by Bill Barrow,
The Times-Picayune
Charity Hospital
State officials
are considering spending an estimated $40 million of federal money to gut Charity Hospital despite the lack of any
decision about its future use, Louisiana Recovery Authority chief Paul
Rainwater said.
Such a move is
months away at the soonest, and officials have not determined exactly what
the gutting would involve. But Rainwater said the early talks have begun to
underscore the commitment of Gov. Bobby Jindal's
administration to preserve the 70-year-old building that has been shuttered
since September 2005.
"There's such
an emotional attachment to that building. It has to be preserved," he
said of the art deco structure recognized for its architectural significance
and its longtime distinction as a teaching hospital serving New Orleans' poor and uninsured.
Advertisement
A Jindal appointee, Rainwater said the administration
remains completely supportive replacing Charity with a new hospital complex
in lower Mid-City. That estimated $1.2 billion project is fraught with
financing gaps, questions over who will run the enterprise, legal challenges,
and persistent calls from several organizations pushing to gut Charity and
rebuild a hospital within its shell.
Rainwater
underscored that if the state guts Charity, it would be for some use other
than a hospital.
Spending Community
Development Block Grant money for that purpose would require a series of
approvals by the LRA governing board, state lawmakers and federal
bureaucrats. The money was authorized by Congress after Hurricanes Katrina
and Rita.
In addition,
Rainwater said no decision on gutting would occur before the state settles
its dispute with the Federal Emergency Management Agency over Katrina-damage
compensation for Charity. With a new arbitration process set to launch this
fall, a Charity settlement is expected no sooner than December.
A leading historic
preservationist, whose group is among those pushing to scrap plans for a
brand-new state hospital structure in Mid-City, expressed optimism at
Rainwater's remarks.
"It's
gratifying that the state recognizes the great value and potential of this
landmark building," said Sandra Stokes of the Foundation for a
Historical Louisiana. "We feel assured that once it is gutted, and once
the exterior receives some long-needed care and cleaning, more people will
see that Charity can provide the best location for the state-of-the-art
teaching hospital."
It is not clear
whether the state's timeline would allow for Stokes' scenario.
http://www.nola.com/news/t-p/capital/index.ssf?/base/news-7/1251004807309730.xml&coll=1
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Louisiana
Landmark Society names New Orleans'
9 most endangered historical sites
by Bruce Eggler, The Times-Picayune
Jennifer Zdon / The
Times-Picayune
Charity Hospital, glowing with activity in 2004, is one of New Orleans most endangered sites, according to the Louisiana Landmarks
Society.
Charity
Hospital, the Orpheum Theater, an Algiers library and the former home of the New Orleans Center
for Creative Arts are among the sites on the Louisiana Landmarks Society's
2009 list of New Orleans'
Nine Most Endangered Sites.
Also on the list
are a collection of buildings in the 400 block of South Rampart Street that
were important in the early history of jazz and a collection of
"downtown riverfront neighborhoods" said to be endangered by plans
for a frozen-chicken warehouse at the foot of Esplanade Avenue.
The Landmarks Society,
a preservation group founded in 1950, released its first "New Orleans
Nine" list in 2005. It skipped compiling the list in 2006 because of
Hurricane Katrina but resumed it in 2007.
The society's
list, like the National Trust for Historic Preservation's annual list of the
11 most endangered sites nationwide, is intended to make the public aware of
threats to historic places, with the goal of spurring action to protect them
from demolition, damage or deterioration.
"New Orleans is the envy of other cities across the United States
for our unparalleled inventory of historic buildings, even after all the
losses from Katrina, " said Sara Orton,
chairwoman of the committee that chose the nine sites. "We hope that our
list will serve as a reminder of the importance of our historic resources and
refresh New Orleanians' pride in our city."
The 2008 edition
of the list included the Dixie Brewery, St. Francis de Sales Church,
Deutsches Haus, several
mid-20th century public schools, the former Bohn Ford building and
custodians' cottages at public schools citywide.
The annual list
often features humble structures or offbeat but distinctive design features.
The 2005 list, for example, included the blue-and-white street name tiles
once common in sidewalks throughout older sections of the city, as well as
the 200-700 blocks of Bourbon
Street, best known for strip clubs and T-shirt
shops.
The 2007 list
included the Lafitte public housing complex, most of which has since been
demolished. The fate of the Iberville housing complex, which was on the 2005
list, remains uncertain.
Nominations for
the 2009 list were solicited from the public in January and February. A
committee of 15 preservation leaders chose the final nine.
The sites on the 2009 list are:
-- The 400 block
of South Rampart Street: Jazz historians say that few sites in New Orleans
have more connections with the early history of jazz than this block, home of
the former Eagle Saloon, Odd Fellows Ballroom, Iroquois Theater and a tailor
shop run by the Karnofsky family, friends of the
young Louis Armstrong. Various proposals have been made in recent years to
restore the buildings, which date from around 1885 to 1910, but little has
come of them and the structures remain in danger from "demolition by
neglect."
-- LaSalle Elementary School,
6048 Perrier St.:
This Italianate-style school, built around 1900, is better known as the
former home of the New Orleans
Center for Creative
Arts. Musical stars such as Wynton and Branford
Marsalis and Harry Connick Jr. studied and
practiced there as teens. The building has been vacant since NOCCA moved out
in early 2000 and is deteriorating rapidly, with broken windows and weeds
growing from the roof.
-- Downtown
riverfront neighborhoods: The Landmarks Society says this label refers to the
French Quarter, Faubourg Marigny
and Treme, which it fears are threatened by the
Port of New Orleans' plan to relocate New Orleans Cold Storage's
frozen-poultry warehouse to the Gov. Nicholls Street and Esplanade Avenue
wharves. "This plant should be constructed in an industrial area
separate from historic residential neighborhoods and significant historic
assets, " the society says. Port officials said
recently they are exploring the idea of putting the facility at another site.
-- Myrtle Banks Elementary School,
1307 Oretha
Castle Haley Blvd.: This three-story school was
built in 1910 and occupies an entire block. It has been closed since 2002 and
was damaged by fire in 2008. It is slated for demolition, but it remains
structurally sound, despite exposure to the elements, and "offers
tremendous redevelopment potential and is critical to the
revitalization" of O.C.
Haley Boulevard and the Central City
neighborhood, the society says.
-- Orpheum
Theater, 129 University Place:
This 1921 beaux-arts-style vaudeville house and later movie theater was home
to the Louisiana Philharmonic Orchestra but has been vacant since it was
flooded in Katrina. "Little to no progress has been made on repairing or
restoring this significant building, " the
society says, and "continued neglect endangers the future of this
important piece of the cultural and architectural fabric of New Orleans' downtown."
-- Overseer's
house at the New Orleans
Adolescent Hospital,
210 State St.:
This Creole cottage is believed to date from the early 1830s; the side wings
and front gallery were added about 1860. It is among very few buildings in New Orleans remaining
from the 1830s heyday of local sugar plantations. However, it is no longer in
use and has deteriorated. With the state closing the entire hospital, the
building's future is very much in doubt.
-- Charity Hospital, 1532 Tulane Ave.: The fate of this
massive 1939 art-deco-style hospital has been much in the news lately, as
debate continues over plans for a new state teaching hospital a few blocks
away. "The loss of Charity as a functioning medical hub would leave a
score of empty buildings on the periphery of the Central Business District,
making it more difficult to attain the density required for an active street
life, " the society says.
-- Hubbell
Library, 725 Pelican Ave.:
This "Carnegie library" opened in 1907 and for many decades was the
only public library in Algiers.
The library, known since 1975 as the Algiers Point Branch, reopened after
Katrina but was closed in 2008 because of serious damage to its roof. Repairs
have yet to be made, and it is unclear when the library will reopen.
-- New Orleans Center for the Education of Adults, 1815 St. Claude Ave.:
Built in 1908 and formerly known as McDonogh No.
16, this three-story school was still in use at the time of Katrina. Though
it sustained little or no damage, it did not reopen and has been scheduled
for demolition by school officials. "This building is located on a
crucial corner lot in a neighborhood that can ill afford the loss of another
substantial building on a primary corner, " the
society says.
http://www.nola.com/news/index.ssf/2009/08/louisiana_landmark_society_nam.html
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by Jonathan Tilove, Washington
bureau
WASHINGTON -- Republican members of the Louisiana congressional delegation opposed it; Gov.
Bobby Jindal used a nationally televised address to
deride it; and many in New Orleans
saw it as a missed opportunity to help the city's hurricane recovery.
But the Obama
administration's $786 billion stimulus package is contributing in important
ways to rebuilding New Orleans and the Gulf Coast,
Vice President Joe Biden told The Times-Picayune in advance of the fourth
anniversary of Hurricane Katrina.
Biden's comments
marked the administration's most vigorous and detailed defense of the stimulus
bill in the face of local concern that the measure ignored the needs of a
community recovering from the nation's costliest disaster.
"A lot of
money in the stimulus act -- covering everything from construction,
infrastructure to education -- is money that is discretionary, and the
discretionary money is designed to go to the places with the most need or the
most innovation," Biden said.
There was
disappointment in New Orleans
that the massive spending plan did not more directly target efforts to rebuild
the wounded city. That negative impression was compounded by a White House
estimate on the eve of the congressional vote on the plan that it would
create or preserve fewer jobs in Louisiana's
2nd Congressional District than any in the nation, chiefly because the
calculations were based on the district's storm-depleted population.
Retired Marine
Corps Maj. Gen. Doug O'Dell, who was coordinator of the federal Office of
Gulf Coast Rebuilding under President Bush when the Obama administration took
over, said he had advised Janet Napolitano, before she took command of the
Department of Homeland Security, that the new administration should use the
stimulus package as an opportunity to transcend ongoing funding battles
between FEMA and Louisiana officials in a number of high-profile situations.
Among those
situations, O'Dell said, were "Charity, Tulane, LSU Health Science,
criminal justice facilities, Orleans Parish sewer and water" -- all of
which he said could have been rolled into a $1.5 billion "silver bullet
to make all those problems go away, and still minuscule in the whole
panoply" of the stimulus package.
But the
administration did not take O'Dell's advice and, under pressure to avoid the
appearance that the stimulus act would become the mother of all pork-barrel
spending bills, the administration did not allow any
specific projects, such as the rebuilding of Charity Hospital,
to be cited in the legislation.
"When you ask
whether we could have come along and said, 'Look, New Orleans: Out of the
Recovery Act, we're going to come up with $500 million to rebuild Charity,'
the answer is, 'No, we couldn't do it that way,' " Biden said.
But in spending
the money, he said the administration has kept its eyes out for the Gulf Coast,
"particularly New Orleans,
because this has been a day-to-day focus of people inside the White House, as
well as the department heads."
"Even where
we can't technically say that New
Orleans qualified over somewhere else, there is
always the focus on where is the most need that it can be most effectively
spent," he said.
When will they
visit?
In the absence of
a presidential visit to commemorate the fourth anniversary of Katrina, the
Obama administration is taking care to deliver a message to the people of New Orleans and the Gulf Coast
that it remains mindful and committed to the rebuilding of the city and the
region. Obama and Biden, for example, granted interviews to The
Times-Picayune.
In the White House
interview, Obama, who is spending this week on vacation in Martha's Vineyard
in Massachusetts, promised to come to New Orleans by year's
end.
Asked when he
plans to visit, Biden replied, "My next trip, and I do want to go back,
is appropriately after the president goes.
"He's going
to go by the end of the year, so my guess is I will be going down just before
the end of the year or just after the first of the year," said Biden,
whose daughter graduated from Tulane University just before Katrina and who
spoke familiarly and affectionately of the city and its environs.
Obama assigned
Biden to oversee implementation of the two-year Recovery Act, which was
signed into law in February. All the Republicans in the Louisiana delegation voted against the
stimulus package, and Gov. Bobby Jindal rejected
some monies that he thought "would ultimately burden the state with
greater costs."
"We only had
a couple of governors who weren't crazy about receiving billions of
dollars," Biden said.
But, he said,
"we've announced over $3.3 billion just out of the Recovery Act for
Louisiana, a significant portion of that -- $2.2 billion -- has actually been
made available, and they've spent about a half a billion so far, and they are
about on track as other states, . . . and I was really pleased, and I mean
this sincerely, genuinely pleased that the governor has embraced this."
Biden said many
governors and mayors, with an eye toward tough budgets ahead, are already
asking, "Hey Joe, when's the second stimulus coming?" because they
have come to depend on this "$786 billion, two-year project to help the
American people stay above water and not drown as we begin to build a new
economy."
"I haven't
met a single governor, including the governor of Louisiana, who hasn't been appreciative in
talking to me about the stimulus act, that they would not have been able to
make it, etc.," Biden said.
Jindal criticized the stimulus package because he
thinks it unfocused, neither temporary nor targeted, and says it will add
massively to the federal deficit. However, he said he approved of using
stimulus money when it was "speeding up infrastructure projects that
were going to happen anyway."
'Real-life dollars'
The Recovery Act
includes 22 highway and transit projects in Orleans Parish, for which more
than $50 million have been obligated.
"Two of the
largest road projects are repairing hurricane damage (and) slated to begin
this fall, likely November," Biden said. "Twelve million bucks for
Fleur de Lis Drive, near the levee breach at the
17th Street Canal -- I've been stuck in traffic there -- and $9.6 million for
Earhart Boulevard, . . . actual real-life dollars going to projects that have
been stalled since the hurricane."
Biden said he
hoped and expected that New Orleans might
apply this fall for money to repair and perhaps expand streetcar service
through a program to support improvising new community transportation
infrastructure, noting that the streetcars in New Orleans
"are viewed a little like cable cars in San Francisco. It's not just a means of
transportation; it's a definitional element of the culture of the city."
In addition to
infrastructure, the vice president said, the Recovery Act provided tax relief
for working families; augmented checks to those receiving Social Security
disability, veterans' and unemployment benefits; paid to save teachers' jobs;
and helped hire or keep police officers, including 15 in New Orleans and 14 in St. Bernard Parish.
New Orleans has also received $7.6 million to be
distributed this fall to those at risk of becoming homeless.
"That means
7.6 million bucks is going to be distributed to people on the verge of losing
their homes to be able to help pay security deposits, utility payments,
moving costs, practical stuff that I don't think anybody who has not been hit
by that kind of distress has any idea, that makes a real big freakin' difference to somebody," the vice president
said.
Biden also singled
out a $5 million neighborhood-improvement grant for the Holy Cross
neighborhood in the Lower 9th Ward.
"They are
going to be actually constructing exactly the kind of thing I think is needed
-- their decision, but I happen to think it's a good idea -- a community
center that's going to include a visitors' center, corner store, cafe, small
bank, ATM, a meeting place -- the kinds of things that will pull a community
back together," the vice president said.
On health care, he
said, "we built 24 health care centers through 25 million bucks in the
Recovery Act. You now got about 49,000 new patients, including almost 20,000
uninsured patients, that are now being served."
Among the 24 are centers in Orleans and Jefferson parishes.
Meanwhile, the
existing St. Thomas
Community Health
Center has received
$1.4 million in stimulus money.
"With the
hospital system damaged in Katrina, St.
Thomas has stepped up to fill the gap, and we've stepped
up to help them," Biden said.
Charity 'still in dispute'
The White House
estimate, before the stimulus vote, that the package would create fewer jobs
in the 2nd District than any in the country, proved decisive for Rep. Anh "Joseph" Cao, R-New Orleans, who had been
leaning toward voting yes, but ended up voting no.
But, according to
a running tally compiled by ProPublica, an
independent investigative journalism site, so far, in stimulus money sent
directly to parishes, Orleans has received $372 per capita, putting it fourth
in the state behind Jackson, Lafourche and Plaquemines, which ranked first at
$798 per capita.
On the question of
whether any stimulus money could have gone to help replace Charity Hospital,
Biden said that apart from the fact that no earmarks were permitted in the
stimulus, "we couldn't have disposed of Charity like that, because your
local officials are still in dispute with FEMA as to what the total loss
is."
Instead, Sen. Mary
Landrieu, D-La., added an amendment to the stimulus package requiring the
administration to establish an arbitration panel to decide unresolved
disputes, such as the one between Louisiana
and FEMA over how much the state is owed for the damage at Charity.
"One of the
things about Barack, the president, I like is that he's a really practical
guy," Biden said. "He said, 'Look,' when talking to Mary
(Landrieu), 'let's just arbitrate this thing. Let's get this done.' "
Referring to plans
for a new hospital complex for the city that will include both a teaching
hospital to replace Charity and a new veterans
hospital, Biden said: "I hope New
Orleans figures out how to leverage both those
things."
http://www.nola.com/news/index.ssf/2009/08/_4309291_doug_odell_advised.html
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by Jonathan Tilove and Bruce Alpert, The Times-Picayune
When Hurricane
Katrina hit in 2005, Barack Obama was a fresh face on the national scene, a
man of uncommon eloquence, and the only African-American in the U.S. Senate.
It was hardly
surprising then that in the immediate aftermath of the storm, Obama emerged
as one of the most compelling critics of the Bush administration's handling
of the disaster.
In the years that
followed, and in five post-Katrina trips to the city, Obama honed his
critique and an alternative vision of what he would do if he were in charge,
culminating in a campaign speech at Tulane University on Feb. 7, 2008 in which he
asked the overflow crowd to "have the imagination to see the unseen, and
the determination to work for it."
Obama hasn't been
back to New Orleans
since, nor, in the seven months of his presidency, has he turned his
oratorical gifts more than fleetingly to the continuing struggle to bring the
city back from the brink. Unlike his sweeping pronouncements at Tulane in
2008, his approach to recovery along the Gulf Coast
as president has not been one of bold strokes or grand gestures.
But his
administration has shown a dogged dedication to bending the federal
bureaucracy in what Flozell Daniels Jr., president
and CEO of the Louisiana Disaster Recovery Foundation, describes as a
"kinder, gentler" direction.
With "federal
agencies finally working as partners and not adversaries, " Sen. Mary
Landrieu, D-LA, said, "in its first seven months, the Obama
Administration has made significant progress toward making the Gulf Coast
recovery effort quicker and more efficient."
"I would say
what they have demonstrated in this first year is a low-key but genuine
commitment to accelerate the business of recovery, " said Amy Liu,
deputy director of the Brookings Institution's Metropolitan Policy Program,
which publishes an annual New Orleans Index, detailing the city's progress
since Katrina.
Or as the
president put it in an Oval Office interview in advance of the fourth
anniversary, of Katrina: "In terms of rebuilding, two of my best Cabinet
members, Secretary Napolitano of Homeland Security and HUD Secretary Donovan,
have been spending an extraordinary amount of time thinking about how to deal
with the blockage of assistance in the region."
"As a
consequence of their efforts, " the president
said, "we have already seen a billion dollars that had already been
appropriated, but was stuck, now released. Projects like Southern University
of New Orleans now getting million of dollars for reconstruction. Schools,
they are now getting the help they need, police departments, fire
departments, infrastructure projects finally getting
on line."
Obama may have not
visited New Orleans as president -- though he
says he will by year's end -- but in the first six months of his term, half
his Cabinet has visited the Gulf Coast, with 19 senior administration officials
making a total of 30 trips to the coast, 20 to Louisiana.
And so Zach Rosenburg, co-founder and CEO of the St. Bernard Project,
which is helping homeowners rebuild their homes, said he recently found
himself spending four or five hours with HUD Secretary Shaun Donovan
discussing ways to expedite reconstruction efforts.
"There seems
to be a sense of light and doing right that was not there before, " said Pam Dasheill,
co-director of the Lower 9th Ward
Center for Sustainable
Engagement and Development. "For me there's a trust that's never been
there before, a sense that somebody has our back."
In the view of
Paul Rainwater, who as the executive director of the Louisiana Recovery
Authority is the state's chief hurricane recovery adviser, the Obama
administration has exhibited an understanding of something fundamental about
Hurricane Katrina that the Bush administration never did: that this was not
another disaster, but a catastrophe beyond "anything anybody's ever seen
before."
"They
appreciate that recovery is recovery and that it doesn't always fit into a
nice, neat package of rules, it's a messy business, and it's tough, and if
you really want people to come back you have to look at it in a different way, " he said.
A turnaround at FEMA
After Katrina,
FEMA became a four-letter word along the Gulf Coast,
and Obama said his administration's new direction in the Gulf "starts
with Craig Fugate, " his new FEMA
administrator. "We got someone with 25 years of emergency response
experience, bipartisan praise of his selection and he is already moving to
make sure that there is a timely, resilient response to any hurricanes or
natural disasters, " Obama said.
As important for
the rebuilding in Louisiana, by most
accounts, was Janet Napolitano's decision to name Tony Russell as the new
head of the FEMA Transitional Recovery Office in New Orleans.
"I think
we've seen a sea change there," Rainwater said. "There is no doubt
they truly want to work with us and help the city rebuild."
Gov. Bobby Jindal also praised the new team, saying, "Day to
day we have a great working relationship from Craig Fugate to Secretary
Napolitano to the HUD officials we work with.
It's "like
night and day, " said Rep. Anh
"Joseph" Cao, a Republican, citing as one example the brokering by
FEMA and the Louisiana Recovery Authority last week of a $27.8 million
settlement for St. Mary's Academy in New Orleans to help the school
consolidate its badly damaged 11 campus buildings into a single education
building. Under FEMA's recent decision, rather than having to replace
contents "book for book, " the school can lump replacements needs
into four broad categories -- making the replacement efforts not only easier
but more responsive to St. Mary's current needs.
When Paul Vallas, head of the Recovery School District, learned
that the formula in the stimulus package for apportioning money for teaching
disadvantaged students would have cost the district nearly $40 million
because it relied on a depleted student census for the post-Katrina 2007
school year, Education Secretary Arne Duncan, who succeeded Vallas as head of the Chicago schools, worked to make up
the difference by including money targeted for hurricane-affected districts
in the 2010 budget.
Last month,
prodded by Landrieu, HUD ruled that Neighborhood Stabilization Program funds,
aimed at helping communities struggling with foreclosures, could also be used
to redevelop blighted properties for housing purposes, a boon for New Orleans.
Administration has critics
But Sen. David Vitter,
R-LA, said he was disappointed that the "administration had to be
brought in kicking and screaming" to implement a more flexible
arrangement to allow essential building in flood-prone communities such as
Grand Isle.
Both Vitter and Jindal faulted the administration for not redesigning a
Medicaid funding formula that will dramatically shortchange Louisiana because it counts Road Home and
insurance money as if it represented a real and permanent increase in income.
"I don't think anybody feels we should lose federal health care dollars
because they were victims of an awful event, " Jindal said.
According to the
Obama administration, the formula is enshrined in law and requires a
legislative fix.
Jindal also said the administration had missed an
opportunity to settle the ongoing dispute over Charity Hospital,
which has been closed since Katrina.
In his Tulane
speech, Obama promised, as president, to "build new hospitals, including
a new medical center downtown."
Asked about
Charity, Obama cited disagreements within Louisiana about the Jindal
administration's plan for a new Mid-City teaching hospital. "The problem
has not been an absence of resources. This is a classic problem where
coordination in terms of siting, in terms of
disputes between state and local players and activists have gotten in the way
of us going ahead and moving forward."
To date, FEMA has
refused to pay Louisiana
the $492 million it claims it is owed to replace Charity, and the dispute is
now likely headed to a new arbitration panel established by the
administration under the direction of legislation authored by Landrieu.
"It was
important for us not to try by fiat to solve the problem,
" Obama said. "The key was to make sure that there was a
process where everybody felt they were heard. We came up with a sensible
resolution, and I think that's what's going to happen and the nice thing is
we know within 60 days it's got to happen."
On flood safety,
the president said that Category 5 storm protection "is still an
aspiration, " while Jindal
and Rep. Steve Scalise, R-Jefferson, said it is
essential. Scalise said he hopes Obama will
expedite the release of oil and gas revenue sharing to help pay for coastal
restoration, for which Jindal said he has yet to
see evidence of a strong federal financial commitment.
Asked about the
status of Category 5 protection and coastal restoration, Obama said there is
an interagency working group on the issue.
"Music to my
ears, " said Anne Milling of Women of the
Storm, who said she had been frustrated in her efforts to get the new
administration "to move forward to look to the future. If we don't solve
this problem, we are going to wash away."
Reinventing New Orleans
Four years after
the storm, Amy Liu of Brookings said she detects a broader shift in thinking
in and about New Orleans.
"I think
there's a real desire to now get past disaster recovery and really help New Orleans reinvent
itself with some signature transformative initiatives,
" Liu said. "That's what happened after the Los Angeles earthquake.
That's what happened after the Chicago
fire."
Liu said the
administration's priorities -- urban policy, transportation, health care,
global warming, green jobs, economic recovery -- are ripe for testing in New Orleans, and that Obama won't be able to mark the
fifth anniversary if he hasn't etched a vision for New Orleans on a broader canvas than a FEMA
public assistance worksheet.
As Obama put it in
remarks on the Senate floor just days after Katrina struck. "I hope we
realize the people of New Orleans were not just abandoned during the
hurricane, they were abandoned long ago -- to murder and mayhem in their
streets, to substandard schools, to dilapidated housing, to inadequate health
care, or a pervasive sense of hopelessness.'"
"We know the
president took over an unbelievable mess, "
said Jacques Morial, a brother of former Mayor Marc
Morial who works as an organizer on health care and
social justice issues for the Louisiana Justice Institute. "I think
after the economic meltdown, people were realistic -- save the economy first,
because if you don't we certainly don't have a chance."
But as time has
worn on, he said, "we're respectfully impatient."
http://www.nola.com/news/index.ssf/2009/08/obama_keeps_close_tabs_on_new.html
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Shreveport Times | 08.23.09
By Mike Hasten
BATON ROUGE — A
system that electronically links rural hospitals, allows doctors at LSU
Health Sciences Center-Shreveport to treat patients in remote locations and
puts patients' electronic records at doctors' fingertips has gained national
recognition.
Advance, a
national magazine for health information professionals, in its August issue
selected the collaborative effort of the Louisiana Rural Health Information
Exchange, the Louisiana Rural Hospital Association and the LSUHSC-S as the
nation's top health information technology project for the year. The system
brings high-quality health care to patients in rural central and north Louisiana.
The idea was born
of necessity in 2005 following Hurricane Katrina, said Dr. Donald Hines of
Bunkie, executive director of LARHIX.
"When we
started the project, health care in New Orleans
was in a shambles," Hines said, and the LSU hospital in Shreveport
was swamped with patients that normally were sent to New Orleans. Former LSUHSC-S Chancellor Dr.
John McDonald "wanted to avoid unnecessary transfers, sending patients
great distances for care."
But it wasn't
until 2007 that the first funding was approved — $13 million to preserve
health records, develop an Internet-based system so all patient records could
be accessed by health care providers and patients, and develop a way so
patients wouldn't have to travel long distances for treatment.
Initially, seven
hospitals were equipped to enable them to electronically connect and exchange
patient data with each other and the LSU hospital. Now, 14 hospitals are
linked, and 23 have telemedicine and distance learning capabilities that
allow rural doctors to communicate with those at the Shreveport hospital to get diagnostic and
treatment advice and training. Fifteen of the hospitals are doing
telemedicine consultations.
Currently, sharing
medical records are hospitals in Bunkie, Homer, Bernice, Farmerville, Delhi, Ferriday, Winnsboro, Jena,
Jonesboro, Pollock, Olla, Coushatta, Mansfield and Leesville.
"The budget
crunch canceled plans to add seven more this year," Hines said. The
system will extend its services to others and expand into south Louisiana "when
we get some money."
Hines said it has
helped rural doctors practice better medicine and made it much easier on
patients, who once had to travel to Shreveport
for any kind of specialized care.
Prior to LARHIX,
rural residents often waited from 110 to 180 days for an appointment at
LSUHSC-S for specialized care. Now they wait four to five days for a
telemedicine consultation.
Dr. Ishak Mansi, associate
professor of clinical medicine at LSUHSC-S and medical director of LARHIX,
said the system "makes access to health care much easier" and
"has made specialized care available for the first time in some
communities" that have no specialists.
"There are
all sorts of specialties available" through telemedicine, he said.
"It suddenly opens a new face of medical care for rural
communities."
With the new
system, specialists at LSUHC-S can examine and converse with patients and
examine X-rays or CT scans. And if patients do need to come to the hospital,
their medical records, including any tests that have been done, are
automatically at the hospital.
"We don't
have to repeat tests," Mansi said, "so it
avoids lots of cost and patient discomfort."
And when a patient
returns to his regular physician, everything that was done at the LSU
hospital is automatically in the records.
Hines said the
first big challenge was transferring doctors' paper records to a digital
format, especially when a rural doctor was actively treating a patient.
"It was like
trying to change a tire while the car was still rolling," he said. But
once it was complete, it makes keeping up with a patient's ailments,
allergies, medication and diagnoses simple.
Another challenge
was that most facilities don't use the same electronic format for digital
records. So, an "engine" was developed that translates all
electronic languages to the same format, enabling LSU doctors to read records
from any participating physician.
LSUHSC's internal medicine residency program, with
an emphasis on rural medicine, is providing physicians for rural hospitals.
Six third-year residents a year for three years (18 total residents) will
rotate through the rural hospitals. They're supported by an internal medicine
specialist on staff at LSUHSC-S.
http://www.shreveporttimes.com/article/20090823/NEWS01/908230335/1060
[BACK TO TOP]
By Bill Barrow
Staff writer
Throughout her
political career, Sen. Mary Landrieu has styled herself a centrist
deal-maker, a conciliator in a legislative process dominated by partisan
rancor.
It's a political
necessity for a Democrat in conservative Louisiana, and it appears to be her
strategy again as contentious debate about the American health system
consumes the nation.
Yet when she
returns to Capitol Hill from the August recess, Landrieu could end up being a
deciding vote that could put her at odds with her party leaders and President
Barack Obama, depending on what Senate Majority Leader Harry Reid brings to
the floor.
The third-term
senator also could have to choose sides between business and labor, competing lobbies that backed her 2008 re-election
bid but take different postures on some major health care policy questions.
Either possibility
adds intrigue in a chamber where Democrats hold 60 seats -- the minimum
necessary to overcome minority delay tactics -- and that count drops by two
with the absence of ailing Robert Byrd of West Virginia
and cancer-stricken Ted Kennedy of Massachusetts.
Viewed from one
perspective, it's an enviable position. "Everybody loves to be wanted,
don't they?" mused Amanda Austin, a top lobbyist for the National
Federation of Independent Business.
It can just as
easily become the political equivalent of an armadillo, dead in the roadway,
painted over with double-yellow stripes.
"I don't know
that I would want to be that senator," said JoAnn
Volk, legislative representative for the AFL-CIO, speaking generally about
the prospect of Landrieu choosing between powerful, irreconcilable
constituencies.
Landrieu echoes
business and labor in citing the need for any final product to control health
care costs. But unlike business associations, the AFL-CIO, the nation's most
powerful union, maintains that affordability can't be accomplished without a
public insurance plan to compete alongside the private market.
The U.S. Chamber
of Commerce and the National Federation of Independent Business oppose
mandates that employers provide coverage, components of a leading Democratic
House bill that includes the public option.
Landrieu, who won
rare twin endorsements last year from the national chamber and AFL-CIO,
described her role at this point in the debate as more of an active
negotiator and lobbyist among her colleagues, rather than sitting on the
sidelines and being recruited.
"I'm not
feeling pressure from my colleagues," Landrieu said.
--- Costs come
first ---
Earlier this
summer, Landrieu convened a hearing of her Small Business subcommittee to
hear concerns about health care costs for those enterprises. She has held a
series of roundtables in the state, where invited parties -- business, labor,
medical providers, lawyers -- discuss policy. And
she plans her first town hall session Thursday in Reserve, where she appeared
last month with Obama's health secretary, Kathleen Sebelius.
In an interview,
Landrieu repeated her skepticism about a public insurance plan, arguing that
the federal budget cannot sustain the cost. She said she thinks the
supporters of a "public option" are focused more on expanding
access, which she described as a secondary priority that must follow
controlling costs within the current system.
"I want to
make sure, No. 1, that whatever we do lowers costs for consumers and
business, for the people who drive the economy," she said.
Landrieu said she
is actively engaged with Sens. Ron Wyden, D-Ore., and Bob Bennett, R-Utah, on
a health care bill first introduced in 2007. The measure has seven
co-sponsors from each party but has gained much less attention as the Finance
Committee negotiates in advance of a fall vote on its version.
The Wyden-Bennett
bill includes a government-regulated insurance exchange, but only with
private plans, and it puts the burden on individuals to buy coverage, with
the government providing subsidies for premiums based on need.
Perhaps most
fundamental, it would begin to shift the entire insurance market away from
its current employer-based model by ending the income tax exemption on health
benefits, instead giving taxpayers generous tax breaks for insurance
coverage.
The political
question for Landrieu is whether the bill that Senate leaders bring to the
full chamber -- with Obama's blessing -- looks more like the Wyden-Bennett
model or whatever emerges from the House. A related matter is how much Reid
and the White House turn the screws once the first
question is settled.
--- Not choosing
sides yet ---
Volk, of AFL-CIO,
said she has seen few indications that the Wyden-Bennett group will find
itself well-represented when Finance Chairman Max Baucus, D-Mont., moves on
the issue.
Wyden, Landrieu
said, has had several meetings at the White House, including with the
president.
Landrieu said she
"reserves her options" on any floor votes.
The views of
interested figures in Louisiana and Washington and the
lobbying efforts of key groups portend what the senator could face at that
point.
The Family
Research Council, based in Washington,
D.C., meanwhile, is in the
middle of a statewide cable and radio advertising campaign against House
Democratic plans, arguing in part that a public plan could end up covering
abortions.
The group said it
targeted Louisiana
because it is home to a potential swing vote, a familiar spot for Landrieu on
abortion-related matters.
From the other end
of the spectrum, liberal groups have financed ads chiding Landrieu for
accepting $1.6 million in contributions from health care and insurance
sources.
At the National Federation
of Independent Business, Austin
said: "It's been a good road with her. I hope we can continue to get her
to listen."
Volk, from
AFL-CIO, said, "We don't debate her commitment to health care reform.
She's not a senator we are worried about."
Michael Mitternight, who owns a heating and air-conditioning
business in Metairie, is a self-described
conservative Republican who participated in Landrieu's roundtables and
continues to talk with her aides.
Mitternight, who said he spends between $40,000 and
$50,000 annually on a health plan for his 10 employees, said, "I agree
there are people who need help (getting coverage), and I would hope she would
find a way to do that, but not at the expense of the people who drive the
economy. . . . In her defense, I believe that's what she's trying to
do."
State AFL-CIO
chief Louis Reine of Baton Rouge indicated he's more willing
than his national counterparts to look at ideas that do not include a public
insurance plan. But he said access is still a priority.
"Mary has
stood up for the working people of Louisiana,"
Reine said. "We hope she'll again step forward
and find a way to make sure all families have affordable health care."
At the grass-roots
level, Metairie resident Zach Hudson has
organized Louisianians for Real Healthcare Reform,
a small but active group pushing to include a government option.
"Sen.
Landrieu won her election saying she was fighting for Louisiana,"
Hudson said.
"She's helping block the plan that would give choice to Louisiana workers and
families. She needs to reconcile that with herself and the voters."
Looking ahead to
her public forum in Reserve, Landrieu said, "I hope to have a
productive, civil discussion."
http://www.nola.com/news/t-p/frontpage/index.ssf?/base/news-13/1251091263172760.xml&coll=1
[BACK TO TOP]
Shreveport Times | 08.24.09
By Drew Pierson
More than a year
after a state law made way for local control of certain state human services
decisions via tax-levying regional districts, some local officials still have
questions.
"We're still
trying to learn about the act: what responsibilities we would have, how it
(the district) would operate, how it would function, who makes the decisions
and questions concerning funding," said Bossier Parish Administrator
Bill Altimus. "We're told they (the state)
will continue to fund (services) at current levels, but that question comes
into play when you look at the difficulties the state is facing, particularly
in education and health services."
The law, which
took effect in June 2008, allows regional human services districts to be
created. Each district would be run by a governing board, with board members
representing each parish in the district. Each district also would have a
local administrator and staff. The districts have authority to levy property
taxes, which must be approved by voters — similar to how rural fire districts
are funded.
Eliminating delays
and streamlining processes are among the reasons why the state passed the law
allowing the districts' creation. When the local branch of the Louisiana
Office for Addictive Disorders needs to make a simple contract change with,
for example, a private counselor, local administrators estimate it can take
from three to six months to call the governing agency in Baton Rouge, file the necessary paperwork
and make the change.
"The benefit
of it being under local governance is that, sometimes, communications have go
from the regional office down to the state then back to the region in order
for things to happen," said Russell Semon, an
administrator with the local branch of the state Office of Mental Health.
"Local government doesn't have to go that far."
State
administrators say this is the best of all worlds: local bodies get more
control over states services while the state still pays the bill for services
provided by agencies such as the Office for Addictive Disorders and the
Office of Mental Health. If locals determine they need more money, they now
have the ability to raise the funds themselves.
But Bossier
officials suspect now that these districts are able to raise their own money,
the state may start reducing health budgets in the future and leaving it up
to the districts to fund the difference. The state already has cut millions
in health services this year to help reduce a budget deficit that ranged in
the billions before the spring legislative session, an economic situation
that does not appear to be improving anytime soon.
"What's going
to happen to our (state) operations if we continue to have a shortfall of
money?" asked Bossier Parish Police Juror Jerome Darby, a youth
counselor and the police jury's point man on the subject. "Those are
things we don't know right now. And when they say we could choose to do a
millage, basically, that's something that's very difficult for me to see:
people saying OK, let's do a millage for mental
health."
Four out of 10 of
the proposed health districts in Louisiana
have been formed already, including those surrounding the areas of Baton Rouge and New
Orleans. State administrators in the area have
referred to the pre-district system as isolated "towers," where
each state branch, though working in the same area, can sometimes act
independently of another because there is no central coordinator.
Streamlining that
process and putting it under one roof is the goal of this legislation, said
Lauren Mendes, a spokeswoman for DHH.
"The concerns
regarding future funding for the district were recently discussed, and DHH
officials were made aware that parish officials do not want to be in a
position to lose funding if the state must reduce spending to meet any future
drop in revenue," Mendes said. "Parish officials were informed
that, although spending reductions are always a possibility given the current
national economic situation, the LGEs
(local governing entity) are not specifically targeted. The state has
continued to fulfill its obligation to fund basic care."
How the board is
comprised is another concern of local officials because, as Bossier Parish
officials and others interpret the law, if a single parish does not appoint
its board member the district cannot form. Currently, the district
surrounding Monroe
is stalling because parishes in that area are not appointing board members, Semon said.
Besides Bossier Parish,
eight other parishes would be included: Bienville, Caddo, Claiborne, DeSoto, Natchitoches,
Sabine, Red River and Webster parishes.
Darby and others
say they will wait until at least October before taking any action. That's
when a regional meeting between area police juries has been called to discuss
matters including the health districts. Until then, Darby said, the police
jury will simply try to talk to its neighbors, and gather as much information
as it can.
"We need to
remember that it's not our money: it's the public's money," Darby said.
"And it's very important, very critical to me as an advocate for people
that they are receiving the services they need — that's paramount."
http://www.shreveporttimes.com/article/20090824/NEWS01/908240301/1060
[BACK TO TOP]
Letter: U.S. health-care ranking questioned
Nick Ferrara
Your Opinion
article about the United
States ranking of 37th in health care in
the world was truly incredulous.
Your liberal
slanting of the news continues.
Do you buy that
statistic? If you were sick, say with cancer, for instance, you would prefer
to go to 36 other countries, rather than be treated here in the United States?
Take a survey of
Advocate employees and report your findings (if you want to be honest).
We have the best
health-care providers in the world here. Our system may need some improving
(no doubt), but we have the best medical technology and technicians in the
entire world here.
How do you define
“health care,” if we rank 37th? And could you possibly give us the rankings
by country, since you seem to be so knowledgeable in this area.
Nick Ferrara
Independent
insurance broker
Baton Rouge
http://www.2theadvocate.com/opinion/54394677.html
[BACK TO TOP]
Shreveport Times | 08.24.09
By the LSU AgCenter
Lifelong eating
habits often are learned early. Eating while watching television may become a
habit for your young child and lead to unhealthy eating habits, according to
LSU AgCenter nutritionist Dr. Beth Reames.
"Research
suggests that kids may consume more calories while watching TV or crave foods
advertised on TV," Reames says.
Turning off TV and
tuning into each other at mealtime can be positive for both children and
adults, according to the nutritionist.
"Sharing food
and conversation around the table is important for children," Reames said. "Meals eaten together provide a time to
enjoy being with other family members and to learn about food."
The nutritionist
suggests ways to help encourage young children to eat at the table:
# Plan regular
mealtimes that allow family members to eat together. Allow children to choose
their favorite TV programs to watch outside of family mealtimes. Let children
know you are willing to change mealtime occasionally to let them watch a
special program.
# Spark your
children's interest in meals by including them in the planning and
preparation. Participation helps children feel good about themselves
and learn about important nutrients and foods at the same time.
# Let children
help set the table with colorful plates and decorations to make mealtime fun.
Try to make mealtime pleasant and relaxed. Be patient, casual and set a good
example by saying nice things about food, encouraging friendly conversations
and practicing good manners.
Reames offered additional tips to help children
learn good eating habits that will last a lifetime:
# Start each day with
a good breakfast.
# Eat three meals
a day and eat a variety of foods.
# Eat nutritious
snacks between meals.
# Enjoy eating
together as a family and try to make mealtimes pleasant and relaxed.
# Help plan and
prepare meals.
# Drink milk with
meals, and eat lots of vegetables and fruits.
#
Chew food well, eat
until full and then stop eating.
http://www.thetowntalk.com/article/20090824/NEWS01/908240309
[BACK TO TOP]
Allison Aubrey
The fitness boot
camp craze is evolving. It's no longer just the crack-of-dawn, sergeant-led
calisthenics classes.
Mommy Bootie Camp
in Kensington, Md., packs a lot of punch, with a focus on
interval training.
Moms meet three
times a week at a local synagogue — and many of them bring their kids along.
"They have a built-in play date while we exercise," says instructor
Kristine Oleson.
To maximize the
hour-long class, Oleson incorporates a lot of short
bursts of high-impact cardio. There's skipping, jumping rope and running in
place.
"Pick up your
intensity," Oleson calls out to her class of
about 30 moms as they move through a round of skipping. "Really push
it!"
The goal is to get
heart rates up to about 85 percent of maximum for short clips of time, and
then dial back down to a slow or moderate pace.
"The benefit
of interval training is that it's a very efficient way to increase your
fitness quickly," says researcher Tim Church of the Pennington Biomedical
Research Center.
Church says
intervals aren't just for athletes and fit moms. Increasingly there's
interest in building them into the routines of older folks and those with
chronic conditions such as diabetes or heart disease.
"This is
really a hot area of research," Church says. Preliminary studies suggest
there's an additional benefit — beyond the benefits of steady-paced exercise
— to mixing in some interval training.
Interval Training For The Middle-Aged And
Slightly Plump
Researchers in Australia
have tried to find the most effective pacing for interval training. They're
focused on bringing the approach to folks who are pudgy around the middle and
older than 40.
"Everybody
can do 8-second sprints," says Steve Boutcher,
a professor of exercise science at the University of New South
Wales.
His studies have
documented the benefits of 20-minute workouts on stationary bikes.
Participants cycled three times per week. They alternated between 12 seconds
of slow, gentle peddling and 8-second intense sprints, peddling as hard as
they could.
"In the
20-minute bout," Boutcher says, the actual
hard exercise totaled just 8 minutes, "so it's not that much
exercise." But the payoff was significant.
Over the course of
four months, participants lost an average of 6 pounds of body fat. By
comparison, those who cycled at a steady pace for 40 minutes, without mixing
in the interval sprints, lost less than 2 pounds.
Researchers are
not certain how to explain this difference. But Boutcher
is studying the role of chemical compounds called catecholamines.
Boutcher says our bodies seem to produce higher
levels of catecholamines during sprint-type
exercises that elevate the heart rate.
"These are
hormones that tell the fat cells to release their fat," Boutcher explains.
Don't Want To Cycle? There Are Alternatives
If cycling doesn't
interest you, Boutcher's advice is to try swimming,
rowing or stair-climbing. If you like to walk, throw in some hills at a
faster clip — anything to mix up the pace.
But it's also
important to recognize your limits, and to start out slowly.
"I'm a huge
supporter of interval training because I think the payoffs are great,"
Church says. "I mix them into my workouts on a weekly basis." But
he cautions that people need to be careful.
"We see men
who are 45, and they've been sitting at a desk for the last 15 years, and
they want to start doing their high school football workouts again,"
Church says. They don't realize how out of shape they may be. Church advises
people to check in with their physicians before starting any intense interval
training, especially those who are managing a chronic condition.
Seeing Results At Mommy Bootie Camp
After years of
running, mostly at a steady pace, the interval approach emphasized at Mommy
Bootie Camp is paying off for one regular in the class.
"I think it
increases stamina, and it does seem to help with weight loss," says
Kathleen Sylvester, who brings her two preschool-age children with her to
class.
She says interval
training has also helped her build long, lean muscles. One other reason she
keeps coming: The baby-sitting is built-in.
http://www.npr.org/templates/story/story.php?storyId=112069354
[BACK TO TOP]
By Joseph A. Donchess
Special to The
News-Star
"Make no mistake "” home-care
programs are beneficial for the families they serve. But if Louisiana is to seriously address the
long-term care funding crisis that looms ahead, we must acknowledge the
facts: We have created a new home-care 'entitlement,' a
An Aug. 9 article
titled "Aging population increases needs" paints nursing home care
with a broad-brush stroke and fails to fully recognize the unique patient
services nursing homes provide that distinguish them from home care and fails
to account for the un-sustainability of the home- and community-based care
system. Also, the article leaves out a critical component to long-term care
planning: personal responsibility.
Long-term care
encompasses a full spectrum of services in a variety of settings including
assisted-living residences, skilled nursing facilities, nursing homes and
home- and community-based services. Each of these long-term care services
provides specialized care based on patient needs.
Frail, elderly and
disabled individuals should be cared for in the most appropriate setting that
meets both their clinical needs as well as their personal desires. Not
everyone who requires long-term care services can have his needs met through
home and community-based care. As providers, we need to ensure that the
patient has access to the most appropriate services for his needs and that
there are proper assurances that the care delivered is of the highest
caliber.
Today's nursing
homes provide quality care, 24 hours a day, often for individuals who can no
longer care for themselves or be cared for in the home environment. These
facilities also provide critical skilled rehabilitation services, where
patients return to the home environment after a short stay in the skilled facility.
The trend for
expansion of home- and community-based services, or HCBS, raises concerns
about the current lack of quality assurances regarding the delivery of
long-term care services, as well as the insufficient government oversight of
the settings where services are provided and of the individuals providing
care for these vulnerable seniors.
It is misleading
to claim that HCBS will save the state money. To compare, as the article did,
nursing home costs to three community-based services that provide only a
fraction of the necessary services to our elderly is deceptive and confusing.
Louisiana
nursing homes are seeing an increasingly diverse patient base and providing a
greater variety of sub-acute care, rehabilitative and convalescent services
that cannot be delivered elsewhere.
Well-intentioned
policy makers motivated by the desire to provide alternatives to nursing
homes harbor the false belief that expansion of home-care programs will keep
elderly and disabled people from entering nursing homes and that, ultimately,
the Medicaid system will save money because home and community social welfare
services are less expensive. Unfortunately, both of these beliefs in Louisiana and
experiences in other states prove that theory false.
What's happened is
that individuals previously cared for by family and friends are now
"coming out of the woodwork" and receiving Medicaid dollars to hire
someone to provide home care. Despite vigorous efforts by Louisiana's Department of Health and
Hospitals, very few people who have been living in nursing homes have been
able to be moved back to their communities. Before the implementation of this
service, people were content to get help from family members, friends, church
groups and charities, and the taxpayer was not forced to pick up the tab.
Other states,
including New Mexico, Oregon, Virginia and North Carolina, have already
witnessed this "woodwork effect" whereby skyrocketing, unchecked
demand for home and community-based social welfare services result in
unexpectedly higher state government costs. Some have halted further
expansion until the funding issues are resolved.
Make no mistake —
home-care programs are beneficial for the families they serve. But if Louisiana is to
seriously address the long-term care funding crisis that looms ahead, we must
acknowledge the facts: We have created a new home-care
"entitlement," and the state has to "rob" from the other
programs to pay for it.
The challenge now
is to continue to promote citizens' access to the care setting that best
suits their needs while ensuring adequate funding to nursing homes — keeping
in mind that because people are staying home longer, those who enter nursing
homes are now sicker and more expensive to care for than in years past.
Lastly, it is
crucial to the health-care and long-term care debate to fully investigate
personal responsibility. Certainly taking care of your health is part of
this, but in the event that extended care becomes necessary, long-term care
insurance is a viable and cost-effective option. Personal over-reliance on
government funding is unnecessary and unpredictable. Medicare does not pay
for extended nursing home care, and in order to use Medicaid, you must first
deplete your own savings. Furthermore, private supplemental policies, such as
Medigap, will only help pay for certain services.
Long-term care
insurance is the only option that gives you the security, flexibility and
freedom in the event that extended health care is needed in your lifetime.
This type of insurance can help maintain dignity and financial independence
if extended long-term care is needed. In the end, it is up to the individual
to make his or her own plans for long-term care.
This leads us into
a topic that should benefit all parties — beneficiaries, our State Medicaid
Agency and providers. The federally approved long-term care partnership
program, once it is adopted in Louisiana,
will allow individuals to buy long-term care insurance policies which cover a
multitude of services, including home care, assisted living and nursing home
care. If an individual outlives the length of the coverage (typically three
years) Medicaid would care for the person without requiring that person to
impoverish himself. If we could reduce our Medicaid enrollment by just 5
percent, the state and Medicaid could save millions of dollars.
Louisianans should
not ask what the government can do for them; they should take personal
responsibility and save for their futures. The long-term care partnership
program can help them do just that.
Joseph A. Donchess is executive director of the Louisiana Nursing
Home Association.
http://www.thenewsstar.com/article/20090823/OPINION02/908230311
[BACK TO TOP]
The Kingston Whig Standard | 08.23.09
By PETER
JANISZEWSKI
Leading health
experts and entire scientific associations are taking vehement exception to a
recent Time magazine cover story absurdly entitled "Why exercise won't
make you thin."
The author of the
article, John Cloud, selectively -- and often incorrectly -- reports on
scientific research, misquotes experts and exposes his naive understanding of
physiology, all to arrive at what I believe was the preconceived conclusion
that not only will exercise not help you lose weight --it may actually make
you fatter.
The
much-publicized conclusion is in direct opposition to the recommendations of
leading medical authorities, which promote regular physical activity as a means
of managing weight as well as improving overall health.
For example, in a
recent Whig column ("Losing weight all about calories," Aug. 13),
Dr. Gifford-Jones reinforced the notion that regular physical activity is a
key component to a lifestyle-based approach to shedding excess weight.
Paradoxically, in
the Time article, Cloud states: "Exercise ... isn't necessarily helping
us lose weight. It may even be making it harder."
In response, the American College of Sports Medicine swiftly
released a public statement denouncing the conclusion reached by Cloud.
"The
statement 'in general, for weight loss, exercise is pretty useless' is not
supported by the scientific evidence when there is adherence to a sufficient
dose of physical activity in overweight and obese adults," leading
obesity researcher Dr. John Jakicic said in
response to the Timearticle.
To the contrary,
numerous studies, including some conducted at Queen's University, have shown
that when it comes to weight loss, exercise is just as effective as dieting.
For example, in a series of studies performed in the laboratory of Dr. Robert
Ross, obese men and women who underwent three months of either dieting or
daily exercise lost the same amount of weight (about six to eight kilograms),
regardless of the method.
What's worse is
that Dr. Timothy Church, a scientist at the Pennington
Biomedical Research
Center in Louisiana, who was prominently featured in
Cloud's article, has accused Cloud of misrepresenting his professional
opinions. This is most unfortunate for Cloud, because much of his argument
rests on the results of a recent study by Church and Cloud's erroneous
extrapolations from it.
Throughout the
article, Cloud describes, with apparent distaste, his four hours of weekly
exercise, which he performs begrudgingly with the purpose of losing weight.
The interesting thing about his confessions is that only 90 minutes of his
weekly exercise is composed of aerobic activity (for example, jogging,
swimming and cycling) -- the type of exercise you should be doing if your
goal is to slim down.
Current
recommendations suggest that individuals attempting to lose weight should
perform 60 to 90 minutes of aerobic exercise on most days of the week. Thus,
Cloud's apparent inability to lose weight is not surprising given that he
performs in one week the amount of exercise that must be performed daily if
weight loss is to be achieved.
While Cloud
demonizes exercise as the cause of his apparent inability to shed excess
pounds, one gets the impression that the cause of his unsuccessful weight
management is improper nutrition. For example, he admits to previously
"self-medicating with lots of Italian desserts" and describes
craving French fries or greasy burritos after exercising.
Proper nutrition
is a critical component of a lifestyle-based approach to dealing with excess
weight. You can't expend 300 calories on a jog, follow it up with a
500-calorie burrito and expect to lose weight.
More importantly,
regular physical activity is good for your health and reduces your risk of
getting most diseases, independent of its effect on body weight.
Individuals of all
sizes and ages can vastly improve their health by becoming more active, even
when their weight on the scale refuses to budge. Due to the prevailing focus
on weight loss, the lack of weight change is too often interpreted as a
treatment failure, leading to discontinuation of the healthy activity.
Unfortunately,
this is exactly the conclusion Cloud comes to at the end of the article, and
it is this conclusion that is the most damaging. In the last sentence, Cloud
sums up by stating that "Tomorrow I might skip the Versa Climber."
I truly hope
others do not follow Time's misguided advice.
Peter Janiszewski is a PhD candidate in the School of Kinesiology
and Health Studies at Queen's University. For more health and fitness news,
visit his website at www.obesitypanacea.com.
http://www.thewhig.com/ArticleDisplay.aspx?e=1712058
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Joseph M. Scholl
As a 74-year-old senior citizen, I am amazed that so many
of my fellow elderly folks have allowed themselves to become paranoid because
of the many false statements being circulated about health care plans.
Thanks to the government-operated Medicare program, my
father received excellent care and treatment that enabled him to live to the
age of 87 while having congestive heart disease for many years.
My father-in-law received the same Medicare service until
he passed away at the age of 92 also. Although I am still working, my wife
and I were recently removed from a private medical insurance program, and
went on the Medicare program with a supplement.
The cost has been less, the coverage improved and my wife
is covered despite being a cancer and stroke survivor, with diabetes,
glaucoma and arthritis. I would encourage senior citizens to contact their
congressional delegation to express their concerns regarding the future of
Medicare.
Joseph M. Scholl
Metairie
http://www.nola.com/news/t-p/letterstoeditor/index.ssf?/base/news-14/1250919097292840.xml&coll=1
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Margaret Mary Grimsley
Re: "We can't afford this bill," Your Opinions,
Aug. 18.
Frank Gilbert's opinion, that we cannot afford any reform
of our faulty "for profit" health care system, is appalling and
incredibly misguided.
Mr. Gilbert asserts that we do not need to intervene in
the health system due to the availability of charity facilities.
Respectfully, who does Mr. Gilbert think pays the bill upon a patient's
discharge from a charity hospital? Americans pick up the inflated check!
I am puzzled by the fierce reaction to the possibility of
controlling medical costs and fiscally planning for the health care needs of
our citizens. In fact, Mr. Gilbert's self-professed usage of Medicare is a
suitable example of the government providing a reliable service at a
controlled cost.
If the health care bill with the provision of cost control
does not pass, Americans will indeed continue paying for exaggerated health
care expenditures for charity-type accommodations, as well as private
insurance.
Therefore, we are not saving money by doing nothing. Can
we afford this?
Margaret Mary Grimsley
Covington
http://www.nola.com/news/t-p/letterstoeditor/index.ssf?/base/news-14/1250919099292840.xml&coll=1
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Advocate staff report
Published: Aug 22, 2009 - Page: 5B
The number of Louisiana
people living with HIV infection increased annually from 1999 to 2004, state
public health figures show.
Because of the number of people leaving the state after
Hurricane Katrina hit, the figures dipped from 2004 to 2005, according to the
Louisiana Office of Public Health, HIV/AIDS Prevention Program.
Since 2005, however, state residents living with HIV
infection have again increased annually. For 2008, the number reached its
highest level ever — 16,282.
The office of public health also reports:
·
As of Dec. 31, 2008, a cumulative total of 28,665
people have been diagnosed with HIV infection in Louisiana, including 308 cases in children
under the age of 13.
·
The case rate for black residents continues to
be disproportionately high — almost seven times higher than among white
residents.
·
Women represented 33 percent of new HIV
diagnoses in 2008.
http://www.2theadvocate.com/news/54047067.html
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President Obama talks about health care reform
Thursday in Washington.
WASHINGTON (CNN) -- Facing a recent erosion of public
support for health-care overhaul, President Obama lashed out at his opponents
Saturday for spreading "outrageous myths" on the Internet,
television, and at town hall forums.
Republican leaders, in turn, said it was Obama who is
guilty of playing "fast and loose with the facts."
They repeated their assertion that the president's
proposed government-funded public health insurance option would destroy the
current private insurance-based system.
"I'm glad that so many are engaged," Obama said
in his weekly radio address. But it should "be an honest debate, not one
dominated by willful misrepresentations and outright distortions, spread by
the very folks who would benefit the most by keeping things exactly as they
are."
Obama emphasized that, contrary to the assertions of many,
illegal immigrants will not get health insurance under a reform plan.
"That idea has never even been on the table," he
said.
He said the charge that funding for abortions would be
mandated is false, as is the notion that federal "death panels"
would be established to discourage care for the sick and elderly. Video Watch
as the president debunks what he calls the myths about health care »
The health-care bill advanced in the House of Representatives
would include coverage of end-of-life counseling for Medicare beneficiaries
who want it. The provision was recently dropped, however, by Senate
negotiators.
Obama asserted that his plan would not lead to "a
government takeover of health care," and said the proposed public option
is just "one idea among many to provide more competition and
choice."
"If you like your doctor, you can keep your
doctor," he said. "If you like your private health insurance plan,
you can keep your plan. Period."
Republican Rep. Tom Price of Georgia had a different take.
Video Watch Rep. Price outline his opinions »
"The plan being promoted by the White House would
give Washington
the power to make highly personal medical decisions on behalf of patients --
on behalf of you," Price, a former physician, said in the weekly GOP
address.
Obama "has also said that he thinks the government
should compete with your current health care plan.
"But we all know that when the government is setting
the rules and is backed by tax dollars, it will destroy -- not compete --
with the private sector. The reality is, whether or not you get to keep your
plan, or your doctor, is very much in question under the president's
proposal," Price said.
Price also argued that under Obama's plan "every
health care plan will have to meet a new federal definition for coverage --
one that your current plan might not match, even if you like it."
Price urged a "bipartisan solution that puts patients
in charge" and rejects "a government-centered approach."
The latest charges and countercharges came after another
week of highly publicized arguments among congressional Democrats over the
political viability of a public health option.
One of the top Senate negotiators, Sen. Kent Conrad, a
North Dakota Democrat, has insisted that a public option cannot get the 60
votes required to overcome a Senate filibuster.
House Speaker Nancy Pelosi asserted Thursday that a bill
cannot pass the House of Representatives if it does not include a public
option.
The No. 2 Democrat in the House, however, seemed less
definitive. Majority Leader Rep. Steny Hoyer,
D-Maryland, told reporters Friday on a conference call, "As I've said in
the past, I'm for a public option but I'm also for passing a bill. ... But,
you know, we'll have to see because there are many other aspects of the bill
as well."
After Hoyer's conference call, an aide told CNN that the
majority leader is in full agreement with the speaker over the need for a
public option, and that it will be hard to pass the House without one. What
he was acknowledging, the aide said, was the reality that a public option
will be hard to pass in the Senate and therefore in Congress as a whole.
The public option has been cleared by three committees in
the House as well as by the Senate Health, Education, Labor, and Pensions
Committee.
But a bipartisan group of six negotiators on the Senate
Finance Committee -- the last committee that needs to clear health-care
legislation before it can be taken up on the Senate floor -- is considering
dropping a public option in favor of nonprofit cooperatives that would
negotiate collective polices for members.
Some top Democrats have responded in recent days by
hinting that they may instead try to short-circuit the traditional Senate
legislative process by passing a health-care bill through an obscure tactic
known as reconciliation, a type of budget maneuver that requires only a
simple majority -- 51 votes -- to pass.
Such a maneuver would boost the prospects for Senate
passage of a public health option. But Republicans have equated such a move
to legislative warfare.
White House Press Secretary Robert Gibbs reiterated Friday
that the president remains committed to crafting a bipartisan bill.
http://www.cnn.com/2009/POLITICS/08/22/obama.health.care/
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The New York Times | 08.23.09
By KATIE ZEZIMA
MAMARONECK,
N.Y. — For 10 days in June,
Kristen Murphy chose to live somewhere she and many others fear: a nursing
home.
Ms. Murphy, who is in perfect health, had to learn the
best way to navigate a wheelchair around her small room, endure the
humiliation that comes with being helped in the bathroom, try to sleep
through night checks and become attuned to the emotions of her fellow
residents.
And Ms. Murphy, 38, had to explain to friends, family and
fellow patients why she was there.
Ms. Murphy, a medical student at the University
of New England in Biddeford,
Me., who is interested in geriatric
medicine, came to New York
for a novel program that allowed her to experience life as a nursing home
patient.
Students are given a “diagnosis” of an ailment and
expected to live as someone with the condition does. They keep a daily
journal chronicling their experiences and, in most cases, debunking their
preconceived notions.
The program started in 2005 after a student approached Dr.
Marilyn Gugliucci, the director of geriatrics
education at the medical school. “ ‘Dr. G,’ ” she
recalled the student saying, “ ‘I would like to learn how to speak with
institutionalized elders.’ What came out of my mouth was, ‘Will you live in a
nursing home for two weeks?’ ”
To Dr. Gugliucci’s surprise, she
found nursing homes in the region that were willing to participate and
students who were willing to volunteer. No money is exchanged between the
school and nursing homes, and the homes agree to treat students like regular
patients.
“My motivation is really to have somebody from the inside
tell us what it’s like to be a resident,” said Rita Morgan, administrator of
the Sarah Neuman Center for Healthcare and
Rehabilitation here, one of the four campuses of Jewish Home Lifecare.
“But she is really there to study herself, her own
feelings about living in a nursing home,” Ms. Morgan added, referring to Ms.
Murphy.
Geriatric specialists hope the program and others like it
help generate interest in the profession, one of the most underrepresented
fields in medicine. Medical schools and residencies require little to no
geriatric training, and many students are reluctant
to get into the field because it is among the lowest paid in medicine.
In 2005, there was one geriatrician for every 5,000 people
over 65, according to the American Geriatrics Society; by 2030 that ratio is
expected to increase to one for every 8,000 patients. Geriatricians must
participate in a two-year fellowship program after medical school to become
certified. In 2007, only 253 of 400 fellowship slots were filled, and only 91
of the physicians graduated from medical school in the United States.
“It’s kind of a crisis,” said Dr. Cheryl Phillips,
president of the society. “I don’t think many seniors recognize this.”
Like many medical students, Ms. Murphy was scared of
nursing homes. The feeling began when, as a young adult, she visited her
grandmother, who had Alzheimer’s disease.
“I think nursing homes are scary,” she said, “but I don’t
think you can be a good doctor if you’re scared of the place where a lot of
your patients live.”
The first few days, which included filling out paperwork,
undergoing a full-body mole and sore check, eating pureed foods and being
raised out of bed with a lift, did nothing to validate her decision. When she
wedged her wheelchair into a corner and could not get out, she cried in
frustration.
“All I wanted to do was shut my door and stay in here,”
said Ms. Murphy, whose “diagnosis” was a mild stroke that affected her right
side, difficulty swallowing and chronic lung disease. “But I understood I had
to go out.”
Not everyone does. Some patients want to talk for hours,
while others act out, like a woman who pinched Ms. Murphy as hard as she
could. Many sit in the hallway by the nurse’s station each day because it is
a hub of activity. Emotions run high.
Ms. Murphy said she soon learned that many patients cried
because they knew that they would most likely never live anywhere else, or
because they missed family and their old life.
“At times I felt really lonely and got depressed,” she
said. “Sometimes it was an emotional roller coaster, up and down, up and
down.”
No one said a word the first time Ms. Murphy showed up at
the daily bingo game. She started to talk to anyone who would listen. And she
was surprised what happened.
First she bonded with Camille Stanley, the “queen bee” of
the social scene. Then she found Dr. Thomas N. Silverberg, 89, a former
internist and arthritis specialist with advanced rheumatoid arthritis. “My
specialty is slowly killing me,” Dr. Silverberg said.
The two talked for hours about life and medicine. Unlike
the friendships she makes as an adult, slowly nurtured over dinners and
drinks, bonds in a nursing home, where there is nothing to do but talk, are
forged quickly and deeply.
“When I came in, I was worried about working with older
folks because I was afraid I wouldn’t be good at it,” Ms. Murphy said. “Now,
if anything, I’m worried I’ll love them too much and it will really hurt to
work with folks at the end of their lives.”
Most residents knew why she was there. During her
going-away party they presented her with a big card, and shouts of “We love
Kristen” were heard throughout.
The program has solidified Ms. Murphy’s desire to work
with older people. And the hardest lesson she learned — that for some people,
it is better to be in a wheelchair or to have limited mobility — will make
her become a better doctor, she said.
“As a doctor, my job is to help patients live the life
they want to,” she said. “And if they’re in pain, you have to say ‘That’s
O.K. if you want to spend your time in a wheelchair.’
“For me that’s such a different place to be. Because I
hate this chair. It still startles me that that’s the choice.”
Ms. Murphy said the care she received at the home was
outstanding. But there were things that could use improvement: she did not
realize she could ask for things like soda, and she felt that shower bars
were too high for someone in a wheelchair. She also told the staff at a
debriefing session that families should be included in more activities.
Dr. Phillips of the American Geriatrics Society, which is
not involved with this program, said the challenge was to see “how this
replicates everywhere else and how enthusiastic medical students are to take
this on.”
Another of the 10 students who have gone through the
program, William Vogt, spent 10 days last summer in a nursing home at the
Veterans Affairs hospital in Augusta, Me. Mr. Vogt, who spent a day wheeling
around with petroleum jelly smeared on his glasses and cotton stuck in his
ears, said he was particularly struck by the fact that many patients
considered the nursing home to be home and the staff “a second family.”
Mr. Vogt said the little things counted, like lowering
nameplates so patients could locate their rooms and not putting a remote on
top of a television, out of reach.
“There’s a little part of it that works its way into
everything I do, from patient interaction and awareness of how I come across
to what I say,” said Mr. Vogt, a medical student doing clinical work at a
hospital in Watertown, N.Y. “There’s this shift of the humanity of it.”
http://www.nytimes.com/2009/08/24/health/24nursing.html?_r=1&ref=health
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The New York Times | 08.23.09
By WALECIA KONRAD
Gary Kazanjian
for The New York Times
Ed and Toni Eames and their guide dogs, Latrell, left, and Keebler, at
their home in Fresno, Calif.
Mr. Eames is president of the International Association of Assistance Dog
Partners.
BECAUSE she suffers from a rare genetic disorder,
17-year-old Siobhan O’Connor walks with braces and cannot speak. Her
assistance dog, Gaynor, helps Siobhan keep her balance and navigate crowds
when she leaves her Santa Monica,
Calif., home. The dog can also
pick up dropped items or open and close doors.
“Gaynor has been a tremendous help for my daughter
physically, and a great bridge socially,” said Siobhan’s mother, Linda Karr
O’Connor.
That is why Ms. O’Connor was so surprised when the company
that administers her employer’s flexible spending health account rejected her
claim for hundreds of dollars of veterinary bills and other maintenance costs
for Gaynor. (A flexible spending health care account lets employees use
pretax dollars to pay for qualified medical expenses.)
Service dog expenses are medical costs approved by the
Internal Revenue Service, and Ms. O’Connor had filed similar expenses under
her flexible spending plan in the past without problem.
But her employer had recently switched plan
administrators, and the new company balked at paying the claims. Only now,
after dozens of letters and phone calls, is the check supposedly in the mail.
“It took an amazing amount of effort, but I wouldn’t give
up,” Ms. O’Connor said. “I felt like it was almost a form of harassment or
even discrimination against my disabled daughter.”
The O’Connors’ situation
illustrates the financial burden that people with assistance dogs may face.
Wonderful as the animals are, it can be costly to buy, feed and care for
them. No health insurance policies cover these costs.
More people are likely to enter this thicket in coming
years. Although few firm numbers are available, people in the profession say
the number of assistance dogs in use in this country has continually grown,
as experts have been able to train dogs for more types of tasks. Besides
traditional activities, like guiding the blind and acting as hearing dogs for
the deaf, the animals are increasingly being used to help people in
wheelchairs and children with autism. Some dogs can even warn people with
diabetes that they have low blood sugar or people with epilepsy that they are
about to have a seizure. Still others help patients who are suffering from
brain trauma and other cognitive disorders function better in the everyday
world.
Service dogs have proved so successful for wounded Iraqi
war veterans that legislation has been introduced in both the House and the
Senate to start a comprehensive government-sponsored assistance dog program
for vets.
There are dozens of established nonprofit organizations,
including Canine Companions for Independence
and the Guide Dog Foundation for the Blind, that
provide service dogs free of charge to those who need them. But the wait can
be long.
Plenty of other programs, especially those specializing in
the newer uses of assistance dogs, will charge you part or all the cost of
raising and training the dog — which can range from $15,000 to $50,000.
And whether the dog is donated or purchased, once the
animal is home, it becomes the owner’s responsibility to feed and groom it
and keep it healthy. Food and routine veterinarian bills on average add up to
about $1,500 a year, said Jeanine Konopelski,
director of marketing for Canine Companions for Independence. And “if a dog becomes ill or
is hurt, vet bills can go much, much higher,” she said.
Ed Eames, president of the International Association of
Assistance Dog Partners, a nonprofit advocacy organization, said, “We hate to
see people missing out on this incredible aide because they can’t afford to
take care of an assistance dog.” Mr. Eames and his wife, Toni, are both blind
and both use guide dogs.
“And remember,” Mr. Eames said. “This is not a wealthy
group. Seventy percent of disabled people are unemployed.”
Fortunately, there are programs aimed at helping to defray
the costs of caring for an assistance dog. The following advice can help
people take advantage of the resources available and get the most for their
money.
CHOOSE CAREFULLY. “There are some phony programs out
there, so you have to be careful,” Mr. Eames warned. “You’ll pay a lot and
end up with a poorly trained dog.”
Look for established programs with a history of successful
fund-raising and large budgets. The Guide Dog Foundation for the Blind, for
example, spends about $55,000 to breed and train each of the 130 guide and service dogs it places each year, and has an
annual budget of $8 million.
Assistance Dogs International and the International
Association of Assistance Dog Partners list various organizations that train
all types of service dogs throughout the country.
Check to make sure the program you pick provides dogs and
equipment like special leashes free and also covers the costs of training the
human partner.
CREDENTIALS COUNT. You want your dog to come from a
program accredited by Assistance Dogs International, especially when
participating in a program where you are paying some or all of the costs.
This credential ensures that the program is adhering to industry training
standards.
Dogs from accredited programs are also more likely to
behave well in public, making it easier for people to go to places that are
often dog-unfriendly, like restaurants. Being denied such access is a common
problem for people using assistance dogs.
PICK THE RIGHT TRAINER. Recently, it has become more
common for human partners to train their own assistance dogs, usually with
the help of a professional trainer. This can be expensive, however, with no
guarantee of results, warns Mr. Eames.
Trainers charge anywhere from $5,000 to $15,000 for each
dog. If you go with a private trainer, look for one who has previously worked
for one of the main assistance-dog training programs.
GET HELP WITH VET BILLS. Many veterinarian chains, animal
hospitals, teaching hospitals and local vets offer discounts on services for
assistance dogs. Ms. O’Connor, for instance, receives a 10 percent discount
on vaccinations and other services for Gaynor from her veterinarian.
For large vet bills, say for a surgery or major illness,
check back with the organization where you got the dog. Many programs have
emergency vet money available. In addition, the International Association of
Assistance Dog Partners lists many veterinarian hospitals that offer free
critical care for ill or injured assistance dogs and also runs a fund for
people in financial need who face large vet bills.
CHECK FOR TAX BREAKS. If your medical expenses equal more
than 7.5 percent of your adjusted gross income, you can write off those
expenses on your income taxes, including the cost of maintaining a service
dog.
And many companies do allow this expense on their flexible
spending accounts — without the impediments Ms. O’Connor faced. Check with
your employer’s benefits department.
http://www.nytimes.com/2009/08/22/health/22patient.html?ref=health
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