Serious flaws in DC's paramedic system

Recent health Articles, Events, Jobs, and Resources.

CONTENTS

1. Article: Ex-chief regrets DC fire merger with EMS
2. Article: Former DC hospital crowded with homeless families
3. Article: Insurers test health plans that stress patient choices
4. Article: Health overhaul to expand Medicaid to all poor adults
5. Article: After swine flu frenzy, biotechs come back to earth
6. Article: A better female condom
7. Article: DISB delays approval of CareFirst rate increase
8. Editorial: Serious flaws in DC's paramedic system
9. Editorial Cartoon: Passing health care reform
10. Letter to Editor: Washington Hospital Center's snow angels
11. Update: Health Wellness and Nutrition Supplement
12. Update: The DC budget process

ARTICLE SUMMARIES

1. Article: Ex-chief regrets D.C. fire merger with EMS
By Matthew Cella, The Washington Times, March 12, 2010

Summary: The former DC fire chief tasked with merging his firefighting and emergency medical services divisions to improve a beleaguered ambulance service now says the department should be divided, in large part because the culture of the historically white fire service makes employees indifferent to treating needy DC residents. Adrian Thompson, who led the department from July 2002 through December 2006, no longer thinks the plan can work. The former chief said white firefighters with generational ties to the department largely have been less accepting of the job's evolving responsibilities -- particularly an increased emphasis on providing pre-hospital care. Thompson said black and needy DC residents continue to be marginalized and that little progress has been made in healing the District's racial divide. The merger involved cross-training paramedics as firefighters, posting them on fire engines, and stationing firefighters trained as emergency medical technicians on ambulances. Thompson also took issue with Mayor Adrian Fenty, who often criticized former Mayor Anthony Williams on issues that included EMS, but has done little to help DC's needy residents. Fenty famously pledged in 2006 to separate fire and EMS, but backtracked on the pledge after he was elected. Thompson now frequently spends his days delivering Meals on Wheels.  |  Read article

2. Article: Former D.C. hospital crowded with homeless families
By Darryl Fears, The Washington Post, March 12, 2010

Summary: Flooded with more homeless families than the city has ever seen, District officials jammed up to 200 families into space at the DC General shelter meant for 135. The result: serious overcrowding, with people bunking together in common rooms and sleeping on cots in hallways. On Monday, more than 190 families -- 242 adults and 390 children -- were living at the family shelter on the former hospital's campus. The number of families fell to 175 Thursday as officials worked feverishly to place at least 50 families in alternate housing by the end of Friday. The crowding led to arguments and near-fisticuffs between residents. Conditions are sometimes unsanitary, with small swarms of gnats or fruit flies and roaches, paint chips flaking from the walls onto beds, and mildew in shower stalls. DHS officials, who manage the shelter, attributed the crowding to record unemployment, now 12% in the District; a sharp rise in evictions; and record low temperatures and snowfall. The District issued 99 hypothermia alerts thus far in the Nov. 1 to March 31 hypothermia season, compared with 92 during the season last year. Alerts are issued when the temperature and wind chill dip below freezing. The Hoya Clinic, which is run by the Georgetown University Medical Center, provides medical treatment to between five and 20 people a day.  |   Read article

3. Article: Insurers test health plans that stress patient choices
By Julie Appleby, USA Today, Kaiser Health News, March 11, 2010

Summary: Workers at a Portland, Ore., steel mill soon will be able to pick a new type of insurance that offers free care for some illnesses, such as diabetes or depression, but requires hefty extra fees for treatments deemed overused, including hip and knee replacements, hysterectomies, heart bypass surgery, and heart stents. The insurance, which will be offered by five different insurers in Oregon, is the most far-reaching and potentially controversial step in an effort by employers nationally to rein in medical spending by redesigning health benefits. Workers who choose the option over a more traditional plan next year could see their costs drop sharply if they have one of six chronic conditions but might pay hundreds more in deductibles and co-payments. The policies are among the first to apply financial incentives on both sides of one important factor driving up the nation's health care tab: The underuse of proven treatments and overuse of certain surgeries and diagnostic tests that may be less valuable. Value-based insurance design help steer patients to high-quality treatments, which could improve health and possibly slow health costs over time. But efforts to charge workers more for some treatments put employers in the position of playing doctor and are well into a danger zone of limiting access to medical care.  |  Read article

4. Article: Health Overhaul To Expand Medicaid To All Poor Adults
By Rick Schmitt, National Public Radio, Kaiser Health News, March 8, 2010

Summary: While Medicaid is the main government health insurance plan for the poor, the joint state-federal program excluded millions of adults with no dependent children since the 1960s. Medicaid has been limited mainly to children in poor families, the elderly, pregnant women, and the disabled. Some states tried to fill the gap, but childless adults now comprise a majority of uninsured Americans. The lowest-income members of the group would be among the big beneficiaries of the Democratic health insurance overhaul plans in Washington. Over 10 years, Medicaid enrollment would grow by 15 million, including not only childless adults but others whose incomes don't qualify now for the program. Covering childless adults would mark a radical shift in thinking about who deserves a helping hand, not to mention a departure from what Congress intended when it created Medicaid 45 years ago. The exclusion is rooted in the welfare system of 17th Century England, and an attitude that able-bodied men shouldn't be on the public dole. Imported to America, the distinction was reflected in cash assistance laws enacted during the New Deal, which served as a blueprint for Medicaid years later.  |  Read article

5. Article: After swine flu frenzy, biotechs come back to earth
By Vandana Sinha, Washington Business Journal, March 12, 2010

Summary: For much of 2009, the swine flu was the biotech industry's cash cow. The virus' sudden contagion last spring spread rapidly and lucratively to the local life sciences community, where a handful of companies scrambled to assemble enough money and staffers to launch studies, conduct research, and shape products to respond to the first documented flu pandemic in 40 years. Their battle against the H1N1 virus generated millions of dollars in revenue and lifted some stock prices to new yearly highs, with some leaping as much as 700% over the course of last year. But the pandemic's relatively light impact -- only 16,455 people died worldwide, compared with 1 million to 50 million deaths in past flu pandemics -- and a shorter-than-expected flu season brought some of those biotechs, not to mention their stock prices, back to earth. The companies are now evaluating their performance and lessons learned last year to push for improving flu vaccine technology in time for the next outbreak. Companies in the area now are either concentrating on how they can be part of the seasonal flu market or how they can prepare for the next pandemic. The swine flu frenzy touched several local biotechs in different ways.  |  Read article

6. Article: A Better Female Condom
By Kate Dailey, Newsweek, March 10, 2010

Summary: DOH officials announced a $500,000 grant from the MAC AIDS Fund to promote and distribute female condoms in DC. The announcement marks an ambitious collaboration of private and public organizations: CVS, which is distributing the condoms; the Female Health Co., which manufactures them; the District of Columbia; and the MAC AIDS Fund, the philanthropic wing of the cosmetics company. All this comes at a time when rates of HIV in DC area women are dangerously high, and when women's roles in AIDS prevention are often overlooked. It's a big investment in a bold plan -- but can female condoms really make a difference? The female condom, which can be inserted several hours before intercourse, remains the only way for women to initiate protection against sexually transmitted diseases. It allows a woman to protect herself without having to persuade the man with whom she's sleeping to change his behavior. Empowering women to take control of their own health and safety is the theory behind today's rollout in DC. Female condoms were available in DC prior to this partnership on a smaller scale, and women who use them like them.  |  Read article

7. Article: Complaint, error scuttle D.C.'s approval of CareFirst rate increase
By Keith L. Martin, Insurance & Financial Advisor, IFAwebnews.com, March 11, 2010

Summary: Reacting to a consumer complaint about unusually high health insurance premiums, the DC Department of Insurance, Securities and Banking rescinded its approval of a rate increase proposed by CareFirst after discovering a filing error by the regional insurer. An order rescinding the prior approval, issued to the insurer March 3, states that health insurance premiums for affected customers will revert to their previous rate until CareFirst files and receives approval for a revised rate. The new rate can take effect 90 days after CareFirst notifies subscribers. The order also provided for a refund of any overpayments plus interest. CareFirst's filing for the individual, non-Medigap indemnity health insurance policy through its subsidiary, Group Hospitalization and Medical Services, was initially approved by the DISB in October 2009, where the increased rate was to take effect Jan. 1. Due to an administrative error on the part of the insurer, an incorrect ratio was used to approve the 35% rate increase. GHMSI didn't incorporate the premium rates approved by the DISB in 2009 for the Comprehensive Major Medical coverage into its administrative system, resulting in affected subscribers being charged the prior year's premium rates.  |  Read article

8. Editorial: Serious flaws in D.C.'s paramedic system
The Washington Post, March 11, 2010

Summary: Problems still exist in the DC Fire and Emergency Medical Services. District officials need to determine why more progress hasn't been made in fixing the systematic deficiencies first identified in David Rosenbaum's case. Mayor Adrian Fenty wasn't in office when the case was bungled, but once elected he reached out to the Rosenbaum family with promises to do better. The family dropped a multimillion-dollar lawsuit, and a task force was formed; the result was some commendable improvements, such as toughening of qualifications for new hires. But it's clear that progress stalled. Medical providers have yet to be fully integrated into a department that clings to a culture where firefighters are valued over emergency medical personnel. The No. 1 recommendation of the Rosenbaum task force was to provide equivalent pay and benefits for medical personnel and unify operations. But Fenty and the Council have been at an impasse over how to accomplish this. There has been a revolving door of people serving in the critical role of medical director. Training is inadequate, and DC paramedics fail to meet minimum national standards. Fenty must renew the reform of this department. The Post urges him to reconvene the Rosenbaum task force to assess the department's progress and plot where it still needs to go.  |  Read editorial

9. Editorial Cartoon: Passing Health Care Reform
By Tom Toles, The Washington Post, March 12, 2010

Summary: Obama's using a complicated procedural mechanism to pass his health care plans!  |  View cartoon

10. Letter to Editor: Washington Hospital Center's snow angels
By Lisa M. Boyle (Great Falls), The Washington Post, March 11, 2010

Summary: "D.C. hospital fires 11 nurses, 5 staffers for snowstorm absences" and "21 District hospital workers fired for being blizzard no-shows" on dismissals at the Washington Hospital Center missed an opportunity to tell a compelling story. The remarkable story was that more than 1,100 professionals put patients' needs above personal considerations and came to work. In a week in which airports closed and governments were brought to a halt, life-sustaining and often life-saving care continued uninterrupted at WHC. During the week of storms, nearly 750 patients, many critically ill, received the care they needed. Fractured hips were fixed, heart attacks treated, burn victims cared for and, 90 babies were born. None of this would have been possible if not for the selfless professionalism displayed by nurses, technicians, and support personnel who showed up and stayed as long as required. They did what was needed for their patients. Despite their having to work overtime, sleep on cots, and eat hospital food, complaints were few. DC residents should know that no matter what catastrophes befall them, the medical care they have come to depend on will be there. (Boyle is president of the medical staff at WHC and associate chair of the department of surgery.)  |  Read letter

11. Update: Health Wellness and Nutrition Supplement
The Washington Informer, March 11, 2010 

Summary: Efforts in Washington, DC, to fix our broken health care system and provide affordable coverage for all Americans are only part of the battle. Companies and organizations teamed up in this edition to help make a difference in our community and become part of the solution. Outreach is a key part of the health care debate.  |  View supplement

12. Upate: How it works: The Budget Process in Washington, DC
Think Twice Before You Slice, March 2010

Summary: The District's operating and capital budgets identify the programs that are to be funded in the fiscal year and the revenue that'll support these programs. Additionally, the budget document provides a four-year financial plan, which shows the long-term impact of current spending and is a critical tool in ensuring the fiscal health of the District. Both the operating and capital budgets provide stakeholders with information on the operations of the District's approximately 80 agencies. The mayor develops and submits the proposed budget and financial plan for the next fiscal year to the DC Council by March 18. The Council holds public hearings and accepts the mayor's budget or adopts its own version. The mayor may sign or veto the Council's budget. If the mayor vetoes the budget, the Council may override the veto. Once agreement is reached between the mayor and the Council, the budget is adopted and transmitted to the president for submission to Congress for approval. Congress must approve the District's budget as one of the 13 annual federal appropriations bills.  |  Read update

EVENTS

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