Fla. group home’s sex policy raises questions
Filed under: Health journalism, Hot Health Headline
St. Petersburg Times reporter Justin George has painstakingly assembled the story of a group home for developmentally disabled adult men in Florida which, George writes, “enacted a bold and unorthodox policy permitting sex between residents.” Many of the men in the home were sex offenders and, according to experts, the policy created “a sexually charged atmosphere that may have encouraged sexual assaults.”
While this may sound more like a story for the crime and justice beat, keep in mind that the center “received approximately $100,000 in Medicaid funding per person annually for most residents,” despite reports that it is in an advanced state of disrepair.
George pulled hundreds of records from numerous government agencies and conducted more than 40 interviews over the course of two years. It shows in his reporting. You should read the full story to understand the breadth and complexity of the issue at hand, but I’ll summarize for the time-challenged.
Center officials regard sex as a basic human right (as the World Health Organization declared in 1975) and, in one 2005 case, “staff wrote that they could not evaluate whether Kevin was learning appropriate sexual behavior because his mother wouldn’t let him have sex with other campus men,” George found.
Compounding the problem, the state agency that oversees HDC (the group home) did not object to the policy until a whistle-blower complained to a state legislator. An investigation documented multiple instances of improper sexual activity between residents.
HDC officials say that banning sex is not the answer. It would deny basic rights and simply sweep the issue under the rug, a response they say is all too common when dealing with sex abusers.
But two years later, the state still has not written an official policy concerning sex in group homes. The whistle-blower was fired, and the mentally disabled man at the center of the controversy is stuck in a facility that he — like other men there — is desperate to leave.
After it learned of George’s investigation, the state finally set out to draft a policy for sex in state-run group homes, and perhaps for private homes as well.
A draft of one policy would ensure that sexually aggressive residents don’t room with anyone else, but it doesn’t prohibit sexual activity in group homes unless the disabled are children. Prohibiting adult sex might violate civil rights, Palecki said.
The Human Development Center’s revised policy on sexual behavior states it will not promote sexual activity among residents. Condoms will still be available, but only if competent adults ask for them.
George also tells the stories of two women who lost their jobs after speaking out about the situation and suspicions that a resident has been unable to move to a different home because his mother has cooperated with an investigation.
Florida addicts priced out of private rehab
In the St. Petersburg Times, reporter Leonora LaPeter Anton attempts to reconcile a local paradox: The state has suffered from epidemic of prescription drug abuse, yet Florida’s numerous private drug rehab centers remain empty. Why aren’t supply and demand coming together? The short answer, she found, is price.
… few who succumb to prescription drugs get the treatment they need. A national drug study estimated that just 10 percent of those who need treatment ever get it.
The problem is cost. Those with insurance quickly exhaust meager benefits and most don’t have $5,000 to $20,000 a month for round-the-clock rehab.
And the long answer? It comes back to insurance, then takes a sharp turn toward federal legislation. Insurers are reluctant to cover even 30-day treatment stays these days, Anton writes. “The typical plan at Blue Cross and Blue Shield of Florida, for example, offered $2,500 a year in substance abuse benefits. Anything over that was not covered.”
It’s a gap that the newly implemented Mental Health Parity and Addiction Treatment Act was designed to overcome. The new laws require that issues like substance abuse be covered at the same level that classic “medical” problems are.
Still, the new regulations apply only to companies with 51 or more employees. Though the law will likely improve care and make it more affordable, it won’t change the way insurers decide what is medically necessary. So with the push away from inpatient treatment, many addicts will try outpatient programs, which cost less, experts say.
Perhaps that is why 120 outpatient programs opened across Florida in the past two years. Florida licensed almost 400 new substance abuse treatment programs across the state, including 62 in the Tampa Bay area. Many focus on intervention, detox and the use of weaning medications such as Suboxone and methadone.
Lawsuit reveals failures in hospital hiring practices
St. Petersburg Times reporter Curtis Krueger’s story about a successful whistleblower suit against a Florida hospital provides a powerful storyline about how disciplined health care workers continue to get hired. Here, he skips the government agencies and state databases and looks at communication between the hospitals themselves.
After all, don’t hospitals consult references and do background checks when hiring new doctors and nurses? In the corporate world of major hospitals, the answer is apparently “yes, but it doesn’t seem to do any good.”
… in general, (Beth Hardy, a spokeswoman for Morton Plant Mease Hospitals) said, if a hospital calls seeking information about a former employee, the company will simply confirm the worker’s dates of employment and last position held. She said that is “a standard and accepted policy across a lot of large organizations.”
The whistleblower suit itself, which resulted in a $450,000 award, involved a nursing supervisor who was fired soon after she criticized nurse Bernard M. Moran for falsifying records, a practice which got him fired at a previous job. Moran now works at another area hospital, one which says it checks the disciplinary records of all new hires.
The story only came to light because of the lawsuit. To understand just how many blind eyes were turned toward Moran’s behavior during this series of events, just take a look at Krueger’s story.
(Hat tip to Health News Florida)
Florida pill mills spread, resist prosecution
Filed under: Health policy, Hot Health Headline, Pharmaceuticals, Public health
With South Florida beginning to crack down, the pain pill mills that fuel the Appalachian drug trade are moving northward. Kate Howard and Paul Pinkham of the Florida Times-Union report that the trade, which has ravaged Appalachia for a decade and exploded in recent years, has hit Jacksonville with a vengeance. There are more than 50 pain clinics in the area, and they even tell stories of 20-something clinic owners and physicians driving sports cars and intimidating each other in competition for the lucrative out-of-state trade. Florida’s first statewide steps to combat the trade haven’t yet taken hold, the duo writes.
After years of trying, Florida became the 39th state to pass a prescription monitoring bill last year, but it wasn’t funded. Amid lingering questions about its potential effectiveness, the database was slated to launch in December with $500,000 raised through grants and private funding, but is now on hold because of a bid dispute.
Even if Florida does succeed in stopping the pill mills, there are fears that tough legislation will just push the problem into neighboring (and less regulated) Georgia.
Why is it so hard to crack down on pill mills?
Across the state, Letitia Stein and Susan Taylor Martin of the St. Petersburg Times explore what makes it so impossible to shut down the handful of rogue doctors who can each put thousands of pills a day into the hands of abusers. In some ways, it’s similar to other disciplined doctors stories we’ve been seeing lately, as it carefully details the administrative wasteland that stands between local doctors and actual punishment for their actions. Cases languish for an average of 18 months, there is not always consistent communication between enforcement agencies, and disciplinary board members say they don’t have the legal power to search for problem doctors.
“The biggest problem is. we can’t discipline anybody unless a complaint is filed,” said Rosenberg, a West Palm Beach dermatologist on the Board of Medicine. “And drug addicts aren’t about to complain about their drug dealer.”
Stein and Martin looked at about 200 Florida doctors who had been disciplined or investigated for inappropriately prescribing pain pills in the past five years, and found that more than a quarter still have active licenses. Most of them are experienced doctors with specialty certifications, and some practice despite being convicted of crimes or linked to fatal overdoses.
And Florida’s new legislative crackdown on pill mills? The reporters say it specifically targets pain clinics, yet rogue physicians often operate out of other settings.
(Hat tip to Carol Gentry of Health News Florida)
Tougher concussion rules from high school assn.
The National Federation of State High School Associations has released tougher rules about removing players with potential concussions from the field. The initial release outlines the changes:
Photo by Les_Stockton via Flickr
The previous rule directed officials to remove an athlete from play if “unconscious or apparently unconscious.” The previous rule also allowed for return to play based on written authorization by a medical doctor. Now, officials are charged with removing any player who shows signs, symptoms or behaviors consistent with a concussion, such as loss of consciousness, headache, dizziness, confusion or balance problems, and shall not return to play until cleared by an appropriate health-care professional.
The Tampa Tribune’s Mary Shedden and Katherine Smith reported on how the change would affect Florida high school football and on how implementations of the new rule vary from district to district.
Language in the new rule is vague, stating a player can’t return until cleared by a “health-care representative.” In Hillsborough and Pinellas counties, players will need a doctor’s clearance, but Pasco officials may interpret the rule to include medical officials who were at the game, said Phil Bell, Pasco’s supervisor of athletic programs and facilities.
The best-known guidelines for returning to the game come from a sports medicine expert consortium in Zurich. It recommends athletes gradually return to activities, from light aerobic activity to noncontact drills to game day. Each step takes a minimum of 24 hours, and if symptoms return, an athlete must revert to the previous step.
Texas, Oregon and Washington have state laws mandating when players should be taken off the field; many other states rely on their athletic associations to format such rules. With the school year and football season getting under way, this would be a good time for reporters to check on the policies at local schools. Read more about concussions, including some recent reports and Congressional testimony.
New project covers health care in Florida
A health journalism project has launched in Tampa, Fla., supported by the Corporation for Public Broadcasting, reports the Tampa Tribune [see second story on the linked page].
The Healthy State Collaborative Local Journalism Center is a two-year project “aimed at strengthening collaboration among six public broadcasting stations geographically centered in Florida,” according to its website. Those stations are WUSF-Tampa, WEDU-Tampa, WMNF-Tampa, WGCU-Fort Myers, WMFE-Orlando and WUFT-Gainesville.
The site will offer health care coverage through audio, text, video, photos, blogs, social networking, dynamic syndication and mobile applications and hopes to engage a younger, well-educated audience.
Jennifer Molina, formerly of Newsweek.com, is the project’s executive editor. Her staff will include a multimedia manager, a community engagement specialist, and five reporters, each assigned to a participating station. According to the Tampa Tribune report, Molina is in the process of hiring reporters.
The Corporation for Public Broadcasting issued a call for grant proposals “from groups of 3-6 stations willing to form multi-platform reporting Local Journalism Centers around a single topic or issue that will result in an elevated quality and quantity of journalism.”
In announcing the initiative, Patricia Harrison, CEO and president of the Corporation for Public Broadcasting, said the centers were intended to “enhance public media’s ability to meet the information needs of local communities at a time when access to high quality, original reporting is declining.”
The project is one of seven in the country to develop news coverage of an issue relevant to each region. [Video of the announcement of the programs.]
Winning work: Swine flu, costs and mental health
In the SPJ’s 2010 Sunshine State Awards, AHCJ members made their presence felt in the “Medical/Health Care/Science Reporting” category, where they snagged two of the three spots.
The Miami Herald; John Dorschner; Healthcare costs
“Thanks to Dorschner’s detail-oriented reporting, readers of The Miami Herald learned just how much a 45-hour hospital stay for thyroid treatment might cost. Dorschner did not stop there either, confronting the hospital with the charges and asking them to justify the expenses – which they declined to do.”
The Palm Beach Post; Stacey Singer; Swine flu
“So many stories were written about swine flu in 2009 but few of them provided the human details and intimate touches of Stacey Singer’s reports. She introduces us to the people who were deeply affected by the flu, especially the expectant mothers and their children who were most vulnerable to it. She tells their stories with vivid, insightful details.”
In Mental Health America’s Awards for Excellence in Coverage, Portrayals of Mental Health Issues David Jackson pulled in the investigative reporting award for the Compromised Care series he did with Gary Marx. Read The Chicago Tribune’s full package here. AHCJ members can read an article about how they reported the story.
Florida keeps doctors’ arrests, convictions offline
Health News Florida’s Carol Gentry reports on health department disclosure of the arrest of medical professionals, writing “It’s the policy of Florida’s Department of Health not to post public information about arrests and convictions until a professional licensing board takes final action, no matter how long that takes.”
The department has a consumer-oriented site designed to notify Florida residents of disciplined physicians, but Gentry writes that it doesn’t even include already-public records and often fails to post issues until long after they have occurred. A representative told Gentry that their procedure was to not make information public while “due process is going on,” and added that if consumers wanted that information they were welcome to call the health department.
In a follow-up story, Gentry reports that attorneys who defend doctors in disciplinary matters think the Department of Health’s stance is “entirely appropriate.” But a consumer advocacy group says the public has a right to know about complaints. As Gentry points out, “It can take years to resolve pending cases, especially if the professional contests the case or if there is a backlog.”
Academics: Media added to reform confusion
Filed under: Health care reform, Health data, Hot Health Headline, Member news
Health News Florida’s Carol Gentry talked to journalism professors at three major Florida universities about the effect of media coverage on public perception of health care reform. The trio suggested that the media muddied the issue by focusing coverage on the political horse-race aspects while neglecting to invest the time necessary to fully explain the proposed legislation’s finer details.
In a column for AHCJ, Trudy Lieberman, the organization’s immediate past president has discussed some of the same shortcomings of health reform coverage. The academics say this is nothing new – many of the same issues surfaced during Clinton’s health reform push in the early ’90s, but say today’s fragmented media environment and 24-hour news cycle have certainly exacerbated matters.
[Kim Walsh-Childers, University of Florida journalism professor] said many Americans get their information from talk radio or blogs, “which are far less likely to provide balanced, complete information than are traditional news outlets, especially newspapers.”
“Even those who read newspapers may be getting far more information about the political strategies (of) the various stakeholders … than they are about what those proposals actually would mean for the average family,” Walsh-Childers continued.
Walsh-Childers praised NPR and The New York Times for their more thoughtful reform coverage, and said layoffs of experienced health reporters had likely weakened coverage at many outlets.
Gentry also cited surveys conducted by the Kaiser Family Foundation which found that peoples’ opinions of reform changed when they were better informed of the bills’ actual components.
Surveyors found that while a majority said they were opposed to the legislation, support grew markedly when survey participants found out the major parts of the plan.
Three-fourths became more favorable when they heard about tax credits for small businesses and two-thirds liked what they heard about health exchanges, constraints on health insurers and plugging the Medicare prescription-drug “doughnut hole.”
Related
More columns by Lieberman about coverage of health reform:
- Putting a human face on McCain, Obama health plans
- Look for opportunities to localize the debate on national health reform
- If candidates won’t focus on aging issues, journalists better
- Candidates’ health reform language needs closer scrutiny, definition
- Journalists must do better to inform, educate public
Health reform and the Supreme Court
Filed under: Government, Health care reform, Health data
Sarasota Health News‘ David Gulliver and Health News Florida’s Mary Jo Melone considered exactly how last Thursday’s Supreme Court ruling on campaign contributions by corporations would impact the health care lobby and the health reform debate. Their most interesting angle? That health care companies have already spent such gigantic sums of money on lobbying (more than $2.2 billion in 2008 and 2009) that the ruling won’t have the same impact on health as it will on other industries. In other words, the medical industry has already had the volume on the lobbying amp cranked to 10 for some time now, and it’s just not possible to ratchet it up any higher.
Gulliver and Melone on exactly what has changed in theory:
Until now, companies could not spend their own money directly on political advertising. They had to create political action committees, or a shadowy type of nonprofit known as a 527 organization. Then those groups could raise money from donors to pay for advertisements. For PACs, those donations are limited under federal law to $5000 per person per year.
In practice, the impact is less clear. Even under the previous system, those with money found ways to use it with impunity. It’ll be a more straightforward process now but, especially in health care, may not lead to huge changes in the money being spent. According to one school of thought, the biggest change will be in the use of explicit anti-candidate advertising threats as a metaphorical club during negotiations.
NOTE: It’s important to remember that, in a companion decision, the court upheld the transparency requirements that accompany these political donations. If you’re interested in tracking the changes in donations post-decision, head over to OpenSecrets.org, where they have a post explaining exactly how to use their tools to do so.
As for immediate impact, the reporters quote several experts who seem to think that unrestrained spending won’t transform the health care reform debate, partly because it’s already been so thoroughly transformed by other factors.
(Brad Ashwell of Florida Public Interest Research Group) said the legislative health-reform package pending in Congress is already “pretty moderate,” and it’s not likely to get more consumer-friendly now that business interests “can go straight to their treasuries.”
Even before the Supreme Court ruling, chances of helping Florida’s 3.8 million uninsured were looking increasingly sketchy, with a special-election loss that cost Democrats a crucial seat in the U.S. Senate this week. The only quick route to passage was for the House to accept the version of the legislative package that barely passed in the Senate on Christmas Eve, and House Speaker Nancy Pelosi announced Thursday she doesn’t have the votes to pull it off.
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