Sapien wins award for natural gas impact coverage
An investigation into the environmental impact of natural gas drilling, conducted by AHCJ member Joaquin Sapien and his ProPublica colleagues Abrahm Lustgarten and Sabrina Shankman, earned a second place, print, Kevin Carmody Award for Outstanding Investigative Reporting in the Society of Environmental Journalists’ Awards for Reporting on the Environment.
Photo by arimoore via Flickr
In its announcement of the award, SEJ cited four particular entries in the extensive series (64 parts!), including Sapien’s “With Natural Gas Drilling Boom, Pennsylvania Faces an Onslaught of Wastewater.”
This exhaustive ProPublica series into the environmental impact of natural gas drilling on water resources raised public awareness of an important, but largely overlooked, environmental issue and helped to spur politicians to action. The methodical and well-written stories were easily understandable, neatly melding the human experience with the investigative paper chase. Importantly, the series exposed not just problems, but also pointed to solutions.
Agreement lets disciplined nurses work in 24 states
Filed under: Health data, Health journalism, Nursing, Public records
ProPublica’s Tracy Weber and Charles Ornstein are back on the disciplined caregivers beat, this time cooperating with USA Today to expose a licensing gap that makes it easier for disciplined nurses to find work in other states. The licensing agreement in question was signed a decade ago as 24 states agreed to recognize each other’s licenses in an attempt to alleviate care shortages by allowing nurses to work where they are needed most.
In some cases, nurses have retained clean multistate licenses after at least one compact state had banned them. They have ignored their patients’ needs, stolen their pain medication, forgotten crucial tests or missed changes in their condition, records show.
Critics say the compact may actually multiply the risk to patients. There is no central licensing for the compact, so policing nurses is left to the vigilance of member states.
Outside the compact, each state licenses and disciplines its own nurses. But within it, states effectively agree to allow in nurses they have never reviewed.
Ornstein and Weber found numerous instances in which a caregiver disciplined in one state was able to work for an extended period in another without being red-flagged, and are helping spark a debate over the costs, benefits and implementations of such agreements.
Calif. finds 3,500 nurses were disciplined elsewhere
Filed under: Health data, Health journalism, Hospitals, Hot Health Headline, Nursing
California’s nursing board has confirmed what fans of Charles Ornstein and Tracy Weber’s disciplined caregivers series for ProPublica and the Los Angeles Times already suspected, that about 3,500 California nurses had clean records there despite being disciplined in other states. You can find Ornstein and Weber’s report on these developments at ProPublica or the LA Times.
After last year’s report by ProPublica and The Times, California ran its list of 376,000 active and inactive nurses against a database maintained by the National Council of State Boards of Nursing, to which nearly all states voluntarily report their disciplinary actions. Among the matches were nurses who had been disciplined by multiple states, sometimes for the same incident.
California officials said they couldn’t disclose the names of any nurses who turned up in the search until a formal disciplinary charge is filed. While those cases are pending, the nurses remain free to practice in California.
Of the 3,500 nurses whose records matched, “as many as 2,000 … will face discipline in California, officials estimate,” Ornstein and Weber write. “That’s more registered nurses than the state has sanctioned in the last four years combined.”
Military slow to treat mild traumatic brain injury
Filed under: Government, Health journalism, Hot Health Headline
ProPublica’s T. Christian Miller and NPR’s Daniel Zwerdling have found unpublished military documents which indicate that tens of thousands of soliders who suffer from mild traumatic brain injury have gone undiagnosed.
Photo by isafmedia via FlickrThese are in addition to the 115,000 soldiers known to suffer from such injuries, many of which are inflicted by shock waves caused by roadside bombs. They write that the lack of concern shown by top brass for mild traumatic brain injuries was “a reflection of ambivalence about these wounds at the highest levels.”
“It’s obvious that we are significantly underestimating and underreporting the true burden of traumatic brain injury,” said Maj. Remington Nevin, an Army epidemiologist who served in Afghanistan and has worked to improve documentation of TBIs and other brain injuries. “This is an issue which is causing real harm. And the senior levels of leadership that should be responsible for this issue either don’t care, can’t understand the problem due to lack of experience, or are so disengaged that they haven’t fixed it.”
After a thorough review, one not helped by a top medical official’s early attempts to prevent local medical commanders from responding to the reporters, the duo distilled their findings into three bullet points:
- From the battlefield to the home front, the military’s doctors and screening systems routinely miss brain trauma in soldiers. One of its tests fails to catch as many as 40 percent of concussions, a recent unpublished study concluded. A second exam, on which the Pentagon has spent millions, yields results that top medical officials call about as reliable as a coin flip.
- Even when military doctors diagnose head injuries, that information often doesn’t make it into soldiers’ permanent medical files. Handheld medical devices designed to transmit data have failed in the austere terrain of the war zones. Paper records from Iraq and Afghanistan have been lost, burned or abandoned in warehouses, officials say, when no one knew where to ship them.
- Without diagnosis and official documentation, soldiers with head wounds have had to battle for appropriate treatment. Some received psychotropic drugs instead of rehabilitative therapy that could help retrain their brains. Others say they have received no treatment at all, or have been branded as malingerers.
Read the full investigation at ProPublica or NPR. It’s some of the deepest work on the subject we’ve seen thus far, and includes incredible quotes such as “What’s the harm in missing the diagnosis of mTBI?” as well as graphics and an explanation of why the numbers are so fuzzy.
Sapien chronicles formaldehyde battle
Filed under: Conflicts of interest, Government, Health policy, Hot Health Headline
At ProPublica, Joaquin Sapien tells the story of how Louisiana Republican Sen. David Vitter successfully obstructed the FDA’s attempts to get formaldehyde, which has been linked to leukemia, as a known carcinogen. Right now, it’s still listed as “probable.” The industry’s favorite tool, and the one Vitter employed for them in this case, was to force the EPA into conducting yet another costly, time-consuming study.
The EPA’s chemical risk assessments are crucial to protecting the public’s health because they are the government’s most comprehensive analysis of the dangers the chemicals present and are used as the scientific foundation for state and federal regulations. But it usually takes years or even decades to get an assessment done, or to revise one that is outdated. Often the industry spends millions on lobbying and on scientific studies that counter the government’s conclusions.
Sapien’s history of Sen. Vitter’s stonewalling, as well as his ties to the formadehyde industry, are an excellent example of just how difficult it has been for the EPA to upgrade key risk assessments.
Sapien’s story is well worth reading, but those looking for an overview can also refer to his excellent timeline, that goes from the EPA’s first health assessment in 1989 to Vitter’s demand that an assessment of the chemical be reviewed by the National Academy and his subsequent block of an EPA nomination late last year.
Fink wins Dart award for Memorial story
AHCJ member Sheri Fink’s 13,000-word piece on the difficult choices made at Memorial Hospital in the wake of Hurricane Katrina continues its run this awards season, adding the 2010 Dart Award for Excellence in Coverage of Trauma to the Pulitzer Prize for investigative reporting, second place in the large magazine category of AHCJ’s 2009 Awards for Excellence in Health Care Journalism, and numerous other honors. It originally ran in The New York Times Magazine and on the ProPublica Web site.
A project of the Columbia University Graduate School of Journalism, the Dart Center for Journalism & Trauma focuses on reporting on violence, conflict and tragedy. It has awarded the Dart Award for Excellence in Coverage of Trauma since 1994.
Fink wrote an article for AHCJ members about how she reported the story and her insights for others undertaking long-form investigative reporting.
AHCJ member Fink wins investigative Pulitzer
Filed under: Health journalism, Hospitals, Hot Health Headline
Get reporting tips from winners, finalists
ProPublica reporter and AHCJ member Sheri Fink, M.D., won the 2010 Pulitzer Prize for investigative reporting for her recounting of “the urgent life-and-death decisions made by one hospital’s exhausted doctors when they were cut off by the floodwaters of Hurricane Katrina. the days immediately following Hurricane Katrina.” Her piece also earned second place in AHCJ’s 2009 Awards for Excellence in Health Care Journalism.
Read Fink’s article for AHCJ about how she reported the story.
An entry from the Los Angeles Times and ProPublica, written by AHCJ President Charles Ornstein and Tracy Weber (a joint entry), was a nominated finalist in the public service category. Ornstein and Weber reported on “gaps in California’s oversight of dangerous and incompetent nurses, blending investigative scrutiny and multimedia storytelling to produce corrective changes.” AHCJ’s Web site features an extensive tip sheet from the reporters about how to evaluate nurse oversight in any state.
Health Journalism 2010 speaker wins for explanatory journalism
Explanatory Pulitzer winner Michael Moss, who wrote about “contaminated hamburger and other food safety issues that, in print and online, spotlighted defects in federal regulation and led to improved practices” will be speaking about food safety at Health Journalism 2010.
New federal caregiver database full of holes
Filed under: Hot Health Headline, Public records, Tools
Tracy Weber and Charles Ornstein are still working with databases of disciplined caregivers, this time exposing gaping holes in the federal database released to hospitals on March 1 (LA Times version | ProPublica version). Weber and Ornstein trace the holes to a lack of reporting by state agencies, and mention California, South Dakota, New Hampshire, Alabama, Delaware, Ohio, Tennessee, Indiana as states whose database entries were demonstrably incomplete. Some states don’t even have a single disciplined caregiver showing up in the federal database even though scores of offenders are listed on those states’ own sites.
The omissions took federal health officials by surprise. Only last month, a spokesman for the agency that oversees the database told reporters that “no data is missing.” Another official said the agency had been “constantly” checking its data against state licensing board websites.
But Friday, the head of the Health Resources and Services Administration (HRSA) acknowledged that records were missing. She said her agency had launched a “full and complete” review to determine what is wrong and how to fix it.
The Department of Health and Human Services has reacted swiftly, Ornstein and Weber report. HHS boss Kathleen Sebelius sent U.S. governors a letter requesting that they identify and correct any holes in the federal database by June 1, at which point any states whose entries were not updated will be named and shamed in an HSS report. HHS will train state staff in compliance and audit the database to make sure everybody’s following the rules. States have, as of yet, not faced any penalties for failing to update the list over the preceding two decades.
Problem nurses move from state to state
Filed under: Health journalism, Hot Health Headline
ProPublica’s Charles Ornstein and Tracy Weber have, with the help of the Los Angeles Times‘ Maloy Moore, released the final installment in their nurses series (full series: ProPublica | LA Times), this one focusing on how “caregivers with troubled records can cross state lines and work without restriction.” They found that a large number of these cross-state issues could be prevented if state regulators took advantage of readily available information.
By simply typing a nurse’s name into a national database, state officials can often find out within seconds whether the nurse has been sanctioned anywhere in the country and why. But some states don’t check regularly or at all.
The failure to act quickly in such cases has grave implications: Hospitals and other healthcare employers depend on state nursing boards to vouch for nurses’ fitness to practice.
The reporters found an army of examples, from the disturbing anecdote they lead with to the 117 California nurses whose licenses had been revoked, suspended, denied or surrendered elsewhere or the 10 nurses who were disciplined in Rhode Island, yet operated with clear licenses in neighboring Massachusetts.
Most of these transgressions are recorded in a federal database, as well as in one operated by the National Council of State Boards of Nursing. Both are incomplete, even though states are required to update the federal database within 30 days of a disciplinary action. And the federal database, while more complete, is rarely used, probably because it costs money while the state boards’ database is free. Some states only check these databases when licensing a nurse the first time, others rely on the nurses themselves to disclose their own problems. A handful check their nurse list against the database regularly, but they appear to be in the minority.
Health care reform for the young and healthy
Filed under: Health care reform, Hot Health Headline
As part of the ProPublica Eye on Health Care Reform blog’s ongoing “What Health Care Reform Means For…” series, reporters Sabrina Shankman and Olga Pierce considered how the Senate and House reform bills would effect young, healthy, independent Americans. Here are a few highlights from their piece:
- They’ll no longer have the option of going without insurance (unless they’re willing to incur a penalty).
- They’ll get to ride their parents coverage until age 26 or 27, depending on which version you’re looking at. At present, it doesn’t last much past 19.
- The poorest may be eligible for Medicaid, even if they don’t have kids.
- In the Senate version, they’d also have the option of bare-bones coverage until age 30.
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Spend a week at the CDC studying public health, meeting sources. Apply for the AHCJ-CDC Health Journalism Fellowships today!
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