November 25, 2009

Providence Bishop Tobin says Kennedy ‘erratic’ — but he’s not referring to mental-health issues

PROVIDENCE, R.I. –– Roman Catholic Bishop Thomas J. Tobin on Monday said Rep. Patrick J. Kennedy has shown “increasingly erratic and unpredictable behavior” during their escalating dispute, but said he was “not at all” referring to the congressman’s well-publicized mental-health issues.

The bishop also said he was not suggesting that Kennedy was unfit for office. He said he was “not familiar” or only “generally familiar” with mental-health and drug-addiction problems Kennedy has openly acknowledged and sought treatment for — most recently four weeks of addiction treatment at a medical facility in June.

“His fitness for office is nothing that I would ever comment on,” said Bishop Tobin. “I think that’s up to the voters to make that decision. But I am concerned about his statements and his reactions to some of these recent events. No, I’m concerned about him and I’m praying for him. As I said before, my door is always open, and I hope we can bring a good reconciliation to all this.”

The bishop said the real issue is “the special responsibilities of a Catholic in public life.”

Neither Kennedy nor his spokeswoman, Kerrie Bennett, could be reached for comment Monday. Meanwhile, Bishop Tobin made a round of national TV appearances, including on CNN and MSNBC’s “Hardball with Chris Matthews” (see related story, Page A8), and spoke on local talk-radio programs. More were scheduled today.

The bishop’s comments came amid continuing controversy over whether Kennedy’s support for abortion rights affects his standing in the Catholic Church. It began when Kennedy, a Democratic four-term representative and the only remaining public official in the nation’s most prominent Catholic family, criticized the Catholic stance on abortion clauses in the health-care overhaul legislation pending before Congress.

In a story in The Sunday Journal, Kennedy alleged that Bishop Tobin forbade him from receiving Communion and that the bishop had “instructed the diocesan priests not to give me Communion.” Bishop Tobin said Kennedy’s statement “has no basis in truth,” and that in 2007 he sent a letter to Kennedy that was “a respectful and gentle request,” not an order.

Bishop Tobin commented about Kennedy’s behavior during interviews with the Associated Press and on the John DePetro show on WPRO talk radio on Monday. He was asked about them later Monday, during an unrelated appearance at La Salle Academy.

“This debate with the congressman is very unfortunate,” he said on the DePetro show. “I’m praying for him, I wish him well. I need to say, honestly, I’m very concerned about the congressman’s increasingly erratic and unpredictable behavior. I think a lot of us are concerned about that. It’s very hard to get a handle on that.

“As his bishop and pastor and also, one of his constituents, by the way, I’m really concerned how he’s responding to this situation. I really hope, I really hope and pray that his friends and supporters and his staff are giving him the help and assistance he needs at this time.”

The bishop took questions at La Salle after a bill-signing ceremony authorizing a Rhode Island license plate for the New England Patriots Charitable Foundation, and a kickoff to the 2009-10 “Keep The Heat On” campaign, a five-year-old diocesan program.

He was asked several times to elaborate on his characterization of Kennedy’s behavior as “erratic,” in the context of Kennedy’s long-acknowledged struggles with alcohol and drug addiction and bipolar disorder, or manic depression. Kennedy sought addiction treatment after a 2006 automobile accident. He spent four weeks in addiction treatment this summer, he said, “to ensure I am being as vigilant as possible in my recovery.”

The bishop said he was talking about Kennedy’s “behaviors,” but “not him personally.”

“No, it has no reference at all to his mental-health issue or his drug issue. I’m not even familiar with all that background. I’m talking about his behaviors recently that are very hard to predict and very hard to respond to …”

The bishop said, “For example, two weeks ago here in Providence, he said he wasn’t going to talk any more about his faith or his status in the Church, and then he returns to Washington and gives a major interview about that.”

Bishop Tobin added, “His statement that was released over the weekend — that somehow I’d instructed all the priests to refuse to give him Holy Communion — has no basis in truth. Again, I’m not in a position to analyze him at all. But I am concerned. I hope he’s doing OK. I’m concerned about his personal, and ultimately his spiritual well-being. That’s what this is all about.”

At the heart of this debate, said Bishop Tobin, “is what it means to be a Catholic in public life ... Being a Catholic in public office carries extra responsibilities. It’s public behavior that affects the community — someone who is in a position to pass legislation and so forth. A person in a public position has a special responsibility, when he or she doesn’t act properly, it can cause scandal and confusion in the community …”

The bishop also reiterated his disappointment Monday that Kennedy had decided to go public with what the bishop said he intended as a private pastoral discussion. “I certainly didn’t relish the idea of discussing his faith or his membership in the church in public. That’s something he put on the table, or erroneously put on the table, I think, so I had to respond.”Bishop Tobin said he still hopes for a private discussion with Kennedy, “after the dust settles.”


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Doctors' group blasts Senate healthcare bill in front of Freedom Tower

As U.S. senators prepared for a critical vote on the healthcare bill Saturday morning, dozens of dissenting physicians and nurses protested at the Freedom Tower in one of 24 rallies staged nationwide.

Holding signs and making speeches touting objections to the proposed reforms, the medical professionals warned that the bill coming before the Senate this week would drastically change the relationship doctors have with their patients.

The bill, which seeks to lower healthcare costs and increase access to medical services for the uninsured, came under fire by those at the rally, including Fort Lauderdale rheumatologist Dr. Yvonne Sherrer.

``Our legislators are committing legislative malpractice,'' Sherrer shouted into a microphone, claiming that the changes proposed by the bill would further restrict how doctors can treat patients.

``We want reform that will take away the current problems in our healthcare system and not take away what's good: the relationship between the doctor and the patient,'' she later said.

Although the bill passed in October by the House of Representatives differs from the one currently being reviewed by the senators, both propose squeezing more than $400 billion out of expected increases in Medicare costs.

The Senate bill also proposes the development of ``new patient care models'' -- a strong issue of contention for the largely conservative crowd at Saturday's event, where doctors criticized what they deemed a takeover by the federal government.

Dr. Patrick Abuzeni, one of two physicians who organized the nationwide rallies, fears the bill will not sufficiently address existing problems, such as ballooning healthcare costs. He said it would simply layer government bureaucracy over a healthcare system already ruined by insurance companies and hospital management staff.

Abuzeni, who blames the high costs born by patients on medical malpractice suits and excessive influence of insurance giants, said elected officials should vote down the bill and instead redirect control of the industry to physicians.

That loss of control, he said, led to a restructuring of the healthcare system that allowed insurance companies to rake in massive profits. One example he noted was last year's $3.2 million compensation plan for UnitedHealth Group's CEO, Stephen Hemsley.

``Those millions of dollars were meant for patient care . . . not Gulfstream jets,'' he said.



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Bill would block same-sex benefits

An Alabama legislator is picking up support for his bill to stop the state's public universities from offering employee benefits to same-sex couples.

Rep. DuWayne Bridges, R-Valley, said he has prepared a bill for the legislative session beginning in January. The bill would prohibit public universities from receiving state funds if they offer benefits to same-sex partners.

"I don't think universities should waste money by making a liberal or politically correct statement," Bridges said.

His bill is aimed at two campuses of the University of Alabama System, which Bridges said are ignoring the intent of a 2006 amendment to Alabama's constitution that banned same-sex marriages.

The University of Alabama at Birmingham on Oct. 1 began enrolling eligible adult domestic partners of either sex of faculty and staff in medical, dental and vision plans. The University of Alabama in Huntsville will extend benefits to domestic partners Jan. 1.

At the University of Ala-
bama's Tuscaloosa campus, President Robert Witt recently told the faculty that the policy is under consideration.

Auburn University does not offer domestic partner benefits, a spokesman said.

Dale Turnbough, a UAB spokeswoman, said offering the benefits helps UAB's medical school compete with other top schools that routinely offer the benefits. She said partner benefits "create a positive, supportive and diverse work environment in which faculty and staff can excel."

Republican Gov. Bob Riley "supports Rep. Bridges 100 percent," Riley press secretary Todd Stacy told The Tuscaloosa News.

Republican gubernatorial candidate Tim James has also endorsed Bridges' bill. Bridges said what the UA campuses are doing amounts to "tacit recognition of same-sex marriage and civil unions."

State Rep. Patricia Todd, who described herself as Alabama's "first openly gay legislator," said many companies and universities are offering domestic partner benefits because they are expected by many top wage-earners.

"They're only going to go someplace that has that kind of benefit," Todd, D-Birmingham, told The Birmingham News.

According to the nonprofit organization Human Rights Campaign, 74 of the 130 universities on the U.S. News & World Report list of top schools offer domestic partner benefits.


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Beebe Releases Flood Aid

LITTLE ROCK — Gov. Mike Beebe announced Wednesday he has authorized the release of $2 million from the Governor’s Disaster Fund to provide limited individual assistance for flood and storm victims in 12 Arkansas counties, including four area counties.

Arkansans with uninsured damage to their primary residences may be eligible for state aid in Franklin, Johnson, Logan, Scott, Columbia, Grant, Lincoln, Lonoke, Ouachita, Pulaski, Union and White counties.

“While we will request a presidential disaster declaration for flooding damage to infrastructure in Arkansas, we don’t believe we will meet the federal requirements for individual assistance,” Beebe said in a release issued by his office. “The state can provide limited funds to help uninsured homeowners in the counties hardest hit start toward recovery.”

Eligibility for state assistance will be based on the Federal Emergency Management Agency’s disaster damage guidelines.

Beginning Thursday morning, victims whose residences have been rendered temporarily or permanently uninhabitable due to the flooding and severe storms on Oct. 29 and 30 can contact the Arkansas Department of Emergency Management at (888) 683-2336. Applications for uninsured damage grants and temporary housing assistance will be accepted for two weeks.

A total of 51 Arkansas counties have been granted state disaster status due to severe weather in October.


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Car insurers should not depend on black boxes

Car insurers should not depend on the data collected by event data recorders (EDR) boxes, as the reasons behind a driver's actions will not be recorded, according to the RAC Foundation .

Philip Gomm, a spokesperson for the organisation, also expressed concern about the expense of introducing the boxes being levied against the drivers as "safety should not be an expensive, optional extra". He added that the government should foot part of the bill as society will benefit from a reduced number of accidents .

EDR will store the speed and actions of the driver, such as breaking and indicating, reported The Telegraph, citing research by the European Commission. It would also monitor any changes in acceleration and record the 30 seconds before a crash and 15 seconds after. This information can then be downloaded by the police .

Earlier this year, The Office for National Statistics reported that in 2007 the total number of road fatalities had fallen by seven per cent when compared to the previous year.


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Heating cover will ensure households stay warm this winter

The number of households that are without heating cover has risen to 65 per cent this year, according to research carried out by uSwitch.com.

Consumers could face substantial bills if something goes wrong and they don’t have insurance . If a boiler breaks down, it can cost up to £1,200 to replace four key parts however, there are some suppliers that will provide support for less than £10 a month.

While gas boilers should be serviced every year to check for poisonous carbon monoxide emissions, 42 per cent of households choose to disregard this industry advice. In the last year 14 people have died and 234 suffered illness after being exposed to the gas, reported the Gas Safe Register .

Will Marples, energy expert at uSwitch.com, explained: "Although budgets are stretched this year, in the long term it could cost you dearly not to have a plan from your provider."


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Car insurance should be renewed in good time to avoid penalties

With the strong possibility of more postal strikes to come, specialist insurance broker Footman James is warning customers to renew their car insurance in good time to avoid penalty points, fines or having their vehicle impounded and crushed.

Paul Matthews, Footman James’ managing director, said: "Our records show that 16 per cent of motorists leave renewing their insurance until the actual day it is due for renewal. In fact, 60 per cent renew within only four days of their renewal date and nearly three per cent actually renew after their renewal date. There are no days of grace – you’re either insured or you’re not."

He added that occurrences such as postal strike action mean that people who prefer to renew by post could have their paperwork delayed and therefore not processed in time.

As a large insurance broker, Footman James has the daily duty of updating details on the Motor Insurance Database (MID) which was launched to help combat uninsured driving and contains the details of all insured vehicles on the UK’s roads.


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Car insurer says female driver stereotypes are outdated

Old-fashioned stereotypes corresponding to women and cars are dead and buried and a new generation of female drivers have arrived, according to Admiral .

Research conducted by Admiral's specialist women's car insurance provider Diamond, revealed that 44 per cent of women discuss their motors with their friends and less than three per cent would pick a car because of its colour.

Sian Lewis, managing director of Diamond car insurance, commented that modern women are making informed choices about which car they buy. She also indicated that female drivers are dedicated to looking after their vehicle . Ms Lewis said: "Our research shows many of the stereotypes you hear about women drivers are very much outdated and untrue."

Recently, Admiral reported that many people are putting themselves at risk if they get behind the wheel when they are stressed. It found that 45 per cent of drivers are more likely to lose concentration when they are anxious .


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Schools to get first swine flu vaccines

Delaware's Division of Public Health will begin its school-based swine flu vaccination campaign Monday, starting with public elementary school students, who will receive the nasal-spray vaccine.

Health officials Thursday would not release the names of all schools that will receive vaccines next week, disclosing only that Christina's Smith Elementary, Capital's East Dover Elementary and Cape Henlopen's Milton Elementary will be among them. The full list of schools expected to receive the vaccines will be released today, according to division spokeswoman Heidi Truschel-Light.

Five teams of nurses will conduct inoculation clinics at schools in New Castle County, and five similar teams will visit schools in Kent and Sussex counties. The teams of about 10 to 16 nurses each will focus on children in grades K-5. A contractor that specializes in mass vaccinations will visit children in public middle and high schools starting Nov. 9, said Dr. Karyl Rattay, public health director.

The division provided permission slips to be distributed in Delaware's 19 school districts and 18 charter schools earlier this month. The deadline for returning them was last Friday. Rattay said the number of vaccines sent to schools will depend on the number of signed consent forms, for which she did not have a tally.

Students in grades K-5 will receive a vaccine that is sprayed into both nostrils. Students younger than 10 will need a second dose after four weeks. Consent forms for the second dose will be sent to parents after the first vaccinations.

Students in grades 6-12 will receive a flu shot and will require only one dose.

There are 125,000 public school students in the state. Delaware has been allocated 520,000 doses of the vaccine but received only 46,000 doses so far.

Rattay said 26,314 doses of the injectable H1N1 vaccine and 2,541 doses of the nasal-spray will arrive in Delaware next week. All of the nasal-spray doses and about 8,000 of the injectable doses will go toward the school-based vaccination campaign, she said.

The remaining injectable vaccines will go to pediatricians, oncologists and university health clinics for students with chronic conditions -- such as asthma, diabetes, heart disease, obesity and a suppressed immune system.

The same contractor that will work in the public secondary schools also will administer vaccines for children in grades K-12 in private and parochial schools. That part of the campaign isn't expected to get under way until late November, Rattay said. Consent forms also were sent to private schools earlier this month.

Health officials say children are particularly vulnerable to the swine flu virus. More than 1,000 people in the United States -- including almost 100 children -- have died from the strain of flu known as 2009 H1N1. Delaware has had three deaths believed related to the swine flu virus. All three victims also had other medical conditions. One was a 15-year-old boy.

Health officials Thursday revised the number of confirmed H1N1 cases from 191 to 377 for the week of Oct. 11 to 17. They said the revision was because of the lag time between when doctors take and submit samples to when they can be tested and confirmed.

Last week, there were 265 new cases, bringing the number of confirmed swine flu cases in Delaware since Oct. 4 to 1,011.

According to public health officials, there were 296 reports of people with flu-like symptoms during the week of Oct. 11 to 17. That number jumped to 603 last week.


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Cost of Halloween tricks may be picked up by insurance

Axa has advised its home insurance customers that their policy should cover them if somebody plays a trick on them over the Halloween period and their property is damaged.

Nick Kidd, head of household at Axa, said that the company does not want to spoil anyone's fun, but he advised people to check that their doors and windows are locked during the festivities. His comments were made following research by the organisation which showed that the week between October 30th and November 5th is the worst of the year for malicious damage claims.

Mr Kidd said: "Damage caused to another person's property is not only anti-social but also a criminal offence and while insurance can pick up the cost, it can't deal with the emotional trauma." The firm also reported that over 1,000 people are injured every year as a result of fireworks.

Recently, Axa revealed that a third of businesses are unaware of their legal requirements to insure their employees.


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Planned background checks for in-home healthcare workers are criticized

County social service chiefs in California protest the Schwarzenegger administration's plan for prospective health aides, saying they aren't ready to enact the new application process.

Reporting from Sacramento - A storm of protest has erupted over the Schwarzenegger administration's push to require prospective home health aides for the elderly and disabled to begin undergoing criminal background and fingerprint checks next week.

Social service chiefs in counties throughout the state have warned that they aren't ready to begin the time-consuming new application process -- and the delay could mean some elderly and frail patients would go without care.

Advocates for the elderly and disabled say the administration's rush to begin the checks, part of an anti-fraud effort Gov. Arnold Schwarzenegger pushed during last summer's budget negotiations, seems to have an ulterior motive: dissuading new patients and providers from participating in the $5.5-billion government-funded home healthcare program.

"This is just a disaster in the making," said Deborah Doctor, legislative advocate for Disability Rights California. "I don't want to overdramatize this, but it could have the same effect as cutting people off the program."

A legislative oversight hearing is slated for today to address the concerns and potentially make a push to delay the start of the new process, which would apply starting Monday to all new applicants for home health aide jobs. The state's more than 376,000 existing care workers would have to undergo the new background checks by June.

"This has created chaos and uncertainty for frail elderly and disabled people," said Assemblywoman Noreen Evans, who wants a three- to four-month delay.

Administration officials referred queries about the program to the state's Department of Social Services, which has been hustling to start the new application process.

Lizelda Lopez, the department's spokeswoman, said the looming deadline was set by the Legislature during budget negotiations and should come as no surprise.

"Nobody denies these were very aggressive time frames," Lopez said. But she said the department has been working with the counties for months to enact the new procedures. "We didn't start talking to them yesterday."

The In-home Supportive Services program has been caught in a tug-of-war between the Schwarzenegger administration, which contends that it is rife with potential fraud, and Democrats in the Legislature who see it as a humane and cost-effective alternative to nursing homes and other institutionalized care.

Coloring the debate is the fact that the in-home program is a big growth sector for labor unions, which traditionally have supported Democratic candidates and causes while reliably opposing those backed by Schwarzenegger and other Republicans.

Schwarzenegger tried during the summer budget fight to cut aid to 90% of the program's participants, but Democrats kept the program largely funded while going along with the anti-fraud effort.

"My question is whether this is an attempt by the administration to do what the Legislature would not allow it to do," Evans said.

County officials said the new rules have caused confusion and concern for patients and their healthcare providers.

"Our lobbies are flooded, telephones ring continuously, and staff have insufficient information to provide answers," Linda Haugan, assistant administrator for San Bernardino County Human Services, said in a letter to the state. "This has created a major disruption."

County officials say there are several key logistical problems.

The new rules require prospective healthcare workers to undergo an orientation session that will require counties to hire new staff and office space. Meanwhile, some counties say the new enrollment forms haven't been provided yet.

Officials in Los Angeles County, where more than 185,000 people receive in-home care, said they received the latest instructions just a day ago, giving them a week to prepare.

With more than 4,000 new applications each month for in-home care workers, the inability to approve new providers "will create an extreme hardship on aged and disabled individuals," Philip L. Browning, director of the county Department of Public Social Services, said in a letter to the state.


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Forgiving loans could draw med students to primary care and curb a projected shortage

It's one small piece of health care reform, but it's a big deal for medical schools and doctor's offices: forgiving the student loans of doctors who choose primary care.

With fewer medical school students choosing the lower-paying fields of family medicine, internal medicine and pediatrics, lawmakers and others say something has to be done to attract them. Helping students repay their loans could help fill a shortage of general physicians that one report estimates could reach 44,000 by 2025.

"The financial burden drives very responsible people to make decisions that may not be in our state and country's best interest," said Dr. Patricia Simmons, a member of the University of Minnesota's Board of Regents and a professor at the Mayo Clinic.

Primary care physicians now make up 35 percent of today's physician workforce, according to the Council on Graduate Medical Education. Already there are shortages in some parts of the country. But only 20 percent of medical school graduates are choosing those fields. Instead, often loaded with debt, they're picking higher-paying specialties.

If health care reform allows millions of uninsured people to get regular care, more general practitioners will be needed to do their annual checkups and treat their diseases.

They'll need people like Dustin Sperr.

Sperr, 25, plans to be a doctor, and by doctor he means family physician -- the only kind there was growing up in Herman, Minn. He loves the idea of handling everything from ear infections to Alzheimer's.

"There's a lot of ownership in that kind of patient care," said Sperr, a med student at the University of Minnesota.

He'll make less in family medicine than he would with a specialty such as surgery, but that's OK with him.

He also knows that if he moves back to western Minnesota he'll qualify for loan repayment programs. State and federal programs offer providers in areas with under-served populations yearly payments toward their debt.



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Travellers warned about holiday accidents

A comparison website is warning customers not to risk going on holiday without travel insurance as accidents often happen when people are away from home.

Lee Griffin, business development director at Gocompare.com, made his comments following research by the website which found that almost 29 per cent of people taking a holiday in a second home did not get insured for the trip.

Mr Griffin claimed that people are just as susceptible to illnesses and theft when they are at their second home as they are in any other travel accommodation . He explained: "If you have an accident or fall ill and you're not insured, you could end up in the ludicrous position of having to sell your holiday home to settle your medical bill." Such bills can end up costing thousands of pounds in some countries, he added.

Recently, Gocompare.com launched a pet insurance comparison service, which it claimed is the first of its kind in the UK.


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Advocates plan protest over possible cuts in mental health

Advocates for the mentally ill are planning a large protest at the State House tomorrow amid fears of deep state budget cuts to the Department of Mental Health, which could threaten the lifeline of many of the state’s neediest, they said.

Gov. Deval Patrick is expected to announce by the end of the week how he will close an existing $600 million budget gap. Workers in the mental health field say they fear the governor will make cuts to the state’s clubhouse programs, which house job training, housing placement and education services for the mentally ill.


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Top 20 hotspots for car insurance claims revealed

Car insurance claims for theft from their car or theft of their car are most likely to be made by drivers in Chislehurst in Bromley in Kent and Wingate in Cleveland.

Many big cities were also featured in the top 20 for theft claims on car insurance, including Manchester, Sheffield and Bradford . However, Steve Sweeney from moneysupermarket.com, who provided the data, said: "What the research does reveal is a broad mix of places across the country are at risk, highlighting the issue that no matter where you live, there is always a chance you could become a victim of theft and motorists should take this risk seriously."

Car insurance premiums in higher risk areas are likely to cost more. It is therefore essential for motorists to shop around and get the best car insurance deals to meet their needs. While there are ways to save money on car insurance, it is also important to ensure that vehicles are secure. They should be locked and parked in a safe place.


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Rell told she can't close High Meadows

Hartford (AP) - Gov. M. Jodi Rell announced Tuesday that $15 million in bonding is expected to be approved for the design and construction of a new detention facility in Bridgeport for delinquent females.

It's a facility that Connecticut has lacked since 2003.

The State Bond Commission, which Rell oversees, is scheduled to meet Friday to vote on the funding for the 18- to 24-bed facility.

Separately, Attorney General Richard Blumenthal released a legal opinion that says the Rell administration cannot close High Meadows, a state-run residential facility in Hamden for boys with severe behavioral and emotional problems.

Blumenthal said the General Assembly specifically restored funding in the state budget for High Meadows and clearly intended that the 43-bed facility, which serves boys ages 12 to 17, should remain open.

"Closing this long-standing facility is absolutely barred by plain language and crystal clear legislative intent," he said. "The budget approved by the legislature and signed by the governor cannot be unlawfully disregarded."

Rell's budget director, Robert Genuario, disagrees that the closure is legislatively prohibited. In a letter to Rell, he said the General Assembly did not pass any legislation that spells out how the money in the High Meadows line item should be spent. Genuario said that decision is left to the Department of Children and Families commissioner.

DCF has said it plans to close High Meadows in an effort to reduce the agency's investment in residential care. An application to shut it down is awaiting state regulatory approval. A hearing on the matter is scheduled for Friday.

DCF said it could not comment on Blumenthal's ruling because of the pending hearing.

State Child Advocate Jeanne Milstein said both developments - the possible closure of High Meadows and the announcement of the new facility for delinquent girls - don't address what's really needed for these troubled teens.

"We can't make decisions based on the closing of a facility, opening of a facility," Milstein said.

"I think we need to sit back and think about what are some of the less restrictive programs we need," she added.

Milstein said she has supported a secure facility being built for delinquent girls in Connecticut, but one that's much smaller with about four to six beds. She said more needs to be done to help girls before they need such a setting, such as high quality, early intervention programs.

Connecticut has not had a secure facility for girls since the Long Lane School in Middletown closed in February 2003. Rell said that population has "some of the most challenging and urgent needs in our state" and that a girls-only facility can help them.

Many of the girls have gone to hospitals or privately run group homes. Some have been sent to York Correctional Institution, an adult women's prison in Niantic.

The new facility, to be built on state-owned land, is scheduled to open in 2011.

Milstein said she's also concerned about the possible closure of High Meadows. She said DCF has not planned enough for moving the boys to other, appropriate facilities.


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Patrick to try to aid small business

Governor Deval Patrick is expected to announce a plan today that would give state insurance regulators the authority to review health insurance premiums that are charged to small businesses, an approach meant to stem the growing health care costs.

Patrick plans to outline the proposal this morning in Quincy, according to several administration officials who spoke on the condition of anonymity.

The administration will begin looking more in depth at the health care premiums charged to small businesses, partly in an effort to resolve complaints that small firms are being driven to the brink of bankruptcy by double-digit rate increases.

“In the insurance industry, people are going to be taking a lot of notice,’’ said one administration official, who was not authorized to speak publicly in advance of the governor’s announcement. “We’re . . . using all the power that we have to alleviate the cost pressures that the small business community has been feeling.’’

The administration plans to draft legislation that would give the state’s Division of Insurance broader authority in reviewing insurance rates before they are implemented, a move that state officials hope will give them and small businesses greater understanding over what is driving the cost increases.

The state also proposes to hold hearings next month to examine the differences between health care rates for small businesses and large and to explore whether small businesses be allowed to form cooperatives so they can bargain for cheaper insurance rates.

Allowing small businesses to band together to buy health insurance would be a major shift that could pit small business advocates against large health insurance providers.

Small businesses have long maintained that they are at a disadvantage because they do not have the buying power that large corporations have to obtain cheaper insurance rate. A 1996 state law prohibits small businesses from negotiating as a group.

“The whole health care reform in Massachusetts had previously been centered around big government and big business,’’ said Jon Hurst, president of the Retailers Association of Massachusetts, which represents many small businesses. “We’re excited about it, because it puts the big insurers on notice that the administration, the regulators, are not going to put up with these double-digit increases anymore.’’

The proposal will probably be opposed by insurance providers, who suggest that the governor is singling them out, while ignoring the primary cause of the problem.

“This is the wrong prescription for health care,’’ said Dr. Marylou Buyse, president of the Massachusetts Association of Health Plans. “The governor’s proposal misses the mark, and it fails to get at the main drivers of health care costs, and that’s the rates that doctors and hospitals are charging for their services.’’

Small business owners have said that they are shouldering annual double-digit increases as they struggle with the economic downturn. Larger businesses typically face 7 to 9 percent increases.

“I welcome the conversation and certainly want to participate in some way,’’ said Richard C. Lord, a board member of the Connector Authority, the state agency that oversees the 2006 insurance law, and chief executive of Associated Industries of Massachusetts, the largest business group in the state. “We’ve got to start somewhere.’’

Some of the issues stem in part from the state’s 2006 landmark health care reform law. State law requires businesses with the equivalent of 11 or more full-time workers to offer coverage or pay a penalty.

President Obama has been praised by small business groups because his national health care reform proposal would offer tax credits to offset costs and would create an exchange in which employers could buy coverage at competitive prices.

During the national debate on health care reform, Massachusetts has been held up as an example, both by proponents, who point to the number of residents who have health insurance, and by opponents, who point to soaring health care costs.


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Insurers see surge in health insurance for pets

Insurers have revealed that there has been a surge in health insurance for customer’s pets .

As veterinary bills rise and consumers spend more time with their pets, the health insurance industry is set to expand. However, while less than one per cent of pet owners own health insurance policies for their animals, those in the marketplace see a growing trend.

David Goodnight, president of Purina Care Health Insurance, said, "Pets are becoming more and more important to people and they are looking at them more as family members. The other factor is that we are seeing a rapid increase, really an explosion, in the cost of veterinary care because of new technologies and the procedures."

New trends are emerging, such as the Pet Health Consortium which is a new group working to promote pet health insurance . The group is calling for the government to allow pet insurance to be treated as an optional pre-tax benefit that companies could offer their employees .


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Healthcare advisor abruptly resigns

TALLAHASSEE -- One of Gov. Charlie Crist's top healthcare advisors abruptly resigned her state job Thursday, a strong signal that Republican Holly Benson plans to run for attorney general.

If, as expected, Benson seeks the Cabinet post, she will be challenging Jeff Kottkamp, the man Crist picked as his lieutenant governor in 2006.

Benson, secretary of the Agency for Health Care Administration since February 2008, sent her employees an e-mail in which she announced her resignation. She cited ``some opportunities that lie ahead,'' adding: ``I regret that because of those opportunities I will no longer be able to serve as your Secretary. I have submitted my resignation.''

Benson, 38, a lawyer from Pensacola, served in the state House from 2000 to 2007, and played a leading role in overhauling Florida's laws governing the Medicaid program and the operation of the state court system. She was initially hired by Crist to run the Department of Business and Professional Regulation.

There are signs the Benson-Kottkamp race could intensify quickly. Kottkamp's political advisor, Rocky Pennington, last month sought all of Benson's official e-mail correspondence at AHCA, which is public record under state law. Such requests are common in campaigns as each side vacuums the record for damaging political information.

The agency told Pennington on Thursday he must pay an up-front fee of $20,000 before the agency will review all 48,000 e-mail messages, at a rate of one minute per e-mail.

(Messages to healthcare officials could contain personal medical information that is exempt from disclosure.)

Kottkamp had underwhelming fundraising results last quarter, in which he raised $180,000, less than either of the two Democrats running for the post; state Sen. Dave Aronberg of Greenacres and state Sen. Dan Gelber of Miami Beach.



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Money off car insurance when motorists fill up with Total fuel

Total has teamed up with swiftcover.com to give away £30 off car insurance when motorists buy at least 30 litres or more of its advanced Total Excellium fuel .

Total Excellium is a range of advanced fuels designed to improve engine performance and give more miles per gallon. By using Total, drivers can reduce their fuel consumption by on average 4 per cent and reduce carbon emissions by over 5 per cent. The fuel also reduces noise in diesel engines by 37 per cent.

Until 3rd November 2009, customers will receive a voucher when they buy 30 litres or more of fuel at selected Total forecourts. The voucher can then be redeemed online when purchasing car insurance with swiftcover.com.

Gemma Shepherdson, Brand Manager, Total said: "At Total we are keen to offer our customers promotions that they will genuinely benefit from. By purchasing just 30 litres of fuel customers can receive £30 off car insurance with swiftcover.com. It really is that simple."


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New business insurance launched by Post Office

The Post Office is launching a new business insurance which will be available at Post Office branches.

As 80 per cent of companies that suffer a major incident or loss fail within 18 months as a result of having inadequate insurance, it is essential for small businesses to have the right insurance in place.

Businesses can choose the cover which meets their individual requirements and the Post Office says it can offer cover for at least 95 per cent of all small and medium sized companies. The organisation also has a dedicated team on hand to help businesses identify what insurance they need by law and what extra cover might be helpful for other parts of their business, like professional indemnity .

Duncan Caesar-Gordon, Post Office head of business insurance, said: "The Post Office is at the heart of every local business community and our new policy will make it even easier for small companies to find business insurance without having to trawl the internet or look around.


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Pennsylvania Gov. Ed Rendell lost 50 pounds during budget impasse

Gov. Ed Rendell started his diet in June when it became apparent an on-time budget was growing increasingly unlikely, and he wanted something positive to focus on. Over the 101-day budget impasse he knocked off about 50 pounds.

While the impasse lasted far longer than many groups that depend on state funding would have liked, Rendell said that diet-wise, it may not have lasted long enough. He said on Friday he figures it would have probably taken 30 more days for him to meet his 200-pound goal for his 5-foot-11-inch frame.

“I’m about 16, 17 pounds short of my goal but I think for the good of the citizens, I’ll try to make it without the daily frustrations of the budget. We’ll see,” he said.


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Humphrey: Tax collections still down

NASHVILLE - Gov. Phil Bredesen estimates Tennessee's tax collections will not return to 2008 levels until 2013, and for now they continue to shrink.

Finance Commissioner Dave Goetz said Friday that September state tax collections were $920.9 million, which is 5.7 percent below a year ago and $41.4 million less than expected when the current state budget was adopted in June.

Bredesen's comments came in a letter to U.S. Sen. Bob Corker and U.S. Rep. Bart Gordon, voicing concerns that national health care reform will mandate increased state spending.

"Bob and Bart, the problem that we're facing is simple: By 2013, we expect to have returned to 2008 levels of revenue and will have already cut programs dramatically - over a billion dollars," Bredesen wrote.

"At that point, we will have to start digging out - we will have not given state employees or teachers a raise for five years, our pension plans will need shoring up, our cash reserves ('rainy day fund') will have been considerably depleted and in need of restoration, and we will not have made any substantial new investments for years," the letter says.

Also at that point, he said, the next governor - Bredesen's term ends in January 2011 - will have dealt with "major cuts" to state programs.

"It's going to take at least a full decade to dig our way out and back to where we were prior to the recession," he said.

Goetz said he was "very disappointed" in the decline of revenue collections during September, which are based on taxable activity occurring in August.

The revenue shortfall makes it more likely that Bredesen will have to make additional cuts in budgeted expenditures - as authorized by the Legislature in the appropriations act.

"Going forward, we must continue to closely monitor state expenditures, in order to keep the budget in balance," Goetz said in a statement.

The report on the current revenue shortfall by Goetz is based on calculations by the Department of Finance and Administration. The Legislature's Fiscal Review Committee began doing its own calculations last month and did so again for the September figures.

Tom Humphrey may be reached at 615-242-7782.


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November 16, 2009

Rising interest in green travel insurance

People would rather reduce the energy consumption within their houses than give up on flying for a year, according to new findings from Loughborough University .

The study showed that out of the people surveyed, almost 88 per cent claimed that they would like to cut down the amount of energy usage in their homes . However, only 26 per cent said that they would abandon air travel for a year.

In the year 2012, the air duty for passengers travelling short distances is likely to rise by £12. However, when asked to name an amount in the rise in price of air duty which would deter them from short distance air travel, almost 80 percent said £50. The findings concluded that the higher prices in airfare would act as a bigger deterrent to travellers than harm to the environment .

Travel insurance companies are now taking advantage of this fact and offering travel insurance that is tailored especially for the traveller who is environmentally aware.

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Pets in the house can put home insurance policies at risk

Millions of pet owners risk their level of home security by switching off their home alarm systems, according to home insurance provider Swinton.

Pets often trigger alarms and so people turn them off. However, pet owners may not realise that they could be invalidating their home insurance policies as a result. A survey conducted by Swinton of two thousand of its home insurance customers revealed that only 33 percent of the households in the UK use their burglar alarms . Also, 72 percent of the people surveyed said that they switched off their alarm systems on account of pets who roam about at night or when they are not at home.

Generally, failing to activate a home alarm system, which may be mentioned on a policy, can render a home insurance policy null and void. This is because mentioning an alarm system in the policy may have brought the policyholder lower premiums to pay on their home insurance. Read More...

Investigation finds $63 million in Medicaid fraud in just five states

A California man took on the name of a dead person to receive taxpayer-funded health care for more than three years, charging $200,000 to the Medicaid system, including $2,870 to buy controlled substances under an assumed identity.

A Houston-area physician's assistant kept on signing the name of the doctor who once employed her after that doctor had died. The prescriptions, many of which were also covered by Medicaid, were also for prescription pain killers.

More than 1,800 prescriptions were filled for people who are dead and another 1,200 prescriptions were written with the signatures of deceased doctors, according to an investigation of five states by the Government Accountability Office (GAO). And those were only two of the startling findings in a report that discovered $63.2 million in waste in five states alone.

That GAO report issued last week found 65,000 cases of fraud in the Medicaid prescription drug program in California, Illinois, New York, North Carolina, and Texas. The report also found widespread doctor-shopping by Medicaid recipients.

Medicaid, launched in 1965, is a federal program administered by the states to provide health care financial assistance for low-income persons and families. A little more than 60 million people used Medicaid in 2007 at a cost of $319 billion.
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Economists warn of another big Florida budget deficit

TALLAHASSEE -- Another year. Another budget deficit.
A new financial report shows that all the tax increases, spending cuts and raids on savings accounts weren't enough for Florida's budget, which could have a deficit next year of as much as $2.6 billion.
The main cost-driver: Medicaid.
The subsidized healthcare program for the poor is growing as the economy shrinks. And the federal stimulus money that helped the state avoid deep budget cuts runs out next December -- in the middle of next budget year.

The numbers are the latest sobering reminder that the federal stimulus package didn't so much stimulate Florida's economy as it did bail out the state budget -- temporarily.

Amy Baker, head of the Legislature's Office of Economic & Demographic Research office, told the Senate's budget committee Tuesday that the state's sales tax-fueled budget of $66.5 billion won't get a huge shot in the arm, even in the holiday season.

``Christmas is probably going to be rough,'' said Baker, who presented the financial numbers to the committee. ``I don't think you're going to see a Christmas like we normally see.''

Next legislative session also won't resemble this year's. It will also be an election year, so the chances of tax increases are slimmer from a Republican Legislature under a Republican governor who is running for the U.S. Senate in a heated primary.

This year, the Legislature and Gov. Charlie Crist approved $2.2 billion in higher taxes and fees.

Lawmakers said they won't know how big the budget deficit will be until the federal government decides how much of the Medicaid program it will pay for. Senate budget chief J.D. Alexander fretted that the federal government could pick up so little of the Medicaid tab that it could cost the state an extra $3 billion.

Alexander said the state needs to be on guard.

``It's devastating,'' Alexander said. ``Three billion dollars is equivalent to a penny sales tax.''


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AA Insurance warns motorists of collisions with animals

The AA has warned motorists to be aware that collisions with animals on the road can result in a car being a write-off in a car insurance claim.

Director of the organisation, Simon Douglas, made his comments as the company announced that October is the peak month for deer strikes, when collisions with deer occur due to the creatures moving around during their mating season.

Mr Douglas indicated that collisions can take place with little or no warning and the result can be just as serious for the occupants of the car as for the animal that is hit. He said: "A natural reaction is to try to avoid the collision but as a result, drivers may miss the deer and hit other vehicles or trees, which can be even worse."

AA Insurance revealed that there could be as many as 74,000 deer strikes happening each year, although only around 42,500 were reported. Read More...

Budget means less for Medicaid, nursing homes

State health budget cuts passed by the House and Senate would mean fewer nursing home workers and the gutting or elimination of programs aimed to prevent pregnancy, diabetes, lead poisoning and infant mortality.

The Department of Community Health budget calls for an 8 percent cut in Medicaid reimbursement rates to doctors and providers.

That cut would likely lead more doctors to refuse to treat Medicaid patients, said Dr. Bobby Mukkamala, an ear, nose and throat specialist in Flint.

"Doctors say, 'You know what? I didn't like it anyway, now that it's 8 percent less, forget it,' " he said.

At Hurley Medical Center in Flint, 42 percent of patients are on Medicaid. An 8 percent cut in reimbursement will mean a loss of between $6 million and $10 million to the hospital, said Kevin Murphy, senior vice president and chief financial officer. "That puts us in the red," Murphy said.

Nursing homes are hit even harder, said Reggie Hartsfield, president and owner of Advantage Management Group, which operates eight nursing home facilities in the state -- six in Metro Detroit.

With 800 residents and 85 percent of them on Medicaid, "an 8 percent cut is about $3 million," Hartsfield said.

The budget for the Healthy Michigan Fund, which coordinates health care prevention programs, is cut from $25 million to $11 million. Numerous programs were cut completely, including programs to help prevent lead poisoning in children and two infant mortality projects.

The state cut $400,000 to Wayne State University for diabetes education and outreach in Detroit.

Pregnancy prevention funding was slashed from close to $6 million to $1.1 million.
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ARRA - HITECH: Health Care Information Breach Notification Regulations Now In Effect

Have you had a health data security breach? Do you know what a health data breach is? Are you required to notify individuals impacted by the breach? Do you have to notify federal agencies of such breach?

Read on for more information regarding the Office for Civil Right (OCR) and Federal Trade Commission (FTC) regulations requiring health care providers and other health data business vendors to assess and in some cases notify and report health information data breaches under the new federal law created by ARRA-HITECH.

The new regulations went into effect on September 23, 2009 and September 24, 2009, respectively, with a full compliance date of February 22, 2010. Health care providers covered under HIPAA and third party users of health information, including personal health record (PHR) companies and vendors, PHR related entities, health 2.0 companies and other third party health data service providers, should examine the regulations and understand the impact on their business.

The regulations require entities to develop internal compliance processes to act upon and advise individuals of data breaches that pose a significant risk of financial, reputational or other harm to the affected individual. The OCR regulations apply mainly to covered entities and business associates under HIPAA and the FTC regulations apply mainly to PHR vendors and PHR related entities. The regulations define a "breach" and set forth the time frames and scope of notification required. The regulations require the tracking and reporting of such data breaches to OCR and FTC. Also, OCR has published separate guidance specifying the technology and methods that will render health information unusable, unreadable and undecipherable as defined under ARRA-HITECH.

OCR has provided a summary of the breach notification rule on its website. OCR has also published instructions for reporting breaches to the HHS Secretary. The instructions include details for reporting "Breaches Affecting 500 or More Individuals" and "Breaches Affecting Fewer than 500 Individuals." OCR will also maintain a list of reported breaches that impact 500 or more individuals. The FTC also has a section on its website providing information on its health breach notification rule.

Below are links to the full regulation text:

* OCR Interim Final Rule - Breach Notification for Unsecured Protected Health Information (45 CFR Part 160 and 164) 74 Fed. Reg. 42740 (Aug 24, 2009).

* OCR Guidance Specifying the Technologies and Methodologies That Render Protected Health Information Unusable, Unreadable, or Indecipherable to Unauthorized Individuals for Purposes of the Breach Notification Requirements Under Section 13402 of Title XIII (Health Information Technology for Economic and Clinical Health Act) of the American Recovery and Reinvestment Act of 2009; Request for Information 74 Fed. Reg. 19006 (April 27, 2009).

* Federal Trade Commission: Health Breach Notification Rule: Final Rule -- Issued Pursuant to the American Recovery and Reinvestment Act of 2009 -- Requiring Vendors of Personal Health Records and Related Entities To Notify Consumers When the Security of Their Individually Identifiable Health Information Has Been Breached (16 CFR Part 318) 74 Fed. Reg. 42962 (Aug 25, 2009). The FTC has also issued a Breach Notification Form.
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Businesses that are not insured put themselves at risk

Aviva has stated that businesses which don’t insure themselves are putting themselves at risk and that they could lose out in the event of an unforeseen incident.

David Bruce, commercial product manager at the organisation, made these comments following the release of data which revealed that 12 per cent of small and medium-sized enterprises (SME) are not commercially insured . He commented that any conscientious business leader should cover their company in order to ensure that they protect it in case of an accident that could bankrupt the organisation.

Mr Bruce explained: "If one of your staff, or a customer, has an accident at work it is unlikely you would be able to pay out a claim that could run into thousands of pounds yourself."

The survey by Aviva also found that 56 per cent of SMEs are working towards getting through the current economic climate by diversifying their business.
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Alabama teacher health insurance premiums may see cost rise

Alabama education leaders say they will consider increasing the amount educators pay for health insurance, an increase that would be the first since the program was established in 1983.

Teachers have paid $2 a month for single-coverage health insurance since 1986, when the premium was lowered from $10. The portion paid by the state is now $752 per employee each month, more than 19 times what it was back then.

When some state officials have tried to increase the amount paid by teachers over the years, the Alabama Education Association has fought the increases and won. But even Paul Hubbert, executive secretary for AEA, now acknowledges it may be impossible to keep the rates the same.

"The condition of the Education Trust Fund has deteriorated over the last two to three years, so we may have to consider going up on the costs," Hubbert said this week.

State education officials warn that by 2011 the costs for health care will increase 32 percent from what they are today, and picking up those costs may mean being unable to fully fund programs such as the Alabama Reading Initiative; the Alabama, Math, Science and Technology Initiative; and the Advanced Placement initiative.

The Public Education Employees' Health Insurance Plan, PEEHIP, is the state's health care plan for active and retired educators. In 1985, employees and retirees paid $10 a month for single coverage, while the state picked up the remaining $60 a month.

In 1986, the amount paid by employees dropped to $2 and has remained the same since. However, the cost the state must pick up for each employee on the program has increased just about every year since, from $60 a month in 1985 to $752 today.

Hubbert said the amount paid by teachers has remained the same in lieu of teacher raises....
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Health insurance essential for winter sports

Skiing and snow boarding are still proving to be among the most popular winter sports among many in the UK.

However due to the nature of these sports and because no-one is immune to injuries and freak accidents, holidaymakers are being advised to ensure they take out adequate travel and health insurance cover in case of an accident.

Medicare International’s David Pryor said: "It is a must to wear appropriate safety equipment and have a basic knowledge of survival training when stranded in situations like avalanches." In case of an injury, good health insurance cover can save precious minutes if not hours in transfer from a vulnerable position to the safety of a hospital bed.

Since the tragic and untimely death of English stage actress Natasha Richardson, from a head injury she sustained during her skiing lessons, more people have become aware of the benefits of health insurance.


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Jindal to GOP: Work with Obama

Louisiana Republican Gov. Bobby Jindal urged his party Tuesday to shift to offering health care solutions instead of just rejecting what President Barack Obama and the Democratic majority in Congress are proposing.

“I think now is the perfect time to pivot and to say, not only here’s what we’re against, and not only here’s how we’re going to contrast ourselves, but here’s what we’re for,” Jindal said in an interview with POLITICO.

Jindal acknowledged that the Republican Party for years had been too slow to stake out positions on the health care debate “to our peril and the nation’s peril.”

“I think that in some circles, it was viewed as a Democratic issue,” said Jindal, who served in top posts at the Department of Health and Human Services during the Bush administration and ran his state’s health department in the ’90s.

Jindal urged congressional Republicans to go to the White House and find common ground with Obama.

“Let’s start anew,” he said they should tell the president. “We’re willing to work with you in a bipartisan way.”

The governor, who has downplayed talk that he could be a presidential contender in 2012, ticked off what he said could be areas of consensus between the two parties to address the issue: coverage of pre-existing conditions, access across state lines and between jobs, funding for electronic medical records, malpractice reform, Medicare and Medicaid reform, and expanding health-savings accounts and insurance purchasing pools.

But Jindal wouldn’t say how much money his reforms would save American families or how many people would be left uninsured, arguing that both would depend largely on how aggressively lawmakers squeezed savings from Medicare, tort reform and other areas.

A former House member, Jindal was, however, candid about the political realities of a capital with heavy Democratic majorities in both houses of Congress.

“I think they’ll sign a bill and say this was health care reform, this is a great step forward we’re going to have to come back and do more,” he said.

Democrats, Jindal said, have learned a lesson from their failure to pass health care reform under President Bill Clinton in the ’90s: “It would be worse to go home with nothing than to get something done.”

But even as it appears unlikely that congressional Republicans are in a mood to compromise or that many congressional Democrats want to limit the scope of reform, the governor insisted that the two parties could find a way to reach a deal in a fashion so that “the bases aren’t going to be happy.”

Jindal explained: “I think it’s better policy, it’s better politics to have more than 51 votes, more than 60 votes for bipartisan health care proposals that are meaningful, that drive down the cost of health care and that resonate with what the American people want.”

Now in his second full year as governor, Jindal has sought to carve out a national niche as an ideas-oriented conservative, particularly on the issue that has become the central focus in the nation’s political debate.

But with significant challenges in a home state still recovering from hurricane damage, he has sought to balance any future ambitions on the national stage with assurances that he plans to run for reelection in 2011 — and serve two full terms.

Jindal was in Washington to help raise money in the Virginia suburbs for the GOP gubernatorial candidate Bob McDonnell, but his staff also noted he was in the capital to build his own reelection war chest.

“I’m not; I’m thinking about running for reelection in ’11,” Jindal said when asked whether he was thinking at all about running for president.



And in a sign that he is keeping a close eye on his own political standing, both in Baton Rouge and beyond, the governor pointedly declined to offer his endorsement of Sen. David Vitter (R-La.), who could face a serious reelection battle next year in the wake of his appearance on a Washington madam’s client list and his subsequent admission of an undefined “very serious sin.”

“We’ll make a decision whether we’ll get involved in that race once we get closer. We haven’t made that decision yet,” said Jindal, who has been cautious in the past about his endorsements. While allowing that Vitter was doing well in polls and fundraising, Jindal noted it’s still “very early in that election cycle” and that many average voters aren’t yet paying attention.

In the interview, he also staked out some of the ground that helped Obama get elected last fall — appealing for bipartisanship and seeking to tamp down some of the partisan vitriol in Washington. Jindal offered little in the way of direct criticism of Obama, except to say that he thought the Republican Party was effectively channeling many Americans’ reluctance to support what looked like a Big Government solution to health care.

As for the that issue that is looming on the minds of many of his constituents down on the bayou, Jindal said he admired star Florida quarterback Tim Tebow and hoped the Heisman Trophy winner would come back from the concussion he suffered last Saturday to be in uniform for the much-anticipated Gators showdown at Louisiana State University next month.

When an aide joked that Jindal, an ardent LSU fan, may not want to say that publicly, the governor shot back: “As long as the Tigers beat him, we can be gracious.”
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Care facility fine $8K; state rules were violated

A specialized Tucson long-term care facility has agreed to pay $8,000 in fines to the state health department for failing to follow state rules on caring for four patients, including a diabetic who died with elevated blood sugar.
The fine followed an Arizona Department of Health Services investigation in March, which was prompted by four complaints about Cornerstone Hospital of Southeast Arizona. The investigation details problems with medication errors, including giving drugs to the wrong patient, and facility's failure to adhere to its own policies on staff training.

Most of the fine — $6,000 — related to the care of one of those patients, the diabetic who died Feb. 22. The patient had elevated blood sugar and there was no documentation of the patient's vital signs from 4 a.m. to the time of death at 3:30 p.m., state records show.
State investigators say Cornerstone failed to follow a physician's order on administering insulin to the patient who died, and also failed to notify a doctor that the patient's blood sugar level was greater than 400 milligrams per deciliter. Normal is typically considered to be 140 mg/dl or below.
The agreement also said that Cornerstone failed to discontinue giving an extremely potent controlled substance — Fentanyl — to the patient who died. The patient received six doses of Fentanyl after the discontinue order was issued, records show.
Cornerstone is a 34-bed acute care facility that specializes in helping patients with complex conditions who need long-term hospital stays, according to a profile on the Web site of its owners from the Texas-based Cornerstone Healthcare Group. It is located at 7220 E. Rosewood St., near Speedway and Kolb.
Calls to the company's corporate headquarters on Monday and Tuesday were not returned.
Cornerstone has since submitted an acceptable plan of correction and is now considered in compliance with state rules and regulations, said Alan Oppenheim, deputy assistant director for the Arizona Department of Health Services' division of licensing.
As part of its agreement with the state, Cornerstone has promised to provide education and training about diabetic management, including reviewing its diabetic policies and procedures, with its nursing staff. Cornerstone paid the fine Aug. 13.
Some of the problems stemmed from not properly training the contracted personnel it uses to supplement staffing, state documents show.
The state also found that Cornerstone failed to administer insulin as ordered by a physician to a second patient, and did not adequately document neurological changes in a third patient.
A fourth patient was given the Novolog insulin rather than regular insulin, which was what a physician had ordered, state records show. Also, there was never an assessment of that patient by a registered nurse, investigators said.
The sanction marked the third time the state has fined Cornerstone in the last 12 months. In May the facility paid a $1,500 fine for failing to respond to an emergency patient need in a timely manner, for failing to adequately monitor and assess another patient, and for failing to have a qualified person observe a cardiac telemetry monitor.
Last Oct. 15, Cornerstone paid $500 for failure of its nurse executive to require that a registered nurse direct and evaluate a patient's nursing services.
In the latest case, investigators again faulted the facility's nurse executive, this time for failing to follow Cornerstone's own plan on appropriate staffing numbers to meet patient needs.
During an investigation in March, the state found several other violations:
• Multiple medication errors, including giving patients wrong dosages, and multiple cases where patients received the wrong drug.
• No documentation that contracted nurses had been oriented about Cornerstone's nursing policies and procedures and about its safety policies.
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GAO report: Millions in fraud, drug abuse clogs Medicaid

WASHINGTON — As Congress debates the government's role in health care, a report out Wednesday finds that state and federal officials failed to detect millions of dollars in Medicaid prescription drug abuse.

An audit of the government program in five large states found about 65,000 instances of beneficiaries improperly obtaining potentially addictive drugs at a cost of about $65 million during 2006 and 2007 — including thousands of prescriptions written for dead patients or by people posing as doctors.

The report, by the Government Accountability Office (GAO), represents "an enormous opportunity to save money," says Sen. Tom Carper, D-Del., who has scheduled a hearing Wednesday on the findings.

When bills for the doctors' visits are added, along with the potential for Medicaid fraud in states not reviewed by the GAO audit, Carper said: "We're talking hundreds of millions of dollars."

SENATE PANEL: Place 'public option' on respirator

That could be good news for President Obama, who argues that a massive expansion of health care coverage can be funded by squeezing waste out of the current system. But as Obama continues to press for a government-run health insurance plan, the GAO report also reveals shortcomings in how the government manages Medicaid. The program for low-income and disabled Americans, run jointly by states and the federal government, underwrote more than $23 billion in drug costs last year.

The GAO audit focused on 10 types of frequently abused prescription drugs — painkillers and mood-altering medications. Abuse of such medications is "second only to marijuana," Joseph Rannazzisi of the Drug Enforcement Administration says in prepared testimony for the hearing.

A well-known example is the death of pop star Michael Jackson, which was ruled a homicide in August after revelations that the singer had pressed his personal physician to prescribe powerful sedatives to help him sleep.

The states targeted by the GAO — California, Illinois, New York, North Carolina and Texas — accounted for 40% of Medicaid's prescription drug payments in fiscal years 2006 and 2007. They are not fully taking advantage of federal databases or technology that could spot fraud, the report said.

The GAO found:

• About 65,000 cases where Medicaid beneficiaries visited six or more doctors and up to 46 different pharmacies to acquire prescriptions — a practice known as "doctor-shopping" that allows purchasers to exceed the legal limit of drugs.

• Sixty-five doctors or pharmacists writing or filling prescriptions after being banned from Medicaid, some for illegally selling such drugs.

• About 1,800 prescriptions written for dead patients and 1,200 prescriptions "written" by dead physicians.

States are working to prevent Medicaid prescription abuse but there are "significant issues that must be addressed," Ann Kohler, director of the National Association of State Medicaid Directors, says in testimony prepared for the hearing. One obstacle she identified: tight state budgets that are slowing needed information-technology improvements.
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