Saturday, September 12, 2009

It would seem the House Rep from South Carolina has a need for addiction recovery. Typical, he is in self-denial. Pity.


Rob Miller for South Carolina House. Let's face it, South Carolina needs someone that cares about the people. They have a Governor that was legislated into receiving Stimulus dollars and now this humiliation. How much can the people of South Carolina stand?
Act Blue (click here)

Meet Rob Miller (click here) - One of Rob's Campaign focus is to stop outsourcing jobs.
Born and raised in South Carolina as the youngest son of a Navy Veteran, Rob learned the importance of hard work from a very early age. Facing staggering medical bills after his father passed away, 14-year old Rob went to work washing dishes to help support his family. Through hard work and lots of support from family and the community around them, Rob’s family weathered the financial storm....


12:42 September 11th, 2009
No lie! Poll shows Joe Wilson trailing in reelection bid (click here)
Posted by: Thomas Ferraro
Congressman Joe Wilson might be tempted to yell “You lie!” again – this time at a poll that shows the presidential heckler trailing in his reelection bid.
The survey by Public Policy Polling found Democratic challenger Rob Miller leading the five-term Republican lawmaker by 44 percent to 43 percent. The numbers had Democrats cheering, and at least one pollster offering a new view of the contest in the heavily Republican South Carolina district....


Evidently, the Obama Presidency is making history at every turn.

...Campaigns have always played fast and loose with the facts. (click title to entry - thank you) But as the partisan divide in Washington has grown, the rules have changed
“Now we’re in an era of the permanent campaign, and the line between campaigning and governing is virtually gone,” said Gary Jacobson, a political science teacher at the University of California-San Diego.
Enter Wilson. After his shout on Wednesday night heard ’round the political world, his Democratic challenger raised $400,000 by Thursday evening.
Proof enough for Kim Alfano Doyle, a Republican campaign strategist for two decades, who said that Wilson’s move was crass and that the take-no-prisoners approach is a mistake.
“It just looks ugly, it looks petty, it looks like no one’s getting anything done,” she said. “When you’re up there having a slap fight, you’re not taking it seriously. Everything’s a campaign, and that’s a shame.”
The Washington Post contributed to this report. To reach David Goldstein, call 202-383-6105 or send e-mail to
dgoldstein@mcclatchydc.com.

Wilson took caffeine pills in 2007 (click here)
By Jordan Fabian - 09/10/09 06:21 PM ET
Rep. Joe Wilson (R-S.C.), who shouted "you lie!" at President Obama during his Wednesday night address to Congress, admitted to regularly consuming caffeine pills in 2007.
It is unclear if Wilson still takes NoDoz, a brand of pill that contains 200 milligrams of caffeine a pop. By comparison, a seven ounce cup of drip coffee contains 115 to 175 milligrams of caffeine.
A source told The Hill in 2007 that the congressman ingested the tablets “like candy," but Wilson insisted he was not addicted despite the fact that he had been taking them since high school.
"I love coffee, but I don’t have time to drink it and I don’t have access to it," Wilson said at the time.
The fifth-term Republican said he shared his NoDoz use with his doctor, who Wilson said assured him that the over-the-counter pills are not dangerous unless you get addicted.
Wilson interrupted the president yesterday night after he said that his health reform plan will not insure illegal immigrants. He quickly apologized for his outburst last night but maintained that Obama was lying in a radio interview today.


Page 151, lines 6 through 22:

(c) GAO STUDY ON NURSING FACILITY UNDER CAPITALIZATION.—
(1) IN GENERAL.—The Comptroller General of the United States shall conduct a study that examines the following:
(A) The extent to which corporations that own or operate large numbers of nursing facilities, taking into account ownership type (including private equity and control interests), are undercapitalizing such facilities.
(B) The effects of such undercapitalization on quality of care, including staffing and food costs, at such facilities.

(C) Options to address such undercapitalization, such as requirements relating to surety bonds, liability insurance, or minimum capitalization.

Nursing Homes are a huge issue. It requires attention and it requires attention now. There are many reasons to 'get this right.' The next generation of elderly will be numerous and some will require Long Term Care. The Baby Boomers come from a generation that would rather 'opt' for longevity with activity and purpose, however, there will be the exceptions.

By every definition of 'Sandwich Generation' I should be one of those taking care of elderly parents while paying for a child's wedding. But. I am not. Why? Because my parents are in excellant health for their age and they live in their own home able to take care of themselves. That, by the way, is true for most of my extended family. Irish Americans. Evidently, we are a sturdy bunch.

I say this with anticipation of seeking the same autonomy for myself, until my death. And. I expect the same 'ideals' hold true for my generation. I believe that is an important 'directive' for any Health Care Insurance Reform. Why? Because if The Baby Boomers are able to care for themselves all their lives, the SNF (Skilled Nursing Facilities) just might be a thing of the past. And, that is another thing. Why aren't their 'earning' opportunities for Seniors that live in Nursing Homes, should they have the ability. Imagine a 'Mom and Pop Country Store' in every SNF that residents and visitors can frequent for the latest in DVDs, Music Downloads or Gourmet Frozen Dinners.

It will be vital for the next generation of 'elders' to remain active, in good health and quite possibly able to produce an income that will continue to contribute to the country's tax base. BUT. In realizing there is a chance that will be part of the American Landscape, please let it be in balance with 'respect for The Golden Years' and some entitlement of Seniors for 'down time' and relaxation as they seek to send it.

There is also this 'hazard' accompanying longevity. It is the 'longevity of job occupation.' And by occupation, I don't mean 'profession.' By occupation I mean staying in a position too long. While some of the most qualified employees a company has is their 'experienced' and older workers and executives, there is a moral issue with 'job protection' in the face of a younger generation 'stuck in the rut' of No-Advancement and no advancement opportunity. It is a concern for many reasons.

As Americans live longer, they will work longer. Even in retirement, the opportunities to earn and fight 'built in' inflation of retirement income, will be met with job seekers. There is a problem with that as it 'oppresses' younger workers and potential executives. There needs to be a 'longevity' component to those jobs frequently sought for their higher income or prestige or responsibility. There comes a time when 'the younger generations' need a chance at their goals. Now, this is somewhat of Age Discrimination, but, it doesn't have to be. If an individual comes into a managerial position with a healthy income in their forties, there needs to be some expectation on 'changing' such employment within twenty years of achieving it.


Why?


Not because the older worker can't do the work, they can probably accomplish it handily. But. There are several reasons that will enhance 'the futrue' of any enterprise, including, local economies.


An enterprise that has longevity has the right to remain vital. It is good for the economy. Often younger workers will become diminished in abilities if they are 'stuck' in lower paying and lower expectation employ. In that, there is a hazard. It is a dynamic that needs to be addressed from the standpoint of what is good for any company to remain viable and what enhances 'vitality' in the American economy. Why discourage younger workers from achieving if they feel their best years will be stalemated in lower or middle management or jobs of lower esteem than they hoped for when graduating from classes, be it High School or the University.

With anticipated increased longevity. Longevity with purpose and income. There needs to be an understanding to the extent longevity will play in any economic dynamics. That is not Age Discrimination, unless, it is viewed as being OPPRESSIVE against young workers. And by young, it includes those in their fourth and fifth and sixth decade of life that has yet 'the chance' to reach for the Gold Ring.

It may be that this unique dynamic might be exclusive to the Baby Boomers and Generation X will find a more 'traditional' meaning to retirement. But, to anticipate such an issue is to address it. That was off the path of reading the House Bill as it stood before Summer Recess.

There are problems with 'chain store' SNFs. Corporate structure removes 'compassion' from SNF. There are also opportunities for fiscal exploitation of the USA Treasury and SSI, especially considering there might be increased demand for such services. So, to understand the SNF and its fiscal 'habits' is more than prudent for any National Health Care Insurnace Reform Bill.

Page 551, lines 23 and 24 and Page 552, lines 1 and 2:

(2) REPORT.—Not later than 18 months after the date of the enactment of this Act, the Comptroller General shall submit to Congress a report on the study conducted under paragraph (1).

It sound not only correct to proceed, but, neglectful if we don't.

The bill goes on to list definitions, the website which sounds like a central clearinghouse for information and certifications. There is recommendations for 'staffing improvements' or at least 'consumer awareness' of what staffing should be available. Usually that type of information will bring about change for the better with consumer advocacy.


Page 555, lines 1 through 3:

‘‘(IV) an explanation that appropriate staffing levels vary based on patient case mix.

That is more than interesting. In today's SNF, staffing it arbitrary based on parameters set up by the Director/Vice President of Nursing. They are viewed as 'standards' by the profession, but, there is little to no application of 'staffing for acuity.' There is no reason why a SNF should not be viewed as a 'fluid' environment for changes in 'residents' acuity. There is also no reason why that dynamic should be 'ignored' as a part of any management practice within any facility. It may mean that two more Nursing Assistants are needed on The Alzheimer Unit as some of the residents are changing their wellness status, while The Rest Home Unit is enjoying many agile residents needing far less assistance.

Most hospital units today use some type of acuity scale to staff probably. There is no reason why that dynamic cannot be applied to SNFs as a way of maintaining clearer understandings of their 'client population' and their ever changing needs.

But, this is more or less about 'empowering' the consumer seeking a SNF, as a method to compliance of 'quality of care.' The new website, of which has a name, ‘Nursing Home Compare,’ will provide a place to download forms when a complaint needs to be filed.


Page 555, lines 13 through 19:


‘‘(v) The standardized complaint form developed under subsection (f)(8), including explanatory material on what complaint forms are, how they are used, and how to file a complaint with the State survey and certification program and the State long-term care ombudsman program.

The legislation goes on to define staff that acts in a criminal manner, enforcement, deadlines for provisions in the bill to be incompliance, there is stated the 'agencies' the Secretary will consult with, Page 557, line 21 and 25, Page 558, lines 1 through 5:

‘‘(B) CONSULTATION.—In conducting the review under subparagraph (A)(i), the Secretary shall consult with—
‘‘(i) State long-term care ombudsman programs; ‘‘(ii) consumer advocacy groups; ‘‘(iii) provider stakeholder groups; and ‘‘(iv) any other representatives of programs or groups the Secretary determines appropriate.’’.

Continued in entry below.

Continued from previous.



Young adults a key to health care reform (click title to entry - thank you)
Many are uninsured, with mixed opinions on need for change

By Childs Walker, Stephanie Desmon and Paul West Baltimore Sun reporters
September 11, 2009

...In the debate over health care reform, Stokes and his peers are known as "invincibles," strong and healthy young adults who have no experience with wallet-crippling illness and feel they have no need for coverage....

Yet, young males are at risk for serious diseases such as Testicular Cancer. Young women have incidence of Breast Cancer. We aren't speaking to our young people the way they need us to speak to them.

Testicular cancer is the most common form of cancer among males age 15 to 44 (click here). After motor vehicle accidents and suicide, cancer is the leading cause of death in this age group, followed by homicide, heart disease, and HIV. Testicular cancer is known as the young man's cancer.

This table is on Page 46 of article (click here). It was the only 'study' on the internet that was handy. Unfortunately, it only addresses White Males, but, I think the 'idea' of misinformed youth is validated.


TABLE 1. Age-specific and age-adjusted incidence rates of testicuiar cancer (per 100,000) for US White males from 1973 to 1995: Surveillance, Epidemiology and End Results Program
In 1995 - ages 15 thru 19 there were 3.9 cases per 100,000 Caucasian men.

In 1995 - ages 20 to 24 there were 7.9 cases per 100,000 Caucasian men.

In 1995 - ages 25 to 29 there were 15.9 cases per 100,000 Caucasian men.

To return to the legislation, Page 559, lines 11 through 17:

‘‘(8) SPECIAL FOCUS FACILITY PROGRAM.— ‘‘(A) IN GENERAL.—The Secretary shall conduct a special focus facility program for enforcement of requirements for skilled nursing facilities that the Secretary has identified as having substantially failed to meet applicable requirement of this Act.

This entire provision sets up Consumer Education and Advocacy as well as sets expectations for SNFs. The title of this initiative is "Special Focus Facility Program." It's a good title. Leaves open the inclusion of 'miscellaneous' facilities including Rehab facilities like the one that welcomes and specializes in returning, disabled veterans.

Proper staffing will ultimately be an initiative with this Secretary of Health and Human Services.

Page 560, lines 20 through 25 and Page 561, lines 1 through 6.

‘‘(i) Staffing data for each facility (including resident census data and data on the hours of care provided per resident per day) based on data submitted under subsection (b)(8)(C)(ii), including information on staffing turnover and tenure, in a format that is clearly understandable to con2
sumers of long-term care services and allows such consumers to compare differences in staffing between facilities and State and national averages for the facilities. Such format shall include—

Properly staffed and well run SNFs looks to be a priority of the Secretary.

Page 566, lines 7 though 10:

‘‘(B) PERIODIC SURVEYS.—Under such program the Secretary shall conduct surveys of each facility in the program not less often than once every 6 months.’’.

The provision provides for transparency in that the reports and surveys will be available at the website to the public and professionals. The States are going to have a role in quality assurance as well.

Page 568, lines 7 through 18:

(1) GUIDANCE.—The Secretary of Health and Human Services (in this subtitle referred to as the ‘‘Secretary’’) shall provide guidance to States on how States can establish electronic links to Form 2567 State inspection reports (or a successor form), complaint investigation reports, and a facility’s plan of correction or other response to such Form 2567 State inspection reports (or a successor form) on the Internet website of the State that provides information on skilled nursing facilities and nursing facilities and the Secretary shall, if possible, include such information on Nursing Home Compare.

And I have to apologize here. I usually cover at least 50 pages per day, but, I have some personal business that is pressing and I won't be able to complete this review until Monday afternoon or evening.

In hoping everyone is well...

...until then...