeness, quality, nutritive value, cost, convenience and informative labeling are some aspects to consider when purchasing meat.

 

Under federal law, all meat processed in plants that sell their products across state lines must be inspected for wholesomeness by the U.S. Department of Agriculture’s Food Safety and Inspection Service. Many states operate their own inspection programs for plants that produce meat for sale within state lines.

 

These programs must be certified by the USDA as compliant with the federal program. Federal and state inspectors supervise the cleanliness and operating procedures of meat packing and processing plants to make sure meat is not contaminated or adulterated.

 

Meat that has passed federal inspection for wholesomeness is stamped with a round purple mark, “U.S. INSP’D & P’S’D.” The mark is put on carcasses and major cuts, so it might not appear on such cuts as roasts and steaks. However, meat that is packaged in an inspected facility will have an inspection legend that identifies the plant on the label.

 

Meat inspection procedures are designed to minimize the likelihood of harmful bacteria being present in meat products. However, some bacteria could become a problem if the meat is not handled properly. That’s why it’s important to handle meat properly during storage and preparation. The USDA requires that safe handling and cooking instructions be put on all packages of raw meat. This includes any meat product not considered “ready to eat.”

 

Processed meat products that are considered “ready to eat,” such as hot dogs, luncheon meats or canned ham, are also perishable. They should be refrigerated and handled with care to prevent spoilage.

 

Use the “Nutrition Facts” panel on each individual product label to learn about the nutrient content of that food and how it fits into an overall daily diet. The “Nutrition Facts” panel must appear on all processed meat products, while its use is voluntary on single-ingredient raw meat.

 

Quite apart from the wholesomeness of meat is its quality: its tenderness, juiciness and flavor. Consumers can be assured of always getting the quality of meat they expect by looking for the USDA grade shield on raw meat packages.

 

The shield-shaped USDA grade mark is your assurance that the meat is wholesome, because only meat that has first passed inspection for wholesomeness may be graded. USDA’s quality grading program is voluntary and paid for by user fees.

 

USDA has quality grades for beef, veal, lamb, yearling mutton and mutton. It also has yield grades for beef, pork and lamb. Although there are USDA quality grades for pork, these do not carry through to the retail level as do the grades for other kinds of meat.

 

Michael R. Bell is an extension educator in agriculture science working with the University of Maryland Cooperative Extension’s Carroll County office.

 

Copyright 2009 Carroll County Times.

 

Opinion

 

Regulating Carbon

EPA rules under the Clean Air Act aren't the way to do the job. But a carefully crafted tax might be.

 

Washington Post Editorial

Tuesday, March 24, 2009; A12

 

THE ENVIRONMENTAL Protection Agency has told the White House that global warming is endangering public health and welfare, The Post's Juliet Eilperin reported yesterday. This "finding" under the Clean Air Act may seem like a no-brainer, given the potential ill effects of climate change. But that law, enacted in 1970, was never intended to deal with greenhouse gases and is not suited to that task. The Bush administration's failure to tackle climate change directly drove states and environmental advocates to seek back-door paths to regulation. If this one goes forward, the EPA would have to regulate greenhouse gases from all sources, including cars, houses and commercial buildings. This would create what Rep. John Dingell (D-Mich.) has called "a glorious mess." Congress should avert it putting a price on carbon.

 

Such a market-based solution could be accomplished either through a tax or, as the Obama administration supports, by setting a cap on greenhouse gas emissions and having polluting companies pay for the right to emit. Mr. Obama's budget anticipates collecting $645.7 billion over the next 10 years from such a cap-and-trade regime. But such a complex system would take time to develop and institute, even if Congress supports it. Laurie Williams and Allan Zabel, two EPA enforcement attorneys for more than 20 years in the agency's San Francisco office and writing as private citizens, released a paper last month advocating a "carbon fee" because, they argue, a cap-and-trade system "will not insure a competitive price advantage for clean energy over fossil fuel energy in the near future." Rajendra Pachauri, chairman of the United Nations Intergovernmental Panel on Climate Change, supports cap-and-trade. But when we asked him whether opponents of a carbon tax were right in saying that a tax would not guarantee emissions reductions, Mr. Pachauri said no. "If you rationally design the tax, you could meet the carbon emissions reduction goals," he said, because it "should lead to a shift to other sources of energy or other technologies that reduce energy use efficiently."

 

Yes, we know. A carbon tax is a politically unpalatable solution for some. But it has advantages over a complex trading system and should be considered. And either a carbon fee or cap-and-trade would be far superior to bureaucratic regulation under the Clean Air Act.

 

Copyright 2009 Washington Post.

 

 

 

 

Misfire in Maryland

Arming abuse victims is the wrong way to curb domestic violence.

 

Washington Post Editorial

Tuesday, March 24, 2009; A12

 

THE PROBLEM: Guns accounted for more than half of the deaths resulting from domestic violence in Maryland from June 2007 to July 2008. The solution, according to some lawmakers: more guns. The Maryland Senate may vote as early as today on an amendment that would make it easier for victims of domestic violence to obtain guns. In theory, empowering victims could discourage potential abusers. In practice, adding guns to an already combustible situation is likely to lead to more violence. The Senate should reject the amendment.

 

The provision undermines two potentially life-saving bills that would make it more difficult for suspected abusers to carry firearms. One bill would allow judges to strip abuse suspects who were subject to temporary restraining orders of the right to carry firearms. The other bill would bar abuse suspects who were subject to final restraining orders from possessing guns. In past years, similar legislation passed the Senate but died in the House Judiciary Committee. When the House passed the bills last week, free of amendments that would mar their effectiveness, it seemed that there were few obstacles left.

 

Enter Sens. C. Anthony Muse (D-Prince George's) and Alex X. Mooney (R-Frederick). The two lawmakers, members of the Senate Judicial Proceedings Committee, proposed an amendment that would expedite the process by which domestic abuse victims could obtain firearms. The committee approved the provision, which was tacked on to the bill that deals with final protective orders, by a 6 to 5 vote.

 

Victims' advocates and law enforcement officers have serious concerns about the amendment. They worry that an abuser could discover a firearm hidden by a victim or wrestle away a gun during a dispute. It takes considerable training, police officials note, to be able to effectively wield a gun in self-defense. There's another wrinkle: An abuser could misleadingly claim to be a victim of domestic violence and file for a protective order. This would rush a gun into the hands of someone capable of violence. And police officers called to domestic disputes could find themselves in greater danger.

 

Maybe backers of the amendment have seen one Jodie Foster film too many, but, in the real world, victims don't usually resolve dangerous situations with gunfire. Strong legislation to keep guns away from abusers, not easy-to-obtain guns, is the best protection for victims.

 

Copyright 2009 Washington Post.

 

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