Alabama to expand trauma care communication system

Alabama is working to plug a deadly hole in the treatment of highway accident and other trauma victims - getting injured patients to the correct hospital.

Half of the state, including metro Birmingham-Hoover, Huntsville and Mobile, is already covered by a state trauma communications system that saves lives. Beginning early next month, 10 counties in east Alabama will join the system, including six with major highways used by Birmingham-area residents on trips to Atlanta, Auburn and Chattanooga.

Without such a system, an estimated 60 percent of injured patients end up in a hospital that can't properly treat them, and then are transferred to another hospital hours later, Alabama state health officials say. This can mean missing the "golden hour" after trauma, those fleeting minutes when prompt medical treatment gives the best chance of survival from serious injury.

An example would be a car wreck victim with a closed-head injury who was sent to a hospital that lacked a neurosurgeon. If there were bleeding inside the head, he could quickly deteriorate before reaching a surgeon who could help.

The same threat would exist for an accident victim who had two injuries to his long bones - either the upper arms or upper legs - if he were sent to a hospital that lacked an orthopedic surgeon.

Trauma death rates in metro Birmingham have dropped 12 percent since the Birmingham Regional Emergency Medical Service System started its pioneering trauma communication system 13 years ago, according to the Alabama Department of Public Health.

"This whole system is geared so that no one ever has to be transferred," said Dr. John Campbell, the department's EMS and trauma medical director. "They're always taken to the hospital that can give definitive care immediately, so hundreds of lives can be saved every year."

Eight volunteer hospitals in the east region have been screened and approved by the state health department, said Choona Lang, a registered nurse and the state trauma administrator.

"We are now installing computers and software to give real-time information on their ability to accept a trauma patient," she said.

With the system, medics at the accident scene evaluate the patient and contact Alabama Trauma Communications Center, based at the University of Alabama at Birmingham. A computer there lists all the trauma hospitals ready to accept patients, and it updates that information every 90 seconds.

"Paramedics (at UAB) will discuss the patient's injuries and will route the patient to an appropriate hospital," Lang said. Discussions may also include hospital emergency department staff, trauma surgeons and other caregivers.

After east Alabama joins the system, metro Montgomery and a large swath of west-central and southeast Alabama will be the last areas unprotected.

The state health department hopes to include those counties by the end of the year, making Alabama a model for the nation, Lang said. "No other state that we know of has the statewide, centralized communications center."

This will be particularly important for travelers on the road. According to the state health department, almost 80 percent of Alabama's trauma cases come from motor vehicle crashes, and trauma is the leading cause of death in the state for people younger than 45.

E-mail: jhansen@bhamnews.com Read More...

California hospitals fined for errors

Eleven California hospitals were fined $25,000 each in administrative penalties Thursday for violations that, in some cases, led to death or serious injury, according to Department of Public Health officials.

Most of the hospitals fined were in Southern California, and about half were cited because doctors or hospital staff had left foreign objects in patients after surgery. Coast Plaza Doctors Hospital in Norwalk and Los Angeles County-USC Medical Center were fined for failing to follow proper surgical procedures.

At County-USC, surgeons had to operate a second time to remove a surgical sponge left inside a gunshot victim in June 2008. The hospital has been fined two other times in the last two years, including a citation earlier this month for leaving surgical sponges and towels behind during surgery on another gunshot victim. County-USC doctors and staff perform about 1,000 surgeries a month, including a quarter of the county's trauma cases, said chief executive Pete Delgado.

Coast Plaza was fined after staff left two surgical clamps in a patient during surgery in December 2008 and had to operate again to remove them.

Of 115 penalties issued to 80 hospitals since the penalties became law two years ago, 21% were related to foreign objects left behind during surgery, the second-leading violation, according to Ralph Montano, a health department spokesman. About 36% of fines are due to medication or pharmacy errors, Montano said.

Other hospitals fined included Saint John’s Health Center in Santa Monica, where staff failed to follow surgical procedures in December 2008 and a fire erupted during eyelid surgery, burning a patient's face.

USC University Hospital was fined after mixing up two patients' test results, mistakenly telling a patient with a broken leg that he had cancer in August 2007 and unnecessarily amputating his leg. The hospital was also fined $30,300 for failing to report the incident, but hospital officials have appealed that fine, state records show.

Tenet Health Corp. sold the hospital to the university in April, and state officials emphasized that the fine was against Tenet, not the university. A Tenet spokesman said they may appeal the penalty.

Other local hospitals fined Thursday included Kindred Hospital in Ontario; Loma Linda University Medical Center; Sharp Chula Vista Medical Center and Tri-City Hospital District in Oceanside. Read More...

$350,000 grant going to water project in Southern Hills

State officials have approved a $350,000 grant that will help continue a water project aimed at eventually bringing drinking water to rural residents and cities throughout the Southern Black Hills.

The state Board of Water and Natural Resources this week approved a $350,000 State Water Resources Management System grant for Southern Black Hills Water System Inc. Other funds have been made available through the U.S. Department of Agriculture’s Rural Development program.

The money will be used to build pipeline from a project well along the 7-11 road west of Buffalo Gap west to about halfway to S.D. Highway 89 south of Pringle, according to Bob Peplinski, a member of the water system board.

Phase One of the project will bring Madison Aquifer water to about 130 families in the area, Peplinski said.

He said the board hoped to put the initial project out for bid within the next 30 to 40 days.

Phase Two of the project will bring water farther west to include several rural subdivisions west of Highway 89.

The project has a permit to drill a second well, Peplinski said.

The water system board hopes to build a system that eventually would pump water along more than 100 miles of trunk line connecting Hermosa, Hot Springs, Edgemont, Pringle, Custer, Hill City and, eventually, Keystone. The line could provide drinking water to as many as 6,000 rural residents of the Southern Hills, where finding drinkable well water is an iffy proposition.

Peplinski said costs for the entire project could reach well over $100 million.

Gov. Mike Rounds recommended the $350,000 funding to the 2009 Legislature, and lawmakers appropriated funds from the state Water and Environment Fund through the Governor’s 2009 Omnibus Water Funding Bill.

“Because of the lack of water supplies in the southern Black Hills, this area needs a regional water system to supply a reliable source of high-quality, safe drinking water to enhance continued economic growth,” Rounds said. “These funds will help keep this much-needed project moving forward.” Read More...

6.3% of children uninsured statewide

An estimated 11.8 percent of St. Cloud residents ages 18-64 did not have health insurance last year, according to the Census Bureau’s 2008 American Community Survey. An estimated 3.2 percent of St. Cloud’s children under 18 are uninsured.

The American Community Survey is the federal government’s annual survey of about 3 million households. It provides a wealth of social, economic and demographic information between the 10-year census.

Last year was the first time the American Community Survey included a question about health insurance coverage.

The results show that uninsured rates vary greatly across the nation. According to the new snapshot, one in four people in Texas lacked health insurance in 2008, the highest rate in the nation. At the other end of the spectrum, fewer than one in 20 Massachusetts residents lacked coverage.

The uninsured rate for children ranged from 2.1 percent in Massachusetts to 20.2 percent in Nevada.

Among the 50 states, Minnesota’s uninsured rates — 11 percent for working-age adults and 6.3 percent for children — were near the bottom.

That’s partly because Minnesota has a state-sponsored health insurance program for low-income residents called MinnesotaCare. Enrollees pay a monthly premium based on their family’s income, size and number of family members covered.

“Minnesota tends to have a lower uninsured rate than many other states,” said Kathy Parsons, director of managed care for St. Cloud Hospital. There are additional programs that cover children, she said.

But Parsons said the survey results indicate a higher percentage of uninsured than she would have expected, and could be due to people losing insurance coverage because of job layoffs.

In Stearns County, the number of uninsured — 9.2 percent for adults and 4.5 percent for children — is slightly below the state rate.

Sherburne County’s numbers are similar to Minnesota’s, with an estimated 12.5 percent of adults age 18-64 and 4.8 percent of children without insurance. No data is available for Benton County because it is too small to be included in the ACS.

The uninsured rate for adults 65 and older tends to be very low because they qualify for Medicare, the federal government’s health insurance program for seniors.

No job, no insurance

It’s not clear from the data how the recession is affecting uninsured rates, but experts say they suspect it’s having an impact.

Andy Vinson, executive director of HealthPartners Central Minnesota Clinics, said his clinics have seen only a slight increase in the number of uninsured patients in recent months.

However, they have seen a shift from most people having employer-backed insurance plans to more having government-sponsored insurance, something Vinson attributes to job loss.

An employee can get continuing insurance coverage after losing a job, but it may be more expensive, said Li Zhang, assistant professor of finance, insurance and real estate at St. Cloud State University.

And if there’s a lapse in coverage of more than a couple months, the employee’s pre-existing conditions won’t be covered for a certain period of time once he or she does get insurance, she said.

Zhang said she expects the uninsured rate to increase if job losses in the area continue. Even for those with health insurance, the costs are going up as many employers shift more of the cost to employees, she said.

Reasons, impact

There are other reasons a percentage of the population doesn’t have coverage despite the availability of government-sponsored insurance, experts say.

They might earn too much or have too many assets to qualify for MinnesotaCare or other programs, or they might not think they can afford the premiums, Parsons said. Or they might not even be aware of the programs.

“Sometimes you don’t think about it until you need it,” Parsons said.

Sometimes recent college graduates who haven’t found a job remain uninsured, Parsons said, or younger, healthy adults decide not get coverage.

“They’re kind of in that middle place where they’re going to take that chance,” she said.

The impact of the uninsured on the health care system can be costly. People without insurance often skip regular physicals and preventive or prenatal care and can end up in the emergency room with a more complex health problem, Parsons said.

“The ER is the most expensive place to try to get your basic care,” she said.

It can also be costly for individuals, particularly if they have a catastrophic health problem or accident.

“It is a leading cause of personal bankruptcy,” Zhang said. Read More...

Senate OK’s Kennedy successor bill

The state Senate approved a bill yesterday that would let Governor Deval Patrick appoint an interim successor to Edward M. Kennedy, paving the way for the appointment of a new US senator as early as tomorrow and providing Democrats in Washington the potential 60th vote they have been seeking to pass a health care overhaul.

The state Senate approved the measure by a 24-to-16 vote, just five days after the House had voted 95 to 58 to change Massachusetts election law and allow the appointment of an interim US senator. Both chambers are planning to give a final procedural endorsement to the measure and to send it to the governor’s desk today; the only potential hurdle is that Republicans are contemplating a last-ditch legal challenge in an effort to derail the legislation.

News of the vote reverberated yesterday from Beacon Hill to Washington, where US Senate majority leader Harry Reid, informed of the news when a note was passed to him, pumped his fist into the air and cracked a small smile, according to an aide.

All attention now turns to Patrick, who has been weighing the appointment options with a close circle of advisers in recent days, asking them to cast a wide net, according to a person with knowledge of the process who requested anonymity because of the sensitivity of the discussions. It has been an “extensive vetting process,’’ but the governor is still mulling over candidates, the person said.

The governor is hoping to be able to appoint someone tomorrow or Friday, the person said.

Mindful of recent controversies over interim US Senate appointments in New York and Illinois, Patrick administration officials have declined to release the names of those under consideration.

“The governor appreciates the support voiced in the Senate today and the action taken by the House last week to ensure Massachusetts has full representation in the Congress,’’ Patrick’s spokesman, Kyle Sullivan, said in a statement.

The interim senator appointed by Patrick would serve until voters elect a new senator in a Jan. 19 special election. That senator would serve the remaining three years of Kennedy’s term.

Kennedy’s two sons, US Representative Patrick J. Kennedy of Rhode Island and businessman Edward M. Kennedy Jr., have told Governor Patrick that their first choice for an interim senator is former Democratic National Committee chairman Paul G. Kirk Jr., according to a Kennedy family associate.

Kirk, an attorney who lives on Cape Cod, worked as a special assistant to Senator Kennedy from 1969 to 1977, is currently the chairman of the John F. Kennedy Library Foundation, and last month served as master of ceremonies at a widely watched memorial service the night before Senator Kennedy’s funeral. Read More...

More than 10,000 children in isles remain uninsured

Hawaii appears to be increasing health insurance coverage among residents.
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But despite the state's health insurance programs for the poor and elderly, it still has tens of thousands of uninsured, including more than 10,000 children.

The percentage of those without health insurance in Hawaii was 6.7 percent in 2008, compared with 8.2 for years 2006-2007, according to the U.S. Census Bureau.

In 2008 an estimated 83,111 people were without health insurance in Hawaii, more than 10,330 under age 18, the Census Bureau said.

State Sen. David Ige, chairman of the Senate Health Committee, said lawmakers are aware there is a gap group of working poor who do not qualify for state services.

Ige (D, Aiea-Pearl City) said the Legislature authorized $350,000 to cover an estimated 4,500 children without health insurance statewide in 2007 and 2008, but Gov. Linda Lingle's administration has ceased the program and declined to release the funds.

State Department of Human Services spokeswoman Toni Schwartz said the administration has raised the level of income eligibility and increased the number of families qualifying for health insurance benefits.

Schwartz said the department halted the release of funds for the gap group because people who could afford insurance were entering the health insurance program.

The Census Bureau ranked Hawaii first for the percentage of workers who carpool to work and was seventh in the U.S. for workers 16 and over who travel to work by public transportation.

Hawaii also led states in the largest percentage of households with at least three generations living together.

They totaled 7 percent of Hawaii's households, followed by California, Mississippi, Texas and Louisiana. Read More...

Specialist insurers do not always offer the lowest quote

Specialist insurers, which are marketed towards a specific type of driver are not always the cheapest, according to a comparison website .

Steve Sweeney, head of motor insurance at moneysupermarket.com, noted that there are many people who use specialist insurers because they believe they will always be offered a lower quote . He indicated that this is true for some drivers, but not everybody, so people should shop around for the best deal. He added: "I would advise anyone unsure about whether to go down the specialist insurer route or stick to more traditional providers to weigh up all their options."

Mr Sweeney also said that often specialist insurers will provide worthwhile extra benefits such as handbag cover on women-only policies, however in general it will not pay to stay with your existing insurer.

Recently, moneysupermarket.com stated that it will be showing the total excess payable on policies when people compare quotes on its website. Read More...

Privatizing workers’ comp would raise Oklahoma's rates, some say

Small businesses in Oklahoma likely would see their rates go up if the state agency that provides workers’ compensation insurance were changed to a private firm, an industry expert told legislators Wednesday. "Most likely they would see an increase,” said Roy Wood, state relations executive with the National Council on Compensation Insurance.

Sen. Cliff Aldridge, R-Midwest City, co-chairman of the Task Force on the Privatization of CompSource Oklahoma, had asked Wood what effect small business policy holders could expect if the state agency was converted to a mutual operation or a private company.

A special fund would be formed to handle high-risk or small businesses, Wood said. But a mutual or private company probably would charge higher rates because they would be unable to subsidize them as CompSource is able to now, said Wood, whose company, based in Boca Raton, Fla., manages the nation’s largest database of workers’ compensation insurance information.

CompSource has about a 5 percent advantage over private carriers because it doesn’t have to pay premium taxes and doesn’t have to contribute to the state’s guarantee fund, which covers the costs of claims of an insolvent insurance company. A law passed this year states it is the intent of the Legislature to privatize CompSource no later than Dec. 31, 2010.

Jason Clark, president and chief executive officer of CompSource, said after the meeting he was not surprised by Wood’s words.

"We’re good for Oklahoma employers, we provide stability to the rates in Oklahoma,” he said. "We’re there throughout the market cycle.”

Wood said about 6 percent of the workers’ compensation insurance market in Oklahoma would be made up of small or high-risk businesses.

Clark said he didn’t know what percentage of CompSource’s approximately 26,000 policyholders would fit into that category, but estimated it usually averages between 5 and 10 percent. But it could be as high as 20 percent during a weak economy.

"We take all comers,” Clark said. "We don’t ask, ‘Have you been declined coverage elsewhere?’” Read More...

State leaders trade accusations on Medicaid

JACKSON — Mississippi’s Medicaid director told lawmakers Wednesday that Attorney General Jim Hood has refused to prosecute a possible case of $24 million in fraud by a man paid to provide behavioral services to patients.

“He wouldn’t get in there,” Bob Robinson said.

In an interview later, Hood said he didn’t know the details of the case Robinson discussed. But speaking of Medicaid officials, Hood said, “If they showed us a criminal case, we pursued it.”



Hood accused Robinson of trying to protect a rural hospital that filed for bankruptcy after allegedly misspending $24 million from Medicaid, the government health insurance program for the needy and disabled.

“He needs to resign and get out of that agency because it has been mismanaged,” Hood said.

Robinson was not immediately available to respond.

Robinson’s comments came as he appeared before the Joint Legislative Budget Committee to discuss Medicaid’s spending request for the year that begins July 1.

He told lawmakers he believes there is fraud and abuse in the program.

When Democratic Rep. Percy Watson of Hattiesburg pressed for details, Robinson replied: “Listen, it’s not the beneficiaries. It’s not even a blip on the screen. It’s the providers.”

Medicaid providers include hospitals, nursing homes, physicians, dentists, pharmacists, therapists and others who are paid to give services to patients.

Officials say 605,289 people were enrolled in the program as of Aug. 31.

Robinson said he suspects a $24 million of fraud occurred two or three years ago when a behavioral services provider overcharged to drive patients to medical facilities where they were shown movies.

Robinson would not release the name of the person.

“Look, I’m not going to tell you that if he hasn’t even been indicted,” Robinson told The Associated Press as he left the legislative meeting.

Robinson told lawmakers that federal prosecutors also have shown no interest in the alleged fraud.

House Speaker Billy McCoy, D-Rienzi, said he found that difficult to believe.

“Well, by God, we want to track it down,” McCoy said.

House Public Health Committee Chairman Steve Holland, D-Plantersville, said he told Medicaid officials years ago about the provider he believes Robinson was discussing.

Holland said the man was providing daytime care for mentally disabled adults at several hospitals, which Holland considered “very valuable services.”

Holland said, though, that he wasn’t sure whether the provider was properly billing Medicaid for the transportation and other services.

“I warned Medicaid that he bore to be watched,” Holland said.

Holland said he thought Robinson was trying to create “political fodder” against Hood.

Hood is a Democrat and a frequent critic of Republican Gov. Haley Barbour, who appointed Robinson. Read More...

Alabama's college flu rates 2nd in the U.S.

Colleges and universities in Alabama are being hit harder by the flu than schools in any other state except Washington, according to a weekly survey of college administrators. Nearly all confirmed cases in Alabama are the new H1N1 flu.

The American College Health Association survey found 119 new suspected flu cases per 10,000 students in Alabama last week. The national rate was 25. Only Washington, with 130 new cases per 10,000 students, was hit harder.

Dr. Don Williamson, Alabama's state health officer, said colleges in the state are being hammered by the flu primarily because students in the Southeast typically go back to school earlier than students in other regions. More time together on campus means a higher rate of infection.

"Right now Alabama is the epicenter of H1N1," he said. "I'm not surprised that our state's rate is high. I'm surprised other states' rates are low."

Among surrounding states, Georgia had the next highest rate of new cases on campus last week, with 57 new cases per 10,000 students.

It wasn't immediately clear which Alabama campuses had reported the jump in flu cases. Officials with colleges and universities contacted Wednesday afternoon said they had significant numbers of sick students, but had seen no dramatic increase.

Deedie Dowdle, a spokeswoman for Auburn University, said the school was seeing 10 to 20 new cases a day, a number that has been consistent all semester.

Cathy Andreen, a spokeswoman for the University of Alabama, said solid numbers for illness at UA were not immediately available, but that health officials on campus report the number of cases there decreased in the last week.

The Health Association survey found 321 new suspected cases on campuses in the state last week, and a rate of new suspected cases that had more than doubled from the previous week. The survey does not include all colleges in the state.

On campuses nationwide, the survey found 7,696 reports of suspected new cases at the 267 colleges and universities surveyed. Among those schools, 243 reported new cases. Since the survey began Aug. 22, about 21,000 students have reported having the flu. Read More...

County focus on infant mortality rate

When she found out she was pregnant at age 17, Kyndra Bell thought of her teenage classmates who already had children and those who felt too "ashamed" to seek out the proper prenatal care.

Instead, she became determined to take care of her baby.

"I said, 'It's not about myself no more,'" she said. "I took my prenatal vitamins every day. I tried to eat the right foods, and I walked."

She also enrolled in a baby basics class at the Chattanooga-Hamilton County Health Department, where a health educator introduced her to a high-risk-pregnancy obstetrician and provided some extra education.

"It was a big help," Kyndra said. "The nurses up there, they were always able to put a smile on my face."

Her baby ShyNella is now almost 2 months old and healthy after recovering from surgery to repair a congenital defect, she said.

Hamilton County is one of the worst counties in the state in terms of infant mortality, but public health advocates said at a news briefing Tuesday that local initiatives -- such as having the health educators at the health department -- will begin to turn those numbers around.

With 9.7 deaths per 1,000 births, Hamilton County has the second-worst infant death rate of all Tennessee counties, second only to Shelby County.

"To decrease these rates it takes more than just one or two groups working on this," local health department administrator Becky Barnes said at the event. "The solutions are community solutions. They have to be community identified, community driven, community implemented."

Thanks to increased state funding, a clinic run by the University of Tennessee College of Medicine in Chattanooga's obstetrics-gynecology department has been able to reach out to more low-income patients, resulting in a 20 to 35 percent increase in patient visits, said Dr. Daniel Schubert, director of gynecology and ambulatory care.

The department also is partnering with the Southside and Dodson Avenue Community Health Centers to provide significantly expanded OB-GYN coverage for the centers' patients, said Bill Hicks, executive director of the centers, which receive federal funding to treat underserved and low-income populations.

La Paz de Dios' Health Promoters program is focusing on reaching out to local pregnant Hispanic women, while Girls, Inc. in Chattanooga is engaging local teenagers in a peer education campaign in which the teens write and create public service announcements about infant mortality.

Girls Inc. program participant Kermisha Tate, 17, a senior at Boyd-Buchanan School, said the area's dismal infant mortality rates undermine Chattanooga's many positive attributes.

"Chattanooga has so much potential ... but it's not going to be one of the great cities in Tennessee if our babies keep dying," she said.

CORE LEADERSHIP

The Hamilton County Core Leadership Group, which is coordinating and supporting the efforts of several community-based programs, was created in 2007 by Gov. Phil Bredesen's Office of Children's Care Coordination to reduce the county's infant mortality rate. Similar programs were implemented in Shelby and Davidson counties. Read More...

Plenty of H1N1 vaccine

So far, 250 doctors and pharmacists have signed up to get the swine flu vaccine that's expected to arrive by mid-October, State Epidemiologist Dr. Mary Currier told lawmakers working on the state budget Tuesday. State health officials said they are moving forward with plans to vaccinate students and other residents next month amid news that the state has recorded its seventh death related to the H1N1 flu.

"We anticipate that there will be plenty of vaccine," she told reporters after addressing members of the Joint Legislative Budget Committee.

There are 898 confirmed swine flu cases in the state, according to the state Department of Heath.

The most recent death was reported Monday and involved a Jones County woman - the second woman to die in Jones County from the H1N1 flu. The earlier Jones County fatality and a woman in Tippah County who died from the flu were reported Saturday.

Other swine flu deaths in Mississippi were a male child in Jackson County reported July 25, a female child in Hancock County reported Aug. 29, a woman in Washington County reported Sept. 5 and a woman in Hancock County reported Sept. 12.

Currier said that priority status for the vaccine will be given to those who are particularly vulnerable to the flu, such as pregnant women, caregivers of children aged 6 months and younger and emergency and medical personnel.

Other priority groups for vaccination are those 25-64 years old with chronic heart, lung (including asthma), kidney and liver problems; and those who are immunosuppressed, as well as health care and emergency service providers.

The Health Department expects the H1N1 flu vaccine to be available for free at all county health departments. It also will be available at participating private physicians' offices, community health centers, some pharmacies, and other clinics that will target priority groups for the swine flu vaccine.

"We're also trying to provide Tamiflu to community health centers and to pharmacies, especially to pharmacies so we can ensure that folks who don't have access, have access," Currier said.

Nationwide and in Mississippi, swine flu deaths remain comparable to those from seasonal flu, according to the Health Department. Also, seasonal and swine flu remain similar in most symptoms and in duration and severity.

The Health Department is working with schools regarding vaccine administration and will work with Head Start programs, day-care centers, colleges and universities throughout the state.

Currier said swine flu responds well to traditional anti-virals. Most people recover without hospitalization. Read More...

Reports Criticize Pandemic Planning

Many state and local governments are not adequately prepared to deal with a surge of patients in a flu pandemic or quickly distribute vaccine and antiviral drugs, according to two reports by federal investigators being released on Monday.

An analysis of preparations by five states and 10 municipalities around the country found that many had failed to take steps crucial during a pandemic, such as recruiting health-care workers to volunteer, creating systems to track hospital beds and medical equipment, and determining how to manage a patient load that exceeds what emergency rooms are able to handle.

"Our review found that although the selected states and localities are making progress within the five components of medical surge that we reviewed, more needs to be done to improve states' and localities' ability to respond to a pandemic," investigators from the Department of Health and Human Services' Office of Inspector General concluded in one report.

The findings come as federal, state and local officials are preparing for a second wave of swine flu infections. The H1N1 virus emerged in Mexico last spring and quickly spread to the United States and elsewhere. Although the virus appears no more dangerous than seasonal flu, many more people than usual are expected to become ill because most people have no immunity against it.

For the first report, investigators collected information last summer about pandemic planning in Portland and Lewiston, Maine; St. Louis and Rolla, Mo.; Sioux Falls and Mitchell, S.D.; Virginia Beach and Blacksburg; and Seattle and Longview, Wash.

In a 30-page report, investigators found:

-- Although all 10 communities had developed committees to help plan for a pandemic and health-care coalitions to coordinate care, "the degree to which coordination occurred varied" among them.

-- Fewer than half of the communities had started to recruit volunteer medical workers to help with a surge of patients, and none of the states had implemented an electronic system to manage such volunteers.

-- All 10 communities had acquired additional medical equipment to respond to a pandemic, but "many experienced difficulties with managing this equipment," and only three states had electronic systems to track beds and equipment. Read More...

State health premiums may see rise

JACKSON – Unless innovative ways are found to hold down health care costs, legislative leaders were told Monday, insurance premiums will increase for state employees and for retired state employees.

The cost of health insurance also would be increasing for the state.

Legislative leaders said Monday the increase would be difficult for state employees and for the government to absorb during the current economic downturn, which is causing a slowdown in tax collections.

The Mississippi government picks up the cost of health insurance for most state employees and teachers.

But dependent coverage is paid by the employee, and retirees pay the bulk of their coverage, though those insurance premium costs are partially subsidized by the state. More than 194,000 people are on the state plan.

Teresa Planch, the state insurance administrator, told members of the Legislative Budget Committee that the board overseeing the health insurance plan resisted increasing premiums this past year even though the program was losing money.

It is contemplating an 11 percent increase for the coming year, which would cost the state $56 million. For retirees and employees with dependent coverage, the total cost would be $35 million.

An 11 percent increase would increase costs for an average family by $62, to $625 per month.

The problem, said Planch, is that the continuing increase in health care costs is eating away at needed reserve funds in the state health insurance program.

Rita Wray, deputy executive director of the Department of Finance and Administration, which is the agency responsible for administering the program, said efforts are being made to find innovative ways to hold down the costs.

The Legislative Budget Committee heard the news Monday on the first day of hearings for next year’s budget. Through Thursday, state agency heads will present their budget requests for the upcoming legislative session.

A need to put an additional $50 million in health insurance is the last thing the legislative leaders wanted to hear as they deal with a dramatic drop in state revenue during the current national recession.

Legislative leaders and Gov. Haley Barbour have said they expect the budget situation to be dire for the next two years and numerous cuts are anticipated.

“We can’t get through the next two years doing things the way we have done them in the past,” said Senate Appropriations Committee Chair Alan Nunnelee, R-Tupelo. “We have to be looking at not how to do things better, but how to do things differently.”

Nunnelee cited a larger premium for smokers as one method to encourage smokers to quit and thus hold down the costs in the program.

During the tough economic times, an increase in premiums also would cause difficulties for state employees and retirees, said House Appropriations Committee Chairman Johnny Stringer, D-Montose.

“They can’t afford that,” Stringer said. Read More...

The harm in pharmacy misfills

It never occurred to Gwen Dalley that there was anything wrong with the prescription antibiotic pills she picked up at a Loganville pharmacy. But within a day of taking them, while driving her usual school bus route, she was so overcome with dizziness that she had to pull over and radio for a substitute driver. As Dalley continued to take the pills, her symptoms got worse. She was nauseated, started having headaches and her vision blurred. She was briefly hospitalized, but doctors couldn’t figure out what was wrong.

Eventually she noticed that some of the pills in the pharmacy bottle were larger than others. It turned out most of them were not the antibiotic her doctor had prescribed, but an antidepressant with significant side effects, according to a complaint Dalley filed in January with the Georgia Board of Pharmacy.

Every year, dozens of Georgia consumers complain to state regulators about mistakes made at local pharmacies. Patients have received double, quadruple, even 10-times their prescribed dosages. They’ve been sent home with the wrong drugs: One patient was given the risky blood thinner warfarin – instead of a diabetes medication. Another was given diet pills instead of blood pressure pills. Still another was dispensed an Alzheimer’s treatment instead of sleeping pills, according to pharmacy board disciplinary records.

In response to the AJC’s questions, officials at several major pharmacy chains — including CVS, Rite Aid, Kmart and Kroger — issued statements saying that safety is their top priority and that they all have systems to ensure prescription accuracy.

Yet mistakes still happen.

Nobody knows exactly how many because only a fraction are reported to regulators; most are handled privately by the pharmacies.

Some studies indicate that about 3 percent of the prescriptions dispensed by pharmacies have potentially harmful errors. The patient may be given the wrong drug, the wrong dosage or the wrong directions.

“That’s pretty big numbers overall,” said Michael Cohen, a pharmacist and president of the Institute for Safe Medication Practices, noting the billions of prescriptions Americans get filled each year. “You should be concerned enough to look at your medication, talk to the pharmacist and know what can go wrong in the pharmacy.”

Allie Fennell learned this lesson the hard way.

Fennell, 34, had taken a generic version of the popular allergy drug Allegra for years without problems. Then in May 2008 she picked up a refill from the CVS pharmacy at 1544 Piedmont Avenue in Atlanta that instead contained a psychiatric drug called nefazodone, according to a complaint she filed with the pharmacy board.

“I kept taking them every day and my allergies were getting worse,” Fennell said. On top of that, she began feeling like her brain was in a fog and she became nauseated. She eventually noticed a description of the pills on the label didn’t match the pills in the bottle.

Dalley, the school bus driver, said she’s still outraged about being given the wrong drug by a CVS pharmacy in Loganville in 2007. “What if I’d been driving down the road with 50 kids and passed out?” she asked.

CVS officials declined to comment on the incidents. Trent Speckhals, an attorney who represented Dalley and Fennell, said both women settled their cases confidentially.

Pharmacy regulators said they can’t confirm or deny whether the women’s complaints were ever received. Under Georgia law, the complaint process, as in most states, is mostly kept secret.

Only if the pharmacy board votes to publicly reprimand the pharmacist or pharmacy are any details available for review.

But many reprimands are delivered privately as letters of concern. The public is not allowed to see these. Board officials were unable to say last week how many of these private warning letters have been issued.

The AJC reviewed more than 200 public disciplinary documents issued by the pharmacy board since 2006 and posted on the Web at http://tinyurl.com/puborders . Many involved pharmacists with substance abuse problems or who had dispensed narcotics without valid prescriptions. Others involved pharmacists voluntarily surrendering their licenses without any details being given as to why. A few involved pharmacy employees preparing or dispensing medications without a licensed pharmacist being present to oversee the accuracy of their work.

About 50 public disciplinary actions involved medication mistakes. In most cases the pharmacist was fined $500 and required to take a medication safety course; the pharmacy they worked for usually received a similar fine.

After a mistake is made, one or two years may pass before the board issues the public reprimand, records show. The reasons for the delays are unclear due to the secretive nature of the process.

When pharmacy mistakes happen, fatigue and overwork are the main factors said Rick Allen, deputy director of the Georgia Drugs and Narcotics Agency, which serves as the board’s investigative arm.

Allen said his agency receives five to 10 complaints a month about misfilled prescriptions. Most of the complaints are valid, he said.

The pressure on retail pharmacists to crank out prescriptions can be intense, he said, with some overseeing hundreds of prescriptions a day.

“Most of the time they’re overworked. They let their technician do too much of the work and they’re not checking what the technician did,” Allen said.

Technicians’ training may be minimal, Allen said, which is why a licensed pharmacist is required to review each prescription being dispensed. Georgia pharmacists are only allowed to supervise the prescription-filling work of three technicians.

From 2004 through 2007, regulators found CVS pharmacies across the state making mistakes and often having too many technicians and not enough pharmacists, records show. In September 2007 the pharmacy board required CVS to pay a $75,000 fine.

CVS, which has 300 stores in Georgia, has the No. 1 market share of total drug store sales in the Atlanta area.

CVS/pharmacy spokesman Mike DeAngelis, in an e-mail, said: “We recognize that any process involving people is not immune from the possibility of error or accidental deviation from procedural controls,” noting that if an error occurs, the pharmacy works to learn what happened and what can be done to prevent it from happening again.

Regulators can only investigate the mistakes that are reported, and few are. Most consumers complain directly to the pharmacy, which usually handles the matter privately, Allen said.

“What we get is really a trickle of what’s happening,” Allen said. “Most stores do not report their misfills to us. ... It would be good if they were reported. If we’ve got a pharmacist with a problem, we need to know about it.”

But Allen admits that a flood of complaints could drown his shrinking staff of investigators.

“We’ve gone from 13 agents down to really nine because of furloughs and state layoffs,” Allen said. That’s less than the agency had 35 years ago, when there were half the number of pharmacies in the state and Georgians took a fraction of the prescription drugs they do now, he said.

Still, he said, “If a patient has been injured we try to get on to that and put everything else aside.”

-------------------------------------

Mistakes take many forms

The Georgia Board of Pharmacy makes some of its reprimands -- called public board orders -- available for review on the Web. In many cases there is a significant lag time between when the mistake occurred and when action is taken.

● A 27-year-old woman who was prescribed an anti-anxiety medication for an allergic condition instead received a powerful heart drug from a Kmart pharmacy in Cartersville. The woman was hospitalized for three days after suffering a reaction to the drug. The board order was issued in September 2008; the prescription was misfilled in February 2007.

● Pharmacists at a Wal-Mart in Newnan misfilled a patient’s prescription for Quinamm, to treat malaria, with Quinapril, a blood pressure medication. And they did it three times. A board order was issued in January 2008; the incidents occurred in November 2005 and in June and July 2006.

● A CVS pharmacy on Jones Bridge Road in Alpharetta improperly refilled a 10-month-old child’s prescription for Zantac – needed to control stomach acid — with liquid Zyrtec, an allergy medication. Even though the child’s mother called the pharmacy to ask why the liquid smelled different, she “was assured by the pharmacist on duty that the correct drug had been given.” The child took the drug for a week before the mother noticed the pharmacy label was covering another showing the drug was actually Zyrtec. The board issued its order in July 2007; the incident occurred in May 2005.

● A Kmart pharmacy in Canton sent a patient home with a bottle of the antibiotic Levaquin that said to take the pills four times a day — instead of just once a day as the doctor prescribed. The patient followed the wrong instructions on the bottle and in August 2007 Kmart settled a claim over the misfill and notified the board. The board issued its order in December 2008; the incident occurred in 2005.

Source: Georgia Board of Pharmacy, public board orders. CVS and Kmart officials declined to comment on the specifics of these cases; Wal-Mart didn’t respond.

--------------------

Protecting Yourself

● Look in the bag: Before you leave the pharmacy counter, take a look at the label the pharmacy has put on your medication. Is your name spelled correctly? Is your doctor’s name correct? If not, you might have someone else’s prescription. Make sure the right drug and dosage are on the label.

● Talk to the pharmacist: Experts say many mistakes are caught when patients talk with the licensed pharmacist on duty — not a technician — about the drug they’re picking up. Tell the pharmacist what you’re taking the drug for. Tell the pharmacist about other medications you’re taking and any medical conditions. Ask how the drug should be taken and about potential side effects.

● Be wary: If pills you’ve been taking are a different color or shape, ask questions.

● Get more information: The Institute for Safe Medication Practices has more useful tips at www.consumermedsafety.org . To get updates about new safety alerts for the medications you take, go to www.consumermedsafety.org/medsafetyalert.asp

--------------------

Where to complain

● Georgia Board of Pharmacy: Complaints can be filed online at: http://tinyurl.com/soscomplaint . Or write to: Georgia Board of Pharmacy, 237 Coliseum Drive, Macon, GA 31217. Make sure to include your name and contact information.

● Tell the AJC: The Spotlight column wants to know about complaints filed by consumers with the pharmacy board and whether any action was taken. If you’ve filed a complaint in recent years, tell us about your experience: 404-526-5041 or spotlight@ajc.com.

--------------------

Check our sources

Public reprimands involving pharmacies and pharmacists are posted on the Secretary of State’s Web site, http://sos.georgia.gov/plb/PublicOrders/

In most cases, however, the documents are listed in the name of the pharmacist, and the pharmacy’s name is mentioned within the document. Pharmacies are often identified by store number, not address. Read More...

Mass H1N1 shots in public schools urged

PHOENIX — State health officials are urging counties to conduct mass vaccinations at public schools in an effort to get as many children inoculated against the novel H1N1 flu as possible.
But they won't force the vaccines on anyone.
Will Humble, acting director of the Arizona Department of Health Services, said the goal is to get the vaccine to close to 80 percent of school-age children. At that point, he said, their immunity will help protect the others who are not vaccinated.
But Humble told members of the House and Senate Health committees on Thursday that the vaccination rate for the regular seasonal flu — the only other comparison he has — is closer to 20 percent.
Pima County Health Department spokeswoman Patti Woodcock said Thursday that she's not aware of any plans to hold H1N1 vaccinations in local schools.
Humble reassured lawmakers that no one who doesn't want the inoculations against what has become more commonly known as the swine flu is going to be forced to get it.
"I have absolutely no intention of making this vaccine mandatory in any way, shape or form, whether it's for school entry or otherwise," he said. "It's going to be strictly voluntary.' "
More to the point, Humble said school-based clinics will be legally precluded from giving the vaccine to any youngster absent a signed permission slip from a parent or guardian.
That still left state Sen. Thayer Verschoor, R-Gilbert, uncomfortable.
"I know you say you're not going to do that," he said. "But when you start seeing these children dying, that changes the dynamics."
Humble acknowledged that the governor does have certain powers in a "state of emergency." But he said he doubts that could be legally triggered, even if 50 percent to 60 percent of Arizonans became infected.
He also said a mandate would only make the public suspicious that there's something wrong with the vaccine. Instead, Humble said, he hopes to educate people as to why they should get inoculated.
Anyway, Humble said, there won't be enough vaccine available to inoculate everyone.
While that comforted some lawmakers, the possibility that a large number of children will be without protection concerned Rep. Phil Lopes, D-Tucson.
"You have to get to a certain level, do you not, in order for the 'herd immunity' concept to take place?" he asked. Lopes worried that enough parents would refuse the shots for their children, to the point that it would help spread the disease.
Humble said he is not spending a lot of time trying to reach any particular immunization level, but rather focusing on making information available "so that parents can make responsible decisions that they believe are appropriate for their families."
"We're hoping most families will decide to get their children vaccinated because, No. 1, it will protect their individual family," he said. "But it also has, as you said, an added bonus in that it has a community effect if you can get the vaccination threshold into the 70-80 percent range."
Lopes said, though, that goal is being undermined by what he said is irresponsible information on the World Wide Web claiming the vaccine is dangerous.
"Is it a pipe dream to think we can get 80 percent if we're at 20 now?" Lopes asked. He said he is getting e-mails from parents who are "scared as hell about this and don't want to do it."
Maricopa County Health Director Bob England said it will depend a lot on what is being reported in the media.
He said that if there are lots of stories about "extremely rare side effects" of a similar vaccine from 33 years ago, then people will avoid the shots.
"If, in the media, there are stories about the children who are dying from this, then it will flip the exact opposite way and people will demand the vaccine."
Rep. Nancy Barto, R-Phoenix, said there are questions about the effects of the preservative in the vaccine. Some people have said there's a link between autism and the preservative, which contains mercury.
Humble said there is an alternative for those who are concerned. He said that while most vaccines are delivered in 10-dose vials, which require preservatives, there are single-dose syringes also available that do not need the extra chemicals.
"As for me, I wouldn't care if my kid got the vial or the pre-filled syringes because I'm confident that the amount of preservative in the vial is negligible," he said.
But there are parents "who might be concerned about that,'' Humble said. "To overcome those objections, the pre-filled syringes are available. Either way, they get immunity."
Humble said, though, he is sure that some parents will still come up with other objections.
"Our job is to overcome as many barriers as we can and really speak as clearly as we can about the safety of the vaccine," he said. "But, ultimately, it's parents on their own that make those decisions for their families."
England said one reason for concentrating on inoculating children is that it appears many adults have some immunity from this virus based on their exposure to a strain that went around about 50 years ago. Read More...

Ex-Hawaii inmate awarded $932,900 for substandard medical care

A former state prison inmate has been awarded $932,900 in damages after he was rendered infertile by substandard medical care he received while incarcerated at Halawa High Security Correctional Center. Circuit Judge Victoria Marks made the decision this afternoon in a lawsuit against the state by Gregory Slingluffer, who was imprisoned at Halawa in 2003-2004 for a drug offense.

In September 2003, Slingluffer developed an infected scrotum that was treated with the wrong antibiotics and incorrect dosages, according to testimony in a four-day trial earlier this month.

And delays in his treatment caused his scrotum to swell first to the size of a "grapefruit" and then to a "small watermelon," his lawyer, Richard Turbin, said.

Slingluffer's scrotal sac was surgically removed and replaced with grafted skin from his thigh.

Slingluffer, 41, a furniture store employee, faces more reconstructive surgery over the next 18 months.

He declined comment after the court session.

Turbin called Marks' decision "a modest award" for Slingluffer.

"The state could have saved a lot of money if it had only followed its own (medical) protocols," he said.

Deputy Attorney General Kendall Moser declined comment as he was leaving court, saying, "The case is still pending."

Turbin said he did not know if the state intends to appeal Marks' decision. Read More...

State considers cutting optional Medicaid services

RIO RANCHO — Thousands of low-income New Mexicans could lose medications, vision and dental services, hospice care and physical therapy because of a potential huge shortfall in Medicaid, Human Services Secretary Pam Hyde told state lawmakers Wednesday.

As of Jan. 1, 2011, New Mexico could face a $300 million gap in the budget for the state’s low-income health insurance program known as Medicaid. And officials are eyeing many previously off-the-table scenarios, including eliminating many, if not all, optional Medicaid services, because of the severity of the situation.

The potentially extreme measure is part of the mix this year because mandatory Medicaid services — such as hospital stays and physician services — are projected to grow to $550 million in early 2011. That’s compared to a projected $340 million for optional services, Hyde said.

If the state cuts $300 million to close the shortfall, very little money would be left for services that aren’t mandatory.

The implications of such deep cuts are potentially dire for New Mexico, where one in four residents gets health coverage in whole or part through some form of public assistance.

“It’s a lousy situation,” Hyde acknowledged Wednesday but said no final decisions had been made. “I am here to help give you information.”

But she made clear to state lawmakers that the decisions before them are not easy and reminded them how difficult it was a few years ago to cut Medicaid by $30 million.

“Remember all the calls you got,” she said.

The potential loss of optional services could have wide-ranging repercussions. The list of optional services covered in New Mexico is longer than the list of mandatory services and includes adult dental and vision services, inpatient psychiatric for individuals under 21, podiatric services and speech therapy.

Cutting optional services wasn’t the only cost-saving measure Hyde mentioned the state could implement to close the potential shortfall. Another measure being considered is the dismantling New Mexico’s State Coverage Insurance (SCI) program.

SCI helps pay premiums for thousands of low-income individuals, and small businesses take advantage of the program to insure employees, officials said.

Another cost-cutting option–and one generally considered to be one of the easiest to accomplish–is to reduce the rate of reimbursement to medical providers, such as physicians and nurse practitioners. Medicaid reimburses medical providers at various rates.

But reducing provider rates could lead to unintended consequences like decreased access to health care, said Laura Tobler of the National Conference of State Legislatures, who also presented Wednesday.

”There is documented evidence that that reimbursement rate reductions leads to reductions in provider participation,” Tobler said.

The size of the problem Hyde outlined Wednesday elicited concern and hand-wringing from many speakers.

“That is absolutely huge,” Dr. Lee Reynis, director of the University of New Mexico’s Bureau of Business and Economic Research, told lawmakers of the potential $300 million shortfall.

Advocates, meanwhile, argued that deep cuts to Medicaid would ripple across New Mexico, pushing up the number of uninsured New Mexicans at a time when the nation is trying to solve the uninsured problem.

“There are no good places to cut,” said Sireesha Manne, staff attorney for the New Mexico Center on Law and Poverty. “We already are the second highest rate of uninsured in the country. Let’s not make this any higher.”

Kim Posich, the center’s executive director, added that Medicaid cuts would hurt rural areas disproportionately.

“In New Mexico’s rural areas, poverty tends to be deeper and rates of health insurance coverage lower,” Posich said. “This has rural health care providers even more reliant on Medicaid reimbursement than the rest of the state.”

Advocates also called Medicaid cuts unfair because they would place a disproportionate burden of balancing the state’s budget on the state’s most fragile population. They recommended raising taxes instead.

“There are a lot of economists who are out there saying the worst thing to do during a recession is to raise taxes,” said Ruth Hoffman of the Lutheran Advocacy Ministry New Mexico. “I want you to know there are a lot of people who disagree with that. The worst thing you can do is to cut spending. Please don’t tie one hand behind your back by simply dismissing” raising taxes.

Rep. Dennis Kintigh, R-Roswell, however, disputed that line of thinking. On several occasions Kintigh said he was under the impression after talks with medical providers in his community that many Medicaid recipients were on the program because of life choices.

“I’ve been told people have come in who are obese, and that is a life choice,” Kintigh said.

Hyde’s presentation came as Gov. Bill Richardson and the New Mexico Legislature expect to go into special session next month to close a projected shortfall of $433 million for this year’s state budget.

But some legislators are already saying they believe the shortfall may approach $550 million before this fiscal year ends June 30, said House Minority Whip Keith Gardner, R-Roswell.

Richardson has said he opposes raising taxes and making any cuts to public education to balance this year’s budget. He and lawmakers disagree over how deeply to cut state agencies, with his administration demanding 3 percent cuts while some lawmakers say it will take deeper cuts, perhaps 5 or 6 percent.

As for cuts to Medicaid Richardson said Friday that “health care, Medicaid, we are waiting to see what happens with the national health care plan, what the Congress is doing. My hope is that the cuts in Medicaid will be minimal. But we are going to have to make some cuts there. I just don’t want to cut kids, and education, and public schools. I don’t want to raise taxes. I don’t want to have layoffs and furloughs. We don’t need to do that.”

Hyde said the Medicaid program, in addition to facing a huge shortfall in 2011, is already in the red this year. The program faces a $40 million shortfall this year that could grow to $60 million in coming months, Hyde said. That’s due in part to a growing number of New Mexicans who are enrolling in the program because of the sour economy.

Her agency has adopted some cost-cutting measures to close this year’s shortfall, including cutting outreach to potentially eligible Medicaid recipients, Hyde said. The thinking behind stopping outreach is that fewer people who enroll would mean a potential slowing of rising costs. Read More...

New for flu season: Pharmacists can give shots with physician approval

ROCHESTER — For the first time, area residents can obtain a seasonal flu shot from a pharmacist as long as they have a prescription from their doctor.

Pharmacist Glenn Raymond, who works at the South Main Street Walgreen's, has provided more than 50 vaccinations to customers and employees since it began on Sept. 9.

"It's actually been very successful," Raymond said, adding people seem to enjoy the convenience of scheduling an appointment at the pharmacy rather than go to a clinic.

"You come in here, make an appointment and you're in and out in 20 minutes usually," Raymond said, adding there is a form participants must fill out and a brief waiting period afterward to ensure no adverse effects occur — which are both precautions.

"It's no different than the procedures if a nurse was giving it," Raymond said.

Raymond said pharmacists are waiting for the state Legislature to allow one physician to sign a standing order to enable pharmacies to provide flu vaccinations. He expects officials to start discussing the matter mid-October and Walgreens has already reached an agreement with a local doctor in anticipation of the upcoming change.

Raymond said while Walgreens in Maine have not been given permission to provide flu shots, all New Hampshire locations will have pharmacists on duty 11 a.m. to 4 p.m. Monday through Friday until Sept. 30. There is a $24.99 charge for the vaccination, which is covered by Medicare A/B and most insurance plans.

Vaccinations for seasonal flu are already available in Maine and New Hampshire through health care providers, retail outlets and state distribution points in Maine, but neither the vaccination for the H1N1 nor a complete distribution plan has been released yet, according to N.H. Infectious Disease Epidemiologist Jody Smith and Maine Medical Epidemiologist Andrew Pelletier.

Both Smith and Pelletier encourage all residents to be vaccinated for both strains, especially those people more susceptible to illness. They added both states have ordered more seasonal flu shots this year based on a national recommendation to vaccinate all students.

Smith said there are three million more seasonal flu shots nationwide this year, including 40,000 to 50,000 more in New Hampshire alone. She added seasonal flu vaccinations are created based on reports from the Southern Hemisphere.

"Flu season affects the Southern Hemisphere during our summer," Smith said, adding officials are not expecting an unusual flu season — even with the H1N1 strain present.

"Usually we see flu action October through February," Smith said, added the flu season varies from year to year, but area residents can protect themselves by washing their hands often, coughing into their sleeve and staying healthy.

If flu symptoms arise, those affected should stay hydrated, get plenty of rest and stay home to prevent it from spreading. Flu symptoms include: fever, headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose, muscle aches and possible nausea, vomiting and diarrhea.

"H1N1 is acting like the seasonal flu has done in the past," Smith said.

Pelletier anticipates that H1N1 vaccinations will not be available until at least mid October and will be used on the people who have the highest risk, depending on the amount states receive.

The Center for Disease Control recommends the following people receive a seasonal flu vaccination each year:

Children between six months and 19 years, pregnant woman, people 50 years and older, people with certain chronic medical conditions, people living in nursing homes and other long-term care facilities and people who care for or are in contact with those at high risk for flu, including health care workers.

For more information about the season flu or the H1N1 virus, visit www.cdc.gov/flu/index.htm Read More...

State plans to ship flu-treatment drugs on trucks with booze

Tequila and Tamiflu should be coming to a location near you on the same delivery truck in the next few weeks.

That's the plan state health department officials have arranged with the Department of Alcoholic Beverage Control to quickly transport current stockpiles of Tamiflu and Relenza for treating H1N1 flu to local health departments statewide.

DABC spokeswoman Sharon Mackay confirmed Wednesday that the antiviral drugs will be on the same trucks that transport hard liquor throughout the state.

"We're not warehousing it. (The Department of Health) is coordinating transportation through us. Since we already distribute liquor throughout the state, we have the trucks and staff to transport it," she said.

"We're kind of on-call when they are ready to distribute it to the various (local) health departments statewide."

Tamiflu and Relenza help shorten the length of the flu and curb its severity if they are taken within several days of the onset of symptoms. Pharmacies in many parts of the nation, including Utah, ran low on the drugs last spring when word about the H1N1 virus began making headlines.

Utah and several other states received shipments of both drugs from the national stockpile, and Utah's supply is still being held in reserve.

State health department spokesman Tom Hudachko said if local health departments fall "below 50 percent of their own supply" for the antiviral drugs, "that's when they'll notify us" and the shipments will begin. "At this point we haven't had any of that," he said, though the number of cases of H1N1 in Utah is trending up again.

Both the Utah Department of Public Safety and the National Guard have been notified about the arrangement, and "if we get to the point where we're shipping out of the national stockpile" supply that was sent to Utah last spring, "they're willing to provide security, and we're happy to have it.

"So long as we're shipping supplies out of that stockpile, we have the ability to use their resources."

Hudachko said the state won't be using the same arrangement to transport the H1N1 vaccine once it becomes available, because there are strict temperature control requirements for vaccines that don't apply to the antiviral drugs.

The Centers for Disease Control and Prevention in Atlanta will ship the H1N1 vaccine to a distribution group called McKesson, which has temperature-controlled distribution points nationwide, he said.

McKesson will then ship the vaccine directly to the distribution points, including doctors' offices and local health departments, Hudachko said.

As for the distribution of Tamiflu and Relenza, the drugs are expected to be increasingly in demand as the number of both H1N1 and seasonal flu cases grows this fall.

The DABC operates 41 liquor stores and about 100 additional "package agencies" around the state that are under contract with the state to sell liquor, so utilizing its broad transportation network for the antiviral drugs makes sense, Mackay said. Read More...

Safe at home

After Red Sox visits to Walter Reed, team foundation and MGH launch effort to help struggling war veterans. It was supposed to be a brief stop for the Red Sox to share the World Series trophy with wounded soldiers. But the team lingered at Walter Reed Army Medical Center for much of the afternoon, deeply moved by their conversations with amputees and veterans suffering from post traumatic stress disorder.

Now that visit in February 2008 has turned into much more. The Boston Red Sox Foundation and Massachusetts General Hospital will announce today the launch of a $6 million program to treat the rising number of men and women returning from Iraq and Afghanistan with post-traumatic stress and traumatic brain injuries and to encourage reluctant veterans to seek services.

The players hope to take a crucial role in trying to diminish the stigma many veterans feel about asking for help for a mental disorder. Pitcher Tim Wakefield has filmed the first of a series of planned public service announcements in which he implores veterans to get treatment. “Being on a team means never having to face a challenge alone,’’ he says.

The unusual Home Base Program will include a clinic at Mass. General to evaluate and treat veterans and to counsel family members, who can suffer when a veteran abuses alcohol or has angry outbursts. It will also provide training for psychiatrists in the community and expand research into post-traumatic stress and combat brain injuries.

All of it grew out of the team’s visit to Walter Reed hospital and a previous trip there after the 2004 World Series victory.

“We talked to vets who were clearly going through some challenges,’’ Thomas Werner, chairman of the Boston Red Sox and head of the foundation board, said of the 2008 trip. “Many of them are going through multiple deployments, and they’re just kids; they’re younger than my kids. There was a connection between the vets and the team, and we felt the Red Sox could do a lot in educating the public.’’

Many veterans in the rehabilitation unit for amputees also suffered from post-traumatic stress. One patient did not want to leave his room, so he gave his baseball cap and glove to his mother, who asked catcher Jason Varitek to sign them for her son, said Dr. Laurence Ronan of Mass. General, chief internist for the Red Sox, who accompanied the team.

Pitching coach John Farrell visited a neighbor’s son, who was in the hospital with a traumatic brain injury, Ronan said.

A number of studies have found that post-traumatic stress, an anxiety disorder some people develop after experiencing a life-threatening traumatic event, and traumatic brain injuries are rampant among veterans returning from the Middle East. Of the more than 1.6 million troops deployed since October 2001, nearly 20 percent report symptoms of post-traumatic stress or major depression, and 20 percent have possible traumatic brain injuries, according to a report from the Rand Corporation in April 2008.

The Rand report estimated that almost half of the 300,000 military service members who had returned home with symptoms of post-traumatic stress or depression had not sought treatment.

Navy Chief Petty Officer Bryan Zimmerman, 36, said he delayed getting help because he was scared of harming his Navy career. Unlike in most civilian jobs, commanders in the military are told when a subordinate is being treated for medical or emotional problems, he said.

Zimmerman, who lives in Rhode Island and appears in the first public service announcement with Wakefield, was a physician’s assistant in the battle of Fallujah in November and December 2004, some of the heaviest urban combat US Marines have experienced.

Zimmerman took care of injured Marines in the city, meaning he was exposed to constant enemy fire. He was able to save 30 Marines who had life-threatening injuries, but 22 in his unit died.

“When I first came back, I felt normal, as if I were just like everyone else,’’ he said. But several years later, he became aggressive and violent toward his family and his co-workers at a medical clinic in Newport.

Working in battle, “you have to have the confidence and moxie to pull it off,’’ he said. “I couldn’t turn that off when I came back.’’

Even though he had become a discipline problem at work, it took him a year to participate in extensive therapy for post-traumatic stress. “My fear was that if I admitted I had a problem, the Navy would be done with me,’’ he said. “I didn’t want to seem weak. This program is going to open doors that have never been opened to service members.’’

Soon after the trip to Washington, Werner and other Red Sox officials, Ronan, and Mass. General chief executive Peter Slavin began negotiating the program and meeting with military and Veterans Administration officials to enlist their help. The late Senator Edward M. Kennedy and his staff arranged many of these meetings.

The Red Sox Foundation and Mass. General each have promised to raise at least $3 million over three years; the Red Sox also will produce an unspecified number of public service announcements. The plan is for the Veterans Administration to participate, including by allowing physicians to treat veterans in the Mass. General clinic.

Dr. John Parrish, a Mass. General physician and Vietnam veteran who has suffered from post-traumatic stress, will head the Home Base Program. He said the rate of the disorder among veterans today appears to be much higher than for men returning from Vietnam.

Veterans of the wars in Iraq and Afghanistan “had multiple deployments and were in constant danger from roadside bombs,’’ he said. “There was no safe place, even if you had a desk job.’’ Read More...

Hawaii health insurance costs far outpacing wages, group says

Hawai'i's health insurance premiums grew an estimated 3.7 times faster than worker earnings during the past decade, according to a new report from a group advocating affordable health care. The study by Families USA said family health care premiums jumped 94.2 percent during the period, while median earnings grew at a slower 25.7 percent pace.

"Costs are going up and earnings aren't keeping pace," said Ron Pollack, executive director of Families USA, a Washington-based nonprofit.

The report was released as a national debate transpires over health care reform, with one argument for implementing changes being the rising costs faced by consumers, businesses and government programs. Families USA has supported various forms of reform being discussed on Capitol Hill, with Pollack saying he is optimistic about the effort succeeding.

Pollack, speaking on a conference call with reporters yesterday, said the share of premiums paid by workers has edged up during the past 10 years as businesses shift some of the rapidly increasing costs to employees. At the same time the average insurance policy has become "thinner," with higher deductibles and co-payments while what's covered has been cut.

Doubled in decade

Study researchers estimate the worker's portion of annual family premiums rose 110 percent to $2,759 during the period. The employer's portion was up about 90 percent to $8,981 during the same period.

For individuals, Hawai'i premiums increased to $481, about 153 percent more than a decade earlier.

The employer portion jumped 65 percent to $3,592.

The increases "threaten the financial well-being of families across the country," Pollack said.

He said the surge in premiums nationally is tied to people making greater use of services, lack of insurance market regulation in some states, less competition among insurance companies as they consolidate and an increase in the number of uninsured people.

He said unpaid expenses incurred by the uninsured added about $1,017 to premiums last year.
solution unclear

The Business Roundtable, an association of corporate CEOs, also yesterday issued a report saying annual health care costs per employee will triple to almost $29,000 nationally over the next decade without marketplace reforms to reduce costs, expand coverage and improve delivery.

Other groups, while agreeing costs must be stemmed, have disagreed with some of the health care reforms being proposed, including a government-sponsored health care plan that would compete with private companies. Others have said they are worried the reforms being proposed will add to government spending.

Families USA said the research used data from the U.S. Census Bureau, the U.S. Department of Labor and the U.S. Department of Health and Human Services.

It said 2009 earnings and costs were estimated using trends from 2008 insurance premium data and 2007 gross earnings data. Read More...

California soda survey gives weight to health concerns

A sweeping statewide study released today points to soda and other sugar-sweetened beverages as one of the main reasons why we are fat.

"For the first time, we have strong scientific evidence that soda is one of the – if not the largest – contributors to the obesity epidemic," Dr. Harold Goldstein, executive director of the California Center for Public Health Advocacy, said Wednesday.

Obesity costs California $41 billion a year, an earlier report from the same organization found.

Suspicion of a link between soda and obesity isn't fresh news, but authors said the study is unprecedented in its scope.

"Bubbling Over: Soda Consumption and Its Link to Obesity in California" – a joint effort by the California Center for Public Health Advocacy and the UCLA Center for Health Policy Research – interviewed 42,000 Californians of all ages.

The study found that 24 percent of adults drink one or more non-diet sodas a day, and these adults are 27 percent more likely to be overweight.

The results for children were worse, researchers said. Sixty-two percent of adolescents ages 12 to 17 and 41 percent of children ages 2 to 11 imbibe at least one sugar-sweetened drink a day.

These kids, Goldstein said, will end up costing the state in future health care bills.

"This could be the first generation in modern history that will have a shorter life expectancy than their parents," he said.

The main culprit in soft drinks is sugar – lots of it. Soda racks up 17 teaspoons of sugar and about 250 calories per 20-ounce serving, and many add caffeine.

"A bottle of soda is nothing more than a sugar delivery device," said Goldstein. "We have a lot of very sweet kids."

He says the key to fixing the obesity epidemic is eliminating soda consumption, because many soft drinks are high-calorie and do little to curb hunger.

"When you eat food, it makes you full," said Judith Stern, a professor at the University of California, Davis' nutrition department. "When you drink a soda, it doesn't make you feel full, so it's wasted calories."

American soda consumption has been steadily rising: Compared with 30 years ago, we consume an average 278 more calories per day, almost half of it from soda, according to the California Center for Public Health Advocacy.

In the mid-1990s, children's intake of sugared beverages surpassed milk. And for each glass of soda consumed per day, a child's likelihood of becoming obese increases 60 percent.

Beverage makers say soda is unfairly demonized. In promoting healthy lifestyles, some soda companies – including Coca-Cola and PepsiCo – have introduced vitamin- enhanced zero-calorie sodas in the past several years, marketed as "sparkling beverages."

"The fact remains you can be a healthy person and enjoy a soft drink," Dr. Maureen Storey, an American Beverage Association spokeswoman, wrote in a statement.

Experts on childhood obesity say a sweet tooth for soda develops early in life.

"I have seen a number of children who come into the doctor's office with soda in their baby bottle," said Dr. Ulfat Shaikh, a pediatrician who works at UC Davis Children Hospital's weight management clinic. "That, frankly, is frightening."

Some parents say banning soda from the start is the only way to go.

Debi Ravenscroft of Loomis has never allowed her 10-year-old daughter to drink soda, even though her husband, Bob, drinks six to eight sodas a day.

Because her daughter never started drinking soda, she doesn't crave it.

"If she is at her friend's house and they offer soda to her, she says, 'Can I have a water, please?' " Ravenscroft said.

Ravenscroft sees other positive effects of keeping soft drinks away from her daughter.

"I have seen other kids who are allowed to drink Pepsi, and I honestly believe that's the reason why they can't sit still," she said.

The study also rekindled talk of a "soda tax" among California policymakers.

California limits school sales of sodas, candy and other junk food. Sodas, unlike most other foods, are subject to sales tax.

A 1 cent tax per ounce of soda would generate $1.8 billion per year in California.

Six states – Arkansas, Missouri, Rhode Island, Tennessee, Virginia, and West Virginia – have soda taxes.

"It's time to revisit the soda tax debate, now that we have ever-more convincing evidence of its role in obesity," said state Sen. Alex Padilla, D-San Fernando Valley, who chairs a committee on obesity and diabetes.

On a weekday afternoon, middle-schoolers on the way home from California Middle School stopped by a Marie's Do-Nut Shop on Freeport Boulevard in Sacramento. Several purchased soft drinks.

"It's just so … sugary," said 13-year-old Duy Ngo, as he snapped open a can of 7-Up. Read More...

In public health bill, a contagion of fear

The banner, bold and provocative, was tattooed with a syringe, skull and crossbones, and a call to action: “Say no to forced vaccination.’’ The message, delivered last week on Beacon Hill, was aimed at a seemingly prosaic piece of legislation that aims to better define - and, in some respects, restrict - the emergency powers of the state’s public health officials.

Within the bill’s arcane language, a 16-month-old activist coalition sees government authority run amok: mandated vaccinations, quarantines, arrests, fines. Swine flu, they warn, will be the virus that opens the door to the public health police.

“We have a concern that we will be forced to be quarantined if we refuse the vaccine,’’ said Laura Jackson, president of the Liberty Preservation Association of Massachusetts, which mustered 30 to 40 members for the lobbying drive. “What I’d like to see done with this law is have it burned.’’

Those concerns, public health authorities insist, are entirely unfounded. But the association’s multimedia campaign - aired over talk radio and its website - compelled state Public Health Commissioner John Auerbach to send an italicized, bold-faced missive to legislators, stressing that “mandatory vaccination is not and has never been part of the plan or discussion in Massachusetts’ pandemic response.’’

The bill, Auerbach and other top officials said in interviews, would never force anyone to be vaccinated unwillingly, and its extraordinary measures - such as quarantining people who decline inoculations - would be reserved for equally extraordinary times, such as a bioterror attack or the emergence of a highly lethal, rapidly spreading germ. Swine flu, caused by the H1N1 virus, is not such a germ, Auerbach said.

The protest by the group, whose founders supported Republican Ron Paul in the 2008 presidential election, reached its pitch at an especially delicate moment for public health authorities. Auerbach’s letter demonstrates that his agency is worried the dissent could raise doubts about vaccination and imperil an unprecedented campaign to inoculate millions this fall against the seasonal flu and the swine strain.

“Accuracy of information is going to be key in terms of the public understanding what they should do,’’ Auerbach said in an interview.

In the opposition to Massachusetts’ revised public health emergency law, as well as in the combustible health care town hall meetings that greeted some members of Congress this summer, analysts see more than traditional conservative concerns about individual liberty and big government.

They also find signs of deeper worries about a world descending into uncertainty, with panic over economics and the emergence of a novel flu strain.

“It doesn’t surprise me that when you have another epidemic, another threat of a disease, then you get emotions tweaked up, and separately in the health care debate, we’ve seen a rise in emotionalism replacing logic,’’ said Gene W. Matthews, a senior fellow at the University of North Carolina’s Institute for Public Health.

Matthews was among those who presided over efforts to update public health emergency regulations when he was the top attorney at the US Centers for Disease Control and Prevention.

The terrorist attacks of Sept. 11, 2001, and the arrival of anthrax-laced letters at congressional and media offices a month later revealed a largely ignored truth about those laws: In many states, they had not been updated for decades.

A team led by Lawrence O. Gostin, a Georgetown University law professor, drafted the language that has served as a model for Massachusetts’ proposed law and for revised rules adopted in 37 states so far.

“Most of the laws were very antiquated,’’ Matthews said, “and they didn’t recognize concepts of due process and individual rights and legal evolution that had occurred in the last 50 years.’’

In times of emergency, medical authorities had long possessed sweeping powers to do what was necessary to protect the public’s well-being. According to the state Department of Public Health, such emergencies have been declared only three times since the 1970s, with the most recent being a 2006 order for aerial spraying to combat Eastern equine encephalitis in Southeast Massachusetts. In 1993, when West Stockbridge’s water supply ran dry, the agency used its powers to tap water from a private source. And in the 1970s, the state took control of a financially teetering nursing home.

The updated legislation, passed by the Senate in late April and awaiting action in the House, carries penalties for certain violations: People who refuse orders to remain isolated could face up to a month in jail and fines as high as $1,000 a day.

But the proposed law also would, in certain instances, provide a check on the power of health officials. For example, a judge’s approval would now be needed before a government agency could perform tests or a physical examination on someone thought to present a significant medical risk to the community.

Bob Dwyer, an opponent of the law, said the Liberty Preservation Association was “not trying to say don’t take the vaccines’’ against the flu.

Still, he said, he believes the emergency law “violates numerous rights that we have in the Bill of Rights and the Constitution,’’ including the right to freely assemble. The law is unnecessary, he insisted, because most people don’t need the threat of legal action to persuade them to remain home when they’re sick.

It’s understandable that some people might greet talk of quarantines with trepidation, said Valerie Bassett, executive director of the Massachusetts Public Health Association.

But such measures, taken in rare circumstances, are “the same reason you drive within the lane on the highway,’’ Bassett said. “It’s about the protection of health and life.’’ Read More...

Fulton State Hospital biggest project on list

A joint Missouri legislative committee has issued a report listing $350 million of a possible $1.3 billion in federal stimulus money be used to build a new high security Fulton State Hospital.

The Fulton project was the largest individual spending item of all state projects listed.

Committee chairman Ryan Silvey, R-Kansas City, committee member Mike Cunningham, R-Springfield, and members of the committee staff toured the Biggs Forensic Center in Fulton Tuesday to learn more about the facility to be replaced under the recommendation of the committee.

The committee's spending proposals broke the projects around the state into four parts that included $250 million for each part.

To view the entire article, please go to our e-edition. http://www.newstribune.com/e-edition Read More...

Arizona adds 126 confirmed cases of swine flu

The number of new cases of swine flu in Arizona is increasing.

The Department of Health Services reported Wednesday that the state has now had 1,480 confirmed cases. That's an increase of 126 in the past week, compared with an increase of 109 cases in the previous week.

The Phoenix metropolitan area is seeing a growing impact from the outbreak, with roughly 70 percent of the new cases reported in Maricopa County. That compares with about 60 percent of the total cases.

The only county without a confirmed case remains tiny Greenlee County in southeastern Arizona. Read More...

Japanese being healed by Wisconsin technology

Governor Doyle is optimistic about Asian dollars coming to Wisconsin. As he continues his Trade Mission in Asia, Doyle said he’s been informing Japanese government and business leaders of the research and labor resources available in the Badger State.

Doyle is looking to build on existing Wisconsin exports of health care technology to China and Japan. The Governor visited Japanese hospitals that were using equipment from Milwaukee’s GE-Healthcare and Madison-based Tomo Therapy.

Doyle also plugged Wisconsin’s alternative energy capabilities, something that Japan is pursuing as their economy has been slowing down due in part to lagging auto sales.

The Asian nation must do further adjusting as a new prime minister takes over this week. The ruling conservative party, which had been dominant for more than 50 years, was recently defeated by a center-left party.

Governor Doyle will be China Wednesday. Read More...

Family health insurance costs outpace Texas wages, nonprofit finds

Associated Press

Family health care premiums rose about 4 ½ times as fast as earnings for Texas workers from 2000 through 2009, according to a report released Tuesday by a consumer advocacy group.

Families USA, a Washington-based nonprofit, said that family health insurance premiums rose by about 92 percent while median earnings rose by about 20 percent during the 10-year period.

"Rising health care costs threaten the financial well-being of families across the country," Ron Pollack, executive director of Families USA, said in a conference call.

The report is based on data from the U.S. Census Bureau, the U.S. Department of Labor and the U.S. Department of Health and Human Services.

Nationally, family health insurance premiums rose almost five times as fast as earnings, said Kim Bailey, a senior health policy analyst for Families USA.

The nonpartisan group says the average annual health insurance premium in Texas in the 2000-09 period for family health coverage provided in the workplace rose from $6,638 to $12,721.

At the same time, Texas workers' median earnings rose from about $23,032 to about $27,573.

"If health care reform does not happen soon, more and more families will be priced out of the health coverage they used to take for granted," Pollack said in a news release.

The news release said that between 2000 and 2008, the percentage of companies across the nation offering health coverage declined by 6 percentage points.

It also noted that the increases in premiums have continued despite coverage offering fewer benefits or having higher deductibles. Read More...

Insurance costs rising faster than paychecks

Since the new millennium, Kansas health insurance premiums have risen 4.2 times faster than median earnings.

“Rising health care costs threaten the financial well-being of families across the country,” said Ron Pollack, executive director of Families USA, a national organization for health care consumers. “If health care reform does not happen soon, more and more families will be priced out of the health coverage that they used to take for granted.”

On Tuesday, Families USA released its findings on 15 states, including Kansas, in a report called “Costly Coverage.” The report is based on data from the U.S. Census Bureau and the U.S. Department of Health and Human Services.

In Kansas, the report found:

• The average annual health insurance premium for family coverage rose from $6,237 in 2000 to $12,397 in 2009, or 98 percent.

• The median earnings of Kansas workers rose from $22,351 to $27,565, or 23 percent.

The state is about on par with the nation, which saw premiums rise 4.9 times faster than wages. Of the 15 states, Oklahoma had the lowest difference at 2.8, and Alaska and Washington had the highest at 5.3.

Need for reform

“What is so surprising about these increases, is that these premiums now purchase thinner coverage,” Pollack said, referring to higher deductibles, higher co-payments and less benefits.

“For America’s businesses and families, the absence of health care reform is unaffordable and unacceptable. It will mean that businesses will have a harder time staying competitive and more and more families have to cope with stagnant wages and loss of health coverage.”

In Kansas, employers are footing the largest chunk of the increase.

The employer’s portion of annual premiums for family coverage rose from $4,353 to $9,260, or 112 percent. Meanwhile, the worker’s portion grew from $1,884 to $3,136, or 66 percent.

The findings come as no surprise to small Lawrence business owner Margie Wakefield, who provides health insurance for two full-time employees and her family. She said her premiums go up every year without explanation.

“The insurance company is completely in control,” she said. “It doesn’t matter how long you’ve been a customer or how little you’ve used the service. It makes no difference. You play by the rules. You do everything right, and you still get penalized.”

Growing costs

Pollack said there are a few key reasons for the rising costs of health care, which ultimately end up in premiums. These are:

• Greater use of health care services.

The United States is treating more people with common chronic conditions. In 2005, nearly half of Americans had at least one chronic condition, and care for chronic conditions accounts for three-quarters of U.S. health spending, with diabetes alone costing more than $174 billion annually.

• An insurance market without necessary protections.

According to Families USA, companies are governed by a hodgepodge of state and federal rules. In many states, companies have free rein over how much of each dollar they collect in premiums is retained as profit or spent on overhead. In some markets, insurers are free to charge people more or deny coverage.

• There’s been a consolidation of insurance companies, which means less competition. A 2008 study found that in 44 percent of major metropolitan areas, a single insurance company controlled half or more of the market.

• Costs are being shifted from the uninsured to insured.

The Census Bureau announced last week that there were 46.3 million people without health insurance in 2008, and 330,000 people in Kansas.

“Insurance premiums significantly are affected by the large number of people who are uninsured,” he said. “When an uninsured person goes to the emergency room and gets care, somebody has to pay for it and guess who pays for it? You and I pay for it if we have health insurance.”

He said it’s known as the “hidden health tax” and in 2008, that tax increased premiums for family health coverage by an average of $1,017.

Pollack said these are a few of the reasons that health care reform must happen.

“We have experienced this growing crisis in terms of costs and more and more people joining the ranks of the uninsured for a long, long time,” he said. “I mean this is not something where people are acting precipitously. There have been proposals made and hearings conducted for many years about the need for health care reform.

“If we do not achieve meaningful health care reform, then costs will continue to skyrocket, more businesses will find costs unaffordable, families will be priced out of health care and more and more people will lose health coverage. So, the time for really doing nothing or going slow has passed.” Read More...

Sleeping bag drive shares warmth

DOVER -- Like almost every parent, Meika Toth wants her child -- 4 1/2-year-old Ayden -- to be safe and warm at night. She wants him to thrive and she is able to help him do it. Ayden has his own bed and his own room, with pictures of John Deere tractors on the wall.

But Toth also wants her son to think about kids who don't have as much.

So Tuesday afternoon, she picked up her little boy at preschool and brought him to Legislative Hall, sleeping bag in hand, to help launch a statewide "Sleeping Bag Campaign."

Ayden said he has never slept in a sleeping bag himself, because he hasn't gone camping yet. But he understood Tuesday that this bag wasn't going camping. This sleeping bag would go to a kid who didn't have a bed.

That's life for more than 2,600 children in Delaware, said Wendy Strauss of the Governor's Advisory Council for Exceptional Children which is overseeing the project.

"It's so sad," Ayden's mother said as she held her son on her knee. "I just can't imagine there are that many kids."

It's probably many more than that 2008 figure now, after a year when thousands of families lost jobs, homes and rainy-day savings.

The 30 beds at The Shepherd Place have been filled all summer, said Jessica Hazzard, a case manager at the Dover shelter. Usually, the number of people drops off in warmer months.

"People who are working at lower-income jobs, losing their jobs, losing their apartment -- where do you go?" Hazzard said. "A lot of those people have children."

Homelessness is a far more complicated problem than a sleeping-bag drive can solve.

But sleeping bags represent something important to the kids who will get them -- warmth, comfort, stability -- said Vivian Rapposelli, secretary of the Kids Dept., more formally known as the Delaware Department of Services for Children, Youth and their Families.

"This provides protection, if even just for a good night's sleep," Rapposelli said.

Several groups around the state already have started their collections, and Toth hopes her son's preschool will join the effort, too. Students from Polytech High School brought the 51 sleeping bags they collected in one week's time, Attorney General Beau Biden's office sent 50. In addition to sleeping bags, students at Salesianum and Nativity Prep are collecting books for homeless kids, Strauss said.

The sleeping-bag collection continues until Dec. 20, with dropoff spots in every county. A list of collection sites will be available today on the Web site of the state Developmental Disabilities Council at www.state.de.us/ddc, state officials said. Read More...