NEWS MONSTER
House reconciliation package would provide path to citizenship
Wed, 08 Sep 2021 05:05:41 GMT

A provision tucked in the $3.5 trillion reconciliation package would direct Congress to chart a path for citizenship for millions of undocumented people.

If passed, the House provision would provide a pathway to citizenship for those in the Deferred Action for Childhood Arrivals program, often referred to as Dreamers; farmworker workers; those who hold a temporary protected status, meaning they are unable to return to their countries; and essential workers. The Senate’s version also supports a pathway to citizenship for undocumented people, but doesn’t specify which groups would qualify.

There are more than 11 million undocumented people in the U.S., according to the Migration Policy Institute, a nonpartisan think tank that studies migration.

If passed, the provision could affect dozens of states with high immigrant populations such as Florida, California, Texas, Georgia, New Jersey, Virginia, Maryland and Pennsylvania, according to the Migration Policy Institute

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“Aside from being the moral thing to do, providing a pathway to lawful permanent resident (LPR) status for Dreamers, recipients of Temporary Protected Status (TPS), farmworkers, and essential workers will be a boon for our economy,” according to the House’s 2022 budget resolution, which provides reconciliation instructions to all committees. 

The Senate package provides the Senate Judiciary Committee with $107 billion for “lawful permanent status for qualified immigrants,” border security investments and the community violence intervention initiative. Lawmakers will have a soft deadline of Sept. 15.

House Speaker Nancy Pelosi (D-Calif.) said during a press conference that immigration reform would be included in the reconciliation package. 

“I do believe that immigration should be in the reconciliation, some piece of that in the reconciliation,” Pelosi said.

Hispanic Caucus opposition

Since the presidential election, immigration advocates have pushed for DACA to not only be written into law, but expanded to include family members of the recipients’, as well as wanting bigger reform on immigration policy.

Some states with large numbers of DACA recipients include Florida, Colorado, Missouri, Georgia, North Carolina, Nevada, New Mexico and Arizona, according to data from the U.S. Citizenship and Immigration Services and the 2016 Census.

But members of the House Congressional Hispanic Caucus raised opposition to policies that would undermine immigration reform, such as only allowing DACA recipients to be eligible for citizenship and excluding TPS holders, farmworkers and essential workers. 

“As the Senate undergoes the budget reconciliation process, we call on our colleagues to oppose provisions that would undermine immigration reform efforts,” the chair of the caucus, Rep. Raul Ruiz (D-Cali.) said in a joint statement. “The inclusion of any anti-immigrant amendment could threaten the package’s prospects in the House of Representatives.”

Some Republicans, such as Sens. Thom Tillis of North Carolina and John Cornyn of Texas have advocated for a separate provision to only allow DACA recipients to be eligible for citizenship. There are about 700,000 recipients protected under DACA. 

CHC Immigration Executive Orders and Budget Reconciliation Sub-Task Force Co-Chairs Reps. Veronica Escobar (D-Texas) and Adriano Espaillat (D-N.Y.) joined Ruiz’s statement as well, arguing that immigration reform would benefit the economy.

“The CHC remains a strong advocate for immigrant communities across our country and will continue working to ensure immigration is part of the budget reconciliation process, which will benefit our economy and our recovery,” they said.

A report by the Center for American Progress found that if Congress provided a pathway to citizenship for the nearly 11 million undocumented people in the U.S., the country’s gross domestic product would boost by $1.7 trillion over the next 10 years and create nearly half a million new jobs.

‘DACA is not enough’

Rep. Pete Aguilar (D-Calif.), the vice chair of the House Democratic Caucus, said that he had a meeting at the White House with the president, along with Senate Democratic Whip Dick Durbin of Illinois and Sen. Bob Menendez (D-N.J.) “to reiterate our support for reconciliation, including immigration proposals.”

Many immigrant advocacy groups have felt that immigration reform has fallen by the wayside with the Biden administration, so those groups are either hoping for change through the reconciliation process or pushing lawmakers to support their cause. 

“I know DACA is not enough and won’t stop fighting until everyone in my family and community is protected,” Yazmin Valdez, aDACA recipient and member of United We Dream Action, an immigration advocacy group, said in a statement.

Valdez, who was out canvassing in Arizona to advocate for support of pathways to citizenship for undocumented people, said that Arizona Democratic Sens. Kyrsten Sinema and Mark Kelly “must be reminded that it was Black, brown, and directly impacted communities who mobilized millions to turn Arizona blue and deliver them seats in office.”

“Now it’s time they use their critical role in the Senate to deliver what their constituents and the majority of Americans overwhelmingly support, citizenship for millions,” she said.

Tess Wilkes, a supervising attorney at Santa Fe Dreamers Project, a group in New Mexico that provides legal and advocacy services for immigrants, said she’s hoping to see bipartisan legislation for immigration reform, “but we haven’t seen that yet.”

“If this is the way that it has to happen then we are in support of it,” Wilkes said of reconciliation. 

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The post House reconciliation package would provide path to citizenship appeared first on Colorado Newsline.

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Ox Pro Rodless Cartridge Gun Review
Thu, 23 Dec 2021 17:34:21 GMT
Ox Pro Rodless Cartridge Gun Review

Ox Pro Rodless Caulk Gun works in tight spaces without sacrificing power

The Ox Pro Rodless Caulk Gun has a very unusual design compared to most caulk guns. We wanted to know what its strength is and whether its benefits are worth buying. So we invited some of our favorites and got to work.


benefits The pole-less design fits into smaller spaces Simple resetting of the piston Belt hook included Integrated tip cleaner More comfortable handle design than most cartridge guns disadvantage Using the Ox Pro Rodless Cartridge Gun

There is no question that Ox’s rodless design is very different from most cartridge guns on the market. Each time you pull the trigger, you move the plunger forward on the end of what is essentially a very strong tape measure blade.


When we started testing, our main concern was whether the blade could squeeze some of the toughest sealants we use without kinking. We loaded some OSI Quad Max sealant and left the tip with just a small opening. Despite the incredibly thick consistency and small opening, the pusher had the strength to apply it.

However, that’s not the ideal use for this weapon. With a thrust ratio of 7: 1, it is better suited for latex and silicone. Still, it’s nice to know that the mechanism is stronger than it needs to be.

To reset the plunger, press the silver release button on the back and send the black pusher on top of the tool forward. It’s a very simple reset process.

The rodless design is more than just a novelty. It gets into tighter spaces, especially when you’re at the start of a new tube.

Design highlights of the rodless cartridge pistol Ox Pro The riveted and reinforced cage has a durable construction Nylon handle is more comfortable than most metal handles Belt hook Pipe cleaning pin attached to the underside of the frame Ox Pro Rodless Cartridge Gun Price

Amazon is the best place to buy this. It costs $ 39.99 and is Prime ready. Ox gives a one-year guarantee on the cartridge pistol.

The bottom line

Although more expensive than standard sealing guns with rods, the Ox Pro Rodless sealing gun is really convenient to use. Even if you’re not working in particularly tight spaces, it’s more comfortable than most, and we certainly don’t miss a bar that protrudes backwards. Combined with a sturdy construction, we recommend Ox the next time you are looking for a new cartridge gun.

Specifications Model: OX-P044910 Thrust ratio: 7: 1 Capacity: 10 ounces Length: 13 1/2 inches Price: $ 39.99 1 year warranty The post Ox Pro Rodless Cartridge Gun Review first appeared on America's Firearms Newsource.
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An Anesthesiology Practice’s Busy Day in Court Collecting on Surprise Bills
Thu, 23 Dec 2021 14:52:05 GMT
An Anesthesiology Practice’s Busy Day in Court Collecting on Surprise Bills

Owen Loney’s surprise bill resulted from an emergency appendectomy in 2019 at a Richmond, Virginia, hospital.

Insurance covered most of the cost of the hospital stay, he said. He didn’t pay much attention to a bill he received from Commonwealth Anesthesia Associates and expected his insurance to cover it. A few months ago, he got a notice that Commonwealth was suing him in Richmond General District Court for $1,870 for putting him under during the surgery, court records show.

“Wow, seriously?” the 30-year-old information technology manager recalled thinking after getting the court summons. Loney didn’t have that kind of money at hand. His plan was to try to negotiate down the amount or “take out another credit card to pay for it.”

Loney’s is a classic, notorious type of surprise bill that Congress and activists have worked for years to eliminate: an out-of-network charge not covered by insurance even though the patient had an emergency procedure or sought care at an in-network hospital thinking insurance would cover most charges.

Commonwealth said it was in-network for Loney’s insurer, UnitedHealthcare. But the insurer rejected the anesthesiology charge because it said his primary care doctor was out of network, claims records show.

The federal No Surprises Act, passed at the end of 2020, has been hailed by consumer advocates for prohibiting such practices. Starting Jan. 1, medical companies in most cases cannot bill patients more than in-network amounts for any emergency treatment or out-of-network care delivered at an in-network hospital.

But as much as the legislation is designed to protect millions of patients from unexpected financial consequences, it will hardly spare all consumers from medical billing surprises.

“It’s great that there will be surprise billing protections … but you’re still going to see lawsuits,” said Zack Cooper, an economist and associate professor at the Yale School of Public Health. “This is by no means going to get rid of all of the problems with billing.”

The law will kick in too late for Loney and many others saddled with surprise out-of-network bills in states that don’t already ban the practice.

“It doesn’t prohibit surprise bills that are happening now in states that don’t have protections” against them, said Erin Fuse Brown, a law professor at Georgia State University who studies hospital billing. “And it doesn’t prohibit collection activity for surprise bills that arose prior to January.”

Virginia’s surprise-bill protection law took effect only this year and doesn’t apply to self-insured employer health plans, which cover a large portion of residents.

The federal legislation also does nothing to reduce another kind of unpleasant, often surprising bill — large, out-of-pocket payments for in-network medical care that many Americans can’t afford and might not have realized they were incurring.

Two substantial changes in recent years shifted more risk to patients. Employers and other payers narrowed their provider networks to exclude certain high-cost hospitals and doctors, making them out of network for more patients. They also drastically increased deductibles — the amount patients must pay each year before insurance starts contributing.

The No Surprises Act addresses the first change. It does nothing to address the second.

For a snapshot of the past and future of surprise and disputed medical bills, KHN examined Commonwealth’s lawsuits against patients in central Virginia and attended court hearings where patients contested their bills.

“The whole thing with insurance not covering my bills is a headache,” said Melissa Perez-Obregon, a Richmond-area dance teacher whom Commonwealth sued for $1,287 over services she received during the 2019 birth of her daughter, according to court records. Her insurance paid most but not all of a $5,950 anesthesia charge, billing records show.

“I’m a teacher,” she said, standing in the lobby at Chesterfield County General District Court. “I don’t have this kind of extra money.”

Commonwealth is one of the more active creditors seeking judgments in the Richmond area, court records show. From 2019 through 2021, it filed nearly 1,500 cases against patients claiming money owed for treatment, according to the KHN analysis of court filings.

In numerous cases, it initiated garnishment proceedings, in which creditors seize a portion of patients’ wages.

Describing itself as “the largest private anesthesiology practice in Central Virginia,” Commonwealth said it employs more than 100 clinicians who care for roughly 55,000 patients a year in hospitals and surgery centers, mostly in the Richmond area.

Commonwealth said more than 99% of the patients it treats are members of insurance plans it accepts. It garnishes wages only as a “last resort” and only if the patient has the ability to pay, Michael Williams, Commonwealth’s practice administrator, said in a written statement.

“Over the past three years we have filed suit to collect from just over 1% of our patients,” mostly for money owed for in-network deductibles or coinsurance, Williams said. Nearly half the bills are settled before the court date, he said.

Gwendolyn Peters, 67, said she was shocked to receive a court summons this summer. Commonwealth was suing her for $1,000 for anesthesia during a lumpectomy for breast cancer in 2019, according to court records.

“This is the first time I have ever been in this situation,” she said, sitting in the Chesterfield court with half a dozen other Commonwealth defendants.

Because patients typically have little or no control over who puts them under, Brown said, anesthesiologists face less risk to their businesses and reputations than other medical specialists do in using aggressive collections tactics.

The specialty is often “one of the worst offenders because they don’t depend on their reputation to get patients,” she said. “They’re not going to lose business because they engage in these really aggressive practices that ruin their patients’ finances.”

The average annual deductible for single-person coverage from job-based insurance has soared from $303 to $1,434 in the past 15 years, according to KFF. Deductibles for family coverage in many cases exceed $4,000 a year. Coinsurance — the patient’s responsibility after the deductible is met — can add thousands of additional dollars in expenses.

That means millions of patients are essentially uninsured for care that might cost them a substantial portion of their income. Surveys have repeatedly found that many consumers say they would have trouble paying an unexpected bill of even a few hundred dollars.

Loney’s insurer, UnitedHealthcare, agreed to pay the bill from Commonwealth for his emergency appendectomy after being contacted by KHN and saying it “updated” information on the claim. Otherwise, Loney said, he couldn’t have paid it without borrowing money.

In Richmond-area courthouses, hearings for Commonwealth lawsuits take place every few months. A lawyer for the anesthesiology practice attends, sometimes making payment arrangements with patients. Many defendants don’t show up, which often means they lose the case and might be subject to garnishment.

Commonwealth sued retiree Ronda Grimes, 66, for $1,442 for anesthesia claims her insurance didn’t cover after a 2019 surgery, billing and legal records filed in Richmond General District Court show.

“That’s a lot of money, especially when you have health insurance,” she said.

New research by Cooper and colleagues examining court cases in Wisconsin shows that medical lawsuits are disproportionately filed against people of color and people living in low-income communities.

“Physicians are entitled to get paid like everyone else for their services,” Cooper said. But unaffordable, out-of-pocket medical costs are “a systemic issue. And this systemic issue generally falls on the backs of the most vulnerable in our population.”

For uninsured patients, Commonwealth matches any financial assistance given by the hospital and will be “enhancing” its financial assistance program in 2022, Williams said.

Two of the nine people being sued by Commonwealth and interviewed by KHN at courthouse hearings were Hispanic. Four were Black.

One was Darnetta Jefferson, 61, who underwent a double mastectomy in early 2020 and came to court wearing a cancer-survivor shirt. Commonwealth sued her for $836 it said she owed in coinsurance for anesthesia she was given during the surgery. Commonwealth’s lawyer agreed to drop the lawsuit if she agreed to pay $25 a month toward the balance until it’s paid, she said.

“If I ever have some extra money to pay it off someday, I will,” said Jefferson, who worked at Ukrop’s supermarket for many years before her cancer forced her to go on disability. “But right now, my circumstances are not looking good.”

Although she is living on a reduced income, her rent just went up again, said Jefferson, who also survived lung cancer diagnosed in 2009. Rent now runs close to $1,000 a month.

Paying Commonwealth’s bill in monthly $25 increments, she said, means “it’s going to be a long way to go.”

Jay Hancock:
jhancock@kff.org,
@JayHancock1

The post An Anesthesiology Practice’s Busy Day in Court Collecting on Surprise Bills first appeared on DAILY CALIFORNIA PRESS.
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Rural Communities Left Hurting With out a Hospital, Ambulance or Docs Close by
Thu, 23 Dec 2021 16:26:52 GMT


STATENVILLE, Ga. — Georgia’s Echols County, which borders Florida, could be called a health care desert.

It has no hospital, no local ambulances. A medical provider comes to treat patients at a migrant farmworker clinic but, other than a small public health department with two full-time employees, that’s about the extent of the medical care in the rural county of 4,000 people.

In an emergency, a patient must wait for an ambulance from Valdosta and be driven to a hospital there, or rely on a medical helicopter. Ambulances coming from Valdosta can take up to 20 minutes to arrive, said Bobby Walker, county commission chairman. “That’s a pretty good wait for an ambulance,” he added.

Walker tried to establish an ambulance service based in Statenville, the one-stoplight county seat in Echols, but the cost of providing one was projected at $280,000 a year. Without industry to prop up the tax base, the county couldn’t come up with that kind of money.

In many ways, Echols reflects the health care challenges faced in rural areas nationwide, such as limited insurance coverage among residents, gaps in medical services and shortages of providers.

Dr. Jacqueline Fincher, an internal medicine physician who practices in rural Thomson, in eastern Georgia, said such communities have a higher share of people 65 and older, who need extensive medical services, and a much higher incidence of poverty, including extreme poverty, than the rest of the country.

About 1 in 4 Echols residents has no health insurance, for example, and almost one-third of the children live in poverty, according to the County Health Rankings and Roadmaps program from the University of Wisconsin’s Population Health Institute.

Like Echols, several Georgia counties have no physician at all.

It’s difficult to recruit doctors to a rural area if they haven’t lived in such an environment before, said Dr. Tom Fausett, a family physician who grew up and still lives in Adel, a southern Georgia town.

About 20% of the nation lives in rural America, but only about 10% of U.S. physicians practice in such areas, according to the National Conference of State Legislatures.

And 77% of the country’s rural counties are designated as health professional shortage areas. About 4,000 additional primary care practitioners are needed to meet current rural health care needs, the Health Resources and Services Administration has estimated.

“Many physicians haven’t experienced life in a rural area,” said Dr. Samuel Church, a family medicine physician who helps train medical students and residents in the northern Georgia mountain town of Hiawassee. “Some of them thought we were Alaska or something. I assure them that Amazon delivers here.”

Rural hospitals also have trouble recruiting nurses and other medical personnel to fill job vacancies. “We’re all competing for the same nurses,” said Jay Carmichael, chief operating officer of Southwell Medical, which operates the hospital in Adel.

Even in rural areas that have physicians and hospitals, connecting a patient to a specialist can be difficult.

“When you have a trauma or cardiac patient, you don’t have a trauma or cardiac team to take care of that patient,” said Rose Keller, chief nursing officer at Appling Healthcare in Baxley, in southeastern Georgia.

Access to mental health care is also a major problem, said Dr. Zita Magloire, a family physician in Cairo, a city in southern Georgia with about 10,000 residents. “It’s almost nonexistent here.”

Dr. Zita Magloire, a family physician in Cairo, Georgia, says access to mental health treatment for patients is a major problem in rural areas. “It’s almost nonexistent here,” she says.(Andy Miller/KHN)

A map created at Georgia Tech shows wide swaths of rural counties without access to autism services, for example.

One factor behind this lack of health care providers is what rural hospital officials call the “payer mix.”

Many patients can’t pay their medical bills. The CEO of Emanuel Medical Center in Swainsboro, Damien Scott, said 37% of the hospital’s emergency room patients have no insurance.

And a large share of rural hospitals’ patients are enrolled in Medicaid or Medicare. Medicaid typically pays less than the cost of providing care, and although Medicare reimbursements are somewhat higher, they’re lower than those from private insurance.

“The problem with rural hospitals is the reimbursement mechanisms,” said Kirk Olsen, managing partner of ERH Healthcare, a company that manages four hospitals in rural Georgia.

Georgia is one of 12 states that have not expanded their Medicaid programs under the Affordable Care Act. Doing so would make additional low-income people eligible for the public insurance program. Would that help? “Absolutely,” said Olsen, echoing the comments of almost everyone interviewed during a monthslong investigation by Georgia Health News.

“If Medicaid was expanded, hospitals may become more viable,” said Dr. Joe Stubbs, an internist in Albany, Georgia. “So many people go into a hospital who can’t pay.”

Echols County isn’t the only place where ambulance service is spotty.

Ambulance crews in some rural areas have stopped operating, leaving the remaining providers to cover greater distances with limited resources, said Brock Slabach, chief operations officer of the National Rural Health Association. It’s difficult for a local government to afford the cost of the service when patient volumes in sparsely populated rural areas are very low, he said.

“If people aren’t careful, they’re going to wake up and there’s not going to be rural health care,” said Richard Stokes, chief financial officer of Taylor Regional Hospital in Hawkinsville, Georgia. “That’s my big worry.”

Andy Miller:
amiller@kff.org,
@gahealthnews

The post Rural Communities Left Hurting With out a Hospital, Ambulance or Docs Close by first appeared on DAILY GADGET AND GIZMOS NEWS.
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Catholic Sacred Heart of Jesus Church in Tampa
Thu, 23 Dec 2021 15:46:26 GMT
Catholic Sacred Heart of Jesus Church in Tampa

Located along Florida Avenue in downtown Tampa is one of the city’s oldest churches.

The Sacred Heart Catholic Church was built in 1905 and has 18 original stained glass windows. The church is elegant and has the look and feel of a European cathedral.

Sacred Heart will hold church services this weekend on Christmas Eve (4:00 pm, 6:00 pm, 8:00 pm, 11:00 pm) and on Christmas Day (7:30 am, 9:00 am, 10:30 am, 12:00 pm).

You can also take part in a historical lecture and guided tour every second and fourth Sunday of the month.

Zack Perry with Taste and See Tampa Bay takes us inside with a drone.

Click here for more info.

The post Catholic Sacred Heart of Jesus Church in Tampa first appeared on Daily Florida Press.
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Watch: One Metropolis’s Effort to Increase Vaccination Charges Amongst Black Residents
Thu, 23 Dec 2021 17:28:30 GMT




December 23, 2021


About 72% of Americans have received at least one dose of a covid-19 vaccine. During much of the vaccine rollout, Hispanic and Black Americans have been less likely than white Americans to get vaccinated. The gap between white and Hispanic Americans has largely closed, but the vaccination rate for the Black community still lags significantly behind. KHN correspondent Sarah Varney and PBS NewsHour producer Jason Kane report on how Hartford, Connecticut, has tried to close the gap in vaccination rates.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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The post Watch: One Metropolis’s Effort to Increase Vaccination Charges Amongst Black Residents first appeared on DAILY GADGET AND GIZMOS NEWS.
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Cowboys BREAKING: What Dallas will do next if Malik Hooker joins the COVID list
Thu, 23 Dec 2021 20:12:55 GMT
Cowboys BREAKING: What Dallas will do next if Malik Hooker joins the COVID list

FRISCO – The Dallas Cowboys opened the day here at The Star on Thursday by announcing that rookie wide receiver Simi Fehoko tested positive for COVID-19 and is getting into the protocol. Unfortunate but not a huge chunk in terms of squad impact as the 10-4 cowboys prepare to host the Washington Football team.

But at the same time as head coach Mike McCarthy was telling us about this news, he also mentioned that a second player who appears to be symptomatic is being tested.

And now we know: Malik Hooker’s playmaker security goes into the record.

Fehoko and Hooker join defensive line coach Aden Durde, special teams assistant Matt Daniels, and defensive tackle Trysten Hill on the COVID-19 protocol for Dallas. … as well as reserve running back JaQuan Hardy, who is moving to the COVID reserve list today. Hardy was recently added to the roster after Tony Pollard suffered a foot injury.

Hooker got about 50 percent of the snapshots revolving around Dallas’ very improved defense. He could theoretically return for Sunday night’s game depending on his status and how he fares on the upcoming Tests over the next few days, but the Cowboys plan to move on without him.

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Cowboys BREAKING: What’s next when Malik Hooker is OUT?

And now we know the second man of the day: Playmaker safety Malik Hooker goes into the protocol.

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It is noteworthy that Donovan Wilson is now practicing in safety and is authorized to leave the IR.

Hooker just made his first interception of the year against the Giants last week.

In the meantime, the cowboys informed the small list of us allowed on The Star that next week in terms of media access would likely be an “all virtual” week, another nod to COVID.

A91C2D7C-058B-42DF-B537-C1CC742294CF202EF1C7-FDFB-40AE-B5A2-F19121732966B8033B64-7838-4280-9E2D-15216B6BF05DE3EA0C6E-C0C3-4C01-880A-67FE357F2F11679C823E-73AB-4036-B826-B5B8512B77511B78C551-2411-498B-91BC-61FF161B8C8A9F0BDA39-64EF-488B-A77D-41EB96FFDC2E0D75F792-28F0-40D9-9B8A-B62CB242B7DF32A3BE64-DC29-45D0-BFAF-E488E376E7A0CB8DCB0D-6C08-41B2-8A2A-86DE6AC74015A3D9760B-86BB-4A01-8A01-52DC880D1D81A88E4976-7184-4338-8D66-96E4CA50BA418B688216-68EB-412A-B694-FEB2CE1B4E0F5D694A0B-5EE8-479D-9A59-4BF32D7A836A

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The post Cowboys BREAKING: What Dallas will do next if Malik Hooker joins the COVID list first appeared on DAILY TEXAS NEWS.
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Wie ‘Let’s Go Brandon’ das Bewusstsein für die Interessenvertretung in der häuslichen Pflege weckte
Sat, 13 Nov 2021 14:37:26 GMT
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Europäische Sommerzeit. Lesezeit: 7 Minuten

Als das Jahr 2020 begann, begannen die Anwohner Lynn Weidner und Brandon Kingsmore gerade erst, sich für bessere Bedingungen und Löhne für häusliche Pflegekräfte einzusetzen. ein Thema, das ihnen am Herzen liegt. Quick zwei Jahre später hat ihre Advocacy-Arbeit internationale Medienaufmerksamkeit erhalten, die nicht unbedingt aus den von ihnen erwarteten Gründen gedacht wurde.

Kingsmore lebt mit spastischer tetraplegischer Zerebralparese und benötigt für viele seiner täglichen Aktivitäten Unterstützung. Das Paar hat sich vor 11 Jahren kennengelernt, und Weidner ist seit neun Jahren sein hauptberuflicher Hausmeister.

Weidner erwarb 2003 ihre Lizenz zur zertifizierten Krankenpflegehelferin und während ihrer gesamten Karriere im Gesundheitswesen hat sie die Kämpfe, mit denen Hauspflegekräfte konfrontiert sind, wie niedrige Löhne und fehlende Leistungen, aus erster Hand miterlebt.

„Als ich 2003 anfing, in Pflegeheimen zu arbeiten, verdiente ich 13 Greenback die Stunde, und derzeit verdiene ich als Heimpfleger (18 Jahre später) zwölf Greenback und fünfzig Cent“, sagte Weidner, der in Hellertown aufgewachsen ist und derzeit lebt in Allentown.

Weidners Gehalt wird durch Geld finanziert, das Kingsmore über Medicaid erhält. Dies wird als verbraucherorientiertes Modell der häuslichen Pflege bezeichnet.

Laut der Web site der United Residence Care Staff of Pennsylvania (UHCWP) beträgt der durchschnittliche Stundenlohn für Hauspflegekräfte in Pennsylvania 10,26 USD, und zwei von fünf verbraucherorientierten Hauspflegekräften verlassen jedes Jahr ihren Arbeitsplatz.

Trotzdem zog Weidner schnell die individuelle Betreuung als Heimpflegerin an, die sie dem schnelllebigen „Förderband“-System, das sie aus Pflegeheimen gewohnt struggle, vorzog.

„Mein Hauptziel in der häuslichen Pflege ist es, die Menschen in ihre Gemeinschaften einzubeziehen“, sagte Weidner. “Was ich wirklich tun wollte, ist, das Leben der Menschen zu unterstützen und zu verbessern.”

Verbesserte Löhne und Bedingungen für häusliche Pflegekräfte, dachte Weidner, würden mehr Menschen für den Bereich gewinnen.

„Es gibt nicht genug Pflegekräfte, um sich um alle Menschen zu kümmern, die die Hilfe tatsächlich benötigen“, sagte sie.

Mehr häusliche Pflegekräfte würden es mehr Amerikanern ermöglichen, die medizinische Hilfe zu erhalten, die sie in einer von ihnen bevorzugten Umgebung benötigen. Eine aktuelle Umfrage der American Advisors Group fanden heraus, dass 90 Prozent der Senioren lieber zu Hause bleiben, als in eine Einrichtung für betreutes Wohnen umzuziehen.

Weidners Wunsch, sich stärker im Kampf für bessere Arbeitsbedingungen in der häuslichen Pflege zu engagieren, führte sie zu UHCWP, einer Ortsgruppe der Service Workers Worldwide Union (SEIU), der sie im November 2019 beigetreten struggle. Mit der Gewerkschaft fühlte sie sich plötzlich wie sie hatte eine Stimme, um für Veränderungen einzutreten.

„Als Heimpfleger haben Sie nicht wirklich das Gefühl, dass die Leute Ihnen zuhören. Wenn Sie mit Ihrem Vertreter sprechen wollten, tätschelten sie Ihnen den Kopf und schickten Sie auf den Weg“, sagte sie. „Plötzlich habe ich eine ganze Gruppe von Menschen hinter mir und eine ganze Reihe von Pflegekräften, die auch die gleichen Probleme haben. Es ist additionally wie in dieser Gemeinschaft, in der wir uns gegenseitig unterstützen und uns auf höchstem Niveau einsetzen. ”

Kingsmore habe sich von Anfang an auch stark für Verbesserungen im Bereich der häuslichen Pflege eingesetzt, sagte Weidner.

„Brandon struggle hundertprozentig bei mir“, sagte sie. “Er hat eine erstaunliche Geschichte und eine erstaunliche Fähigkeit, mit Menschen in Kontakt zu treten.”

Ihre Fürsprachearbeit brachte Weidner eine Einladung zu einem Runden Tisch ein, der im Januar 2020 von US-Senator Bob Casey (D-PA) veranstaltet wurde. Die Anwesenden sammelten Unterstützung für den Inexpensive Care Act, auf den sich einige Heimpfleger bei der Krankenversicherung verlassen.

Schon kurz nach der Veranstaltung waren die weitreichenden Auswirkungen der COVID-19-Pandemie auf der ganzen Welt zu spüren. Hauspflegekräfte, sagte Weidner, seien von der Pandemie besonders hart getroffen worden. Sie erklärte, dass ein Großteil der Unterstützung, die andere Mitarbeiter des Gesundheitswesens während der Pandemie erhalten haben, nicht für häusliche Pflegekräfte bereitgestellt wird.

„Wir sind jetzt Mitarbeiter des Gesundheitswesens, die in einer Pandemie arbeiten, aber wir haben keine Vorteile. Wir haben oft nicht einmal PSA“, sagte sie. „Ich muss mir Handschuhe bei Sam’s Membership kaufen, und dann gibt es einen Run auf Handschuhe. Additionally kann ich jetzt keine Handschuhe kaufen und muss mit bloßen Händen mit Körperflüssigkeiten arbeiten.“

„Ich bin eine Heimpflegerin, die Masken aus Bettlaken näht, weil es für Heimpflegekräfte keine Masken gibt“, so Weidner weiter. “Sie wurden einfach nicht bereitgestellt.”

Weidner und Kingsmore setzten sich als Reaktion auf die Widrigkeiten weiter ein.

Sie sagte, sie hätten Anfang des Jahres an Pressekonferenzen mit US-Arbeitsminister Marty Walsh, Handelsministerin Gina Raimondo und Kongressabgeordneter Susan Wild (D-7) teilgenommen.

Sie führten auch Gespräche mit Ai-jen Poo, Direktorin der Nationwide Home Staff Alliance (NDWA), einer Bewegung, die sich der Vereinigung und Stärkung von Hausangestellten wie Kindermädchen, Hausputzern und Hauspflegekräften widmet.

Weidner und Kingsmore nahmen am 23. September an einer Kundgebung im US-Kapitol teil, die von der SEIU, NDWA und der American Affiliation of Individuals with Disabilities organisiert wurde. Die Kundgebung mit dem Titel „Care Cannot Wait“ unterstützte Bundesinvestitionen, um gewerkschaftliche Pflegejobs zu schaffen, den Zugang zu häuslicher Pflege zu erweitern und rassistische und geschlechtsspezifische Ungerechtigkeit von Pflegekräften zu bekämpfen.

Das ist ein Wickel! Unsere Forderungen als Pflegekräfte sind klar: INVEST IN CARE!

Jetzt ist es an der Zeit, zu handeln, Kongress. #CareCantWait #CareIsEssential pic.twitter.com/zqBDxvuZvi

— SEIU (@SEIU) 23. September 2021

“Wir haben mit all diesen Aktivisten gesprochen und all diese Pressekonferenzen seit Monaten gemacht”, sagte Weidner. „Das hat dazu geführt, dass wir die Gelegenheit haben, den Präsidenten in Scranton zu treffen.“

Präsident Joe Biden besuchte am 20. Oktober seine Heimatstadt Scranton, um die öffentliche Unterstützung für den Construct Again Higher Act zu gewinnen, eine große Ausgabenrechnung, die eine Vielzahl von Programmen umfasst, die arbeitenden Amerikanern helfen sollen. Der Gesetzentwurf sieht eine Investition von 150 Milliarden US-Greenback in die häusliche Pflegebranche vor.

Senator Casey lud die beiden nach Scranton ein, wo sie mit dem Präsidenten sprechen konnten.

„(Der Präsident) und Brandon hatten diese Verbindung. Ich weiß nicht einmal, wie ich das erklären soll“, sagte Weidner. „Brandon erzählte ihm, wie Menschen mit Behinderungen auf die häusliche Pflege angewiesen sind und dass die häuslichen Pflegekräfte für sein Leben so wichtig sind.“

Das Paar wurde zu einem Fototermin mit dem Präsidenten eingeladen, wo sie weitere Geschichten über ihre Fürsprache teilten.

„Ich wurde nervös und (Brandon) struggle cool wie eine Gurke, aber es struggle wirklich eine tolle Erfahrung“, sagte Weidner.

Weidner und Kingsmore wurden während seines Besuchs in Scranton im Oktober zu einem Treffen mit Präsident Joe Biden eingeladen. Kurz nach der Veranstaltung fragte das Web, ob das Treffen als Reaktion auf das Professional-Trump-Mem “Let’s go Brandon” geplant struggle.

Was Weidner und Kingsmore nicht erwartet hatten, struggle die spätere Medienaufmerksamkeit, die ihr Besuch beim Präsidenten auf sich ziehen würde.

In den Wochen vor ihrem Besuch wurde der Satz „Let’s go Brandon“ zu einem beliebten Euphemismus, der „f – Joe Biden“ bedeutet. Das Mem stammt von einem NASCAR-Occasion am 2. Oktober, bei dem ein Reporter die Followers verwechselte, die den vulgären Satz mit den Worten “Lass uns Brandon” skandierten.

Der Satz hat sich seitdem im Web und außerhalb verbreitet, wo er auf einer Vielzahl von Waren, einschließlich T-Shirts und Flaggen, aufgetaucht ist.

Der republikanische Senator Ted Cruz (R-TX) wurde mit dem Satz gefangen genommen während eines World Sequence-Spiels im letzten Monat, und ein Pilot von Southwest Airways benutzte den Satz, als er Passagiere vor einem Flug von Houston am 29. Oktober ansprach.

Nach dem offiziellen POTUS Twitter-Account twitterte ein Video von Kingsmore, das mit dem Präsidenten spricht Am 22. Oktober dachten viele Internetnutzer, dass das Treffen zwischen Biden und einem Mann namens Brandon eine orchestrierte Reaktion auf das wachsende Mem struggle.

Ich kämpfe jeden Tag dafür, dass Leute wie Brandon meine Construct Again Higher Agenda verabschieden. Seine Geschichte ist wie so viele, die ich im ganzen Land gehört habe. Die Leute suchen nur nach einer Kampfchance und danach, mit der Würde behandelt zu werden, die sie verdienen – und darum geht es bei meiner Agenda. pic.twitter.com/GFm9AShbEe

Präsident Biden (@POTUS) 22. Oktober 2021

Später an diesem Tag On-line-Nachrichtenpublikationen, wie die britische On-line-Zeitung The Impartial, veröffentlichte Geschichten, in denen spekuliert wurde, ob das Treffen eine Reaktion auf das virale Mem struggle.

„Mit der Publicity danach habe ich nicht gerechnet“, sagte Weidner. “Ich glaube, keiner von uns hat es getan.”

“Ich hatte von (dem Satz) gehört, aber es struggle so nebenbei, dass ich nicht wirklich an ‘Oh, sein Identify ist Brandon’ und ‘Lass uns Brandon geht’ dachte”, fuhr sie fort.

Weidner bemerkte dann herablassende Kommentare als Reaktion auf den Tweet. Sie sagte, sie habe Kommentare gesehen, in denen behauptet wurde, Kingsmore werde manipuliert und als Geisel gehalten, und sie seien nach Scranton eingeladen worden, um dem Präsidenten eine Möglichkeit zu geben, das virale Mem „zu beseitigen“.

„Ich antwortete ihnen wie: ‚Sie spielen die ganze Arbeit herunter, die wir gemacht haben, um an diesen Punkt zu kommen’“, sagte Weidner. „Brandon ist nicht nur irgendein Sort im Rollstuhl, weißt du? Er ist ein erwachsener Mann, der hart gearbeitet hat, um sich zu verteidigen.“

Nicht alle Interaktionen seien negativ gewesen, sagte Weidner. Eine Twitter-Nutzerin, ein Mädchen aus Großbritannien, schickte ihr eine Direktnachricht über die Lobbyarbeit, die sie und Kingsmore geleistet haben. Weidner sagte, das Mädchen habe keine Ahnung von den Kämpfen, mit denen Hauspflegekräfte in Amerika konfrontiert seien.

Tatsächlich sagte Weidner, dass die Publicity, die der Tweet anzog, dazu beigetragen habe, genau die Themen ins Rampenlicht zu rücken, für die sie und Kingsmore sich eingesetzt hatten, um sich zu ändern.

„Ich habe das Gefühl, dass die Leute, die ‘Let’s go Brandon’ trollen, Biden schlecht aussehen lassen wollten, aber was es wirklich tat, struggle, Brandon und seine Rolle in der Fürsprache in der häuslichen Pflege hervorzuheben und wie wichtig die häusliche Pflege ist. weil das viel mehr Leute gesehen haben“, sagte sie.

Die Anwaltschaftsarbeit von Weidner und Kingsmore ist noch lange nicht abgeschlossen. Während die Aufnahme von Investitionen in die häusliche Pflege in die Agenda für einen besseren Construct Again von vielen als positiver Schritt nach vorne angesehen wird, sind andere der Meinung, dass sie den Anliegen der häuslichen Pflegekräfte und ihrer Verbraucher nicht ausreichend Rechnung trägt.

Bidens Verwaltung ursprünglich eine Investition von 400 Milliarden US-Greenback in die häusliche Pflege vorgeschlagen als Teil ihres American Jobs Plan (AJP). Viele der im Rahmen des AJP enthaltenen Initiativen wurden stattdessen in das parteiübergreifende Infrastrukturgesetz und den Construct Again Higher Act aufgenommen, wo diese Investitionen bereits deutlich auf 150 Milliarden US-Greenback gekürzt wurden.

Es bleibt abzuwarten, wie viel von dieser 150-Milliarden-Greenback-Investition übrig bleibt, nachdem die Tagesordnung des Gesetzentwurfs von Mitgliedern des Repräsentantenhauses und des Senats erörtert wurde.

„Wir feiern zwar die Arbeit, die wir bisher geleistet haben, wissen aber, dass sie noch lange nicht zu Ende ist“, sagte Matthew Yarnell, Präsident von SEIU Healthcare Pennsylvania.

Ein Teil der jüngsten Lobbybemühungen von Weidner und Kingsmore zielte darauf ab, Pandemie-Hilfsgelder für häusliche Pflegekräfte zu sichern. Weidner sagte, das Pennsylvania Division of Human Companies habe über den American Rescue Plan Geld erhalten, aber dieses Geld sei noch nicht an die häuslichen Pflegekräfte ausgezahlt worden.

„Wir warten und warten auf dieses Geld, und wir müssen Druck auf unsere Vertreter ausüben“, sagte sie. „Jeder, der kann, rufen Sie Ihre Vertreter an und sagen Sie ihnen, warum häusliche und gemeindebasierte Dienste wichtig sind und warum sie glauben, dass dieses Geld für uns bereitgestellt werden sollte.“

Staatssenatorin Lisa Boscola (D-18) kann in ihrem Büro in Bethlehem unter der Telefonnummer (610) 868-8667 oder per SMS (610) 756-2432 erreicht werden.

Staatsrepräsentant Robert Freeman (D-136) erreichbar unter (610) 253-5543.

Staatsrepräsentant Milou Mackenzie (R-131) erreichbar unter (610) 965-5830.

The post Wie ‘Let’s Go Brandon’ das Bewusstsein für die Interessenvertretung in der häuslichen Pflege weckte first appeared on LABOR NEWS WIRE.
Category: SEIU
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Norwin makes provisional pact with teachers and canteen workers
Sun, 14 Nov 2021 12:39:36 GMT
4438250_web1_web-norwinhigh

Norwin has preliminary contracts with its academics’ union and canteen employees.

The college board is anticipated to vote on the contract with the Norwin Training Affiliation and the settlement with the Service Staff Worldwide Union 32 BJ on Monday. Particulars of the preparations weren’t included on the agenda for the November eight faculty committee assembly, and the board didn’t focus on the provisional pacts.

Superintendent Jeff Taylor was unavailable for remark.

The NEA represents round 320 academics, profession counselors and faculty nurses. His five-year contract expired on August 31. The academics have been on responsibility since courses started on September eighth.

Through the time period of the expired contract, the will increase granted to academics elevated the district’s annual payroll by 2.94%. This proportion enhance takes into consideration new instructor medical health insurance contributions which were returned to the varsity district.

Ryan Lynn, a Hillcrest Intermediate Faculty instructor and president of the Norwin Training Affiliation, declined to remark.

The preliminary contract with SEIU Native 32 BJ contains round 35 canteen employees.

In August, cafeteria employees complained to the varsity board that Norwin’s provide of an annual elevate of $ 0.20 an hour for a brand new two-year contract was “not a good elevate,” stated Jackie Kucera, chief steward for Norwin cafeteria employees .

Julie Karant, a spokeswoman for SEIU Native 32 BJ, was unavailable Wednesday for remark.

Joe Napsha is a contributor to Tribune Evaluation. You possibly can contact Joe at 724-836-5252, jnapsha@triblive.com, or on Twitter.

The post Norwin makes provisional pact with teachers and canteen workers first appeared on LABOR NEWS WIRE.
Category: SEIU
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Russian women, hanyu in Japan on the hunt for winter Olympic programs
Thu, 23 Dec 2021 17:12:28 GMT
Russian ladies, hanyu in Japan on the hunt for winter Olympic courses

The main focus of the determine skating world this week is solely on the japanese hemisphere.

The ladies’s Olympic favorites are prone to be introduced on the Russian nationwide championships, and two-time reigning gold medalist Yuzuru Hanyu will make his season debut on the Japanese championship.

Athletes from Russia gained solely three of the 15 medals in determine skating on the 2018 Winter Video games in Pyeongchang, together with gold for Alina Zagitova and silver for Evgenia Medvedeva within the ladies’s marquee.

With 4 of the highest 5 ladies skaters within the present world rankings, led by document champion Kamila Valiyeva, there’s a probability the Russian ladies will hit the medal podium if the Beijing Video games start in lower than six weeks.

“I imply, it is completely wonderful what they’re doing, particularly their technical components,” mentioned Karen Chen, who will attempt to type her second Olympic staff when the US holds its nationwide championships in early January.

“There isn’t any query how wonderful it’s to take action many quads and triple axels and issues like that,” mentioned Chen.

Valiyeva, who was simply 11 on the Pyeongchang Video games, would be the favourite when the Russian Championships begin on Thursday night and final by the weekend. She made her senior debut in October, successful Grand Prix assignments on the Skate Canada and Rostelecom Cups, whereas setting data for brief program, freestyle and complete factors.

Valiyeva’s complete rating of 272.71 is greater than 36 factors forward of the ladies’s second-highest rating this season.

And when you think about: she’s not even the highest-ranking Russian skater.

This title belongs to Anna Shcherbakova, who, like Valiyeva, is educated by the famend Eteri Tutberidze. The primary lady to land a Quad Lutz in a contest swept her personal Grand Prix appearances in Italy and France.

Valiyeva and Shcherbakova are pushed by Elizaveta Tuktamysheva, the world silver medalist; Alexandra Trusova, the world bronze medalist; Maya Khromykh, who has gained medals in her two Grand Prix appearances; and Sofia Samodurova, the previous European champion who got here third within the Budapest Trophy.

Alena Kostornaya, who has dominated worldwide competitors in recent times, however was compelled to withdraw from the nationwide staff as a result of a damaged hand, as reported by Russian tv, is absent from the sphere.

“The Olympics are a dream come true for many,” mentioned Johnny Weir, three-time US champion and now NBC determine skating analyst. “As an athlete, you do all the pieces to make this dream come true. Russian ladies are so dominant and so sturdy that will probably be troublesome for non-Russian ladies to land on the rostrum in Beijing. ”

Within the meantime, the boys will get probably the most consideration when Japan’s nationwide championships happen this weekend.

The 27-year-old Hanyu has sustained a lot of accidents since successful the Video games in Sochi and Pyeongchang and has but to compete in a world match this season as a result of an ankle damage. However Hanyu mentioned he intends to hit the three-peat in Beijing and that quest begins with a robust exhibiting from Japan internationals.

Hanyu’s greatest competitors on the Nationwide Championships might be his 2018 Olympic teammate, Shoma Uno, and Yuma Kagiyama.

“Beijing is an extension of all the pieces I do and I do know I might need to go all-in now,” Hanyu mentioned after Thursday’s follow session in Saitama, the place he mentioned he would strive the primary quad throughout his free time – Axel in competitors to land ice skate.

“I have been refining it for 2 years and a part of me says I ought to simply let it go. However then I labored on it for about an hour and a half, pushing and pushing myself, ”mentioned Hanyu. “I believed, ‘I’ve come this far.’ I am the one who jumps, however I owe that bounce to everybody. Many individuals have informed me that I’m the one one who is ready to do that. “

___

Extra AP Winter Olympics: https://apnews.com/hub/winter-olympics and https://twitter.com/AP_Sports

The post Russian women, hanyu in Japan on the hunt for winter Olympic programs first appeared on DAILY COLORADO NEWS.
Category: Olympics
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Rayo Vallecano simply handled Mallorca
Tue, 23 Nov 2021 04:52:52 GMT
Rayo Vallecano easily dealt with Mallorca

The team from the suburbs of Madrid continues to pleasantly surprise this season, as they reached their seventh victory in 14 matches played.

Rayo recorded a previous victory over Barcelona, ​​followed by a draw with Celta and a defeat by Real.

This time, Rayo Vallecano defeated Mallorca at home with 3: 1.

The scorers for the home team were Guardiola in the 16th minute, Garcia in the 20th minute and Trejo in the 61st minute, while the only goal for the guests was scored by Prats in the 89th minute.

La Liga, Round 14:

Levante – Bilbao 0: 0
Celta – Villarreal 1: 1
Sevilla – Alaves 2: 2
Atletico Madrid – Osasuna 1: 0
Barcelona – Espanyol 1: 0
Getafe – Cadiz 4: 0
Granada – Real Madrid 1: 4
Elche – Betis 0: 3
Real Sociedad – Valencia 0: 0
Rayo Vallecano – Mallorca 3: 1

Table:

Real Madrid 30
Real Sociedad 29
Seville 28
Atletico Madrid 26
Betis 24
Rayo Vallecano 23
Barcelona 20
Athletic Bilbao 19
Osasuna 19
Valencia 18
Espanyol 17
Villarreal 16
Mallorca 15
Alaves 14
Celta 13
Cadiz 12
Elche 11
Granada 11
Getafe 9
Levante 7

The post Rayo Vallecano simply handled Mallorca first appeared on Welcome to Serbia.
Category: Vallecano
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LDK Rama: We must work in Kodra e Trimave, to give it the greatness it deserves
Sun, 03 Oct 2021 16:12:12 GMT
LDK Rama: We must work in Kodra e Trimave, to give it the greatness it deserves

The candidate for mayor of Pristina from the ranks of LDK, Përparim Rama, has visited the neighborhood Kodra e Trimave, a neighborhood for which he said they should work for him, in order to give him the greatness he deserves.

“Kodra e Trimave is a very important neighborhood for our city and we must work for it, to give it the greatness it deserves,” Rama wrote on Facebook.

“Together with my team we visited Kodra e Trimave.

We walked long distances through the streets of this neighborhood. During the walk we were accompanied by a fruitful conversation with the citizens, with whom we talked about the conditions that this neighborhood lacks. “Residents had the most basic requests,” Rama said.

The post LDK Rama: We must work in Kodra e Trimave, to give it the greatness it deserves first appeared on Kosovo Now.
Category: Work
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Watch The Beat Highlights: Dec. 22
Thu, 23 Dec 2021 08:31:41 GMT


Watch highlights from Wednesday's The Beat with guest anchor Alicia Menendez The Beat airs weeknights at 6 p.m. on MSNBC.

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Mental disorders in adolescence in connection with absence from school and work
Thu, 23 Dec 2021 19:47:45 GMT

The diagnosis of adolescents with psychiatric disorders, particularly psychosis and autism spectrum disorder (ASD), is according to those published in The British Journal of Psychiatry.

The researchers analyzed socio-economic data and the medical history of a longitudinal study by the Finnish Institute for Health and Welfare of children born in Finland in 1987 without diagnosed intellectual disabilities.

Investigators found that 1,438 people (2.6%) had not been in employment, education, training, parental leave, and job seeker programs for at least 5 years. 65.1% of these people were male and 65% had no upper secondary education.

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In 44% of the cohort with long-term NEET in young adulthood, a psychiatric or neurodevelopmental disorder was diagnosed as an adolescent. Depressive disorders (20.1%) and anxiety disorders (16.6%) were the most common. People with ASD (44%) and psychosis (36.5%) were proportionally the most likely to experience long-term NEET.

The lack of an upper secondary level qualification had the highest effect size (OR 10.1 95% CI 9.0 – 11.2). A total of 10% of those who did not complete upper secondary education were later long-term NEETs.

The researchers found that 70.6% of those with ASD and 48.4% of those with psychosis experienced long-term NEET if they hadn’t completed upper secondary education.

Psychiatric or neurodevelopmental diagnoses in adolescence increased the likelihood of long-term NEET in young adulthood by 7.1-fold, the researchers found. ASD (OR 17.3 95% CI 11.5-26.0) and psychosis (OR 12.0 95% CI 9.5-15.2) had the highest effect sizes for long-term NEET.

Associations held for Asperger’s Syndrome (OR 29.4) and other ASD (OR 21.3) when analyzed individually. When the researchers excluded individuals with schizophrenia and schizoaffective disorder, the association was held for other types of psychosis (OR 14.5). Associations for other diagnostic categories remained when the researchers removed people with diagnosed substance use disorder, psychosis, or ASD.

Patients who received inpatient treatment when they were younger than 10 years were 7.3 times more likely to experience long-term NEET. Those who were hospitalized between 10 and 20 years of age were 11.5 times more likely to experience long-term NEET.

“Our finding of a clear link between major psychiatric diagnoses in adolescence and long-term NEET in young adulthood suggests that effective adolescent mental health services, including prevention, early intervention, social services and vocational rehabilitation, should be seen as important elements of a strategy to combat them Marginalization of young people, ”said the researchers.

“The combination of inclusive and targeted strategies could reduce individual suffering and the costs to society of long-term NEETs. The results of this study can serve as a starting point if the number of young people who are marginalized or suffer from psychiatric illnesses increases after the COVID-19 pandemic. “

Disclosure: A study author stated links with biotech, pharmaceutical, and / or device manufacturers. For a full list of author disclosures, see the original reference

relation

Ringbom I, Ringbom I, Suvisaari J, Kääriälä A, et al. Psychiatric disorders diagnosed in adolescence and subsequent long-term exclusion from education, employment or training: national longitudinal study of the birth cohort. Br. J. Psychiatry. Published online October 5, 2021. doi: 10.1192 / bjp.2021.146

This article originally appeared on Psychiatry Advisor

The post Mental disorders in adolescence in connection with absence from school and work first appeared on DAILYZ HEALTH NEWS.
Category: Neurological
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Rural Communities Left Hurting Without a Hospital, Ambulance or Doctors Nearby
Thu, 23 Dec 2021 16:42:15 GMT


STATENVILLE, Ga. — Georgia’s Echols County, which borders Florida, could be called a health care desert.

It has no hospital, no local ambulances. A medical provider comes to treat patients at a migrant farmworker clinic but, other than a small public health department with two full-time employees, that’s about the extent of the medical care in the rural county of 4,000 people.

In an emergency, a patient must wait for an ambulance from Valdosta and be driven to a hospital there, or rely on a medical helicopter. Ambulances coming from Valdosta can take up to 20 minutes to arrive, said Bobby Walker, county commission chairman. “That’s a pretty good wait for an ambulance,” he added.

Walker tried to establish an ambulance service based in Statenville, the one-stoplight county seat in Echols, but the cost of providing one was projected at $280,000 a year. Without industry to prop up the tax base, the county couldn’t come up with that kind of money.

In many ways, Echols reflects the health care challenges faced in rural areas nationwide, such as limited insurance coverage among residents, gaps in medical services and shortages of providers.

Dr. Jacqueline Fincher, an internal medicine physician who practices in rural Thomson, in eastern Georgia, said such communities have a higher share of people 65 and older, who need extensive medical services, and a much higher incidence of poverty, including extreme poverty, than the rest of the country.

About 1 in 4 Echols residents has no health insurance, for example, and almost one-third of the children live in poverty, according to the County Health Rankings and Roadmaps program from the University of Wisconsin’s Population Health Institute.

Like Echols, several Georgia counties have no physician at all.

It’s difficult to recruit doctors to a rural area if they haven’t lived in such an environment before, said Dr. Tom Fausett, a family physician who grew up and still lives in Adel, a southern Georgia town.

About 20% of the nation lives in rural America, but only about 10% of U.S. physicians practice in such areas, according to the National Conference of State Legislatures.

And 77% of the country’s rural counties are designated as health professional shortage areas. About 4,000 additional primary care practitioners are needed to meet current rural health care needs, the Health Resources and Services Administration has estimated.

“Many physicians haven’t experienced life in a rural area,” said Dr. Samuel Church, a family medicine physician who helps train medical students and residents in the northern Georgia mountain town of Hiawassee. “Some of them thought we were Alaska or something. I assure them that Amazon delivers here.”

Rural hospitals also have trouble recruiting nurses and other medical personnel to fill job vacancies. “We’re all competing for the same nurses,” said Jay Carmichael, chief operating officer of Southwell Medical, which operates the hospital in Adel.

Even in rural areas that have physicians and hospitals, connecting a patient to a specialist can be difficult.

“When you have a trauma or cardiac patient, you don’t have a trauma or cardiac team to take care of that patient,” said Rose Keller, chief nursing officer at Appling Healthcare in Baxley, in southeastern Georgia.

Access to mental health care is also a major problem, said Dr. Zita Magloire, a family physician in Cairo, a city in southern Georgia with about 10,000 residents. “It’s almost nonexistent here.”

Dr. Zita Magloire, a family physician in Cairo, Georgia, says access to mental health treatment for patients is a major problem in rural areas. “It’s almost nonexistent here,” she says.(Andy Miller/KHN)

A map created at Georgia Tech shows wide swaths of rural counties without access to autism services, for example.

One factor behind this lack of health care providers is what rural hospital officials call the “payer mix.”

Many patients can’t pay their medical bills. The CEO of Emanuel Medical Center in Swainsboro, Damien Scott, said 37% of the hospital’s emergency room patients have no insurance.

And a large share of rural hospitals’ patients are enrolled in Medicaid or Medicare. Medicaid typically pays less than the cost of providing care, and although Medicare reimbursements are somewhat higher, they’re lower than those from private insurance.

“The problem with rural hospitals is the reimbursement mechanisms,” said Kirk Olsen, managing partner of ERH Healthcare, a company that manages four hospitals in rural Georgia.

Georgia is one of 12 states that have not expanded their Medicaid programs under the Affordable Care Act. Doing so would make additional low-income people eligible for the public insurance program. Would that help? “Absolutely,” said Olsen, echoing the comments of almost everyone interviewed during a monthslong investigation by Georgia Health News.

“If Medicaid was expanded, hospitals may become more viable,” said Dr. Joe Stubbs, an internist in Albany, Georgia. “So many people go into a hospital who can’t pay.”

Echols County isn’t the only place where ambulance service is spotty.

Ambulance crews in some rural areas have stopped operating, leaving the remaining providers to cover greater distances with limited resources, said Brock Slabach, chief operations officer of the National Rural Health Association. It’s difficult for a local government to afford the cost of the service when patient volumes in sparsely populated rural areas are very low, he said.

“If people aren’t careful, they’re going to wake up and there’s not going to be rural health care,” said Richard Stokes, chief financial officer of Taylor Regional Hospital in Hawkinsville, Georgia. “That’s my big worry.”

Andy Miller:
amiller@kff.org,
@gahealthnews

The post Rural Communities Left Hurting Without a Hospital, Ambulance or Doctors Nearby first appeared on DAILY LEGAL PRESS.
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Tucson Desert View responds to adversity at Top Tucson Marana 46-28 | Football
Sat, 02 Oct 2021 11:35:32 GMT
Tucson Desert View responds to adversity at Top Tucson Marana 46-28 |  Football

Tucson Desert View put on their rally caps and found a fit in a high school football match in Arizona October 1 on Friday, dropping Tucson Marana 46-28.

The start wasn’t the problem for Tucson Marana, who started with a 14-12 lead over Tucson Desert View by the end of the first quarter.

The defense put both offensives in the second and third quarters into a deep sleep without a goal being scored.

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The post Tucson Desert View responds to adversity at Top Tucson Marana 46-28 | Football first appeared on Arizona Daily Press.
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As Patients Fell Ill With Covid Inside Hospitals, Government Oversight Fell Short
Thu, 23 Dec 2021 14:25:25 GMT



One by one, the nurses taking care of actress Judi Evans at Riverside Community Hospital kept calling out sick.

Patients were coughing as staffers wheeled the maskless soap opera star around the California hospital while treating her for injuries from a horseback fall in May 2020, Evans said.

She remembered they took her to a room to remove blood from her compressed lung where another maskless patient was also getting his lung drained. He was crying out that he didn’t want to die of covid.

No one had told her to wear a mask, she said. “It didn’t cross my mind, as I’m in a hospital where you’re supposed to be safe.”

Then, about a week into her hospital stay, she tested positive for covid-19. It left the 57-year-old hospitalized for a month, staring down more than $1 million in bills for treatment costs and suffering from debilitating long-haul symptoms, she said.

Hospitals, like Riverside, with high rates of covid patients who didn’t have the diagnosis when they were admitted have rarely been held accountable due to multiple gaps in government oversight, a KHN investigation has found.

While a federal reporting system closely tracks hospital-acquired infections for MRSA and other bugs, it doesn’t publicly report covid caught in individual hospitals.

Medicare officials, tapped by Congress decades ago to ensure quality care in hospitals, also discovered a gaping hole in their authority as covid spread through the nation. They could not force private accreditors — which almost 90% of hospitals pay for oversight — to do targeted infection-control inspections. That means Riverside and nearly 4,200 other hospitals did not receive those specific covid-focused inspections, according to a government watchdog report, even though Medicare asked accreditors to do them in March 2020.

Seema Verma, former chief of Medicare and Medicaid under President Donald Trump, said government inspectors went into nearly every nursing home last year. That the same couldn’t be done for hospitals reveals a problem. “We didn’t have the authority,” she told KHN. “This is something to be corrected.”

KHN previously reported that at least 10,000 patients nationwide were diagnosed with covid in hospitals last year after being admitted for something else — a sure undercount of the infection’s spread inside hospitals, since that data analysis primarily includes Medicare patients 65 and older.

Nationally, 1.7% of Medicare inpatients were documented as having covid diagnosed after being admitted for another condition, according to data from April through September 2020 that hospitals reported to Medicare. CDIMD, a Nashville-based consulting and data analytics company, analyzed the data for KHN.

At Riverside Community Hospital, 4% of the covid Medicare patients were diagnosed after admission — more than double the national average. At 38 other hospitals, that rate was 5% or higher. All those hospitals are approved by private accreditors, and 29 of them hold “The Gold Seal of Approval” from their accreditor.

To be sure, the data has limitations: It represents a difficult time in the pandemic, when protective gear and tests were scarce and vaccines were not yet available. And it could include community-acquired cases that were slow to show up. But hospital-employed medical coders decide whether a case of covid was present on admission based on doctors’ notes, and are trained to query doctors if it’s unclear. Some institutions fared better than others — while the American public was left in the dark.

Spurred by serious complaints, federal inspectors found infection-control issues in few of those 38 hospitals last year. In Michigan, inspectors reported that one hospital “failed to provide and maintain a sanitary environment resulting in the potential for the spread of infectious disease to 151 served by the facility.” In Rhode Island, inspectors found a hospital “​​failed to have an effective hospital-wide program for the surveillance and prevention” of covid.

KHN was able to find federal inspection reports documenting infection-control issues for eight of those 38 hospitals. The other 30 hospitals around the country, from Alabama to Arizona, had no publicly available federal records of infection-control problems in 2020.

KHN found that even when state inspectors in California assessed hospitals with high rates of covid diagnosed after admission, they identified few shortcomings.

“The American public thinks someone is watching over them,” said Lisa McGiffert, co-founder of the Patient Safety Action Network, an advocacy group. “Generally they think someone’s in charge and going to make sure bad things don’t happen. Our oversight system in our country is so broken and so untrustworthy.”

The data shows that the problem has deadly consequences: About a fifth of the Medicare covid patients who were diagnosed after admission died. And it was costly as well. In California alone, the total hospital charges for such patients from April through December last year was over $845 million, according to an analysis done for KHN by the California Department of Health Care Access and Information.

The Centers for Disease Control and Prevention has pledged funding for increased infection-control efforts — but that money is not focused on tracking covid’s spread in hospitals. Instead, it will spend $2.1 billion partly to support an existing tracking system for hospital-acquired pathogens such as MRSA and C. diff.

The CDC does not currently track hospital-acquired covid, nor does it plan to do so with the additional funding. That tracking is done by another part of the U.S. Department of Health and Human Services, according to Dr. Arjun Srinivasan, associate director for the CDC’s health care-associated infection-prevention programs. But it’s not made public on a hospital-by-hospital basis. HHS officials did not respond to questions.

The Scene at Riverside

In March 2020, Evans was alarmed by nonstop TV footage of covid deaths, so she and her husband locked down. They hadn’t been going out much, anyway, since losing their only child at the end of 2019 to another public health crisis — fentanyl.

At the time, concerns about covid were mounting among the staff at Riverside Community Hospital, a for-profit HCA Healthcare facility.

The hospital’s highly protective N95 masks had been pulled off the supply room shelves and put in a central office, according to Monique Hernandez, a shop steward for her union, Service Employees International Union Local 121RN. Only nurses who had patients getting aerosol-generating procedures such as intubation — which were believed at the time to spread the virus — could get one, she said.

She said that practice left the nurses on her unit with a difficult choice: either say you had a patient undergoing such procedures or risk getting sick.

Nurse unions were early adopters of the notion — now widely accepted — that covid is spread by minuscule particles that can linger in the air. Studies since have matched the genetic fingerprint of the virus to show that covid has spread among workers or patients wearing surgical masks instead of more protective masks like N95s.

On April 22, 2020, Hernandez and other nurses joined a silent protest outside the hospital where they held up signs saying “PPE Over Profit.” By that time, the hospital had several staff clusters of infection, according to Hernandez, and she was tired of caregivers being at risk.

In a statement, Riverside spokesperson David Maxfield said the hospital’s top priority has been to protect staff “so they can best care for our patients.”

“Any suggestion otherwise ignores the extensive work, planning and training we have done to ensure the delivery of high-quality care during this pandemic,” he said.

In mid-May, Judi Evans’ husband coaxed her into going horseback riding — one of the few things that brought her joy after her son’s death. On her second day back in the saddle, she was thrown from her horse. She broke her collarbone and seven ribs, and her lung was compressed. She was taken to Riverside Community Hospital.

There, many of her nurses wore masks they had previously used, Evans recalled. Other staffers came in without any masks at all, she said. A few days in, she said, one of the doctors told her it’s crazy that the hospital was testing her for MRSA and other hospital infections but not covid.

Maxfield said that the hospital began enforcing a universal mask mandate for staff and visitors on March 31, 2020, and, “in line with CDC, patients were and are advised to wear masks when outside their room if tolerated.” He stressed “safety of our patients and colleagues has been our top priority.”

After about a week in the hospital, Evans said, she spiked a fever and begged for a covid test. It was positive. There is no way to know for certain where or how she got infected but she believes it was at Riverside. Covid infections can take two to 14 days from exposure to show symptoms like a fever, with the average being four to five days. According to CDC guidance, infection onset that occurs two days or more after admission could be “hospital-associated.”

Doctors told her they might have to amputate her legs when they began to swell uncontrollably, she said.

“It was like being in a horror film — one of those where everything that could go wrong does go wrong,” Evans said.

She left with over $1 million in bills from a month-long stay — and her legs, thankfully. She said she still suffers from long-covid symptoms and is haunted by the screams of fellow patients in the covid ward.

By the end of that year, Riverside Community Hospital would report that 58 of its 1,649 covid patients were diagnosed with the virus after admission, according to state data that covers all payers from April to December.

That’s nearly three times as high as the California average for covid cases not present on admission, according to the analysis for KHN by California health data officials.

“Based on contact tracing, outlined by the CDC and other infectious disease experts, there is no evidence to suggest the risk of transmission at our hospital is different than what you would find at other hospitals,” Maxfield said.

A lawsuit filed in August by the SEIU-United Healthcare Workers West on behalf of the daughter of a hospital lab assistant who died of covid and other hospital staffers says the hospital forced employees to work without adequate protective gear and while sick and “highly contagious.”

The hospital “created an unnecessarily dangerous work environment,” the lawsuit claims, “which in turn has created dangerous conditions for patients” and a “public nuisance.”

Attorneys for Riverside Community Hospital are fighting the ongoing lawsuit. “This lawsuit is an attempt for the union to gain publicity, and we have filed a motion to end it,” said Maxfield, the hospital spokesperson.

The hospital’s lawyers have said the plaintiffs got covid during a spike in local cases and are only speculating that they contracted the virus at the hospital, according to records filed in Riverside County Superior Court.

They also said in legal filings that the court should not step into the place of “government agencies who oversee healthcare and workplace safety” and “handled the response to the pandemic.”

‘A Shortcoming in the Oversight System’

Decades ago, Congress tasked Medicare with ensuring safe, quality care in U.S. hospitals by building in routine government inspections. However, hospitals can opt to pay up to tens of thousands of dollars per year to nongovernmental accreditors entrusted by CMS to certify the hospitals as safe. So 90% do just that.

But these accrediting agencies — including the Joint Commission, which certified Riverside — are private organizations. Thus they are not required to follow CMS’ directives, including the request in a March 20 memo urging the accrediting agencies to execute targeted infection-control surveys aimed at preparing hospitals for covid’s onslaught.

And so they didn’t send staffers to survey hospitals for the specialized infection-control inspections in 2020, according to a June 2021 Health and Human Services Office of the Inspector General report.

Riverside, despite allegations of lax practices, holds The Gold Seal of Approval from the Joint Commission, which last inspected the hospital on-site in May 2018 before going in on Nov. 19 this year.

The inspector general’s office urged CMS to pursue the authority to require special surveys in a health emergency — lest it lose control of its mission to keep hospitals safe.

“CMS could not ensure that accredited hospitals would continue to provide quality care and operate safely during the COVID-19 emergency,” and could not ensure it going forward, the report said.

“We’re telling CMS to do their job,” the report’s author, Assistant Regional Inspector General Calvin Jones, said in an interview. “The covid experience really showed a shortcoming in the oversight system.”

CMS spokesperson Raymond Thorn said the agency agrees with the report’s recommendation and will work on a regulation after the public health emergency ends.

Accrediting agencies, however, pushed back on the inspector general’s findings. Among them: DNV Healthcare USA Inc. Its director of accreditation, Troy McCann, said there was not a gap in oversight. Although he said travel restrictions limited accreditors ability to fly across state lines, his group continued its annual reviews after May 2020 and incorporated the special focus on infection control into them. “We have a strong emphasis, always, on safety, infection control and emergency preparedness, which has left our hospitals stronger,” McCann said.

Angela FitzSimmons, spokesperson for the Accreditation Commission for Health Care, said that the accrediting organization’s surveys typically focus on infection control, and the group worked during the pandemic to prioritize hospitals with prior issues in the area of infection prevention.

“We did not deem it necessary to add random surveys that would occur at a cost to the hospital without just cause,” FitzSimmons said.

Maureen Lyons, a spokesperson for the Joint Commission, told KHN that, after evaluating CMS guidance, the nonprofit group decided it would incorporate the infection-control surveys into its surveys done every three years and, in the meantime, provide hospitals with the latest federal guidance on covid.

“Hospitals were operating in extremis. Thus, we collaborated closely with CMS to determine optimal strategies during this time of emergency,” she said.

The Joint Commission cited safety issues for its inspectors, who travel to the hospitals and need proper protective equipment that was running low at the time, as part of the reason for its decision.

Verma, the CMS administrator at the time, pushed back on accreditors’ travel safety concerns, saying that “narrative doesn’t quite fit because the state and CMS surveyors were going into nursing homes.”

Though Verma cautioned that hospitals were overwhelmed by the crush of covid patients, “doing these inspections may have helped hospitals bolster their infection-control practices,” she said. “Without these surveys, we really have no way of knowing.”

‘Immediate Jeopardy’

Medicare inspectors can go into a privately accredited hospital after they get a serious complaint. They found alarming circumstances when they visited some of the hospitals with high rates of covid diagnosed after a patient was admitted for another concern last year.

At Levindale Hebrew Geriatric Center and Hospital in Baltimore, the July 2020 inspection report says “systemic failures left the hospital and all of its patients, staff, and visitors vulnerable to harm and possible death from COVID-19.”

In response, hospital spokesperson Sharon Boston said that “we have seen a large decrease in the spread of the virus at Levindale.”

Inspectors had declared a state of “immediate jeopardy” after they investigated a complaint and discovered an outbreak that began in April and continued through the beginning of July, with more than 120 patients and employees infected with covid. And in a unit for those with Alzheimer’s and other conditions, 20% of the 55 patients who had covid died.

The hospital moved patients whose roommates tested positive for covid to other shared rooms, “potentially exposing their new roommate,” the inspection report said. Boston said that was an “isolated” incident and the situation was corrected the next day, with new policies put in place.

The Medicare data analyzed exclusively for KHN shows that 52 of Levindale’s 64 covid hospital patients, or 81%, were diagnosed with covid after admission from April to September 2020. Boston cited different numbers over a different time period: Of 67 covid patients, 64 had what she called “hospital-acquired” covid from March to June 2020. That would be nearly 96%.

The hospital shares space with a nursing home, though, so KHN did not group it with the general short-term acute-care hospitals as part of the analysis. Levindale’s last Joint Commission on-site survey was in December 2018, resulting in The Gold Seal of Approval. It had not had its once-every-three-years survey as of Dec. 10, 2021, according to the Joint Commission’s tracking.

Boston said Levindale “quickly addressed” the issues that Medicare inspectors cited, increasing patient testing and more recently mandating staff vaccines. Since December 2020, Boston said, the facility has not had a covid patient die.

At the state level, hospital inspectors in California found few problems to cite even at hospitals where 5% or more patients were diagnosed with covid after they were admitted for another concern. Fifty-three complaints about such hospitals went to the Department of Public Health from April until the end of 2020. Only three of those complaints resulted in a finding of deficiency that facility was expected to fix.

CDPH did not respond to requests for comment.

A New Chapter

Things are better now at Riverside Community Hospital, Hernandez said. She is pleased with the current safety practices, including more protective gear and HEPA filters for covid patients’ rooms. For Hernandez, though, it all comes too late now.

“We laugh at it,” she said, “but it hurts your soul.”

Evans said she was able to negotiate her $1 million-plus hospital bills down to roughly $70,000.

Her covid aftereffects have been ongoing — she said she stopped gasping for air and reaching for her at-home oxygen tank only a few months ago. She still hasn’t been able to return to work full time, she said.

For the past year, her husband would wake up in the middle of the night to check whether her oxygen levels were dipping. Terrified of losing her, he’d slip an oxygen mask on her face, she said.

“I would walk 1,000 miles to go to another hospital,” Evans said, if she could do it all over again. “I would never step foot in that hospital again.”

Methodology

KHN requested custom analyses of Medicare, California and Florida inpatient hospital data to examine the number of covid-19 cases diagnosed after a patient’s admission.

The Medicare and Medicare Advantage data, which includes patients who are 65 and older, is from the Centers for Medicare & Medicaid Services’ Medicare Provider Analysis and Review (MedPAR) file and was analyzed by CDIMD, a Nashville-based medical code consulting and data analytics firm. The data is from April 1 through Sept. 30, 2020. The data for the fourth quarter of 2020 was not yet available.

The data shows the number of inpatient Medicare hospital stays in the U.S., including the number of people diagnosed with covid-19 and the number of admissions for which the covid diagnosis was not “present on admission.” CMS considers some medical conditions that are not “present on admission” to be hospital-acquired, according to the agency. The data is for general acute-care hospitals, which may include a psychiatric floor, and not for other hospitals such as those in the Department of Veterans Affairs system or stand-alone psychiatric hospitals.

KHN requested a similar analysis from California’s Department of Health Care Access and Information of its hospital inpatient data. That data was from April 1 through Dec. 31, 2020, and covered patients of all ages and payer types and, in general, private psychiatric and long-term acute-care hospitals. Etienne Pracht, a University of South Florida researcher, provided the number of Florida covid patients who did not have the virus upon hospital admission for all ages and payer types at general and psychiatric hospitals from April 1 through Dec. 31, 2020. KHN subtracted the number of Medicare patients in the MedPAR data from the Florida and California datasets so they would not be counted twice.

To calculate the rate of hospitalized Medicare patients who tested positive for covid — and died — KHN relied on the MedPAR data for April through September. That data includes records for 6,629 seniors, 1,409 of whom, or 21%, died. California data for all ages and payer types from April through December shows a similar rate: Of 2,115 diagnosed with covid-19 after hospital admission, 435, or 21%, died. The MedPAR data was also used to calculate the national rate of 1.7%, with 6,629 of 394,939 covid patients diagnosed with the virus whose infections were deemed not present on admission, according to the CDIMD analysis of data that hospitals report to Medicare. It was also used to calculate which entities licensed as short-term acute care hospitals had 5% or more of their covid cases diagnosed within the hospital. As stated in the story, Levindale Hebrew Geriatric Center and Hospital in Baltimore was not included in that list of 38 because it shares space with a nursing home and had fewer than 500 total discharges.

Data that hospitals submit to Medicare on whether an inpatient hospital diagnosis was “present on admission” is used by Medicare for payment determinations and is intended to incentivize hospitals to prevent infections during hospital care. The federal Agency for Healthcare Research and Quality also uses the data to “assist in identifying quality of care issues.”

Whether covid-19 is acquired in a hospital or in the community is measured in different ways. Some nations assume the virus is hospital-acquired if it is diagnosed seven or more days after admission, while U.S. data counts cases only after 14 days.

Hospitals’ medical coders who examined patient records for the data analyzed for this KHN report focus on each physician’s admission, progress and discharge notes to determine whether covid was “present on admission.” They do not have a set number of days they look for and are trained to query physicians if the case is unclear, according to Sue Bowman, senior director of coding policy and compliance at the American Health Information Management Association.

KHN tallied the cases in which covid-19 was logged in the data as not “present on admission” to the hospital. Some covid cases are coded as “U” for having insufficient documentation to make a determination. Since Medicare and AHRQ consider the “U” to be an “N” (or not present on admission) for the purposes of payment decisions and quality indicators, KHN chose to count those cases in the grand total.

In 409 of 6,629 Medicare cases and in 70 of 2,185 California cases, the “present on admission” indicator was “U.” The Florida data did not include patients whose “present on admission” indicator was “U.” Medical coders have another code, “W,” for “clinically undetermined” cases, which consider a condition present on admission for billing or quality measures. Medical coders use the “U” (leaning toward “not present on admission”) and “W” (leaning toward “present on admission”) when there is some uncertainty about the case. KHN did not count “W” cases.

The Medicare MedPAR data includes about 2,500 U.S. hospitals that had at least a dozen covid-19 cases from April through September 2020. Of those, 1,070 reported no cases of covid diagnosed after admission for other conditions in the Medicare records. Data was suppressed due to privacy reasons for about 1,300 hospitals that had between one and 11 of such covid cases. There were 126 hospitals reporting 12 or more cases of covid that were “not present on admission” or unknown. For those, we divided the number of cases diagnosed after admission by the total number of patients with covid to arrive at the rate, as is standard in health care.

Inspection and Accreditation Analysis

To evaluate which of the 38 hospitals detailed above had federal inspection reports documenting infection-control issues, KHN searched CMS’ publicly available “2567” reports, which detail deficiencies for each hospital for 2020. For surveys listed online as “not available,” KHN requested and obtained them from CMS. KHN further asked CMS to double-check the remaining hospitals for any inspection reports that weren’t posted online. KHN also checked the Association of Health Care Journalists’ database http://www.hospitalinspections.org/ for each of the 38 hospitals for any additional reports, as well as CMS’ Quality, Certification and Oversight Reports site.

To check that each of these hospitals was accredited, KHN looked up each hospital using a site run by the Joint Commission and reached out to the accreditors DNV Healthcare USA Inc. and the Accreditation Commission for Health Care.

To tabulate infection-control complaints for hospitals at the state level in California, KHN used data available through the California Department of Public Health’s Cal Health Find Database. KHN searched the database for the hospitals that had higher than 5% of covid patients being diagnosed after admission, according to the California data, and tallied all complaints and deficiencies found involving infection control from April to December 2020.

The post As Patients Fell Ill With Covid Inside Hospitals, Government Oversight Fell Short first appeared on DAILY POLITICAL PRESS.
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Louisiana governor on Hurricane Ida: ‘We’re just getting started’
Mon, 30 Aug 2021 05:21:56 GMT

“Louisiana Governor John Bel Edwards on Hurricane Ida: ‘We’re just getting started’” was originally published by the Louisiana Illuminator.

Hurricane Ida will remain dangerous and destructive until at least Monday morning, Louisiana Gov. John Bel Edwards said at a press conference Sunday afternoon.

“We’re just getting started,” he said.

The storm came ashore as a Category 4 storm in Port Fourchon on the Louisiana coast just before noon Sunday. With 150 mile-per-hour winds, it is one of the strongest hurricanes to make landfall in Louisiana since the middle of the 19th century. 

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“There is no doubt that the coming days and weeks are going to be extremely difficult for our state, and many, many people are going to be tested in ways that we can only imagine today,” Edwards said. “But I can also tell you that, as a state, we’ve never been more prepared.” 

Ida arrived on the 16th anniversary of Hurricane Katrina — which destroyed much of New Orleans — and two days after the first anniversary of Hurricane Laura, which devastated Lake Charles in the southwestern region of the state.

Edwards said southeastern Louisiana residents who stayed for Hurricane Ida need to be prepared to “shelter in place” for 72 hours after the storm has passed. Search and rescue crews won’t be able to start their work until Monday morning, he said.

“We will be ready at first light tomorrow morning to go out in those areas that we know already have received the most damaging impacts of the storm,” Edwards said.

There is no doubt that the coming days and weeks are going to be extremely difficult for our state.

– Louisiana Gov. John Bel Edwards

Louisiana’s entire National Guard — nearly 5,000 people — has been called up to service. The state fire marshal, law enforcement and Louisiana Department of Wildlife and Fisheries agents will also be involved in search and rescue missions — and there’s an additional 900 people on loan from 16 other states available to help, Edwards said. 

By Sunday evening, Ida had already hit Louisiana’s coastal towns like Houma, which is home to a large segment of the state’s commercial fishing operations and the nexus of the offshore oil and gas industry. Ida also walloped Grand Isle, a popular vacation spot, though Edwards said almost the entire population of that barrier island had been evacuated before the storm.

From Sunday evening to Monday morning, Ida is expected to creep its way up into the most populous areas of Louisiana — hitting New Orleans, Baton Rouge and the north shore of Lake Pontchartrain hard. Communities will not not only face the strongest winds they have seen in decades, but may also be inundated with flooding for much of the rest of the week, according to local weather reports.

Many coastal parishes put mandatory evacuations in place Friday. Notably, New Orleans did not. New Orleans Mayor LaToya Cantrell said the storm was moving too quickly by Friday evening to safely make that call, but thousands of residents fled the city voluntarily, resulting in hours-long traffic jams on interstates going to Texas and Florida on Saturday.

Protection system put to full use

Louisiana is trying to avoid some of the problems it saw in the aftermath of Hurricane Katrina. The Department of Public Safety and Corrections has agreed to house 2,500 jail detainees and prisoners from Acadia, Plaquemines, St. Mary, Orleans, St. Bernard, Vermillion and Terrebonne parishes. After Hurricane Katrina, people in jails struggled to get access to food and water. 

Edwards also insisted Sunday that the state is “more prepared than it ever has been” for a hurricane of Ida’s magnitude. After Hurricane Katrina, the federal government spent billions of dollars developing a new protection system consisting of levees and floodgates around New Orleans and its surrounding parishes. Though Louisiana has been threatened with other storms in recent years, Hurricane Ida is the first time the state intends to make use of the full protection system.

“Will (New Orleans storm protection system) be tested? Yes. But it was built for this moment,” Edwards said. 

The governor said about 1,400 people were being housed in public shelters across the state Sunday afternoon, but expected that number to grow. Power companies are warning Louisiana residents that they could be without electricity — and air conditioning — for several days.

The governor expects that more people will find their homes uninhabitable after the hurricane passes. The state has enough capacity to house approximately 10,300 people now and more public shelters will be opened. 

The state will also provide over 150 buses to help people get from the areas affected by the hurricanes to safer places in north Louisiana. Louisiana may also pay for some evacuees to stay in hotel rooms in an attempt to mitigate the spread of COVID-19.

One major concern that remains is whether Louisiana’s hospitals will be able to withstand Hurricane Ida.

Four smaller hospital facilities, 22 nursing homes, 18 assisted living facilities and 61 intermediate care facilities in the state have already been evacuated, but major hospitals don’t have the option of evacuation right now. 

Hospitals throughout the region are at capacity with COVID-19 patients and those in safe areas don’t have enough beds to accommodate the patients that would need to be transferred.

“No (major) hospitals have been evacuated — the Tier 1 hospitals — because, quite simply put, there’s nowhere to bring those individuals,” Edwards said. “They’re in a hospital because they need that setting and we don’t have the capacity elsewhere.”

Hospitals in the path of Ida are operating with extra generators, water and medication on hand in anticipation of not being able to evacuate, but the governor said the hurricane could also put additional strain on medical staffing in hospitals over the next few days. 

Doctors, nurses and other medical professionals may not be able to stay working in hospitals  if their homes become damaged, their houses lose power or they have to evacuate with family, he said.

The governor said the state was bringing additional medical staff into Louisiana to help out hospitals with Louisiana’s COVID-19 surge, but those staff members weren’t able to get to the state because they couldn’t secure hotel rooms ahead of the storm. The state will try to bring those relief medical staff members back to Louisiana again after Hurricane Ida has passed. 

“We know that the longer the power stays out, the more challenging this is going to be,” Edwards said.

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The post Louisiana governor on Hurricane Ida: ‘We’re just getting started’ appeared first on Colorado Newsline.

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Strolling tour makes use of augmented actuality to inform the story of San Jose Japantown
Thu, 23 Dec 2021 15:31:22 GMT
New Mexico 49, Fresno St. 39

It was 4:30 p.m. on a Thursday in November. As the sky darkened, the tour of Japantown San Jose began.

A group of ten walked down N. Fifth Street, where the San Jose Buddhist Church is located. They looked at their smartphones in the air and looked into the two-dimensional projected space.

In contrast to the calm streetscape in the real world, the city was decorated on the canvas with augmented reality (AR) art in glittering colors and showed immigrants from China, Japan and the Philippines.

“This is a place where there has been exclusion from various ethnic groups in the past,” the tour guide slowly began to explain.

Hidden Histories project

This is part of the Hidden Histories project organized by the Japanese American Museum of San Jose.

Community leaders Susan Hayase and Tom Izu led the project to tell the untold stories of the 130-year history of San Joses Japantown.

Tour participants can install the free mobile app on their smartphone or tablet and see nine AR art installations on the streets while strolling through Japantown.

The AR art installations were created by local artists related to Japantown in San Jose.

A young artist discovers the untold family story

This year marks the 80th anniversary of the attack on Pearl Harbor that later led first and second generation Japanese Americans to internment camps. The number of people who have experienced such turbulent times is decreasing every year.

“Once they’re gone, their stories are gone too,” said Maylea Saito, one of the local artists who joined the Hidden Histories project.

Saito is half the third generation Japanese American and the second generation Sino-Taiwanese American. Her father and family experienced the Heart Mountain, Wyoming internment camp during World War II.

San Jose’s Japantown is her father’s hometown. When she was young, Saito often visited her grandmother and aunt. However, they rarely talked about their experiences in the detention center and the history and tradition of Japanese Americans.

“Growing up I definitely felt disconnected from my Japanese-American heritage,” Saito said.

But it wasn’t until she was in her early twenties that she took up an ethnic study program in college. When she visited the Japanese-American Museum on an excursion, she recognized the name of the camp where her father and his family were interned on part of the exhibition.

“That made me really curious about everything because I knew the name of the camp and that was it,” Saito said.

Saito joined the Hidden Histories project to learn more about Japantown and its connection to it.

She chose a location for her AR art exhibit at Amy’s beauty salon, which her aunt Amy Okazaki ran for over 40 years.

She created a floating cloud of tanzaku, which are colored signs that people write wishes on during the Tanabata, or the Star Festival traditionally held in Japan during the summer. According to legend, the annual meeting of the stars Vega and Altair is celebrated here to renew their old love bond on July 7th.

On each of the tags shown on AR, Saito illustrated questions she had while reflecting on her family’s experiences growing up in Japantown, such as “What stories would you like to see passed on?” “What do you want to leave behind in the past?” and “How do the two different generations combine through the arts they create?”

Share history against anti-Asian hatred

The Hidden Histories project that was launched came about at the time when a number of hate crimes were emerging against Asians and Asian Americans.

“The wave of anti-Asian hatred during the pandemic triggered many strong emotions such as anger, sadness and fear,” Saito reflected.

“I’ve really thought about what it means to have ‘Asian Pride’ and how often this conversation skips studying our history and our relationships with other communities,” Saito said.

During the emotionally difficult times, it turned out that the project meant more to them than just discovering the family history.

“I believe one solution to stop hatred is that we are all able to see each other’s humanity. It does this through listening, reflecting and sharing personal stories, emotions and history, ”Saito explained.

History of San Joses Japantown

San Jose’s Japantown has been home to a large number of immigrant communities who have faced exclusion policies and violations of civil liberties over its 130-year history.

Originally it was Chinatown. However, the Chinese Exclusion Act of 1882 prohibited Chinese immigrants from entering the United States. As an alternative to Chinese labor, Japanese immigrants began moving to the United States and found refuge in Chinatown. They worked as farmers by leasing existing farmland from white owners. Filipino immigrants also settled in Japantown since the mid-1920s.

When World War II broke out, then President Franklin D. Roosevelt signed Executive Order 9066, authorizing the imprisonment of 120,000 Japanese Americans on February 17, 1942. Japanese Americans were forcibly relocated to 10 desolate internment camps, including Topaz, Utah, from 1942 to 1945.

At the internment camps, adults were given a questionnaire asking if they would serve in the military and would swear allegiance to the US mainland and Hawaii.

In order to prove their loyalty and national identity to the Americans, the team has set up its motto “Go for broke”. The 442nd team was known for breaking the Nazi Gothic line that protected Germany from the rest of Europe.

Although they had to sell or give up all of their property before moving to the camps, San Jose’s Japantown remains the only Japantown to be in the exact same location as it was before World War II.

It was rebuilt on a family business foundation, which makes the community unique today.

Current generations of Japanese Americans like Saito understand the importance of passing this unique story down.

“I feel the cultural pride that we were able to cope with the situation. Over the generations, the present generations want to ensure that this story does not repeat itself,” Saito said.

Copyright © 2021 Bay City News, Inc. All rights reserved. Republication, retransmission, or redistribution is prohibited without the express written consent of Bay City News, Inc. Bay City News is a 24/7 news service that covers the greater Bay Area.

Copyright © 2021 by Bay City News, Inc. Republication, redistribution, or other reuse is prohibited without the express written consent of Bay City News, Inc.

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File Variety of Individuals Signal Up for ACA Well being Insurance coverage
Thu, 23 Dec 2021 18:30:41 GMT


A record 13.6 million Americans have signed up for health coverage for 2022 on the Affordable Care Act marketplaces, with nearly a month remaining to enroll in most states, the Biden administration announced Wednesday.

President Joe Biden’s top health advisers credited the increased government subsidies, which lowered out-of-pocket costs, for the surge in enrollment. They also said enhanced personal assistance and outreach helped connect more people to health insurance plans.

Some of the largest increases are in Florida, Texas, Georgia and nine other states that have not expanded Medicaid under the Affordable Care Act.

The previous marketplace enrollment record was 12.7 million in 2016, the final year of President Barack Obama’s administration. Enrollment largely stagnated under President Donald Trump, who cut tens of millions of dollars in funding for navigators, who help people sign up for coverage.

Open enrollment for the marketplace began Nov. 1 and ends Jan. 15.

Through Dec. 15, enrollment in Florida had soared to 2.6 million people, up from 2.1 million in the same period a year earlier.

“This is a very big deal as it means we have made a dent in the uninsured pool and we are not only insuring people but keeping people signed up,” said Jodi Ray, program director for Florida Covering Kids & Families.

Ray has used federal grants to help Floridians sign up for private coverage on the marketplace for several years. During the Trump presidency, she said, she could help only people in half the counties in the state because of funding constraints. “You cannot overlook the impact that one-on-one assistance has in getting people through the process,” Ray said.

Enrollment has jumped more in states that have not expanded Medicaid because they have more uninsured residents than expansion states. In expansion states, people with incomes from 100% to 138% of the federal poverty level — about $12,880 and $17,770 for an individual — can enroll in Medicaid. In states that haven’t expanded the program, they can get subsidies to enroll in private plans through the Affordable Care Act marketplaces.

Georgia enrollment jumped to 653,990 from about 514,000 the previous year.

“That’s the most we’ve ever had enrolled,’’ said Laura Colbert, executive director of the consumer advocacy group Georgians for a Healthy Future. She said the enrollment spike helps show that Republican Gov. Brian Kemp’s plan to scrap healthcare.gov and replace it with a privately run portal isn’t needed.

The Biden administration is reviewing that proposal.

“Hundreds of thousands of Georgians still opt to remain uninsured rather than shop on the federal platform,” Kemp spokesperson Katie Byrd said Wednesday. “This means that the one-size-fits-all approach by the federal government is not working for Georgia.”

The 13.6 million enrollment number includes people who used state-run marketplaces, in addition to those who enrolled through the federally run healthcare.gov portal that handles sign-ups for more than 30 states.

Texas’ enrollment rose to 1.7 million from 1.3 million.

Texas, Georgia and South Dakota each showed gains of at least 20%, said Chiquita Brooks-LaSure, administrator of the Centers for Medicare & Medicaid Services. None of those states has expanded Medicaid under the Affordable Care Act.

In non-expansion states, “our outreach efforts have been so robust this year,’’ Brooks-LaSure told reporters during a press call. The federal government is using four times the number of navigators, or insurance counselors, to help people sign up for insurance, said Xavier Becerra, secretary of the U.S. Department of Health and Human Services.

The big driver behind the enrollment gains is new discounts on premiums.

As part of a covid-19 relief bill passed this year, Congress increased the subsidies consumers receive when they enroll in health insurance via the marketplace. CMS said 92% of people in healthcare.gov states will get the tax credits for 2022 coverage. Becerra said that for 4 in 5 enrollees, monthly premiums cost $10 or less, which he said is “less than going to a movie.”

But conservatives chafe at the idea of higher subsidies. Brian Blase, a former Trump adviser and president of the conservative think tank Paragon Health Institute, stressed that the federal government is paying 85% of people’s monthly insurance premiums.

“People will buy something that provides them with little value if the after-subsidy price is zero or close to zero, and that’s what is generally happening here,” Blase said. “Ultimately, the big winners are the health insurance companies that are getting billions of dollars in additional government subsidies.”

Another driver of enrollment is that some people may have lost job-based coverage during the pandemic and are seeking insurance on their own.

The marketplaces also offer consumers more choices than in previous years. The average consumer now has between six and seven insurers to choose from, up from four to five in 2021, federal officials said.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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An Anesthesiology Practice’s Busy Day in Court Collecting on Surprise Bills
Thu, 23 Dec 2021 15:46:45 GMT

Owen Loney’s surprise bill resulted from an emergency appendectomy in 2019 at a Richmond, Virginia, hospital.

Insurance covered most of the cost of the hospital stay, he said. He didn’t pay much attention to a bill he received from Commonwealth Anesthesia Associates and expected his insurance to cover it. A few months ago, he got a notice that Commonwealth was suing him in Richmond General District Court for $1,870 for putting him under during the surgery, court records show.

“Wow, seriously?” the 30-year-old information technology manager recalled thinking after getting the court summons. Loney didn’t have that kind of money at hand. His plan was to try to negotiate down the amount or “take out another credit card to pay for it.”

Loney’s is a classic, notorious type of surprise bill that Congress and activists have worked for years to eliminate: an out-of-network charge not covered by insurance even though the patient had an emergency procedure or sought care at an in-network hospital thinking insurance would cover most charges.

Commonwealth said it was in-network for Loney’s insurer, UnitedHealthcare. But the insurer rejected the anesthesiology charge because it said his primary care doctor was out of network, claims records show.

The federal No Surprises Act, passed at the end of 2020, has been hailed by consumer advocates for prohibiting such practices. Starting Jan. 1, medical companies in most cases cannot bill patients more than in-network amounts for any emergency treatment or out-of-network care delivered at an in-network hospital.

But as much as the legislation is designed to protect millions of patients from unexpected financial consequences, it will hardly spare all consumers from medical billing surprises.

“It’s great that there will be surprise billing protections … but you’re still going to see lawsuits,” said Zack Cooper, an economist and associate professor at the Yale School of Public Health. “This is by no means going to get rid of all of the problems with billing.”

The law will kick in too late for Loney and many others saddled with surprise out-of-network bills in states that don’t already ban the practice.

“It doesn’t prohibit surprise bills that are happening now in states that don’t have protections” against them, said Erin Fuse Brown, a law professor at Georgia State University who studies hospital billing. “And it doesn’t prohibit collection activity for surprise bills that arose prior to January.”

Virginia’s surprise-bill protection law took effect only this year and doesn’t apply to self-insured employer health plans, which cover a large portion of residents.

The federal legislation also does nothing to reduce another kind of unpleasant, often surprising bill — large, out-of-pocket payments for in-network medical care that many Americans can’t afford and might not have realized they were incurring.

Two substantial changes in recent years shifted more risk to patients. Employers and other payers narrowed their provider networks to exclude certain high-cost hospitals and doctors, making them out of network for more patients. They also drastically increased deductibles — the amount patients must pay each year before insurance starts contributing.

The No Surprises Act addresses the first change. It does nothing to address the second.

For a snapshot of the past and future of surprise and disputed medical bills, KHN examined Commonwealth’s lawsuits against patients in central Virginia and attended court hearings where patients contested their bills.

“The whole thing with insurance not covering my bills is a headache,” said Melissa Perez-Obregon, a Richmond-area dance teacher whom Commonwealth sued for $1,287 over services she received during the 2019 birth of her daughter, according to court records. Her insurance paid most but not all of a $5,950 anesthesia charge, billing records show.

“I’m a teacher,” she said, standing in the lobby at Chesterfield County General District Court. “I don’t have this kind of extra money.”

Commonwealth is one of the more active creditors seeking judgments in the Richmond area, court records show. From 2019 through 2021, it filed nearly 1,500 cases against patients claiming money owed for treatment, according to the KHN analysis of court filings.

In numerous cases, it initiated garnishment proceedings, in which creditors seize a portion of patients’ wages.

Describing itself as “the largest private anesthesiology practice in Central Virginia,” Commonwealth said it employs more than 100 clinicians who care for roughly 55,000 patients a year in hospitals and surgery centers, mostly in the Richmond area.

Commonwealth said more than 99% of the patients it treats are members of insurance plans it accepts. It garnishes wages only as a “last resort” and only if the patient has the ability to pay, Michael Williams, Commonwealth’s practice administrator, said in a written statement.

“Over the past three years we have filed suit to collect from just over 1% of our patients,” mostly for money owed for in-network deductibles or coinsurance, Williams said. Nearly half the bills are settled before the court date, he said.

Gwendolyn Peters, 67, said she was shocked to receive a court summons this summer. Commonwealth was suing her for $1,000 for anesthesia during a lumpectomy for breast cancer in 2019, according to court records.

“This is the first time I have ever been in this situation,” she said, sitting in the Chesterfield court with half a dozen other Commonwealth defendants.

Because patients typically have little or no control over who puts them under, Brown said, anesthesiologists face less risk to their businesses and reputations than other medical specialists do in using aggressive collections tactics.

The specialty is often “one of the worst offenders because they don’t depend on their reputation to get patients,” she said. “They’re not going to lose business because they engage in these really aggressive practices that ruin their patients’ finances.”

The average annual deductible for single-person coverage from job-based insurance has soared from $303 to $1,434 in the past 15 years, according to KFF. Deductibles for family coverage in many cases exceed $4,000 a year. Coinsurance — the patient’s responsibility after the deductible is met — can add thousands of additional dollars in expenses.

That means millions of patients are essentially uninsured for care that might cost them a substantial portion of their income. Surveys have repeatedly found that many consumers say they would have trouble paying an unexpected bill of even a few hundred dollars.

Loney’s insurer, UnitedHealthcare, agreed to pay the bill from Commonwealth for his emergency appendectomy after being contacted by KHN and saying it “updated” information on the claim. Otherwise, Loney said, he couldn’t have paid it without borrowing money.

In Richmond-area courthouses, hearings for Commonwealth lawsuits take place every few months. A lawyer for the anesthesiology practice attends, sometimes making payment arrangements with patients. Many defendants don’t show up, which often means they lose the case and might be subject to garnishment.

Commonwealth sued retiree Ronda Grimes, 66, for $1,442 for anesthesia claims her insurance didn’t cover after a 2019 surgery, billing and legal records filed in Richmond General District Court show.

“That’s a lot of money, especially when you have health insurance,” she said.

New research by Cooper and colleagues examining court cases in Wisconsin shows that medical lawsuits are disproportionately filed against people of color and people living in low-income communities.

“Physicians are entitled to get paid like everyone else for their services,” Cooper said. But unaffordable, out-of-pocket medical costs are “a systemic issue. And this systemic issue generally falls on the backs of the most vulnerable in our population.”

For uninsured patients, Commonwealth matches any financial assistance given by the hospital and will be “enhancing” its financial assistance program in 2022, Williams said.

Two of the nine people being sued by Commonwealth and interviewed by KHN at courthouse hearings were Hispanic. Four were Black.

One was Darnetta Jefferson, 61, who underwent a double mastectomy in early 2020 and came to court wearing a cancer-survivor shirt. Commonwealth sued her for $836 it said she owed in coinsurance for anesthesia she was given during the surgery. Commonwealth’s lawyer agreed to drop the lawsuit if she agreed to pay $25 a month toward the balance until it’s paid, she said.

“If I ever have some extra money to pay it off someday, I will,” said Jefferson, who worked at Ukrop’s supermarket for many years before her cancer forced her to go on disability. “But right now, my circumstances are not looking good.”

Although she is living on a reduced income, her rent just went up again, said Jefferson, who also survived lung cancer diagnosed in 2009. Rent now runs close to $1,000 a month.

Paying Commonwealth’s bill in monthly $25 increments, she said, means “it’s going to be a long way to go.”

Jay Hancock:
jhancock@kff.org,
@JayHancock1

The post An Anesthesiology Practice’s Busy Day in Court Collecting on Surprise Bills first appeared on REALESTATE NEWS24.
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Small Business Ideas for Beginners
Thu, 23 Dec 2021 14:46:20 GMT

There are 31.7 million small businesses in the U.S. and growing, leading to more new business owners turning up every day. They are a great way to get in on the entrepreneur spirit, earn money and even build wealth in many cases. In short, new business ideas are not something we can run out of anytime soon. But how do you find the right small business idea?

If you are looking for inspiration to start your own small business, take a look at these 40 great business ideas for beginners.

How to Choose the Perfect Small Business Idea for Your Own Business

It can be tough to make it in the business world, so make sure your business ideas count. A solid idea for any size business requires a certain level of due diligence, planning and research so that you can make sure it is feasible for your unique situation.

Here are some tips to match the right business idea with your personality, skillset and goals:

Focus on your skills, experience and preferences. What are you good at? What do you like to do? Are there activities that make you happy and feel fulfilled? When answering these questions, it is important to think about what skills come naturally to you. Narrow down your list. Once you have a general idea of the types of businesses that interest you, start researching them on the internet. Then, ask people in your local community and your local businesses to see if any companies match this description. Consider what you will need to start the business. Do you have the necessary funds to start a business? Are you able to do all or most of the work yourself to keep costs down? Are your personal and business finances in order? Do you have a business plan? By the way, the SBA has a an excellent free business plan template you can use to write your business plan. Make a list of pros and cons. This is an important step for helping you decide whether or not the business is a good fit for you. Noodle out the business/lifestyle ratio. The good news is when you work for yourself, you can often set your own hours. The bad news is that you might be working 60+ hours a week, especially during the startup phase. If you believe in balancing business with time for you and your family, then it is important to find a small business idea that will allow for this. The Ultimate Small Business Ideas List

Now that you’ve decided you’re ready to start a business let’s dig into the list of 40 best small business ideas for beginners. Below, you’ll find ideas about anything from being a virtual assistant to owning a specialty supermarket. By the time you’re finished, you should have plenty of inspiration to get started on the right track to owning a thriving business.

1. Virtual Assistant

If you have strong organizational skills and a knack for detail, consider becoming a virtual assistant, as it is an easy way to get a business started. As a VA, you can support business owners who are too busy or don’t have the time to do everything themselves. You can perform tasks such as managing schedules, booking travel, answering emails and more.

2. Childcare

If you’re good with children, starting a childcare business could be the right choice. It requires minimal startup costs and is easy to get started—usually, all you need are some educational certificates or training in early education development. You can begin by offering daycare services for infants, toddlers, preschoolers, school-aged kids and even special needs children.

3. Social Media Consultant

Knowing the ins and outs of Facebook, Twitter and Instagram can lead to this lucrative service business. Here, a consultant acts as a social media manager to help enterprises develop their social media accounts and execute a social media strategy. This could include helping create or manage profiles on various platforms, developing and implementing campaigns and more.

4. Instagram Influencer

If you have a large following on places like Instagram, consider becoming an influencer. As an Instagram influencer, you can promote products and services to your followers in exchange for money. You’ll typically be paid per post or by commission for the products you sell. Be sure you read up on the FTC’s Disclosures 101 for Social Media Influencers before starting one of these online businesses though.

5. Etsy Seller

An Etsy shop is a great business idea if you have a creative flair. For the uninitiated, Etsy is a platform where artists and crafters can sell their handmade or vintage items. You’ll need to create a profile with photos of your products, set up payment and shipping information and write a description of your items. Then, when someone buys something from your shop, you’ll need to ship it out.

6. Dog Walking Business

Many people find themselves with more time on their hands than money. However, if you enjoy the company of dogs, dog walking is an easy way to get some extra cash and be your own boss while doing it!

7. Event Planning Business

Consider starting your own event planning business if you love to plan events. As an event planner, you’ll be responsible for all aspects of the event planning process, from budgeting to coordinating vendors to designing invitations.

8. Hairdresser

Do you have a passion for hair and styling? If so, starting your own hair salon could be the perfect business venture for you. It’s relatively easy to start a hair salon—you just need to invest in some basic equipment and supplies. Plus, plenty of online courses are available to help you get started.

9. Yoga Teacher

If you’re a yoga teacher, you can build a yoga business to make money while doing something you love. It’s important to note that starting a yoga studio can be expensive—you’ll need to invest in equipment and rent or purchase space. But if you have the right connections and are willing to put the time and effort into it, you could be looking at a profitable business venture.

10. Landscaping Business

A landscape business is a profitable small business to start if you’re good with your hands and have a love for nature. As a landscaper, you’ll be responsible for designing, installing, and maintaining landscapes and gardens. Tasks you’ll be doing could include mowing lawns, planting flowers, trimming trees and more.

11. SEO Consultant

A consulting business is one of the more lucrative ideas on this list. And if you are knowledgeable about search engine optimization, being an SEO consultant is an excellent small business idea. An SEO consultant analyzes a client’s website and makes recommendations for improving its search engine rankings. You can provide your consultation services to businesses who need them, or you could even start an agency offering these types of services.

12. Web Development

For online business ideas, you really can’t beat web development. A web developer designs websites, creates content for them, tests their functionality and ensures they function properly. Web development makes for a great side business, especially if you like tech. But, of course, it is a great business to own and do as a full-time job too.

13. Digital Marketing

Another up-and-coming business is digital marketing. Business owners here are responsible for building and promoting websites. Here’s what you do: You build a website, promote it on channels like Facebook, Twitter, Pinterest etc., use SEO to improve its ranking in search engines (Google/Yahoo), manage online advertising campaigns, update company collateral with new messages that fit the online branding and so on.

14. Professional Photography Business

If you have some starting capital, consider investing in equipment and offering photography services online. Areas you can go into include concert photography or LinkIn professional photos. Also, you can upload pictures to photo-sharing sites for royalties and sell them as prints or on products like phone cases, T-shirts etc.

15. Visual Artist

This is the best business for graffiti artists and spray paint artists. You won’t be a starving artist if you’re good, and both options allow you to obtain gainful employment. While it will be a challenge to get as rich as artists like David Choe and Banksy, visual artists can make anywhere from $16 to $70 per hour by mastering their spray cans.

16. Sign Company

There is a big push right now to make older neon signs more eco-conscious by replacing them with greener LED-powered signage. Fortunately, that’s creating a big niche, especially in California, where they are trying to reach a decarbonized electric grid. So, if you have a knack for business and design, consider starting your own sign company.

17. Acting Coach

If you want to become an acting coach in the United States, it’s important that you have proper training first. Usually, at least two years of college or conservatory-level courses are required before being certified by the state.

18. Accounting Business

If you’re an accountant, starting your own accounting firm could be a great way to make money. You can offer services such as bookkeeping, tax preparation, and consulting.

19. Bookkeeping Business

This business is accounting without the hassle of tax preparation and consulting. So if you love numbers and are good at bookkeeping, consider starting your own bookkeeping service. You can offer bookkeeping services for small businesses as well as for individuals.

20. Personal Chef Service

If you have a passion for cooking, consider starting your own personal chef service. As a personal chef, you’ll be responsible for preparing meals for your clients—either in their homes or yours. This could include anything from breakfast to dinner to a whole week of meals.

21. Blogger

If you have a way with words and an eye for style, blogging could be perfect for you. First, you’ll need to get a domain and your own website, but the rest is up to you. When you create an online presence, you can monetize your blog and generate revenue from ads and affiliate links.

22. Online Store

If you have an eye for fashion or design, consider starting your own e-commerce store. You can sell anything from clothing and accessories to home decor and furniture.

23. Graphic Designer

Graphic designers create visual concepts using images, words or other elements for companies in need of marketing materials. All it takes to get started is a degree in graphic design, a digital diploma or mad skills in Photoshop and Illustrator (and talent, of course).

24. Personal Trainer

If you’re passionate about fitness and helping others achieve their health goals, consider providing personal training services. You’ll be responsible for designing custom workout programs and helping your clients reach their fitness goals.

25. Catering Business

If you love to cook, consider starting your own catering business. As a caterer, you’ll be responsible for preparing and serving food at events such as weddings, corporate functions, and birthday parties.

26. Ice Cream Shop

Ice cream shops are a great small business for someone with limited startup funds, as most require a relatively small initial investment to get started. If you ever want some inspiration, read about kid CEO “Beau” Tracy Shell. He started his ice cream catering business Lil’ Ice Cream Dude when he was eight. In 2019, he opened his own ice cream shop Lil’ Ice Cream Dude’s Cool World at the ripe old age of 15.

27. Clothing Boutique

If you have a way with style and an eye for fashion, consider opening your own clothing boutique. You can sell anything from jewelry to accessories to clothes and shoes.

28. Coffee Shop

You’ve probably heard of Starbucks, but there are still plenty of opportunities out there if you want to start your own coffee shop or café—especially if you’re willing to put in the extra effort to differentiate yourself from the competition.

29. Hot Spot Owner

The great thing about starting a hot spot is that you can do it anywhere—all you need is a space, Wifi and desktops or laptops. You can then start charging for people to come work from your space (co-working), listen to music or just hang out. Better yet, combine it with your coffee shop to have another source of revenue going

30. Health Coach

If you’re passionate about health and fitness, consider launching your own wellness business. As a coach, you can help others achieve their health goals through exercise routines and nutritional advice.

31. Car Detailing Business

Detailing cars is a great way to make money on the side. In addition, it’s a relatively low-cost business to start, as you can get started with just some cleaning supplies and your own labor.

32. Asphalt Maintenance Company Business

If you have a van or large truck, consider starting your own asphalt maintenance company. You will be responsible for sealing and repairing cracks in parking lots and driveways with asphalt sealants like epoxy resin crack fillers (a polyurethane material).

33. Pressure Washing Company Business

Pressure washing is a great business to start if you’re looking for something relatively low-cost and easy to get started. You can start by buying a pressure washer, some cleaning supplies and getting insurance.

34. Junk Removal Business

Junk removal is a great business for someone who doesn’t mind getting their hands dirty. It can be a relatively low-cost business to start, and you can get started with just a few tools and supplies.

35. Food Truck Business

Owning a food truck is one of the most profitable business ideas on this list of business ideas. If you have a love for food and cooking, starting your own food truck business could be the perfect venture for you. To start a food truck, you’ll need to consider factors such as startup costs, equipment needs (i.e., refrigeration), location requirements, and how much you’ll need to charge for your food.

36.Specialty Supermarket

If you get tired of the same hum-drum, cookie-cutter supermarket chains, know this: Everyone else is too! That reason is why starting a specialty supermarket can be a lucrative business venture. As the name suggests, a specialty supermarket focuses on selling unique and hard-to-find items that you won’t find at your local Walmart or Safeway.

37. Home Contractor

If you have experience in home repairs or remodeling, consider starting your own home contractor business. As a contractor, you’ll be responsible for repairing and renovating homes and apartments.

38. Handyperson Service Provider

Handypersons are in high demand for home repairs. But if you get started with a small business of your own, you can offer additional services like organizing closets and garages.

39. Raise Honeybees

Of all the home business ideas on the list, this one is the sweetest! Honeybees are in high demand, and with a little bit of startup capital and know-how, you can start your own honeybee farm. First, you’ll need to purchase hives, bees, and other supplies like pollen patties, smokers and special apparel that helps keep bees out of your clothes.

40. Flea or Farmer’s Market Vendor

If you’re crafty and enjoy selling your creations, consider becoming a flea market vendor. It can be a great way to make some extra money on the side, and you’ll have the freedom to sell whatever you want!

Start Setting Up Your Own Small Business and Use this Guide for Inspiration

There you have it—40 small business ideas to get future small business owners started! Meanwhile, if you want more chances to enjoy a successful business, it’s important to create a business plan and get your business finances in order before you launch it.

However, if you’re still having difficulty deciding what type of business to start, consider using this guide as inspiration. These businesses are all relatively low-cost and easy to start, so you can rest assured that you won’t be breaking the bank. And who knows? With a little bit of effort, you just might find your next million-dollar idea!

Image: Depositphotos

The post Small Business Ideas for Beginners first appeared on DAILYZ HEALTH NEWS.
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Small-Business Owners Share 6 Tips for Using Instagram
Thu, 23 Dec 2021 19:12:28 GMT
Small-Business Owners Share 6 Tips for Using Instagram

There are reasons to get angry about social media – for one, it can be irritatingly addicting and potentially isolating. But like everything else in today’s social landscape, it’s a two-sided coin.

Social media also fosters connections that would be difficult to make personally, especially between businesses and consumers. It gives companies the ability to be relatable and the data shows it works. According to Instagram data from October 2019, at least 90% of people on Instagram follow a business.

Instagram is a crucial tool for growing your small online business – and you don’t have to dive headfirst into the influencer hype to leverage it successfully. To get you started, here are six Instagram marketing tips from small business owners and marketers.

1. Keep it internal, but don’t be afraid to delegate

Suzie Mills, co-founder of Practice Everywhere, a digital fitness company, and Honest Soul Yoga, a yoga studio based in Texas and Virginia, tried to hire an outside firm to manage the companies’ social media accounts. Ultimately, the curated approach didn’t work. “It wasn’t up to date, it didn’t make sense, it never looked personal,” she says.

Instead of spending a lot of money on a third party company, you can find people with a knack for social media in your own company. Julia Lopez, co-founder of Mills, suggests giving some trusted employees access to the company’s Instagram account.

“You have to give your Instagram to the people who know your business and your brand best,” she says.

2. Plan ahead

Planning content and time to publish Instagram posts is critical to the productivity of busy small business owners.

“It’s so important to know what days I post and what days I just share my story,” Dominique Lenaye, owner of Itty Bitty Bookstore in Stoughton, Wisconsin, said in an email. In contrast to conventional Instagram posts, stories disappear after 24 hours. Likewise, Lopez and Mills have added their Instagram photos and captions to their Google Calendar so they can stay on schedule and collaborate more easily.

Angel Kwiatkowski, founder of Cohere Coworking in Fort Collins, Colorado, says her best advice for new small business owners is to “take photos relentlessly”. That way, you don’t have to worry about content ideas – or focus too much on promotional content. To avoid the latter, Chelsea Huddleston, Marketing Director of ELEV8 Climbing and Fitness in Traverse City, Michigan, tries to strike a balance on the gym’s Instagram account: 60% photo and 40% promotional content.

3. Share the spotlight with employees and customers

If you’re not sure what to post next, don’t be afraid to pass the baton and give your reps and customers some attention. Lopez says following your employees is a solid first step. If they share your passion, they might already be sharing “things that are in line with the business” on Instagram. In this case, simply post the relevant content again – with recognition, of course.

And be sure to check out posts that tag your business. Reposting the positive interactions customers have with your brand (especially in Stories) shows your business and shows your customers some love.

4. Use the functions that make sense for your company

There are numerous ways to promote your business on Instagram – but not all of them make sense for your particular brand.

“I definitely think that overwhelming your Instagram with two or three posts a day is not the way to go,” says Lopez. This is where stories come into play, she adds. Stories are a great way to share snippets of your day without flooding your followers’ feeds. By adding interactive elements like polls or questions, you can also better understand your audience and what they want from your account.

Maria Romo, owner of The Brow Shaping Queen in Frisco, Texas, thinks tagging certain businesses is more organic than hashtags. Therefore, she uses her energy here. “I have a feeling that if you tag other companies, you will likely be seen more because they’ll share you again,” she says.

5. Let apps do the work for you

There’s no shortage of small business apps that make every aspect of your business – including social media – easier.

Lenaye uses Planoly, a free Instagram scheduling app, to organize her company’s account, while Huddleston uses Canva Pro templates to make the posting process easier. Aimee Breeden, owner of Studio A Staging in Baltimore, turns to Adobe Lightroom for photo editing. Other apps like Unfold also offer free post and story templates.

6. Remember that Instagram is not the be-all and end-all

“It’s so easy to believe that each method is what makes or breaks your business,” says Kwiatkowski. But the future of your business doesn’t depend on one thing alone – Instagram included.

“Believe in yourself,” says Breeden. “The more you do it, the better you’ll do it.”

Hillary Crawford writes for NerdWallet. Email: hcrawford@nerdwallet.com.

The post Small-Business Owners Share 6 Tips for Using Instagram first appeared on Wolverine State Watch.
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Deep Roots Help This Chicago Pharmacist Avoid Creating Another Drugstore Desert
Thu, 23 Dec 2021 13:05:10 GMT
Deep Roots Help This Chicago Pharmacist Avoid Creating Another Drugstore Desert

CHICAGO — Del-Kar Pharmacy in the North Lawndale neighborhood has had a front-row seat to history. Martin Luther King Jr. bought his daily newspaper there when he lived in Chicago in the late 1960s. The Black Panthers’ local headquarters was a block away, and the pharmacy shared a building with the Conservative Vice Lords, a notorious street gang whose members still check in on owner-pharmacist Edwin Muldrow today.

When King’s assassination sparked riots in Chicago in 1968, the white-owned pharmacies in the area were ransacked. Muldrow’s father went to check on the pharmacy only to be told by the Vice Lords he had nothing to worry about.

“‘Go home,’” Muldrow said they told his father. “‘We’re not gonna let anybody touch you.’”

For nearly 60 years, the small drugstore has survived by building deep roots in the community, selling medicine, food and electronics in a neighborhood largely ignored by the large drugstore chains. Del-Kar is bucking a trend that has undermined numerous other pharmacies in Chicago and other U.S. cities. Although chain pharmacies are pulling out of many urban areas, sometimes citing rioting or theft, Muldrow isn’t quitting.

“Once you respect the community, the neighborhood looks out for you,” said Muldrow, 51, who started working as a pharmacist at Del-Kar in 1992. “They know that you’re here and you’re doing something positive.”

Like other community pharmacists nationwide, Muldrow has seen private insurers steer his customers toward their own allied chain, mail-order and specialty pharmacies. Urban independent pharmacies, particularly those in low-income Black and Latino communities, have been more likely to close than chain drugstores.

And pharmacies of all kinds in these communities, chain and independent, face a tough economic situation: They often have a disproportionately high share of customers enrolled in Medicaid or Medicare, which pay lower rates than private insurance.

“There’s really no financial incentive for pharmacies to open and stay open in minority neighborhoods,” said Dima Qato, a University of Southern California pharmacy professor.

According to a recent analysis she worked on, Black and Latino neighborhoods accounted for a third of pharmacy openings in Chicago from 2015 to 2020 but more than half of closures. As a result, the prevalence of pharmacy deserts increased from 33% of majority-Black census tracts to 45% and from 9% of majority-Latino tracts to 14%.

“Pharmacies are choosing to open in areas that already have pharmacies, in part because those are also the areas that have higher incomes and insurances that provide higher pharmacy reimbursement rates,” said Jenny Guadamuz, a University of Southern California health disparities researcher who led the study.

Muldrow said insurance often pays less for a medication than it costs him to acquire it. For example, he might be reimbursed $400 for an Advair inhaler that costs him $600.

“The profession is not what it used to be,” he said. “The profitability has been snatched.”

Average dispensing fees, set by insurance plans and intended to cover Muldrow’s overhead and salary, have plummeted from about $3 per prescription 30 years ago to as little as 10 cents, he said. He once sold medical supplies like lift chairs and oxygen tanks. But since Medicare implemented new fraud safeguards requiring accreditation, he said, he would have to pay $1,500 to $2,000 a year to continue receiving Medicare reimbursement.

“Now you have elderly people in the neighborhood that can’t come and get stuff,” Muldrow said. “They have to go to the hospital. They got to go through the mail.”

Muldrow keeps his store open by supplementing the meager payments he gets for filling prescriptions with other income. “The secret to our success here is that we own the property,” Muldrow said. “If I was paying $3,000, $4,000 or more a month rent, I would have been wiped out.”

Muldrow had job offers from multiple chain drugstores when he graduated from pharmacy school but chose to work for his father. “‘The only way I can repay you for giving me the opportunity to go to school is to come down here and work and continue what you started,’” he recalled telling him.

Chicago has encouraged pharmacies to locate in underserved areas — with little success. Qato pointed to a CVS branch that in 2010 received nearly $1 million in incentives to open in East Garfield Park. A nearby independent drugstore quickly closed, and the CVS shut its doors several years later, creating a pharmacy desert.

Illinois launched a program in 2019 to subsidize pharmacies in underserved urban and rural areas. But, Qato said, the program doesn’t adequately target neighborhoods at risk of becoming pharmacy deserts and excludes large chain pharmacies, which may be the only drugstores remaining in a neighborhood.

A year into the program, she said, only three of 80 eligible pharmacies in Chicago have received funds. Muldrow said he hadn’t heard of the program.

Some business strategies create de facto deserts. Late last year, the health insurer Aetna, owned by CVS Health, began preventing its Medicaid patients in Illinois from filling prescriptions at Walgreens pharmacies. As a result, some patients could no longer use the closest drugstore.

Dr. Thomas Huggett, a family physician at the Lawndale Christian Health Center on the West Side of Chicago, said some of his patients had trouble getting their medications in the first month of the new policy. One patient, who was homeless and had been diagnosed with severe mental illness, couldn’t get his prescription filled. Another had to take two buses to get his injectable antipsychotic medication. A third patient couldn’t get Suboxone, a treatment for opioid addiction.

“In the middle of one of the hotter spots in the country for opioid overdoses on the West Side of Chicago, it’s hard to imagine how anybody could justify it,” Huggett said.

In urban areas, Illinois regulations require prescription insurance plans to have at least one in-network pharmacy within a 15-mile radius or a 15-minute drive of their enrollees. But that can be too far to be practical for many customers, Huggett said.

“The majority of patients who have Medicaid have Medicaid because they are poor, and they generally don’t have cars,” Huggett said. “Looking at the maps, it is just so stark to see. The CVSs are intentionally avoiding black areas of Chicago.”

CVS spokesperson Mike DeAngelis said that about half of CVS stores nationwide are in areas that rank high on the Centers for Disease Control and Prevention’s Social Vulnerability Index, which tracks poverty, lack of vehicle access and crowded housing, among other factors.

“Maintaining access to pharmacy services in underserved communities is an important factor we consider when making store closure decisions,” DeAngelis said in an email. “Other factors include local market dynamics, population shifts, a community’s store density, and ensuring there are other geographic access points to meet the needs of the community.”

James Spidle, a 66-year-old veteran with serious heart problems, walks a mile using a cane to catch a bus in the Washington Heights neighborhood, about 13 miles south of Del-Kar, to pick up his prescriptions from a Walmart.

“I do the walk back and forth as a stress test,” he said. “If I don’t have any chest pains, I keep going.”

A closer option, a Walgreens, closed in 2016. A sign on the door directed customers to another branch that was a mile away in a more affluent neighborhood and had a grocery store pharmacy across the street.

The Endeleo Institute, the community development arm of Trinity United Church of Christ, has tried to fill the gap, using church vans to drive people to the nearest pharmacies. Melvin Thompson, its executive director, listed four other chain pharmacies that had closed within a three-mile radius of the Walgreens that shuttered in Washington Heights.

“Here we are in the midst of a pandemic, and we’re losing even more of these vital services in communities that can’t afford to lose,” he said. “It’s citywide, but it just seems to be relegated to Black and brown communities.”

Walgreens officials did not answer questions about how the company decides to close stores, but said that in metro Chicago about 99% of Chicagoans live within 2 miles of one of their stores. Walgreens spokesperson Kris Lathan said the company allocated $35 million to reopen 80 stores in Chicago damaged during the civil unrest after the murder of George Floyd in 2020.

“All but two of those locations have reopened,” she said. “The remaining two will open in the first half of 2022.”

Democratic state Rep. La Shawn Ford said pharmacy closures represent a loss of health care access for the community. “The pharmacy is not just a place to pick up medicine, it’s a surrounding of health care,” he said. “Who’s going to talk to that person when they get their medicine mail-delivered?”

It can also be a lifeline in other ways. During the pandemic, when indoor dining was shut down, Muldrow set up an outdoor grill and served burgers, tacos and other food. That showed him how much the neighborhood needed him — and for a lot more than medications. He is planning an expansion, to include a bodega with a juice bar and restaurant.

Muldrow was also reminded that the community is there for him in return. Last year, during the civil unrest, several businesses near Del-Kar were destroyed. But, in an echo of 1968, his shop emerged unscathed.

“I didn’t have any worries. I slept real good,” Muldrow said. “The brothers over here on Lawndale, they watched over me. If you know the people, the people look out for you.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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This story can be republished for free (details).

The post Deep Roots Help This Chicago Pharmacist Avoid Creating Another Drugstore Desert first appeared on America's Firearms Newsource.
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17 wichtige Netflix-Tipps, Methods und versteckte Funktionen
Thu, 23 Dec 2021 15:36:20 GMT

AKTUALISIERT: Werden Sie ein Netflixer der nächsten Generation mit unserem Streaming-Masterplan, einschließlich der Anforderung neuer Titel…

Was haben Netflix, Die Simpsons und frittierte Mars-Bars gemeinsam? Sie alle haben verborgene Tiefen, die unter einem scheinbar einfachen Äußeren lauern, obwohl sie leicht zu übersehen sind. Schließlich ist es viel einfacher, Squid Game (oder was auch immer das “neue” Squid Game diese Woche ist) zu starten, dank der Art und Weise, wie Netflix jetzt Trendshows und -filme hervorhebt.

Jedoch, Mit ein wenig Herumbasteln an Einstellungen und Software von Drittanbietern können Sie Ihr Binge-Watching-Erlebnis auf eine Weise personalisieren, die zunächst nicht möglich erscheint. Von den versteckten Menüs und Untergenres von Netflix bis hin zur Optimierung der Untertitelgröße haben wir unsere bevorzugten Möglichkeiten zusammengefasst, um das Beste aus dem Dienst herauszuholen.

Hier sind die besten Netflix-Tipps, Tricks und versteckten Funktionen, die jeder Streamer kennen sollte.

1) Seien Sie alle Daumen

Netflix als “verwirrend” für die Benutzer anführend, hat Netflix sein altes Sternebewertungssystem im Jahr 2017 aufgegeben und es durch ein viel einfacheres Modell mit Daumen hoch/Daumen runter ersetzt. Indem wir den Benutzern eine binäre Wahl geben – hat uns etwas gefallen oder nicht? – Anstatt sie zu bitten, etwas von fünf zu bewerten, hat Netflix versucht, sie zu ermutigen, mehr Artikel zu bewerten.

Der springende Punkt dabei ist natürlich, die Empfehlungsalgorithmen von Netflix mit wertvolleren Daten zu füttern, um die Sendungen und Filme, die Sie tatsächlich mögen werden, direkt vor sich zu platzieren und diesen Sendungen eine persönliche prozentuale Bewertung zu geben (die je höher der Prozentsatz, desto höher die Wahrscheinlichkeit, dass es Ihnen gefällt).

Wie bei vielen undurchsichtigen Arbeiten hinter den Kulissen des Dienstes ist es schwer zu sagen, wie viel Unterschied die Bewertung von Dingen tatsächlich macht, aber laut Netflix spielt es eine Rolle (zusammen mit Ihrem Streaming-Verlauf und den Bewertungen anderer Benutzer, die haben einen ähnlichen Geschmack wie Sie).

2) Spielen Sie mit Profilen

Ihre kleine Nichte könnte Peppa Pigs tiefe Handlungsstränge lieben, aber Sie möchten nicht, dass Ihre Empfehlungen von den Filmen von Jason Statham und John Woo abgelenkt werden.

Separate Profile für deine Kinder, Mama, Katze und Goldfisch Gary sorgt dafür, dass sich nichts von ihrem Dreck mit deinem vermischt, und sorgt dafür, dass deine Empfehlungen reibungslos funktionieren.

Wenn Sie das Glück haben, der einzige Benutzer des Kontos zu sein, können Sie auch Profile verwenden, um die Benutzeroberfläche von Netflix zu personalisieren und Ihre Couch-Potato-Effizienz zu steigern – zum Beispiel mit einem Profil für „TV-Sendungen“ und einem anderen für „Filme“. Stellen Sie nur sicher, dass Sie Bewertungen verwenden, um Netflix Baumwolle in Ihren Plan aufzunehmen.

Wäre es nicht toll, eine Watchlist zu haben, die Ihre Lieblings-Netflix-Shows mit dem Besten von Prime Video, iPlayer und Now TV kombiniert?

Schau nur kommt diesem Organisationstraum am nächsten. Sicher, Sie können in der App keine Sendungen ansehen, aber die Möglichkeit, in allen Ihren Diensten nach Sendungen zu suchen, ist unglaublich nützlich und benachrichtigt Sie auch, wenn etwas von Ihrer Wunschliste zu Netflix hinzugefügt wurde.

Die Abdeckung der Dienste ist umfassend, von Netflix und Amazon Prime Video bis hin zu iTunes, PlayStation, dem Google Play Store und allem dazwischen.

Jetzt herunterladen: JustWatch für iOS

Jetzt herunterladen: JustWatch für Android

4) Verpasse keine neuen Netflix-Shows

Netflix zeigt Warnungen für Shows und Filme an, die unmittelbar auf der Detailseite ablaufen, aber es ist immer noch leicht, Klassiker zu verpassen, bevor sie gelöscht werden.

Aus diesem Grund lohnt es sich, @NewonNetflixUK auch auf Twitter zu folgen, um #lastchance-Benachrichtigungen zu Filmen und Shows zu erhalten, die kurz davor sind, die Axt zu bekommen.

5) Stellen Sie eine Anfrage

Sie können Ihre Lieblingsfolge von MacGyver auf Netflix nicht finden? Warum nicht direkt zur Quelle gehen und sie bitten, dieses Versehen zu korrigieren? Gehen Sie zur Titelanforderungsseite von Netflix und Sie können bis zu drei Vorschläge gleichzeitig eingeben. Natürlich gibt es keine Garantie, dass sie tatsächlich auf Ihre Anfragen reagieren, aber Sie haben es zumindest versucht…

6) Erweitere dich mit geheimen Netflix-Codes

Wenn Sie wie wir sind, werden Sie mehr Zeit damit verbringen, endlose Seiten mit Dingen zu durchblättern, die Sie sich ansehen können, als sich etwas anzusehen.

Aus diesem Grund lohnt es sich, Ihre Netflix-Watchlist in Chrome zu erstellen. wo Sie Browsererweiterungen verwenden können, um zusätzliche Informationen abzurufen. Mit der FindFlix-Erweiterung können Sie die vielen versteckten Untergenres von Netflix wie asiatische Actionfilme, Alien-Science-Fiction und Werwolf-Horrorfilme praktisch durchsuchen.

Wenn Sie dafür keine Erweiterung verwenden möchten, können Sie über to What’s On Netflix für eine Liste aller geheimen Netflix-Kategoriecodes.

Kombinieren Sie beides mit der leistungsstarken FlixPlus-Erweiterung, die unter anderem Bewertungen von Rotten Tomatoes einbezieht, und Sie werden die effizienteste Binge-Watching-Maschine seit dem Binge Watcher-Modell IV 3000 sein.

Jetzt installieren: FindFlix für Chrome installieren

Jetzt installieren: FlixPlus für Chrome installieren

Während KI-Bots (zum Glück) ein gutes Stück davon entfernt sind, Ihren Toaster zu infiltrieren und Sie im Schlaf zu verbrennen, sind sie immer noch ziemlich clever.

Nehmen Sie den AndChill-Bot von Facebook Messenger. Es wird über einige überraschend gute Filmempfehlungen feuern, die auf Dingen basieren, die Sie ihm sagen, zusammen mit einigen Trailern, damit Sie ein Gefühl für die Auswahl bekommen.

8) Zufallsmodus

Wenn Sie nach einem anstrengenden Tag besonders nervös sind und mit minimalem Aufwand etwas auswählen möchten, empfiehlt Netflix Roulette etwas ganz Zufälliges.

Naja, nicht ganz zufällig, sonst sieht man vielleicht Avalanche Sharks. Wählen Sie Filter wie Schauspieler, Genre und Sternebewertung aus, aber stellen Sie sicher, dass eine strikte „No Re-Spin“-Richtlinie durchgesetzt wird.

9) Festival herunterladen

Die lang erwartete Download-Funktion von Netflix wurde in der Stuff-Welt mit lustvollen, offenen Armen empfangen und ist ein Glücksfall für Flüge und Pendelfahrten mit toten Winkeln.

Um Sendungen auf iOS- oder Android-Geräte herunterzuladen, navigieren Sie entweder zum Abschnitt “zum Download verfügbar” oder klicken Sie auf das Download-Symbol neben der Sendung. Um Ihre Offline-Shows zu finden, gehen Sie zum Menü und dann zu “Meine Downloads”.

Beachten Sie, dass die Anzahl der Geräte, auf die Sie Inhalte herunterladen können, begrenzt ist. Je nach Plan kann dies ein bis vier Geräte sein.

Jeder Download hat auch eine andere Ablaufzeit. Shows, die in weniger als sieben Tagen ablaufen, zeigen die verbleibende Zeit im Abschnitt “Meine Downloads”. Bei vielen Downloads muss die Anzeige auch innerhalb von 48 Stunden nach dem Drücken der Play-Taste abgeschlossen sein. Bereiten Sie sich also nicht zu weit im Voraus auf Ihren Flug vor.

10) Vergrößere es

Downloads sind großartig und alles, aber sie werden Speicherplatz auf Ihrem Gerät verbrauchen. Um den Überblick zu behalten, gehen Sie zu “App-Einstellungen”, um eine Grafik anzuzeigen.

Um schnell Speicherplatz freizugeben, klicken Sie auf „Alle Downloads löschen“. Sie können Ihre Videoqualität auch auf „höher“ (HD) ändern, aber denken Sie daran, dass diese etwa doppelt so viel Speicherplatz beanspruchen.

Eine einstündige HD-Show nimmt etwa 500 MB ein, obwohl die SD-Qualität normalerweise für einen Telefon- oder Tablet-Bildschirm gut genug ist.

11) Shows auf SD-Karte herunterladen

Mit Netflix können Sie derzeit nur Apps auf den Speicherplatz Ihres Telefons herunterladen. Aber wenn Sie ein Android-Telefon mit einem microSD-Steckplatz rocken, gibt es einige Problemumgehungen, mit denen Sie sie auf eine große SD-Karte bringen können. Es gibt zwei Möglichkeiten:

Methode 1

Die erste besteht darin, einen Dateibrowser herunterzuladen, ihn so einzustellen, dass versteckte Dateien angezeigt werden, und heruntergeladene Inhalte auf die microSD-Karte zu kopieren.

Das Problem bei dieser Methode besteht jedoch darin, dass Inhalte nicht von der microSD-Karte selbst abgespielt werden können – Sie müssen sie zurück in den richtigen Ordner auf Ihrem Telefon kopieren, um sie abzuspielen.

Es ist dann praktisch zum Speichern, aber ziemlich umständlich, wenn Sie zwischen den Anzeigen ständig Dateien hin und her kopieren und einfügen müssen.

Methode 2

Eine nützlichere (aber auch anfangs mühsame) Problemumgehung besteht darin, Ihre microSD-Karte mit dem internen Speicher Ihres Telefons zusammenzuführen, wodurch Android im Wesentlichen glaubt, dass Ihre microSD-Karte ein interner Teil des Smartphones selbst ist.

Entfernen Sie Ihre microSD-Karte und legen Sie sie erneut ein und tippen Sie auf „Einrichten“, sobald eine Benachrichtigung angezeigt wird. Wählen Sie „Als internen Speicher verwenden“. Dadurch wird die Karte vollständig gelöscht. Stellen Sie also sicher, dass Sie zuvor alles gesichert haben. Sobald Sie dazu aufgefordert werden, wählen Sie die Option zum Migrieren Ihrer Daten in Ihren neuen Speicher aus.

Während Sie jetzt mit Ihrer SD-Karte die Kapazität des internen Speichers Ihres Telefons künstlich erhöht haben, sollten Sie beachten, dass Sie mindestens eine Karte der Klasse 6 benötigen, um sehr langsame Ladezeiten und Leistung zu vermeiden.

Wenn Sie diesen Weg einschlagen, entfernen Sie die Karte niemals, es sei denn, Sie möchten das gesamte Telefon zurücksetzen, da wichtige Systemdateien darauf gespeichert werden.

12) Wählen Sie den besten Browser für Netflix

Wenn Sie Netflix über das Internet ansehen, wissen Sie möglicherweise nicht, dass die Wahl Ihres Browsers eine große Rolle dabei spielt, wie scharf und detailliert Ihr Bild aussieht.

Bei Firefox, Opera und Chrome ist die Streaming-Auflösung auf 720p beschränkt (es sei denn, Sie verwenden einen Chrome OS-Computer, in diesem Fall bietet Chrome eine Qualität von bis zu 1080p), während Internet Explorer und Safari schärferes 1080p-Streaming bieten. Der Edge-Browser von Microsoft ist jedoch möglicherweise die beste Option, sofern verfügbar, da er eine 4K-Auflösung unterstützt (vorausgesetzt, Ihr PC verfügt über einen Intel Core-Prozessor der 7. Generation und eine HDCP 2.2-kompatible Verbindung zu einem 4K-Display, Natch).

Wenn Sie ein eingefleischter Chrome- oder Firefox-Benutzer sind und nicht einmal mit Konkurrenten flirten möchten, können Sie für beide Erweiterungen installieren, die eine 1080p-Wiedergabe ermöglichen: Netflix 1080p (für Chrome); und 1080p-Wiedergabe erzwingen (für Firefox).

13) Lass die Party beginnen

Nur weil Sie Freunde und Familie nicht sehen können, heißt das nicht, dass Sie keinen Filmabend der alten Schule haben können!

Die Chrome-Erweiterung Netflix Party synchronisiert die Wiedergabe zwischen den Teilnehmern, sodass alle die Aktion gleichzeitig verfolgen können, während Sie über eine Chat-Box auf dem Seitenbildschirm über den Film (oder alles andere) sprechen können..

Es gibt leider keine leckere virtuelle Popcorn-Option. Noch.

Jetzt installieren: Netflix Party für Chrome

14) Hör auf, bei Untertiteln zu blinzeln

Sie sehen sich einen fremdsprachigen Film an, haben aber Schwierigkeiten, die Untertitel zu lesen? Ändern Sie deren Größe, Stil und Farbe in der Webbrowser-Oberfläche von Netflix, indem Sie auf “Ihr Konto” und dann auf “Erscheinung der Untertitel” gehen.

Änderungen funktionieren auch auf anderen Geräten wie der Konsolen-App von Netflix, also wählen Sie mit Bedacht aus (vielleicht nicht Comic Sans, es sei denn, Sie möchten, dass Pablo Escobar wie in einer Slapstick-Komödie aussieht).

Sie können auch Untertitel erhalten, auch wenn diese nicht direkt im Inhalt enthalten sind. go zu Subflix und laden Sie die Netflix-freundlichen Untertitel in der Sprache Ihrer Wahl herunter.

Sobald dies erledigt ist, laden Sie sie über die Super Netflix Chrome-Erweiterung hoch und Sie sind goldrichtig. Leider funktioniert dies vorerst nur auf PCs und Macs.

15) Mischen Sie es durch

Flixband. Wie Mixtape, aber mit Netflix. Kapiert? Nein? Nun, es ist wirklich ganz einfach.

Melden Sie sich mit Ihrem Netflix-Konto bei Flixtape an, und Sie können Wiedergabelisten mit Inhalten erstellen, sie nach Belieben benennen und mit Ihren Freunden teilen.

Comedy Horror Night In könnte zum Beispiel What We Do In The Shadows und Scary Movie haben. Ihre Möglichkeiten sind nur durch Ihre Vorstellungskraft begrenzt. Und die Bibliothek von Netflix, vermuten wir.

16) Sprachsteuerung

Tolle Neuigkeiten für Besitzer von Google Home, die Rick & Morty sehen möchten, ohne einen Finger rühren zu müssen: Es ist möglich, Netflix mit dem intelligenten Lautsprecher von Google über einen Chromecast zu steuern, der an Ihren Fernseher angeschlossen ist (oder indem Sie einen Fernseher mit eingebauter Chromecast-Funktionalität haben) in).

Rufen Sie die Google Home App auf, gehen Sie zu Menü > Google Assistant > Weitere Einstellungen > Videos und Fotos und Sie sehen die Option zum Verknüpfen von Netflix und Ihrem Google Home. Sobald das verbunden ist, kannst du einfach sagen „OK Google, sieh dir Narcos an und dein Fernseher wird sofort anfangen, kolumbianische Drogenbarone zu zeigen.

17) Teilen Sie Ihr Konto (aber nicht Ihr Passwort)

Möchten Sie jemandem vorübergehend Zugriff auf Ihr Netflix-Konto gewähren, während Sie im Urlaub sind?

Mit der Chrome-Erweiterung AccessURL (kostenlos für Chrome) können Sie einen Link mit einem integrierten Ablaufdatum teilen, damit Ihre Großzügigkeit nicht missbraucht wird.

The post 17 wichtige Netflix-Tipps, Methods und versteckte Funktionen first appeared on DAILY GADGET AND GIZMOS NEWS.
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Immerse your sweet tooth in chocolatey treats at this Braselton event
Thu, 23 Dec 2021 15:45:26 GMT
Immerse your sweet tooth in chocolatey treats at this Braselton event

Are Christmas cookies only used to intensify your sweet tooth and leave you tormented when and where you could find your next solution? Downtown Braselton has a remedy.

A precursor to Valentine’s Day is the city’s eighth annual Chocolate Walk, which takes to the streets on Saturday, February 5, allowing 250 ticket holders to indulge in decadent goodies from participating business owners from 11 a.m. to 4 p.m.

Menu details are still being ironed out, although chocolate walks of the past have brought chocolate lovers to candy, chocolate fountains, chocolate-coated pretzels, and sweet treats with a hearty flair.

“It’s definitely a nice way to see what kind of stores we have downtown,” said Jessica Payne, Braselton’s downtown assistant. “Nothing says ‘community’ better than chocolate.”

According to Payne, this year’s participating companies include some of those preparing to move into The 1904, as well as Braselton Brewing Company, Joy Company Market, Local Station, Blake’s of Braselton, House of Boykin, Elements Day Spa and Marketplace, Countryside Antiques and olive basket.

Tickets are $ 15 and are available now through February 1, although Payne expects them to “definitely sell out” before that.

One of the very first walks in Braselton designed to help people discover and connect with downtown shops, the Chocolate Walk sells out every year.

“This is a very popular event,” said Payne. “We get a lot of regular customers and people who just love chocolate.”

Several key factors contribute to the event’s popularity, Payne said.

“The first is that they probably love chocolate and our companies have high quality chocolate items,” she said. “I think that makes a difference. The other (reason) is that it’s like an adult scavenger hunt, and who doesn’t love a scavenger hunt? Even if it may have existed before, it is different every year – the delicacies are different, the stops change a little. It gives them a reason to come downtown and then come back downtown. The feedback we always get on these walks is: ‘I didn’t know this was here, I didn’t know that there were so many shops in the city center.’ This helps to make companies that participate. “

While the walk is eagerly awaited by locals, Payne says Payne is also attracting the attention of some outside of the Braselton-Hoschton area who “plan to attend this event all Saturday”.

On the day of the event, ticket holders begin their chocolate stroll in the common room of the police and city court of Braselton, where they exchange their ticket for a card with all of the day’s “chocolate stops” and a bag to take away their loot.

Hikers also receive a stamp card upon check-in that they can fill out to win a $ 100 Downtown Dollar Gift Certificate.

Check-in starts at 10:45 AM and ends at 1:00 PM

Ticket holders must be at least 16 years old to participate.

For more information, visit explorebraselton.ticketleap.com/2022-durban-chocolate-walk/details.

The post Immerse your sweet tooth in chocolatey treats at this Braselton event first appeared on Daily Florida Press.
Category: Gainesville
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Colorado secretary of state files lawsuit to strip Tina Peters of election authority
Tue, 31 Aug 2021 05:24:01 GMT

Colorado Secretary of State Jena Griswold has filed a lawsuit as part of an effort to prevent the Mesa County clerk and recorder from maintaining her authority over elections.

The lawsuit was filed Monday in state district court in Mesa County. The lawsuit seeks to remove Mesa County Clerk and Recorder Tina Peters as the designated election official.

“My priority is ensuring that the voters of Mesa County have accessible and secure elections. With the quickly approaching election, I am taking action to ensure that the county’s election office can provide great elections for Mesa voters,” Griswold said in a statement. Peters “is not fit to serve” as the designated election official, she said.

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Peters is accused by Griswold of participating in activity that led to the release of election-system hard drive images and passwords to election-fraud conspiracy theorists, including Ron Watkins, a leading QAnon figure.

The reported breach is the subject of an investigation by the secretary of state, as well as separate criminal probes by 21st Judicial District Attorney Dan Rubinstein and the FBI. No criminal charges have yet been filed against Peters in connection with the incident.

Peters, a Republican adherent of debunked claims that the November election was fraudulent, has not cooperated with investigators from the secretary of state’s office, and she’s reportedly out of the state “in hiding” and under the protection of MyPillow CEO and election conspiracist Mike Lindell. She was a featured speaker at an election fraud “Cyber Symposium” in South Dakota hosted by Lindell from Aug. 10 through Aug. 12, when state investigators traveled to her office in Grand Junction to inspect election equipment, which Griswold determined was compromised and ordered decertified.

Peters is the subject of at least two ethics complaints related to her participation in the Lindell event and his subsequent patronage, The Daily Sentinel reported. The complaints accuse Peters of violating the state’s ban on gifts for government employees and elected officials.

On Aug. 17, Griswold designated a new supervisor, Mesa County Treasurer Sheila Reiner, as well as a three-person advisory committee, to oversee elections in Peters’ place. The advisory committee includes state Rep. Janice Rich, Ouray County Clerk and Recorder Michelle Nauer, and former Secretary of State Bernie Buescher. In opposition to Griswold’s order, Mesa County commissioners voted to reject Reiner and appoint former Secretary of State Wayne Williams to oversee Mesa County elections. Williams and Reiner had agreed to work as a team to supervise elections.

But as part of Griswold’s court filing, she asks that Williams be appointed as the designated election official and Reiner be appointed as the director of elections. That would mean Reiner would answer to Williams.

In her Aug. 17 order, Griswold also prohibited two clerk’s office staff members accused of involvement in the election-system breach — Deputy Clerk Belinda Knisley and elections manager Sandra Brown — from any role in elections.

This is a developing story.

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The post Colorado secretary of state files lawsuit to strip Tina Peters of election authority appeared first on Colorado Newsline.

Category: Personal Injury
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As Sufferers Fell Sick With Covid Inside Hospitals, Authorities Oversight Fell Brief
Thu, 23 Dec 2021 14:25:56 GMT



One by one, the nurses taking care of actress Judi Evans at Riverside Community Hospital kept calling out sick.

Patients were coughing as staffers wheeled the maskless soap opera star around the California hospital while treating her for injuries from a horseback fall in May 2020, Evans said.

She remembered they took her to a room to remove blood from her compressed lung where another maskless patient was also getting his lung drained. He was crying out that he didn’t want to die of covid.

No one had told her to wear a mask, she said. “It didn’t cross my mind, as I’m in a hospital where you’re supposed to be safe.”

Then, about a week into her hospital stay, she tested positive for covid-19. It left the 57-year-old hospitalized for a month, staring down more than $1 million in bills for treatment costs and suffering from debilitating long-haul symptoms, she said.

Hospitals, like Riverside, with high rates of covid patients who didn’t have the diagnosis when they were admitted have rarely been held accountable due to multiple gaps in government oversight, a KHN investigation has found.

While a federal reporting system closely tracks hospital-acquired infections for MRSA and other bugs, it doesn’t publicly report covid caught in individual hospitals.

Medicare officials, tapped by Congress decades ago to ensure quality care in hospitals, also discovered a gaping hole in their authority as covid spread through the nation. They could not force private accreditors — which almost 90% of hospitals pay for oversight — to do targeted infection-control inspections. That means Riverside and nearly 4,200 other hospitals did not receive those specific covid-focused inspections, according to a government watchdog report, even though Medicare asked accreditors to do them in March 2020.

Seema Verma, former chief of Medicare and Medicaid under President Donald Trump, said government inspectors went into nearly every nursing home last year. That the same couldn’t be done for hospitals reveals a problem. “We didn’t have the authority,” she told KHN. “This is something to be corrected.”

KHN previously reported that at least 10,000 patients nationwide were diagnosed with covid in hospitals last year after being admitted for something else — a sure undercount of the infection’s spread inside hospitals, since that data analysis primarily includes Medicare patients 65 and older.

Nationally, 1.7% of Medicare inpatients were documented as having covid diagnosed after being admitted for another condition, according to data from April through September 2020 that hospitals reported to Medicare. CDIMD, a Nashville-based consulting and data analytics company, analyzed the data for KHN.

At Riverside Community Hospital, 4% of the covid Medicare patients were diagnosed after admission — more than double the national average. At 38 other hospitals, that rate was 5% or higher. All those hospitals are approved by private accreditors, and 29 of them hold “The Gold Seal of Approval” from their accreditor.

To be sure, the data has limitations: It represents a difficult time in the pandemic, when protective gear and tests were scarce and vaccines were not yet available. And it could include community-acquired cases that were slow to show up. But hospital-employed medical coders decide whether a case of covid was present on admission based on doctors’ notes, and are trained to query doctors if it’s unclear. Some institutions fared better than others — while the American public was left in the dark.

Spurred by serious complaints, federal inspectors found infection-control issues in few of those 38 hospitals last year. In Michigan, inspectors reported that one hospital “failed to provide and maintain a sanitary environment resulting in the potential for the spread of infectious disease to 151 served by the facility.” In Rhode Island, inspectors found a hospital “​​failed to have an effective hospital-wide program for the surveillance and prevention” of covid.

KHN was able to find federal inspection reports documenting infection-control issues for eight of those 38 hospitals. The other 30 hospitals around the country, from Alabama to Arizona, had no publicly available federal records of infection-control problems in 2020.

KHN found that even when state inspectors in California assessed hospitals with high rates of covid diagnosed after admission, they identified few shortcomings.

“The American public thinks someone is watching over them,” said Lisa McGiffert, co-founder of the Patient Safety Action Network, an advocacy group. “Generally they think someone’s in charge and going to make sure bad things don’t happen. Our oversight system in our country is so broken and so untrustworthy.”

The data shows that the problem has deadly consequences: About a fifth of the Medicare covid patients who were diagnosed after admission died. And it was costly as well. In California alone, the total hospital charges for such patients from April through December last year was over $845 million, according to an analysis done for KHN by the California Department of Health Care Access and Information.

The Centers for Disease Control and Prevention has pledged funding for increased infection-control efforts — but that money is not focused on tracking covid’s spread in hospitals. Instead, it will spend $2.1 billion partly to support an existing tracking system for hospital-acquired pathogens such as MRSA and C. diff.

The CDC does not currently track hospital-acquired covid, nor does it plan to do so with the additional funding. That tracking is done by another part of the U.S. Department of Health and Human Services, according to Dr. Arjun Srinivasan, associate director for the CDC’s health care-associated infection-prevention programs. But it’s not made public on a hospital-by-hospital basis. HHS officials did not respond to questions.

The Scene at Riverside

In March 2020, Evans was alarmed by nonstop TV footage of covid deaths, so she and her husband locked down. They hadn’t been going out much, anyway, since losing their only child at the end of 2019 to another public health crisis — fentanyl.

At the time, concerns about covid were mounting among the staff at Riverside Community Hospital, a for-profit HCA Healthcare facility.

The hospital’s highly protective N95 masks had been pulled off the supply room shelves and put in a central office, according to Monique Hernandez, a shop steward for her union, Service Employees International Union Local 121RN. Only nurses who had patients getting aerosol-generating procedures such as intubation — which were believed at the time to spread the virus — could get one, she said.

She said that practice left the nurses on her unit with a difficult choice: either say you had a patient undergoing such procedures or risk getting sick.

Nurse unions were early adopters of the notion — now widely accepted — that covid is spread by minuscule particles that can linger in the air. Studies since have matched the genetic fingerprint of the virus to show that covid has spread among workers or patients wearing surgical masks instead of more protective masks like N95s.

On April 22, 2020, Hernandez and other nurses joined a silent protest outside the hospital where they held up signs saying “PPE Over Profit.” By that time, the hospital had several staff clusters of infection, according to Hernandez, and she was tired of caregivers being at risk.

In a statement, Riverside spokesperson David Maxfield said the hospital’s top priority has been to protect staff “so they can best care for our patients.”

“Any suggestion otherwise ignores the extensive work, planning and training we have done to ensure the delivery of high-quality care during this pandemic,” he said.

In mid-May, Judi Evans’ husband coaxed her into going horseback riding — one of the few things that brought her joy after her son’s death. On her second day back in the saddle, she was thrown from her horse. She broke her collarbone and seven ribs, and her lung was compressed. She was taken to Riverside Community Hospital.

There, many of her nurses wore masks they had previously used, Evans recalled. Other staffers came in without any masks at all, she said. A few days in, she said, one of the doctors told her it’s crazy that the hospital was testing her for MRSA and other hospital infections but not covid.

Maxfield said that the hospital began enforcing a universal mask mandate for staff and visitors on March 31, 2020, and, “in line with CDC, patients were and are advised to wear masks when outside their room if tolerated.” He stressed “safety of our patients and colleagues has been our top priority.”

After about a week in the hospital, Evans said, she spiked a fever and begged for a covid test. It was positive. There is no way to know for certain where or how she got infected but she believes it was at Riverside. Covid infections can take two to 14 days from exposure to show symptoms like a fever, with the average being four to five days. According to CDC guidance, infection onset that occurs two days or more after admission could be “hospital-associated.”

Doctors told her they might have to amputate her legs when they began to swell uncontrollably, she said.

“It was like being in a horror film — one of those where everything that could go wrong does go wrong,” Evans said.

She left with over $1 million in bills from a month-long stay — and her legs, thankfully. She said she still suffers from long-covid symptoms and is haunted by the screams of fellow patients in the covid ward.

By the end of that year, Riverside Community Hospital would report that 58 of its 1,649 covid patients were diagnosed with the virus after admission, according to state data that covers all payers from April to December.

That’s nearly three times as high as the California average for covid cases not present on admission, according to the analysis for KHN by California health data officials.

“Based on contact tracing, outlined by the CDC and other infectious disease experts, there is no evidence to suggest the risk of transmission at our hospital is different than what you would find at other hospitals,” Maxfield said.

A lawsuit filed in August by the SEIU-United Healthcare Workers West on behalf of the daughter of a hospital lab assistant who died of covid and other hospital staffers says the hospital forced employees to work without adequate protective gear and while sick and “highly contagious.”

The hospital “created an unnecessarily dangerous work environment,” the lawsuit claims, “which in turn has created dangerous conditions for patients” and a “public nuisance.”

Attorneys for Riverside Community Hospital are fighting the ongoing lawsuit. “This lawsuit is an attempt for the union to gain publicity, and we have filed a motion to end it,” said Maxfield, the hospital spokesperson.

The hospital’s lawyers have said the plaintiffs got covid during a spike in local cases and are only speculating that they contracted the virus at the hospital, according to records filed in Riverside County Superior Court.

They also said in legal filings that the court should not step into the place of “government agencies who oversee healthcare and workplace safety” and “handled the response to the pandemic.”

‘A Shortcoming in the Oversight System’

Decades ago, Congress tasked Medicare with ensuring safe, quality care in U.S. hospitals by building in routine government inspections. However, hospitals can opt to pay up to tens of thousands of dollars per year to nongovernmental accreditors entrusted by CMS to certify the hospitals as safe. So 90% do just that.

But these accrediting agencies — including the Joint Commission, which certified Riverside — are private organizations. Thus they are not required to follow CMS’ directives, including the request in a March 20 memo urging the accrediting agencies to execute targeted infection-control surveys aimed at preparing hospitals for covid’s onslaught.

And so they didn’t send staffers to survey hospitals for the specialized infection-control inspections in 2020, according to a June 2021 Health and Human Services Office of the Inspector General report.

Riverside, despite allegations of lax practices, holds The Gold Seal of Approval from the Joint Commission, which last inspected the hospital on-site in May 2018 before going in on Nov. 19 this year.

The inspector general’s office urged CMS to pursue the authority to require special surveys in a health emergency — lest it lose control of its mission to keep hospitals safe.

“CMS could not ensure that accredited hospitals would continue to provide quality care and operate safely during the COVID-19 emergency,” and could not ensure it going forward, the report said.

“We’re telling CMS to do their job,” the report’s author, Assistant Regional Inspector General Calvin Jones, said in an interview. “The covid experience really showed a shortcoming in the oversight system.”

CMS spokesperson Raymond Thorn said the agency agrees with the report’s recommendation and will work on a regulation after the public health emergency ends.

Accrediting agencies, however, pushed back on the inspector general’s findings. Among them: DNV Healthcare USA Inc. Its director of accreditation, Troy McCann, said there was not a gap in oversight. Although he said travel restrictions limited accreditors ability to fly across state lines, his group continued its annual reviews after May 2020 and incorporated the special focus on infection control into them. “We have a strong emphasis, always, on safety, infection control and emergency preparedness, which has left our hospitals stronger,” McCann said.

Angela FitzSimmons, spokesperson for the Accreditation Commission for Health Care, said that the accrediting organization’s surveys typically focus on infection control, and the group worked during the pandemic to prioritize hospitals with prior issues in the area of infection prevention.

“We did not deem it necessary to add random surveys that would occur at a cost to the hospital without just cause,” FitzSimmons said.

Maureen Lyons, a spokesperson for the Joint Commission, told KHN that, after evaluating CMS guidance, the nonprofit group decided it would incorporate the infection-control surveys into its surveys done every three years and, in the meantime, provide hospitals with the latest federal guidance on covid.

“Hospitals were operating in extremis. Thus, we collaborated closely with CMS to determine optimal strategies during this time of emergency,” she said.

The Joint Commission cited safety issues for its inspectors, who travel to the hospitals and need proper protective equipment that was running low at the time, as part of the reason for its decision.

Verma, the CMS administrator at the time, pushed back on accreditors’ travel safety concerns, saying that “narrative doesn’t quite fit because the state and CMS surveyors were going into nursing homes.”

Though Verma cautioned that hospitals were overwhelmed by the crush of covid patients, “doing these inspections may have helped hospitals bolster their infection-control practices,” she said. “Without these surveys, we really have no way of knowing.”

‘Immediate Jeopardy’

Medicare inspectors can go into a privately accredited hospital after they get a serious complaint. They found alarming circumstances when they visited some of the hospitals with high rates of covid diagnosed after a patient was admitted for another concern last year.

At Levindale Hebrew Geriatric Center and Hospital in Baltimore, the July 2020 inspection report says “systemic failures left the hospital and all of its patients, staff, and visitors vulnerable to harm and possible death from COVID-19.”

In response, hospital spokesperson Sharon Boston said that “we have seen a large decrease in the spread of the virus at Levindale.”

Inspectors had declared a state of “immediate jeopardy” after they investigated a complaint and discovered an outbreak that began in April and continued through the beginning of July, with more than 120 patients and employees infected with covid. And in a unit for those with Alzheimer’s and other conditions, 20% of the 55 patients who had covid died.

The hospital moved patients whose roommates tested positive for covid to other shared rooms, “potentially exposing their new roommate,” the inspection report said. Boston said that was an “isolated” incident and the situation was corrected the next day, with new policies put in place.

The Medicare data analyzed exclusively for KHN shows that 52 of Levindale’s 64 covid hospital patients, or 81%, were diagnosed with covid after admission from April to September 2020. Boston cited different numbers over a different time period: Of 67 covid patients, 64 had what she called “hospital-acquired” covid from March to June 2020. That would be nearly 96%.

The hospital shares space with a nursing home, though, so KHN did not group it with the general short-term acute-care hospitals as part of the analysis. Levindale’s last Joint Commission on-site survey was in December 2018, resulting in The Gold Seal of Approval. It had not had its once-every-three-years survey as of Dec. 10, 2021, according to the Joint Commission’s tracking.

Boston said Levindale “quickly addressed” the issues that Medicare inspectors cited, increasing patient testing and more recently mandating staff vaccines. Since December 2020, Boston said, the facility has not had a covid patient die.

At the state level, hospital inspectors in California found few problems to cite even at hospitals where 5% or more patients were diagnosed with covid after they were admitted for another concern. Fifty-three complaints about such hospitals went to the Department of Public Health from April until the end of 2020. Only three of those complaints resulted in a finding of deficiency that facility was expected to fix.

CDPH did not respond to requests for comment.

A New Chapter

Things are better now at Riverside Community Hospital, Hernandez said. She is pleased with the current safety practices, including more protective gear and HEPA filters for covid patients’ rooms. For Hernandez, though, it all comes too late now.

“We laugh at it,” she said, “but it hurts your soul.”

Evans said she was able to negotiate her $1 million-plus hospital bills down to roughly $70,000.

Her covid aftereffects have been ongoing — she said she stopped gasping for air and reaching for her at-home oxygen tank only a few months ago. She still hasn’t been able to return to work full time, she said.

For the past year, her husband would wake up in the middle of the night to check whether her oxygen levels were dipping. Terrified of losing her, he’d slip an oxygen mask on her face, she said.

“I would walk 1,000 miles to go to another hospital,” Evans said, if she could do it all over again. “I would never step foot in that hospital again.”

Methodology

KHN requested custom analyses of Medicare, California and Florida inpatient hospital data to examine the number of covid-19 cases diagnosed after a patient’s admission.

The Medicare and Medicare Advantage data, which includes patients who are 65 and older, is from the Centers for Medicare & Medicaid Services’ Medicare Provider Analysis and Review (MedPAR) file and was analyzed by CDIMD, a Nashville-based medical code consulting and data analytics firm. The data is from April 1 through Sept. 30, 2020. The data for the fourth quarter of 2020 was not yet available.

The data shows the number of inpatient Medicare hospital stays in the U.S., including the number of people diagnosed with covid-19 and the number of admissions for which the covid diagnosis was not “present on admission.” CMS considers some medical conditions that are not “present on admission” to be hospital-acquired, according to the agency. The data is for general acute-care hospitals, which may include a psychiatric floor, and not for other hospitals such as those in the Department of Veterans Affairs system or stand-alone psychiatric hospitals.

KHN requested a similar analysis from California’s Department of Health Care Access and Information of its hospital inpatient data. That data was from April 1 through Dec. 31, 2020, and covered patients of all ages and payer types and, in general, private psychiatric and long-term acute-care hospitals. Etienne Pracht, a University of South Florida researcher, provided the number of Florida covid patients who did not have the virus upon hospital admission for all ages and payer types at general and psychiatric hospitals from April 1 through Dec. 31, 2020. KHN subtracted the number of Medicare patients in the MedPAR data from the Florida and California datasets so they would not be counted twice.

To calculate the rate of hospitalized Medicare patients who tested positive for covid — and died — KHN relied on the MedPAR data for April through September. That data includes records for 6,629 seniors, 1,409 of whom, or 21%, died. California data for all ages and payer types from April through December shows a similar rate: Of 2,115 diagnosed with covid-19 after hospital admission, 435, or 21%, died. The MedPAR data was also used to calculate the national rate of 1.7%, with 6,629 of 394,939 covid patients diagnosed with the virus whose infections were deemed not present on admission, according to the CDIMD analysis of data that hospitals report to Medicare. It was also used to calculate which entities licensed as short-term acute care hospitals had 5% or more of their covid cases diagnosed within the hospital. As stated in the story, Levindale Hebrew Geriatric Center and Hospital in Baltimore was not included in that list of 38 because it shares space with a nursing home and had fewer than 500 total discharges.

Data that hospitals submit to Medicare on whether an inpatient hospital diagnosis was “present on admission” is used by Medicare for payment determinations and is intended to incentivize hospitals to prevent infections during hospital care. The federal Agency for Healthcare Research and Quality also uses the data to “assist in identifying quality of care issues.”

Whether covid-19 is acquired in a hospital or in the community is measured in different ways. Some nations assume the virus is hospital-acquired if it is diagnosed seven or more days after admission, while U.S. data counts cases only after 14 days.

Hospitals’ medical coders who examined patient records for the data analyzed for this KHN report focus on each physician’s admission, progress and discharge notes to determine whether covid was “present on admission.” They do not have a set number of days they look for and are trained to query physicians if the case is unclear, according to Sue Bowman, senior director of coding policy and compliance at the American Health Information Management Association.

KHN tallied the cases in which covid-19 was logged in the data as not “present on admission” to the hospital. Some covid cases are coded as “U” for having insufficient documentation to make a determination. Since Medicare and AHRQ consider the “U” to be an “N” (or not present on admission) for the purposes of payment decisions and quality indicators, KHN chose to count those cases in the grand total.

In 409 of 6,629 Medicare cases and in 70 of 2,185 California cases, the “present on admission” indicator was “U.” The Florida data did not include patients whose “present on admission” indicator was “U.” Medical coders have another code, “W,” for “clinically undetermined” cases, which consider a condition present on admission for billing or quality measures. Medical coders use the “U” (leaning toward “not present on admission”) and “W” (leaning toward “present on admission”) when there is some uncertainty about the case. KHN did not count “W” cases.

The Medicare MedPAR data includes about 2,500 U.S. hospitals that had at least a dozen covid-19 cases from April through September 2020. Of those, 1,070 reported no cases of covid diagnosed after admission for other conditions in the Medicare records. Data was suppressed due to privacy reasons for about 1,300 hospitals that had between one and 11 of such covid cases. There were 126 hospitals reporting 12 or more cases of covid that were “not present on admission” or unknown. For those, we divided the number of cases diagnosed after admission by the total number of patients with covid to arrive at the rate, as is standard in health care.

Inspection and Accreditation Analysis

To evaluate which of the 38 hospitals detailed above had federal inspection reports documenting infection-control issues, KHN searched CMS’ publicly available “2567” reports, which detail deficiencies for each hospital for 2020. For surveys listed online as “not available,” KHN requested and obtained them from CMS. KHN further asked CMS to double-check the remaining hospitals for any inspection reports that weren’t posted online. KHN also checked the Association of Health Care Journalists’ database http://www.hospitalinspections.org/ for each of the 38 hospitals for any additional reports, as well as CMS’ Quality, Certification and Oversight Reports site.

To check that each of these hospitals was accredited, KHN looked up each hospital using a site run by the Joint Commission and reached out to the accreditors DNV Healthcare USA Inc. and the Accreditation Commission for Health Care.

To tabulate infection-control complaints for hospitals at the state level in California, KHN used data available through the California Department of Public Health’s Cal Health Find Database. KHN searched the database for the hospitals that had higher than 5% of covid patients being diagnosed after admission, according to the California data, and tallied all complaints and deficiencies found involving infection control from April to December 2020.

The post As Sufferers Fell Sick With Covid Inside Hospitals, Authorities Oversight Fell Brief first appeared on DAILY ZSOCIAL MEDIA NEWS.
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The cost of coal in South Africa: dirty skies and sick children
Thu, 11 Nov 2021 06:32:47 GMT
The cost of coal in South Africa: dirty skies and sick children

In 2019, scientists from the South African government completed a study on the health effects of pollution from the country’s sprawling coal industry.

The researchers at the state council for scientific and industrial research had been assured by government agencies that their long-term study would be published, according to three people familiar with the matter.

It has not yet seen the light of day.

The study, a copy of which was verified by Reuters, showed that more than 5,000 South Africans die annually in the country’s coal belt because the government has not fully enforced its own air quality standards. It also found that nearly a quarter of households in the region, home to 3.6 million people, have children with persistent asthma. That is double the national price.

The South African government has been granting its indebted state-owned energy and fuel companies Eskom and Sasol exemptions from emission limits in order to save money.

This type of ongoing government support underscores a problem in many coal-dependent countries, from Australia to Indonesia, that is hindering the transition to cleaner energy. In producing countries, governments, companies and local residents often see coal as an economic lifeline.

South Africa’s coal industry, the fifth largest in the world, employs 90,000 miners, generates 80% of the country’s electricity and supplies the raw materials for about a quarter of the country’s liquid fuel for vehicles, all at a time of rising unemployment and frequent blackouts.

The cost of a mammoth coal industry is also high, and not just for the climate. South Africa’s coal belt is covered in smog and coal ash; the stench of sulfur permeates. According to experts, the area east of Johannesburg is one of the most polluted in the world and can compete with Beijing and New Delhi.

A disused coal mine can be seen in the background while a woman and her children watch a township in Emalahleni. | REUTERS

In 2017, UK air pollution expert Mike Holland calculated that the health impact of Eskom’s emissions alone cost South Africa $ 2.37 billion each year.

Environment Minister Barbara Creecy, whose division commissioned the 2019 coal health study, declined to say why it remains unpublished. She said the government still intends to release it at some point.

“We understand that communities are facing serious health challenges,” she said, adding that the government believes that improving air quality is “absolutely essential”.

But Creecy’s agency – the Department of Fisheries, Forestry and the Environment – has publicly defended its lax enforcement of pollution regulations as an economic necessity in legal battles with activists. A recent submission said the main challenge was to fight pollution without “hurting the poor who are desperate for work”.

Coal in the crosshairs

Coal is in the crosshairs of global efforts to replace it with cleaner fuels.

According to the non-profit Global Carbon Atlas, South Africa is the twelfth largest greenhouse gas emitter in the world. This water-stressed country is also one of the big losers from climate change. According to the International Panel on Climate Change, temperatures in southern Africa are rising twice as fast as the global average, pushing the region’s northwestern deserts south.

To secure foreign investment, Eskom is planning a $ 10 billion plan to shut down most of its coal-fired power plants by 2050 and use renewable energies like wind and solar with funding from wealthy nations. The United States, Britain, France, Germany and the European Union gave these efforts a big boost last week, earmarking $ 8.5 billion to help South Africa move away from coal.

However, Eskom’s green push has brought the company into conflict with Energy Minister Gwede Mantashe, who has called abandoning coal an “economic suicide”.

Mantashe represents a powerful constituency within the ruling ANC, which includes labor unions, the support of which the party relies on to win elections. These unions, like Mantashe, are concerned about job losses.

A child collects lumps of coal from a colliery while smoke rises from the Duvha coal-fired power station in Emalahleni.  |  REUTERS A child collects lumps of coal from a colliery while smoke rises from the Duvha coal-fired power station in Emalahleni. | REUTERS

“We shouldn’t collapse our economy because it is greedy for green finance,” Matashe said at a South African mining conference in October. He previously said shutting down the country’s coal-fired power plants would allow South Africans “to breathe fresh air in the dark”.

Mantashe declined to comment on this story.

Darkness is already a familiar experience in the coal belt. Power outages are a daily reality for the barracks between the mine shafts and cooling towers of cities like Emalahleni – “The place of coal” in the Zulu language.

If people stay, it’s for the chance of a job.

“Your chest scratched”

Mbali Matabule and her partner were high school students when they exchanged phone numbers on a dirt road in Vosman, a community outside Emalahleni. After graduation, her partner found work at Sasol’s Secunda plant, which converts coal into liquid fuel for cars. The following year, Matabule gave birth to their first child, Princess.

His salary enabled them to feed and dress their daughter and buy the stuff of middle-class living: a television, microwave, refrigerator, and electric stove to house her in her hut on her parents’ property.

Then, in May 2018, as she neared her fourth birthday, Princess began struggling to breathe. They took her to the hospital, where a doctor put a mask on princess’s face that was attached to a nebulizer.

“They said she had asthma,” said Matabule. “I thought: why? She was not born with asthma. “

Towards the end of the year they had a second child, Asemahle, who soon also had breathing problems.

“Her chest was scratching,” said Matabule.

Hospital visits became routine and medical costs rose. With no health insurance, the couple spent 2,500 rand (184.03) a month on medical bills for their children, nearly half the salary of Mbali’s partner.

Among the worst in the world

The smog released when burning coal is mixed with chemicals such as sulfur and nitrogen oxides, mercury and lead, and radioactive elements such as uranium and thorium.

“We know that coal pollution causes lung problems and heart disease. It affects the cognitive development of children, ”said Mohammed Tayob, a doctor in Middleberg, one of the hardest hit cities in the coal belt.

The CSIR study received by Reuters in 2019 concluded that 5,125 lives could be saved in the coal belt every year by enforcing national air quality standards for soot, also known as particulate matter.

The air in Emalahleni contains around 20% more particulate matter than the national limit of 40 micrograms per cubic meter and more than three times more than recommended by the World Health Organization.

The region’s sulfur dioxide levels are now off the charts. The nonprofit Center for Research on Energy and Clean Air found this month that Eskom alone emits more SO2 than the entire power sector in the United States and China combined.

To clear the air would require tough crackdown on polluting industries.

Smoke rises from the Duvha coal-fired power station in Emalahleni |  REUTERS Smoke rises from the Duvha coal-fired power station in Emalahleni | REUTERS

Eskom environmental manager Deidre Herbst said the government exemptions allowing his company to exceed pollutant limits were an economic imperative: it would cost 300 billion rand ($ 20 billion) and last 10 to 15 years in order to fully meet the national SO2 standards, leading to prolonged outages in the meantime.

“There is no way we can get compliant right away,” she said, and South Africa cannot just shut down all coal-fired power plants.

Sasol spokesman Matebelo Motloung said the company’s emissions are allowed under its operating licenses and the company hopes to adopt cleaner technologies in the future.

“People were sick and died”

Matabule hadn’t imagined that the haze in her neighborhood was behind her children’s illness until she attended a local meeting about air pollution and heard the stories of neighbors.

“I got so angry because nobody was doing anything and people were sick and dying,” said Matabule.

But like her husband, who depends on coal for his paycheck, many in their community are skeptical about a transition to cleaner energy.

Vosman, 33, Valentia Msiza said her family has been doing well since her husband got his job in the coal mines. They fear a transition might leave them behind.

They too have a child with respiratory problems – and without the man’s salary and health insurance, they cannot afford to care for him. The family is looking for a specialist to treat their toddler’s lung disease.

“This is our last hope now,” said Valentia.

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The post The cost of coal in South Africa: dirty skies and sick children first appeared on Africa Chamber News.
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Record Number of Americans Sign Up for ACA Health Insurance
Thu, 23 Dec 2021 18:19:04 GMT
Record Number of Americans Sign Up for ACA Health Insurance

A record 13.6 million Americans have signed up for health coverage for 2022 on the Affordable Care Act marketplaces, with nearly a month remaining to enroll in most states, the Biden administration announced Wednesday.

President Joe Biden’s top health advisers credited the increased government subsidies, which lowered out-of-pocket costs, for the surge in enrollment. They also said enhanced personal assistance and outreach helped connect more people to health insurance plans.

Some of the largest increases are in Florida, Texas, Georgia and nine other states that have not expanded Medicaid under the Affordable Care Act.

The previous marketplace enrollment record was 12.7 million in 2016, the final year of President Barack Obama’s administration. Enrollment largely stagnated under President Donald Trump, who cut tens of millions of dollars in funding for navigators, who help people sign up for coverage.

Open enrollment for the marketplace began Nov. 1 and ends Jan. 15.

Through Dec. 15, enrollment in Florida had soared to 2.6 million people, up from 2.1 million in the same period a year earlier.

“This is a very big deal as it means we have made a dent in the uninsured pool and we are not only insuring people but keeping people signed up,” said Jodi Ray, program director for Florida Covering Kids & Families.

Ray has used federal grants to help Floridians sign up for private coverage on the marketplace for several years. During the Trump presidency, she said, she could help only people in half the counties in the state because of funding constraints. “You cannot overlook the impact that one-on-one assistance has in getting people through the process,” Ray said.

Enrollment has jumped more in states that have not expanded Medicaid because they have more uninsured residents than expansion states. In expansion states, people with incomes from 100% to 138% of the federal poverty level — about $12,880 and $17,770 for an individual — can enroll in Medicaid. In states that haven’t expanded the program, they can get subsidies to enroll in private plans through the Affordable Care Act marketplaces.

Georgia enrollment jumped to 653,990 from about 514,000 the previous year.

“That’s the most we’ve ever had enrolled,’’ said Laura Colbert, executive director of the consumer advocacy group Georgians for a Healthy Future. She said the enrollment spike helps show that Republican Gov. Brian Kemp’s plan to scrap healthcare.gov and replace it with a privately run portal isn’t needed.

The Biden administration is reviewing that proposal.

“Hundreds of thousands of Georgians still opt to remain uninsured rather than shop on the federal platform,” Kemp spokesperson Katie Byrd said Wednesday. “This means that the one-size-fits-all approach by the federal government is not working for Georgia.”

The 13.6 million enrollment number includes people who used state-run marketplaces, in addition to those who enrolled through the federally run healthcare.gov portal that handles sign-ups for more than 30 states.

Texas’ enrollment rose to 1.7 million from 1.3 million.

Texas, Georgia and South Dakota each showed gains of at least 20%, said Chiquita Brooks-LaSure, administrator of the Centers for Medicare & Medicaid Services. None of those states has expanded Medicaid under the Affordable Care Act.

In non-expansion states, “our outreach efforts have been so robust this year,’’ Brooks-LaSure told reporters during a press call. The federal government is using four times the number of navigators, or insurance counselors, to help people sign up for insurance, said Xavier Becerra, secretary of the U.S. Department of Health and Human Services.

The big driver behind the enrollment gains is new discounts on premiums.

As part of a covid-19 relief bill passed this year, Congress increased the subsidies consumers receive when they enroll in health insurance via the marketplace. CMS said 92% of people in healthcare.gov states will get the tax credits for 2022 coverage. Becerra said that for 4 in 5 enrollees, monthly premiums cost $10 or less, which he said is “less than going to a movie.”

But conservatives chafe at the idea of higher subsidies. Brian Blase, a former Trump adviser and president of the conservative think tank Paragon Health Institute, stressed that the federal government is paying 85% of people’s monthly insurance premiums.

“People will buy something that provides them with little value if the after-subsidy price is zero or close to zero, and that’s what is generally happening here,” Blase said. “Ultimately, the big winners are the health insurance companies that are getting billions of dollars in additional government subsidies.”

Another driver of enrollment is that some people may have lost job-based coverage during the pandemic and are seeking insurance on their own.

The marketplaces also offer consumers more choices than in previous years. The average consumer now has between six and seven insurers to choose from, up from four to five in 2021, federal officials said.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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The post Record Number of Americans Sign Up for ACA Health Insurance first appeared on DAILY TEXAS NEWS.
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Gender neutral living for the YMCA’s upcoming summer camp season in Ann Arbor
Thu, 23 Dec 2021 14:22:46 GMT
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ANN ARBOR, MI – Non-binary and non-gendered children will have their own housing option at the Ann Arbor YMCA residential camp this summer.

Although the YMCA currently allows children to stay in either male or female huts during their time at Camp Al-Gon-Quian, a summer residential camp, the 2022 summer camp season will also see residential areas for children who do not want to stay overnight in either space, said officials.

“Northside has historically been a home for campers who have an affinity for feminine space while Southside has historically been a home for campers who have an affinity for masculine space,” Y officials said in a statement announcing the change.

“While every camper is welcome to live on the side of their choice, the Y believes that a place for those who are neither Northside nor Southside is an important addition to the traditional camp program.”

Regardless of the area in which a camper is staying, he or she has an individual bunk and space for personal items as well as access to a bathhouse with privacy screens.

Each cabin accommodates between seven and nine campers, with two to three supervisors in each cabin, according to Ann Arbor’s YMCA website.

Camp Al-Gon-Quian, located on Burt Lake in Saginaw County, will host Ann Arbor YMCA Camp in the summer of 2022, which begins January 11th. The camp offers a variety of outdoor activities, including archery, horse riding, a climbing wall, and a lumber shop.

“At Ann Arbor YMCA, we strive to be a welcoming and inclusive non-profit for the LGBTQ community and to give youth a voice in the types of programs and services we offer,” said Toni Kayumi, Ann Arbor YMCA President / CEO. “We want individuals to know that they can be their authentic selves at Camp AGQ and at all of our locations.”

Read more from the Ann Arbor News:

Could a charging station for electric cars in the Ypsilanti area be the future? US MP Dingell hopes so

Former Livingston County Undersheriff faces drunk driving charges

“Stink, stank, stank,” says the attorney general of the Michigan toy company accused of fraudulent deals

The post Gender neutral living for the YMCA’s upcoming summer camp season in Ann Arbor first appeared on Wolverine State Watch.
Category: Ann Arbor
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Detroit Phoenix Center Advocates for Young People Experiencing Homelessness
Thu, 23 Dec 2021 14:37:40 GMT
Detroit Phoenix Center Advocates for Young People Experiencing Homelessness

Azaria Terrell was just leaving the foster family when she found out about the Detroit Phoenix Center.

My dad thought it was a good idea for me [join] because he heard that it’s all about girls and that I don’t have many women in my life, ”says Terrell. “What made me want to go is because he said [the Phoenix Center] had a really cool one SAT Learning program, and I’ve always wanted to learn and prepare myself. ”

After getting to know each other Courtney Smith, Founder and CEO of the Detroit Phoenix Center and participating in the center’s various activities, from learning to cook to yoga to attending events, Terrell said it made it easier for her to make friends and get out of her comfort zone.

That was four years ago. Today Azaria Terrell is a high school graduate and a leading member of the organization’s Youth Action Board. “Now I can take part in the development of programs and fundraisers, talk to people, and get involved in the dissemination,” she says. “It was wonderful.”

The Detroit Phoenix Center (DPC) was created in response to the needs of underserved and transient youth in Detroit. The non-profit organization is committed to raising awareness and putting an end to homelessness among young people. What began as a daily point of contact for teens and young adults ages 13 to 24 has evolved into school-based youth, human resource development and emergency crisis support programs, and the Blair Memorial Scholarship Fund, which recognizes students interested in higher education.

Smith’s mission to help underserved and ephemeral youth in Detroit and center young people’s voices in the homelessness narratives that emerge from their own experiences in the care system as adolescents. She wanted to ensure access to support services and resources for people emerging from homelessness and poverty.

It is estimated that 4.2 million teenagers and young adults experience homelessness every night. In Detroit, among others Data book project by the Poverty Solutions research team and University of Michigan stakeholders (Smith, commissioned by DPC, one of them), who analyzed homelessness and housing instability in Detroit and educational institutions, reported that over 11,000 students in the Detroit Public Schools Community District (DPSCD) may be homeless and not identified by their schools.

Teenage homelessness looks very different from adult homelessness, ”says Smith, acknowledging that there are different definitions.

Terrell says people often think that homelessness is just about sleeping outdoors, “but it’s about more,” she says. “There are a lot of misunderstandings. I know people who surf on the couch or who have lived without water or heating for months. Most people fail to realize that these living conditions are indicative of young people’s homelessness. Even in schools, principals or teachers do not notice when a student is taking home extra meals or taking little notice of things [show] maybe a child has problems. ”

This strengthens the Detroit Phoenix Center’s mission and commitment to change. January will mark the centre’s five-year anniversary and testify to the impact Smith and her team have made and the work ahead.

We have evolved that way. I think our greatest development is young people – giving young people a seat at the table and really giving them opportunities to change that narrative [involving homelessness and youth homelessness]“, Thinks Smith. “We offer a service [where] The young people who benefit from the program are also involved in this process. ”

Terrell adds, “I keep telling Mrs. Courtney that I really appreciate being with the DPC and I love that I’m a part of it because I know that not many people my age have the opportunity to really express their voice in big changes like this in the environment and in the world. ”

Find out how to participate in the Detroit Phoenix Center’s annual One Night Without A Bed Campaign Here.

Listen: Learn about the Detroit Phoenix Center and its movement to fight young homelessness. Reliable, accurate, up-to-date.

WDET strives to make our journalism accessible to everyone. As a public media institution, we maintain our journalistic integrity through independent support from readers like you. If you value it WDET as your source for news, music and conversation, please make a gift today.

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The post Detroit Phoenix Center Advocates for Young People Experiencing Homelessness first appeared on Wolverine State Watch.
Category: Detroit
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Director Bae Merola’s Tallahassee roots and the Quadio creative app help him think outside the box
Thu, 23 Dec 2021 18:32:17 GMT
Director Bae Merola's Tallahassee roots and the Quadio creative app help him think outside the box

Merola is currently on hiatus from Tallahassee Community College to explore new opportunities in LA, and says the Quadio creative community app gave him the platform to connect with artists from across the country. “I definitely get inspiration from all of the other artists,” he said. “My favorite part of the app is how you see what people specialize in and what they’re interested in.”

For Merola, apps like Quadio will only make it easier for younger generations of developers to pursue their passions, something that circumstances and obligations like work and school can sometimes derail. “It can be easy to feel constricted at a young age,” he explains. “This app is like a safe place for people to see your work and give you support and advice.”

The post Director Bae Merola’s Tallahassee roots and the Quadio creative app help him think outside the box first appeared on Daily Florida Press.
Category: Tallahassee
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Nursing Homes Bleed Staff as Amazon Lures Low-Wage Workers With Prime Packages
Thu, 23 Dec 2021 14:01:19 GMT

ERLANGER, Ky. — The sleek corporate offices of one of Amazon’s air freight contractors looms over Villaspring of Erlanger, a stately nursing home perched on a hillside in this Cincinnati suburb. Amazon Prime Air cargo planes departing from a recently opened Amazon Air Hub roar overhead. Its Prime semi-trucks speed along the highway, rumbling the nursing home’s windows.

This is daily life in the shadow of Amazon.

“We haven’t even seen the worst of it yet,” said John Muller, chief operating officer of Carespring, Villaspring’s operator. “They are still finishing the Air Hub.”

Amazon’s ambitious expansion plans in northern Kentucky, including the $1.5 billion, 600-acre site that will serve as a nerve center for Amazon’s domestic air cargo operations, have stoked anxieties among nursing home administrators in a region where the unemployment rate is just 3%. Already buckling from an exodus of pandemic-weary health care workers, nursing homes are losing entry-level nurses, dietary aides and housekeepers drawn to better-paying jobs at Amazon.

The average starting pay for an entry-level position at Amazon warehouses and cargo hubs is more than $18 an hour, with the possibility of as much as $22.50 an hour and a $3,000 signing bonus, depending on location and shift. Full-time jobs with the company come with health benefits, 401(k)s and parental leave. By contrast, even with many states providing a temporary covid-19 bonus for workers at long-term care facilities, lower-skilled nursing home positions typically pay closer to $15 an hour, often with minimal sick leave or benefits.

Nursing home administrators contend they are unable to match Amazon’s hourly wage scales because they rely on modest reimbursement rates set by Medicaid, the government program that pays for long-term care.

Across the region, nursing home administrators have shut down wings and refused new residents, irking families and making it more difficult for hospitals to discharge patients into long-term care. Modest pay raises have yet to rival Amazon’s rich benefits package or counter skepticism about the benefits of a nursing career for a younger generation.

“Amazon pays $25 an hour,” said Danielle Geoghegan, business manager at Green Meadows Health Care Center in Mount Washington, Kentucky, a nursing home that has lost workers to the Amazon facility in Shepherdsville. The alternative? “They come here and deal with people’s bodily fluids.”

The nursing home industry has long employed high school graduates to feed, bathe, toilet and tend to dependent and disabled seniors. But facilities that sit near Amazon’s colossal distribution centers are outgunned in the bidding war.

“Chick-fil-A can raise their prices,” said Betsy Johnson, president of the Kentucky Association of Health Care Facilities. “We can’t pass the costs on to our customer. The payer of the service is the government, and the government sets the rates.”

And while gripes about fast-food restaurants having to close indoor dining because of a worker shortage have ricocheted around Kentucky, Johnson said nursing homes must remain open every day, every hour of the year.

“We can’t say, ‘This row of residents won’t get any services today,’” she said.

Reaching Upstream

Nationwide, long-term care facilities are down 221,000 jobs since March 2020, according to a recent report from the American Health Care Association and National Center for Assisted Living, an organization that represents 14,000 nursing homes and assisted living communities caring for 5 million people. While many hospitals and physicians’ offices have managed to replenish staffing levels, the report says long-term care facilities are suffering a labor crisis worse “than any other health care sector.” Industry surveys show 58% of nursing homes have limited new admissions, citing a dearth of employees.

Kentucky and other states are relying on free or low-cost government-sponsored training programs to fill the pipeline with new talent. Luring recruits falls to teachers like Jimmy Gilvin, a nurse’s aide instructor at Gateway Community and Technical College in Covington, Kentucky, one of the distressed River Cities tucked along the Ohio River.

On a recent morning, Gilvin stood over a medical dummy tucked into a hospital bed, surrounded by teenagers and young adults, each toting a “Long-Term Care Nursing Assistance” textbook. Gilvin held a toothbrush and toothpaste, demonstrating how to clean a patient’s dentures — “If someone feels clean, they feel better,” he said — and how to roll unconscious patients onto their side.

The curriculum covers the practical aspects of working in a nursing home: bed-making, catheter care, using a bedpan and transferring residents from a wheelchair to a bed.

“It takes a very special person to be a certified nursing assistant,” Gilvin said. “It’s a hard job, but it’s a needed job.”

Over the past five years, Gilvin has noticed sharp attrition: “Most of them are not even finishing, they’re going to a different field.” In response, nursing schools are reaching further upstream, recruiting high school students who can attend classes and graduate from high school with a nurse’s aide certificate.

“We’re getting them at a younger age to spark interest in the health care pathways,” said Reva Stroud, coordinator of the health science technology and nurse’s aide programs at Gateway.

Stroud has watched, with optimism, the hourly rate for nurse’s aides rise from $9 an hour to around $15. But over the years that she’s directed the program, she said, fewer students are choosing to begin their careers as aides, a position vital to nursing home operations. Instead, they are choosing to work at Walmart, McDonald’s or Amazon.

“There is a lot of competition for less stress,” Stroud said. A staunch believer in the virtue of nursing, she is disheartened by the responses from students: “‘Well, I could go pack boxes and not have to worry about someone dying and make more money.’”

Even for those who want a career in nursing, becoming a picker and packer at Amazon carries strong appeal. The company covers 100% of tuition for nursing school, among other fields, and has contracted with community colleges to provide the schooling.

Amazon is putting Kayla Dennis, 30, through nursing school. She attended a nursing assistant class at Gateway but decided against a career as a nurse’s aide or certified nursing assistant. Instead, she works at the Amazon fulfillment center in Hebron, Kentucky, for $20.85 an hour with health insurance and retirement benefits while attending school to become a registered nurse, a position requiring far more training with high earning potential.

“Amazon is paying 100% of my school tuition and books,” Dennis said. “On top of that, they work around my school schedule.”

Waiting for a Rising Tide

The nursing home workforce shortages are not a top concern for the state and local economic development agencies that feverishly pursue deals with Amazon. Cities nationwide have offered billions of dollars in tax breaks, infrastructure upgrades and other incentives to score a site, and the spoils abound: Amazon has opened at least 250 warehouses this year alone.

Amazon has been a prominent force in northern Kentucky, resurfacing the landscape with titanic warehouses and prompting pay bumps at Walmart, fast-food franchises and other warehouse companies. The company has “made significant investments in our community,” said Lee Crume, chief executive officer of Northern Kentucky Tri-County Economic Development Corp. “I’m hard-pressed to say something negative.”

Amazon representatives did not respond to interview requests for this story.

Some labor experts said Amazon’s “spillover effect” — the bidding up of wages near its hubs — suggests companies can afford to compensate workers at a higher rate without going out of business.

Clemens Noelke, a research scientist at Brandeis University, said that is true — to a point. Because Amazon draws workers indiscriminately from across the low-wage sector, rather than tapping into a specific skill profile, it is hitting sectors with wildly different abilities to adapt. Industries like nursing homes, home health care agencies and even public schools that rely on government funding and are hampered in raising wages are likely to lose out.

“There are some employers who are at the margin, and they will be pushed out of business,” Noelke said.

A survey conducted in November by the Kentucky Association of Health Care Facilities found 3 in 5 skilled nursing facilities, assisted living communities and care homes were concerned about closing given the number of job vacancies.

The solutions proffered by state legislators rely largely on nurse training programs already offered by community colleges like Gateway. Republican Rep. Kimberly Poore Moser, a registered nurse who chairs the state’s Health and Family Services Committee, said that while legislators must value health care jobs, “we have a finite number of dollars. If we increase salaries for one sector of the health care population, what are we going to cut?”

Moser said Kentucky’s bet on Amazon will pay off, eventually. “The more we inject into our economy, the more our Medicaid budget will grow,” she said.

That confidence in a rising-tide-lifts-all-boats approach frustrates Johnson, president of the Kentucky Association of Health Care Facilities. Lawmakers have difficulty grasping the complexity of financing a nursing home, she said, noting that Kentucky’s Medicaid reimbursement rates stagnated at a one-tenth of 1% increase for five years, before receiving a larger increase to offset inflation the past two years.

The Biden administration’s Build Back Better Act, still before Congress, would infuse billions of dollars into in-home care and community-based services for seniors, largely through federal Medicaid payments. It includes funding aimed at stimulating recruitment and training. But the measure is focused largely on expanding in-home care, and it’s not clear yet how it might affect nursing home pay rates.

For now, the feeding frenzy continues. Just off Interstate 65 in Shepherdsville, Wendy’s, White Castle and Frisch’s Big Boy dangle offers of “work today, get paid tomorrow.” FedEx signs along the grassy medians that once advertised $17 an hour are stickered over with a higher offer of $23. The colossal Amazon warehouse bustles with workers in yellow safety vests.

And in nearby Mount Washington, Sherrie Wathen, administrator of the Green Meadows nursing home, strains to fill a dozen vacancies, knowing she can’t match Amazon’s package for her entry-level slots. Instead, Wathen, who began her own nursing career at 18, tells prospective employees to consider life at a factory: “You’re going to have the same day over and over.”

At the nursing home, she said, “I am the only family this lady has. I get to make an impact rather than packing an item in a box.”

Sarah Varney:
svarney@kff.org,
@SarahVarney4

The post Nursing Homes Bleed Staff as Amazon Lures Low-Wage Workers With Prime Packages first appeared on DAILYZ HEALTH NEWS.
Category: Public Health
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Përparim Rama: The regional hospital in Prishtina will be built immediately
Sun, 03 Oct 2021 08:08:18 GMT
Përparim Rama: The regional hospital in Prishtina will be built immediately

The candidate of the Democratic League of Kosovo for mayor of Pristina, Përparim Rama, met with emergency workers in Pristina, where they talked about their working conditions.

Health workers at the Prishtina Emergency Department sought to increase the capacity of teams operating in the capital, a regional hospital, the creation of a digitized zoning map, the restructuring of the emergency room and the establishment of a paramedic school.

While Rama said that all the conditions they require must be met immediately because they are more than necessary.

Full article by Përparim Rama:

👩‍⚕️👨‍⚕️ Work and a lot of dedication!

They do the impossible for us, they are heroes for many of us and such should be considered.

Together with my team, we visited the city emergency. The city emergency has 110 workers, of which 10 in the administration and 100 health workers. The emergency works in 5 shifts, in each shift there are 4 medical teams.🚑

Together with the staff there we talked about their working conditions, about the difficulties and challenges they have every day and that are not few.

They sought to increase the capacity of teams operating in the capital, a regional hospital, the creation of a digitized zoning map, emergency restructuring and the formation of a paramedic school.

All the conditions they require must be met immediately because they are more than necessary.

#PR4PR
# PërparimRama
#LDK160
#PerPrishtinenPraktike

The post Përparim Rama: The regional hospital in Prishtina will be built immediately first appeared on Kosovo Now.
Category: Regional
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Phoenix Suns: is this Chris Paul’s best team ever?
Sat, 02 Oct 2021 13:59:34 GMT
Phoenix Suns: is this Chris Paul's best team ever?

The Phoenix Suns have an extensive basketball history, as does point guard Chris Paul. He has played at the NBA level for 16 years and knows his way around the league, having run with several different teams and alongside countless Superstar players.

But he finally made it to the NBA final last year, a goal he kept missing out on throughout his career. Though Paul didn’t get away with a Larry O’Brien trophy in hand, the Suns team that catapulted him there nonetheless received national praise for his competitiveness and demeanor under head coach Monty Williams.

Still trying to recover from the loss, however, the Suns spent their final off-season retooling their team and raising it to remarkable standards. They brought in the Brooklyn Nets sniper Landry Shamet first, but then also brought in high-flyers JaVale McGee and Elfrid Payton.

Certainly with more talent, this new team seems poised to make a bigger claim to the NBA throne this season. But is it better than last year’s winners in the Western Conference, and better than any other team Paul has played for before?

Will the Phoenix Suns 2021-22 be Chris Paul’s best team ever?

With so many seasons behind Paul, the first task is to answer that question.

To remove the weeds, let’s limit ourselves to that 2007-08 New Orleans Hornets, the 2013-14 Los Angeles Clippers, the 2014-15 Los Angeles Clippers, the 2017-18 Houston Rockets, and of course the 2020-21 Phoenix Suns. These teams had the five highest odds in Paul’s career and the most playoff successes.

From that point on, this breakdown includes both general skills and direct preference.

The post Phoenix Suns: is this Chris Paul’s best team ever? first appeared on Arizona Daily Press.
Category: Phoenix
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Brown County Sheriff Talks About Counterfeit Prescription Drugs That Give Back to the Community | WFRV Local 5
Thu, 23 Dec 2021 15:53:50 GMT
Brown County Sheriff Talks About Counterfeit Prescription Drugs That Give Back to the Community |  WFRV Local 5

GREEN BAY, Wisconsin (WFRV) – Brown County Sheriff Todd Delain joined Local 5 and discussed several topics, including increasing overdoses and the recent opportunities the department returned to the community in the latest community update.

Delain mentioned that fentanyl has increased in the area and can be found mixed with heroin. The Brown County Sheriff’s Office is investigating these situations, and Delain says this has increased during the pandemic.

Local Aaron Rodgers lookalike turns heads in Lambeau before the Christmas play

Alongside fentanyl, Delain spoke about how counterfeit prescription drugs are becoming a problem in the area. One of the problems is that those who buy these counterfeit drugs do not know what they contain. Which can lead to overdosing or addiction.

With the holidays gone, Delain wanted to make sure those who wanted to drink had a plan to get home safely. Delain says there is more and more alcohol consumption and driving around this time of year.

Some of the safe driving options offered by Delain are:

To have a plan Call for a ride Name a driver Use the Drive Sober app (through the Wisconsin Department of Transportation)

The Brown County Sheriff’s Office was also busy giving back to the community. Both the “Fill The Cruiser” event and the “Police Lights of Christmas” are programs that give something back to the community.

Stadium District Closure Bill: What You Need To Know

Delain said the department filled numerous patrol cars.

The post Brown County Sheriff Talks About Counterfeit Prescription Drugs That Give Back to the Community | WFRV Local 5 first appeared on Daily Badger Bulletin.
Category: Green Bay
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Conan O’Brien rocks cowboy hat for a stroll via Aspen with spouse Liza and 18 yr outdated daughter Neve
Thu, 23 Dec 2021 18:49:34 GMT
Yes-ha!  Four-time Emmy winner Conan O'Brien rocked a cowboy hat and black down vest for a family stroll through Aspen, CO on Wednesday afternoon

Conan O’Brien rocks cowboy hat for a stroll via Aspen with spouse Liza and 18 yr outdated daughter Neve

4-time Emmy winner Conan O’Brien wore a cowboy hat and black down vest for a household stroll via Aspen, CO on Wednesday afternoon.

The 58-year-old comic was joined by his spouse Liza Powel, with whom he’ll rejoice a powerful 20-year marriage on January 12th.

Conan initially met the 51-year-old former copywriter “in 2000” when she was showing in a industrial for his NBC discuss present Late Night time.

Sure-ha! 4-time Emmy winner Conan O’Brien rocked a cowboy hat and black down vest for a household stroll via Aspen, CO on Wednesday afternoon

O’Brien was additionally accompanied by his daughter Neve for a day of buying, however there was no hint of his 16-year-old son Beckett.

The 18-year-old Marlborough College graduate, sporting a white down coat from The North Face, has reportedly already been inducted into Yale College’s class by 2026.

Boston-born Funnyman and Neve each made positive to guard themselves and others from the coronavirus by sporting face masks.

As of Thursday, there have been reportedly 2,660 new COVID-19 circumstances in Colorado and 31 new deaths – principally because of the fast-spreading variant of Omicron.

Still strong!  The 58-year-old comedian was joined by his wife Liza Powel (L), with whom he will celebrate an impressive 20-year marriage on January 12th

Nonetheless robust! The 58-year-old comic was joined by his spouse Liza Powel (L), with whom he’ll rejoice a powerful 20-year marriage on January 12th

Bonding Before the Holidays: Conan was also accompanied by his daughter Neve (R) for a day of shopping, but his 16-year-old son Beckett was nowhere to be seen

Bonding Earlier than the Holidays: Conan was additionally accompanied by his daughter Neve (R) for a day of buying, however his 16-year-old son Beckett was nowhere to be seen

Congratulation!  The 18-year-old Marlborough School graduate, wearing a white down coat from The North Face, has reportedly already been inducted into Yale University's class by 2026

Congratulation! The 18-year-old Marlborough College graduate, sporting a white down coat from The North Face, has reportedly already been inducted into Yale College’s class by 2026

And whereas 8.Eight million vaccine doses have been administered worldwide, there have been a staggering 5.three million deaths since 2020 – in accordance with Johns Hopkins College.

The board member of the John F. Kennedy Presidential Library will seem in Ashton Gleckman’s 10-part documentary sequence Kennedy, due for launch in Fall 2022 and at the moment in post-production.

“I spoke to Conan O’Brien in his Los Angeles studio,” the 21-year-old filmmaker and composer advised Carmel Month-to-month Journal in June.

“What lots of people do not learn about him is that he went to Harvard” [University] and studied literature and historical past. He is a passionate historian and one of many funniest guys on the earth.

'Scoring is officially on the move!'  The board member of the John F. Kennedy Presidential Library will appear in Ashton Gleckman's 10-episode documentary series Kennedy - expected in the fall of 2022 - which is currently in post-production (pictured December 15).

‘Scoring is formally on the transfer!’ The board member of the John F. Kennedy Presidential Library will seem in Ashton Gleckman’s 10-episode documentary sequence Kennedy – anticipated within the fall of 2022 – which is at the moment in post-production (pictured December 15).

The 21-year-old filmmaker and composer told Carmel Monthly Magazine in June:

The 21-year-old filmmaker and composer advised Carmel Month-to-month Journal in June, “What lots of people do not learn about him is that he went to Harvard.” [University] and studied literature and historical past. He is a passionate historian and one of many funniest guys on the earth. There have been many similarities between Conan and Kennedy ‘

“There have been a number of similarities between Conan and Kennedy – it was a extremely thrilling interview.”

Conan – who will begin a weekly selection present on HBO Max in 2022 – additionally hosts his weekly Group Coco podcast, Conan O’Brien Wants a Good friend.

O’Brien – who beforehand wrote for SNL and The Simpsons – hosted late-night discuss reveals for almost 28 years, ending on June 24 when he was taping his remaining episode of TBS ‘Conan.

Not retired yet!  O'Brien - who will start a weekly variety series on HBO Max in 2022 - also hosts his weekly Team Coco podcast Conan O'Brien Needs a Friend (pictured in interview with Quentin Tarantino on December 15)

Not retired but! O’Brien – who will begin a weekly selection sequence on HBO Max in 2022 – additionally hosts his weekly Group Coco podcast Conan O’Brien Wants a Good friend (pictured in interview with Quentin Tarantino on December 15)

End of an Era: Conan - who previously wrote for SNL and The Simpsons - hosted late-night talk shows for nearly 28 years, ending on June 24th when he played his final episode of TBS 'Conan.  recorded O'Brien can be seen on the first episode of his chat show, which aired on September 13, 1993

Finish of an Period: Conan – who beforehand wrote for SNL and The Simpsons – hosted late-night discuss reveals for almost 28 years, ending on June 24th when he performed his remaining episode of TBS ‘Conan. recorded

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The post Conan O’Brien rocks cowboy hat for a stroll via Aspen with spouse Liza and 18 yr outdated daughter Neve first appeared on DAILY COLORADO NEWS.
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Milwaukee’s Pink Bakery dedicates creating allergen-free desserts
Thu, 23 Dec 2021 14:55:43 GMT
Nubian Simmons' The Pink Bakery makes allergen-free baking mixes.

Kristine M. Kierzek

Nubian Simmons never considered herself a baker. Living with severe allergies to wheat and dairy products meant she often missed out on her favorite desserts.

She spent five years developing her recipes. Feedback from family and a desire to help others enjoy safely inspired them to start The Pink Bakery. She met some of her first clients through St. Jude Children’s Research Hospital in Memphis, Tennessee, and the Milwaukee native wanted to build a facility there when COVID-19 changed everything.

In August 2020 she moved back to Milwaukee and found her ideal place for a manufacturing facility. The special facility is located in Miller Valley near the west side, and they now ship their gluten-free, dairy-free, GMO-free, fair trade, vegan, and plant-based cake, biscuit, and brownie mixes nationwide.

Prices range from $ 18 to $ 50 and orders can be placed at pinkbakery.com. For information about the ingredients call (844) 336-4937. Select blends are available from Plantonic Cafe, 46 N. Johnson St., Hartford, and Wellness for Life, 1896 Highway 33 East, West Bend.

Become a baker

None of my siblings have the same allergies. You can have things so you only suffer. I’ve had memories of how things taste and I get this rice cake. I do not want that! We went to dinner, there was crème brulee, brownie a la mode. I have orange slices …

I got home and decided to try baking. I’m learning some of the basic baking ingredients to bake without wheat, gluten, milk, and eggs. It’s been difficult so far, but what kept me going was wanting to have something that tastes good and doesn’t hurt me.

Creating their recipes

It took me five years. Since my siblings don’t have any allergies, I would enjoy them. Does this taste good? I didn’t want it to be allergen free. I wanted it to be fine. I didn’t want anyone to bring our cake mix home, only the person with a food allergy would eat it and everyone else would eat something else. I didn’t want anyone who had our things to feel left out. Mom’s darling, our No Frownie Brownie and Not So Plain Jane Sugar Cookie – those were the original three created here in Milwaukee.

Nubian Simmons' The Pink Bakery makes allergen-free baking mixes.

Return to their roots

I attended Lloyd Street School, Sarah Scott Middle School, and Riverside University High School. I am a product of the Milwaukee Public Schools. There are many amazing talents that come from Milwaukee.

Milwaukee to Memphis

I was asked to come to Memphis and work with St. Jude. I am in Milwaukee. “But your products would be great for our children with weakened immune systems …”

I never thought it was a business. I had no experience in the food industry. I kept praying. I am a very spiritual person. I kept praying to God, “I think you asked the wrong person to do this.” But it was probably best that it was me. … I have the experience that my customers have. I react very negatively to cross-contamination. I have a science background. I tested and baked 10,000+ cupcakes to get my recipe.

Mixed blessings

We found land in Memphis to build a bakery. In the week before we were due to close (on the property), we received an environmental report on the property. It was poisonous. We looked at over 100 properties. I’m very spiritual so I understand that sometimes you get no and it means ‘not like that’. If this country doesn’t work, I don’t think I should do the next leg of the trip here.

As devastated as I was, COVID arrived a week later.

Find your future

I have these mixes. I can fall back on them. Even if the baking mix customer is different from the one who wants the finished cake, I could send it anywhere …

Here I found my place in the Miller Valley. It’s a completely (gluten-free, dairy-free, vegan) dedicated space, which comes from my experience. If I look at a product that says it is allergen-free and yet it is made in a facility that has those things that I am allergic to, I will not be able to eat it.

More information about labels

There are companies that do not have to legally disclose everything on the label. They hope and pray that everything is on the labels. That’s why I’m so transparent.

If you look at our website you will see a picture of my reaction. It came from a restaurant here that didn’t reveal what was in the food. I asked questions and the restaurant gave me what I thought was just crab meat. It was a wheat starch imitation crab. I wouldn’t have eaten it if I had known.

Lauren’s cake

Nubian Simmons' The Pink Bakery makes allergen-free baking mixes, including a white cake called Lauren's Cake.

I was a salesman in St. Jude (in Memphis). That’s where I met Lauren, whom I got very close. She told me, “I’m allergic to seven of the top eight allergens. I’m getting married in a year, I need a white cake. “I said,” I don’t have a white cake. ” She came back with, “You have a year.”

I came up with this cake for her wedding, so I named it after her. We had a disclaimer at the wedding: “Don’t touch this cake. The bride could die if you do that. ”We joked about it, but we knew it was serious. She wants to make people feel like they belong without worrying about going to the hospital.

Your favorite dessert

The first thing I did was mom’s favorite. It really is my mother’s favorite. She is a chocolate alcoholic. This is a chocolate chocolate cake.

My favorite is my No Frownie Brownie. It is very easy to do. That’s the other thing because I wasn’t a baker, I didn’t want to spend a lot of time in the kitchen.

Frosting facts

You can’t have a cake without the frosting. I didn’t know how to make a non-animal based frosting. We are a vegan and plant-based company. It took a while to find things, especially companies that were dedicated and had good manufacturing processes. I would ask about crop rotation. If you’re rotating soybeans with your sugar crop, I’m not going to buy this. I know you put soy there. It’s a lot of in-depth research. It was for me, I wanted to make sure I wasn’t reacting negatively to things, but my clients benefited from it.

Fork. Spoon. Life. examines the day-to-day relationship local dignitaries (inside and outside the food community) have with food. To propose future personalities for a profile, send an email to psullivan@gannett.com.

More:Many of her friends couldn’t digest dairy products. So this ice cream machine found a plant-based way of doing it

More:Downtime during the pandemic led the couple to open the Shorewood wine store

The post Milwaukee’s Pink Bakery dedicates creating allergen-free desserts first appeared on Daily Badger Bulletin.
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Third Dose of COVID-19 Vaccines for immunocompromised individuals administered in Boulder County – Guerin Green
Mon, 30 Aug 2021 23:33:58 GMT

All clinics offering Pfizer and/or Moderna in the county can administer the vaccine

Immunocompromised individuals in Boulder County can get their third vaccine dose in all clinics offering Pfizer and/or Moderna in the county. People who have a moderately to severely compromised immune system may benefit from an additional dose of vaccine to ensure they are protected against COVID-19.

The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) recommends people whose immune systems are moderately to severely compromised receive an additional dose of mRNA COVID-19 vaccine at least four weeks (28 days) after their second dose.

It is not recommended that people receive more than three mRNA COVID-19 vaccine doses.

On Aug. 12, 2021, the Food and Drug Administration (FDA) amended the Emergency Use Authorizations for both the Pfizer and Moderna COVID-19 vaccines to allow an additional dose after the first two doses in certain immunocompromised people. The additional dose should be the same vaccine product as the first two doses.

At this time an additional dose of the Johnson & Johnson (J&J) vaccine has not been authorized for immunocompromised people.

“The additional dose of the vaccine for immunocompromised people will help increase their protection and prevent severe illness, hospitalization and death,” said Indira Gujral, Boulder County Public Health Manager of Communicable Disease & Emergency Management. “This is a great step toward protecting vulnerable people in our community. If you are immunocompromised, go get your third dose today!”

People who are recommended to receive an additional dose include those who have:

Been receiving active cancer treatment for tumors or cancers of the blood Received an organ transplant and are taking medicine to suppress the immune system Received a stem cell transplant within the last two years or are taking medicine to suppress the immune system Moderate or severe primary immunodeficiency (such as DiGeorge syndrome or Wiskott-Aldrich syndrome) Advanced or untreated HIV infection Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response.

Additional doses are free, and no ID, insurance or proof of medical history is required to receive one. Individuals may self-report their immunocompromising conditions to vaccine providers.

Boosters for the general population have not been approved by the CDC or FDA.

The CDC has stated booster shots might begin the week of Sept. 20 for all Americans who have had a second dose at least eight months prior. CDC also anticipates booster shots for the J&J (Janssen) vaccine will become available.

To find a COVID-19 vaccine provider in Boulder County, visit www.boco.org/covidvaccines.

For information about additional doses for immunocompromised individuals, call the Boulder County Call Center at 720-776-0822, Monday-Friday, 9 a.m. to 2 p.m.

Category: What Next
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In Tucson, nearly half were denied medical and religious exemptions
Sat, 02 Oct 2021 05:34:27 GMT
In Tucson, nearly half were denied medical and religious exemptions

TUCSON, Arizona (KOLD News 13) – The city of Tucson has vaccinated 85 percent of its nearly 4,000 employees. But that leaves another 15% who aren’t, and many of them work with the public.

“If you, as a civil servant, choose to essentially tell the public and staff that it’s my way or the freeway,” said Steve Kozachik, Ward 6 councilor. “Then I’d say take the freeway. “

The city manager’s office released the numbers of how many city workers requested medical or religious exemptions instead of taking the vaccine.

627 workers requested exemptions, but only 317 were granted. And 289 were rejected. Another 24 are being examined.

Much of the filing came from the Tucson Police and Fire Department, the city’s two largest departments.

192 applied for a special permit for the fire brigade. 117 were approved and 65 were rejected. 10 are still pending.

194 applied to the police for a special permit. 100 were accepted and 86 were rejected. Eight are still pending.

To break these numbers down further, the fire department had 100 requests for medical exemptions. 77 were accepted and 17 were rejected. Four are still pending.

Police had 85 requests for religion waiver, of which 67 were approved and 17 were rejected, with one pending.

As for medical requests, the fire department has approved 92 out of 40 and rejected 48, four of which are pending.

For the police, there were 109 requests, of which 33 were accepted, 69 were rejected and seven were pending.

For those who have not received a waiver, according to a memo from Tucson City Manager Michael Ortega, “they have until next Tuesday, October 5th at 5:00 p.m. to get at least their first dose of COVID vaccine and provide proof of vaccination.” .

Failure to do so will be considered a policy violation according to the memo.

With one exception, these workers must wear masks on duty and undergo weekly tests, a program the city will set up next week.

For those who have been rejected, there is a choice to be made.

“If you decide not to follow our guidelines that have passed the law, find another job,” said Kozachik.

The more stringent proposals, a five-day free suspension or a possible termination, were suspended until the final judicial clarification of the mandate issue.

However, they could be revived when the city meets next Tuesday to discuss its options.

“Some of them play chicken with us and see how far we can go,” said Kozachik. “And I think that’s a bad die roll on your part.”

Copyright 2021 KOLD News 13. All rights reserved.

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The post In Tucson, nearly half were denied medical and religious exemptions first appeared on Arizona Daily Press.
Category: Vaccination order
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Veterans Day 2021 events in central North Carolina
Thu, 11 Nov 2021 12:39:32 GMT
Veterans Day 2021 events in central North Carolina

RALEIGH, NC (WTVD) – Central North Carolina is home to many Veterans Day events.

NC State is hosting a special ceremony in honor of the men and women who have served our country. The event starts early with an annual 5K run.

The run begins at North Carolina State University’s Memorial Belltower, which was designed in the 1920s to honor the school’s alumni killed in World War I.

Veterans Day 2021: Free Meals, Military Discounts | PERFORM

Hundreds of runners take part in the 5K every year. This year’s event started around 6 a.m. and is expected to last about an hour.

After the run there will be a ceremony with presentations and speeches from local veterans.

WATCH: Retired Navy Heroes Get Full Mortgage Off on Brand New North Carolina Home

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A Marine couple in Jacksonville, North Carolina learned on national television that their new home was fully paid off.

Durham County honors its veterans with a virtual ceremony that begins at 11 a.m. The ceremony will be broadcast on the county’s website and social media pages.

The City of Cary will hold its Veterans Day ceremony in Veterans Freedom Park at 11 a.m.

The Chapel Hill Veterans Day ceremony also begins at 11am. It takes place at the Seymour Center.

SEE ALSO: Why is Veterans Day on November 11th? What you should know about the national holiday

Louisburg gives everything for Veterans Day. The city holds a parade, concert, and more. The celebration begins at 11 a.m. in front of the Franklin County Courthouse.

Copyright © 2021 WTVD-TV. All rights reserved.

The post Veterans Day 2021 events in central North Carolina first appeared on North Carolina Chronicle.
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GOP legislative maps all but assure a less racially diverse General Assembly
Thu, 11 Nov 2021 11:16:15 GMT
GOP legislative maps all but assure a less racially diverse General Assembly

Several Democratic lawmakers of color now reside in districts that strongly favor Republicans

More than a half dozen of North Carolina’s Black legislators are in danger of losing their seats, as Republican legislators decided not to draw election districts to comply with the federal Voting Rights Act as legislatures had in the past.  

Republican map-makers said they did not use data on race or partisanship in drawing the maps to avoid getting them overturned in court as racial or political gerrymanders. They refused Democrats’ requests for a study of racially-polarized voting.  

Voting rights groups have sued over the decision to not draw Voting Rights Act districts, which are intended to give Black voters the opportunity to elect the candidates of their choice.  

As a result, two Black state senators representing eastern North Carolina counties, Sen. Toby Fitch, who now represents parts of Wilson, Halifax and Edgecombe counties, and Sen. Ernestine Bazemore, who represents all or parts of six counties from Vance to Beaufort, are now in majority Republican districts, according to information from the Princeton Gerrymandering Project. The project gave the state House and Senate redistricting plans “F”s for partisan fairness.  

Rep. Bobby Hanig, a member of the legislature’s far-right Freedom Caucus, announced last week that he will be giving up his House seat to  run in the redrawn Senate district where Bazemore lives, according to The Daily Advance.  

In the House, Rep. Raymond E. Smith Jr. of Goldsboro is now in a Republican district along with Republican Rep. John Bell, the House Majority Leader.  

Reps. Howard Hunter III of Ahoskie, Linda Cooper-Suggs of Wilson, and Rep. James Gailliard of Rocky Mount have also been placed in highly competitive districts.  

“An era of retrogression”

In most elections, North Carolina voters split about 50-50 between Democratic and Republican candidates, but the new legislative maps would likely allow Republicans to expand their majorities in the state House and Senate.  

“We probably are in an era of retrogression,” said Mickey Michaux, a former legislator from Durham who was first encouraged to run for office by The Rev. Martin Luther King Jr.  

“It took us a long time and a hard row to plow to get that representation that was sorely needed,” Michaux said. “The representation that comes out of the eastern district, those folks have acted in a fair and descent manner to all the citizens, not just the minority community.” 

Rep. Kandie Smith

As the House debated the new districts, Democratic lawmakers described the plans as blatant gerrymanders.  

“All of them reek,” said Rep. Kandie Smith, a Greenville Democrat. 

“It appears that there’s an attack on the African American vote, but there’s no concern for that,” she said. “It’s important to know that people are supposed to elect us [legislators], and not the other way around.” 

Beyond the eastern counties, Sen. Sydney Batch, a Wake Democrat, is in a district that Republicans have a chance of taking back after a Democrat flipped it in 2018.  

The legislature could lose Native American and Latino representation, too.  

Rep. Charles Graham, a Democrat from Lumberton and a member of the Lumbee Tribe, told his colleagues that there’s a chance, under the new map, that the area he represents could break the decades-long tradition of electing an American Indian to the legislature. Graham has announced he is running for Congress. 

Republican House members defeated Graham’s proposed change to the district lines. The new House district that would be easy for a Republican candidate to win.  

Rep. Ricky Hurtado

Rep. Ricky Hurtado of Alamance County, a Democrat and the only Latino member of the General Assembly, has also been placed in a district with redrawn lines that would make it harder for him to win a second term.  

Although they represent diverse electorates, Black legislators are known to advocate for the state’s historically Black public universities at budget time.  

Several Black legislators were members of Gov. Roy Cooper’s Task Force For Racial Equity in Criminal Justice.  

Black Republicans can win elections in the state, as Lt. Gov. Mark Robinson has shown. But few Black Republicans have been elected to the legislature in modern times. The last was Pearl Burris-Floyd of Gaston County, who was elected in 2008 and lost a primary in 2010.  

Public interest groups for years have tried to convince legislators to stop drawing their own districts and hand the responsibility to an independent group of citizens.  

Wilson City Council member Michael Bell said it would be a better way.  

“Put it in the hands of citizens – Democrats, Republicans and independent. Allow the districts to reflect the diversity and the demographics of that area,” Bell said. 

Discouraging prospective candidates of color

Having fewer Black lawmakers may indirectly curb the ambitions of young Black people who won’t see a path to office, said Moses Carey, a founder of the North Carolina Black Alliance. The alliance serves to connect Black elected officials at city, county, and state levels.  

“Many of the people in the Black community would like to see people in leadership roles who look like them,” Carey said. He is a former chairman of the Orange County Board of Commissioners and served in Gov. Bev Perdue’s administration.  

“Obviously, when young, upwardly mobile Black people see others in roles” they would like to hold, “they’re motivated by that,” he said.  

“When they don’t see them in those leadership roles, that blunts their motivation to serve and belief they can get elected to those particular positions. Drawing districts in a way that makes it less possible for Black folk, young Black folk, to get elected is detrimental to the society in which we live.  

“We need a system of developing the districts in a way that is equitable for everybody involved, including for people in communities of color.” 

Before legislators draw district lines, they arrange counties into “clusters” to avoid creating districts that cross county lines.  

The lawsuit filed by the North Carolina branches of the NAACP and Common Cause last month says legislators had a choice of clusters in northeastern North Carolina for the state Senate map and chose one with the smaller population of Black people of voting age.  

“Even without explicating viewing racial data during drafting, any individual with passing familiarity with this area of North Carolina would understand the choice” would “undermine Black voters’ ability to continue electing the candidate of their choice,” the complaint states.



originally published at https%3A%2F%2Fncpolicywatch.com%2F2021%2F11%2F11%2Fgop-legislative-maps-all-but-assure-a-less-diverse-general-assembly%2F by Lynn Bonner

The post GOP legislative maps all but assure a less racially diverse General Assembly first appeared on North Carolina Chronicle.
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TikTok Surpasses Google to Turn out to be World’s Most Visited Web site in 2021
Thu, 23 Dec 2021 11:03:26 GMT
tiktok

Cloudflare, an American technology security company, reported Monday that TikTok was the most visited website in the world in 2021, beating last year’s market leader, Google. Most popular in the US, Europe, and Southeast Asia, TikTok is owned by Beijing-based technology company Bytedance, which also operates a sister app for mainland China called Douyin.

Last year, Google was the most visited domain in the world, while TikTok only finished seventh or eighth according to Cloudflare.

The article also reveals that TikTok ranked first for several days between February, March and May of this year, but after August 10 “was in a leading position most of the time”. There have been a few moments that Google took first place, but TikTok took the top spot in October and November, including US Thanksgiving Day (November 25th) and Black Friday (November 26th).

On the evening of September 27th of this year, TikTok announced that its monthly active users worldwide exceeded 1 billion. TikTok has thus successfully developed into the top 5 applications in terms of global user activity alongside Instagram, Facebook, WhatsApp, Messenger and WeChat.

According to ByteDance, TikTok had around 55 million users worldwide in January 2018. In December 2018, that number exceeded 271 million. By December 2019, that number rose to 507 million. Last summer, the app had almost 700 million monthly active users.

ALSO SEE: TikTok Launches 300 Delivery-Only Digital Restaurants in the US

According to a ByteDance internal material, as of June this year, the company’s actual revenue in 2020 was 236.6 billion yuan ($ 37.14 billion), up 111% year over year, and the operating loss reached 14 , 7 billion yuan. By the end of 2020, the number of monthly active users of ByteDance products had reached 1.9 billion worldwide and the number of the company’s employees worldwide had reached 110,000.

The post TikTok Surpasses Google to Turn out to be World’s Most Visited Web site in 2021 first appeared on DAILY ZSOCIAL MEDIA NEWS.
Category: Worlds
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‘We have the watch’: Stories from inside NORAD on 9/11
Thu, 09 Sep 2021 05:21:09 GMT

At the height of the Cold War, the U.S. Army Corps of Engineers supervised the excavation of Cheyenne Mountain, a peak pimpled with rocky outcrops and shaded by evergreen trees southwest of Colorado Springs. They pulled out the mountain’s innards and paved over the gravelly cavern, dividing the space into high-tech offices for U.S. military personnel.

The project — creating a hardened, protected command and control center that could withstand direct attacks — was a response to threats of long-range Soviet missiles. By 1966, Cheyenne Mountain Air Force Station was fully operational as the North American Aerospace Defense (NORAD) Combat Operations Center.

These were the chambers where decisions would be made if an attack came to North American soil.

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But for nearly 40 years, no major attacks came. The Cold War faded, the turn of the century came and went, and NORAD began to downsize its alert bases — outposts around the nation that collected and reported information to the combat operations center. NORAD’s remaining sensors were all pointed outwards, focused on intercepting threats from across the oceans. No one anticipated an attack would come from the inside. 

On Sept. 11, 2001, 19 men associated with the Afghanistan-based terrorist group al-Qaida hijacked four commercial airplanes, flying two into the World Trade Center of New York, one into the Pentagon in Washington, D.C., and another into a Pennsylvania field. According to “The 9/11 Commission Report,” then-President George Bush called the vice president after the Pentagon was hit, but before the crash in Pennsylvania: “We’re at war,” he said. “Somebody’s going to pay.” 

We’re at war … Somebody’s going to pay.

– President George W. Bush

What ensued was a scramble for information and a call to action. While military personnel launched a mission for retribution and reconstruction that stretched into 20 years of U.S. involvement in Afghanistan, NORAD redesigned the defense plan for North America. But across the globe, countless lives have been and continue to be affected by events unfolding after 9/11. In Colorado, the presence of U.S. military installations grew, as did the importance of NORAD and its eventual operations mate, U.S. Northern Command (USNORTHCOM), established in 2002 — together now known as “the epicenter of Homeland Defense.” 

To commemorate the 20th anniversary of 9/11, we asked those who during the attack were serving in the U.S. military and working with NORAD or at Cheyenne Mountain Air Force Station to share their stories.


Senior Airman Ricardo Collie, a 721st Security Forces member, patrols the north gate of the Cheyenne Mountain Complex at the then-Cheyenne Air Force Station, now known as the Cheyenne Mountain Space Force Station, in Colorado. (Staff Sgt. Andrew Lee/U.S. Air Force photo/Public domain)

Steven Armstrong was NORAD’s chief of plans and forces. He is now vice director of NORAD Operations and chief of NORAD Strategic Engagements.

We were in Cheyenne Mountain that morning actually doing an exercise. Vigilant Guardian was the name of the exercise back then, where it’s basically an escalation of Russian activities and U.S. activities that ultimately results in a nuclear exchange — we would do that exercise every year. 

Tanya Hurwitz was a captain. She now serves in the U.S. military personnel exchange program, reporting for duty as a lieutenant colonel to the Royal Australian Air Force in Canberra, Australia.

I had been on the midnight shift participating in an upgrade training. After going through all our normal procedures that were assigned to us, and it looked like things were going to be quiet, my instructor sent me home around 2 a.m. 

Steven Armstrong: Each day of the exercise, I’d come in and do a handoff with the guy that was on the night shift, and he’d basically say, “Hey, here’s what we’ve done over the night shift, and here’s where we’re at with acquiring additional forces, and how we’re going to posture those forces, and how we were going to respond to any potential inputs into the exercise scenario.” So we did our handoff. It was early in the morning out here, and I started working the exercise issues of the day. Then we got word via CNN — literally CNN is where we were drawing all of our information, at least initially. We were getting indications that there was something going significantly wrong in the national airspace system.

Tanya Hurwitz: I lived by myself and went to bed. I think I woke up at like 6 in the morning, and at the time I had a TV in my bedroom, so I turned on the TV to check the news … I was keeping it low, I was trying to go back to sleep again, because I was supposed to go back to the Mountain for another shift that night. I was watching the “Today” show and then I saw it happen live on TV, just like 99% of Americans who were watching TV at the time. 


Tanya Hurwitz circa 1997. (Courtesy of Tanya Hurwitz)

James Austinwas a second lieutenant. Now a lieutenant colonel, he serves on Ramstein Air Base, in Germany, as Branch Chief for Theater Integration for the U.S. Air Forces in Europe and Africa. His remarks came via email.

I rode the bus into the mountain that morning and overheard a couple of folks talking about a plane flying into a building in New York City. In my mind, I imagined a fogged-in New York and a small Cessna aircraft stuck in a building 50-60 stories up. As I walked into my office I asked if anyone had heard about a plane flying into the World Trade Center and my entire work center looked back and said, “You just missed the second one flying in real time.”

John Nerwinski was an airman first class. As a major, he now serves at Schriever Space Force Base near Colorado Springs.

I was in the space analysis center looking up at the TV. At those times, the TVs sat on something mounted to the wall, because TVs were still boxes back then, and I remember seeing the towers. I think they were both standing at that time, just kind of burning there. We knew it was going to mean something big for the military, not exactly sure what that would mean, but we definitely knew it’s gonna be something big. 

Victor Cordero was a senior airman. Now, a chief master sergeant at Joint Base Anacostia-Bolling outside Washington, D.C, he manages the U.S. Air Force’s cyberspace support career field.

That day, I was not supposed to work. It was my day off. And I remember my family was like“Look at the TV! Look at the TV!” And I’m just waking up, I’m looking at the TV, and it was just surreal … I thought I was watching a movie. Like in my mind, I was like, is this a movie? I had to check down on the lower screen to make sure it was a news outlet. 


Victor Cordero, seen here at left at the entrance to the Cheyenne Mountain Air Force Station in the early 2000s, was a senior airman. He now serves the U.S. Air Force as a chief master sergeant at Joint Base Anacostia-Bolling outside Washington, D.C. (Courtesy of Victor Cordero)

Jonathan Kelley was an airman deployed to Saudi Arabia from Colorado. He now serves the U.S. Air Force as a senior master sergeant at Sheppard Air Force Base in Texas.

I was in Riyadh, in Saudi Arabia, in Eskan Village. I was getting prepared for one of our final meetings before we were supposed to leave for our return back to Colorado. I had my bags packed. And I remember looking at somebody’s TV, thinking it was like an action movie, like, “Wow, this is pretty cool.” Then someone says, “Hey, this is real life.” And you’re like, “No way, you’re pulling my leg.” And he’s like, “No, this is actually happening.” So you’re just watching this, like, “Wow, never in a million years did you ever think something like that would actually happen.”

Thomas Cucchi was a flight commander providing air defense as directed by NORAD for the southeastern United States. Now, as a major general, he serves as mobilization assistant to the NORAD commander.

I was down in Miami waiting to do a flight when I got a call from the detachment down at Homestead Air Force Base. They were asking me where I was. “Obviously,” they said,“you saw the airplanes go into the World Trade Center.” And so they asked me to get down to Homestead as quickly as I could, they said that this was not over yet. And so I got into my car and during that hour drive, both of those buildings collapsed.

Victor Cordero: All of a sudden I hear the news anchor on TV saying, “Breaking news, there’s another plane that’s hitting the Pentagon.” And then, “There’s another plane we haven’t identified in Pennsylvania.” So I was just thinking, “What is going on? Is Colorado Springs next? Are we being impacted by this?” At that point I started thinking, from my training, that this is an orchestrated attack. We don’t know who’s coming or anything. And then even without receiving a phone call, I started getting ready.

So I was just thinking, ‘What is going on? Is Colorado Springs next?’

– Chief Master Sgt. Victor Cordero

Steven Armstrong: As we saw that second aircraft hit the tower, that’s when we kind of got over the numbness of watching the events. Basically we had to start thinking about how we were going to defend the air space. 

James Austin:At that moment, I knew we were under attack, but I was not sure from who or what else to expect. I went to my squadron and group leadership and started preparing to stand up the Crisis Action Team area where key leadership would gather to analyze and decide what actions were required to take. 


The tunnel entrance to the Cheyenne Mountain Complex as seen in 1999. (U.S. National Archives/Public domain)

The last time a hijacking had required coordination between military management and the Federal Aviation Administration had been in 1993. The FAA regulates the safety and security of civil aviation (commercial and personal airplanes and flight schedules). In 2001, the organization wasn’t equipped with direct communication channels to the U.S. military — if it needed assistance it first had to work through a long chain of command. Also, the FAA’s decentralized structure at the time segregated information by region that had to be manually disseminated. 

“On the morning of 9/11, the existing protocol was unsuited in every respect for what was about to happen,” states the “9/11 Commision ReportAs a result, NORAD had about 9 minutes of advance notice on the first hijacked plane, and no advance notice on the following three planes.

In New York, One World Trade Center was hit at 8:46 a.m. (6:46 a.m. in Colorado Springs). Two World Trade Center was hit at 9:03 a.m. Eastern time. The first collapsed at 10:28 a.m., the second at 9:59 a.m. All 157 people aboard the two planes perished, along with more than 2,700 people in New York City. 

Hijackers en route to the Pentagon hit the building at 9:37 a.m. Eastern timekilling 59 aboard the airplane and 125 military and civilian personnel inside the building.

In Pennsylvania, the plane’s passengers interfered with the hijackers’ mission and forced the plane to crash into an empty field in Shanksville, Pennsylvania, at 10:03 a.m. All 44 people on board died.


Thomas Cucchi on Sept. 11, 2001, was a flight commander providing air defense as directed by NORAD for the southeastern United States. Now, as a major general, he serves as mobilization assistant to the NORAD commander. (U.S. Air Force)

Thomas Cucchi: All of NORAD’s sensors basically looked (outward); we never thought a threat would come from the inside. We always thought we’d have enough time to react because we thought the hijack attempt would come from overseas to the U.S., not necessarily starting from, in this case, Boston, Newark, and Washington. 

Steven Armstrong: We tried to reach out to the FAA, but as you can imagine, they were significantly busy trying to figure out exactly what was going on as well, given the fact that they had other indications that other aircrafts may have been hijacked or maybe missing in the airspace. We immediately started trying to figure out how to get additional forces, not for the exercise, but for the real world. Within a matter of hours, we had a couple hundred fighters available at our disposal to be able to put in air patrols up above the United States. And we started coordinating with the FAA to be able to get all the other air traffic down that was still flying. It took us literally hours to get all those civilian aircraft on the ground so that we could sanitize the airspace to be able to figure out if there were any bad guys still flying. 

Thomas Cucchi: When I got to Homestead Air Force base, they basically said, “Suit up. You’re going to go fly, because we don’t know if it’s over or notSo I got my uniform flak gear on and about an hour later, around noon, I was airborne with another wingman, going up and down from Orlando to Miami, waiting for something else to happen. The FAA had grounded all air traffic in the U.S. It was eerie in the fact that I had flown no-fly enforcement zones in Iraq, and no airplanes were airborne after the first Desert Storm, so it was like flying over there, except everything was green in Florida. 

James Austin: The Department of Defense instructed all bases to increase to force protection condition delta (reserved for “attack imminent” or “actual attack occurring”) — that was a trigger for me to report to the 721st Security Forces Squadron and begin my role as a security forces augmentee. My duty was to guard part of the perimeter of Cheyenne Mountain. From there I heard multiple fighter aircraft buzzing across the sky as the Air Force scrambled military jets and instructed all commercial aircraft to land.

Victor Cordero: I kissed my wife, kissed my son who was about a year and a half at that point — he was playing right in front of the TV while I was looking at this, and I was just numb at that point. I got all my equipment. I worked law enforcement and security at Cheyenne Mountain, so I got my gear, my belt, any other protective equipment that I needed. And I took my “A bag,” which is a green bag that we have to take for any contingency responses, because we didn’t know when we’d be going back home. 


Jonathan Kelley was an airman deployed to Saudi Arabia from Colorado. He now serves the U.S. Air Force as a senior master sergeant at Sheppard Air Force Base in Texas.  (Courtesy of Jonathan Kelley)

Jonathan Kelley: The communication between our home unit (in Colorado) and our base (in Saudi Arabia) was limited, if you will, because at that point in time, it was just a lot of unknowns and we were taking things hourly. As the information would come through, our leadership personnel would make decisions, and so we stood by and waited for what our next direction was. 

Steven Armstrong: At the operational and strategic level, we were trying to get additional forces from the other services and additional capability and capacity. But I remember even after the aircraft crashed in Pennsylvania, we had indications that there were one or two more aircraft that were likely out there, which we were going to have to try and find. 

Victor Cordero: We were living at Peterson Air Force Base in base housing. You could just see everybody from base housing moving with a sense of urgency. They had a quick step and you could see everybody outside going somewhere or doing something in response to those events that were occurring at that point. As I depart, or I try to depart, Peterson Air Force Base, there was a large amount of traffic going in and out. Force protection level measures were applied on Peterson Air Force Base so it took me a while to just get out of the base. 

John Nerwinski: Coming up onto NORAD Road, it’s windy and it’s wooded off to the sides. Back then anyway, and probably still to this day, sometimes you’d have to stop because there’d be like a flock of turkeys walking across the road. 

Tanya Hurwitz: The entrance that they show in the TV show and movie “Stargate” — the entrance to the hidden place, where they have the star gate, where they can travel through wormholes to other worlds — the entrance that they show on TV is the actual entrance to Cheyenne Mountain.

Victor Cordero: I saw a line of cars as we got closer to the entrance. They checked my vehicle, did a search, and then I went up and I started getting ready, putting on the helmet, the body vest, and instead of just carrying one weapon, we had two weapons, a long rifle and a small arms. 

People arrive for the Cheyenne Mountain anniversary in 2016.
Members of the community and military attend the 50th Anniversary Rededication Ceremony at Cheyenne Mountain Air Force Station April 15, 2016. After nearly five years of construction, Cheyenne Mountain Air Force Station was declared fully operational April 20, 1966. After decades of operation by the 21st Space Wing and 721st Mission Support Group at Peterson Air Force Base, in July 2021 the installation was renamed Cheyenne Mountain Space Force Base and is now operated by Space Delta 2 at Peterson Space Force Base. (Staff Sgt. Tiffany DeNault/U.S. Air Force/Public domain)

Cheyenne Mountain Air Force Station housed other tenants in addition to NORAD personnel that supported the mission of aerospace warning and aerospace control, including the U.S. Air Force Space Command and U.S. Strategic Command. 

As national security information criss-crossed the country that morning — with the president in Florida, the vice president in Washington, D.C., NORAD in Colorado, FAA centers in multiple states, and rescue crews in New York, Washington and Pennsylvania — additional potential threats were identified in Colorado. 

Steven Armstrong: We really didn’t get a whole lot of information, to be quite honest with you, from an operational level. On the intel and the law enforcement side, we were starting to get indications of more threats. As a precautionary measure, the most prudent thing that we could do was shut the doors and clamp down on who had access and who didn’t. We put Cheyenne Mountain into war fighting mode. 

James Austin: About one or two hours into my new role as a Security Forces member, I was asked to look for any inbound aircraft, as rumor was a plane was unaccounted for and possibly headed for Colorado Springs, with Cheyenne Mountain as the target. 

I was asked to look for any inbound aircraft, as rumor was a plane was unaccounted for and possibly headed for Colorado Springs, with Cheyenne Mountain as the target.

– Lt. Col. James Austin

Victor Cordero: On that day, all boots were for defending the mission and the base. So as I went to the armory and received my weapons, we received our briefing. I ended up going down to the main gate with my fellow defenders. Each vehicle, before they entered, we checked their credentials to make sure they were valid and a need to enter the installation, and we searched the vehicles. There was a line like I’ve never seen before at the installation — it was just hours and hours of a heightened sense of awareness. Each one of us looked at each other, saying, “Hey, we gotta take care of each other. We gotta protect whatever occurs here.”

John Nerwinski: Some folks were definitely in shock and trying to process what was happening. And the other folks, probably myself included, were, I won’t say excited, but a little bit more like we’re gonna be ready for something, and we don’t know what that something is. ‘Cause I had only been in the Air Force for two years at that point, and so I had a long career still to go — it was definitely going to mean something for me for the rest of that time. 


The ‘Tribute in Light’ memorial lights up lower Manhattan near One World Trade Center on Sept. 11, 2018, in New York City. The tribute at the site of the World Trade Center towers has been an annual event in New York since March 11, 2002. (Spencer Platt/Getty Images)

The threats against Cheyenne Mountain did not come to fruition. 

Victor Cordero: I didn’t get off that day until 11 p.m. or so. Then I had to wait in line to get back on Peterson Air Force Base, and I think I had to show up at about 4:30 a.m. the next day to go work at Cheyenne Mountain again. So waiting there, it gave me an opportunity to just wait and digest everything, my mixed emotions. I remember that I was crying, because it’s like, you see people falling out of the Twin Towers, the Pentagon, just thinking … America has been hit and we didn’t know where it was coming from. We don’t know what it was. And it just totally shaped the way we were looking at terrorism at that point. So there were plenty of mixed emotions.

Steven Armstrong: I think I was there for almost 24 hours that first day. It was a very, very, very long day. By the time I went home that next morning, my wife and kids were there and met me and, you know, the looks on their faces, those are some of the things you don’t forget as well. 

John Nerwinski: I remember hearing on the news that it was going to probably start gouging the gas prices. So I remember going home and getting gas on the way home.

Jonathan Kelley: We already had our bags packed up for the most part, ready to go home, and we just literally picked everything up, went back, and unpacked it all because it was like, “Well, obviously knowing what we’re seeing now, whatever you need from us, just tell us, and we’re here to make sure the job gets done.”

Thomas Cucchi: Throughout the following weeks, we had brought a lot of airplanes, F-15s, down to Homestead, and basically we were doing 24-hour combat air patrols with all the pilots that were there at the time.

James Austin: In the ensuing days and months, those of us with the Security Forces Squadron rotated on 13-plus-hour shifts.

Steven Armstrong: Over Colorado Springs and over Denver, we had air patrols going 24/7 for several days. And in Washington, D.C., and New York City, we flew 24/7 air patrols over the top of those two cities well into December. 

Jonathan Kelley: I’d just hit or was approaching my one-year mark. You’re talking, like, baby for the Air Force, but you know, it was exciting. I was nervous at first, but I was excited to experience something different. 

John Nerwinski: I think it got back to normal for me pretty quick. The satellites still had to be tracked.


William Glover was the N2C2 Operations Support director for the North American Aerospace Defense Command at Peterson Air Force Base. On Sept. 11, 2001, he was an Air Force lieutenant colonel in charge of NORAD Air Defense Operations and was in the Cheyenne Mountain operations center on that day. (Tech. Sgt. Thomas Doscher/NORAD/Public domain)

9/11 brought the threat of civilian airliners being used as weapons to the U.S. military’s attention. This new threat required a new set of procedures and exposed more assets requiring defense. “While our mission did not change, our responsibilities had increased,” William Glover, the Air Force lieutenant colonel in charge of NORAD Air Defense Operations on 9/11, told NORAD and USNORTHCOM Public Affairs on 9/11’s 10th anniversary. 

In response to 9/11, a new defense playbook was written for North America, named Operation Noble Eagle. Operation Noble Eagle gives NORAD commanders more authority to investigate civilian aircrafts in the U.S. and Canada, and it outlines new force structures for times of peace and war. In 2002, USNORTHCOM (U.S. Northern Command) was created, becoming the 11th combatant command in the U.S. Department of Defense (and the only one tasked with detering, detecting, and defeating threats to U.S. soil. USNORTHCOM headquarters was placed insideCheyenne Mountain alongside NORAD. 

Steven Armstrong: Within two or three days, I actually was sent by Gen. (Ralph) Eberhart to Washington, D.C., to write the plan on how we would array forces — in other words, Operation Noble Eagle, which is still in effect today. We’ve made some tweaks and some adjustments, predicated on force structure and requirements over the years, but by and large, it’s still the same apparatus that we stood up after 9/11. 

Thomas Cucchi: For the FAA to ask for assistance prior to 9/11, it would take like an hour to go through the national military command center and then get to NORAD. Now the FAA, all they have to do is ask us and we will provide them, at a moment’s notice, with military assistance. We also have the Domestic Event Network now; a lot of agencies collaborate on that, from the FAA to NORAD to the major airlines, so information is shared. If an airliner is not talking to anybody, I know right away, and if that goes on for 10 to 15 minutes and the FAA needs assistance, I know right away that we’re going to be scrambling to help the FAA out. What took an hour now takes seconds, and we have immediate situational awareness thanks to the Domestic Event Network.

To fill the roles outlined in Operation Noble Eagle, a total of 35,000 military men and women were called in to participate. Fort Carson, an Army base just east of Cheyenne Mountain, became a training and deployment hub for those serving global anti-terror missions. It remains so to this day. In July 2021, 1,800 soldiers from Fort Carson were deployed to Iraq.

Tanya Hurwitz: 9/11 ultimately shaped everyone’s careers after that point. With all the deployments and everything else, it changed the trajectory of what everyone is going to do. For the longest time, even after I’d moved on to different jobs, I kept the number from my desk and I always had my phone nearby if I was on a plane, thinking if something happened, I’d call them. 


Tanya Hurwitz in 2020. (Tanya Hurwitz)

Victor Cordero: Our deployments quadrupled, they surged, and with that came … many bad things, because we lost people, whether it be at deployed locations, serving our country and serving those people that needed us in other places, or people coming back that weren’t the same. Some of the impacts — whether it be psychological, physical, TBI, PTSD — that’s the cost. But if you asked each one of us, it’s well worth it because of what we believed in our service, and why we chose to be in the military and serve our country and help people around the world. 

John Nerwinski: 9/11 probably made me a little bit more conservative, gave me a little bit more love for the country, I suppose. I probably had it back then, but I was still young, I was only in my very early 20s, and so I was still finding myself as an adult. 

In 2008, the Cheyenne Mountain Complex was redesignated as NORAD and USNORTHCOM’s Alternate Command Center, used as a training site for crew qualifications. Daily crew operations for the two missions moved and now take place at Peterson Space Force Base in Colorado Springs.

Steven Armstrong: Colorado does and will continue to play a very significant role in the defense of our nation, given the fact that it’s the epicenter of Homeland Defense with NORAD and USNORTHCOM headquartered here. 

Thomas Cucchi: The bigger picture is that Colorado is where the defense of the U.S. basically goes from cradle to grave, as far as concepts and implementation. It’s not like Colorado is the focal point of it, it just happens to be where the headquarters is and where all the massive brain power that comes up with the defense plans comes together.

Steven Armstrong: About 10 years ago, we instituted a slogan in our command center where the daily execution and running of NORAD and USNORTHCOM operations occur: “We have the watch.” What that means is we have the watch for North America. We’re responsible for the homeland defense of North America, and that includes our mission partners up in Canada. It’s a significant thing that we’re doing for this nation.

These oral dictations were lightly edited and condensed for clarity.

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The post ‘We have the watch’: Stories from inside NORAD on 9/11 appeared first on Colorado Newsline.

Category: Lawyers
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HUAWEI P50 Pocket Official takes it with the Z Flip 3. on
Thu, 23 Dec 2021 10:59:01 GMT

Source: HUAWEI (YouTube)

HUAWEI unveiled its competitor, the Samsung Galaxy Z Flip 3, the HUAWEI P50 Pocket, at an event in China today. First of all, let’s talk about the display and design of the P50 Pocket. On the outside, the clamshell-style foldable device from HUAWEI has a unique round 1.04-inch display on the outside and a tall 6.9-inch display on the inside. The outer top has two round recesses: one for the round display and one for the camera housing.

The round display called “Smart Screen” is a 1.04 inch display with 340 x 340 pixels, on which the date / time, notifications, weather, music control, navigation direction and much more can be shown. The main camera setup of the device is located above this display. This camera body contains an f / 1.8 40MP main camera, an f / 2.2 13MP ultra-wide camera with a 120-degree FoV and another f / 1.8 32MP “super spectrum” sensor. This superspectrum sensor can be used for a cool fluorescence photo mode. Aside from that, HUAWEI also claims that this sensor on the P50 Pocket can detect whether the person is wearing sunscreen or not.

When opening the foldable clamshell, the 6.9-inch inner folding display becomes visible. This is an OLED display that offers a refresh rate of 120 Hz and has an aspect ratio of 21: 9. HUAWEI also claims that this foldable display has a hinge design that leaves no space between the two display parts. Since the device is foldable in the clamshell style, it is 15.2 mm thick when folded and only 7.2 mm thick when unfolded. The smartphone weighs only 190 grams.

The HUAWEI P50 Pocket is powered by Qualcomm’s Snapdragon 888 4G processor. Since HUAWEI is not allowed to use Qualcomm’s 5G modem, a 4G version of the Snapdragon 888 chipset was chosen. The smartphone is powered by a 4,000 mAh battery (700 mAh more than Samsung’s Z Flip 3) and supports 40 W fast wired charging. It runs on HUAWEI’s own HarmonyOS 2. It is available in three colors: white, black and a special gold color that was designed in collaboration with prominent haute couture designer Iris Van Herpen.

Source: HUAWEI

HUAWEI P50 Pocket Specifications specification HUAWEI P50 bag
Display technology Foldable (clamshell style)
External display 1.04 inch circular (340 x 340)
Inner display 6.9 inches (2,790 x 1,188), OLED, 120 Hz refresh rate
processor Snapdragon 888 4G
Reversing cameras 40MP main, 13MP ultra wide angle, 32MP super spectrum
Front camera 10.7 MP
battery 4,000 mAh
Loading speed 40W
Storage and storage 8 GB + 256 GB, 12 GB + 512 GB
operating system Harmony OS 2
Connectivity 4G, no support for 5G
HUAWEI P50 Pocket: price and availability

Source: HUAWEI

HUAWEI P50 Pocket is available in China starting today. It costs 8,988 CNY (~ $ 1,411) for the model with 8 GB RAM and 256 GB internal storage. The model with 12 GB of RAM and 512 GB of onboard storage costs you CNY 10,988 (~ $ 1,725). Compared to the Samsung Galaxy Z Flip 3, the HUAWEI P50 Pocket has become significantly more expensive. The foldable smartphone is only available in China for the time being. There is currently no information about the worldwide availability of the HUAWEI P50 Pocket.

What do you think of the foldable clamshell style from HUAWEI? Let us know in the comments section below!

The post HUAWEI P50 Pocket Official takes it with the Z Flip 3. on first appeared on DAILY GADGET AND GIZMOS NEWS.
Category: Cases And Accessories
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5 facts anti-abortion activists get wrong
Thu, 09 Sep 2021 05:14:02 GMT

Want to reduce abortions? 

Great — but doing so doesn’t require unconstitutional abortion bans.

Conversations on female reproductive biology have long been muted. The duct tape is often applied by religious and conservative sects that historically view even the most basic utterances of sexual education as lewd. The result? A fundamental lack of understanding of reproductive health by sexually active people — including by people who can get pregnant.

In light of Texas’ controversial six-week abortion ban, it is therefore all the more reason to address the science behind pregnancy, and illustrate why anti-abortion activists have yet again missed the boat:

Terminology

Anti-abortion activists love to tell you you’re killing babies, yet there are at least four distinct scientific terms relating to human development that should not be used interchangeably: zygote, embryo, fetus and baby. 

A zygote is an egg cell that has been fertilized with a male gamete, or sperm. Contrary to popular thought, this is not the start of a pregnancy. The weekly calendar count actually begins on the first day of the pregnant person’s last menstrual period, often a full two weeks prior to fertilization. The zygote marks the combination of DNA.

Pregnancy tests are reliable starting about 10 days after this time, which can total nearly four weeks after the start of the pregnancy. Accordingly, the average pregnancy is not detected until four to seven weeks, with zero guarantee of carrying to full term at this stage. In fact, it’s estimated that up to 50% of fertilized ovums this early result in miscarriages

After fertilization, the zygote will form into a blastocyte and then an embryo. This cluster of cells begins to map head versus tail and primitive systems. Only after the eighth week of pregnancy is the term fetus applied. There remains no guarantee of successful development, and rates of miscarriages throughout the first trimester stay as high as 20%.

The fourth term, baby, does not apply until the fetus is delivered from the womb. Given the limits on viability, this renders phrases such as “unborn baby” or “unborn child” misleading, as they make assumptions of viability that cannot be determined.

The so-called six-week ‘fetal heartbeat

At six weeks, the embryo — not fetus — does not have a fully functioning heart. Instead, an ultrasound detects electrical activity in localized primitive cells of the embryo that will later go on to develop into a full cardiac system. With absolutely no guarantee of viability at this stage — for either the heart or the pregnancy — defining the embryo as having certain viability is scientific nonsense.

Poll after poll shows the majority of Americans agree that abortions should be legal in all or most circumstances, while only 39% believe they should be illegal.

Actual fetal viability

Despite many advances in medicine, fetal viability remains a gray zone under 24 weeks. Even at 24 weeks, 30% to 40% of preemies do not survive despite robust medical intervention. It is not until 28 weeks that survival rates reach 80% to 90%, although some that survive will continue to experience long-term symptoms of underdevelopment. Romanticizing potential viability of an embryo or fetus prior to this stage is unscientific and causes much emotional harm.

Late-term abortions

Late-term abortions are overwhelmingly due to health complications or a lack of access to early care. Evidence-based reform could help eliminate many late-term abortions.

Most people don’t regret getting an abortion 

Over 95% of people who received an abortion said in a five-year follow up study it was the right choice for them.

Poll after poll shows the majority of Americans agree that abortions should be legal in all or most circumstances, while only 39% believe they should be illegal. This sentiment is well enshrined in the landmark case Roe v. Wade, and despite misinformation attempts by anti-abortion activists, reasonable fetal viability is not seen until well near 28 weeks. 

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It’s critical to note that recognizing the science of human development in no way belittles the birthing experience for those who become pregnant, yet dismissing the nuanced biology can have severe negative impacts on those who are forced to carry an embryo or fetus against their will. The changes required to break misinformation cycles are extensive, and include addressing the lack of diversity and scientific expertise in leadership.

For example, in Colorado, voters have never elected a woman to governor, U.S. Senate or Denver mayor. This creates a dearth of experiences and narratives, leaving men like Gov. Jared Polis, Sen. Michael Bennet, Sen. John Hickenlooper and Mayor Michael Hancock to be responsible for nearly 50% of constituents with whom they do not share reproductive biology. 

Without adequate representation, pregnant people rely on the voices of our allies to educate and combat misinformation. If they aren’t comfortable discussing female sexual health, then perhaps they ought to cede ground to the women and scientists who are.

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The post 5 facts anti-abortion activists get wrong appeared first on Colorado Newsline.

Category: Coping With The Injury
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Teams need to stop playing Valor Christian
Sun, 29 Aug 2021 05:26:13 GMT

Valor Christian High School, based on statements from school officials and the former Valor coach they forced out for being gay, practices a form of rank bigotry.

The school, located in the south metro Denver community of Highlands Ranch, is unabashed in its religiosity, and administrators think they can flash faith as a form of ethical immunity from charges of prejudice. They are wrong. Hate is hate. When you discriminate against a person or group based on immutable characteristics, such as skin color, ethnicity or sexual orientation, you practice hate, no matter who put you up to it, even God.

In its attitude toward gay members of the school community, Valor behaves like a hate group. Yet too many people shield themselves from this aspect of the school to justify interacting with it in the normal course of scholastic activities. The athletic teams of other schools are happy to meet Valor as a peer on the field of play, but doing so abets bigotry, and, in the interest of promoting among young people the true value of brotherly love, they must reconsider their role in maintaining Valor’s undeserved good standing in Colorado’s educational community.

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As first reported by Denver7, Inoke Tonga, a volleyball coach, recently discussed on Facebook his life as a gay Christian man. The post alerted Valor officials to a conflict between Tonga’s identity and their religious strictures, and, according to Tonga, they told him he could either “denounce” being gay or resign.

“They did say it was a danger to be in front of the kids,” Tonga told 9News. “And that to protect the kids I couldn’t be in front of them.” This is the language of committed, unconcealed hate, revealed here to be a part of routine operations at the school.

Valor officials have claimed vaguely that Inoke has “misrepresented” parts of the episode, but they have not denied his central allegations and in fact have affirmed that Inoke’s Facebook post “suggested he may not support Valor’s beliefs pertaining to sexuality and marriage.”

His account was reinforced when, spurred by coverage of Inoke’s story, a second coach came forward to describe a similar experience. Lauren Benner, former head women’s lacrosse coach at Valor and the school’s 2019 coach of the year, said she also was pushed out for being gay. Benner said the school wanted her to “go through prayer” to guide her “towards a life that would be in alignment with their beliefs that homosexuality is wrong.” And it’s not just coaches who are speaking up about bigotry at Valor. Students are corroborating their assertion that the atmosphere at the school is overtly hostile to gay and trans people.

Athletes should refuse to engage with Valor’s teams on the field and court.

It is unclear if Valor’s institutional discrimination is illegal. State law prohibits employers from discrimination based on sexual orientation, among other protected classes. But the law contains an exemption — call it a hate loophole — for religious institutions, such as a Christian school, where an employee is performing work “connected with the carrying on” of the institution’s activities. 

But whatever legal exposure the school could face, it should face social exposure. Valor is a member of the Colorado High School Activities Association, through which its sports teams compete with other schools in the state. The top football player in the state wears a Valor jersey. Bronco great Ed McCaffey is a recent former head coach at Valor, and his son, Dylan, led the team to the Class 5A state championship four years in a row. “Sports are a big deal at Valor,” the school says. But other teams that compete with Valor, such as Mountain Vista, Castle View, Highlands Ranch and ThunderRidge, are in a position to make Valor’s bigotry an even bigger deal. Their athletes should refuse to engage with Valor’s teams on the field and court. This could be a disruptive and painful response for students and coaches who simply want to participate in the worthy pursuit of high school athletics. But compared to the disruption and pain that hate inflicts on its victims, it’s not even in the same ballpark.

Half a century ago, Brigham Young University’s football team was the subject of boycotts because of discrimination against Black people by The Church of Jesus Christ of Latter-day Saints, which operates the school. Black church members were barred from the priesthood. At first, church president Spencer Kimball held firm to his bigoted beliefs. But after what he described as a revelation from God — a moment hilariously memorialized in a lyric from “The Book of Mormon” — he changed his mind. More recently, BYU has seen calls for football boycotts in response to the school’s anti-LGBTQ policies.

Valor has earned a similar rebuke. The alternative is to look away as the school promotes hate. Coloradans wouldn’t condone such bigotry in any other civic setting. There’s no reason to accept it when it’s perpetrated under the banner of faith.

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The post Teams should stop playing Valor Christian appeared first on Colorado Newsline.

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Governor Newsom Announces Judicial Appointments 12.23.21
Thu, 23 Dec 2021 20:21:33 GMT
Governor Newsom Announces Judicial Appointments 12.23.21

Published: Dec 23, 2021

SACRAMENTO – Governor Gavin Newsom today announced the appointment of two judges to the Fresno County Supreme Court and Kern County Supreme Court.

Fresno District Court

Charles J. Lee, 44, of Clovis, was appointed Justice of the Fresno District Court. Lee has been a Senior Litigator in the Office of the Federal Public Defender, Eastern District of California since 2020, where he has held various positions since 2008, including Head of the Fresno Office and Deputy Federal Public Defender. From 2005 to 2008, he served as the assistant public attorney for the Fresno County Attorney’s Office. Lee was an associate at Ciummo and Associates in 2005 and 2003-2004. From 2004 to 2005 he was an associate at Wallin and Klarich. Lee earned a doctorate in law from the University of California, Davis School of Law. He is filling the post created by the retirement of Judge Jane A. Cardoza. Lee is a Democrat.

Kern County High Court

Christie Canales Norris, 37, of Bakersfield, was appointed as a judge in Kern County Superior Court. Norris joined the Kern County Superior Court as a Senior Attorney in 2018. She served as an individual solicitor in the Kern County Public Defender’s Office from 2013 to 2020 and Assistant Public Defender from 2011 to 2013. Norris was an associate with Malcolm Cisneros, A Law Corporation from 2010 to 2011. She earned a doctorate in law from the University of Iowa College of Law. She is filling the post created by Judge Lorna H. Brumfield’s retirement. Norris is a Democrat.

The compensation for each of these positions is $ 225,074.

###

The post Governor Newsom Announces Judicial Appointments 12.23.21 first appeared on DAILY LEGAL PRESS.
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Kurti is ready within the workplace for the police officer who arrested him 16 years in the past
Sun, 03 Oct 2021 15:57:07 GMT
Kurti e pret në zyrë policin i cili e kishte arrestuar para 16 vjetësh

Prime Minister Albin Kurti received today in his office the senior management staff of the Kosovo Police.

Among them was Besart Ahmeti, head of the Special Operations Unit, who was the leader of the operation in the north.

Kurti in an Instagram post said that he reunited Ahmeti after 16 years as he shared a photo when Ahmeti had arrested Kurti at that time during a Vetëvendosje protest.

“In my office at the Prime Minister, today I received the Minister of Interior and senior leader of the Kosovo Police. Among them was Besart Ahmeti, whom I reunited closely after 16 years. Captain Ahmeti has professionally led the police of the special unit in Brnjak and has conducted excellent field negotiations there. We did not shake hands because of the pandemic.

The post Kurti is ready within the workplace for the police officer who arrested him 16 years in the past first appeared on Kosovo Now.
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Kaiser Permanente strikes averted with provisional deal
Sun, 14 Nov 2021 01:37:59 GMT
Kaiser Permanente strikes averted with provisional deal

Kaiser Permanente and unions, which symbolize almost 50,000 healthcare staff, reached a preliminary settlement on Saturday to narrowly keep away from strikes of tens of 1000’s subsequent week.

The settlement is between Kaiser Permanente and the Alliance of Well being Care Unions, an affiliation of 21 unions, together with the United Nurses Associations of California / Union of Well being Care Professionals, Hawaii Nurses and Healthcare Professionals and the Oregon Federation of Nurses and Well being Professionals.

Nevertheless, Kaiser Permamente’s work issues will not be over but. A neighborhood Worldwide Union of Working Engineers in Northern California that has been on strike since September stays on the picket line. Roughly 40,000 well being care staff, represented by the Service Staff Worldwide Union-United Healthcare Staff West and two different unions, plan to hitch the engineers on a one-day sympathy strike on Thursday, regardless of the well being system’s separate settlement with the alliance of well being unions SEIU-UHW -Speaker wrote in an e mail.

The Financial Subcommittee of the Alliance of Well being Unions authorized the draft contract on Saturday. Subsequent, a bigger physique will vote, after which union members will vote on ratification earlier than the four-year contract is finalized, a course of the coalition believes will take weeks. The deal would apply retrospectively to October 1, the date on which the earlier alliance contracts expired.

“This settlement signifies that sufferers will proceed to obtain the very best care and that alliance members can have the very best jobs,” mentioned Hal Ruddick, government director of the Alliance of Well being Care Unions, in a press launch. “This contract protects our sufferers, affords safe workers and ensures honest wages and advantages for each alliance member.”

In accordance with the tentative settlement, staff will obtain annual wage will increase, no cuts in medical and dental advantages, alternatives for bonuses by means of a newly created plan, and might be protected by a brand new secure workers language by means of 2025, the press launch mentioned.

Negotiations between the well being system and the union had been suspended over a two-tier wage system proposed by Kaiser Permanente that may have provided new hires decrease pay in comparison with present workers. Neither get together wished to touch upon whether or not the two-tier construction was included within the preliminary contract, nevertheless it was not included within the publicly shared phrases.

“This groundbreaking settlement positions Kaiser Permanente for a affluent future that’s centered on delivering high quality well being care that’s inexpensive and accessible to our 12+ million members and the communities through which we serve wages and advantages,” Christian Meisner, Senior Vice President and Chief Human Sources Officer at Kaiser Permanente, mentioned within the press launch. “These have been difficult negotiations, however this preliminary settlement reveals the power of our Labor Administration Partnership and the distinctive success it could possibly obtain after we work collectively . “

The Labor Administration Partnership is a 24-year settlement between the well being system and its unions – now the Coalition of Kaiser Permanente Unions and Alliance of Well being Care Unions – to collectively make choices about affected person care, entry and high quality.

The post Kaiser Permanente strikes averted with provisional deal first appeared on LABOR NEWS WIRE.
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Nursing Homes Bleed Staff as Amazon Lures Low-Wage Workers With Prime Packages
Thu, 23 Dec 2021 14:29:46 GMT
Nursing Homes Bleed Staff as Amazon Lures Low-Wage Workers With Prime Packages

ERLANGER, Ky. — The sleek corporate offices of one of Amazon’s air freight contractors looms over Villaspring of Erlanger, a stately nursing home perched on a hillside in this Cincinnati suburb. Amazon Prime Air cargo planes departing from a recently opened Amazon Air Hub roar overhead. Its Prime semi-trucks speed along the highway, rumbling the nursing home’s windows.

This is daily life in the shadow of Amazon.

“We haven’t even seen the worst of it yet,” said John Muller, chief operating officer of Carespring, Villaspring’s operator. “They are still finishing the Air Hub.”

Amazon’s ambitious expansion plans in northern Kentucky, including the $1.5 billion, 600-acre site that will serve as a nerve center for Amazon’s domestic air cargo operations, have stoked anxieties among nursing home administrators in a region where the unemployment rate is just 3%. Already buckling from an exodus of pandemic-weary health care workers, nursing homes are losing entry-level nurses, dietary aides and housekeepers drawn to better-paying jobs at Amazon.

The average starting pay for an entry-level position at Amazon warehouses and cargo hubs is more than $18 an hour, with the possibility of as much as $22.50 an hour and a $3,000 signing bonus, depending on location and shift. Full-time jobs with the company come with health benefits, 401(k)s and parental leave. By contrast, even with many states providing a temporary covid-19 bonus for workers at long-term care facilities, lower-skilled nursing home positions typically pay closer to $15 an hour, often with minimal sick leave or benefits.

Nursing home administrators contend they are unable to match Amazon’s hourly wage scales because they rely on modest reimbursement rates set by Medicaid, the government program that pays for long-term care.

Across the region, nursing home administrators have shut down wings and refused new residents, irking families and making it more difficult for hospitals to discharge patients into long-term care. Modest pay raises have yet to rival Amazon’s rich benefits package or counter skepticism about the benefits of a nursing career for a younger generation.

“Amazon pays $25 an hour,” said Danielle Geoghegan, business manager at Green Meadows Health Care Center in Mount Washington, Kentucky, a nursing home that has lost workers to the Amazon facility in Shepherdsville. The alternative? “They come here and deal with people’s bodily fluids.”

The nursing home industry has long employed high school graduates to feed, bathe, toilet and tend to dependent and disabled seniors. But facilities that sit near Amazon’s colossal distribution centers are outgunned in the bidding war.

“Chick-fil-A can raise their prices,” said Betsy Johnson, president of the Kentucky Association of Health Care Facilities. “We can’t pass the costs on to our customer. The payer of the service is the government, and the government sets the rates.”

And while gripes about fast-food restaurants having to close indoor dining because of a worker shortage have ricocheted around Kentucky, Johnson said nursing homes must remain open every day, every hour of the year.

“We can’t say, ‘This row of residents won’t get any services today,’” she said.

Reaching Upstream

Nationwide, long-term care facilities are down 221,000 jobs since March 2020, according to a recent report from the American Health Care Association and National Center for Assisted Living, an organization that represents 14,000 nursing homes and assisted living communities caring for 5 million people. While many hospitals and physicians’ offices have managed to replenish staffing levels, the report says long-term care facilities are suffering a labor crisis worse “than any other health care sector.” Industry surveys show 58% of nursing homes have limited new admissions, citing a dearth of employees.

Kentucky and other states are relying on free or low-cost government-sponsored training programs to fill the pipeline with new talent. Luring recruits falls to teachers like Jimmy Gilvin, a nurse’s aide instructor at Gateway Community and Technical College in Covington, Kentucky, one of the distressed River Cities tucked along the Ohio River.

On a recent morning, Gilvin stood over a medical dummy tucked into a hospital bed, surrounded by teenagers and young adults, each toting a “Long-Term Care Nursing Assistance” textbook. Gilvin held a toothbrush and toothpaste, demonstrating how to clean a patient’s dentures — “If someone feels clean, they feel better,” he said — and how to roll unconscious patients onto their side.

The curriculum covers the practical aspects of working in a nursing home: bed-making, catheter care, using a bedpan and transferring residents from a wheelchair to a bed.

“It takes a very special person to be a certified nursing assistant,” Gilvin said. “It’s a hard job, but it’s a needed job.”

Over the past five years, Gilvin has noticed sharp attrition: “Most of them are not even finishing, they’re going to a different field.” In response, nursing schools are reaching further upstream, recruiting high school students who can attend classes and graduate from high school with a nurse’s aide certificate.

“We’re getting them at a younger age to spark interest in the health care pathways,” said Reva Stroud, coordinator of the health science technology and nurse’s aide programs at Gateway.

Stroud has watched, with optimism, the hourly rate for nurse’s aides rise from $9 an hour to around $15. But over the years that she’s directed the program, she said, fewer students are choosing to begin their careers as aides, a position vital to nursing home operations. Instead, they are choosing to work at Walmart, McDonald’s or Amazon.

“There is a lot of competition for less stress,” Stroud said. A staunch believer in the virtue of nursing, she is disheartened by the responses from students: “‘Well, I could go pack boxes and not have to worry about someone dying and make more money.’”

Even for those who want a career in nursing, becoming a picker and packer at Amazon carries strong appeal. The company covers 100% of tuition for nursing school, among other fields, and has contracted with community colleges to provide the schooling.

Amazon is putting Kayla Dennis, 30, through nursing school. She attended a nursing assistant class at Gateway but decided against a career as a nurse’s aide or certified nursing assistant. Instead, she works at the Amazon fulfillment center in Hebron, Kentucky, for $20.85 an hour with health insurance and retirement benefits while attending school to become a registered nurse, a position requiring far more training with high earning potential.

“Amazon is paying 100% of my school tuition and books,” Dennis said. “On top of that, they work around my school schedule.”

Waiting for a Rising Tide

The nursing home workforce shortages are not a top concern for the state and local economic development agencies that feverishly pursue deals with Amazon. Cities nationwide have offered billions of dollars in tax breaks, infrastructure upgrades and other incentives to score a site, and the spoils abound: Amazon has opened at least 250 warehouses this year alone.

Amazon has been a prominent force in northern Kentucky, resurfacing the landscape with titanic warehouses and prompting pay bumps at Walmart, fast-food franchises and other warehouse companies. The company has “made significant investments in our community,” said Lee Crume, chief executive officer of Northern Kentucky Tri-County Economic Development Corp. “I’m hard-pressed to say something negative.”

Amazon representatives did not respond to interview requests for this story.

Some labor experts said Amazon’s “spillover effect” — the bidding up of wages near its hubs — suggests companies can afford to compensate workers at a higher rate without going out of business.

Clemens Noelke, a research scientist at Brandeis University, said that is true — to a point. Because Amazon draws workers indiscriminately from across the low-wage sector, rather than tapping into a specific skill profile, it is hitting sectors with wildly different abilities to adapt. Industries like nursing homes, home health care agencies and even public schools that rely on government funding and are hampered in raising wages are likely to lose out.

“There are some employers who are at the margin, and they will be pushed out of business,” Noelke said.

A survey conducted in November by the Kentucky Association of Health Care Facilities found 3 in 5 skilled nursing facilities, assisted living communities and care homes were concerned about closing given the number of job vacancies.

The solutions proffered by state legislators rely largely on nurse training programs already offered by community colleges like Gateway. Republican Rep. Kimberly Poore Moser, a registered nurse who chairs the state’s Health and Family Services Committee, said that while legislators must value health care jobs, “we have a finite number of dollars. If we increase salaries for one sector of the health care population, what are we going to cut?”

Moser said Kentucky’s bet on Amazon will pay off, eventually. “The more we inject into our economy, the more our Medicaid budget will grow,” she said.

That confidence in a rising-tide-lifts-all-boats approach frustrates Johnson, president of the Kentucky Association of Health Care Facilities. Lawmakers have difficulty grasping the complexity of financing a nursing home, she said, noting that Kentucky’s Medicaid reimbursement rates stagnated at a one-tenth of 1% increase for five years, before receiving a larger increase to offset inflation the past two years.

The Biden administration’s Build Back Better Act, still before Congress, would infuse billions of dollars into in-home care and community-based services for seniors, largely through federal Medicaid payments. It includes funding aimed at stimulating recruitment and training. But the measure is focused largely on expanding in-home care, and it’s not clear yet how it might affect nursing home pay rates.

For now, the feeding frenzy continues. Just off Interstate 65 in Shepherdsville, Wendy’s, White Castle and Frisch’s Big Boy dangle offers of “work today, get paid tomorrow.” FedEx signs along the grassy medians that once advertised $17 an hour are stickered over with a higher offer of $23. The colossal Amazon warehouse bustles with workers in yellow safety vests.

And in nearby Mount Washington, Sherrie Wathen, administrator of the Green Meadows nursing home, strains to fill a dozen vacancies, knowing she can’t match Amazon’s package for her entry-level slots. Instead, Wathen, who began her own nursing career at 18, tells prospective employees to consider life at a factory: “You’re going to have the same day over and over.”

At the nursing home, she said, “I am the only family this lady has. I get to make an impact rather than packing an item in a box.”

Sarah Varney:
svarney@kff.org,
@SarahVarney4

The post Nursing Homes Bleed Staff as Amazon Lures Low-Wage Workers With Prime Packages first appeared on Peach State Press.
Category: Newsbreak
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Do You Think You Know the AR15?
Thu, 23 Dec 2021 13:46:47 GMT
Do You Think You Know the AR15?

The AR-15 is often used as a scapegoat for gun violence. Some media reports have even suggested that the “assault rifle” is a weapon of war that has no place in the hands of the average civilian. It is often described as “almost identical” to what US war fighters wore on the battlefields of Vietnam, Iraq, and Afghanistan.

The backlash from these reports has grown so great that retailers like Dick’s Sporting Goods announced in 2018 that they would no longer sell AR weapons. And yet the typical media descriptions of the AR-15 rifle rightly fall into the misinformation category.

The “AR” in the name does not stand for “assault rifle”, but for ArmaLite Rifle, after the original manufacturer of the firearm. The confusion lies in the fact that ArmaLite sold the patent and designs to Colt Firearms, which produced the military version – the M16 – that was used in the Vietnam War.

However, Colt also produced the AR commercially. The company continued this even after these patents had expired in the late 1970s. Since 2004, when the original assault weapon ban expired, many manufacturers have produced similar models and launched an entire category of AR-style semi-automatic rifles.

While the design is cosmetically similar to today’s military assault rifles, there are some significant differences.

The weapons carried by soldiers are select fire, which means that they can be operated in both semi-automatic and fully automatic mode. The media also like to play there, simply referring to the weapon as “automatic”. A notorious 2004 presidential campaign by John Kerry even went so far as to suggest that modern sporting rifles – the gun industry’s preferred term for firearms like the AR – could function like a machine gun. However, the civil models cannot operate in fully automatic mode and, by law, function like other semi-automatic sporting firearms and can only fire one shot with each trigger.

The most common misinformation is that the AR-15 and similar firearms are also “powerful” weapons. This is technically inaccurate as the rifles are no stronger than other hunting rifles of the same caliber and in most cases are chambered in calibers that are less powerful than conventional big game cartridges such as the .30-06 Springfield and the .300 Win. Like.

What makes the AR platform popular with shooters is that the weapon is lighter, has less recoil, and yet is precise. Unfortunately, the weapon’s ominous design has convinced some lawmakers that the AR-15 is more dangerous than other sporting or hunting rifles. California, Connecticut, Maryland, Massachusetts, New Jersey, and New York have all restricted ownership of the AR-15.

President Joe Biden has repeatedly called for the gun to be banned, but the fact remains – with some twenty million copies sold to date – America just loves the AR-15.

Peter Suciu is a Michigan-based writer who has contributed to more than four dozen magazines, newspapers, and websites. He writes regularly on military small arms and is the author of several books on military headgear, including A Gallery of Military Headdress, which is available on Amazon.com.

Image: Reuters

The post Do You Think You Know the AR15? first appeared on America's Firearms Newsource.
Category: AR15/Modern Sport Rifle
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CU Interim President Todd Saliman seems because the search group begins the nationwide hunt
Thu, 23 Dec 2021 11:10:15 GMT
CU Interim President Todd Saliman appears as the search team begins the national hunt

The University of Colorado interim president says he will seek the permanent position and has notified the ruling regents of the CU as a 16-person team begins a national search for candidates.

CU’s Todd Saliman stepped in at the regents’ request following the resignation of former president, socially conservative former Congressman Mark Kennedy, which came under fire in June.

“CU is an extraordinary place. I would be honored to work with the regents, chancellors, students, faculty and staff to make it even better, ”said Saliman, confirming his decision in an interview with the Denver Post on Tuesday evening.

Last week, Saliman announced to eight of the CU’s nine ruling regents that he would be applying for the job. (Governor Jared Polis appointed a new regent Monday to fill a vacancy.)

In June, the regents named Saliman to head the CU’s four-campus system after negotiating a $ 1.3 million severance agreement with Kennedy, a former Minnesota congressman who moved to CU from the University of North Dakota had. Faculty members had reprimanded Kennedy for “lack of leadership” on issues of diversity, equality and inclusion.

Previously, Saliman served as state lawmaker for eight years, including serving on the legislative body’s joint budget committee from 1998 to 2002. He also served as Director of the State Planning and Budgeting Bureau under Governor Bill Ritter, which consults with lawmakers to develop strategies and spending levels. At CU, he served as senior vice president of strategy, government relations and chief financial officer.

A 16-person selection committee for the CU President met last week and initiated a process for the selection of a new President. They hired the Pennsylvania-based company Storbeck Search to provide support. Regent Lesley Smith, chairman of the committee, has promised an open trial. The committee includes faculty, staff, students, deans, alumni, donors, and residents from across the state. Smith’s goal is to vote on one or more finalists by spring.

Smith declined to comment on Saliman’s decision on Monday. CU spokesman Mike Sandler said the search committee “encourages anyone interested in the position to apply.”

“I know the Board of Regents will do a thorough and thoughtful search,” said Saliman. “The process will be no different for me than it is for any other candidate.”

The provisional presidential contract for Saliman issued by the regents in June stipulated that he would not apply for the permanent position, and a CU press release said at the time: “Saliman has announced that he will not be applying for the permanent position will. ”In September, the regents amended Saliman’s interim presidency contract to allow him to throw his hat in the ring to become president. CU presidents receive approximately $ 850,000 a year.

Saliman was born and raised in Colorado and graduated from CU-Boulder. Past CU presidents who came from Colorado include former US Senator Hank Brown and oil businessman Bruce Benson.

The post CU Interim President Todd Saliman seems because the search group begins the nationwide hunt first appeared on Education News Colorado.
Category: Higher Ed
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Last-minute law shrinks property tax cut measure to a fraction of original size
Fri, 03 Sep 2021 05:18:41 GMT

Last-minute tax legislation passed by the Colorado General Assembly earlier this year would likely reduce by more than 90% the impact of a billion-dollar tax cut measure on the 2021 ballot, a Newsline analysis of state property valuation data shows.

Initiative 27, backed by conservative group Colorado Rising State Action, was officially certified to appear on the 2021 ballot last week, after supporters submitted more than the required 124,632 valid signatures to the secretary of state’s office. If approved by voters, the measure aims to reduce property tax assessment rates from 7.15% to 6.5% for residential property, and from 29% to 26.4% for non-residential property.

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But legislation passed by Democrats and some Republicans in the state Legislature has undercut the ballot measure by changing which kinds of property its rate reductions would apply to. Senate Bill 21-293, signed into law by Gov. Jared Polis in June, amends Colorado’s tax code so that the permanent cuts made by Initiative 27 would apply only to multifamily residential housing and commercial lodging properties, while only temporarily lowering rates for other property classes.

As a result, a tax cut that state analysts initially estimated would reduce local government and school-district revenues by more than $1.2 billion statewide would, if approved, only cause a fraction of those revenue impacts.

Nonpartisan analysts at the state’s Legislative Council Staff have not yet released an updated fiscal summary for Initiative 27 following the passage of SB-293. But based on 2020 valuation data released by the state’s Division of Property Taxation, the annual revenue impacts of the measure’s cuts to multifamily housing and lodging assessment rates would total roughly $70 million statewide. That figure could rise somewhat depending on future growth in property values.

Though they cried foul over SB-293’s passage, backers of Initiative 27 have made little reference to the legislation’s impact on their ballot measure in recent weeks. On the campaign’s website and in media appearances, supporters have continued to portray the measure as delivering a “9% property tax cut” to broad swaths of “families and small businesses.”

My concern about this measure is that it’s going to drive further inequities.

– Carol Hedges, executive director of Colorado Fiscal Institute

Colorado Rising State Action did not respond to requests for comment. As a 501(c)(4), “dark money” nonprofit, the group, which has backed a slew of tax-cutting and anti-government ballot measures in recent years, is not required to disclose its donors.

Michael Fields, the group’s executive director, has previously said that Colorado Rising State Action would seek to “legally challenge” SB-293, but state court records indicate that no lawsuit over the bill has yet been filed.

Carol Hedges, executive director of the left-leaning Colorado Fiscal Institute, said in an interview that in the event that Initiative 27 is approved by voters, a conservative-backed legal challenge is a possibility.

“I think the law is not on their side — I think the Legislature retains the authority to do what they did on (SB-)293,” Hedges said. “But whether or not the usual suspects will decide they want to sue, they may well. They tend to be fairly litigious.”

Critics say measure would worsen inequality

As it stands, Initiative 27 would impact some Colorado communities more than others, especially communities with high concentrations of apartment buildings and hotels. Nearly a third of potential revenue losses would come in the city and county of Denver, while mountain resort communities in Pitkin, Routt and Eagle counties would also face relatively high revenue losses.

Property taxes are collected by local governments, school districts, and special jurisdictions like fire protection districts to fund public services and are calculated based on a biennial assessments conducted by county officials.

Though Initiative 27’s revenue impacts will be much smaller than its backers initially proposed, critics of the measure say that such across-the-board tax cuts still worsen inequality by delivering the largest share of their benefits to the wealthiest property owners.

“My concern about this measure is that it’s going to drive further inequities,” said Hedges.

“There’s been acknowledgement that property taxes are challenging for some folks right now,” she added. “But the biggest benefits from those reductions are going to go to the people who need it the least right now. And then you multiply that by the dramatic loss of services for some people in the community, and reinforcing regional inequities — it just doesn’t seem like it makes a lot of sense to me.”

The post Last-minute law shrinks property tax cut measure to a fraction of original size appeared first on Colorado Newsline.

Category: Glendale News
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As Patients Fell Ill With Covid Inside Hospitals, Government Oversight Fell Short
Thu, 23 Dec 2021 18:48:52 GMT
As Patients Fell Ill With Covid Inside Hospitals, Government Oversight Fell Short


One by one, the nurses taking care of actress Judi Evans at Riverside Community Hospital kept calling out sick.

Patients were coughing as staffers wheeled the maskless soap opera star around the California hospital while treating her for injuries from a horseback fall in May 2020, Evans said.

She remembered they took her to a room to remove blood from her compressed lung where another maskless patient was also getting his lung drained. He was crying out that he didn’t want to die of covid.

No one had told her to wear a mask, she said. “It didn’t cross my mind, as I’m in a hospital where you’re supposed to be safe.”

Then, about a week into her hospital stay, she tested positive for covid-19. It left the 57-year-old hospitalized for a month, staring down more than $1 million in bills for treatment costs and suffering from debilitating long-haul symptoms, she said.

Hospitals, like Riverside, with high rates of covid patients who didn’t have the diagnosis when they were admitted have rarely been held accountable due to multiple gaps in government oversight, a KHN investigation has found.

While a federal reporting system closely tracks hospital-acquired infections for MRSA and other bugs, it doesn’t publicly report covid caught in individual hospitals.

Medicare officials, tapped by Congress decades ago to ensure quality care in hospitals, also discovered a gaping hole in their authority as covid spread through the nation. They could not force private accreditors — which almost 90% of hospitals pay for oversight — to do targeted infection-control inspections. That means Riverside and nearly 4,200 other hospitals did not receive those specific covid-focused inspections, according to a government watchdog report, even though Medicare asked accreditors to do them in March 2020.

Seema Verma, former chief of Medicare and Medicaid under President Donald Trump, said government inspectors went into nearly every nursing home last year. That the same couldn’t be done for hospitals reveals a problem. “We didn’t have the authority,” she told KHN. “This is something to be corrected.”

KHN previously reported that at least 10,000 patients nationwide were diagnosed with covid in hospitals last year after being admitted for something else — a sure undercount of the infection’s spread inside hospitals, since that data analysis primarily includes Medicare patients 65 and older.

Nationally, 1.7% of Medicare inpatients were documented as having covid diagnosed after being admitted for another condition, according to data from April through September 2020 that hospitals reported to Medicare. CDIMD, a Nashville-based consulting and data analytics company, analyzed the data for KHN.

At Riverside Community Hospital, 4% of the covid Medicare patients were diagnosed after admission — more than double the national average. At 38 other hospitals, that rate was 5% or higher. All those hospitals are approved by private accreditors, and 29 of them hold “The Gold Seal of Approval” from their accreditor.

To be sure, the data has limitations: It represents a difficult time in the pandemic, when protective gear and tests were scarce and vaccines were not yet available. And it could include community-acquired cases that were slow to show up. But hospital-employed medical coders decide whether a case of covid was present on admission based on doctors’ notes, and are trained to query doctors if it’s unclear. Some institutions fared better than others — while the American public was left in the dark.

Spurred by serious complaints, federal inspectors found infection-control issues in few of those 38 hospitals last year. In Michigan, inspectors reported that one hospital “failed to provide and maintain a sanitary environment resulting in the potential for the spread of infectious disease to 151 served by the facility.” In Rhode Island, inspectors found a hospital “​​failed to have an effective hospital-wide program for the surveillance and prevention” of covid.

KHN was able to find federal inspection reports documenting infection-control issues for eight of those 38 hospitals. The other 30 hospitals around the country, from Alabama to Arizona, had no publicly available federal records of infection-control problems in 2020.

KHN found that even when state inspectors in California assessed hospitals with high rates of covid diagnosed after admission, they identified few shortcomings.

“The American public thinks someone is watching over them,” said Lisa McGiffert, co-founder of the Patient Safety Action Network, an advocacy group. “Generally they think someone’s in charge and going to make sure bad things don’t happen. Our oversight system in our country is so broken and so untrustworthy.”

The data shows that the problem has deadly consequences: About a fifth of the Medicare covid patients who were diagnosed after admission died. And it was costly as well. In California alone, the total hospital charges for such patients from April through December last year was over $845 million, according to an analysis done for KHN by the California Department of Health Care Access and Information.

The Centers for Disease Control and Prevention has pledged funding for increased infection-control efforts — but that money is not focused on tracking covid’s spread in hospitals. Instead, it will spend $2.1 billion partly to support an existing tracking system for hospital-acquired pathogens such as MRSA and C. diff.

The CDC does not currently track hospital-acquired covid, nor does it plan to do so with the additional funding. That tracking is done by another part of the U.S. Department of Health and Human Services, according to Dr. Arjun Srinivasan, associate director for the CDC’s health care-associated infection-prevention programs. But it’s not made public on a hospital-by-hospital basis. HHS officials did not respond to questions.

The Scene at Riverside

In March 2020, Evans was alarmed by nonstop TV footage of covid deaths, so she and her husband locked down. They hadn’t been going out much, anyway, since losing their only child at the end of 2019 to another public health crisis — fentanyl.

At the time, concerns about covid were mounting among the staff at Riverside Community Hospital, a for-profit HCA Healthcare facility.

The hospital’s highly protective N95 masks had been pulled off the supply room shelves and put in a central office, according to Monique Hernandez, a shop steward for her union, Service Employees International Union Local 121RN. Only nurses who had patients getting aerosol-generating procedures such as intubation — which were believed at the time to spread the virus — could get one, she said.

She said that practice left the nurses on her unit with a difficult choice: either say you had a patient undergoing such procedures or risk getting sick.

Nurse unions were early adopters of the notion — now widely accepted — that covid is spread by minuscule particles that can linger in the air. Studies since have matched the genetic fingerprint of the virus to show that covid has spread among workers or patients wearing surgical masks instead of more protective masks like N95s.

On April 22, 2020, Hernandez and other nurses joined a silent protest outside the hospital where they held up signs saying “PPE Over Profit.” By that time, the hospital had several staff clusters of infection, according to Hernandez, and she was tired of caregivers being at risk.

In a statement, Riverside spokesperson David Maxfield said the hospital’s top priority has been to protect staff “so they can best care for our patients.”

“Any suggestion otherwise ignores the extensive work, planning and training we have done to ensure the delivery of high-quality care during this pandemic,” he said.

In mid-May, Judi Evans’ husband coaxed her into going horseback riding — one of the few things that brought her joy after her son’s death. On her second day back in the saddle, she was thrown from her horse. She broke her collarbone and seven ribs, and her lung was compressed. She was taken to Riverside Community Hospital.

There, many of her nurses wore masks they had previously used, Evans recalled. Other staffers came in without any masks at all, she said. A few days in, she said, one of the doctors told her it’s crazy that the hospital was testing her for MRSA and other hospital infections but not covid.

Maxfield said that the hospital began enforcing a universal mask mandate for staff and visitors on March 31, 2020, and, “in line with CDC, patients were and are advised to wear masks when outside their room if tolerated.” He stressed “safety of our patients and colleagues has been our top priority.”

After about a week in the hospital, Evans said, she spiked a fever and begged for a covid test. It was positive. There is no way to know for certain where or how she got infected but she believes it was at Riverside. Covid infections can take two to 14 days from exposure to show symptoms like a fever, with the average being four to five days. According to CDC guidance, infection onset that occurs two days or more after admission could be “hospital-associated.”

Doctors told her they might have to amputate her legs when they began to swell uncontrollably, she said.

“It was like being in a horror film — one of those where everything that could go wrong does go wrong,” Evans said.

She left with over $1 million in bills from a month-long stay — and her legs, thankfully. She said she still suffers from long-covid symptoms and is haunted by the screams of fellow patients in the covid ward.

By the end of that year, Riverside Community Hospital would report that 58 of its 1,649 covid patients were diagnosed with the virus after admission, according to state data that covers all payers from April to December.

That’s nearly three times as high as the California average for covid cases not present on admission, according to the analysis for KHN by California health data officials.

“Based on contact tracing, outlined by the CDC and other infectious disease experts, there is no evidence to suggest the risk of transmission at our hospital is different than what you would find at other hospitals,” Maxfield said.

A lawsuit filed in August by the SEIU-United Healthcare Workers West on behalf of the daughter of a hospital lab assistant who died of covid and other hospital staffers says the hospital forced employees to work without adequate protective gear and while sick and “highly contagious.”

The hospital “created an unnecessarily dangerous work environment,” the lawsuit claims, “which in turn has created dangerous conditions for patients” and a “public nuisance.”

Attorneys for Riverside Community Hospital are fighting the ongoing lawsuit. “This lawsuit is an attempt for the union to gain publicity, and we have filed a motion to end it,” said Maxfield, the hospital spokesperson.

The hospital’s lawyers have said the plaintiffs got covid during a spike in local cases and are only speculating that they contracted the virus at the hospital, according to records filed in Riverside County Superior Court.

They also said in legal filings that the court should not step into the place of “government agencies who oversee healthcare and workplace safety” and “handled the response to the pandemic.”

‘A Shortcoming in the Oversight System’

Decades ago, Congress tasked Medicare with ensuring safe, quality care in U.S. hospitals by building in routine government inspections. However, hospitals can opt to pay up to tens of thousands of dollars per year to nongovernmental accreditors entrusted by CMS to certify the hospitals as safe. So 90% do just that.

But these accrediting agencies — including the Joint Commission, which certified Riverside — are private organizations. Thus they are not required to follow CMS’ directives, including the request in a March 20 memo urging the accrediting agencies to execute targeted infection-control surveys aimed at preparing hospitals for covid’s onslaught.

And so they didn’t send staffers to survey hospitals for the specialized infection-control inspections in 2020, according to a June 2021 Health and Human Services Office of the Inspector General report.

Riverside, despite allegations of lax practices, holds The Gold Seal of Approval from the Joint Commission, which last inspected the hospital on-site in May 2018 before going in on Nov. 19 this year.

The inspector general’s office urged CMS to pursue the authority to require special surveys in a health emergency — lest it lose control of its mission to keep hospitals safe.

“CMS could not ensure that accredited hospitals would continue to provide quality care and operate safely during the COVID-19 emergency,” and could not ensure it going forward, the report said.

“We’re telling CMS to do their job,” the report’s author, Assistant Regional Inspector General Calvin Jones, said in an interview. “The covid experience really showed a shortcoming in the oversight system.”

CMS spokesperson Raymond Thorn said the agency agrees with the report’s recommendation and will work on a regulation after the public health emergency ends.

Accrediting agencies, however, pushed back on the inspector general’s findings. Among them: DNV Healthcare USA Inc. Its director of accreditation, Troy McCann, said there was not a gap in oversight. Although he said travel restrictions limited accreditors ability to fly across state lines, his group continued its annual reviews after May 2020 and incorporated the special focus on infection control into them. “We have a strong emphasis, always, on safety, infection control and emergency preparedness, which has left our hospitals stronger,” McCann said.

Angela FitzSimmons, spokesperson for the Accreditation Commission for Health Care, said that the accrediting organization’s surveys typically focus on infection control, and the group worked during the pandemic to prioritize hospitals with prior issues in the area of infection prevention.

“We did not deem it necessary to add random surveys that would occur at a cost to the hospital without just cause,” FitzSimmons said.

Maureen Lyons, a spokesperson for the Joint Commission, told KHN that, after evaluating CMS guidance, the nonprofit group decided it would incorporate the infection-control surveys into its surveys done every three years and, in the meantime, provide hospitals with the latest federal guidance on covid.

“Hospitals were operating in extremis. Thus, we collaborated closely with CMS to determine optimal strategies during this time of emergency,” she said.

The Joint Commission cited safety issues for its inspectors, who travel to the hospitals and need proper protective equipment that was running low at the time, as part of the reason for its decision.

Verma, the CMS administrator at the time, pushed back on accreditors’ travel safety concerns, saying that “narrative doesn’t quite fit because the state and CMS surveyors were going into nursing homes.”

Though Verma cautioned that hospitals were overwhelmed by the crush of covid patients, “doing these inspections may have helped hospitals bolster their infection-control practices,” she said. “Without these surveys, we really have no way of knowing.”

‘Immediate Jeopardy’

Medicare inspectors can go into a privately accredited hospital after they get a serious complaint. They found alarming circumstances when they visited some of the hospitals with high rates of covid diagnosed after a patient was admitted for another concern last year.

At Levindale Hebrew Geriatric Center and Hospital in Baltimore, the July 2020 inspection report says “systemic failures left the hospital and all of its patients, staff, and visitors vulnerable to harm and possible death from COVID-19.”

In response, hospital spokesperson Sharon Boston said that “we have seen a large decrease in the spread of the virus at Levindale.”

Inspectors had declared a state of “immediate jeopardy” after they investigated a complaint and discovered an outbreak that began in April and continued through the beginning of July, with more than 120 patients and employees infected with covid. And in a unit for those with Alzheimer’s and other conditions, 20% of the 55 patients who had covid died.

The hospital moved patients whose roommates tested positive for covid to other shared rooms, “potentially exposing their new roommate,” the inspection report said. Boston said that was an “isolated” incident and the situation was corrected the next day, with new policies put in place.

The Medicare data analyzed exclusively for KHN shows that 52 of Levindale’s 64 covid hospital patients, or 81%, were diagnosed with covid after admission from April to September 2020. Boston cited different numbers over a different time period: Of 67 covid patients, 64 had what she called “hospital-acquired” covid from March to June 2020. That would be nearly 96%.

The hospital shares space with a nursing home, though, so KHN did not group it with the general short-term acute-care hospitals as part of the analysis. Levindale’s last Joint Commission on-site survey was in December 2018, resulting in The Gold Seal of Approval. It had not had its once-every-three-years survey as of Dec. 10, 2021, according to the Joint Commission’s tracking.

Boston said Levindale “quickly addressed” the issues that Medicare inspectors cited, increasing patient testing and more recently mandating staff vaccines. Since December 2020, Boston said, the facility has not had a covid patient die.

At the state level, hospital inspectors in California found few problems to cite even at hospitals where 5% or more patients were diagnosed with covid after they were admitted for another concern. Fifty-three complaints about such hospitals went to the Department of Public Health from April until the end of 2020. Only three of those complaints resulted in a finding of deficiency that facility was expected to fix.

CDPH did not respond to requests for comment.

A New Chapter

Things are better now at Riverside Community Hospital, Hernandez said. She is pleased with the current safety practices, including more protective gear and HEPA filters for covid patients’ rooms. For Hernandez, though, it all comes too late now.

“We laugh at it,” she said, “but it hurts your soul.”

Evans said she was able to negotiate her $1 million-plus hospital bills down to roughly $70,000.

Her covid aftereffects have been ongoing — she said she stopped gasping for air and reaching for her at-home oxygen tank only a few months ago. She still hasn’t been able to return to work full time, she said.

For the past year, her husband would wake up in the middle of the night to check whether her oxygen levels were dipping. Terrified of losing her, he’d slip an oxygen mask on her face, she said.

“I would walk 1,000 miles to go to another hospital,” Evans said, if she could do it all over again. “I would never step foot in that hospital again.”

Methodology

KHN requested custom analyses of Medicare, California and Florida inpatient hospital data to examine the number of covid-19 cases diagnosed after a patient’s admission.

The Medicare and Medicare Advantage data, which includes patients who are 65 and older, is from the Centers for Medicare & Medicaid Services’ Medicare Provider Analysis and Review (MedPAR) file and was analyzed by CDIMD, a Nashville-based medical code consulting and data analytics firm. The data is from April 1 through Sept. 30, 2020. The data for the fourth quarter of 2020 was not yet available.

The data shows the number of inpatient Medicare hospital stays in the U.S., including the number of people diagnosed with covid-19 and the number of admissions for which the covid diagnosis was not “present on admission.” CMS considers some medical conditions that are not “present on admission” to be hospital-acquired, according to the agency. The data is for general acute-care hospitals, which may include a psychiatric floor, and not for other hospitals such as those in the Department of Veterans Affairs system or stand-alone psychiatric hospitals.

KHN requested a similar analysis from California’s Department of Health Care Access and Information of its hospital inpatient data. That data was from April 1 through Dec. 31, 2020, and covered patients of all ages and payer types and, in general, private psychiatric and long-term acute-care hospitals. Etienne Pracht, a University of South Florida researcher, provided the number of Florida covid patients who did not have the virus upon hospital admission for all ages and payer types at general and psychiatric hospitals from April 1 through Dec. 31, 2020. KHN subtracted the number of Medicare patients in the MedPAR data from the Florida and California datasets so they would not be counted twice.

To calculate the rate of hospitalized Medicare patients who tested positive for covid — and died — KHN relied on the MedPAR data for April through September. That data includes records for 6,629 seniors, 1,409 of whom, or 21%, died. California data for all ages and payer types from April through December shows a similar rate: Of 2,115 diagnosed with covid-19 after hospital admission, 435, or 21%, died. The MedPAR data was also used to calculate the national rate of 1.7%, with 6,629 of 394,939 covid patients diagnosed with the virus whose infections were deemed not present on admission, according to the CDIMD analysis of data that hospitals report to Medicare. It was also used to calculate which entities licensed as short-term acute care hospitals had 5% or more of their covid cases diagnosed within the hospital. As stated in the story, Levindale Hebrew Geriatric Center and Hospital in Baltimore was not included in that list of 38 because it shares space with a nursing home and had fewer than 500 total discharges.

Data that hospitals submit to Medicare on whether an inpatient hospital diagnosis was “present on admission” is used by Medicare for payment determinations and is intended to incentivize hospitals to prevent infections during hospital care. The federal Agency for Healthcare Research and Quality also uses the data to “assist in identifying quality of care issues.”

Whether covid-19 is acquired in a hospital or in the community is measured in different ways. Some nations assume the virus is hospital-acquired if it is diagnosed seven or more days after admission, while U.S. data counts cases only after 14 days.

Hospitals’ medical coders who examined patient records for the data analyzed for this KHN report focus on each physician’s admission, progress and discharge notes to determine whether covid was “present on admission.” They do not have a set number of days they look for and are trained to query physicians if the case is unclear, according to Sue Bowman, senior director of coding policy and compliance at the American Health Information Management Association.

KHN tallied the cases in which covid-19 was logged in the data as not “present on admission” to the hospital. Some covid cases are coded as “U” for having insufficient documentation to make a determination. Since Medicare and AHRQ consider the “U” to be an “N” (or not present on admission) for the purposes of payment decisions and quality indicators, KHN chose to count those cases in the grand total.

In 409 of 6,629 Medicare cases and in 70 of 2,185 California cases, the “present on admission” indicator was “U.” The Florida data did not include patients whose “present on admission” indicator was “U.” Medical coders have another code, “W,” for “clinically undetermined” cases, which consider a condition present on admission for billing or quality measures. Medical coders use the “U” (leaning toward “not present on admission”) and “W” (leaning toward “present on admission”) when there is some uncertainty about the case. KHN did not count “W” cases.

The Medicare MedPAR data includes about 2,500 U.S. hospitals that had at least a dozen covid-19 cases from April through September 2020. Of those, 1,070 reported no cases of covid diagnosed after admission for other conditions in the Medicare records. Data was suppressed due to privacy reasons for about 1,300 hospitals that had between one and 11 of such covid cases. There were 126 hospitals reporting 12 or more cases of covid that were “not present on admission” or unknown. For those, we divided the number of cases diagnosed after admission by the total number of patients with covid to arrive at the rate, as is standard in health care.

Inspection and Accreditation Analysis

To evaluate which of the 38 hospitals detailed above had federal inspection reports documenting infection-control issues, KHN searched CMS’ publicly available “2567” reports, which detail deficiencies for each hospital for 2020. For surveys listed online as “not available,” KHN requested and obtained them from CMS. KHN further asked CMS to double-check the remaining hospitals for any inspection reports that weren’t posted online. KHN also checked the Association of Health Care Journalists’ database http://www.hospitalinspections.org/ for each of the 38 hospitals for any additional reports, as well as CMS’ Quality, Certification and Oversight Reports site.

To check that each of these hospitals was accredited, KHN looked up each hospital using a site run by the Joint Commission and reached out to the accreditors DNV Healthcare USA Inc. and the Accreditation Commission for Health Care.

To tabulate infection-control complaints for hospitals at the state level in California, KHN used data available through the California Department of Public Health’s Cal Health Find Database. KHN searched the database for the hospitals that had higher than 5% of covid patients being diagnosed after admission, according to the California data, and tallied all complaints and deficiencies found involving infection control from April to December 2020.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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The post As Patients Fell Ill With Covid Inside Hospitals, Government Oversight Fell Short first appeared on Daily Badger Bulletin.
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Stripe vs. PayPal vs. Sq.: Which Is Proper for Your Enterprise? – NerdWallet
Tue, 05 Oct 2021 12:24:40 GMT

Stripe, PayPal and Sq. are fee service suppliers, or PSPs, that assist small companies settle for funds in individual and on-line. Stripe could also be finest for small companies that prioritize customization, and PayPal could also be higher for small companies with a world buyer base. But when value is vital, Sq. could also be your winner.

Here is how the three firms examine.

Stripe is a well-liked fee service supplier that enables small companies to simply accept bank cards, cellular wallets, ACH funds and extra. There are quite a lot of methods to combine Stripe into your e-commerce web site as a result of it’s constructed with builders in thoughts. It additionally gives a fee terminal for in-person card transactions in case you have a brick-and-mortar retailer.

Stripe helps world transactions, can course of over 135 currencies and helps a number of languages, together with Chinese language, Spanish, French, Dutch and Italian; this may be beneficial for small companies that wish to broaden abroad. Stripe’s companies work with main e-commerce platforms comparable to BigCommerce, WooCommerce and Magento.

Stripe has two main fee processing merchandise.

Stripe Join can course of over 135 currencies and full transactions in over 30 nations. Join is very customizable, letting small companies management signup, onboarding and payout timing, and get monetary reporting. Pre-made person interface elements exist, or you’ll be able to customise all the pieces utilizing the Stripe API.

Stripe Checkout streamlines checkout on cellular by way of an API that creates a Stripe-hosted fee web page. It really works throughout desktop and cellular, in addition to with Apple Pay and Google Pay, and you may customise the buttons and background shade. Reductions, gross sales tax and electronic mail receipts are additionally supported. It really works in over 25 languages.

PayPal lets small companies settle for and course of funds in individual and on-line. It gives two fee gateway companies: PayPal Funds Normal and PayPal Funds Professional. PayPal’s companies work with main e-commerce platforms comparable to BigCommerce, Wix and Shopify.

This product could also be finest should you don’t have coding expertise or a developer in your group, as you’ll merely want to repeat and paste a line of code or set up a plug-in that works along with your current buying cart. Both choice ought to solely take quarter-hour, in keeping with PayPal’s web site.

This can be a customizable checkout resolution that additionally gives entry to a digital terminal so you’ll be able to settle for bank cards on-line, by way of cellular or with units that don’t have an exterior card reader. Additionally, you’ll be able to settle for funds in 25 currencies from 200 nations, settle for telephone funds, and get simplified PCI compliance.

Sq. could also be recognized finest for its point-of-sale software program and its little white tile that plugs into checkout programs, however Sq. can also be a fee service supplier. It really works with bank cards, debit playing cards, company playing cards, pay as you go playing cards and reward playing cards.

Card fee acceptance with the Sq. app is obtainable solely in the USA, Canada, Japan, Australia, the Republic of Eire and the UK. It doesn’t assist fee card processing in U.S. territories, nor does it assist cross-border card funds (i.e., you’ll be able to’t obtain card transactions should you’re exterior the nation the place you activated your Sq. account).

Sq. integrates with Wix, BigCommerce, GoDaddy and different e-commerce platforms. The corporate’s APIs permit for personalisation. Companies also can bill prospects digitally and take card funds with out utilizing the Sq. POS.

Along with utilizing its POS {hardware} programs for in-person funds, Sq. can course of funds 3 ways.

Sq. gives on-line fee companies that you just combine into your on-line retailer or cellular app. It’s also possible to get a free e-commerce web site and add pickup and supply companies or promote on social media.

Sq. lets small companies create and ship digital invoices to prospects, and people prospects can then pay with a card or by way of ACH. It’s also possible to ship prospects a fee hyperlink by textual content or electronic mail.

If you could take a fee over the telephone and key-in the data, you are able to do that with Sq.’s app or through the use of its Digital Terminal.

Right here’s how these suppliers examine on month-to-month charges and transaction charges.

Stripe could also be your only option if you need customizable software program at a comparatively low value. But when a easy setup is extra essential, you could wish to go together with PayPal. On value alone, Sq. could also be robust to beat.

The post Stripe vs. PayPal vs. Sq.: Which Is Proper for Your Enterprise? – NerdWallet appeared first on BUSINESS TECHNOLOGY WORLD.

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Nigeria: Trial of separatist leader Nnamdi Kanu adjourned | news
Wed, 10 Nov 2021 18:12:20 GMT
Nigeria: Trial of separatist leader Nnamdi Kanu adjourned |  news

The judge postpones the trial of the leader of the Biafra indigenous group until January 19-20 next year.

The trial of separatist leader Nnamdi Kanu in the Nigerian capital Abuja was adjourned to January after his chief attorney resigned in protest at security officials’ refusal to allow other members of the legal defense to enter the courtroom.

When he last appeared in court on October 21, Kanu, leader of the Indigenous People of Biafra (IPOB), pleaded not guilty on seven charges, including “terrorism”, treason and the perpetuation of falsehoods against President Muhammadu Buhari.

Kanu’s lawyers planned to challenge the prosecution’s jurisdiction on Wednesday, but said State Security officials prevented them from entering the courtroom.

“I have never seen such a travesty of justice,” senior attorney Ifeanyi Ejiofor told reporters outside the courtroom.

Canu’s US-based attorney Bruce Fein was among those denied entry.

“If you are charged with a crime, you have the right to a lawyer. And he was denied access to me five times, ”he said, adding that the Nigerian judiciary cannot be“ trusted ”.

In a court record obtained from Reuters news agency, the judge is asked if Kanu wants to conduct the trial in the absence of his lawyers. “No, my lord,” he replied.

Wednesday’s trial lasted 20 minutes and the trial was postponed to January 19-20 next year.

Security forces again denied journalists access to the court.

IPOB is looking for part of the southeast, home of the Igbo ethnic group, to secede from Nigeria. An attempt to secede as the Republic of Biafra in 1967 sparked a three-year civil war that killed more than a million people.

Kanu was first arrested in 2015 but disappeared on bail in April 2017. More than a year later he appeared in Israel.

His social media posts during his absence outraged the government, which said his comments sparked attacks on security forces in southeastern Nigeria.

Security officials presented him in Abuja court on June 29 after detaining him in an unknown country. His lawyer alleged that he was detained and ill-treated in Kenya.

However, the East African nation has denied participation.

The post Nigeria: Trial of separatist leader Nnamdi Kanu adjourned | news first appeared on Africa Chamber News.
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Report Variety of People Signal Up for ACA Well being Insurance coverage
Thu, 23 Dec 2021 18:29:10 GMT


A record 13.6 million Americans have signed up for health coverage for 2022 on the Affordable Care Act marketplaces, with nearly a month remaining to enroll in most states, the Biden administration announced Wednesday.

President Joe Biden’s top health advisers credited the increased government subsidies, which lowered out-of-pocket costs, for the surge in enrollment. They also said enhanced personal assistance and outreach helped connect more people to health insurance plans.

Some of the largest increases are in Florida, Texas, Georgia and nine other states that have not expanded Medicaid under the Affordable Care Act.

The previous marketplace enrollment record was 12.7 million in 2016, the final year of President Barack Obama’s administration. Enrollment largely stagnated under President Donald Trump, who cut tens of millions of dollars in funding for navigators, who help people sign up for coverage.

Open enrollment for the marketplace began Nov. 1 and ends Jan. 15.

Through Dec. 15, enrollment in Florida had soared to 2.6 million people, up from 2.1 million in the same period a year earlier.

“This is a very big deal as it means we have made a dent in the uninsured pool and we are not only insuring people but keeping people signed up,” said Jodi Ray, program director for Florida Covering Kids & Families.

Ray has used federal grants to help Floridians sign up for private coverage on the marketplace for several years. During the Trump presidency, she said, she could help only people in half the counties in the state because of funding constraints. “You cannot overlook the impact that one-on-one assistance has in getting people through the process,” Ray said.

Enrollment has jumped more in states that have not expanded Medicaid because they have more uninsured residents than expansion states. In expansion states, people with incomes from 100% to 138% of the federal poverty level — about $12,880 and $17,770 for an individual — can enroll in Medicaid. In states that haven’t expanded the program, they can get subsidies to enroll in private plans through the Affordable Care Act marketplaces.

Georgia enrollment jumped to 653,990 from about 514,000 the previous year.

“That’s the most we’ve ever had enrolled,’’ said Laura Colbert, executive director of the consumer advocacy group Georgians for a Healthy Future. She said the enrollment spike helps show that Republican Gov. Brian Kemp’s plan to scrap healthcare.gov and replace it with a privately run portal isn’t needed.

The Biden administration is reviewing that proposal.

“Hundreds of thousands of Georgians still opt to remain uninsured rather than shop on the federal platform,” Kemp spokesperson Katie Byrd said Wednesday. “This means that the one-size-fits-all approach by the federal government is not working for Georgia.”

The 13.6 million enrollment number includes people who used state-run marketplaces, in addition to those who enrolled through the federally run healthcare.gov portal that handles sign-ups for more than 30 states.

Texas’ enrollment rose to 1.7 million from 1.3 million.

Texas, Georgia and South Dakota each showed gains of at least 20%, said Chiquita Brooks-LaSure, administrator of the Centers for Medicare & Medicaid Services. None of those states has expanded Medicaid under the Affordable Care Act.

In non-expansion states, “our outreach efforts have been so robust this year,’’ Brooks-LaSure told reporters during a press call. The federal government is using four times the number of navigators, or insurance counselors, to help people sign up for insurance, said Xavier Becerra, secretary of the U.S. Department of Health and Human Services.

The big driver behind the enrollment gains is new discounts on premiums.

As part of a covid-19 relief bill passed this year, Congress increased the subsidies consumers receive when they enroll in health insurance via the marketplace. CMS said 92% of people in healthcare.gov states will get the tax credits for 2022 coverage. Becerra said that for 4 in 5 enrollees, monthly premiums cost $10 or less, which he said is “less than going to a movie.”

But conservatives chafe at the idea of higher subsidies. Brian Blase, a former Trump adviser and president of the conservative think tank Paragon Health Institute, stressed that the federal government is paying 85% of people’s monthly insurance premiums.

“People will buy something that provides them with little value if the after-subsidy price is zero or close to zero, and that’s what is generally happening here,” Blase said. “Ultimately, the big winners are the health insurance companies that are getting billions of dollars in additional government subsidies.”

Another driver of enrollment is that some people may have lost job-based coverage during the pandemic and are seeking insurance on their own.

The marketplaces also offer consumers more choices than in previous years. The average consumer now has between six and seven insurers to choose from, up from four to five in 2021, federal officials said.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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The post Report Variety of People Signal Up for ACA Well being Insurance coverage first appeared on DAILY GADGET AND GIZMOS NEWS.
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Medicare’s Open Enrollment Is Open Season for Scammers
Thu, 11 Nov 2021 12:35:44 GMT

Finding the best private Medicare drug or medical insurance plan among dozens of choices is tough enough without throwing misleading sales tactics into the mix.

Yet federal officials say complaints are rising from seniors tricked into buying policies — without their consent or lured by questionable information — that may not cover their drugs or include their doctors. In response, the Centers for Medicare & Medicaid Services has threatened to penalize private insurance companies selling Medicare Advantage and drug plans if they or agents working on their behalf mislead consumers.

The agency has also revised rules making it easier for beneficiaries to escape plans they didn’t sign up for or enrolled in only to discover promised benefits didn’t exist or they couldn’t see their providers.

The problems are especially prevalent during Medicare’s open-enrollment period, which began Oct. 15 and runs through Dec. 7. A common trap begins with a phone call like the one Linda Heimer, an Iowa resident, received in October. She won’t answer the phone unless her caller ID displays a number she recognizes, but this call showed the number of the hospital where her doctor works.

The person on the phone said she needed Heimer’s Medicare number to make sure it was correct for the new card she would receive. When Heimer hesitated, the woman said, “We’re not asking for a Social Security number or bank numbers or anything like that. This is OK.”

“I can’t believe this, but I gave her my card number,” said Heimer. Then the caller asked questions about her medical history and offered to send her a saliva test “absolutely free.” That’s when Heimer became suspicious and hung up. She contacted the 1-800-MEDICARE helpline to get a new Medicare number and called the AARP Fraud Watch Network Helpline and the Federal Trade Commission.

But later that morning the phone rang again and this time the caller ID displayed a number matching the toll-free Medicare helpline. When she answered, she recognized the voice of the same woman.

“You’re not from Medicare,” Heimer told her.

“Yes, yes, yes, we are,” the woman insisted. Heimer hung up again.

It’s been only two weeks since Heimer disclosed her Medicare number to a stranger and, so far, nothing’s gone wrong. But armed with that number, scammers could bill Medicare for services and medical supplies that beneficiaries never receive, and the scammers could sign seniors up for a Medicare Advantage or drug plan without their knowledge.

In California, reports of deceptive sales practices for Medicare Advantage and drug plans have been the top complaints to the state Senior Medicare Patrol for the past two years, said Sandy Morales, a case manager for the group. The patrol is a federally funded program that helps seniors untangle insurance problems.

Nationwide, the Senior Medical Patrol has sent 74% more cases in the first nine months of this year than in all of 2020 to CMS and the Health and Human Services Inspector General for investigation, said Rebecca Kinney, director of the Administration for Community Living’s Office of Healthcare Information and Counseling at HHS, which oversees the patrols. She expects more complaints to come in during Medicare’s open-enrollment period.

And last month, CMS officials warned the private insurance companies selling Medicare Advantage and drug plans that federal requirements prohibit deceptive sales practices.

Kathryn Coleman, director of CMS’ Medicare Drug and Health Plan Contract Administration Group, said in a memo to insurers that the agency is concerned about ads widely promoting Advantage plan benefits that are available only in a limited area or to a restricted number of beneficiaries. CMS has also received complaints about sales information that could be construed as coming from the government and pressure tactics to get seniors to enroll, she noted.

Coleman reminded the companies they are “accountable and responsible for their marketing materials and activities, including marketing completed on a MA plan’s behalf” by sales representatives. Companies that violate federal marketing rules can be fined and/or face enrollment suspensions. But a CMS spokesperson could not provide examples of recent violators or their penalties.

If beneficiaries discover a problem before March 31, the date the three-month disenrollment period ends each year, they have one chance to switch to another plan or to original Medicare. (Those who choose the latter may be unable to buy supplemental or Medigap insurance, with rare exceptions, in all but four states: Connecticut, Maine, Massachusetts and New York.) After March, they are generally locked into their Advantage or drug plans for the entire year unless they’re eligible for one of the rare exceptions to the rule.

CMS this year spelled out another remedy for the first time.

Officials can grant a “special enrollment period” for people who want to leave their plan because of deceptive sales tactics. These include “situations in which a beneficiary provides a verbal or written allegation that his or her enrollment in a MA or Part D plan was based upon misleading or incorrect information … [or] where a beneficiary states that he or she was enrolled into a plan without his or her knowledge,” according to the Medicare Managed Care Manual.

“This is a really important safety valve for beneficiaries that clearly goes beyond just the limited opportunity to switch plans when someone feels buyer’s remorse,” said David Lipschutz, associate director of the Center for Medicare Advocacy. To use the new option, beneficiaries should contact their state’s health insurance assistance program at www.shiphelp.org/.

The option to leave is also available if a significant number of plan members are unable to access the doctors or hospitals that were supposed to be in the provider network.

Nonetheless, the scams continue around the country, experts say.

A misleading television commercial in the San Francisco area has enticed seniors with a host of new benefits including dental, vision, transportation benefits and even “money back into your Social Security account,” said Morales. Beneficiaries have told her group that when they called for information they were “erroneously enrolled into a plan that they never gave permission to enroll into,” she said.

In August, an Ohio senior received a call from someone telling him Medicare was issuing new cards because of the covid-19 pandemic. When he wouldn’t provide his Medicare number, the caller became angry and the beneficiary felt threatened, said Chris Reeg, director of the Ohio Senior Health Insurance Information Program.

Reeg said another senior received a call from a salesperson with bad news: She wasn’t getting all the benefits from Medicare she was entitled to. The beneficiary provided her Medicare number and other information but didn’t realize the caller was enrolling her in a Medicare Advantage plan. She found out when she visited her doctor, who did not accept her new insurance.

In western New York, the culprit is an official-looking postcard, said Beth Nelson, the state’s Senior Medicare Patrol director. “Our records indicate … you may be eligible to receive additional benefits,” it says, enticingly. When Nelson’s client called the number on the card in September for more details, she provided her Medicare number and later ended up in a Medicare Advantage plan without her consent.

Heimer’s scammer was persistent. When the stranger tried to reach her a third time, Heimer said, the caller ID displayed the phone number of another local hospital. She told the woman she had reported the calls to CMS, the AARP Fraud Watch Network Helpline and the FTC. That finally did the trick — the woman abruptly hung up.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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The post Medicare’s Open Enrollment Is Open Season for Scammers first appeared on Africa Chamber News.
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CU Denver’s High 10 Tales of 2021
Thu, 23 Dec 2021 14:11:18 GMT

CU Denver News and our Lynx community saw a lot more happy stories in 2021 than the previous year. Thanks to science-based safety measures, CU Denver largely returned to face-to-face teaching for the 2021-2022 school year. Many students, faculty, and staff were back on campus, which looked even better with the new Lynx Crossing Residence Hall and Learning Commons. We’ve also added a wonderful selfie spot with our new larger-than-life lynx statue. But the year has not been without tragedy and the loss of members of our beloved Lynx community, including SEHD Dean Rebecca Kantor. Their good deeds inspire us to keep their memories alive through continued progress at CU Denver. In the selection below you will find the most important and most viewed stories of 2021.

CU Denver campus

On June 17th, Chancellor Marks presented the CU Board of Regents with the Strategic Plan 2030, a profound repositioning of the CU Denver as a public urban research university, the works for everyone: Learners of all kinds and in all stages of life, industries and employers who need ready-made talent and communities who need new solutions and discoveries. “CU Denver 2030: Make Education Work for All” contains big, bold ideas, including the aspiration to become the country’s first capital-building institution and the desire to be a “university for life” that continuously meets the needs of learners – and employers – serves – for a lifetime.

CU Denver campus with the message

The University of Colorado Denver and Anschutz Medical Campus became the first research university in the state to receive Hispanic Serving Institution (HSI) status, according to an appointment by the US Department of Education in October. To qualify for this status, a university must have full-time undergraduate enrollment made up of at least 25% Hispanic students and have a high concentration of students who are eligible for Pell Grants. In practice, this public recognition by the federal government helps provide additional scholarship opportunities to further support Hispanic student services, as well as infrastructure improvements that benefit the university as a whole.

displaced Aurarians on campusNick (Juju) Arguello, front and center, with his extended family at an altar ceremony at his childhood home in the Ninth Street Historic District.

On November 4th, Nick (Juju) Arguello, one of dozen former aurarians and descendants of aurarian families, attended a ceremony at St. Cajetan’s Church, minutes from his parents’ home. The event was hosted by CU Denver to honor the expansion of the Displaced Aurarian Scholarship, approved that day by the CU Board of Regents. Under the new resolution, CU Denver, the Metropolitan State University of Denver (MSU Denver), and the Community College of Denver (CCD) will offer free education to all direct descendants of Aurarians who lived in the neighborhood from 1955 to 1973.

Beginning

US News & World Report published its ranking of the best colleges in 2022, in which CU Denver was named Top Performing School for Social Mobility. CU Denver is officially 1st in Colorado and 55th in the nation in social mobility. With 106th place in 2021, the jump shows the university’s commitment to making higher education accessible to all, the central goal of the Strategic Plan 2030.

Dean Rebecca Kantor

On Thursday April 22nd, the Denver CU Ward learned that the Dean of the School of Education & Human Development, Rebecca Kantor, EdD, had died of an incurable disease. A forward-thinking, influential, and tireless master of education, Dean Kantor served the university for nearly a decade, touching the lives of countless students, faculty, and staff. Dean Kantor has had a solid career as an early childhood teacher, researcher, professor of teacher training, educational policy reformer and public university administrator. Since arriving at CU Denver in 2012, she has led the ongoing transformation of the School of Education & Human Development (SEHD) into an innovative school that provides contemporary, responsive and flexible preparation for educators, counselors and researchers.

City heights

City Heights Residence Hall and Learning Commons isn’t just a new dorm – it’s a turning point for CU Denver. It is a place where freshmen come together for the first time in the history of the university. A space in which they can learn in shared corners, cook in communal kitchens and cultivate lifelong friendships. It’s a place where all CU Denver students get academic support through hands-on services like Math and Statistics Support, Writing Center, and Learning Resources Center. It is a place where students, lecturers and staff meet over a meal in the new dining room or get some fresh air in a spacious, park-like courtyard. The university’s first on-campus residential building for freshmen was officially opened on August 12th.

Photo collage with Anthony Graves, Monique Snowden and Constancio Nakuma, with a photo from CU Denver

Three senior academics will soon join the CU Denver leadership team, bringing with them over 80 years of deep and diverse educational experience. These positions will focus on leading academic innovation and development, improving academic achievement, and strengthening strategic partnerships to equip Denver CU for continued success. In the past few weeks, the University has announced Constancio Nakuma, PhD, as Provost and Executive Vice Chancellor for Academic and Student Affairs, Monique L. Snowden, PhD, as Senior Vice Chancellor for Strategic Enrollment and Academic Achievement, and Anthony E. Graves as inaugural candidate Managing Director for Partnerships and Innovation.

Chancellor grades with students

Chancellor Michelle Marks joined CU Denver during one of the most difficult years in modern history. A global pandemic. Social injustice. Political unrest. Under her leadership, Denver CU held out and plans for a full return to campus in the fall are well underway. As Marks looks back on the past year, she is optimistic that CU Denver will use the lessons learned to become an even more innovative, inclusive and excellent institution.

COVID-19 vaccination card

That summer, states across the country, fearing that COVID-19 vaccination rates weren’t enough to control the virus, began using a novel tactic to increase gun shots – large cash withdrawals that you could partake in with a vaccination . While these lotteries were a seemingly tempting method, an early study of their kind shows that these efforts, which took place in 19 different states, did little to move the needle in terms of increasing vaccination rates. Researchers suggest that other methods, such as better news about the benefits of vaccination, might have been more effective. “Statistically, our research indicates a disappointing result – that is, no significant association was found between an announcement of a cash withdrawal and the number of vaccinations given after the announcement date,” said Andrew Friedson, PhD, associate professor of economics at the University of Colorado Denver.

COVID-19 model

The University of Colorado Denver is proud to announce the winners of the CU Denver 2021 Pandemic Research and Creative Activities Award. The strength and diversity of our research community – a talent pool of economists, chemists, politicians, city planners, bioengineers, and more – made it difficult to narrow down our list. Each of the nominees used their expertise to help tackle the parts of the pandemic that affect our daily lives. “In an ongoing global pandemic, local research through a local lens will contribute more to how we hold out and protect ourselves in the future,” said Martin Dunn, dean of the College of Engineering, Design and Computing and interim chief research officer. He and his team at the Office of Research Services read through more than 50 nominations to make their selections.

The post CU Denver’s High 10 Tales of 2021 first appeared on Education News Colorado.
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I’ve covered Tinder Advantage and Bumble Improve and that’s really how it went
Thu, 23 Dec 2021 14:12:04 GMT
I've covered Tinder Advantage and Bumble Improve and that's really how it went

I’ve covered Tinder Advantage and Bumble Improve and that’s really how it went

You will find a love / hate connection for “dating” applications. I got used to believing they were a story when their first got published when I was in college. Who needs to see anyone on the web when you happen to live with 6,000 teenagers on campus when you check out the Arizona DC neighborhood? We have come across individuals who easily get into a sports worker, have company in Greek life, and get great tangled up in college or university. I then left that behind, like my personal college connection, and I also stay in a brand new city for a few hours.

My friends made it possible for us to have Tinder / OK Cupid / Coffee joins Bagel / etc. to download. They personally wiped too because I was so jaded with the whole concept of originally using this software.

Quickly towards a year later.

Me: “I just bought Tinder as well.”

Friend: “You’re really joking. You actually covered Tinder. “

Maybe you think exactly the same thing. Why are you willing to purchase additional attributes for an app? The answer is simple … I was curious about the media hype. One of my life mottos is “Don’t knock and test soon”. I’ve tried both Tinder Plus and Bumble Improve. Both of them have a great time services that come with the compensated variation.

Tinder Plus

Passport: This is actually the main reason I chose to get Tinder benefits. You set your local area to worldwide. I travel a lot for work with weeks at any time. As soon as I have found out in which direction I will then go, we will change my personal location and provide easy clarification. I first used this feature when I found out I was spending my personal daylight saving time in Augusta, Georgia. I didn’t understand any person there, so it’s a great way to find people to completely relate to before I showed up.

Rewind: Have you ever noticed the cute guy or girl accidentally swiping left after swiping for the last twenty people? You can just rewind and go back to that person’s account to do a double take and swipe accordingly.

Enhance: You may be able to have the visibility go straight to the surface of the queue. Your profile will be better known and you will bring a notification with you claiming that your own profile has been watched by around 10 times the number of people since you were visible on 1. A boost lasts half an hour. Receive one free upgrade every month.

Further functions are the hiding of advertisements, additional “super likes”, unlimited swiping movements, the hiding of your actual age and the hiding of your reach. It’s my job to cover my distance once I change my personal location in Passport so I don’t confuse people.

Bumble Boost

The BeeLine: Between Tinder and Bumble’s solid traits, this could be my FAVORITE skill between the two. I almost never wipe on Bumble again because the BeeLine shows you a summary of the people who have just swept near you! Immediate Confidence Improvement Right? The first time we tried I had over 50 people currently around me and everything I had to do immediately matched anyone I thought was interesting. Once you swipe that person right backwards it becomes an instant addition.

Rematch: We’re all hectic. Sometimes 24 hours in a day can go by in the blink of an eye. At Bumble, a game expires in 1 day if you don’t decrease a number. Sometimes I meet people all night and then you realize that it is currently 7.30 p.m. Now you can combine all of those finished colors again.

Increase chances: People can only extend the chance of a try-on free of charge once a day. When you have Bumble Improve, you have endless time to add to a match. Are you afraid of creating the most beautiful starting area? Extend their match expires earlier. I’ve never used this feature before, but some people have tried it on me. You will receive a notification that your partner has failed to perform for you to run! Again, appreciating information has always been us right?

Maybe you tried Tinder Additional or Bumble Improve? Let me know what your experiences are!

The post I’ve covered Tinder Advantage and Bumble Improve and that’s really how it went first appeared on Peach State Press.
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Real estate CDOs are roaring back, this time to fund commercial properties thrown into flux by pandemic
Thu, 23 Dec 2021 17:27:57 GMT
Real estate CDOs are roaring back, this time to fund commercial properties thrown into flux by pandemic

Wall Street’s real estate CDO machine, shunned and largely shut down since the 2008 global financial crisis, has returned.

According to BofA Global, this year will see a record increase of almost 50 billion compared to the 2020 issue.

The new generation of CRE CLOs, or Collateralized Loan Obligations, will be anchored primarily this year by loans on commercial real estate, teetering on the work-from-home trend that emptied offices and drove urban dwellers to the suburbs during the pandemic. These are unlike the CDOs of yore when Wall Street packaged billions of increasingly hard-to-sell subprime mortgage bonds and derivatives as top-rated “secured debt” or CDOs that became toxic.

With the new bonds, investors can also bet that US commercial real estate will not only survive the COVID crisis, but land on more solid ground over the next five years, given today’s low interest rates.

“People thought commercial real estate was the focus of the storm,” said Tracy Chen, director of global structured credit investing at Brandywine Global Investment Management, in a telephone interview.

“The apocalyptic scenario that everyone was talking about did not materialize.”

Instead, the pandemic means a second chance for a corner of Wall Street looking to leave a bad past behind.

CRE-CLOs are booming

BofA Global, Commercial Mortgage Alert

“Starting with early post-crisis CRE-CLOs, the structures were updated and the look had to be differentiated from the look of pre-crisis CDOs,” said Steven Kolyer, partner in the global finance group at Sidley Austin law firm.

Kolyer was involved when mortgage CDOs first emerged 20 years ago and has helped implement reforms over the past decade, including obliging CRE CLO sponsors to stand by their businesses by keeping some of the risks .

“These are different from pre-crisis CDOs that suffered heavy credit losses, mostly from subprime mortgage investments,” he said.

“The different current credit structure comes at an opportune time as underlying borrowers with ownership interests in commercial real estate are looking for ways to convert their properties from previous uses to future uses.”

Bridge to the future

Many of the loans bundled in CRE-CLOs this year have been floating rate and have been used to finance relatively stable apartment buildings where owners want flexible financing in the COVID era, including selling when prices continue to rise.

Others turned to borrowers who needed temporary funds to convert an office building, retail property, or hotel to attract new tenants.

Related: Shorter leases? Top real estate managers Durst and Jones discuss the future of the office

“Typically, transitional loans prior to COVID-19 were drawn with the expectation of cash flow disruptions,” said Greg Handler, director of mortgage and consumer credit at Western Asset Management.

That means reserving funds for “a period of time to renovate, re-let or reposition real estate,” said Handler, which “has helped alleviate the problems we saw with COVID,” including reducing the proportion of overdue loans was kept low in CRE-CLOs.

Given the boom in the sector, Handler was an investor but also told MarketWatch that his team was exploring the possibility of building its own pipeline of deals. Many of the top issuers in the sector to date have been REITs, including Arbor Realty Trust Inc. ABR
and Bridge Investment Group BRDG,
according to deal tracker Finsight.

“Of course, there will be a need to reshape the future of the office,” said Handler, also speaking about the floor plans of hotels and other types of property that are likely to change.

“Landlords and property owners need to rethink and invest more capital,” he said.

Boom like no other

Analysts said the main risks would be that lending becomes more sloppy as lenders compete for business, the weakness of the exploding multi-family sector, or unsuccessful real estate plans.

Low Interest BX: TMUBMUSD10Y
and a subdued distress helped push commercial property prices up 24% year-over-year, or about 15% above pre-COVID levels, according to the Green Street Commercial Property Price Index.

Barclays’ credit research team, led by Lea Overby, estimated in early December that around 67% of the annual collateral for CRE-CLOs was multi-family loans, with a smaller proportion coming from the office sector.

But unknowns still tarnish commercial real estate as the pandemic nears its two-year mark, including how much office space will be needed in major cities, what business travel will be like, and other concerns.

Although the expected wave of housing crisis has not yet occurred, Brandywine’s Chen has also tied “all risky assets” to central bank support, which until recently meant keeping interest rates low and monetary policy expansionary.

“The rate is still at an all-time low and it will take time to get to dangerous levels,” she said. “CRE-CLOs should benefit from this.”

With the Federal Reserve tightening, Chen believes that if inflation stays high for the next year, real estate “should be a place to hide”, especially for investors with exposure to real estate funded at extremely low interest rates rise in a rate hike cycle.

cashbox: Will US REITs beat the S&P 500 next year?

The post Real estate CDOs are roaring back, this time to fund commercial properties thrown into flux by pandemic first appeared on REALESTATE NEWS24.
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Watch: One City’s Effort to Raise Vaccination Rates Among Black Residents
Thu, 23 Dec 2021 17:49:00 GMT

About 72% of Americans have received at least one dose of a covid-19 vaccine. During much of the vaccine rollout, Hispanic and Black Americans have been less likely than white Americans to get vaccinated. The gap between white and Hispanic Americans has largely closed, but the vaccination rate for the Black community still lags significantly behind. KHN correspondent Sarah Varney and PBS NewsHour producer Jason Kane report on how Hartford, Connecticut, has tried to close the gap in vaccination rates.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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This story can be republished for free (details).

Watch: One City’s Effort to Raise Vaccination Rates Among Black Residents https://khn.org/news/article/watch-one-citys-effort-to-raise-vaccination-rates-among-black-residents/

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As Patients Fell Ill With Covid Inside Hospitals, Government Oversight Fell Short
Thu, 23 Dec 2021 14:32:36 GMT
As Patients Fell Ill With Covid Inside Hospitals, Government Oversight Fell Short


One by one, the nurses taking care of actress Judi Evans at Riverside Community Hospital kept calling out sick.

Patients were coughing as staffers wheeled the maskless soap opera star around the California hospital while treating her for injuries from a horseback fall in May 2020, Evans said.

She remembered they took her to a room to remove blood from her compressed lung where another maskless patient was also getting his lung drained. He was crying out that he didn’t want to die of covid.

No one had told her to wear a mask, she said. “It didn’t cross my mind, as I’m in a hospital where you’re supposed to be safe.”

Then, about a week into her hospital stay, she tested positive for covid-19. It left the 57-year-old hospitalized for a month, staring down more than $1 million in bills for treatment costs and suffering from debilitating long-haul symptoms, she said.

Hospitals, like Riverside, with high rates of covid patients who didn’t have the diagnosis when they were admitted have rarely been held accountable due to multiple gaps in government oversight, a KHN investigation has found.

While a federal reporting system closely tracks hospital-acquired infections for MRSA and other bugs, it doesn’t publicly report covid caught in individual hospitals.

Medicare officials, tapped by Congress decades ago to ensure quality care in hospitals, also discovered a gaping hole in their authority as covid spread through the nation. They could not force private accreditors — which almost 90% of hospitals pay for oversight — to do targeted infection-control inspections. That means Riverside and nearly 4,200 other hospitals did not receive those specific covid-focused inspections, according to a government watchdog report, even though Medicare asked accreditors to do them in March 2020.

Seema Verma, former chief of Medicare and Medicaid under President Donald Trump, said government inspectors went into nearly every nursing home last year. That the same couldn’t be done for hospitals reveals a problem. “We didn’t have the authority,” she told KHN. “This is something to be corrected.”

KHN previously reported that at least 10,000 patients nationwide were diagnosed with covid in hospitals last year after being admitted for something else — a sure undercount of the infection’s spread inside hospitals, since that data analysis primarily includes Medicare patients 65 and older.

Nationally, 1.7% of Medicare inpatients were documented as having covid diagnosed after being admitted for another condition, according to data from April through September 2020 that hospitals reported to Medicare. CDIMD, a Nashville-based consulting and data analytics company, analyzed the data for KHN.

At Riverside Community Hospital, 4% of the covid Medicare patients were diagnosed after admission — more than double the national average. At 38 other hospitals, that rate was 5% or higher. All those hospitals are approved by private accreditors, and 29 of them hold “The Gold Seal of Approval” from their accreditor.

To be sure, the data has limitations: It represents a difficult time in the pandemic, when protective gear and tests were scarce and vaccines were not yet available. And it could include community-acquired cases that were slow to show up. But hospital-employed medical coders decide whether a case of covid was present on admission based on doctors’ notes, and are trained to query doctors if it’s unclear. Some institutions fared better than others — while the American public was left in the dark.

Spurred by serious complaints, federal inspectors found infection-control issues in few of those 38 hospitals last year. In Michigan, inspectors reported that one hospital “failed to provide and maintain a sanitary environment resulting in the potential for the spread of infectious disease to 151 served by the facility.” In Rhode Island, inspectors found a hospital “​​failed to have an effective hospital-wide program for the surveillance and prevention” of covid.

KHN was able to find federal inspection reports documenting infection-control issues for eight of those 38 hospitals. The other 30 hospitals around the country, from Alabama to Arizona, had no publicly available federal records of infection-control problems in 2020.

KHN found that even when state inspectors in California assessed hospitals with high rates of covid diagnosed after admission, they identified few shortcomings.

“The American public thinks someone is watching over them,” said Lisa McGiffert, co-founder of the Patient Safety Action Network, an advocacy group. “Generally they think someone’s in charge and going to make sure bad things don’t happen. Our oversight system in our country is so broken and so untrustworthy.”

The data shows that the problem has deadly consequences: About a fifth of the Medicare covid patients who were diagnosed after admission died. And it was costly as well. In California alone, the total hospital charges for such patients from April through December last year was over $845 million, according to an analysis done for KHN by the California Department of Health Care Access and Information.

The Centers for Disease Control and Prevention has pledged funding for increased infection-control efforts — but that money is not focused on tracking covid’s spread in hospitals. Instead, it will spend $2.1 billion partly to support an existing tracking system for hospital-acquired pathogens such as MRSA and C. diff.

The CDC does not currently track hospital-acquired covid, nor does it plan to do so with the additional funding. That tracking is done by another part of the U.S. Department of Health and Human Services, according to Dr. Arjun Srinivasan, associate director for the CDC’s health care-associated infection-prevention programs. But it’s not made public on a hospital-by-hospital basis. HHS officials did not respond to questions.

The Scene at Riverside

In March 2020, Evans was alarmed by nonstop TV footage of covid deaths, so she and her husband locked down. They hadn’t been going out much, anyway, since losing their only child at the end of 2019 to another public health crisis — fentanyl.

At the time, concerns about covid were mounting among the staff at Riverside Community Hospital, a for-profit HCA Healthcare facility.

The hospital’s highly protective N95 masks had been pulled off the supply room shelves and put in a central office, according to Monique Hernandez, a shop steward for her union, Service Employees International Union Local 121RN. Only nurses who had patients getting aerosol-generating procedures such as intubation — which were believed at the time to spread the virus — could get one, she said.

She said that practice left the nurses on her unit with a difficult choice: either say you had a patient undergoing such procedures or risk getting sick.

Nurse unions were early adopters of the notion — now widely accepted — that covid is spread by minuscule particles that can linger in the air. Studies since have matched the genetic fingerprint of the virus to show that covid has spread among workers or patients wearing surgical masks instead of more protective masks like N95s.

On April 22, 2020, Hernandez and other nurses joined a silent protest outside the hospital where they held up signs saying “PPE Over Profit.” By that time, the hospital had several staff clusters of infection, according to Hernandez, and she was tired of caregivers being at risk.

In a statement, Riverside spokesperson David Maxfield said the hospital’s top priority has been to protect staff “so they can best care for our patients.”

“Any suggestion otherwise ignores the extensive work, planning and training we have done to ensure the delivery of high-quality care during this pandemic,” he said.

In mid-May, Judi Evans’ husband coaxed her into going horseback riding — one of the few things that brought her joy after her son’s death. On her second day back in the saddle, she was thrown from her horse. She broke her collarbone and seven ribs, and her lung was compressed. She was taken to Riverside Community Hospital.

There, many of her nurses wore masks they had previously used, Evans recalled. Other staffers came in without any masks at all, she said. A few days in, she said, one of the doctors told her it’s crazy that the hospital was testing her for MRSA and other hospital infections but not covid.

Maxfield said that the hospital began enforcing a universal mask mandate for staff and visitors on March 31, 2020, and, “in line with CDC, patients were and are advised to wear masks when outside their room if tolerated.” He stressed “safety of our patients and colleagues has been our top priority.”

After about a week in the hospital, Evans said, she spiked a fever and begged for a covid test. It was positive. There is no way to know for certain where or how she got infected but she believes it was at Riverside. Covid infections can take two to 14 days from exposure to show symptoms like a fever, with the average being four to five days. According to CDC guidance, infection onset that occurs two days or more after admission could be “hospital-associated.”

Doctors told her they might have to amputate her legs when they began to swell uncontrollably, she said.

“It was like being in a horror film — one of those where everything that could go wrong does go wrong,” Evans said.

She left with over $1 million in bills from a month-long stay — and her legs, thankfully. She said she still suffers from long-covid symptoms and is haunted by the screams of fellow patients in the covid ward.

By the end of that year, Riverside Community Hospital would report that 58 of its 1,649 covid patients were diagnosed with the virus after admission, according to state data that covers all payers from April to December.

That’s nearly three times as high as the California average for covid cases not present on admission, according to the analysis for KHN by California health data officials.

“Based on contact tracing, outlined by the CDC and other infectious disease experts, there is no evidence to suggest the risk of transmission at our hospital is different than what you would find at other hospitals,” Maxfield said.

A lawsuit filed in August by the SEIU-United Healthcare Workers West on behalf of the daughter of a hospital lab assistant who died of covid and other hospital staffers says the hospital forced employees to work without adequate protective gear and while sick and “highly contagious.”

The hospital “created an unnecessarily dangerous work environment,” the lawsuit claims, “which in turn has created dangerous conditions for patients” and a “public nuisance.”

Attorneys for Riverside Community Hospital are fighting the ongoing lawsuit. “This lawsuit is an attempt for the union to gain publicity, and we have filed a motion to end it,” said Maxfield, the hospital spokesperson.

The hospital’s lawyers have said the plaintiffs got covid during a spike in local cases and are only speculating that they contracted the virus at the hospital, according to records filed in Riverside County Superior Court.

They also said in legal filings that the court should not step into the place of “government agencies who oversee healthcare and workplace safety” and “handled the response to the pandemic.”

‘A Shortcoming in the Oversight System’

Decades ago, Congress tasked Medicare with ensuring safe, quality care in U.S. hospitals by building in routine government inspections. However, hospitals can opt to pay up to tens of thousands of dollars per year to nongovernmental accreditors entrusted by CMS to certify the hospitals as safe. So 90% do just that.

But these accrediting agencies — including the Joint Commission, which certified Riverside — are private organizations. Thus they are not required to follow CMS’ directives, including the request in a March 20 memo urging the accrediting agencies to execute targeted infection-control surveys aimed at preparing hospitals for covid’s onslaught.

And so they didn’t send staffers to survey hospitals for the specialized infection-control inspections in 2020, according to a June 2021 Health and Human Services Office of the Inspector General report.

Riverside, despite allegations of lax practices, holds The Gold Seal of Approval from the Joint Commission, which last inspected the hospital on-site in May 2018 before going in on Nov. 19 this year.

The inspector general’s office urged CMS to pursue the authority to require special surveys in a health emergency — lest it lose control of its mission to keep hospitals safe.

“CMS could not ensure that accredited hospitals would continue to provide quality care and operate safely during the COVID-19 emergency,” and could not ensure it going forward, the report said.

“We’re telling CMS to do their job,” the report’s author, Assistant Regional Inspector General Calvin Jones, said in an interview. “The covid experience really showed a shortcoming in the oversight system.”

CMS spokesperson Raymond Thorn said the agency agrees with the report’s recommendation and will work on a regulation after the public health emergency ends.

Accrediting agencies, however, pushed back on the inspector general’s findings. Among them: DNV Healthcare USA Inc. Its director of accreditation, Troy McCann, said there was not a gap in oversight. Although he said travel restrictions limited accreditors ability to fly across state lines, his group continued its annual reviews after May 2020 and incorporated the special focus on infection control into them. “We have a strong emphasis, always, on safety, infection control and emergency preparedness, which has left our hospitals stronger,” McCann said.

Angela FitzSimmons, spokesperson for the Accreditation Commission for Health Care, said that the accrediting organization’s surveys typically focus on infection control, and the group worked during the pandemic to prioritize hospitals with prior issues in the area of infection prevention.

“We did not deem it necessary to add random surveys that would occur at a cost to the hospital without just cause,” FitzSimmons said.

Maureen Lyons, a spokesperson for the Joint Commission, told KHN that, after evaluating CMS guidance, the nonprofit group decided it would incorporate the infection-control surveys into its surveys done every three years and, in the meantime, provide hospitals with the latest federal guidance on covid.

“Hospitals were operating in extremis. Thus, we collaborated closely with CMS to determine optimal strategies during this time of emergency,” she said.

The Joint Commission cited safety issues for its inspectors, who travel to the hospitals and need proper protective equipment that was running low at the time, as part of the reason for its decision.

Verma, the CMS administrator at the time, pushed back on accreditors’ travel safety concerns, saying that “narrative doesn’t quite fit because the state and CMS surveyors were going into nursing homes.”

Though Verma cautioned that hospitals were overwhelmed by the crush of covid patients, “doing these inspections may have helped hospitals bolster their infection-control practices,” she said. “Without these surveys, we really have no way of knowing.”

‘Immediate Jeopardy’

Medicare inspectors can go into a privately accredited hospital after they get a serious complaint. They found alarming circumstances when they visited some of the hospitals with high rates of covid diagnosed after a patient was admitted for another concern last year.

At Levindale Hebrew Geriatric Center and Hospital in Baltimore, the July 2020 inspection report says “systemic failures left the hospital and all of its patients, staff, and visitors vulnerable to harm and possible death from COVID-19.”

In response, hospital spokesperson Sharon Boston said that “we have seen a large decrease in the spread of the virus at Levindale.”

Inspectors had declared a state of “immediate jeopardy” after they investigated a complaint and discovered an outbreak that began in April and continued through the beginning of July, with more than 120 patients and employees infected with covid. And in a unit for those with Alzheimer’s and other conditions, 20% of the 55 patients who had covid died.

The hospital moved patients whose roommates tested positive for covid to other shared rooms, “potentially exposing their new roommate,” the inspection report said. Boston said that was an “isolated” incident and the situation was corrected the next day, with new policies put in place.

The Medicare data analyzed exclusively for KHN shows that 52 of Levindale’s 64 covid hospital patients, or 81%, were diagnosed with covid after admission from April to September 2020. Boston cited different numbers over a different time period: Of 67 covid patients, 64 had what she called “hospital-acquired” covid from March to June 2020. That would be nearly 96%.

The hospital shares space with a nursing home, though, so KHN did not group it with the general short-term acute-care hospitals as part of the analysis. Levindale’s last Joint Commission on-site survey was in December 2018, resulting in The Gold Seal of Approval. It had not had its once-every-three-years survey as of Dec. 10, 2021, according to the Joint Commission’s tracking.

Boston said Levindale “quickly addressed” the issues that Medicare inspectors cited, increasing patient testing and more recently mandating staff vaccines. Since December 2020, Boston said, the facility has not had a covid patient die.

At the state level, hospital inspectors in California found few problems to cite even at hospitals where 5% or more patients were diagnosed with covid after they were admitted for another concern. Fifty-three complaints about such hospitals went to the Department of Public Health from April until the end of 2020. Only three of those complaints resulted in a finding of deficiency that facility was expected to fix.

CDPH did not respond to requests for comment.

A New Chapter

Things are better now at Riverside Community Hospital, Hernandez said. She is pleased with the current safety practices, including more protective gear and HEPA filters for covid patients’ rooms. For Hernandez, though, it all comes too late now.

“We laugh at it,” she said, “but it hurts your soul.”

Evans said she was able to negotiate her $1 million-plus hospital bills down to roughly $70,000.

Her covid aftereffects have been ongoing — she said she stopped gasping for air and reaching for her at-home oxygen tank only a few months ago. She still hasn’t been able to return to work full time, she said.

For the past year, her husband would wake up in the middle of the night to check whether her oxygen levels were dipping. Terrified of losing her, he’d slip an oxygen mask on her face, she said.

“I would walk 1,000 miles to go to another hospital,” Evans said, if she could do it all over again. “I would never step foot in that hospital again.”

Methodology

KHN requested custom analyses of Medicare, California and Florida inpatient hospital data to examine the number of covid-19 cases diagnosed after a patient’s admission.

The Medicare and Medicare Advantage data, which includes patients who are 65 and older, is from the Centers for Medicare & Medicaid Services’ Medicare Provider Analysis and Review (MedPAR) file and was analyzed by CDIMD, a Nashville-based medical code consulting and data analytics firm. The data is from April 1 through Sept. 30, 2020. The data for the fourth quarter of 2020 was not yet available.

The data shows the number of inpatient Medicare hospital stays in the U.S., including the number of people diagnosed with covid-19 and the number of admissions for which the covid diagnosis was not “present on admission.” CMS considers some medical conditions that are not “present on admission” to be hospital-acquired, according to the agency. The data is for general acute-care hospitals, which may include a psychiatric floor, and not for other hospitals such as those in the Department of Veterans Affairs system or stand-alone psychiatric hospitals.

KHN requested a similar analysis from California’s Department of Health Care Access and Information of its hospital inpatient data. That data was from April 1 through Dec. 31, 2020, and covered patients of all ages and payer types and, in general, private psychiatric and long-term acute-care hospitals. Etienne Pracht, a University of South Florida researcher, provided the number of Florida covid patients who did not have the virus upon hospital admission for all ages and payer types at general and psychiatric hospitals from April 1 through Dec. 31, 2020. KHN subtracted the number of Medicare patients in the MedPAR data from the Florida and California datasets so they would not be counted twice.

To calculate the rate of hospitalized Medicare patients who tested positive for covid — and died — KHN relied on the MedPAR data for April through September. That data includes records for 6,629 seniors, 1,409 of whom, or 21%, died. California data for all ages and payer types from April through December shows a similar rate: Of 2,115 diagnosed with covid-19 after hospital admission, 435, or 21%, died. The MedPAR data was also used to calculate the national rate of 1.7%, with 6,629 of 394,939 covid patients diagnosed with the virus whose infections were deemed not present on admission, according to the CDIMD analysis of data that hospitals report to Medicare. It was also used to calculate which entities licensed as short-term acute care hospitals had 5% or more of their covid cases diagnosed within the hospital. As stated in the story, Levindale Hebrew Geriatric Center and Hospital in Baltimore was not included in that list of 38 because it shares space with a nursing home and had fewer than 500 total discharges.

Data that hospitals submit to Medicare on whether an inpatient hospital diagnosis was “present on admission” is used by Medicare for payment determinations and is intended to incentivize hospitals to prevent infections during hospital care. The federal Agency for Healthcare Research and Quality also uses the data to “assist in identifying quality of care issues.”

Whether covid-19 is acquired in a hospital or in the community is measured in different ways. Some nations assume the virus is hospital-acquired if it is diagnosed seven or more days after admission, while U.S. data counts cases only after 14 days.

Hospitals’ medical coders who examined patient records for the data analyzed for this KHN report focus on each physician’s admission, progress and discharge notes to determine whether covid was “present on admission.” They do not have a set number of days they look for and are trained to query physicians if the case is unclear, according to Sue Bowman, senior director of coding policy and compliance at the American Health Information Management Association.

KHN tallied the cases in which covid-19 was logged in the data as not “present on admission” to the hospital. Some covid cases are coded as “U” for having insufficient documentation to make a determination. Since Medicare and AHRQ consider the “U” to be an “N” (or not present on admission) for the purposes of payment decisions and quality indicators, KHN chose to count those cases in the grand total.

In 409 of 6,629 Medicare cases and in 70 of 2,185 California cases, the “present on admission” indicator was “U.” The Florida data did not include patients whose “present on admission” indicator was “U.” Medical coders have another code, “W,” for “clinically undetermined” cases, which consider a condition present on admission for billing or quality measures. Medical coders use the “U” (leaning toward “not present on admission”) and “W” (leaning toward “present on admission”) when there is some uncertainty about the case. KHN did not count “W” cases.

The Medicare MedPAR data includes about 2,500 U.S. hospitals that had at least a dozen covid-19 cases from April through September 2020. Of those, 1,070 reported no cases of covid diagnosed after admission for other conditions in the Medicare records. Data was suppressed due to privacy reasons for about 1,300 hospitals that had between one and 11 of such covid cases. There were 126 hospitals reporting 12 or more cases of covid that were “not present on admission” or unknown. For those, we divided the number of cases diagnosed after admission by the total number of patients with covid to arrive at the rate, as is standard in health care.

Inspection and Accreditation Analysis

To evaluate which of the 38 hospitals detailed above had federal inspection reports documenting infection-control issues, KHN searched CMS’ publicly available “2567” reports, which detail deficiencies for each hospital for 2020. For surveys listed online as “not available,” KHN requested and obtained them from CMS. KHN further asked CMS to double-check the remaining hospitals for any inspection reports that weren’t posted online. KHN also checked the Association of Health Care Journalists’ database http://www.hospitalinspections.org/ for each of the 38 hospitals for any additional reports, as well as CMS’ Quality, Certification and Oversight Reports site.

To check that each of these hospitals was accredited, KHN looked up each hospital using a site run by the Joint Commission and reached out to the accreditors DNV Healthcare USA Inc. and the Accreditation Commission for Health Care.

To tabulate infection-control complaints for hospitals at the state level in California, KHN used data available through the California Department of Public Health’s Cal Health Find Database. KHN searched the database for the hospitals that had higher than 5% of covid patients being diagnosed after admission, according to the California data, and tallied all complaints and deficiencies found involving infection control from April to December 2020.

The post As Patients Fell Ill With Covid Inside Hospitals, Government Oversight Fell Short first appeared on Gotham Weekly.
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Fb’s outage probably price the corporate over $60 million
Tue, 05 Oct 2021 13:56:08 GMT

Facebook’s outage likely cost the company over $60 million

Getty Photographs

In a serious outage yesterday, Fb, together with its sibling websites, WhatsApp and Instagram, turned unreachable for hours. Actual-time web site standing tracker DownDetector obtained over 14 million stories from customers who could not use the social media big’s apps and providers.

However past the plain inconvenience to these minimize off from these providers, yesterday’s outage has had monetary repercussions not just for Fb, however many small companies that depend on the platform.

Downtime estimated to price Fb over $60 million

Fb’s 2020 income was $86 billion. Specialists have used this quantity to approximate the common loss incurred by the corporate yesterday at $163,565 for every minute of the outage. Over the six-hour interval, this sums as much as roughly $60 million in misplaced income. One other report by Fortune pinned the loss at $100 million, stating that “for a lot of firms, a $100 million drop in income over any time interval could be a monetary occasion of great concern. For Fb, it’s (for now) a drop within the bucket that buyers will probably shrug off.”

Greater than the lack of income, the occasion additionally affected Fb’s shares, which fell by 4.9 p.c on Monday, translating into $47.3 billion in misplaced market cap.

Julian Dunn, director of product advertising and marketing at PagerDuty, helps firms deal with outages and advised Ars, “Outages [at companies] like Fb and Instagram imply large cash for firms. Some firms are estimated to lose nearly five million dollars for each hour of the outage to their web site. Though multi-hour outages are comparatively uncommon, even quick ones—quarter-hour or half an hour—have an outsized impression, as impatient customers are all too keen to go away a down website and go elsewhere. Plus, there’s an enormous impact on the IT and developer groups that maintain the techniques working on the websites we go to on daily basis.”

And the losses do not finish there. Some small companies and corporations had the equal of a “snow day” yesterday. Boutiques and shops that rely largely on social media platforms to speak with purchasers, schedule appointments, and take funds had been left with out means to run operations.

Commercial

“Configuration adjustments” blamed for implosion

Fb has apologized for the inconvenience attributable to the incident. “To all of the individuals and companies around the globe who rely on us, we’re sorry for the inconvenience attributable to right now’s outage throughout our platforms. We’ve been working as laborious as we are able to to revive entry, and our techniques are actually again up and working. The underlying reason behind this outage additionally impacted most of the inside instruments and techniques we use in our day-to-day operations, complicating our makes an attempt to rapidly diagnose and resolve the issue,” mentioned Santosh Janardhan, VP for infrastructure at Fb.

New York Occasions expertise reporter Sheera Frenkel had moreover reported that some Fb workers couldn’t enter the workplace buildings attributable to badge entry techniques additionally being down from the outage.

Whereas initially cybersecurity specialists had steered everybody’s consideration towards Fb’s lacking DNS information, the probably reason behind the disruption was later attributed to a BGP misconfiguration. An intensive analysis by Celso Martinho and Tom Strickx of Cloudflare explains how the engineers recognized Fb’s BGP routes that had been withdrawn from the Web:

Routes had been withdrawn, Fb’s DNS servers went offline, and one minute after the issue occurred, Cloudflare engineers had been in a room questioning why [our DNS service,] 1.1.1.1 couldn’t resolve fb.com and worrying that it was in some way a fault with our techniques. With these [BGP route] withdrawals, Fb and its websites had successfully disconnected themselves from the Web.

However what appeared to exterior observers as BGP and DNS issues was truly the results of a configuration change that affected your complete inside spine.

In a postmortem replace posted yesterday, Fb’s Janardhan acknowledged that “configuration adjustments on the spine routers that coordinate community site visitors between our information facilities prompted points that interrupted this communication. This disruption to community site visitors had a cascading impact on the best way our information facilities talk, bringing our providers to a halt.”

Fb’s providers had been restored by roughly 7 pm ET yesterday. The corporate has explicitly identified that the foundation reason behind this outage was a defective configuration change and that there is no such thing as a indication right now that any consumer information was compromised. Regardless, the incident is a testomony to the dominance of social media and messaging platforms on numerous elements of our lives and commerce, making their availability now not optionally available.

The post Fb’s outage probably price the corporate over $60 million appeared first on BUSINESS TECHNOLOGY WORLD.

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We need a modern labor movement that brings good jobs
Sat, 13 Nov 2021 19:46:51 GMT
We need a modern labor movement that brings good jobs

As I lately flew to Phoenix Sky Harbor Worldwide Airport, I noticed the ramp employees on the tarmac busily unloading luggage and doing safety checks on the airplane within the 115 diploma warmth. A lot of the passengers had been desirous to get off, able to go to baggage declare, not interested by how a lot work was happening round them to make their journey doable.

Staff reassess employment previous to COVID-19 and refuse to just accept substandard work. Consequently, wages are rising, schedules are extra humane, and social advantages are rising. Thousands and thousands of latest jobs for working folks, largely unionized, will outcome from the $ 3.5 trillion funds plan that goes via Congress. The newest Gallup ballot discovered that 68% of People – and 77% of individuals between the ages of 18 and 34 – have a optimistic opinion about unions. And the devastating pandemic taught America that with out nurses, first responders, lecturers, grocery employees, truck drivers, postal employees, and key heroes, we might be nowhere.

These optimistic developments should not sufficient to place our financial ship again so as. For many years, our financial system has undermined working folks. Earnings inequality stays at an all-time excessive. The center class is hollowed out and more durable than ever to interrupt in.

This neither sustainable nor truthful financial system creates instability and threatens democracy. Whether or not out of self-interest, ethical indignation, or each, it isn’t in anybody’s curiosity that this slide continues.

So welcome, a contemporary labor motion.

A contemporary labor motion begins with placing good jobs and dealing folks on the heart of our nationwide dialog – again to the place it was, when work was culturally revered and economically rewarded. It focuses on creating and defending good, predictable and fascinating union jobs that allow center class residing.

A contemporary labor motion prioritizes inclusivity and displays the radically diversifying and gifted workforce made up of girls, blacks, immigrants, LGTBQ people and different traditionally marginalized teams. It breaks down systemic racism, structural boundaries and different deadly shortcomings in our financial system and society wherever they exist.

A contemporary labor motion includes innovation, experimentation, and alter on the tempo of a contemporary financial system. It ensures that working folks have a say within the improvement and adoption of latest applied sciences akin to AI, machine studying, and superior manufacturing that can drive future development.

A contemporary labor motion organizes each regionally to develop union membership and for legal guidelines in Washington DC, together with securing the fitting to vote, rebuilding our infrastructure, and fixing our damaged labor legal guidelines via the PRO Act, which was created to guard the Staff’ proper to affiliation is important.

In spite of everything, a contemporary labor motion produces outcomes. In a divided nation particularly, a contemporary labor motion should acknowledge what unites us and respect every of our strengths. There’s energy in listening in addition to energy in doing.

With all that we now have to realize, our trendy labor motion will want a gentle hand to sort out tough points head on. As the brand new President of the AFL-CIO and its first feminine chief, I’ve ready for this second all my life.

As Secretary-Treasurer for 12 years, I’ve the privilege of main most of the AFL-CIO’s latest and most prolific breakthroughs. For instance, I’ve introduced a variety of unions collectively to work collectively and donate $ 86 billion in pension fund aid that can guarantee pension safety for thousands and thousands of working households. I used to be proud to work with unions in all sectors to create the AFL-CIO Expertise Institute, which now works with MIT, Stanford, and Carnegie-Mellon to create people-centric know-how jobs. Personally, I used to be delighted to launch Subsequent Up, a program that recruits younger employees nationwide to prepare for change and develop the subsequent era of leaders. And dealing with our development unions, I helped dealer an modern clear vitality cope with a big worldwide wind vitality firm that may be a mannequin for high-paying, good union jobs throughout the east coast.

Unions are in my DNA. My father was a union member and I organized with my mom to struggle for workplace employees who wished a voice at work. My mother and father labored arduous and in return we lived a good, civil life. However then Enron purchased our native utility firm and his reckless conduct bankrupted the corporate and turned my father’s pension into pennies simply as he was retiring. Many years of labor down the drain. It motivated me to hitch the IBEW as a full time grassroots organizer and I’ve by no means appeared again.

I’ve seen firsthand the advantages of fine union work and the cruelty of legal guidelines and rules concentrating on employees.

At present, many corporations and unions work collectively constructively, however within the financial system as a complete that is too usually the exception, not the rule. These partnerships must be the mannequin for the long run primarily based on a shared understanding that equity and decency result in prosperity and stability for working folks, companies and finally the nation.

Thousands and thousands of People go to work daily and are grateful to be employed. However we will and may do rather a lot higher. job is what we wish ourselves and our kids to do. job can change life: it connects folks, builds households and begins careers. job made doable by unions is arguably probably the most highly effective social instrument ever invented. It’s the surest technique to create human dignity, unite communities, increase our financial system, strengthen our democracy and cut back inequality. That’s the mission of a contemporary labor motion. And this Labor Day is our dedication to each working individual in America.

Liz Shuler is president of the American Confederation AFL-CIO, which has 56 unions and 12.5 million members.

The post We need a modern labor movement that brings good jobs first appeared on LABOR NEWS WIRE.
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Novavax CEO: We can now make Covid vaccine at competitive commercial levels
Thu, 23 Dec 2021 08:31:41 GMT


Novavax CEO Stanley Erck joins CNBC's 'Squawk Box' to discuss the company's two-dose Covid-19 vaccine, which it says provides strong immune responses against the omicron variant.

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Title: Novavax CEO: We can now make Covid vaccine at competitive commercial levels
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Record Number of Americans Sign Up for ACA Health Insurance
Thu, 23 Dec 2021 19:08:56 GMT

A record 13.6 million Americans have signed up for health coverage for 2022 on the Affordable Care Act marketplaces, with nearly a month remaining to enroll in most states, the Biden administration announced Wednesday.

President Joe Biden’s top health advisers credited the increased government subsidies, which lowered out-of-pocket costs, for the surge in enrollment. They also said enhanced personal assistance and outreach helped connect more people to health insurance plans.

Some of the largest increases are in Florida, Texas, Georgia and nine other states that have not expanded Medicaid under the Affordable Care Act.

The previous marketplace enrollment record was 12.7 million in 2016, the final year of President Barack Obama’s administration. Enrollment largely stagnated under President Donald Trump, who cut tens of millions of dollars in funding for navigators, who help people sign up for coverage.

Open enrollment for the marketplace began Nov. 1 and ends Jan. 15.

Through Dec. 15, enrollment in Florida had soared to 2.6 million people, up from 2.1 million in the same period a year earlier.

“This is a very big deal as it means we have made a dent in the uninsured pool and we are not only insuring people but keeping people signed up,” said Jodi Ray, program director for Florida Covering Kids & Families.

Ray has used federal grants to help Floridians sign up for private coverage on the marketplace for several years. During the Trump presidency, she said, she could help only people in half the counties in the state because of funding constraints. “You cannot overlook the impact that one-on-one assistance has in getting people through the process,” Ray said.

Enrollment has jumped more in states that have not expanded Medicaid because they have more uninsured residents than expansion states. In expansion states, people with incomes from 100% to 138% of the federal poverty level — about $12,880 and $17,770 for an individual — can enroll in Medicaid. In states that haven’t expanded the program, they can get subsidies to enroll in private plans through the Affordable Care Act marketplaces.

Georgia enrollment jumped to 653,990 from about 514,000 the previous year.

“That’s the most we’ve ever had enrolled,’’ said Laura Colbert, executive director of the consumer advocacy group Georgians for a Healthy Future. She said the enrollment spike helps show that Republican Gov. Brian Kemp’s plan to scrap healthcare.gov and replace it with a privately run portal isn’t needed.

The Biden administration is reviewing that proposal.

“Hundreds of thousands of Georgians still opt to remain uninsured rather than shop on the federal platform,” Kemp spokesperson Katie Byrd said Wednesday. “This means that the one-size-fits-all approach by the federal government is not working for Georgia.”

The 13.6 million enrollment number includes people who used state-run marketplaces, in addition to those who enrolled through the federally run healthcare.gov portal that handles sign-ups for more than 30 states.

Texas’ enrollment rose to 1.7 million from 1.3 million.

Texas, Georgia and South Dakota each showed gains of at least 20%, said Chiquita Brooks-LaSure, administrator of the Centers for Medicare & Medicaid Services. None of those states has expanded Medicaid under the Affordable Care Act.

In non-expansion states, “our outreach efforts have been so robust this year,’’ Brooks-LaSure told reporters during a press call. The federal government is using four times the number of navigators, or insurance counselors, to help people sign up for insurance, said Xavier Becerra, secretary of the U.S. Department of Health and Human Services.

The big driver behind the enrollment gains is new discounts on premiums.

As part of a covid-19 relief bill passed this year, Congress increased the subsidies consumers receive when they enroll in health insurance via the marketplace. CMS said 92% of people in healthcare.gov states will get the tax credits for 2022 coverage. Becerra said that for 4 in 5 enrollees, monthly premiums cost $10 or less, which he said is “less than going to a movie.”

But conservatives chafe at the idea of higher subsidies. Brian Blase, a former Trump adviser and president of the conservative think tank Paragon Health Institute, stressed that the federal government is paying 85% of people’s monthly insurance premiums.

“People will buy something that provides them with little value if the after-subsidy price is zero or close to zero, and that’s what is generally happening here,” Blase said. “Ultimately, the big winners are the health insurance companies that are getting billions of dollars in additional government subsidies.”

Another driver of enrollment is that some people may have lost job-based coverage during the pandemic and are seeking insurance on their own.

The marketplaces also offer consumers more choices than in previous years. The average consumer now has between six and seven insurers to choose from, up from four to five in 2021, federal officials said.

Phil Galewitz:
pgalewitz@kff.org,
@philgalewitz

Andy Miller:
amiller@kff.org,
@gahealthnews

The post Record Number of Americans Sign Up for ACA Health Insurance first appeared on DAILYZ HEALTH NEWS.
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Centro comunitario hispano lidera la vacunación infantil contra covid en Chicago
Wed, 10 Nov 2021 22:05:09 GMT

Chicago.- Mientras la asistente médica se ponía guantes y preparaba la jeringa, Victoria Macías, de 5 años, con una máscara rosada de Minnie Mouse y una blusa blanca, giraba la cabeza y cerraba los ojos.

“No va a doler, ¿OK? Tomaré tu mano, tomaré tu mano “, le dijo su hermana mayor, Alondra, de 8. “Respira profundo, respira profundo”.

La asistente médica, Rachel Blancas, presionó el brazo izquierdo de Victoria durante aproximadamente un segundo. Victoria abrió los ojos. Así, las hermanas Macías fueron de las primeras niñas de 5 a 11 años en recibir la vacuna contra covid-19 en la ciudad más grande del Medio Oeste.

Su madre, María López, las sacó de la escuela temprano para pasar por el sitio de inmunización masiva en el suroeste de Chicago. “Han tenido todas las demás vacunas disponibles, así que ¿por qué no ésta?”, dijo López, de 43 años, quien trabaja en bienes raíces.

Esperanza Health Centers, un centro de salud sin fines de lucro que opera el sitio, ha sido el principal proveedor de vacunas pediátricas contra covid en Chicago, según el Departamento de Salud Pública de la ciudad, administrando alrededor de 10,000 inmunizaciones a jóvenes de 12 a 17 años.

Ahora que la Administración de Alimentos y Medicamentos (FDA) ha autorizado la vacuna de Pfizer-BioNTech para niños de 5 a 11 años, los esfuerzos de la organización pueden brindar lecciones para otros lugares del país que han tenido problemas para vacunar a los niños.

“La gente de la comunidad confía en nosotros”, dijo Verónica Flores, gerenta de respuesta a covid de Esperanza, que tiene cinco clínicas médicas que atienden pacientes sin importar si tienen o no seguro médico o su estatus migratorio. “Cuando comenzó la pandemia, fuimos uno de los primeros en hacer las pruebas”.

Agregó que, en algún momento, Esperanza fue responsable de más de la mitad de todas las pruebas de covid realizadas en la ciudad. El número de pacientes del centro de salud calificado federalmente, que son cerca de un 90% hispanos, se ha duplicado a raíz de covid.

Todos los que trabajan con pacientes en Esperanza son bilingües. El sitio de vacunación tiene un horario extendido y está abierto cinco días a la semana, incluso para personas sin citas. La clínica incluso pagará los viajes en Uber de los pacientes para vacunarse.

Benicio Decker se aferra con fuerza a su oso Batman de peluche mientras la asistente médica Rachel Blancas le administra la vacuna contra covid, el 4 de noviembre en el sitio de vacunación patrocinado por Esperanza Health Centers en Chicago.(Giles Bruce for KHN)

Si los padres o tutores tienen preguntas o inquietudes sobre la vacuna pediátrica, Esperanza los conecta con uno de sus médicos.

El doctor Mark Minier, director médico pediátrico, busca tranquilizar a los pacientes diciéndoles que se descubrió que la inyección, que se administra en una dosis más baja que para los adolescentes y adultos, es segura y efectiva para niños de 5 a 11 años.

Los efectos secundarios relativamente leves pueden incluir dolor en el lugar de la inyección, dolores de cabeza y fatiga que pueden durar uno o dos días. Además, les recuerda que los niños sí corren riesgo de contraer el virus.

“Alrededor de 2 millones de niños de entre 5 y 11 años han sido diagnosticados con covid y ha habido alrededor de 170 muertes”, dijo Minier. “Eso todavía es demasiado. Si tenemos algo que puede ayudar a prevenir la muerte o cualquier tipo de morbilidad por covid para los niños, entonces deberíamos hacerlo”.

Cynthia Galván, una asistente médica de Esperanza que vive cerca, trajo a su hijo de 10 años, Andrés, para recibir la vacuna el jueves 4 de noviembre. Galván espera que esto asegure que su familia tenga un Día de Acción de Gracias mejor que el año pasado, cuando varios de sus familiares estaban enfermos de covid-19.

“Todos en casa ya están vacunados, excepto él”, dijo Cynthia, de 34 años. “Somos 10”.

La tasa de vacunación de Chicago del 58.2% para los jóvenes de 12 a 17 años es más alta que el promedio nacional de alrededor del 50%, en gran parte debido al trabajo de los centros de salud comunitarios como Esperanza, dijo la doctora Allison Arwady, comisionada de Salud de la ciudad.

No solo están familiarizados con los idiomas y culturas locales, sino que también son el tipo de lugares donde es probable que toda la familia reciba inmunizaciones, comenzando con los abuelos el invierno pasado.

“Sabemos que el mayor factor de predicción de si un niño recibe una vacuna es si el padre o tutor está vacunado”, dijo Arwady.

Todavía está preocupada por los aproximadamente 750,000 residentes de la ciudad que no están inmunizados contra covid. Los jóvenes negros de Chicago se han quedado rezagados con respecto a otros grupos, y le preocupa que puedan ocurrir brotes este invierno entre estos grupos no vacunados.

La ciudad está trabajando para aumentar la aceptación de las vacunas ofreciendo tarjetas de regalo de $100, administrando vacunas gratis en casa a cualquiera que las quiera y dando a todos los niños de las escuelas públicas el día libre este viernes 12 de noviembre para vacunarse.

La primera semana de noviembre, Esperanza Health Centers envió mensajes de texto a las familias de cada uno de sus aproximadamente 8,000 pacientes de entre 5 y 11 años para informarles a sus padres que la vacuna estaba disponible.

La organización comenzó a distribuir las vacunas a los niños más pequeños el miércoles 3 por la mañana, pocas horas después de que los Centros para el Control y la Prevención de Enfermedades (CDC) dieran el visto bueno final. Comenzarán a administrar la segunda dosis en tres semanas.

“Odio las inyecciones”, dijo Benicio Decker, de 7 años, mientras jugaba un juego en un iPad en la sala de espera de la clínica. “La única vez que me gustan es cuando tomamos helado después”.

Pero el alumno de segundo grado agregó que estaba dispuesto a soportar un poco de molestia “porque quiero proteger a mi familia, a mí, a mis amigos, a mi maestro”.

En la hermosa tarde de otoño, las familias con niños pequeños entraban y salían del sitio, un antiguo gimnasio de 23,000 pies cuadrados con ventilación expuesta, luces fluorescentes y un piso de goma con pintas azules. Mientras las canciones de Disney sonaban por los altavoces, los niños se tomaban fotografías frente a las paredes con astronautas y globos con los que había decorado el centro de salud.

“Hacen un gran trabajo al hacer que la información esté disponible donde están las personas”, dijo la madre de Benicio, Esmie De María, de 39 años. “Tienen folletos en restaurantes, lavanderías, supermercados. No esperan que la gente venga a ellos”.

Esperanza también ha realizado clínicas de vacunación emergentes en escuelas y parques locales.

De María dijo que no se encontró con listas de espera como le pasó en otros lugares de la ciudad. Incluso reclutó al centro de salud para que impartiera talleres sobre vacunas a sus colegas en una organización de su vecindario.

Esperanza es una institución confiable en una parte mayoritariamente hispana de la ciudad, dijo De María. En Chicago y en todo el país, los latinos han sido menos propensos que los caucásicos y los asiáticos a vacunarse contra el coronavirus, aunque esa brecha se ha ido cerrando.

“Las personas de color tienen todo el derecho, históricamente, a desconfiar de las vacunas”, dijo De María, y señaló que muchas mujeres en su hogar ancestral de Puerto Rico fueron obligadas a ser esterilizadas durante el siglo XX. “Ser escéptico está incrustado en nuestro ADN”.

En la estación de vacunas, Blancas, la asistente médica, le dijo a Benicio que la inyección se sentiría como la picadura de un mosquito. “Estás siendo muy valiente. Te estás ganando ese helado “, dijo su madre.

Cuando Blancas clavó la aguja en el brazo de Benicio, el niño, agarrado con fuerza a su osito de peluche de Batman, soltó un “Ow” sordo. Después, dijo que había sentido un pequeño pellizco.

“Estás oficialmente vacunado”, le dijo su madre, mientras el niño, ya jugando con su teléfono, se sentaba a esperar por 15 minutos, para asegurarse de que no tuviera ninguna reacción alérgica peligrosa. “Va a ser uno de los primeros niños de su escuela en vacunarse. Es un pequeño superhéroe “.

The post Centro comunitario hispano lidera la vacunación infantil contra covid en Chicago first appeared on Africa Chamber News.
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Kim Potter convicted of manslaughter of Daunte Wright’s manslaughter
Thu, 23 Dec 2021 20:14:32 GMT
Kim Potter convicted of manslaughter of Daunte Wright's manslaughter

In this screenshot of police bodycam footage shown in court on December 10th during the trial of Kim Potter, the Brooklyn Center officer reacts after the April 11th traffic control in which Daunte Wright was fatally shot.

AP

Kim Potter, the former Minnesota police officer who mistakenly drew her pistol instead of her taser during a traffic stop in April that fatally shot Daunte Wright, was convicted.

The jury had been deliberating since Monday before they found Potter, who had served as a civil servant in Brooklyn Center, Minnesota, on charges of first and second degree manslaughter in Wright’s death.

The verdict follows a closely watched two-week trial that was crowned by Potter’s appearance on the witness stand, where she sobbed as she remembered the shooting and said she was “so sorry” for what happened.

Whether Potter had intended to draw her taser or her handgun was out of the question in the process. Lawyers on both sides agreed that she had mistakenly drawn the wrong weapon. Instead, the process focused on whether she should have realized she was holding the heavier metal pistol or whether she should have drawn a gun at all.

Potter will be sentenced at a later date. The state’s sentencing guidelines recommend approximately seven years’ imprisonment for the first degree and four years for the second degree, although prosecutors sought a longer sentence.

The deadly confrontation on April 11th began when Potter, along with Anthony Luckey, a new officer she was training that day, pulled Wright, a 20-year-old black man, over because he had expired license brands and a dangling air freshener on the back of his mirror – a Minnesota violation.

The stop escalated when police discovered that Wright, despite not being armed, was wanted for arrest for failing to appear in court for possession of guns. When Luckey tried to arrest Wright and handcuff him, Wright twisted away and got back into his car.

Footage from body-worn cameras and a dashboard camera in the patrol car played for the jury during the trial captured the final chaotic moments in Wright’s life.

“I’ll tase you,” yelled Potter. But in her right hand was a dark 9mm Glock pistol, not the bright yellow taser that stayed in the holster on her left side. Five seconds later she shouted, “Taser! Taser! Taser!” then fired a single round into Wright’s side. He was pronounced dead at the scene.

The footage also shows the immediate aftermath of the shooting, in which Potter appeared in shock. She gasped and said, “I grabbed the wrong gun” before collapsing on the curb with her head in her hands.

Prosecutors say she should have known the difference

Prosecutors do not deny that the shooting was an accident. But they said Potter had received extensive firearms and taser training, including how not to confuse the two, in her 26 years with the police force. They turned to violence experts and the Police Policy Manual to argue that the use of a taser was inherently inappropriate.

“She drew a lethal weapon, she aimed, she pointed it at Daunte Wright’s chest, and she fired,” Assistant Attorney General Erin Eldridge said during the state’s closing speech on Monday.

“That wasn’t a little oopsie. That wasn’t the wrong date on a check. That wasn’t the wrong password typing in anywhere. That was a colossal mistake, a mistake of epic proportions,” said Eldridge. “It was exactly what she was warned about for years and she was trained to prevent it.”

Your lawyers call what happened a “mistake”, not a crime

Potter’s defense team argued that Wright caused his own death by ignoring police orders and trying to escape. Because of this, they said, Potter should not be held criminally responsible.

“A mistake is not a crime,” attorney Earl Gray told the jury in closing arguments.

“In society nobody is perfect. Everyone makes mistakes. Some of these mistakes are small mistakes, but some of them are very serious.”

Potter’s attorneys also argued that the use of lethal force was appropriate as a third officer, Sgt. Mychal Johnson, leaned into the car through the passenger door to prevent Wright from controlling gear changes. If Wright had been allowed to leave, it was said that Johnson’s safety would have been at risk.

Potter, who resigned from the police after the shooting, collapsed in the stands on Friday and cried as she testified that she “didn’t mean to hurt anyone”.

When questioned by the prosecutor, Potter expressed his regret. “I’m sorry it happened,” she said, sobbing.

Wright’s death occurred about 10 miles from the courthouse, where Derek Chauvin, a former Minneapolis police officer, was on trial for the murder of George Floyd, whose death fueled national protests against police abuse and racial injustice.

Potter is believed to be the third Minnesota police officer convicted of the death of a civilian on duty. The first was Mohamed Noor, a Somali-American officer convicted of manslaughter after he fatally shot a white woman. Chauvin became second when convicted of murder in April.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

The post Kim Potter convicted of manslaughter of Daunte Wright’s manslaughter first appeared on America's Firearms Newsource.
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Durham Select Board presents junkyard consent agreement
Thu, 11 Nov 2021 06:18:09 GMT
Durham Select Board presents junkyard consent agreement

A view of a junkyard at 1205 Royalsborough Road in Durham. Screenshot from Google Maps

DURHAM – The Select Board voted 4-0 on Tuesday to discuss a consent agreement that Priscilla Higgins would end up with by Jan.

The board members said they wanted to clarify several points and include clauses in the consent agreement before voting on it.

The scrapyard is operated by Ken Carll, who lives on the property.

During the discussion, Chairman Kevin Nadeau raised concerns that the agreement does not specify what action the city would take if the property did not meet city standards by the date stated.

Selectman Richard George also wondered if the City of Higgins should even allow several months to clear the property.

“These scrapyards, and this one in particular,” he said, “we’ve already given them extensions and deadlines, and this one, for whatever reason, hasn’t really met all of our requirements.”

According to Nadeau, other scrapyards that have received renewals had pre-existing licenses and the renewals were granted to them to give them time to meet the requirements before applying for renewals.

He said the property at 1205 Royalsborough Road previously had a license but it was not reissued as it did not meet city requirements. One requirement is that the junkyard must be in a 300 by 400 foot area, which this is not.

“I think their goal is to be clean and adequately shielded so that they can reapply for approval,” explained Nadeau.

Selectmen and Town Manager Kathy Tombarelli discussed whether the city should even be ready to issue a junkyard license for the property.

“So I think questions need to be answered, for example, should we treat this as if it was already a junkyard or not, what standard is it cleaned by, (and) does the planning bard have to make a condition? Usage permit, ”said Nadeau.

The board discussed the language of the consent agreement and agreed that this should not mean that the city will issue a license if the property meets city and state requirements.

“So we really need to make sure the wording is like this: If you get this reconciled by this date, it has to be clear that you still have a review process to go through with the planning authority and you still need a license from the Select Board, ”said Tombarelli.

In other areas, the Select Board voted 4-0 to renew a contract with the Androscoggin Sheriff’s Office for the Public Safety Answer Station and shipping services. The city will pay the county $ 21,625.76 for the service in 2022.

“They do a good job for us, there is a contact point (for) all problems, everything comes over, we can work with them,” said fire department chief Robert Tripp at the meeting.

Road Commissioner Calvin Beaumier also spoke about road repairs to David Louis Drive. On October 31, a culvert under the road failed due to heavy rain and a beaver dam that collapsed upriver during the storm.

The culvert was cleaned and a beaver dam removed before the storm, but Beaumier said the beavers were building another dam upriver. The public works crews and Durham Fire Department have made a temporary pavement after the fault was discovered and the city is working on restoring the road.

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Heyka’s ups and downs: Weather update for Montana December 22nd | Top story
Thu, 23 Dec 2021 12:38:22 GMT
Heyka's ups and downs: Weather update for Montana December 22nd |  Top story

It was a mild day in most of Montana with temperatures warming to the 30s and 40s with the exception of Glasgow where it stayed in the 20s.

The wind was gusty from Cut Bank and Great Falls south to Livingston.

Another storm system hits western Montana tonight.

A winter weather warning through early Thursday for northwest Montana, from Glacier Park in the west to the Kootenai Cabinet area in the south to Lookout Pass in the Seeley Lake area.

These include the Flathead and Mission Valleys.

Snowfall of 3 to 8 inches in the mountains with a trail of up to an inch or two in the Kalispell area along with the possibility of freezing drizzle.

A winter weather warning through early Friday for the passes in southwest Montana above 6,500 feet.

These include the Monida and Bozeman passes and the West Yellowstone area.

Snowfall from 4 to 12 inches.

A winter storm warning for Absaroka and Beartooth Mountain along with Yellowstone Park.

5 to 10 inches of snowfall from the park’s north entrance to Old Faithful. Ö

ne to two meters in the higher altitudes.

A very active weather pattern is expected during the holiday weekend, followed by a brutal cold across Montana next week.

Advisories and warnings cover the west and southwest of Montana through early Friday for snow or a mixture in the valleys. Regular snow across the country Friday through the weekend.

Most areas will have some aggregation, with the strongest along and west of the watershed and in southwest Montana.

How about a Christmas snow? The best chances of seeing snow on Christmas Eve are with Billings, Miles City and Kalispell.

The best chance on Christmas Eve will be Glasgow, Kalispell and Great Falls.

And Missoula, Kalispell and Lewistown have the best chance for Christmas Day.

Wind will also be a factor.

A wind warning for the Livingston area and the Beartooth foothills and a high wind clock for the Buffalo area of ​​northeast Wyoming.

Gusts up to 65 miles per hour.

Temperatures will stay milder than normal for another day before much colder air enters the state.

Arctic air will initially stay over northeast and north-central Montana on Friday and Saturday before creeping south and west later this weekend and next week.

Early next week, some areas will stay below zero day and night, particularly in northeast Montana.

Lows tonight in the 10s far to the northeast, the 20s elsewhere except in the lower 30s which will be windy, from Great Falls to Livingston.

Highs tomorrow in the 30s and 40s.

The lows will fall to the 10s and 20s on Friday, the single-digit and 20s on Saturday, the single-digit above and below zero on Sunday and well below zero nationwide next week.

Highs fall on the 20s and 30s on Friday, the 10s and 20s on Saturday except in the 30s in the southwest.

The highs will fall nationwide to single-digit values ​​above and below zero next week.

The post Heyka’s ups and downs: Weather update for Montana December 22nd | Top story first appeared on Daily Wyoming Cowboy.
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An Anesthesiology Practice’s Busy Day in Court Collecting on Surprise Bills
Thu, 23 Dec 2021 15:41:05 GMT


Owen Loney’s surprise bill resulted from an emergency appendectomy in 2019 at a Richmond, Virginia, hospital.

Insurance covered most of the cost of the hospital stay, he said. He didn’t pay much attention to a bill he received from Commonwealth Anesthesia Associates and expected his insurance to cover it. A few months ago, he got a notice that Commonwealth was suing him in Richmond General District Court for $1,870 for putting him under during the surgery, court records show.

“Wow, seriously?” the 30-year-old information technology manager recalled thinking after getting the court summons. Loney didn’t have that kind of money at hand. His plan was to try to negotiate down the amount or “take out another credit card to pay for it.”

Loney’s is a classic, notorious type of surprise bill that Congress and activists have worked for years to eliminate: an out-of-network charge not covered by insurance even though the patient had an emergency procedure or sought care at an in-network hospital thinking insurance would cover most charges.

Commonwealth said it was in-network for Loney’s insurer, UnitedHealthcare. But the insurer rejected the anesthesiology charge because it said his primary care doctor was out of network, claims records show.

The federal No Surprises Act, passed at the end of 2020, has been hailed by consumer advocates for prohibiting such practices. Starting Jan. 1, medical companies in most cases cannot bill patients more than in-network amounts for any emergency treatment or out-of-network care delivered at an in-network hospital.

But as much as the legislation is designed to protect millions of patients from unexpected financial consequences, it will hardly spare all consumers from medical billing surprises.

“It’s great that there will be surprise billing protections … but you’re still going to see lawsuits,” said Zack Cooper, an economist and associate professor at the Yale School of Public Health. “This is by no means going to get rid of all of the problems with billing.”

The law will kick in too late for Loney and many others saddled with surprise out-of-network bills in states that don’t already ban the practice.

“It doesn’t prohibit surprise bills that are happening now in states that don’t have protections” against them, said Erin Fuse Brown, a law professor at Georgia State University who studies hospital billing. “And it doesn’t prohibit collection activity for surprise bills that arose prior to January.”

Virginia’s surprise-bill protection law took effect only this year and doesn’t apply to self-insured employer health plans, which cover a large portion of residents.

The federal legislation also does nothing to reduce another kind of unpleasant, often surprising bill — large, out-of-pocket payments for in-network medical care that many Americans can’t afford and might not have realized they were incurring.

Two substantial changes in recent years shifted more risk to patients. Employers and other payers narrowed their provider networks to exclude certain high-cost hospitals and doctors, making them out of network for more patients. They also drastically increased deductibles — the amount patients must pay each year before insurance starts contributing.

The No Surprises Act addresses the first change. It does nothing to address the second.

For a snapshot of the past and future of surprise and disputed medical bills, KHN examined Commonwealth’s lawsuits against patients in central Virginia and attended court hearings where patients contested their bills.

“The whole thing with insurance not covering my bills is a headache,” said Melissa Perez-Obregon, a Richmond-area dance teacher whom Commonwealth sued for $1,287 over services she received during the 2019 birth of her daughter, according to court records. Her insurance paid most but not all of a $5,950 anesthesia charge, billing records show.

“I’m a teacher,” she said, standing in the lobby at Chesterfield County General District Court. “I don’t have this kind of extra money.”

Commonwealth is one of the more active creditors seeking judgments in the Richmond area, court records show. From 2019 through 2021, it filed nearly 1,500 cases against patients claiming money owed for treatment, according to the KHN analysis of court filings.

In numerous cases, it initiated garnishment proceedings, in which creditors seize a portion of patients’ wages.

Describing itself as “the largest private anesthesiology practice in Central Virginia,” Commonwealth said it employs more than 100 clinicians who care for roughly 55,000 patients a year in hospitals and surgery centers, mostly in the Richmond area.

Commonwealth said more than 99% of the patients it treats are members of insurance plans it accepts. It garnishes wages only as a “last resort” and only if the patient has the ability to pay, Michael Williams, Commonwealth’s practice administrator, said in a written statement.

“Over the past three years we have filed suit to collect from just over 1% of our patients,” mostly for money owed for in-network deductibles or coinsurance, Williams said. Nearly half the bills are settled before the court date, he said.

Gwendolyn Peters, 67, said she was shocked to receive a court summons this summer. Commonwealth was suing her for $1,000 for anesthesia during a lumpectomy for breast cancer in 2019, according to court records.

“This is the first time I have ever been in this situation,” she said, sitting in the Chesterfield court with half a dozen other Commonwealth defendants.

Because patients typically have little or no control over who puts them under, Brown said, anesthesiologists face less risk to their businesses and reputations than other medical specialists do in using aggressive collections tactics.

The specialty is often “one of the worst offenders because they don’t depend on their reputation to get patients,” she said. “They’re not going to lose business because they engage in these really aggressive practices that ruin their patients’ finances.”

The average annual deductible for single-person coverage from job-based insurance has soared from $303 to $1,434 in the past 15 years, according to KFF. Deductibles for family coverage in many cases exceed $4,000 a year. Coinsurance — the patient’s responsibility after the deductible is met — can add thousands of additional dollars in expenses.

That means millions of patients are essentially uninsured for care that might cost them a substantial portion of their income. Surveys have repeatedly found that many consumers say they would have trouble paying an unexpected bill of even a few hundred dollars.

Loney’s insurer, UnitedHealthcare, agreed to pay the bill from Commonwealth for his emergency appendectomy after being contacted by KHN and saying it “updated” information on the claim. Otherwise, Loney said, he couldn’t have paid it without borrowing money.

In Richmond-area courthouses, hearings for Commonwealth lawsuits take place every few months. A lawyer for the anesthesiology practice attends, sometimes making payment arrangements with patients. Many defendants don’t show up, which often means they lose the case and might be subject to garnishment.

Commonwealth sued retiree Ronda Grimes, 66, for $1,442 for anesthesia claims her insurance didn’t cover after a 2019 surgery, billing and legal records filed in Richmond General District Court show.

“That’s a lot of money, especially when you have health insurance,” she said.

New research by Cooper and colleagues examining court cases in Wisconsin shows that medical lawsuits are disproportionately filed against people of color and people living in low-income communities.

“Physicians are entitled to get paid like everyone else for their services,” Cooper said. But unaffordable, out-of-pocket medical costs are “a systemic issue. And this systemic issue generally falls on the backs of the most vulnerable in our population.”

For uninsured patients, Commonwealth matches any financial assistance given by the hospital and will be “enhancing” its financial assistance program in 2022, Williams said.

Two of the nine people being sued by Commonwealth and interviewed by KHN at courthouse hearings were Hispanic. Four were Black.

One was Darnetta Jefferson, 61, who underwent a double mastectomy in early 2020 and came to court wearing a cancer-survivor shirt. Commonwealth sued her for $836 it said she owed in coinsurance for anesthesia she was given during the surgery. Commonwealth’s lawyer agreed to drop the lawsuit if she agreed to pay $25 a month toward the balance until it’s paid, she said.

“If I ever have some extra money to pay it off someday, I will,” said Jefferson, who worked at Ukrop’s supermarket for many years before her cancer forced her to go on disability. “But right now, my circumstances are not looking good.”

Although she is living on a reduced income, her rent just went up again, said Jefferson, who also survived lung cancer diagnosed in 2009. Rent now runs close to $1,000 a month.

Paying Commonwealth’s bill in monthly $25 increments, she said, means “it’s going to be a long way to go.”

Jay Hancock:
jhancock@kff.org,
@JayHancock1

The post An Anesthesiology Practice’s Busy Day in Court Collecting on Surprise Bills first appeared on DAILY LEGAL PRESS.
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Colorado faculties proceed to see lowered enrollments
Thu, 23 Dec 2021 15:47:15 GMT
Colorado schools continue to see reduced enrollments

This story by Jason Gonzales was released on Chalkbeat Colorado on December 20, 2021.

Enrollment in school in Colorado is essentially flat this year, with far fewer students showing up for class now than they were before the pandemic.

School principals had hoped enrollment would recover after the severely disrupted 2020-21 school year when more than 20,000 students failed to show up in the state’s K-12 schools. But the preliminary enrollment numbers that have been communicated to the legislature show that this is not the case.

Instead, 843,264 students enrolled in Colorado public schools this year, a 0.3% year-over-year decrease, according to documents presented to lawmakers Friday during a joint budget committee hearing. More detailed information from the country’s October student census will be released in January.

State analysts assume that the mostly flat enrollment could develop into a long-term trend. Your forecasts for the next two school years now envisage a slight increase, which will be offset by a slight decrease in the following year.

The causes seem complex. Some families may have sent their children to private schools or decided to take them home school, but that is not the only reason. Government analysts cite a mix of lower birth rates, lower economic opportunities and high property prices as reasons for the low school enrollment.

Metro Denver, Southwest Mountain, San Luis Valley, Pueblo, and the Eastern Plains have seen the largest percentage drops in student numbers.

Nationwide, kindergarten attendance rose 6% that year as parents enrolled some of the 6-year-olds they had at home last year. As a result, the country expects the number of kindergartens to decline in the next year. That year, the proportion of students who did not enroll in grades 1 through 12 decreased by about 0.8%, or about 6,250 students.

With enrollments expected to increase slightly over the next school year, the state expects to send around $ 186 million to schools in the 2022-23 school year to keep inflation and school enrollment growth in line, the committee documents said. Local governments also need to cover a larger proportion of education students, an estimated $ 77 million increase.

But a lot will depend on whether the legislature offers further pandemic aid. Last year, the Democrats made sure that declines in school enrollment would not lead to less government funding for school districts.

Enrollments in the final school year fell sharply from 2019-20. Colorado school districts reported a 3.3% decrease in overall enrollment and a decrease in the number of students eligible for subsidized lunch, a measure of poverty. Both numbers have an impact on school funding.

The Democrats, who control the state legislature, could try again to prevent funding cuts due to falling schooling. However, Republicans have raised concerns about paying for students that don’t exist.

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The post Colorado faculties proceed to see lowered enrollments first appeared on Education News Colorado.
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Rural Communities Left Hurting Without a Hospital, Ambulance or Doctors Nearby
Thu, 23 Dec 2021 08:31:41 GMT


STATENVILLE, Ga. — Georgia’s Echols County, which borders Florida, could be called a health care desert.

It has no hospital, no local ambulances. A medical provider comes to treat patients at a migrant farmworker clinic but, other than a small public health department with two full-time employees, that’s about the extent of the medical care in the rural county of 4,000 people.

In an emergency, a patient must wait for an ambulance from Valdosta and be driven to a hospital there, or rely on a medical helicopter. Ambulances coming from Valdosta can take up to 20 minutes to arrive, said Bobby Walker, county commission chairman. “That’s a pretty good wait for an ambulance,” he added.

Walker tried to establish an ambulance service based in Statenville, the one-stoplight county seat in Echols, but the cost of providing one was projected at $280,000 a year. Without industry to prop up the tax base, the county couldn’t come up with that kind of money.

In many ways, Echols reflects the health care challenges faced in rural areas nationwide, such as limited insurance coverage among residents, gaps in medical services and shortages of providers.

Dr. Jacqueline Fincher, an internal medicine physician who practices in rural Thomson, in eastern Georgia, said such communities have a higher share of people 65 and older, who need extensive medical services, and a much higher incidence of poverty, including extreme poverty, than the rest of the country.

About 1 in 4 Echols residents has no health insurance, for example, and almost one-third of the children live in poverty, according to the County Health Rankings and Roadmaps program from the University of Wisconsin’s Population Health Institute.

Like Echols, several Georgia counties have no physician at all.

It’s difficult to recruit doctors to a rural area if they haven’t lived in such an environment before, said Dr. Tom Fausett, a family physician who grew up and still lives in Adel, a southern Georgia town.

About 20% of the nation lives in rural America, but only about 10% of U.S. physicians practice in such areas, according to the National Conference of State Legislatures.

And 77% of the country’s rural counties are designated as health professional shortage areas. About 4,000 additional primary care practitioners are needed to meet current rural health care needs, the Health Resources and Services Administration has estimated.

“Many physicians haven’t experienced life in a rural area,” said Dr. Samuel Church, a family medicine physician who helps train medical students and residents in the northern Georgia mountain town of Hiawassee. “Some of them thought we were Alaska or something. I assure them that Amazon delivers here.”

Rural hospitals also have trouble recruiting nurses and other medical personnel to fill job vacancies. “We’re all competing for the same nurses,” said Jay Carmichael, chief operating officer of Southwell Medical, which operates the hospital in Adel.

Even in rural areas that have physicians and hospitals, connecting a patient to a specialist can be difficult.

“When you have a trauma or cardiac patient, you don’t have a trauma or cardiac team to take care of that patient,” said Rose Keller, chief nursing officer at Appling Healthcare in Baxley, in southeastern Georgia.

Access to mental health care is also a major problem, said Dr. Zita Magloire, a family physician in Cairo, a city in southern Georgia with about 10,000 residents. “It’s almost nonexistent here.”

A map created at Georgia Tech shows wide swaths of rural counties without access to autism services, for example.

One factor behind this lack of health care providers is what rural hospital officials call the “payer mix.”

Many patients can’t pay their medical bills. The CEO of Emanuel Medical Center in Swainsboro, Damien Scott, said 37% of the hospital’s emergency room patients have no insurance.

And a large share of rural hospitals’ patients are enrolled in Medicaid or Medicare. Medicaid typically pays less than the cost of providing care, and although Medicare reimbursements are somewhat higher, they’re lower than those from private insurance.

“The problem with rural hospitals is the reimbursement mechanisms,” said Kirk Olsen, managing partner of ERH Healthcare, a company that manages four hospitals in rural Georgia.

Georgia is one of 12 states that have not expanded their Medicaid programs under the Affordable Care Act. Doing so would make additional low-income people eligible for the public insurance program. Would that help? “Absolutely,” said Olsen, echoing the comments of almost everyone interviewed during a monthslong investigation by Georgia Health News.

“If Medicaid was expanded, hospitals may become more viable,” said Dr. Joe Stubbs, an internist in Albany, Georgia. “So many people go into a hospital who can’t pay.”

Echols County isn’t the only place where ambulance service is spotty.

Ambulance crews in some rural areas have stopped operating, leaving the remaining providers to cover greater distances with limited resources, said Brock Slabach, chief operations officer of the National Rural Health Association. It’s difficult for a local government to afford the cost of the service when patient volumes in sparsely populated rural areas are very low, he said.

“If people aren’t careful, they’re going to wake up and there’s not going to be rural health care,” said Richard Stokes, chief financial officer of Taylor Regional Hospital in Hawkinsville, Georgia. “That’s my big worry.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Rural Communities Left Hurting Without a Hospital, Ambulance or Doctors Nearby https://khn.org/news/article/rural-communities-left-hurting-without-a-hospital-ambulance-or-doctors-nearby/

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Israel raises pressure for third dose of vaccine – Latest News
Sun, 03 Oct 2021 11:58:07 GMT

Israel is stepping up pressure on the third dose of the vaccine

world
October 03, 2021 – 13:47

The Israeli government is stepping up pressure on people who have been vaccinated with two doses of the coronavirus vaccine.

From Sunday (October 3) the vaccination certificate which facilitates movement and access to public life, will be valid only six months after receiving the second dose of the vaccine.

After this period people should take the third booster dose to be able to enter indoors. Israel is the first country to include the booster dose of the vaccine in the vaccination certificate.

The move is widely seen as a step towards encouraging booster vaccination.

According to figures from the Ministry of Health, more than 1 million people could be affected by the new regulation.

The certificate is required to participate in almost all areas of public life in Israel.

Everyone aged 3 and over must prove they have been vaccinated, cured of COVID-19 or tested negative if they want to visit sporting or cultural events, gyms, museums, restaurants, universities or conferences.

According to the Ministry of Health, about 61 percent of the approximately 9.4 million inhabitants have been vaccinated with two doses, while about 37 percent with a booster dose.

The precondition for the third dose is that the second vaccination was given at least five months ago.

In early September, Israel recorded more than 11,000 new infections a day, the highest number since the pandemic began.

Since then, the number has gradually decreased.

Many Israelis staged nationwide demonstrations in protest of the new measures. Opponents said it was a form of forced vaccination. / REL

The post Israel raises pressure for third dose of vaccine – Latest News first appeared on Kosovo Now.
Category: Vaccine
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Record Number of Americans Sign Up for ACA Health Insurance
Thu, 23 Dec 2021 18:50:06 GMT

A record 13.6 million Americans have signed up for health coverage for 2022 on the Affordable Care Act marketplaces, with nearly a month remaining to enroll in most states, the Biden administration announced Wednesday.

President Joe Biden’s top health advisers credited the increased government subsidies, which lowered out-of-pocket costs, for the surge in enrollment. They also said enhanced personal assistance and outreach helped connect more people to health insurance plans.

Some of the largest increases are in Florida, Texas, Georgia and nine other states that have not expanded Medicaid under the Affordable Care Act.

The previous marketplace enrollment record was 12.7 million in 2016, the final year of President Barack Obama’s administration. Enrollment largely stagnated under President Donald Trump, who cut tens of millions of dollars in funding for navigators, who help people sign up for coverage.

Open enrollment for the marketplace began Nov. 1 and ends Jan. 15.

Through Dec. 15, enrollment in Florida had soared to 2.6 million people, up from 2.1 million in the same period a year earlier.

“This is a very big deal as it means we have made a dent in the uninsured pool and we are not only insuring people but keeping people signed up,” said Jodi Ray, program director for Florida Covering Kids & Families.

Ray has used federal grants to help Floridians sign up for private coverage on the marketplace for several years. During the Trump presidency, she said, she could help only people in half the counties in the state because of funding constraints. “You cannot overlook the impact that one-on-one assistance has in getting people through the process,” Ray said.

Enrollment has jumped more in states that have not expanded Medicaid because they have more uninsured residents than expansion states. In expansion states, people with incomes from 100% to 138% of the federal poverty level — about $12,880 and $17,770 for an individual — can enroll in Medicaid. In states that haven’t expanded the program, they can get subsidies to enroll in private plans through the Affordable Care Act marketplaces.

Georgia enrollment jumped to 653,990 from about 514,000 the previous year.

“That’s the most we’ve ever had enrolled,’’ said Laura Colbert, executive director of the consumer advocacy group Georgians for a Healthy Future. She said the enrollment spike helps show that Republican Gov. Brian Kemp’s plan to scrap healthcare.gov and replace it with a privately run portal isn’t needed.

The Biden administration is reviewing that proposal.

“Hundreds of thousands of Georgians still opt to remain uninsured rather than shop on the federal platform,” Kemp spokesperson Katie Byrd said Wednesday. “This means that the one-size-fits-all approach by the federal government is not working for Georgia.”

The 13.6 million enrollment number includes people who used state-run marketplaces, in addition to those who enrolled through the federally run healthcare.gov portal that handles sign-ups for more than 30 states.

Texas’ enrollment rose to 1.7 million from 1.3 million.

Texas, Georgia and South Dakota each showed gains of at least 20%, said Chiquita Brooks-LaSure, administrator of the Centers for Medicare & Medicaid Services. None of those states has expanded Medicaid under the Affordable Care Act.

In non-expansion states, “our outreach efforts have been so robust this year,’’ Brooks-LaSure told reporters during a press call. The federal government is using four times the number of navigators, or insurance counselors, to help people sign up for insurance, said Xavier Becerra, secretary of the U.S. Department of Health and Human Services.

The big driver behind the enrollment gains is new discounts on premiums.

As part of a covid-19 relief bill passed this year, Congress increased the subsidies consumers receive when they enroll in health insurance via the marketplace. CMS said 92% of people in healthcare.gov states will get the tax credits for 2022 coverage. Becerra said that for 4 in 5 enrollees, monthly premiums cost $10 or less, which he said is “less than going to a movie.”

But conservatives chafe at the idea of higher subsidies. Brian Blase, a former Trump adviser and president of the conservative think tank Paragon Health Institute, stressed that the federal government is paying 85% of people’s monthly insurance premiums.

“People will buy something that provides them with little value if the after-subsidy price is zero or close to zero, and that’s what is generally happening here,” Blase said. “Ultimately, the big winners are the health insurance companies that are getting billions of dollars in additional government subsidies.”

Another driver of enrollment is that some people may have lost job-based coverage during the pandemic and are seeking insurance on their own.

The marketplaces also offer consumers more choices than in previous years. The average consumer now has between six and seven insurers to choose from, up from four to five in 2021, federal officials said.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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This story can be republished for free (details).

The post Record Number of Americans Sign Up for ACA Health Insurance first appeared on REALESTATE NEWS24.
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Greenworks commercial lawn care equipment
Thu, 23 Dec 2021 09:33:46 GMT
Greenworks Commercial Lawn Care Equipment

GIE 2021 was a big eye opener for us. After a year break with the rest of the world, we had 24 months of product development to catch up on. It was the perfect time for Greenworks Commercial Lawn Care Equipment to find a legitimate reason to get rid of gas equipment.


Why should you consider switching to commercial lawn care equipment from Greenworks?

If you’re a lawn care professional, you probably know the key benefits of battery-powered equipment:

Little noise Reduced emissions Less maintenance

Recently, California put a ban on the sale of many gas-powered categories, including generators and lawn care equipment, effective January 1, 2024. This could mark another move away from gasoline, but battery-powered devices were quickly gaining market share. Some municipalities, large campuses, and certain neighborhoods already prohibit the use of at least some gas appliances.

If you want to continue providing lawn care services in these areas, you will need battery powered devices. If you don’t, you may still want to add battery power to at least one crew as an option for customers who prefer to do so for one reason or another. Since there are still not many battery crews in many areas of the country, you can charge a premium for these services and be more profitable at the end of the day.

Greenworks Commercial Lawn Care Equipment: What’s Different?

Greenworks’ commercial tools are not new. The 82V line has been around for years and the 24V / 48V line is becoming more and more established. What really knocked us off our feet at GIE was the new generation of devices that are now available.

Across the board, the handheld tools are lighter and more powerful than before. The walk-behind mowers have more power and reach an equivalent of 160 cc. The ZT, stand-on and commercial vehicle ranges are making progress. even the battery has been ergonomically upgraded so that it can be charged and discharged more easily. There’s also a 6-port rolling fan-cooled charger to keep your crew in the game.


The point is, Greenworks Commercial lawn care equipment now has the tools to help you switch from gasoline to battery without sacrificing performance and completely changing the way you mow. Even if you’re not entirely sure about this whole battery-powered movement, it’s worth visiting your local Greenworks Commercial dealer to see the tools for yourself and schedule a demo.

When you’re ready to take the plunge, check out some of the deals they’re running right now. For a limited time, there are some great discounts on battery and charger tools around the price of bare tools.

Greenworks Commercial also offers discounts of up to 20% on handheld and walk-behind devices as part of its Green Fleet program.

Have you converted your professional lawn care professional or home to battery operation? Tell us about it in the comments below!

The post Greenworks commercial lawn care equipment first appeared on America's Firearms Newsource.
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Presidency of the College of Colorado
Thu, 23 Dec 2021 08:09:15 GMT
Presidency of the University of Colorado

The University of Colorado (CU) invites nominations and applications for the office of president. With a culture devoted to excellence and access, the CU seeks a president and leader with a vision to uphold the institution’s commitment to being a world class, accessible and transformative public university that provides quality, affordable education with outstanding teaching, learning, research, service and health care. Through collaboration, innovation, technology, and entrepreneurship, the CU expands the academic achievement, diversity, and economic foundation of the state of Colorado.

There are four CU locations: Boulder, Colorado Springs, Denver, and the Anschutz Medical Campus. Each campus has its own role and mission. The CU enrolls over 67,000 students, employs nearly 37,000 people, and has over 490,000 living alumni. CU plays an important role in improving the lives of individuals, businesses, and communities across the state of Colorado, across the country, and around the world.

As the general manager of the university, the next president will implement the guidelines and initiatives set by the board of directors. The President is responsible for the academic, administrative and tax affairs of the university and for compliance with all university affairs with the applicable laws and guidelines of the regents as well as the state and federal constitutions, laws and regulations. The President of the CU will take visionary, innovative leadership to meet the needs of the state and advance the university’s academic policies.

The next President of the University of Colorado will bring: extensive tax and human resource management experience and good business acumen; a high level of cultural competence and a proven commitment to the values ​​of diversity, equality, inclusion and justice; Experience leading a large, complex organization; a successful track record in fundraising and institutional and community development; a basic understanding of – and deep respect for – shared leadership and engagement among faculties; and a track record of working with and supporting local and regional communities.

Please send all nominations and applications for the best possible consideration – electronically and confidentially – to:

Shelly Weiss Storbeck, Global Education
Practice manager and managing director
Carly Rose DiGiovanni, Senior Associate
Abby Kallin, employee
CUPresident@StorbeckSearch.com
For more information, see the University of Colorado system home page at https://www.cu.edu/.

The University of Colorado does not discriminate based on race, color, national origin, gender, pregnancy, age, disability, belief, religion, sexual orientation, gender identity, gender expression, veteran status, political affiliation or political philosophy in admission and access to and treatment and Employment in its educational programs and activities. The university is taking positive action to increase ethnic, cultural and gender diversity; hire qualified people with disabilities; and to offer all students and employees equal opportunities. PRESIDENT

The post Presidency of the College of Colorado first appeared on Education News Colorado.
Category: Higher Ed
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Some schools have tightened COVID-19 policies. Colorado Mesa University has loosened them. 
Sat, 04 Sep 2021 05:33:29 GMT

Colorado Mesa University has done things differently since the start of the COVID-19 pandemic, and this academic year is no different.

Unlike many other institutions of higher education in Colorado — including the University of Colorado system, University of Northern Colorado, and Colorado State University Fort Collins — CMU is not requiring the COVID-19 vaccine for its students or staff. While CMU, a public university in Grand Junction, is encouraging its community members to get vaccinated, it wants to “honor” everyone’s individual choices.

“Our approach is not one of forced compliance, but of engagement, education and empowerment to utilize critical thinking to make informed choices,” the school’s website states. “We are recommending the COVID-19 vaccine for those in our campus community. We’re also honoring everyone’s individual choices and understand that — for a variety of reasons — some of us are not yet ready to receive a vaccination.” 

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Masks are encouraged — but not required — on campus, according to the school’s “Mindful Masking” policy. “We ask that all members of the campus community respect one another’s decision to wear or not wear a mask,” the website says

CMU recommends that students, faculty, and staff wear masks when indoors.

Mesa County, where CMU is located, is the most populous county in Colorado’s Western Slope and had Colorado’s first reported case of the more infectious delta variant, which was discovered on May 5. Representatives from the Centers for Disease Control and Prevention traveledto Mesa County earlier this year to investigate why the delta variant was spreading in the county. In August, the CDC reported on the “rapid increase” of the delta variant in Mesa County over the spring. In May the New York Timesreportedon CMU’s COVID-19 tracking system.

But while other schools in the state have begun totightenCOVID-19 protocols again, CMU has loosened them.

CMU is focusing on “protective immunity,” which it says includes people who are fully vaccinated, as well as people who have tested positive for COVID-19 previously, even if they are not vaccinated. 

“Protective immunity is different than thinking about just vaccinated or unvaccinated. It’s also an understanding of a level of protection, and we know that you can confer a level of protection in a couple of different ways, one of those being that you’ve had COVID in the past, so a natural immunity to COVID. We also know that you can confer protection by being vaccinated. So both of those things confer some level of protected immunity,” said Dr. Amy Bronson, chair of CMU’s Infectious and Communicable Disease Advisory Committee. “What we do know about that data and what the evidence is really painting a clear picture about is both the vaccine and natural levels of immunity essentially are very effective in preventing serious COVID infections, so we’re looking at hospitalizations.”

The concept of protective immunity continues to be vital to understanding our approach to campus COVID policies and protocols. Learn more at https://t.co/2haHxW7O9Z. #CMesaU pic.twitter.com/on9mMPBbV7

— Colorado Mesa University (@ColoradoMesaU) August 30, 2021

“We also understand that some of our population may come from a construct or a family that was going to keep them from wanting them to come to college if there was a mandate in place,” Bronson said. 

Not all agree with CMU’s approach.

From a scientific perspective, there are certain population level interventions that are much more effective if entire populations do them, ” said Phoebe Lostroh, an associate professor of molecular biology at Colorado College. “So vaccinations is an example of a strategy that is most effective if everyone does it, instead of just a few people doing it. And it has a much larger effect on a population where most people have opted in.”

Lostroh also provides regular COVID-19 predictions for El Paso County through the school’s COVID-19 Reporting Project. 

“That’s why we have nearly universal childhood vaccination against measles, mumps, rubella, tetanus, all these things that are routine for children who are under the age of 6,” Lostroh said. “It’s why we have routine vaccination for all dogs against rabies, instead of just some of the dogs, because in order to get rid of an infectious agent in the community, you need to have everybody vaccinated, whether you are talking about a population of dogs or a population of human beings, it doesn’t matter.” 

CMU wants to help students make good personal choices while being accountable to others on campus, Bronson said.

“Our approach is not one of forced compliance, but of engagement, education, and helping those on our campus to utilize critical thinking to make informed choices,” she said. 

“I think it is too bad that this rhetoric around individual freedom is being mobilized against vaccination and mask-wearing. I think that’s a very cynical position, and public health tells us that we have to take care of each other, and that no one is healthy so long as the highest risk people are not protected and made as healthy as possible,” said Lostroh. “The way to have a healthy population is to make sure that the most vulnerable among us have good health care, and in this case, it means we really need to have universal adoption of the vaccine.” 

These are probably some of the safest vaccines that have ever been in use, literally in human history, and so we really should be embracing them much more.

– Phoebe Lostroh, of Colorado College

“These are probably some of the safest vaccines that have ever been in use, literally in human history, and so we really should be embracing them much more,” Lostroh said, referring to COVID-19 vaccinations available in the United States. 

Testing required

Bronson said that the CMU football coach invited Bronson and Michael Reeder, a medical physician on campus, to speak with the school’s football team, whose members had arrived on campus early for their fall football camp, and they had a conversation on why CMU is promoting the vaccine, and the vaccine efficacy and safety. Bronson said many members of the team told them that they were thinking about not playing football and not continuing their academics if they were going to be told they had to get a vaccine. 

“After we took the time to listen, and to hear where they were coming from, to hear some of their fears, and to actually engage them in a conversation, 26 of our football players since returning from fall camp, decided to go and get the vaccine. It was their own autonomy and agency in making that decision, and if you think about the impact of that, that moves beyond just the pandemic,” Bronson said. 

Bronson said while there is not a vaccine mandate, CMU is encouraging students and staff to get the COVID-19 vaccine. 

Fully vaccinated students and staff at CMU are asked to voluntarily upload their vaccination records. Students and staff who have not been vaccinated but had a positive COVID-19 PCR test result last year or have a positive antibody test are asked to upload the test results and the COVID-19 response team will contact them if the students or staff are required to do any further testing. 

Staff who did not have a positive PCR result and have not been vaccinated will be part of Colorado Mesa University’s random COVID-19 testing protocols, according to the website. Students who do not have a positive PCR test result or antibody test are required to show a negative COVID-19 test 72 hours prior to moving on campus, or 72 hours prior to the start of classes for students who are not living on campus. Classes began Aug. 23. Students who do not want to be tested are required to sign a COVID-19 test waiver and will not have access to any campus facilities or campus events, according to the website

It’s unclear whether a positive COVID-19 antibody test or previously having COVID-19 offers adequate protection against a COVID-19 re-infection, especially in light of recent breakthrough infections, which occur when fully vaccinated individuals test positive for COVID-19. 

“We know from SARS-1 that the amount of immunity that they get, in terms of antibodies in their blood, fell precipitously after not a very long period of time, but that it was variable,” Lostroh said. “Some people who survived SARS-1 had antibodies for a long time, and some people had antibodies for just a short period of time. Based on that experience, we would expect that to be the case with SARS-2.” 

“There’s a lot of studies showing that getting the infection and not being vaccinated is much less protective than being vaccinated. In fact, the best thing for someone who has had COVID to do is to get the shot,” Lostroh said. 


A view of Colorado Mesa University in Grand Junction. (Courtesy of Colorado Mesa University)

Some teachers and professors are leaving academia due to COVID-19. Trish Zornio, a columnist for Newsline, left her position as a lecturer at the University of Colorado Denver due to what she considers a lack of COVID-19 protocols. Zornio said faculty were not given any information on who, or even what percentage of people, were vaccinated in their classes. When she asked university administrators about protocols, such as whether a student is uncomfortable coming to class or if a student refuses to wear a mask, Zornio said they had no guidance.

“Ultimately, at the end of the day, I didn’t think it would be an effective teaching semester and I just wasn’t willing to be a part of that,” Zornio said. 

Measles, mumps other vaccines required

“We are extremely proud that CMU allows students the opportunity to think critically about the options available to them in regards to COVID-19,” wrote Jay Shearrow, Aaron Reed, and Mahlet Mamo, members of CMU Associated Student Government in a joint statement, sent to Newsline by a representative of Barefoot PR, which acts as an extension of CMU’s communication team. “We’re proud that our university practices mindful masking to ensure that anyone who wants to wear a mask is comfortable doing so.” 

The school’s student government did not respond to requests for a phone interview.

People at CMU who have protective immunity and are exposed to a person with COVID-19 are not required to quarantine, but they are asked to take a COVID-19 test three to five days after exposure, according to the school’s website. Individuals without protective immunity are required to quarantine for 10 days after being exposed to a person with COVID-19. 

The only vaccines required for students at CMU are vaccines that the state requires Colorado college students to have, which include vaccines for the measles, mumps, and rubella. Students who are doing clinical experiences and internships with “community partners” may need to show proof of vaccination, according to the website

Colorado Mesa University is offering a vaccine clinic on campus for first doses on Sept. 8, and for second doses on Sept. 22 and 29, and Oct. 6. 

CMU’s website encourages students, faculty, and staff members who are undecided on whether to get the COVID-19 vaccine to contact Dr. Michael Reeder, the acting director of the Monfort Family Human Performance Lab, to ask additional questions.

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The post Some schools have tightened COVID-19 policies. Colorado Mesa University has loosened them.  appeared first on Colorado Newsline.

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Ducey Appoints House Chief Clerk, 3 others, as Judges | Government and politics
Sat, 02 Oct 2021 07:45:43 GMT
Ducey Appoints House Chief Clerk, 3 others, as Judges |  Government and politics

PHOENIX (AP) – Arizona Governor Doug Ducey called three people to the Maricopa County Superior Court on Friday, including the Arizona House Representative.

Jim Drake has been Chief Clerk of the House of Representatives since 2015 and was previously Deputy Secretary of State from 2009 to early 2015. From 1996 to 2009 he worked as a regular lawyer and in other staff positions for the House of Representatives.

The general manager oversees parliamentary sessions behind the scenes, gives parliamentary advice during the debates and takes care of other legal matters.

Drake holds a law degree from the California Western School of Law and a bachelor’s degree in economics from the University of Arizona.

Ashley Villaverde Halvorson and Keith Miller were also appointed judges. The three new judges replace the outgoing judges Roger E. Brodman, Connie Coin Contes and Karen A. Mullins.

Halvorson is currently a partner at Jones Skelton & Hochuli and mainly defends insurance companies in complex litigation. She also handles personal injury and wrongful death cases and has served as a pro tem judge. She earned her law degree and a bachelor’s degree in political science from Arizona State University.

Miller currently serves as a freelance attorney with the Fennemore Craig law firm, practicing on business disputes and before state and local authorities. From 2015 to 2019, he served as Assistant Attorney General in Arizona in the Office’s Federalism Department and then served in the Environmental Enforcement Department as an advisor to the Department of Environmental Quality.

The post Ducey Appoints House Chief Clerk, 3 others, as Judges | Government and politics first appeared on Arizona Daily Press.
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Deep Roots Help This Chicago Pharmacist Avoid Creating Another Drugstore Desert
Thu, 23 Dec 2021 14:46:44 GMT
Deep Roots Help This Chicago Pharmacist Avoid Creating Another Drugstore Desert

CHICAGO — Del-Kar Pharmacy in the North Lawndale neighborhood has had a front-row seat to history. Martin Luther King Jr. bought his daily newspaper there when he lived in Chicago in the late 1960s. The Black Panthers’ local headquarters was a block away, and the pharmacy shared a building with the Conservative Vice Lords, a notorious street gang whose members still check in on owner-pharmacist Edwin Muldrow today.

When King’s assassination sparked riots in Chicago in 1968, the white-owned pharmacies in the area were ransacked. Muldrow’s father went to check on the pharmacy only to be told by the Vice Lords he had nothing to worry about.

“‘Go home,’” Muldrow said they told his father. “‘We’re not gonna let anybody touch you.’”

For nearly 60 years, the small drugstore has survived by building deep roots in the community, selling medicine, food and electronics in a neighborhood largely ignored by the large drugstore chains. Del-Kar is bucking a trend that has undermined numerous other pharmacies in Chicago and other U.S. cities. Although chain pharmacies are pulling out of many urban areas, sometimes citing rioting or theft, Muldrow isn’t quitting.

“Once you respect the community, the neighborhood looks out for you,” said Muldrow, 51, who started working as a pharmacist at Del-Kar in 1992. “They know that you’re here and you’re doing something positive.”

Like other community pharmacists nationwide, Muldrow has seen private insurers steer his customers toward their own allied chain, mail-order and specialty pharmacies. Urban independent pharmacies, particularly those in low-income Black and Latino communities, have been more likely to close than chain drugstores.

And pharmacies of all kinds in these communities, chain and independent, face a tough economic situation: They often have a disproportionately high share of customers enrolled in Medicaid or Medicare, which pay lower rates than private insurance.

“There’s really no financial incentive for pharmacies to open and stay open in minority neighborhoods,” said Dima Qato, a University of Southern California pharmacy professor.

According to a recent analysis she worked on, Black and Latino neighborhoods accounted for a third of pharmacy openings in Chicago from 2015 to 2020 but more than half of closures. As a result, the prevalence of pharmacy deserts increased from 33% of majority-Black census tracts to 45% and from 9% of majority-Latino tracts to 14%.

“Pharmacies are choosing to open in areas that already have pharmacies, in part because those are also the areas that have higher incomes and insurances that provide higher pharmacy reimbursement rates,” said Jenny Guadamuz, a University of Southern California health disparities researcher who led the study.

Muldrow said insurance often pays less for a medication than it costs him to acquire it. For example, he might be reimbursed $400 for an Advair inhaler that costs him $600.

“The profession is not what it used to be,” he said. “The profitability has been snatched.”

Average dispensing fees, set by insurance plans and intended to cover Muldrow’s overhead and salary, have plummeted from about $3 per prescription 30 years ago to as little as 10 cents, he said. He once sold medical supplies like lift chairs and oxygen tanks. But since Medicare implemented new fraud safeguards requiring accreditation, he said, he would have to pay $1,500 to $2,000 a year to continue receiving Medicare reimbursement.

“Now you have elderly people in the neighborhood that can’t come and get stuff,” Muldrow said. “They have to go to the hospital. They got to go through the mail.”

Muldrow keeps his store open by supplementing the meager payments he gets for filling prescriptions with other income. “The secret to our success here is that we own the property,” Muldrow said. “If I was paying $3,000, $4,000 or more a month rent, I would have been wiped out.”

Muldrow had job offers from multiple chain drugstores when he graduated from pharmacy school but chose to work for his father. “‘The only way I can repay you for giving me the opportunity to go to school is to come down here and work and continue what you started,’” he recalled telling him.

Del-Kar Pharmacy in the North Lawndale neighborhood of Chicago is an independent Black-owned business that has been selling medicine, food and electronics for nearly 60 years. (Taylor Glascock for KHN)

Chicago has encouraged pharmacies to locate in underserved areas — with little success. Qato pointed to a CVS branch that in 2010 received nearly $1 million in incentives to open in East Garfield Park. A nearby independent drugstore quickly closed, and the CVS shut its doors several years later, creating a pharmacy desert.

Illinois launched a program in 2019 to subsidize pharmacies in underserved urban and rural areas. But, Qato said, the program doesn’t adequately target neighborhoods at risk of becoming pharmacy deserts and excludes large chain pharmacies, which may be the only drugstores remaining in a neighborhood.

A year into the program, she said, only three of 80 eligible pharmacies in Chicago have received funds. Muldrow said he hadn’t heard of the program.

Some business strategies create de facto deserts. Late last year, the health insurer Aetna, owned by CVS Health, began preventing its Medicaid patients in Illinois from filling prescriptions at Walgreens pharmacies. As a result, some patients could no longer use the closest drugstore.

Dr. Thomas Huggett, a family physician at the Lawndale Christian Health Center on the West Side of Chicago, said some of his patients had trouble getting their medications in the first month of the new policy. One patient, who was homeless and had been diagnosed with severe mental illness, couldn’t get his prescription filled. Another had to take two buses to get his injectable antipsychotic medication. A third patient couldn’t get Suboxone, a treatment for opioid addiction.

“In the middle of one of the hotter spots in the country for opioid overdoses on the West Side of Chicago, it’s hard to imagine how anybody could justify it,” Huggett said.

In urban areas, Illinois regulations require prescription insurance plans to have at least one in-network pharmacy within a 15-mile radius or a 15-minute drive of their enrollees. But that can be too far to be practical for many customers, Huggett said.

“The majority of patients who have Medicaid have Medicaid because they are poor, and they generally don’t have cars,” Huggett said. “Looking at the maps, it is just so stark to see. The CVSs are intentionally avoiding black areas of Chicago.”

CVS spokesperson Mike DeAngelis said that about half of CVS stores nationwide are in areas that rank high on the Centers for Disease Control and Prevention’s Social Vulnerability Index, which tracks poverty, lack of vehicle access and crowded housing, among other factors.

“Maintaining access to pharmacy services in underserved communities is an important factor we consider when making store closure decisions,” DeAngelis said in an email. “Other factors include local market dynamics, population shifts, a community’s store density, and ensuring there are other geographic access points to meet the needs of the community.”

James Spidle, a 66-year-old veteran with serious heart problems, walks a mile using a cane to catch a bus in the Washington Heights neighborhood, about 13 miles south of Del-Kar, to pick up his prescriptions from a Walmart.

“I do the walk back and forth as a stress test,” he said. “If I don’t have any chest pains, I keep going.”

A closer option, a Walgreens, closed in 2016. A sign on the door directed customers to another branch that was a mile away in a more affluent neighborhood and had a grocery store pharmacy across the street.

Owner and pharmacist Edwin Muldrow outside Del-Kar Pharmacy in the North Lawndale neighborhood of Chicago. Muldrow’s father opened the business in the 1960s. (Taylor Glascock for KHN)
A list of Black colleges is displayed at Del-Kar Pharmacy on Friday, Dec. 17, 2021 in the Lawndale neighborhood of Chicago, IL. The pharmacy has been independent and Black-owned since the 1960s, an increasing rarity. (Taylor Glascock for KHN)

The Endeleo Institute, the community development arm of Trinity United Church of Christ, has tried to fill the gap, using church vans to drive people to the nearest pharmacies. Melvin Thompson, its executive director, listed four other chain pharmacies that had closed within a three-mile radius of the Walgreens that shuttered in Washington Heights.

“Here we are in the midst of a pandemic, and we’re losing even more of these vital services in communities that can’t afford to lose,” he said. “It’s citywide, but it just seems to be relegated to Black and brown communities.”

Walgreens officials did not answer questions about how the company decides to close stores, but said that in metro Chicago about 99% of Chicagoans live within 2 miles of one of their stores. Walgreens spokesperson Kris Lathan said the company allocated $35 million to reopen 80 stores in Chicago damaged during the civil unrest after the murder of George Floyd in 2020.

“All but two of those locations have reopened,” she said. “The remaining two will open in the first half of 2022.”

Democratic state Rep. La Shawn Ford said pharmacy closures represent a loss of health care access for the community. “The pharmacy is not just a place to pick up medicine, it’s a surrounding of health care,” he said. “Who’s going to talk to that person when they get their medicine mail-delivered?”

It can also be a lifeline in other ways. During the pandemic, when indoor dining was shut down, Muldrow set up an outdoor grill and served burgers, tacos and other food. That showed him how much the neighborhood needed him — and for a lot more than medications. He is planning an expansion, to include a bodega with a juice bar and restaurant.

Muldrow was also reminded that the community is there for him in return. Last year, during the civil unrest, several businesses near Del-Kar were destroyed. But, in an echo of 1968, his shop emerged unscathed.

“I didn’t have any worries. I slept real good,” Muldrow said. “The brothers over here on Lawndale, they watched over me. If you know the people, the people look out for you.”

Markian Hawryluk:
MarkianH@kff.org,
@MarkianHawryluk

The post Deep Roots Help This Chicago Pharmacist Avoid Creating Another Drugstore Desert first appeared on Wolverine State Watch.
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Nigeria’s Helium Health to Acquire Qatars Meddy in Rare Africa GCC Deal – TechCrunch
Thu, 11 Nov 2021 07:16:39 GMT
Nigeria's Helium Health to Acquire Qatars Meddy in Rare Africa GCC Deal - TechCrunch

Nigeria-based health technology startup Helium Health has acquired Meddy, a Qatar-based and UAE-based doctor booking platform for an undisclosed amount.

The acquisition, Adegoke Olubusi, CEO of Helium Health, called “a great deal” on a call is unusual in that it overlaps two regions that are rare in technology: Africa and the Gulf Cooperation Council (GCC)..

Meddy CEO Haris Aghadi and COO Abed Alkarim Khattab will join the Helium leadership team as part of the agreement. You will “play an essential role in the implementation of Helium’s GCC strategy and operations”.

The takeover of Meddy by Helium Health is an important expansion step. Founded in 2016 by Olubisi, Dimeji Sofowora and Tito Ovia, the company is known in Africa for its central electronic health records (EMR) and hospital management solutions. However, since then it has evolved to offer other services under its platform, including HeliumPay, a billing and payments solution; a collateral free credit product, HeliumCredit; Patient Care and Revenue Cycle Management Service HeliumDoc; and data analysis services.

With a presence in six African countries – Nigeria, Ghana, Senegal, Liberia, Kenya and Uganda – Helium Health has signed more than 500 healthcare facilities. Over 7,000 medical professionals from these facilities now care for more than 300,000 patients a month.

Normallya corporate customer needs various services on one platform – from electronic medical records and management information systems to revenue cycle management, consolidated analyzes and telemedicine services.

However, most platforms in the GCC have use cases that are vertical rather than horizontal. Vezeeta and Okadoc, for example, help users book appointments, access teleconsultation services, and order medication; Bayzat offers an online platform for human resources management, payroll and health insurance; and Clinicy operates a digital health management system. So for Enterprise customers, to get a holistic EMR experience, have to Stack these different products on top of each other.

Although SF-based Helium Health has a wide range of B2B offers, these other areas lack particularly telemedicine and appointment bookings, which are more consumer-oriented products. The company could have grown those services, but acquiring Meddy was a better option given its expansion game. In addition to providing a doctor booking platform and a telemedicine product to manage bookings and patient reviews, Meddy also offers marketing solutions for hospitals to improve their online presence and attract new patients.

Helium health

With Meddy, the Y Combinator and Tencent-supported Helium Health can now cover a wider range of services that health groups need. Meddy will merge with the patient care provider and revenue cycle management platform of Helium Health under the name Helium Doc.

“There aren’t many people in the GCC who can offer a suite like ours. If so, they are doing it at such a high price that they have already priced the market out in that sense, ”Olubusi told TechCrunch.

“But we can offer a complete suite in which you can carry out your appointment booking, marketing solution, EMR, hospital management information system and have everything from a single source. It will save you a lot of stress trying to give it a try consolidate many different systems. “

Aghadi adds that the partnership will provide their customers with interoperability, a feature missing in other EMRs and stand-alone platforms.

Many older and new products do not have open APIs, which makes it difficult to exchange data between them. HHealthcare providers feel the brunt of this lack of interoperability when they use such platforms to Make uninformed health decisions.

“Interoperability is a very big challenge in the region, and having this central point of contact like ours solves that, ”remarked Aghadi.

While two obvious factors – capitalizing on the lack of other healthcare platforms and capitalizing on a growing opportunity in the GCC region (where digital infrastructure investments will account for 30% of healthcare investments between 2023 and 2030) – have driven this acquisition and partnership Olubisi and Aghadi point out a third, more subtle factor: the teams.

According to both founders, the Helium Health and Meddy teams are identical in terms of operations, technology execution, culture and market prices. These similarities made it easy for both companies to sign the deal in less than four months.

“In addition to the actual product and market opportunity, this was possible: Yes, really the makeup of the team, how well they implemented the fact that they share a DNA and culture that very much similar to ours, ”said Olubusi.

Meddy currently serves more than 150 private customers in the United Arab Emirates and Qatar. Backed with just $ 1.8 million in VC funding, the company has enabled over 200,000 doctor appointments and enabled healthcare providers to generate approximately $ 130 million in bills.

When the two companies come together, the next plan, according to Olubusi, is to figure out how to better serve the GCC market with its complete EMR solutions while introducing telemedicine and doctor booking services to its customers in Africa.

“Over the next few months, we will be better introducing and serving these consolidated product suites in our markets,” he said. “I mean, we want to double, triple, and grow our customer base over the next two to three years expand our reach even further to ensure that Helium Health is the leading healthcare technology provider in the GCC region only like in Africa. “

The post Nigeria’s Helium Health to Acquire Qatars Meddy in Rare Africa GCC Deal – TechCrunch first appeared on Africa Chamber News.
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African Commission issues restraining order against the death penalty in Egypt – Middle East Monitor
Thu, 11 Nov 2021 11:28:11 GMT
African Commission issues restraining order against the death penalty in Egypt - Middle East Monitor

The African Commission on Human and Peoples’ Rights today issued an injunction against Egypt ordering it to suspend the death sentences imposed on 26 detainees while examining a complaint by former senior members of the Egyptian Freedom and Justice Party (FJP) .

The FJP was the political party of the democratically elected government of Egypt, which was overthrown in a military coup in 2013.

The men, according to the legal team who filed the lawsuit, “have been convicted in mass trials that have been heavily criticized by leading international human rights organizations for serious irregularities in due process and violations of fair trial.” The charges originally brought against them “related to their participation in pro-democratic protests against the coup”.

739 people were charged, with the court sentencing 612 people to 75 death sentences, 47 life sentences and heavy prison terms ranging from five to 15 years. “Complaints about the trials included non-compliance with basic fair trial standards, hearings that involved large numbers of defendants, and failure to identify specific allegations against each of the defendants,” a statement from Bindmans LLP said.

READ: Egypt puts female political prisoners in a cell with criminals, reports ENHR

Egypt now has 15 days to confirm that the special measures will be implemented and 60 days to argue about the admissibility of the men’s complaint. Tayab Ali, a partner at Bindmans LLP, said: “The international community has ignored the serious human rights violations committed by the Egyptian authorities since the 2013 coup.

Egypt’s final stage is to silence the opposition voices through mock trials and the death penalty. These men have no access to further appointments within Egypt and will now rely entirely on the case that will be presented to the African Commission to determine their fate.

The post African Commission issues restraining order against the death penalty in Egypt – Middle East Monitor first appeared on Africa Chamber News.
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Feds expand Pell Grant program for prisoners working on college degrees
Tue, 07 Sep 2021 05:29:23 GMT

WASHINGTON — Prison inmates around the U.S. are getting the chance to do something that was almost unheard of a generation ago: pursue a college degree while behind bars and with financial support from the federal government.

Inmates in 42 states, including Colorado, and Washington, D.C., can now get federal grants to work with colleges and universities to earn trade certifications, associate’s degrees and even bachelor’s degrees. 

And the programs are expected to become even more popular, thanks to a bipartisan effort to let prisoners use federal Pell Grants to help pay for higher education classes while incarcerated. A grant expansion announced by the Biden administration — following another by the Trump administration — will bring the number of participating colleges and universities up to 200

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Todd Butler, the dean of arts and sciences at Jackson College in Michigan, says many prison officials, from wardens to guards, were skeptical when he first started teaching prisoners in 2012. 

“Corrections departments are set up for one thing, and that’s safety. That’s what they’re designed to do. (College classes) are not what they’re designed to do,” he says. “But the longer you work at a facility, the staff starts to see a change in the inmates.”

“Once you start a higher education program in a prison, the students in that program become scholars. They begin behaving differently. They see a future for themselves that they’ve never imagined before. It changes things,” Butler says. “We watch folks slowly become believers in the system.”

Pell Grants are awarded to college students on the basis of need and, unlike loans, do not have to be repaid. The maximum awardfor Pell Grants for all college students is $6,495 for the 2021-2022 award year. 

Shift in crime policy

That Second Chance Pell grants are now growing under President Joe Biden is a remarkable turnaround, considering that in 1994 it was Biden’s signature crime bill that blocked prisoners from getting Pell Grants in the first place. 

But it reflects a major shift in criminal justice policy over the last decade, as both liberals and conservatives have questioned get-tough policies on crime and have instead pushed measures to help inmates get ready for productive lives once they leave prison. 

The issue resonates with policymakers from all political backgrounds, says Margaret diZerega, the director of the Center on Sentencing and Corrections at the Vera Institute, which is providing technical assistance to help with the rollout of Second Chance Pell programs. 

“Access to post-secondary education in prison reduces recidivism rates, and people who participate in these programs are 48% less likely to return to prison,” she says. 

Second Chance Pell by the numbers

Inmates who have participated in Second Chance Pell programs: More than 22,000Black participants: More than 33%Black students on college campuses: 13%Hispanic participants: 11%Hispanic students on college campuses: 20%Non-white Second Chance Pell participants: 59%Non-white students in college overall: 48%

“Most jobs require post-secondary education. Given that 95% of people are going to be returning to our community from prison, these kinds of programs set them up to be able to pursue employment and be able to provide for themselves and their families,” diZerega adds.

More than 22,000 inmates have participated in Second Chance Pell programs since 2016, and some 7,000 of them have earned a professional certificate or academic degree. It’s not known how many of the participants continued their studies after they left prison.

The program also attracts support from people concerned about racial inequities, because more than a third of students in Second Chance Pell Programs are Black, compared to just 13% on college campuses. 

Overall, 59% of Second Chance Pell students say they are not white, compared to 48% of higher education students overall.

At the same time, though, only 11% of Second Chance Pell students say they are Hispanic, compared to 20% on traditional campuses. And white students still make up a higher percentage of students taking Pell-supported classes (41%) than their overall prison population (31%) would suggest. 

Michigan success story

Jackson College is a long-time community college that recently expanded its mission to include four-year programs. Before the 1994 ban on Pell Grants for prisoners, it had a sizable prison-based program. 

It started offering classes in state prisons again a decade ago at the request of the state’s corrections department. 

Those first classes, though, had to be paid for by prisoners and their families, a major barrier to enrollment. Butler and his team talked to 450 potential students, but only enrolled 17 in their first class.

Still, the program attracted money from philanthropies that paid for inmates’ tuition, and the program began to grow. 

When the Obama administration mulled an experimental program to extend Pell Grants to prisoners, getting around the 1994 ban, people involved in the program at Jackson College met with then-Education Secretary Arne Duncan and other Obama administration officials. 

Eventually, Jackson College became one of the first to participate in the experiment, in 2016.

The Trump administration doubled the number of institutions that could participate in the program under then-Education Secretary Betsy DeVos. And President Donald Trump signed a law that included an overhaul of the federal aid application process and the removal of the 1994 ban. 

The Biden administration is now in charge of writing rules for the Pell Grants once the ban is lifted. Those rules are expected to go into effect in July 2023.

COVID-19 hits prisons

Enrollment in Jackson College’s prison-based programs reached as high as 800 before the COVID-19 pandemic. Classes were taught at eight Michigan prisons, including a federal prison. 

The pandemic hit prisons hard, and inevitably that led to disruptions in the college instruction programs too. Many of Jackson College’s students were paroled early to reduce crowding in the facilities. 

Meanwhile, visitors were severely curtailed, and college instructors could no longer meet with their students in person. Instead, teachers had to prepare video recordings or lecture via closed-circuit TV, because students were not allowed to take the classes online.

The lack of in-person meetings also meant that the college couldn’t recruit new students, and enrollment has since dipped to around 500 students, Butler says. 

But prison officials helped keep the program running even with the difficulties.

“Our corrections partners were saying: ‘It is extremely important that we keep this education program, because (the prisoners) needed it. They need some hope. They need to keep busy. They need to keep progressing.’ We heard that, and we agreed with that,” Butler recalls.

Remote learning

The pandemic forced Jackson College and Michigan prisons to increase their reliance on technology, which has become a source of some controversy in other locations. 

Ashland University, a Christian college in Ohio, in particular, has drawn scrutiny for offering courses almost exclusively on tablets, raising questions about the quality of its instruction. 

It has become one of the biggest providers of courses under Second Chance Pell, with operations in 13 states, according to the Marshall Project. A spokesperson from Ashland University did not return a request for comment.

But for Jackson College, Butler says, technology can be as much a barrier to students learning as a tool, especially when there are no college staff to help inmates use their computers and programs. 

Ideally, Butler adds, inmates would be able to get in-person instruction but also be able to use online resources for research with their projects.

Still, Butler says he’s encouraged by the prison-based courses. 

“For many of us, this is the most rewarding work of our lives. It is completely unlike any other place you will teach,” he says. “Anyone who has ever watched or taken part in a prison graduation ceremony will leave rethinking what is possible for the incarcerated population.”

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The post Feds expand Pell Grant program for prisoners working on college degrees appeared first on Colorado Newsline.

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Rural Communities Left Hurting Without a Hospital, Ambulance or Doctors Nearby
Thu, 23 Dec 2021 16:48:20 GMT

STATENVILLE, Ga. — Georgia’s Echols County, which borders Florida, could be called a health care desert.

It has no hospital, no local ambulances. A medical provider comes to treat patients at a migrant farmworker clinic but, other than a small public health department with two full-time employees, that’s about the extent of the medical care in the rural county of 4,000 people.

In an emergency, a patient must wait for an ambulance from Valdosta and be driven to a hospital there, or rely on a medical helicopter. Ambulances coming from Valdosta can take up to 20 minutes to arrive, said Bobby Walker, county commission chairman. “That’s a pretty good wait for an ambulance,” he added.

Walker tried to establish an ambulance service based in Statenville, the one-stoplight county seat in Echols, but the cost of providing one was projected at $280,000 a year. Without industry to prop up the tax base, the county couldn’t come up with that kind of money.

In many ways, Echols reflects the health care challenges faced in rural areas nationwide, such as limited insurance coverage among residents, gaps in medical services and shortages of providers.

Dr. Jacqueline Fincher, an internal medicine physician who practices in rural Thomson, in eastern Georgia, said such communities have a higher share of people 65 and older, who need extensive medical services, and a much higher incidence of poverty, including extreme poverty, than the rest of the country.

About 1 in 4 Echols residents has no health insurance, for example, and almost one-third of the children live in poverty, according to the County Health Rankings and Roadmaps program from the University of Wisconsin’s Population Health Institute.

Like Echols, several Georgia counties have no physician at all.

It’s difficult to recruit doctors to a rural area if they haven’t lived in such an environment before, said Dr. Tom Fausett, a family physician who grew up and still lives in Adel, a southern Georgia town.

About 20% of the nation lives in rural America, but only about 10% of U.S. physicians practice in such areas, according to the National Conference of State Legislatures.

And 77% of the country’s rural counties are designated as health professional shortage areas. About 4,000 additional primary care practitioners are needed to meet current rural health care needs, the Health Resources and Services Administration has estimated.

“Many physicians haven’t experienced life in a rural area,” said Dr. Samuel Church, a family medicine physician who helps train medical students and residents in the northern Georgia mountain town of Hiawassee. “Some of them thought we were Alaska or something. I assure them that Amazon delivers here.”

Rural hospitals also have trouble recruiting nurses and other medical personnel to fill job vacancies. “We’re all competing for the same nurses,” said Jay Carmichael, chief operating officer of Southwell Medical, which operates the hospital in Adel.

Even in rural areas that have physicians and hospitals, connecting a patient to a specialist can be difficult.

“When you have a trauma or cardiac patient, you don’t have a trauma or cardiac team to take care of that patient,” said Rose Keller, chief nursing officer at Appling Healthcare in Baxley, in southeastern Georgia.

Access to mental health care is also a major problem, said Dr. Zita Magloire, a family physician in Cairo, a city in southern Georgia with about 10,000 residents. “It’s almost nonexistent here.”

Dr. Zita Magloire, a family physician in Cairo, Georgia, says access to mental health treatment for patients is a major problem in rural areas. “It’s almost nonexistent here,” she says.(Andy Miller/KHN)

A map created at Georgia Tech shows wide swaths of rural counties without access to autism services, for example.

One factor behind this lack of health care providers is what rural hospital officials call the “payer mix.”

Many patients can’t pay their medical bills. The CEO of Emanuel Medical Center in Swainsboro, Damien Scott, said 37% of the hospital’s emergency room patients have no insurance.

And a large share of rural hospitals’ patients are enrolled in Medicaid or Medicare. Medicaid typically pays less than the cost of providing care, and although Medicare reimbursements are somewhat higher, they’re lower than those from private insurance.

“The problem with rural hospitals is the reimbursement mechanisms,” said Kirk Olsen, managing partner of ERH Healthcare, a company that manages four hospitals in rural Georgia.

Georgia is one of 12 states that have not expanded their Medicaid programs under the Affordable Care Act. Doing so would make additional low-income people eligible for the public insurance program. Would that help? “Absolutely,” said Olsen, echoing the comments of almost everyone interviewed during a monthslong investigation by Georgia Health News.

“If Medicaid was expanded, hospitals may become more viable,” said Dr. Joe Stubbs, an internist in Albany, Georgia. “So many people go into a hospital who can’t pay.”

Echols County isn’t the only place where ambulance service is spotty.

Ambulance crews in some rural areas have stopped operating, leaving the remaining providers to cover greater distances with limited resources, said Brock Slabach, chief operations officer of the National Rural Health Association. It’s difficult for a local government to afford the cost of the service when patient volumes in sparsely populated rural areas are very low, he said.

“If people aren’t careful, they’re going to wake up and there’s not going to be rural health care,” said Richard Stokes, chief financial officer of Taylor Regional Hospital in Hawkinsville, Georgia. “That’s my big worry.”

Andy Miller:
amiller@kff.org,
@gahealthnews

The post Rural Communities Left Hurting Without a Hospital, Ambulance or Doctors Nearby first appeared on REALESTATE NEWS24.
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Securities Fraud Class Action Lawsuit Filed Against Desktop Metal, Inc.
Thu, 23 Dec 2021 15:22:58 GMT

CLICK HERE TO SUBMIT YOUR DESKTOP METAL LOSS

DEADLINE OF THE LEADING APPLICANT: February 22, 2022

SCHOOL LESSON: March 15, 2021 through November 15, 2021

CONTACT A LAWYER TO DISCUSS YOUR RIGHTS:
James Maro, Esq. (484) 270-1453 or Duty free (844) 887-9500 or email at [email protected]

SPECIFIED FAULT BEHAVIOR BY DESKTOP METAL
Desktop Metal produces and sells additive manufacturing solutions for engineers, designers and manufacturers. The platforms include Shop System, a cost-effective, turnkey binding-jetting platform to bring 3D metal printing to machine and contract manufacturing facilities. on February 16, 2021, Desktop Metal has acquired EnvisionTEC, Inc. and some of its affiliates (collectively “EnvisionTEC”), a provider of photopolymer 3D printing solutions for the mass production of consumer parts.

on November 8, 2021, Desktop Metal has revealed that “[o]n November 4, 2021, the Audit Committee of the Board of Directors of Desktop Metal, Inc.… engaged a third party to conduct an independent internal investigation into a whistleblower complaint regarding, among other things, manufacturing and product compliance practices and procedures relating to a Subset of its photopolymer equipment and materials at its EnvisionTec US LLC facility in Dearborn, MichiganIn addition, Desktop Metal announced that the Chief Executive Officer of EnvisionTec US LLC has resigned. Desktop Metal shares fell after the news $ 0.39, or 4% to close at $ 8.81 per share November 9, 2021.

Then, on November 15, 2021, said Desktop Metal that it will notify the US Food and Drug Administration of “compliance issues with certain shipments of EnvisionTEC’s Flexcera dental resins and its PCA4000 curing box.” After the news, Desktop Metal’s stock fell $ 1.19, or 15% to close around $ 6.83 per share November 16, 2021.

WHAT CAN I DO?
Desktop metal investors can do this no later than February 22, 2022, attempt to be appointed as lead class representative by Kessler Topaz Meltzer & Check, LLP, or other legal counsel, or may choose to do nothing and remain an absent class member. Kessler Topaz Meltzer & Check, LLP encourages Desktop Metal investors who have suffered significant losses to contact the company directly for more information.

CLICK HERE TO SIGN UP FOR THE CASE

Who can be a lead plaintiff?
A lead plaintiff is a representative party who acts on behalf of each of the class plaintiffs in the conduct of the dispute. The main plaintiff is usually the investor or small group of investors who have the greatest financial interest and who are also appropriate and typical of the proposed class of investors. The lead plaintiff selects an attorney to represent the lead plaintiff and the group, and those attorneys, if approved by the court, are lead or class plaintiffs. Your ability to participate in a recovery will not be affected by whether or not you will be the lead plaintiff.

ABOUT KESSLER TOPAZ MELTZER & CHECK, LLP
Kessler Topaz Meltzer & Check, LLP pursues class action lawsuits in state and federal courts across the country and worldwide. The company has earned a worldwide reputation for excellence and reclaimed millions of dollars for victims of corporate fraud and other corporate misconduct. All of our work is driven by a common goal: to protect investors, consumers, employees and others from fraud, abuse, misconduct and negligence by companies and trustees. Ultimately, we succeeded if the bad guys pay and you get your wealth back. The complaint in this lawsuit was not filed by Kessler Topaz Meltzer & Check, LLP. For more information on Kessler Topaz Meltzer & Check, LLP, please visit www.ktmc.com.

CONTACT:
Kessler Topas Meltzer & Check, LLP
James Maro, Jr., Esq.
280 König-von-Preußen-Strasse
Radnor, PA 19087
(844) 887-9500 (toll free)
[email protected]

SOURCE Kessler Topaz Meltzer & Check, LLP

similar links

http://www.ktmc.com

The post Securities Fraud Class Action Lawsuit Filed Against Desktop Metal, Inc. first appeared on DAILY LEGAL PRESS.
Category: Securities
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3 Bedroom House in Flagstaff – $ 595,000 |
Sat, 02 Oct 2021 08:01:59 GMT
3 Bedroom House in Flagstaff - $ 595,000 |

Beautiful Presidio House in Excellent Condition! This home has been gently inhabited as a second home and has a great open floor plan with a master in the main building, two bedrooms upstairs and a large loft. The vaulted ceilings and many windows provide plenty of natural light. You’ll love the improved finishes like hardwood floors, wrought iron railings, and beautiful granite countertops with tiled mirrors. Stay warm and cozy by the fireplace and cool off in the summer with the central air conditioning. This home also has a covered, fenced patio area and an attached 2 car garage. See it today!

The post 3 Bedroom House in Flagstaff – $ 595,000 | first appeared on Arizona Daily Press.
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Rural Communities Left Hurting Without a Hospital, Ambulance or Doctors Nearby
Thu, 23 Dec 2021 17:05:11 GMT

STATENVILLE, Ga. — Georgia’s Echols County, which borders Florida, could be called a health care desert.

It has no hospital, no local ambulances. A medical provider comes to treat patients at a migrant farmworker clinic but, other than a small public health department with two full-time employees, that’s about the extent of the medical care in the rural county of 4,000 people.

In an emergency, a patient must wait for an ambulance from Valdosta and be driven to a hospital there, or rely on a medical helicopter. Ambulances coming from Valdosta can take up to 20 minutes to arrive, said Bobby Walker, county commission chairman. “That’s a pretty good wait for an ambulance,” he added.

Walker tried to establish an ambulance service based in Statenville, the one-stoplight county seat in Echols, but the cost of providing one was projected at $280,000 a year. Without industry to prop up the tax base, the county couldn’t come up with that kind of money.

In many ways, Echols reflects the health care challenges faced in rural areas nationwide, such as limited insurance coverage among residents, gaps in medical services and shortages of providers.

Dr. Jacqueline Fincher, an internal medicine physician who practices in rural Thomson, in eastern Georgia, said such communities have a higher share of people 65 and older, who need extensive medical services, and a much higher incidence of poverty, including extreme poverty, than the rest of the country.

About 1 in 4 Echols residents has no health insurance, for example, and almost one-third of the children live in poverty, according to the County Health Rankings and Roadmaps program from the University of Wisconsin’s Population Health Institute.

Like Echols, several Georgia counties have no physician at all.

It’s difficult to recruit doctors to a rural area if they haven’t lived in such an environment before, said Dr. Tom Fausett, a family physician who grew up and still lives in Adel, a southern Georgia town.

About 20% of the nation lives in rural America, but only about 10% of U.S. physicians practice in such areas, according to the National Conference of State Legislatures.

And 77% of the country’s rural counties are designated as health professional shortage areas. About 4,000 additional primary care practitioners are needed to meet current rural health care needs, the Health Resources and Services Administration has estimated.

“Many physicians haven’t experienced life in a rural area,” said Dr. Samuel Church, a family medicine physician who helps train medical students and residents in the northern Georgia mountain town of Hiawassee. “Some of them thought we were Alaska or something. I assure them that Amazon delivers here.”

Rural hospitals also have trouble recruiting nurses and other medical personnel to fill job vacancies. “We’re all competing for the same nurses,” said Jay Carmichael, chief operating officer of Southwell Medical, which operates the hospital in Adel.

Even in rural areas that have physicians and hospitals, connecting a patient to a specialist can be difficult.

“When you have a trauma or cardiac patient, you don’t have a trauma or cardiac team to take care of that patient,” said Rose Keller, chief nursing officer at Appling Healthcare in Baxley, in southeastern Georgia.

Access to mental health care is also a major problem, said Dr. Zita Magloire, a family physician in Cairo, a city in southern Georgia with about 10,000 residents. “It’s almost nonexistent here.”

A map created at Georgia Tech shows wide swaths of rural counties without access to autism services, for example.

One factor behind this lack of health care providers is what rural hospital officials call the “payer mix.”

Many patients can’t pay their medical bills. The CEO of Emanuel Medical Center in Swainsboro, Damien Scott, said 37% of the hospital’s emergency room patients have no insurance.

And a large share of rural hospitals’ patients are enrolled in Medicaid or Medicare. Medicaid typically pays less than the cost of providing care, and although Medicare reimbursements are somewhat higher, they’re lower than those from private insurance.

“The problem with rural hospitals is the reimbursement mechanisms,” said Kirk Olsen, managing partner of ERH Healthcare, a company that manages four hospitals in rural Georgia.

Georgia is one of 12 states that have not expanded their Medicaid programs under the Affordable Care Act. Doing so would make additional low-income people eligible for the public insurance program. Would that help? “Absolutely,” said Olsen, echoing the comments of almost everyone interviewed during a monthslong investigation by Georgia Health News.

“If Medicaid was expanded, hospitals may become more viable,” said Dr. Joe Stubbs, an internist in Albany, Georgia. “So many people go into a hospital who can’t pay.”

Echols County isn’t the only place where ambulance service is spotty.

Ambulance crews in some rural areas have stopped operating, leaving the remaining providers to cover greater distances with limited resources, said Brock Slabach, chief operations officer of the National Rural Health Association. It’s difficult for a local government to afford the cost of the service when patient volumes in sparsely populated rural areas are very low, he said.

“If people aren’t careful, they’re going to wake up and there’s not going to be rural health care,” said Richard Stokes, chief financial officer of Taylor Regional Hospital in Hawkinsville, Georgia. “That’s my big worry.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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The post Rural Communities Left Hurting Without a Hospital, Ambulance or Doctors Nearby first appeared on DAILYZ HEALTH NEWS.
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As Patients Fell Ill With Covid Inside Hospitals, Government Oversight Fell Short
Thu, 23 Dec 2021 19:07:37 GMT
As Patients Fell Ill With Covid Inside Hospitals, Government Oversight Fell Short


One by one, the nurses taking care of actress Judi Evans at Riverside Community Hospital kept calling out sick.

Patients were coughing as staffers wheeled the maskless soap opera star around the California hospital while treating her for injuries from a horseback fall in May 2020, Evans said.

She remembered they took her to a room to remove blood from her compressed lung where another maskless patient was also getting his lung drained. He was crying out that he didn’t want to die of covid.

No one had told her to wear a mask, she said. “It didn’t cross my mind, as I’m in a hospital where you’re supposed to be safe.”

Then, about a week into her hospital stay, she tested positive for covid-19. It left the 57-year-old hospitalized for a month, staring down more than $1 million in bills for treatment costs and suffering from debilitating long-haul symptoms, she said.

Hospitals, like Riverside, with high rates of covid patients who didn’t have the diagnosis when they were admitted have rarely been held accountable due to multiple gaps in government oversight, a KHN investigation has found.

While a federal reporting system closely tracks hospital-acquired infections for MRSA and other bugs, it doesn’t publicly report covid caught in individual hospitals.

Medicare officials, tapped by Congress decades ago to ensure quality care in hospitals, also discovered a gaping hole in their authority as covid spread through the nation. They could not force private accreditors — which almost 90% of hospitals pay for oversight — to do targeted infection-control inspections. That means Riverside and nearly 4,200 other hospitals did not receive those specific covid-focused inspections, according to a government watchdog report, even though Medicare asked accreditors to do them in March 2020.

Seema Verma, former chief of Medicare and Medicaid under President Donald Trump, said government inspectors went into nearly every nursing home last year. That the same couldn’t be done for hospitals reveals a problem. “We didn’t have the authority,” she told KHN. “This is something to be corrected.”

KHN previously reported that at least 10,000 patients nationwide were diagnosed with covid in hospitals last year after being admitted for something else — a sure undercount of the infection’s spread inside hospitals, since that data analysis primarily includes Medicare patients 65 and older.

Nationally, 1.7% of Medicare inpatients were documented as having covid diagnosed after being admitted for another condition, according to data from April through September 2020 that hospitals reported to Medicare. CDIMD, a Nashville-based consulting and data analytics company, analyzed the data for KHN.

At Riverside Community Hospital, 4% of the covid Medicare patients were diagnosed after admission — more than double the national average. At 38 other hospitals, that rate was 5% or higher. All those hospitals are approved by private accreditors, and 29 of them hold “The Gold Seal of Approval” from their accreditor.

To be sure, the data has limitations: It represents a difficult time in the pandemic, when protective gear and tests were scarce and vaccines were not yet available. And it could include community-acquired cases that were slow to show up. But hospital-employed medical coders decide whether a case of covid was present on admission based on doctors’ notes, and are trained to query doctors if it’s unclear. Some institutions fared better than others — while the American public was left in the dark.

Spurred by serious complaints, federal inspectors found infection-control issues in few of those 38 hospitals last year. In Michigan, inspectors reported that one hospital “failed to provide and maintain a sanitary environment resulting in the potential for the spread of infectious disease to 151 served by the facility.” In Rhode Island, inspectors found a hospital “​​failed to have an effective hospital-wide program for the surveillance and prevention” of covid.

KHN was able to find federal inspection reports documenting infection-control issues for eight of those 38 hospitals. The other 30 hospitals around the country, from Alabama to Arizona, had no publicly available federal records of infection-control problems in 2020.

KHN found that even when state inspectors in California assessed hospitals with high rates of covid diagnosed after admission, they identified few shortcomings.

“The American public thinks someone is watching over them,” said Lisa McGiffert, co-founder of the Patient Safety Action Network, an advocacy group. “Generally they think someone’s in charge and going to make sure bad things don’t happen. Our oversight system in our country is so broken and so untrustworthy.”

The data shows that the problem has deadly consequences: About a fifth of the Medicare covid patients who were diagnosed after admission died. And it was costly as well. In California alone, the total hospital charges for such patients from April through December last year was over $845 million, according to an analysis done for KHN by the California Department of Health Care Access and Information.

The Centers for Disease Control and Prevention has pledged funding for increased infection-control efforts — but that money is not focused on tracking covid’s spread in hospitals. Instead, it will spend $2.1 billion partly to support an existing tracking system for hospital-acquired pathogens such as MRSA and C. diff.

The CDC does not currently track hospital-acquired covid, nor does it plan to do so with the additional funding. That tracking is done by another part of the U.S. Department of Health and Human Services, according to Dr. Arjun Srinivasan, associate director for the CDC’s health care-associated infection-prevention programs. But it’s not made public on a hospital-by-hospital basis. HHS officials did not respond to questions.

The Scene at Riverside

In March 2020, Evans was alarmed by nonstop TV footage of covid deaths, so she and her husband locked down. They hadn’t been going out much, anyway, since losing their only child at the end of 2019 to another public health crisis — fentanyl.

At the time, concerns about covid were mounting among the staff at Riverside Community Hospital, a for-profit HCA Healthcare facility.

The hospital’s highly protective N95 masks had been pulled off the supply room shelves and put in a central office, according to Monique Hernandez, a shop steward for her union, Service Employees International Union Local 121RN. Only nurses who had patients getting aerosol-generating procedures such as intubation — which were believed at the time to spread the virus — could get one, she said.

She said that practice left the nurses on her unit with a difficult choice: either say you had a patient undergoing such procedures or risk getting sick.

Nurse unions were early adopters of the notion — now widely accepted — that covid is spread by minuscule particles that can linger in the air. Studies since have matched the genetic fingerprint of the virus to show that covid has spread among workers or patients wearing surgical masks instead of more protective masks like N95s.

On April 22, 2020, Hernandez and other nurses joined a silent protest outside the hospital where they held up signs saying “PPE Over Profit.” By that time, the hospital had several staff clusters of infection, according to Hernandez, and she was tired of caregivers being at risk.

In a statement, Riverside spokesperson David Maxfield said the hospital’s top priority has been to protect staff “so they can best care for our patients.”

“Any suggestion otherwise ignores the extensive work, planning and training we have done to ensure the delivery of high-quality care during this pandemic,” he said.

In mid-May, Judi Evans’ husband coaxed her into going horseback riding — one of the few things that brought her joy after her son’s death. On her second day back in the saddle, she was thrown from her horse. She broke her collarbone and seven ribs, and her lung was compressed. She was taken to Riverside Community Hospital.

There, many of her nurses wore masks they had previously used, Evans recalled. Other staffers came in without any masks at all, she said. A few days in, she said, one of the doctors told her it’s crazy that the hospital was testing her for MRSA and other hospital infections but not covid.

Maxfield said that the hospital began enforcing a universal mask mandate for staff and visitors on March 31, 2020, and, “in line with CDC, patients were and are advised to wear masks when outside their room if tolerated.” He stressed “safety of our patients and colleagues has been our top priority.”

After about a week in the hospital, Evans said, she spiked a fever and begged for a covid test. It was positive. There is no way to know for certain where or how she got infected but she believes it was at Riverside. Covid infections can take two to 14 days from exposure to show symptoms like a fever, with the average being four to five days. According to CDC guidance, infection onset that occurs two days or more after admission could be “hospital-associated.”

Doctors told her they might have to amputate her legs when they began to swell uncontrollably, she said.

“It was like being in a horror film — one of those where everything that could go wrong does go wrong,” Evans said.

She left with over $1 million in bills from a month-long stay — and her legs, thankfully. She said she still suffers from long-covid symptoms and is haunted by the screams of fellow patients in the covid ward.

By the end of that year, Riverside Community Hospital would report that 58 of its 1,649 covid patients were diagnosed with the virus after admission, according to state data that covers all payers from April to December.

That’s nearly three times as high as the California average for covid cases not present on admission, according to the analysis for KHN by California health data officials.

“Based on contact tracing, outlined by the CDC and other infectious disease experts, there is no evidence to suggest the risk of transmission at our hospital is different than what you would find at other hospitals,” Maxfield said.

A lawsuit filed in August by the SEIU-United Healthcare Workers West on behalf of the daughter of a hospital lab assistant who died of covid and other hospital staffers says the hospital forced employees to work without adequate protective gear and while sick and “highly contagious.”

The hospital “created an unnecessarily dangerous work environment,” the lawsuit claims, “which in turn has created dangerous conditions for patients” and a “public nuisance.”

Attorneys for Riverside Community Hospital are fighting the ongoing lawsuit. “This lawsuit is an attempt for the union to gain publicity, and we have filed a motion to end it,” said Maxfield, the hospital spokesperson.

The hospital’s lawyers have said the plaintiffs got covid during a spike in local cases and are only speculating that they contracted the virus at the hospital, according to records filed in Riverside County Superior Court.

They also said in legal filings that the court should not step into the place of “government agencies who oversee healthcare and workplace safety” and “handled the response to the pandemic.”

‘A Shortcoming in the Oversight System’

Decades ago, Congress tasked Medicare with ensuring safe, quality care in U.S. hospitals by building in routine government inspections. However, hospitals can opt to pay up to tens of thousands of dollars per year to nongovernmental accreditors entrusted by CMS to certify the hospitals as safe. So 90% do just that.

But these accrediting agencies — including the Joint Commission, which certified Riverside — are private organizations. Thus they are not required to follow CMS’ directives, including the request in a March 20 memo urging the accrediting agencies to execute targeted infection-control surveys aimed at preparing hospitals for covid’s onslaught.

And so they didn’t send staffers to survey hospitals for the specialized infection-control inspections in 2020, according to a June 2021 Health and Human Services Office of the Inspector General report.

Riverside, despite allegations of lax practices, holds The Gold Seal of Approval from the Joint Commission, which last inspected the hospital on-site in May 2018 before going in on Nov. 19 this year.

The inspector general’s office urged CMS to pursue the authority to require special surveys in a health emergency — lest it lose control of its mission to keep hospitals safe.

“CMS could not ensure that accredited hospitals would continue to provide quality care and operate safely during the COVID-19 emergency,” and could not ensure it going forward, the report said.

“We’re telling CMS to do their job,” the report’s author, Assistant Regional Inspector General Calvin Jones, said in an interview. “The covid experience really showed a shortcoming in the oversight system.”

CMS spokesperson Raymond Thorn said the agency agrees with the report’s recommendation and will work on a regulation after the public health emergency ends.

Accrediting agencies, however, pushed back on the inspector general’s findings. Among them: DNV Healthcare USA Inc. Its director of accreditation, Troy McCann, said there was not a gap in oversight. Although he said travel restrictions limited accreditors ability to fly across state lines, his group continued its annual reviews after May 2020 and incorporated the special focus on infection control into them. “We have a strong emphasis, always, on safety, infection control and emergency preparedness, which has left our hospitals stronger,” McCann said.

Angela FitzSimmons, spokesperson for the Accreditation Commission for Health Care, said that the accrediting organization’s surveys typically focus on infection control, and the group worked during the pandemic to prioritize hospitals with prior issues in the area of infection prevention.

“We did not deem it necessary to add random surveys that would occur at a cost to the hospital without just cause,” FitzSimmons said.

Maureen Lyons, a spokesperson for the Joint Commission, told KHN that, after evaluating CMS guidance, the nonprofit group decided it would incorporate the infection-control surveys into its surveys done every three years and, in the meantime, provide hospitals with the latest federal guidance on covid.

“Hospitals were operating in extremis. Thus, we collaborated closely with CMS to determine optimal strategies during this time of emergency,” she said.

The Joint Commission cited safety issues for its inspectors, who travel to the hospitals and need proper protective equipment that was running low at the time, as part of the reason for its decision.

Verma, the CMS administrator at the time, pushed back on accreditors’ travel safety concerns, saying that “narrative doesn’t quite fit because the state and CMS surveyors were going into nursing homes.”

Though Verma cautioned that hospitals were overwhelmed by the crush of covid patients, “doing these inspections may have helped hospitals bolster their infection-control practices,” she said. “Without these surveys, we really have no way of knowing.”

‘Immediate Jeopardy’

Medicare inspectors can go into a privately accredited hospital after they get a serious complaint. They found alarming circumstances when they visited some of the hospitals with high rates of covid diagnosed after a patient was admitted for another concern last year.

At Levindale Hebrew Geriatric Center and Hospital in Baltimore, the July 2020 inspection report says “systemic failures left the hospital and all of its patients, staff, and visitors vulnerable to harm and possible death from COVID-19.”

In response, hospital spokesperson Sharon Boston said that “we have seen a large decrease in the spread of the virus at Levindale.”

Inspectors had declared a state of “immediate jeopardy” after they investigated a complaint and discovered an outbreak that began in April and continued through the beginning of July, with more than 120 patients and employees infected with covid. And in a unit for those with Alzheimer’s and other conditions, 20% of the 55 patients who had covid died.

The hospital moved patients whose roommates tested positive for covid to other shared rooms, “potentially exposing their new roommate,” the inspection report said. Boston said that was an “isolated” incident and the situation was corrected the next day, with new policies put in place.

The Medicare data analyzed exclusively for KHN shows that 52 of Levindale’s 64 covid hospital patients, or 81%, were diagnosed with covid after admission from April to September 2020. Boston cited different numbers over a different time period: Of 67 covid patients, 64 had what she called “hospital-acquired” covid from March to June 2020. That would be nearly 96%.

The hospital shares space with a nursing home, though, so KHN did not group it with the general short-term acute-care hospitals as part of the analysis. Levindale’s last Joint Commission on-site survey was in December 2018, resulting in The Gold Seal of Approval. It had not had its once-every-three-years survey as of Dec. 10, 2021, according to the Joint Commission’s tracking.

Boston said Levindale “quickly addressed” the issues that Medicare inspectors cited, increasing patient testing and more recently mandating staff vaccines. Since December 2020, Boston said, the facility has not had a covid patient die.

At the state level, hospital inspectors in California found few problems to cite even at hospitals where 5% or more patients were diagnosed with covid after they were admitted for another concern. Fifty-three complaints about such hospitals went to the Department of Public Health from April until the end of 2020. Only three of those complaints resulted in a finding of deficiency that facility was expected to fix.

CDPH did not respond to requests for comment.

A New Chapter

Things are better now at Riverside Community Hospital, Hernandez said. She is pleased with the current safety practices, including more protective gear and HEPA filters for covid patients’ rooms. For Hernandez, though, it all comes too late now.

“We laugh at it,” she said, “but it hurts your soul.”

Evans said she was able to negotiate her $1 million-plus hospital bills down to roughly $70,000.

Her covid aftereffects have been ongoing — she said she stopped gasping for air and reaching for her at-home oxygen tank only a few months ago. She still hasn’t been able to return to work full time, she said.

For the past year, her husband would wake up in the middle of the night to check whether her oxygen levels were dipping. Terrified of losing her, he’d slip an oxygen mask on her face, she said.

“I would walk 1,000 miles to go to another hospital,” Evans said, if she could do it all over again. “I would never step foot in that hospital again.”

Methodology

KHN requested custom analyses of Medicare, California and Florida inpatient hospital data to examine the number of covid-19 cases diagnosed after a patient’s admission.

The Medicare and Medicare Advantage data, which includes patients who are 65 and older, is from the Centers for Medicare & Medicaid Services’ Medicare Provider Analysis and Review (MedPAR) file and was analyzed by CDIMD, a Nashville-based medical code consulting and data analytics firm. The data is from April 1 through Sept. 30, 2020. The data for the fourth quarter of 2020 was not yet available.

The data shows the number of inpatient Medicare hospital stays in the U.S., including the number of people diagnosed with covid-19 and the number of admissions for which the covid diagnosis was not “present on admission.” CMS considers some medical conditions that are not “present on admission” to be hospital-acquired, according to the agency. The data is for general acute-care hospitals, which may include a psychiatric floor, and not for other hospitals such as those in the Department of Veterans Affairs system or stand-alone psychiatric hospitals.

KHN requested a similar analysis from California’s Department of Health Care Access and Information of its hospital inpatient data. That data was from April 1 through Dec. 31, 2020, and covered patients of all ages and payer types and, in general, private psychiatric and long-term acute-care hospitals. Etienne Pracht, a University of South Florida researcher, provided the number of Florida covid patients who did not have the virus upon hospital admission for all ages and payer types at general and psychiatric hospitals from April 1 through Dec. 31, 2020. KHN subtracted the number of Medicare patients in the MedPAR data from the Florida and California datasets so they would not be counted twice.

To calculate the rate of hospitalized Medicare patients who tested positive for covid — and died — KHN relied on the MedPAR data for April through September. That data includes records for 6,629 seniors, 1,409 of whom, or 21%, died. California data for all ages and payer types from April through December shows a similar rate: Of 2,115 diagnosed with covid-19 after hospital admission, 435, or 21%, died. The MedPAR data was also used to calculate the national rate of 1.7%, with 6,629 of 394,939 covid patients diagnosed with the virus whose infections were deemed not present on admission, according to the CDIMD analysis of data that hospitals report to Medicare. It was also used to calculate which entities licensed as short-term acute care hospitals had 5% or more of their covid cases diagnosed within the hospital. As stated in the story, Levindale Hebrew Geriatric Center and Hospital in Baltimore was not included in that list of 38 because it shares space with a nursing home and had fewer than 500 total discharges.

Data that hospitals submit to Medicare on whether an inpatient hospital diagnosis was “present on admission” is used by Medicare for payment determinations and is intended to incentivize hospitals to prevent infections during hospital care. The federal Agency for Healthcare Research and Quality also uses the data to “assist in identifying quality of care issues.”

Whether covid-19 is acquired in a hospital or in the community is measured in different ways. Some nations assume the virus is hospital-acquired if it is diagnosed seven or more days after admission, while U.S. data counts cases only after 14 days.

Hospitals’ medical coders who examined patient records for the data analyzed for this KHN report focus on each physician’s admission, progress and discharge notes to determine whether covid was “present on admission.” They do not have a set number of days they look for and are trained to query physicians if the case is unclear, according to Sue Bowman, senior director of coding policy and compliance at the American Health Information Management Association.

KHN tallied the cases in which covid-19 was logged in the data as not “present on admission” to the hospital. Some covid cases are coded as “U” for having insufficient documentation to make a determination. Since Medicare and AHRQ consider the “U” to be an “N” (or not present on admission) for the purposes of payment decisions and quality indicators, KHN chose to count those cases in the grand total.

In 409 of 6,629 Medicare cases and in 70 of 2,185 California cases, the “present on admission” indicator was “U.” The Florida data did not include patients whose “present on admission” indicator was “U.” Medical coders have another code, “W,” for “clinically undetermined” cases, which consider a condition present on admission for billing or quality measures. Medical coders use the “U” (leaning toward “not present on admission”) and “W” (leaning toward “present on admission”) when there is some uncertainty about the case. KHN did not count “W” cases.

The Medicare MedPAR data includes about 2,500 U.S. hospitals that had at least a dozen covid-19 cases from April through September 2020. Of those, 1,070 reported no cases of covid diagnosed after admission for other conditions in the Medicare records. Data was suppressed due to privacy reasons for about 1,300 hospitals that had between one and 11 of such covid cases. There were 126 hospitals reporting 12 or more cases of covid that were “not present on admission” or unknown. For those, we divided the number of cases diagnosed after admission by the total number of patients with covid to arrive at the rate, as is standard in health care.

Inspection and Accreditation Analysis

To evaluate which of the 38 hospitals detailed above had federal inspection reports documenting infection-control issues, KHN searched CMS’ publicly available “2567” reports, which detail deficiencies for each hospital for 2020. For surveys listed online as “not available,” KHN requested and obtained them from CMS. KHN further asked CMS to double-check the remaining hospitals for any inspection reports that weren’t posted online. KHN also checked the Association of Health Care Journalists’ database http://www.hospitalinspections.org/ for each of the 38 hospitals for any additional reports, as well as CMS’ Quality, Certification and Oversight Reports site.

To check that each of these hospitals was accredited, KHN looked up each hospital using a site run by the Joint Commission and reached out to the accreditors DNV Healthcare USA Inc. and the Accreditation Commission for Health Care.

To tabulate infection-control complaints for hospitals at the state level in California, KHN used data available through the California Department of Public Health’s Cal Health Find Database. KHN searched the database for the hospitals that had higher than 5% of covid patients being diagnosed after admission, according to the California data, and tallied all complaints and deficiencies found involving infection control from April to December 2020.

The post As Patients Fell Ill With Covid Inside Hospitals, Government Oversight Fell Short first appeared on America's Firearms Newsource.
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Strong winds force partial closures on I-25, I-80 in Wyoming; Snow storms possible with snow expected Thursday
Thu, 23 Dec 2021 19:07:53 GMT
Strong winds force partial closures on I-25, I-80 in Wyoming;  Snow storms possible with snow expected Thursday

I-80 Halleck Ridge (WYDOT)

CASPER, Wyo – Both Interstate 25 and I-80 will be partially closed on Thursday at 11:50 am in high winds.

I-25 is closed to light, high-profile vehicles from Cheyenne to Wheatland, according to the Wyoming Department of Transportation. I-80 is closed to light, high-profile vehicles from Laramie to Elk Mountain. WYDOT sensors indicate gusts of wind of up to 60 miles per hour in some areas.

With a snowstorm expected to arrive in Wyoming on Thursday afternoon, more far-reaching effects on travel are expected in Wyoming.

Some areas could experience blizzards with expected snow and strong winds.

5-15 inches are expected in southwest Wyoming “with the highest totals west of a line from Fort Bridger to Lonetree” by 5 a.m. on Christmas Day, according to the National Weather Service in Salt Lake City. With 55 mph gusts of wind, “near-blizzard conditions” are possible late Thursday afternoon through evening.

“The heaviest snowfall time is expected tonight through Friday morning and could affect the main holiday season,” said the NWS in Salt Lake.

According to the National Weather Service in Cheyenne, 3-7 inches of snow and gusts of wind of up to 65 miles per hour are expected in central Carbon Counties, including Rawlins and Sinclair, and the northern foothills of the Snowy Range, including Arlington and Elk Mountain. Blizzard terms are possible. The snow is expected by Friday afternoon.

WYDOT shared the following map showing the forecast travel impact for Thursday:

The NWS at Riverton provides the following overview of the expected impact of the storm across the area by Christmas Day:

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When the Eye on Older Sufferers Is a Digital camera
Tue, 23 Nov 2021 10:56:06 GMT

In the middle of a rainy Michigan night, 88-year-old Dian Wurdock walked out the front door of her son’s home in Grand Rapids, barefoot and coatless. Her destination was unknown even to herself.

Wurdock was several years into a dementia diagnosis that turned out to be Alzheimer’s disease. By luck, her son woke up and found her before she stepped too far down the street. As the Alzheimer’s progressed, so did her wandering and with it, her children’s anxiety.

“I was losing it,” said her daughter, Deb Weathers-Jablonski. “I needed to keep her safe, especially at night.”

Weathers-Jablonski installed a monitoring system with nine motion sensors around the house — in her mother’s bedroom, the hallway, kitchen, living room, dining room and bathroom and near three doors that led outside. They connected to an app on her phone, which sent activity alerts and provided a log of her mother’s movements.

“When I went to bed at night, I didn’t have to guess what she was doing,” Weathers-Jablonski said. “I was actually able to get some sleep.”

New monitoring technology is helping family caregivers manage the relentless task of looking out for older adults with cognitive decline. Setting up an extensive monitoring system can be expensive — Weathers-Jablonski’s system from People Power Co. costs $299 for the hardware and $40 a month for use of the app. With scores of companies selling such gear, including SentryTell and Caregiver Smart Solutions, they are readily available to people who can pay out-of-pocket.

But that’s not an option for everyone. While the technology is in line with President Joe Biden’s plan to direct billions of dollars toward helping older and disabled Americans live more independently at home, the costs of such systems aren’t always covered by private insurers and rarely by Medicare or Medicaid.

Monitoring also raises ethical questions about privacy and quality of care. Still, the systems make it possible for many older people to stay in their home, which can cost them far less than institutional care. Living at home is what most people prefer, especially in light of the toll the covid-19 pandemic took on nursing homes.

Technology could help fill a huge gap in home care for the elderly. Paid caregivers are in short supply to meet the needs of the aging population, which is expected to more than double in coming decades. The shortage is fueled by low pay, meager benefits and high rates of burnout.

And for the nearly 1 in 5 U.S adults who are caregivers to a family member or friend over age 50, the gadgets have made a hard job just a little easier.

Passive surveillance systems are replacing the “I’ve fallen and I can’t get up” medical alert buttons. Using artificial intelligence, the new devices can automatically detect something is wrong and make an emergency call unasked. They also can monitor pill dispensers and kitchen appliances using motion sensors, like EllieGrid and WallFlower. Some systems include wearable watches for fall detection, such as QMedic, or can track GPS location, like SmartSole’s shoe insoles. Others are video cameras that record. People use surveillance systems like Ring inside the home.

Some caregivers may be tempted to use technology to replace care, as researchers in England found in a recent study. A participant who had visited his father every weekend began visiting less often after his dad started wearing a fall detector around his wrist. Another participant believed her father was active around the house, as evidenced by activity sensor data. She later realized the app was showing not her father’s movement, but his dog’s. The monitoring system picked up the dog’s movements in the living room and logged it as activity.

Technology isn’t a substitute for face-to-face interaction, stressed Crista Barnett Nelson, executive director of Senior Advocacy Services, a nonprofit group that helps older adults and their families in the North Bay area outside San Francisco. “You can’t tell if someone has soiled their briefs with a camera. You can’t tell if they’re in pain, or if they just need an interaction,” she said.

In some instances, people being monitored changed their habits in response to technology. Clara Berridge, a professor of social work at the University of Washington who studies the use of technology in elder care, interviewed a woman who stopped her usual practice of falling asleep on the recliner because the technology would falsely alert her family that something was wrong based on inactivity deemed abnormal by the system. Another senior reported rushing in the bathroom for fear an alert would go out if they took too long.

The technology presents another worry for those being monitored. “A caregiver is generally going to be really concerned about safety. Older adults are often very concerned about safety too, but they may also weigh privacy really heavily, or their sense of identity or dignity,” Berridge said.

Charles Vergos, 92 and living in Las Vegas, is uncomfortable with video cameras in his house and wasn’t interested in wearing gadgets. But he liked the idea that someone would know if something went wrong while he was alone. His niece, who lives in Palo Alto, California, suggested Vergos install a home sensor system so she could monitor him from afar.

“The first question I asked is, does it take pictures?” Vergos recalled. Because the sensors don’t have a video component, he was fine with them. “Actually, after you have them in the house for a while, you don’t even think about it,” Vergos said.

The sensors also have made conversations with his niece more convenient for him. She knows he likes to talk on the phone while he’s in his chair in the den, so she’ll check his activity on her iPad to determine whether it’s a good time to call.

People making audio and video recordings must abide by state privacy laws, which typically require the consent of the person being recorded. It’s not as clear, however, if consent is needed to collect the activity data that sensors gather. That falls into a gray area of the law, similar to data collected through internet browsing.

Then there is the problem of how to pay for it all. Medicaid, the federal-state health program for low-income people, does cover some passive monitoring for home care, but it’s not clear how many states have opted to pay for such service.

Some seniors also lack access to robust internet broadband, putting much of the more sophisticated technology out of reach, noted Karen Lincoln, founder of Advocates for African American Elders at the University of Southern California.

The relief monitoring devices bring caregivers may be the most compelling reason for their use. Delaine Whitehead, who lives in Orange County, California, started taking medication for anxiety about a year after her husband, Walt, was diagnosed with Alzheimer’s.

Like Weathers-Jablonski, Whitehead sought technology to help, finding peace of mind in sensors installed on the toilets in her home.

Her husband often flushed too many times, causing the toilets to overflow. Before Whitehead installed the sensors in 2019, Walt had caused $8,000 worth of water damage in their bathroom. With the sensors, Whitehead received an alert on her phone when the water got too high.

“It did ease up a lot of my stress,” she said.

Sofie Kodner is a writer with the Investigative Reporting Program at the University of California-Berkeley Graduate School of Journalism. The IRP reported this story through a grant from The SCAN Foundation.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Alpine Aesthetic: Appear like a professional with the debut ASPENX gear from Aspen Snowmass
Thu, 23 Dec 2021 19:51:30 GMT
Alpine Aesthetic: Look like a pro with the debut ASPENX gear from Aspen Snowmass

The liner of the ASPENX Ajax jacket exhibits a topographical interpretation of Aspen, designed by Paula Crown.
Courtesy of ASPENX

Some skiers swear by “You are solely pretty much as good as your gear” and now you may actually appear to be a professional with the Aspen Snowboarding Firm’s entry into the clothes enterprise for the winter season 2021/22 – considered one of many initiatives that their 75th 12 months Have fun anniversary.

As the primary ski resort operator to create their very own customized kits, the brand new ASPENX label is an umbrella model idea that features the official Aspen Snowmass uniforms for ski slopes, customer support brokers and on-mountain instructors – with the introduction of a devoted line for visitors.

“After listening to worker suggestions on their wants, we knew we may use their experience to develop an attire system for the 4 mountains of Aspen Snowmass,” mentioned Erin Sprague, chief model officer, Aspen Snowmass Rationalization. “These items have been impressed and designed by a few of the finest and most skilled professionals within the ski trade and examined in iconic settings, from the Highland Bowl to the Buttermilk Superpipe. Our visitors (instructors) typically ask about their gear, so we launched the primary ASPENX Ajax Line to supply our loyal Aspen Snowmass skiers and skiers a model of our skilled items. ”

The Ajax line presents operate and magnificence of their basic all-black ski swimsuit: the Ajax jacket ($ 725), insulation ($ 395), and pants ($ 525). Each bit is “function constructed” with a breathable, waterproof exterior and presents superior air flow and lasting safety in all winter climate situations. And the liner of the jacket encompasses a topographical interpretation of Aspen by artist and entrepreneur Paula Crown of the Crown household, homeowners of Skico and The Little Nell Resort Group.

ASPENX particulars.
Courtesy of ASPENX

ASPENX details.  |  Courtesy of ASPENX

ASPENX has additionally partnered with Anon of Burlington, Vt. Because the official helmet and goggle companion for Aspen Snowmass.
Courtesy of ASPENX

ASPENX has also partnered with Anon of Burlington, Vt. As the official helmet and goggle partner for Aspen Snowmass.  |  Courtesy of ASPENX

The ASPENX assortment additionally presents off-mountain types and equipment.
Courtesy of ASPENX

The ASPENX collection also offers off-mountain styles and accessories.  |  Courtesy of ASPENX

Present captionsHide captions

It was Crown who got here up with the ASPENX idea themselves, which can be considered one of their private favourite luxurious vogue homes (“I’ve all the time been a Prada fangirl,” she instructed WWD, who broke the information final week) to collaborate on a restricted version capsule as a part of the gathering: ASPENX Prada.

“Prada’s modern waterproof materials and designs (is spectacular),” Crown instructed me. “Years in the past we examined a design for a Prada ski uniform that was being utilized in European ski resorts. Manufacturing instances and portions couldn’t be coordinated on the time, however I saved Prada’s proposal in my concepts file. As I adopted developments within the trade, I observed Prada’s forward-looking dedication to sustainability and materials reuse – (Skico) shares this overriding worth. “

The restricted ASPENX Prada Excessive-Tex Graphic Jacket.
Courtesy of ASPENX

ASPENX Prada is an extension of the Prada Linea Rossa, marked with the distinctive pink stripe brand, which first appeared in 1997. Each environmentally pleasant article “consists of sustainable textile applied sciences that help an lively and adventurous life”. The gathering’s signature outerwear model – the Excessive-Tex graphic (from $ 5,100) – presents optimum insulation and waterproof properties due to a three-layer cloth that was solely researched and developed by Prada, in addition to “Graphene” padding to manage physique temperature. A complementary collection of ready-made gadgets, together with a recycled double jersey graphic sweatshirt (from $ 1,970), accompanies the jackets for a useful and trendy multi-layered uniform.

“With the introduction of ASPENX, I assumed it was time to contact the (Prada) household boss Lorenzo Bertelli. Throughout 1000’s of miles, time zones and language challenges, we agreed that we must always co-venture, ”added Crown. “There was a number of belief and perception within the idea. This was an iterative course of between Aspen and Milan that took months to take our collaboration to the following stage of efficiency and design. Each element from zippers to powder gaiters has been taken under consideration. “

Each ASPENX and ASPENX Prada are solely accessible on-line and within the model’s not too long ago opened flagship boutique on the foot of Aspen Mountain on Gondola Plaza. Designed by locally-based, award-winning structure and inside design agency Rowland + Broughton, the ASPENX retail expertise is a chic tackle Crown’s imaginative and prescient and options connoisseur take-away gadgets, a espresso and wine bar with concierge service and premium along with gear -Ski rental (particular entry is obtainable to resort visitors at The Little Nell).

“We’re more than happy to have helped design the brand new ASPENX retail retailer. Since 2008, we have now labored with (Skico) on practically 20 tasks, together with Ingredient 47, Ajax Tavern, Cloud 9 Alpine Bistro and Aspen Mountain Membership, with sustainability and our core values ​​in thoughts, ”mentioned Sarah Broughton, Director of Rowland + Broughton.

A rendering of the not too long ago opened ASPENX flagship retailer on Gondola Plaza, designed by Rowland + Broughton.
Courtesy of ASPENX

Aspen Mountain Membership, the members-only enclave adjoining to the Sundeck, has additionally unveiled a brand new id because the ASPENX Mountain Membership. The rebranding can be accompanied by a significant renovation of its unique mountaintop space – the membership’s first main replace because it opened in 2000, carried out by famed Spanish sculptor and designer Luis Bustamante of Luis Bustamante Inside Design, additionally managed by Crown.

The ASPENX Retailer, additional tapping into the famend, world-class hospitality of Aspen Snowmass, can be accessible for bookable night occasions, together with non-public dinners with Matthew Zubrod, culinary director of The Little Nell (suppose 10-course, curated tequila -Tastings, wine shows with a devoted sommelier or a mixology class to create your individual cocktails).

ASPENX formally opened its doorways on December 20th and is open from eight a.m. to six p.m. till the day of relaxation (April 17, 2022); it would begin summer time operations on the finish of Might.

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Watch: One City’s Effort to Raise Vaccination Rates Among Black Residents
Thu, 23 Dec 2021 19:35:19 GMT
Watch: One City’s Effort to Raise Vaccination Rates Among Black Residents



December 23, 2021


About 72% of Americans have received at least one dose of a covid-19 vaccine. During much of the vaccine rollout, Hispanic and Black Americans have been less likely than white Americans to get vaccinated. The gap between white and Hispanic Americans has largely closed, but the vaccination rate for the Black community still lags significantly behind. KHN correspondent Sarah Varney and PBS NewsHour producer Jason Kane report on how Hartford, Connecticut, has tried to close the gap in vaccination rates.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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3 hospitalized in Phoenix after several vehicles collided in critical condition
Sat, 02 Oct 2021 05:58:15 GMT
(Facebook Photo/Phoenix Police Department)...

PHOENIX – Three people were admitted to the hospital on Friday evening after an accident involving several vehicles in which three vehicles were involved in a rollover, the authorities said.

The incident occurred near 35th Avenue and Missouri Avenue around 8 p.m., Phoenix Fire Captain Scott Douglas said in an email.

On arrival, the crews set up a treatment zone and no exemption was required as everyone could get out of their vehicles, Douglas said.

Two pediatric patients, a boy and a girl and an adult woman, were rushed to the local emergency room in critical condition. A total of seven people were examined on site.

Other information was not immediately available.

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Nursing Houses Bleed Employees as Amazon Lures Low-Wage Employees With Prime Packages
Thu, 23 Dec 2021 13:24:46 GMT


ERLANGER, Ky. — The sleek corporate offices of one of Amazon’s air freight contractors looms over Villaspring of Erlanger, a stately nursing home perched on a hillside in this Cincinnati suburb. Amazon Prime Air cargo planes departing from a recently opened Amazon Air Hub roar overhead. Its Prime semi-trucks speed along the highway, rumbling the nursing home’s windows.

This is daily life in the shadow of Amazon.

“We haven’t even seen the worst of it yet,” said John Muller, chief operating officer of Carespring, Villaspring’s operator. “They are still finishing the Air Hub.”

Amazon’s ambitious expansion plans in northern Kentucky, including the $1.5 billion, 600-acre site that will serve as a nerve center for Amazon’s domestic air cargo operations, have stoked anxieties among nursing home administrators in a region where the unemployment rate is just 3%. Already buckling from an exodus of pandemic-weary health care workers, nursing homes are losing entry-level nurses, dietary aides and housekeepers drawn to better-paying jobs at Amazon.

The average starting pay for an entry-level position at Amazon warehouses and cargo hubs is more than $18 an hour, with the possibility of as much as $22.50 an hour and a $3,000 signing bonus, depending on location and shift. Full-time jobs with the company come with health benefits, 401(k)s and parental leave. By contrast, even with many states providing a temporary covid-19 bonus for workers at long-term care facilities, lower-skilled nursing home positions typically pay closer to $15 an hour, often with minimal sick leave or benefits.

Nursing home administrators contend they are unable to match Amazon’s hourly wage scales because they rely on modest reimbursement rates set by Medicaid, the government program that pays for long-term care.

Across the region, nursing home administrators have shut down wings and refused new residents, irking families and making it more difficult for hospitals to discharge patients into long-term care. Modest pay raises have yet to rival Amazon’s rich benefits package or counter skepticism about the benefits of a nursing career for a younger generation.

“Amazon pays $25 an hour,” said Danielle Geoghegan, business manager at Green Meadows Health Care Center in Mount Washington, Kentucky, a nursing home that has lost workers to the Amazon facility in Shepherdsville. The alternative? “They come here and deal with people’s bodily fluids.”

The nursing home industry has long employed high school graduates to feed, bathe, toilet and tend to dependent and disabled seniors. But facilities that sit near Amazon’s colossal distribution centers are outgunned in the bidding war.

“Chick-fil-A can raise their prices,” said Betsy Johnson, president of the Kentucky Association of Health Care Facilities. “We can’t pass the costs on to our customer. The payer of the service is the government, and the government sets the rates.”

And while gripes about fast-food restaurants having to close indoor dining because of a worker shortage have ricocheted around Kentucky, Johnson said nursing homes must remain open every day, every hour of the year.

“We can’t say, ‘This row of residents won’t get any services today,’” she said.

Reaching Upstream

Nationwide, long-term care facilities are down 221,000 jobs since March 2020, according to a recent report from the American Health Care Association and National Center for Assisted Living, an organization that represents 14,000 nursing homes and assisted living communities caring for 5 million people. While many hospitals and physicians’ offices have managed to replenish staffing levels, the report says long-term care facilities are suffering a labor crisis worse “than any other health care sector.” Industry surveys show 58% of nursing homes have limited new admissions, citing a dearth of employees.

Kentucky and other states are relying on free or low-cost government-sponsored training programs to fill the pipeline with new talent. Luring recruits falls to teachers like Jimmy Gilvin, a nurse’s aide instructor at Gateway Community and Technical College in Covington, Kentucky, one of the distressed River Cities tucked along the Ohio River.

On a recent morning, Gilvin stood over a medical dummy tucked into a hospital bed, surrounded by teenagers and young adults, each toting a “Long-Term Care Nursing Assistance” textbook. Gilvin held a toothbrush and toothpaste, demonstrating how to clean a patient’s dentures — “If someone feels clean, they feel better,” he said — and how to roll unconscious patients onto their side.

The curriculum covers the practical aspects of working in a nursing home: bed-making, catheter care, using a bedpan and transferring residents from a wheelchair to a bed.

“It takes a very special person to be a certified nursing assistant,” Gilvin said. “It’s a hard job, but it’s a needed job.”

Over the past five years, Gilvin has noticed sharp attrition: “Most of them are not even finishing, they’re going to a different field.” In response, nursing schools are reaching further upstream, recruiting high school students who can attend classes and graduate from high school with a nurse’s aide certificate.

“We’re getting them at a younger age to spark interest in the health care pathways,” said Reva Stroud, coordinator of the health science technology and nurse’s aide programs at Gateway.

Stroud has watched, with optimism, the hourly rate for nurse’s aides rise from $9 an hour to around $15. But over the years that she’s directed the program, she said, fewer students are choosing to begin their careers as aides, a position vital to nursing home operations. Instead, they are choosing to work at Walmart, McDonald’s or Amazon.

“There is a lot of competition for less stress,” Stroud said. A staunch believer in the virtue of nursing, she is disheartened by the responses from students: “‘Well, I could go pack boxes and not have to worry about someone dying and make more money.’”

Even for those who want a career in nursing, becoming a picker and packer at Amazon carries strong appeal. The company covers 100% of tuition for nursing school, among other fields, and has contracted with community colleges to provide the schooling.

Amazon is putting Kayla Dennis, 30, through nursing school. She attended a nursing assistant class at Gateway but decided against a career as a nurse’s aide or certified nursing assistant. Instead, she works at the Amazon fulfillment center in Hebron, Kentucky, for $20.85 an hour with health insurance and retirement benefits while attending school to become a registered nurse, a position requiring far more training with high earning potential.

“Amazon is paying 100% of my school tuition and books,” Dennis said. “On top of that, they work around my school schedule.”

Waiting for a Rising Tide

The nursing home workforce shortages are not a top concern for the state and local economic development agencies that feverishly pursue deals with Amazon. Cities nationwide have offered billions of dollars in tax breaks, infrastructure upgrades and other incentives to score a site, and the spoils abound: Amazon has opened at least 250 warehouses this year alone.

Amazon has been a prominent force in northern Kentucky, resurfacing the landscape with titanic warehouses and prompting pay bumps at Walmart, fast-food franchises and other warehouse companies. The company has “made significant investments in our community,” said Lee Crume, chief executive officer of Northern Kentucky Tri-County Economic Development Corp. “I’m hard-pressed to say something negative.”

Amazon representatives did not respond to interview requests for this story.

Some labor experts said Amazon’s “spillover effect” — the bidding up of wages near its hubs — suggests companies can afford to compensate workers at a higher rate without going out of business.

Clemens Noelke, a research scientist at Brandeis University, said that is true — to a point. Because Amazon draws workers indiscriminately from across the low-wage sector, rather than tapping into a specific skill profile, it is hitting sectors with wildly different abilities to adapt. Industries like nursing homes, home health care agencies and even public schools that rely on government funding and are hampered in raising wages are likely to lose out.

“There are some employers who are at the margin, and they will be pushed out of business,” Noelke said.

A survey conducted in November by the Kentucky Association of Health Care Facilities found 3 in 5 skilled nursing facilities, assisted living communities and care homes were concerned about closing given the number of job vacancies.

The solutions proffered by state legislators rely largely on nurse training programs already offered by community colleges like Gateway. Republican Rep. Kimberly Poore Moser, a registered nurse who chairs the state’s Health and Family Services Committee, said that while legislators must value health care jobs, “we have a finite number of dollars. If we increase salaries for one sector of the health care population, what are we going to cut?”

Moser said Kentucky’s bet on Amazon will pay off, eventually. “The more we inject into our economy, the more our Medicaid budget will grow,” she said.

That confidence in a rising-tide-lifts-all-boats approach frustrates Johnson, president of the Kentucky Association of Health Care Facilities. Lawmakers have difficulty grasping the complexity of financing a nursing home, she said, noting that Kentucky’s Medicaid reimbursement rates stagnated at a one-tenth of 1% increase for five years, before receiving a larger increase to offset inflation the past two years.

The Biden administration’s Build Back Better Act, still before Congress, would infuse billions of dollars into in-home care and community-based services for seniors, largely through federal Medicaid payments. It includes funding aimed at stimulating recruitment and training. But the measure is focused largely on expanding in-home care, and it’s not clear yet how it might affect nursing home pay rates.

For now, the feeding frenzy continues. Just off Interstate 65 in Shepherdsville, Wendy’s, White Castle and Frisch’s Big Boy dangle offers of “work today, get paid tomorrow.” FedEx signs along the grassy medians that once advertised $17 an hour are stickered over with a higher offer of $23. The colossal Amazon warehouse bustles with workers in yellow safety vests.

And in nearby Mount Washington, Sherrie Wathen, administrator of the Green Meadows nursing home, strains to fill a dozen vacancies, knowing she can’t match Amazon’s package for her entry-level slots. Instead, Wathen, who began her own nursing career at 18, tells prospective employees to consider life at a factory: “You’re going to have the same day over and over.”

At the nursing home, she said, “I am the only family this lady has. I get to make an impact rather than packing an item in a box.”

Sarah Varney:
svarney@kff.org,
@SarahVarney4

The post Nursing Houses Bleed Employees as Amazon Lures Low-Wage Employees With Prime Packages first appeared on DAILY GADGET AND GIZMOS NEWS.
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Nursing Homes Bleed Staff as Amazon Lures Low-Wage Workers With Prime Packages
Thu, 23 Dec 2021 13:24:26 GMT


ERLANGER, Ky. — The sleek corporate offices of one of Amazon’s air freight contractors looms over Villaspring of Erlanger, a stately nursing home perched on a hillside in this Cincinnati suburb. Amazon Prime Air cargo planes departing from a recently opened Amazon Air Hub roar overhead. Its Prime semi-trucks speed along the highway, rumbling the nursing home’s windows.

This is daily life in the shadow of Amazon.

“We haven’t even seen the worst of it yet,” said John Muller, chief operating officer of Carespring, Villaspring’s operator. “They are still finishing the Air Hub.”

Amazon’s ambitious expansion plans in northern Kentucky, including the $1.5 billion, 600-acre site that will serve as a nerve center for Amazon’s domestic air cargo operations, have stoked anxieties among nursing home administrators in a region where the unemployment rate is just 3%. Already buckling from an exodus of pandemic-weary health care workers, nursing homes are losing entry-level nurses, dietary aides and housekeepers drawn to better-paying jobs at Amazon.

The average starting pay for an entry-level position at Amazon warehouses and cargo hubs is more than $18 an hour, with the possibility of as much as $22.50 an hour and a $3,000 signing bonus, depending on location and shift. Full-time jobs with the company come with health benefits, 401(k)s and parental leave. By contrast, even with many states providing a temporary covid-19 bonus for workers at long-term care facilities, lower-skilled nursing home positions typically pay closer to $15 an hour, often with minimal sick leave or benefits.

Nursing home administrators contend they are unable to match Amazon’s hourly wage scales because they rely on modest reimbursement rates set by Medicaid, the government program that pays for long-term care.

Across the region, nursing home administrators have shut down wings and refused new residents, irking families and making it more difficult for hospitals to discharge patients into long-term care. Modest pay raises have yet to rival Amazon’s rich benefits package or counter skepticism about the benefits of a nursing career for a younger generation.

“Amazon pays $25 an hour,” said Danielle Geoghegan, business manager at Green Meadows Health Care Center in Mount Washington, Kentucky, a nursing home that has lost workers to the Amazon facility in Shepherdsville. The alternative? “They come here and deal with people’s bodily fluids.”

The nursing home industry has long employed high school graduates to feed, bathe, toilet and tend to dependent and disabled seniors. But facilities that sit near Amazon’s colossal distribution centers are outgunned in the bidding war.

“Chick-fil-A can raise their prices,” said Betsy Johnson, president of the Kentucky Association of Health Care Facilities. “We can’t pass the costs on to our customer. The payer of the service is the government, and the government sets the rates.”

And while gripes about fast-food restaurants having to close indoor dining because of a worker shortage have ricocheted around Kentucky, Johnson said nursing homes must remain open every day, every hour of the year.

“We can’t say, ‘This row of residents won’t get any services today,’” she said.

Reaching Upstream

Nationwide, long-term care facilities are down 221,000 jobs since March 2020, according to a recent report from the American Health Care Association and National Center for Assisted Living, an organization that represents 14,000 nursing homes and assisted living communities caring for 5 million people. While many hospitals and physicians’ offices have managed to replenish staffing levels, the report says long-term care facilities are suffering a labor crisis worse “than any other health care sector.” Industry surveys show 58% of nursing homes have limited new admissions, citing a dearth of employees.

Kentucky and other states are relying on free or low-cost government-sponsored training programs to fill the pipeline with new talent. Luring recruits falls to teachers like Jimmy Gilvin, a nurse’s aide instructor at Gateway Community and Technical College in Covington, Kentucky, one of the distressed River Cities tucked along the Ohio River.

On a recent morning, Gilvin stood over a medical dummy tucked into a hospital bed, surrounded by teenagers and young adults, each toting a “Long-Term Care Nursing Assistance” textbook. Gilvin held a toothbrush and toothpaste, demonstrating how to clean a patient’s dentures — “If someone feels clean, they feel better,” he said — and how to roll unconscious patients onto their side.

The curriculum covers the practical aspects of working in a nursing home: bed-making, catheter care, using a bedpan and transferring residents from a wheelchair to a bed.

“It takes a very special person to be a certified nursing assistant,” Gilvin said. “It’s a hard job, but it’s a needed job.”

Over the past five years, Gilvin has noticed sharp attrition: “Most of them are not even finishing, they’re going to a different field.” In response, nursing schools are reaching further upstream, recruiting high school students who can attend classes and graduate from high school with a nurse’s aide certificate.

“We’re getting them at a younger age to spark interest in the health care pathways,” said Reva Stroud, coordinator of the health science technology and nurse’s aide programs at Gateway.

Stroud has watched, with optimism, the hourly rate for nurse’s aides rise from $9 an hour to around $15. But over the years that she’s directed the program, she said, fewer students are choosing to begin their careers as aides, a position vital to nursing home operations. Instead, they are choosing to work at Walmart, McDonald’s or Amazon.

“There is a lot of competition for less stress,” Stroud said. A staunch believer in the virtue of nursing, she is disheartened by the responses from students: “‘Well, I could go pack boxes and not have to worry about someone dying and make more money.’”

Even for those who want a career in nursing, becoming a picker and packer at Amazon carries strong appeal. The company covers 100% of tuition for nursing school, among other fields, and has contracted with community colleges to provide the schooling.

Amazon is putting Kayla Dennis, 30, through nursing school. She attended a nursing assistant class at Gateway but decided against a career as a nurse’s aide or certified nursing assistant. Instead, she works at the Amazon fulfillment center in Hebron, Kentucky, for $20.85 an hour with health insurance and retirement benefits while attending school to become a registered nurse, a position requiring far more training with high earning potential.

“Amazon is paying 100% of my school tuition and books,” Dennis said. “On top of that, they work around my school schedule.”

Waiting for a Rising Tide

The nursing home workforce shortages are not a top concern for the state and local economic development agencies that feverishly pursue deals with Amazon. Cities nationwide have offered billions of dollars in tax breaks, infrastructure upgrades and other incentives to score a site, and the spoils abound: Amazon has opened at least 250 warehouses this year alone.

Amazon has been a prominent force in northern Kentucky, resurfacing the landscape with titanic warehouses and prompting pay bumps at Walmart, fast-food franchises and other warehouse companies. The company has “made significant investments in our community,” said Lee Crume, chief executive officer of Northern Kentucky Tri-County Economic Development Corp. “I’m hard-pressed to say something negative.”

Amazon representatives did not respond to interview requests for this story.

Some labor experts said Amazon’s “spillover effect” — the bidding up of wages near its hubs — suggests companies can afford to compensate workers at a higher rate without going out of business.

Clemens Noelke, a research scientist at Brandeis University, said that is true — to a point. Because Amazon draws workers indiscriminately from across the low-wage sector, rather than tapping into a specific skill profile, it is hitting sectors with wildly different abilities to adapt. Industries like nursing homes, home health care agencies and even public schools that rely on government funding and are hampered in raising wages are likely to lose out.

“There are some employers who are at the margin, and they will be pushed out of business,” Noelke said.

A survey conducted in November by the Kentucky Association of Health Care Facilities found 3 in 5 skilled nursing facilities, assisted living communities and care homes were concerned about closing given the number of job vacancies.

The solutions proffered by state legislators rely largely on nurse training programs already offered by community colleges like Gateway. Republican Rep. Kimberly Poore Moser, a registered nurse who chairs the state’s Health and Family Services Committee, said that while legislators must value health care jobs, “we have a finite number of dollars. If we increase salaries for one sector of the health care population, what are we going to cut?”

Moser said Kentucky’s bet on Amazon will pay off, eventually. “The more we inject into our economy, the more our Medicaid budget will grow,” she said.

That confidence in a rising-tide-lifts-all-boats approach frustrates Johnson, president of the Kentucky Association of Health Care Facilities. Lawmakers have difficulty grasping the complexity of financing a nursing home, she said, noting that Kentucky’s Medicaid reimbursement rates stagnated at a one-tenth of 1% increase for five years, before receiving a larger increase to offset inflation the past two years.

The Biden administration’s Build Back Better Act, still before Congress, would infuse billions of dollars into in-home care and community-based services for seniors, largely through federal Medicaid payments. It includes funding aimed at stimulating recruitment and training. But the measure is focused largely on expanding in-home care, and it’s not clear yet how it might affect nursing home pay rates.

For now, the feeding frenzy continues. Just off Interstate 65 in Shepherdsville, Wendy’s, White Castle and Frisch’s Big Boy dangle offers of “work today, get paid tomorrow.” FedEx signs along the grassy medians that once advertised $17 an hour are stickered over with a higher offer of $23. The colossal Amazon warehouse bustles with workers in yellow safety vests.

And in nearby Mount Washington, Sherrie Wathen, administrator of the Green Meadows nursing home, strains to fill a dozen vacancies, knowing she can’t match Amazon’s package for her entry-level slots. Instead, Wathen, who began her own nursing career at 18, tells prospective employees to consider life at a factory: “You’re going to have the same day over and over.”

At the nursing home, she said, “I am the only family this lady has. I get to make an impact rather than packing an item in a box.”

Sarah Varney:
svarney@kff.org,
@SarahVarney4

The post Nursing Homes Bleed Staff as Amazon Lures Low-Wage Workers With Prime Packages first appeared on DAILY POLITICAL PRESS.
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Essentially the most anticipated artwork occasions within the Roaring Fork Valley, Winter 2021-22
Thu, 23 Dec 2021 17:48:33 GMT
The most anticipated art events in the Roaring Fork Valley, Winter 2021-22

After virtually two years of dwelling with pandemic-related restrictions, Aspen’s artwork and tradition scene is now settling into one thing like regular, with most private occasions and sequence again on the calendar. No less than for now (hold our eyes on omicron). After actual experiences resembling concert events, lectures and artwork openings have been virtually wiped off the map final winter, they’re again with world-class provides which can be finest loved collectively.

Right here is the Aspen Instances Weekly’s annual most anticipated listing for the winter of 2021-22 in Aspen and the Roaring Fork Valley.

BOOKS

Powder Days writer Heather Hansman

Winterworte, Paepcke Auditorium

January 12th

The columnist and ski journalist for Outdoors journal will focus on her new guide, Powder Days: Ski Bums, Ski Cities, and the Way forward for Chasing Snow, an examination of the historical past of snowboarding in the USA and the evolution of the trade within the face of local weather change and economics Inequality. A should for each Aspenit.

And don’t forget: The memoirs Ashley C. Ford, Eleanor Henderson and Michelle Zauner on Winter Phrases (digital), February 15 … Announcement of the shortlist for the Aspen Phrases Literary Prize, February 23 … “How the World is Handed” writer Clint Smith on Winter Phrases , March 15th… Bewilderment writer Richard Powers at Winter Phrases, March 29th… Aspen Phrases Literary Prize awarded, April 23rd.

CLASSICAL MUSIC

Inon Barnatan, Harris Live performance Corridor

February 10th

The Israeli pianist and Aspen favourite celebrates the return of the winter evenings with a program that features Handel’s fugue on a theme.

And don’t forget: Boris Godunov, “Met Reside in HD”, Wheeler Opera Home, February eighth… “Fireplace Shut Up in My Bones”, “Met Reside in HD”, Wheeler Opera Home, February 15th… Calder Quartet, Harris Live performance Corridor, Feb. 17… “Cinderella”, “Met Reside in HD”, Wheeler Opera Home, March 1st… The violinist Simone Porter with the pianist Hsin-I Huang, Harris Live performance Corridor, March third.

MOVIE

NEPSA awards, Wheeler Opera Home

March 31

NEPSA (that is Aspen backwards) is a long-loved custom of showcasing one of the best and funniest domestically made ski movies.

And don’t forget: The Assembly Movie Competition on the Wheeler Opera Home, 24.-26. January …

Aspen Shortsfest, Fifth-10th centuries April.

POP MUSIC

Umphreys McGee, Stomach up aspen

March 18, 19 & 20

This winter we’re going again to regular. Meaning hi-fi concert events within the mountains are again, full dance flooring within the golf equipment are again, and this annual multi-night run by the favored six-piece Chicago jam band is again after an extended pandemic hiatus.

And don’t forget: Dillon Francis at Stomach Up, December 23rd… Zhu at Stomach Up, December 25th & 26th… The Chainsmokers at Stomach Up, December 28th & 29th… John Oates with Guthrie Trapp on the Wheeler Opera Home, December 29th… Third Eye Blind at Stomach Up, December 30th… Diplo at Stomach Up, December 31st… Charley Crockett at Stomach Up, January 4th… Mersiv at Stomach Up, January 12th… Residual salmon at TACAW, January 14th… Goth Babe at Stomach Up, Jan 19th … Ferg at Stomach Up, Jan 20th … Fisher at Stomach Up, Jan 21st … The Unlikely Candidates at TACAW, Jan 22nd … Louis the Little one at Stomach Up, Jan 23rd … Jamestown Revival at Stomach Up , January 30th… flight services at Stomach Up, February 1st… Nora En Pure at Stomach Up, February Fifth… Galactic at Stomach Up, February seventh… Donavon Frankenreiter at Stomach Up, February 12th… Lowdown Brass Band at TACAW, February 26th… Drive-By Truckers within the Stomach Up, February 27th… Mardi Gras Music within the Snowmass Base Village, March 1st… Joey DeFranceso Trio within the JAS Café, March 25th-26th. March … Hello-Fi Live performance Collection at Aspen Mountain, March 26 … Yola at Stomach Up, April 1 … Bud Gentle Core Celebration, downtown Aspen, April 2nd … Hello-Fi Live performance Collection, Snowmass Base Village, April 8 … St. Paul & the Damaged Bones at Stomach Up, April 29th.

THEATER & COMEDY & DANCE

Jim Gaffigan & the Aspen Snigger Competition

Aspen Snigger Competition on the Wheeler Opera Home

19th of February

The good gaffigan returns to open the Wheeler Opera Home’s annual comedy competition, which runs by February 23.

And don’t forget: “Chor of Man” at Wheeler Opera Home, January 13th… Kevin Nealon at Wheeler Opera Home, December 27th… Magician Justin Willman at Wheeler Opera Home, December 28th… Pop-up journal “Reside from Aspen, Wheeler Opera Home , 9.-11. January … Bob the Drag Queen & Monet X Change, Wheeler Opera Home, January 20th … Dance the Aspen World Premeiere Ballets, March 4th & Fifth.

VISUAL ART

“Andy Warhol: Lifetimes” and “Warhol in Colorado”

Aspen Artwork Museum & Powers Artwork Heart

Till March 27th & October 15th

Marilyn Diptych

Clearly. It is a milestone within the Aspen arts occasion and one of many largest on this planet this winter. Do not miss any of those exhibits.

And don’t forget: Artists-in-Residence exhibition, Patton-Malott Gallery, Anderson Ranch Arts Heart, till January 28 … Snowmass Luminescence, till February 27 … Treasured Okoyomon, “Each Morning the Sky’s Gentle …” on the Aspen Artwork Museum, till February 18. September… “Decade by Decade: Aspen Revealed” within the Wheeler / Stallard Museum, till spring 2023… Michael Kinsley exhibition in Artwork Base, Basalt, till January 10… David Yarrow exhibition in Casterline | Goodman, by July 15 … Sip & Sketch on the Anderson Ranch Arts Heart, December 16, January 13, February 10, March 10 … Tom Sachs exhibit on the Baldwin Gallery, December 26-February. 12… Radcliffe Bailey Lecture at Anderson Ranch Arts Heart, Jan 6… Julia Buffalohead Lecture at Anderson Ranch Arts Heart, January 20… Dan McCarthy present at Baldwin Gallery, February 18-March 13… Tony Oursler present at Baldwin Gallery, March-April.

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The post Essentially the most anticipated artwork occasions within the Roaring Fork Valley, Winter 2021-22 first appeared on DAILY COLORADO NEWS.
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Deep Roots Help This Chicago Pharmacist Avoid Creating Another Drugstore Desert
Thu, 23 Dec 2021 15:18:47 GMT
Deep Roots Help This Chicago Pharmacist Avoid Creating Another Drugstore Desert

CHICAGO — Del-Kar Pharmacy in the North Lawndale neighborhood has had a front-row seat to history. Martin Luther King Jr. bought his daily newspaper there when he lived in Chicago in the late 1960s. The Black Panthers’ local headquarters was a block away, and the pharmacy shared a building with the Conservative Vice Lords, a notorious street gang whose members still check in on owner-pharmacist Edwin Muldrow today.

When King’s assassination sparked riots in Chicago in 1968, the white-owned pharmacies in the area were ransacked. Muldrow’s father went to check on the pharmacy only to be told by the Vice Lords he had nothing to worry about.

“‘Go home,’” Muldrow said they told his father. “‘We’re not gonna let anybody touch you.’”

For nearly 60 years, the small drugstore has survived by building deep roots in the community, selling medicine, food and electronics in a neighborhood largely ignored by the large drugstore chains. Del-Kar is bucking a trend that has undermined numerous other pharmacies in Chicago and other U.S. cities. Although chain pharmacies are pulling out of many urban areas, sometimes citing rioting or theft, Muldrow isn’t quitting.

“Once you respect the community, the neighborhood looks out for you,” said Muldrow, 51, who started working as a pharmacist at Del-Kar in 1992. “They know that you’re here and you’re doing something positive.”

Like other community pharmacists nationwide, Muldrow has seen private insurers steer his customers toward their own allied chain, mail-order and specialty pharmacies. Urban independent pharmacies, particularly those in low-income Black and Latino communities, have been more likely to close than chain drugstores.

And pharmacies of all kinds in these communities, chain and independent, face a tough economic situation: They often have a disproportionately high share of customers enrolled in Medicaid or Medicare, which pay lower rates than private insurance.

“There’s really no financial incentive for pharmacies to open and stay open in minority neighborhoods,” said Dima Qato, a University of Southern California pharmacy professor.

According to a recent analysis she worked on, Black and Latino neighborhoods accounted for a third of pharmacy openings in Chicago from 2015 to 2020 but more than half of closures. As a result, the prevalence of pharmacy deserts increased from 33% of majority-Black census tracts to 45% and from 9% of majority-Latino tracts to 14%.

“Pharmacies are choosing to open in areas that already have pharmacies, in part because those are also the areas that have higher incomes and insurances that provide higher pharmacy reimbursement rates,” said Jenny Guadamuz, a University of Southern California health disparities researcher who led the study.

Muldrow said insurance often pays less for a medication than it costs him to acquire it. For example, he might be reimbursed $400 for an Advair inhaler that costs him $600.

“The profession is not what it used to be,” he said. “The profitability has been snatched.”

Average dispensing fees, set by insurance plans and intended to cover Muldrow’s overhead and salary, have plummeted from about $3 per prescription 30 years ago to as little as 10 cents, he said. He once sold medical supplies like lift chairs and oxygen tanks. But since Medicare implemented new fraud safeguards requiring accreditation, he said, he would have to pay $1,500 to $2,000 a year to continue receiving Medicare reimbursement.

“Now you have elderly people in the neighborhood that can’t come and get stuff,” Muldrow said. “They have to go to the hospital. They got to go through the mail.”

Muldrow keeps his store open by supplementing the meager payments he gets for filling prescriptions with other income. “The secret to our success here is that we own the property,” Muldrow said. “If I was paying $3,000, $4,000 or more a month rent, I would have been wiped out.”

Muldrow had job offers from multiple chain drugstores when he graduated from pharmacy school but chose to work for his father. “‘The only way I can repay you for giving me the opportunity to go to school is to come down here and work and continue what you started,’” he recalled telling him.

Del-Kar Pharmacy in the North Lawndale neighborhood of Chicago is an independent Black-owned business that has been selling medicine, food and electronics for nearly 60 years. (Taylor Glascock for KHN)

Chicago has encouraged pharmacies to locate in underserved areas — with little success. Qato pointed to a CVS branch that in 2010 received nearly $1 million in incentives to open in East Garfield Park. A nearby independent drugstore quickly closed, and the CVS shut its doors several years later, creating a pharmacy desert.

Illinois launched a program in 2019 to subsidize pharmacies in underserved urban and rural areas. But, Qato said, the program doesn’t adequately target neighborhoods at risk of becoming pharmacy deserts and excludes large chain pharmacies, which may be the only drugstores remaining in a neighborhood.

A year into the program, she said, only three of 80 eligible pharmacies in Chicago have received funds. Muldrow said he hadn’t heard of the program.

Some business strategies create de facto deserts. Late last year, the health insurer Aetna, owned by CVS Health, began preventing its Medicaid patients in Illinois from filling prescriptions at Walgreens pharmacies. As a result, some patients could no longer use the closest drugstore.

Dr. Thomas Huggett, a family physician at the Lawndale Christian Health Center on the West Side of Chicago, said some of his patients had trouble getting their medications in the first month of the new policy. One patient, who was homeless and had been diagnosed with severe mental illness, couldn’t get his prescription filled. Another had to take two buses to get his injectable antipsychotic medication. A third patient couldn’t get Suboxone, a treatment for opioid addiction.

“In the middle of one of the hotter spots in the country for opioid overdoses on the West Side of Chicago, it’s hard to imagine how anybody could justify it,” Huggett said.

In urban areas, Illinois regulations require prescription insurance plans to have at least one in-network pharmacy within a 15-mile radius or a 15-minute drive of their enrollees. But that can be too far to be practical for many customers, Huggett said.

“The majority of patients who have Medicaid have Medicaid because they are poor, and they generally don’t have cars,” Huggett said. “Looking at the maps, it is just so stark to see. The CVSs are intentionally avoiding black areas of Chicago.”

CVS spokesperson Mike DeAngelis said that about half of CVS stores nationwide are in areas that rank high on the Centers for Disease Control and Prevention’s Social Vulnerability Index, which tracks poverty, lack of vehicle access and crowded housing, among other factors.

“Maintaining access to pharmacy services in underserved communities is an important factor we consider when making store closure decisions,” DeAngelis said in an email. “Other factors include local market dynamics, population shifts, a community’s store density, and ensuring there are other geographic access points to meet the needs of the community.”

James Spidle, a 66-year-old veteran with serious heart problems, walks a mile using a cane to catch a bus in the Washington Heights neighborhood, about 13 miles south of Del-Kar, to pick up his prescriptions from a Walmart.

“I do the walk back and forth as a stress test,” he said. “If I don’t have any chest pains, I keep going.”

A closer option, a Walgreens, closed in 2016. A sign on the door directed customers to another branch that was a mile away in a more affluent neighborhood and had a grocery store pharmacy across the street.

Owner and pharmacist Edwin Muldrow outside Del-Kar Pharmacy in the North Lawndale neighborhood of Chicago. Muldrow’s father opened the business in the 1960s. (Taylor Glascock for KHN)
A list of Black colleges is displayed at Del-Kar Pharmacy on Friday, Dec. 17, 2021 in the Lawndale neighborhood of Chicago, IL. The pharmacy has been independent and Black-owned since the 1960s, an increasing rarity. (Taylor Glascock for KHN)

The Endeleo Institute, the community development arm of Trinity United Church of Christ, has tried to fill the gap, using church vans to drive people to the nearest pharmacies. Melvin Thompson, its executive director, listed four other chain pharmacies that had closed within a three-mile radius of the Walgreens that shuttered in Washington Heights.

“Here we are in the midst of a pandemic, and we’re losing even more of these vital services in communities that can’t afford to lose,” he said. “It’s citywide, but it just seems to be relegated to Black and brown communities.”

Walgreens officials did not answer questions about how the company decides to close stores, but said that in metro Chicago about 99% of Chicagoans live within 2 miles of one of their stores. Walgreens spokesperson Kris Lathan said the company allocated $35 million to reopen 80 stores in Chicago damaged during the civil unrest after the murder of George Floyd in 2020.

“All but two of those locations have reopened,” she said. “The remaining two will open in the first half of 2022.”

Democratic state Rep. La Shawn Ford said pharmacy closures represent a loss of health care access for the community. “The pharmacy is not just a place to pick up medicine, it’s a surrounding of health care,” he said. “Who’s going to talk to that person when they get their medicine mail-delivered?”

It can also be a lifeline in other ways. During the pandemic, when indoor dining was shut down, Muldrow set up an outdoor grill and served burgers, tacos and other food. That showed him how much the neighborhood needed him — and for a lot more than medications. He is planning an expansion, to include a bodega with a juice bar and restaurant.

Muldrow was also reminded that the community is there for him in return. Last year, during the civil unrest, several businesses near Del-Kar were destroyed. But, in an echo of 1968, his shop emerged unscathed.

“I didn’t have any worries. I slept real good,” Muldrow said. “The brothers over here on Lawndale, they watched over me. If you know the people, the people look out for you.”

Markian Hawryluk:
MarkianH@kff.org,
@MarkianHawryluk

The post Deep Roots Help This Chicago Pharmacist Avoid Creating Another Drugstore Desert first appeared on Daily Wyoming Cowboy.
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