Regulatory board fails to collect on fines
When a California regulatory board fines dentists for things like unsanitary conditions or failure to provide patient records during an investigation, it actually collects the money only about 20 percent of the time.
Christina Jewett of California Watch found that nugget, about the Dental Board of California, in a recent legislative report.
The state’s Board of Vocational Nursing & Psychiatric Technicians collects about 80 percent of fines. California’s Board of Registered Nursing has, in the past, collected as little as 14 percent until ProPublica exposed problems with the board’s enforcement.
AHCJ members honored with recent awards
AHCJ members Daniel M. Keller, Ph.D., and Eric T. Rosenthal won the 2011 APEX News Series Writing Award for Publication Excellence for their five-part Oncology Times series, “Proton Beam Radiation Therapy: Implications for Cancer.” Earlier the series received a bronze award for Best Feature Article Series from the American Society of Healthcare Publication Editors.
Two AHCJ members were honored in the National Association of Black Journalists’ 2011 Salute to Excellence Awards in four categories:
- Magazine - Single Topic Series: “State of Our Girls,” Yanick Rice Lamb, Kendra Lee, Demene Millner, Eisa Ulen, Heart & Soul Magazine
- Magazine - Specialty: “Cleanse Craze,” Yanick Rice Lamb, Kendra Lee, Robin Stone, Heart & Soul Magazine
- Magazine - Art & Design: Page Design: “Spa Special,” Yanick Rice Lamb, Kendra Lee, Debra Moore, Heart & Soul Magazine
- Television - Specialty: “Food Deserts Fuel U.S. Health Crisis,” Betty Ann Bowser, Bridget DeSimone, Murrey Jacobson and Linda Winslow, PBS Newshour
AHCJ member M.B. Pell was among the winners of the 2011 Awards for Reporting on the Environment presented by the Society of Environmental Journalists:
Kevin Carmody Award for Outstanding In-depth Reporting, Large Market
3rd Place: ”Fueling Fears” by Jim Morris, Senior Reporter; Chris Hamby, Reporter; Center for Public Integrity, and M.B. Pell, Staff Writer, The Atlanta Journal-Constitution, in partnership with ABC News, working with reporter Matthew Mosk and correspondent Brian Ross.
• Use of Toxic Acid Puts Millions at Risk
• Regulatory Flaws, Repeated Violations Put Oil Refinery Workers at Risk
Honorable Mention: ”Renegade Refiner“ by Jim Morris, Senior Reporter, and Emma Schwartz, Reporter, Center for Public Integrity; and M. B. Pell, Staff Writer, The Atlanta Journal-Constitution.
Meet AHCJ’s newest members
Filed under: Health journalism, Member news, Studies
Please welcome AHCJ’s newest group of members. All new AHCJ members are welcome to stop by this post’s comment section to introduce themselves, and you’ll also find many of them waiting on Twitter! Take a minute to follow a few of your new colleagues and find out what they’re adding to the conversation.
- Inemesit Akpan, student, St. John’s University, Queens Village, N.Y.
- Rachana Dixit, associate editor, Inside Health Policy, Arlington, Va. (@rachanadixit)
- Lester Feder, staff writer, Politico, Arlington, Va. (@JLesterFeder)
- Joette Giovinco, medical reporter, WTVT-Tampa, Fla. (@JoetteG)
- Sam Lister, health editor, The Times, London, United Kingdom (@SamListerTimes)
- Gianna Milano, independent journalist, Milan, Italy
- Michael Pell, reporter, The Atlanta Journal-Constitution, Atlanta
- Cathryn J. Ramin, independent journalist, Mill Valley, Calif. (@cjramin)
- Jim Roope, correspondent, CNN, Burbank, Calif. (@jimroopecnn)
- Rebecca Wolfson, student, University of Missouri, Berkeley, Calif. (@RWolfa)
‘Designer’ drugs easily available, unpredictable
The Minneapolis Star Tribune has launched an investigation into synthetic “designer” drugs, finding that they are easy to buy, their legality is murky at best and that often buyers don’t receive the drugs they think they’ve ordered.
An introduction by Star Tribune editor Nancy Barnes says it is “striking” how much “trust buyers put in the notion that it is safe to acquire a synthetic drug over the Internet, from an unproven source.”
In the first installment of the series, reporter Pam Louwagie tells the story of a tragic party in tiny Konawa, Okla., where a college student allegedly ordered a drug over the Internet and, according to court documents, distributed it to party attendees. What he actually received was a different chemical that sickened a number of people and, prosecutors say, led to the death of a 22-year-old.
The story also lists cases in which people using synthetic drugs, such as “bath salts” and “synthetic marijuana,” have been sickened, committed suicide and killed family members.
Calif. prison doc made $777,000 for not treating patients
Using state records, Jack Dolan of the Los Angeles Times found that one of the most highly paid state employees in California is a doctor who has not been allowed to treat patients in six years.
Dr. Jeffrey Rohlfing is a prison surgeon who has a history that includes a psychiatric crisis, revocation of his clinical privileges after a patient died and allegations of substandard care that led to his being fired.
While appealing his termination, he has “been relegated to reviewing paper medical histories, what prison doctors call ‘mailroom’ duty.”
Last year, Rohlfing made $777,423 – that’s his base pay of $235,740 plus back pay for two years when he didn’t work while he successfully appealed his termination.
Rohlfing isn’t the only doctor in California’s cash-strapped prisons earning big money to shuffle paper. Dozens have been relegated to the chore in recent years, according to Kincaid, who said it’s the standard assignment given to physicians when questions arise about their clinical ability. Some eventually return to treating patients, some quit and others are ultimately fired, she added.
Dolan writes that California’s prison system has a history of employing doctors with problems. In 2006, judges said that contributed to the “fact that a prisoner died ‘needlessly’ every six to seven days in a state lockup.”
Hat tip to @wheisel, who has tips from this investigation.
Related
- Tip sheet: Covering health care in jails
Passengers with disabilities encounter obstacles in everyday commuting
Despite progress prompted by the Americans with Disabilities Act, public transportation for people with disabilities is still challenging in many places.
The Washington Post’s Dana Hedgpeth found that, on D.C.’s Metro system, people who rely on wheelchairs, canes and other aids are confronted by broken elevators, narrow walkways, dilapidated platforms, poor lighting and signage.
Metro has a door-to-door shuttle called for those with disabilities called MetroAccess but Hedgpeth says it is more costly, charging based on the time of day and distance a customer travels. One passenger says the service isn’t reliable and forces her to make travel arrangements a day in advance.
The accessibility issues can be downright dangerous at times. Hedgpeth cites cases in which people in wheelchairs have fallen and a blind man fell onto the tracks.
How do people with disabilities in your community get around? Is the system truly useful? Hedgpeth’s article should give you plenty of ideas about what to look for in a transportation system from the perspective of people with disabilities:
- Can someone sitting in a wheelchair see signs?
- Are announcements clear for people with impaired hearing?
- How often are elevators out of service and, when they are broken, what is the alternative?
- If there is an alternative system for passengers with disabilities, is it affordable? Do people using it face extremely long commutes or wait times?
The National Center on Disability & Journalism has information and a style guide for journalists covering disability issues.
Stories to be found in local poison control centers
Poison control centers narrowly escaped losing almost all federal funding this year and their appropriations are down, despite evidence that they keep people out of emergency rooms, writes Maryn McKenna, an independent journalist and AHCJ board member.
McKenna cites statistics showing that, when poison control centers’ budgets are cut, hospital visits to treat poisonings increase. “In 2004, the Institute of Medicine estimated that every dollar of public funding spent on a poison control center saves $10 that would otherwise have been spent on health care.”
The piece, in the Annals of Emergency Medicine, is packed with facts about the 57 centers in the United States, including:
- Poisoning is the second most common cause of injury deaths in the United States
- About 15 percent of calls to poison control centers come from emergency departments, hospitals, and office practices.
- Poison centers increasingly are providing advice for emergency personnel encountering toxicities from prescription drug abuse.
McKenna spoke to a Harvard professor of pediatrics who called budget cuts to poison control centers “the definition of ‘penny-wise, pound-foolish.’”
What’s happening at the poison control center in your area? Is it experiencing budgetary woes? How are staff coping with that? How is that affecting the community and area hospitals?
The American Association of Poison Control Centers has a directory online to help you contact your local center.
How does the budget deal affect the Affordable Care Act?
Filed under: Government, Health care reform, Health policy
So how does this mammoth budget-cutting deal, with its congressional “supercommittee” affect health reform?
Good question, because lots of people in Washington are asking it too.
More specific answers will become clearer in the next few weeks, but here’s a first version of the road map to both the policy and the politics.
What questions do you have about health reform and how to cover it?
Joanne Kenen is AHCJ’s health reform topic leader. She is writing blog posts, tip sheets, articles and gathering resources to help our members cover the complex implementation of health reform. If you have questions or suggestions for future resources on the topic, please send them to joanne@healthjournalism.org.
First, understand there are two different processes – and each, separately, aims at cutting more than $1 trillion over the next decade.
The one that you’ve probably heard most about is the “supercommittee” of 12 members of Congress. They are supposed to identify savings by Thanksgiving. Entitlements – Medicare, Medicaid, Social Security and aspects of the Affordable Care Act – are part of their turf. So are taxes and revenue – at least in theory. It’s not so clear that the Republicans see it that way given the public statements of Congressional leaders.
If they agree on some kind of grand deal by Thanksgiving, Congress has to take it or leave it by the end of December, eliminating the usual congressional dilly-dallying. (It looks like dilly-dallying to the casual observer or much of the public, but remember that all that arcane, tedious process IS policy in Congress. If you slow something down, make it go through hoops, amend it, hold it up, etc., it doesn’t become law. That may be good or, depending on your point of view, bad politics.)
If Congress takes any recommendations that the supercommittee agrees on, that’s the law. If the committee fails, or Congress rejects it, then the “trigger” gets pulled. The official name is “sequestration.” That’s a fancy name for automatic cuts - 2 percent across-the-board cuts in Medicare, for instance, affecting all health care providers, doctors, hospitals, etc. It won’t affect beneficiaries - at least not directly.
MEDICAID is not subject to the trigger. Neither, according to the preliminary interpretations I’ve received from analysts and congressional staff, are the big, key subsidies in the health care reform law - the Medicaid expansion and the subsidies that will help low-income and middle-income people afford health care in the new state exchanges.
Other parts of the health reform law are, however, subject to automatic cuts. Among them: Cost-sharing subsidies for low-income people. This isn’t the help paying the premium; this is the help with the co-pays when people do get care. But the payments are made to health plans, not directly to beneficiaries so it won’t have the direct impact of discouraging care. It may affect how health plans make decisions about what markets to participate in. Gary Claxton and Larry Levitt at Kaiser Family Foundation explain here.
Also, the supercommittee could have a partial deal – meaning there’s still a trigger, but a smaller one. Maybe they won’t reach agreement on $1.2 trillion to $1.5 trillion in savings, which would avoid the trigger. But maybe they could agree on, say, $500 billion. That means a trigger wouldn’t have to go as deep because some of the savings would already be identified.
To recap - before we go on to the second stage of this process: The “super-committee” can do whatever it wants to health care, Medicare, Medicaid, Social Security, etc. - if it can agree, if it can get the rest of Congress to agree and if the president doesn’t veto it. Will the Democratic Senate and the Obama White House agree to cuts that eviscerate health reform? Not likely. In fact, the Democrats “won” on very few aspects of the budget/debt deal. Walling off Medicaid and key parts of the health coverage expansion were two of the “wins.” That’s a bright line worth paying attention to as this moves forward.
Does that mean other health-reform related spending will be untouched? Given how many moving parts there are to any spending deal, and the fact that defense and tax policy are also part of the mix, chances are it will be affected. But expect to see that bright line remain visible - maybe not quite as bright, but visible. (The CLASS Act, the voluntary long-term care program created under health reform, is a different story; it’s quite vulnerable.)
The second part is the annual appropriations process. The budget deal provides for cuts - real cuts in spending, not just slowing the rate of growth. Health programs (aspects of the health reform legislation touching on exchange creation, prevention, community clinics, etc., and just about everything else at the Department of Health and Human Services - the FDA, NIH, CDC, etc. - will be subject to these cuts. But this isn’t an across the board process, it’s a line-by-line, or at least category/agency-by-category/agency, process. And there is some horse trading.
It’s safe to say that the Republicans will try to cut discretionary portions of the new health law. That’s not a new political dynamic, it doesn’t arise out of the debt ceiling or the Wall Street woes. It’s what we’ve seen since last fall’s elections and the repeal/defund fights of the past few months. And House Budget Chairman Paul Ryan has publicly tried to insert health care into any potential deal. So expect to see more Republican push to cut, and continued Democratic push back. Will health spending emerge unscathed? It’s too soon to know but, given the amount of savings Congress needs to find –both in this budget deal and in the perennial quest to fund the “doc fix” payments – some cuts are clearly possible. Some of it may affect aspects of exchange establishment, regulation, prevention, public health, etc. But it’s hard to see the Democrats allowing cuts so deep that they basically constitute a side door to repeal.
One further twist – some Republicans are calling for a delay in health reform implementation to save money.”Delay” may sound better to an ambivalent public worried about spending than “repeal.” What’s delayed (if anything), how it’s delayed, how long it’s delayed, and what stopgaps are created in the meantime could have an impact on how many people get covered in 2014.
Assorted committees and government agencies are still examining the new budget law and how it will affect … everything. So the perspective I’ve outlined here – and I’m writing amid all the market turbulence – may change as the economic and political climates change. But the lines in the sand around the trigger – health reform, Medicaid and Social Security – tell us something about where the White House will come down.
Joplin hospital staff took action during disaster
If you haven’t already, take 90 seconds to read Tulsa World reporter Michael Overall’s brief, powerful account of how emergency preparedness translated to emergency action at the hospital caught in the center of the May tornado in Joplin, Mo.
Photo by Red Cross: Carl Manning GKCARC via Flickr
The staff had practiced severe weather drills and evacuations hundreds of times but, as one administrator told Oklahoma colleagues, “There’s no way you can plan for an F-5 tornado.” Nevertheless, Overall writes, the well-drilled staff of St. John’s hospital “evacuated all 183 patients in just 90 minutes with no major injuries,” a sentence you won’t appreciate until you read Overall’s narrative based on a hospital administrator’s talk at a conference for regional emergency workers.
For those of you looking for story ideas, you might look into local hospitals’ disaster plans. Have they really planned for every contingency? Certainly there are things no one can plan for, but it’s worth reading the story from this hospital and evaluating disaster plans with those events in mind.
For more, read AHCJ’s roundup and review of Joplin tornado coverage.
Reporter predicts Houston to emerge as global health hub
Jaclyn Schiff, writing for the UN Dispatch, makes the case that journalists should look to Houston as the emerging hub of the global health universe, predicting that it may even supplant hotspots like Washington, D.C. and Seattle.
The foundation for Houston’s emergence, she writes, will be built on its already powerful medical community, built on Baylor College of Medicine, the mammoth Texas Medical Center and the MD Anderson Cancer Center, all of which are stepping up their global health efforts.
Photo by Houston TranStar via Flickr
Beyond that pedigree, the particular catalyst for her story is Dr. Peter Hotez’ move from D.C. to work with Baylor and the Texas Children’s Hospital. Hotez is a bit of a global health rock star (Wikipedia bio), known for his work with vaccines and tropical diseases, and he’s bringing his work to Houston with him.
Part of his nonprofit organization, the Sabin Vaccine Institute, is also moving down to Houston, which Hotez calls a “gateway to Latin America.” Hotez will also be the founding dean of the first U.S.-based school of tropical medicine. Its exclusive mandate and Hotez’s track record of achievement are likely to attract some of the brightest physicians with an interest in global health, which is huge for creating a bustling global health community.
Schiff finishes with another prediction, writing that “the Houston Chronicle hasn’t traditionally been a major source of global health news, but I’d start paying closer attention. There’s too much going on for there not to be a story.” For the record, reporters interested in adding the Chronicle to their regular health reading lists can subscribe to its RSS at http://feeds.chron.com/houstonchronicle/health.
As an alternative or supplement to the Chronicle’s coverage, Carrie Feibel covers the Houston health beat for the local NPR affiliate, and you can keep up with her reporting by following her on Twitter at @KUHFHealth.
The UN Dispatch is sponsored by the United Nations Foundation, a private organization which supports UN efforts worldwide, particularly in the public health arena.
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Awards for Excellence in Health Care JournalismDeadline: Feb. 3
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- Why do some patients get stuck in hospitals for weeks, months?
- Investigate health professionals and the boards that regulate them
- Presidents of AHCJ, SPJ call for more openness from Obama administration
