Category: Healthcare


Last I  checked the excuse for the shuffling that was  going on with  scheduling appointments.  Was not an  isolated incident as it was  being  done in more than one  VA Hospital.  Taking place due to  policies being implemented  to  monitor the productivity and efficiency of Hospital personnel and their respective departments. 

Protocols such as this are generally handed down from corporate hierarchy to regional and then local.   It is doubtful that regional or local management implemented these measures on their own and just happened to coincide with similar incidents in other  hospitals in the same way. 

If these protocols were being implemented and enforced  throughout all VA Hospitals , logic would dictate that  they originated higher up the food chain and that local as well as regional management had a stake in the ultimate outcome of these assessments.  After all ,  corporate politics would dictate that promotions and rewards would directly correlate with the outcome of said assessments as well as departmental records.

To establish unrealistic goals without providing adequate means to accomplish said goals effectively.  As well as establishing a competitive situation without adequate control measures to keep the  overzealous and unscrupulous from doing exactly what has been done.  Is an obvious failure on the part of corporate management, Eric Shineski, in this case.  To gloss over that fact is naive at best and criminal at worst.  But then Mr. Obama is no stranger to criminal negligence , gross ineptitude and just plain ignorance of the actions taking place around him.  So I suppose he can sympathize…..

 

~Desert Rose~

 

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VA Secretary Eric Shinseki. (Reuters/Jonathan Ernst).

VA Secretary Eric Shinseki. (Reuters/Jonathan Ernst).

 The Washington Post

 

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House votes 390-33 to speed up VA firings

The House on Wednesday overwhelmingly passed a bill to grant the Veterans Affairs secretary expanded authority to fire senior executives for poor performance.

The measure passed on a 390-33 vote amid allegations that veterans encountered delays in access to medical care at multiple VA hospitals across the country, leading to dozens of deaths. All 33 votes in opposition came from Democrats, including ledership Reps. Steny Hoyer (Md.) and James Clyburn (S.C.). House Minority Leader Nancy Pelosi (D-Calif.) voted to approve the measure.

Under the bill, the VA secretary would be authorized to dismiss senior executives or demote them to the civil service. It would require the VA secretary to notify Congress of such a firing or demotion within 30 days.House Veterans Affairs Committee Chairman Jeff Miller (R-Fla.) said the measure would help rid the department of incompetent employees in light of the controversy.

“The committee has received nothing but disturbing silence from the White House and only excuse after another from the Department of Veterans Affairs,” Miller said.

Rep. Corrine Brown (D-Fla.) said the legislation would send a message that the VA would be held accountable.

“It is very important as we go into Memorial Day that we let the veterans know that we appreciate their service. And we also need to let them know that we’re going to do all we can to make sure they have the quality health care they deserve,” Brown said.

An administration official said the White House supports the overall goals of the legislation, but also had concerns that it could have unintended consequences.

 

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Obama vows fix to veterans’ health care troubles

 

WASHINGTON (AP) – With outrage mounting over veterans’ health care, President Barack Obama declared Wednesday that allegations of misconduct at VA hospitals will not be tolerated, and he left open the possibility that Secretary Eric Shinseki, a disabled war veteran, could be held to account.

“I will not stand for it – not as commander in chief but also not as an American,” Obama said following an Oval Office meeting with the embattled Shinseki.

Congress moved to keep up the pressure on the administration, with the House easily approving a measure Wednesday evening that would give the VA secretary more authority to fire or demote the 450 senior career employees who serve as hospital directors or executives in the agency’s 21 regions. The vote was 390 to 33.

Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee, sponsored the measure, saying VA officials who have presided over mismanagement or negligence are more likely to receive bonuses or glowing performance reviews than any sort of punishment. He declared that a “widespread and systemic lack of accountability is exacerbating” the department’s problems.

The White House said it supported the goal of seeking greater accountability at the VA but had unspecified concerns about the legislation.

The growing furor surrounding the Department of Veterans Affairs centers on allegations of treatment delays and preventable deaths at VA hospitals. The department’s inspector general’s office says 26 facilities are being investigated nationwide, including a Phoenix hospital facing allegations that 40 people died while waiting for treatment and staff kept a secret list of patients in order to hide delays in care.

The allegations have raised fresh concerns about the Obama administration’s management of a department that has been struggling to keep up with the influx of new veterans returning home from the wars in Iraq and Afghanistan. Obama’s comments Wednesday – his first on the matter in more than three weeks – signaled a greater urgency by the White House to keep the matter from spiraling into a deeper political problem in a midterm election year.

 

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Possible drawbacks of the VA firing bill scheduled for Wednesday vote

The House is set to vote this week on a bill that would give the head of the Department of Veterans Affairs authority to fire or demote senior executives for perceived performance problems without going through the usual administrative procedures.

House Majority Leader Eric Cantor (R-Va.) added the measure to the weekly docket on Thursday, the same date VA Secretary Eric Shinseki testified about reports that VA health clinics throughout the country have cooked their books to hide treatment delays, some of which may have affected patients who died while waiting for care.

VA Secretary Eric Shinseki. (Reuters/Jonathan Ernst).

VA Secretary Eric Shinseki. (Reuters/Jonathan Ernst).

Ironically, the American Legion has called for Shinseki’s removal because of the alleged coverups, along with other problems such as a longstanding backlog of disability claims and preventable deaths at various VA hospitals. If the secretary departs, his critics would have to wait for a replacement to fire senior officials for the recent controversy.

Shinseki said during the hearing that he is “mad as hell” about the reported treatment delays, and he vowed to stick around until he improves VA services for veterans or President Obama asks him to resign.

MORE: Shinseki faces tough questions on VA scandal, vows to ‘accomplish a mission’

Although firing VA officials may quell the recent outrage over reported coverups, the Senior Executives Association has raised concerns about the House bill. Below is a summary of the measure’s drawbacks, as outlined in recent statements from the group:

* Due process: Senior executives can appeal firings and demotions to an administrative panel known as the Merit Systems Protection Board, which determines whether the personnel actions were warranted. However, the hearings are informal and the decisions are non-binding for agency executives, unlike with rank-and-file employees.

The SEA said the House bill would rob employees of the right to recourse when department chiefs wrongly punish their workers. They also noted that accountability processes already exist for senior executives.

Agencies must provide a 30-day written notice when they decide to remove senior executives. The officials can then argue against removal, choose to resign, or return back to work at a lower position. They may also be eligible for immediate retirement.

 

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Roll Call: Latest News on Capitol Hill, Congress, Politics and Elections

Obama Backs Shinseki Amid Calls to Resign (Updated)

VA Budget 03 042313 445x295 Obama Backs Shinseki Amid Calls to Resign (Updated)

Updated 6:22 p.m. | The White House is backing Veterans Affairs Secretary Eric Shinseki after he faced calls to resign Monday over allegations that veterans died waiting for care in Phoenix and other problems in his department.

“As the President said last week, we take the allegations around the Phoenix situation very seriously,” said Shin Inouye, a White House spokesman. “That’s why he immediately directed Secretary Shinseki to investigate, and Secretary Shinseki has also invited the independent Veterans Affairs Office of Inspector General to conduct a comprehensive review,” he said.

“We must ensure that our nation’s veterans get the benefits and services that they deserve and have earned. The President remains confident in Secretary Shinseki’s ability to lead the Department and to take appropriate action based on the IG’s findings.”

Earlier Monday, the American Legion called on Shinseki to resign, although the Veterans of Foreign Wars declined to do so. Sen. John McCain, R-Ariz., said he wants the investigation to go forward first. 

 

 

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Senator demands independent investigation as VA scandal spreads

By Jeremy Schwartz

The chair of the Texas Senate’s veteran affairs committee on Monday called for an independent investigation into allegations that wait time data was manipulated at Department of Veterans Affairs clinics in Central Texas and San Antonio.

Sen. Sen. Leticia Van de Putte, D-San Antonio, made her comments as the burgeoning scandal over VA patient care reached the Rio Grande Valley, where a former VA doctor accused the department of delaying colonoscopies for veterans with cancer and jeopardizing veterans’ visits to non-VA specialists because the agency took so long to reimburse private providers.

In Austin, Van de Putte demanded accountability from top VA leaders over claims that scheduling clerks were trained to falsely input appointment data to make it appear that waiting times were far shorter than they really are. The VA aims to see patients within 14 days of their desired appointment dates, and medical centers are graded on their ability to hit those targets.

“It appears the motivation for the deception…was a personal pay day in the form of a VA performance bonus,” Van de Putte said. “Someone is responsible. These scheduling clerks didn’t just decide to falsify reports all over the country at the same time…The allegations show a pattern that crosses multiple clinics and shows the actions were condoned at a pretty high level.”

The claims of whistleblower Brian Turner, a VA scheduling clerk who said he saw data manipulation in Waco, Austin and San Antonio, were first reported by the American-Statesman last week.

On Monday, new allegations emerged against the VA Health Care Center in Harlingen, and officials with the VA’s Texas Valley Coastal Bend Health Care System, which oversees the facility. Dr. Richard Krugman, former associate chief of staff at the center, told investigators that “patient care was impacted by the VA’s requirements to cut costs,” according to documents obtained by the American-Statesman.

 

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Cornyn Demands Answers From VA Secretary

May 13 2014

WASHINGTON – U.S. Senator John Cornyn (R-TX) today announced on Fox News he has sent a letter to Veterans Affairs Secretary Eric Shinseki after several reports surfaced of abuse and mismanagement in VA clinics in Texas and across the country.  The letter asks several questions of Sec. Shinseki, and calls on the Secretary to provide answers during his testimony before the Senate Veterans’ Affairs Committee on Thursday, May 15. A video of Sen. Cornyn’s Fox News interview regarding VA failures can be viewed here. Sen. Cornyn’s questions for Sec. Shinseki include:

“Can you confirm that supervisors at VA facilities in Texas have not and are not ordering employees to ‘game the system’ by concealing wait times?

“Can you confirm that veterans diagnosed with cancer of any kind that requires chemotherapy are provided that treatment in a timely manner by the VA? 

“Can you confirm that any bonuses or pay raises are on hold for senior leaders at VA facilities in San Antonio, Austin, Waco, Harlingen, and all VA facilities where similar allegations have been made?

“Can you confirm that staff at facilities currently under investigation for allegations of falsified reports will not be assigned to investigate other VA facilities? 

“Can you confirm that documents are being preserved at all Texas VA facilities?”

The full text of the letter is below and attached.

May 13, 2014

The Honorable Eric K. Shinseki
Secretary of Veterans Affairs
810 Vermont Avenue, NW
Washington, DC  20420

Dear Secretary Shinseki:

I write to reiterate my deep concern regarding the numerous, troubling reports that continue to surface regarding mistreatment of our nation’s veterans at Department of Veterans Affairs (VA) facilities across the country.  These reports indicate that incidents—including the withholding of life-saving care from some veterans—were the result of a culture of cover-ups, indifference as to the health and welfare of our veterans, and a complete lack of accountability that pervades your Department.  Yet, the Administration’s response to these troubling revelations has been lethargic and its inaction puzzling.

During your testimony before the Senate Veterans’ Affairs Committee on Thursday, I call on you to provide direct, clear answers to these questions:

1.         According to recent reports, you have ordered a “face-to-face audit” of all Department of Veterans Affairs clinics.  Can you describe in detail how you intend for this audit to be conducted, its timeline for completion, and what measures are being taken to ensure these audits are conducted in an independent and transparent manner?  If the allegations are substantiated, what type of action are you willing to take to right these wrongs, and how will the responsible officials be held accountable?

2.         A whistleblower in Texas claims that during his time as a scheduling clerk for VA facilities in Austin, San Antonio, and Waco, he was directed by supervisors to hide true wait times by inputting false records into the VA’s scheduling system.  VA officials in San Antonio deny this, while VA officials in Austin claim employees may have been discouraged from using the electronic scheduling tool that would reveal long wait times, but that those orders did not come from “executive leadership.”  Can you confirm that supervisors at VA facilities in Texas have not and are not ordering employees to “game the system” by concealing wait times?

3.         An Austin-based surgeon recently contacted my office to inform me he is not accepting any further subcontracts from the VA due to failures in patient care that he has personally witnessed.  Specifically, he saw a veteran in August of 2013 who was referred to him by the VA after they detected a lesion they suspected was cancerous.  Already two months had lapsed between the time they detected the lesion and the time he saw the veteran.  This surgeon performed a biopsy and diagnosed it as laryngeal cancer.  He informed the VA that the veteran needed immediate chemotherapy – that they had a real chance to treat his cancer if they started chemotherapy right away.  Almost two months later, he followed up on his case only to learn the VA never provided chemotherapy, with no good excuse as to why.  The veteran died several days later.  Can you confirm that veterans diagnosed with cancer of any kind that requires chemotherapy are provided that treatment in a timely manner by the VA?

4.         A whistleblower in South Texas who formerly served as associate chief of staff for the VA Texas Valley Coastal Bend Health Care System in Harlingen, TX, told the Washington Examiner this week that roughly 15,000 patients who should have had the potentially life-saving colonoscopy procedure either did not receive it or were forced to wait longer than they should have.  He also claims that approximately 1,800 records were purged to give the false appearance of eliminating a backlog.  Can you confirm that veterans requiring colonoscopies to detect cancer are provided with the procedure in a timely manner?

5.         In 2012, VA medical facilities in Central Texas reported that 96 percent of veterans were seen by providers within 14 days of their preferred appointment date.  In the South Texas region that includes San Antonio, the statistics were even more impressive: 97 percent of veterans were seen within two weeks, according to annual performance reports.  Can you produce documents that show the original dates of veterans’ requests for appointments for 2012?

6.         According to public records, the director of the Phoenix VA hospital, where news investigations have discovered at least 40 veterans died while waiting for care and languishing on secret lists, received more than $9,000 in bonus pay in 2013.  Can you confirm that any bonuses or pay raises are on hold for senior leaders at VA facilities in San Antonio, Austin, Waco, Harlingen, and all VA facilities where similar allegations have been made?

7.         My staff attended a Quarterly Congressional Staffer and Veterans Service Organization Representative Meeting at the Central Texas Veterans Health Care System (CTVHS) Friday, May 9, 2014.  Sallie Houser-Hanfelder, director of the Central Texas Veterans Health Care System, told meeting attendees that, as part of the face-to-face audits you have ordered, a quality systems manager from CTVHS would be sent to another VA facility to assist with investigations there.  Can you confirm that staff at facilities currently under investigation for allegations of falsified reports will not be assigned to investigate other VA facilities?

8.         A former VA employee at the VA Greater Los Angeles Medical Center told the Daily Caller that employees at the Center destroyed veterans’ medical files in a systematic attempt to eliminate backlogged veteran medical exam requests.  The former employee said, “The waiting list counts against the hospital’s efficiency.  He said the chief of the Center’s Radiology Department initiated an “ongoing discussion in the department” to cancel exam requests and destroy veterans’ medical files so that no record of the exam requests would exist, thus artificially reducing the backlog.  In addition, you have been subpoenaed by the House Veterans Affairs Committee over concerns by Chairman Jeff Miller that evidence in Phoenix may have been destroyed after the Committee issued a document-preservation order on April 9.  A top VA official testified on April 24 that a spreadsheet of patient appointment records, which may have been a “secret list” proving misconduct, was shredded or discarded.  Can you confirm that documents are being preserved at all Texas VA facilities?

I look forward to your prompt and detailed responses to these pressing questions.

Sincerely,

JOHN CORNYN
United States Senator

 

 

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Watch this video

Deaths tied to VA hospital’s secret list

 

(CNN)

The secret list was part of an elaborate scheme designed by Veterans Affairs managers in Phoenix who were trying to hide that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor, according to a recently retired top VA doctor and several high-level sources.

For six months, CNN has been reporting on extended delays in health care appointments suffered by veterans across the country and who died while waiting for appointments and care. But the new revelations about the Phoenix VA are perhaps the most disturbing and striking to come to light thus far.

Internal e-mails obtained by CNN show that top management at the VA hospital in Arizona knew about the practice and even defended it.

Dr. Sam Foote just retired after spending 24 years with the VA system in Phoenix. The veteran doctor told CNN in an exclusive interview that the Phoenix VA works off two lists for patient appointments:

There’s an “official” list that’s shared with officials in Washington and shows the VA has been providing timely appointments, which Foote calls a sham list. And then there’s the real list that’s hidden from outsiders, where wait times can last more than a year.

Deliberate scheme, shredded evidence

“The scheme was deliberately put in place to avoid the VA’s own internal rules,” said Foote in Phoenix. “They developed the secret waiting list,” said Foote, a respected local physician.

The VA requires its hospitals to provide care to patients in a timely manner, typically within 14 to 30 days, Foote said.

According to Foote, the elaborate scheme in Phoenix involved shredding evidence to hide the long list of veterans waiting for appointments and care. Officials at the VA, Foote says, instructed their staff to not actually make doctor’s appointments for veterans within the computer system.

Instead, Foote says, when a veteran comes in seeking an appointment, “they enter information into the computer and do a screen capture hard copy printout. They then do not save what was put into the computer so there’s no record that you were ever here,” he said.

According to Foote, the information was gathered on the secret electronic list and then the information that would show when veterans first began waiting for an appointment was actually destroyed.

“That hard copy, if you will, that has the patient demographic information is then taken and placed onto a secret electronic waiting list, and then the data that is on that paper is shredded,” Foote said.

“So the only record that you have ever been there requesting care was on that secret list,” he said. “And they wouldn’t take you off that secret list until you had an appointment time that was less than 14 days so it would give the appearance that they were improving greatly the waiting times, when in fact they were not.”

I feel very sorry for the people who work at the Phoenix VA. They all wish they could leave ’cause they know what they’re doing is wrong.
Dr. Sam Foote

Foote estimates right now the number of veterans waiting on the “secret list” to see a primary care physician is somewhere between 1,400 and 1,600.

Doctor: It’s a ‘frustrated’ staff

“I feel very sorry for the people who work at the Phoenix VA,” said Foote. “They’re all frustrated. They’re all upset. They all wish they could leave ’cause they know what they’re doing is wrong.

“But they have families, they have mortgages and if they speak out or say anything to anybody about it, they will be fired and they know that.”

Several other high-level VA staff confirmed Foote’s description to CNN and confirmed this is exactly how the secret list works in Phoenix.

Foote says the Phoenix wait times reported back to Washington were entirely fictitious. “So then when they did that, they would report to Washington, ‘Oh yeah. We’re makin’ our appointments within — within 10 days, within the 14-day frame,’ when in reality it had been six, nine, in some cases 21 months,” he said.

November: A dire situation in South Carolina

Thomas Breen was so proud of his time in the Navy that he wanted to be treated only at a VA facility, his family says.

In the case of 71-year-old Navy veteran Thomas Breen, the wait on the secret list ended much sooner.

“We had noticed that he started to have bleeding in his urine,” said Teddy Barnes-Breen, his son. “So I was like, ‘Listen, we gotta get you to the doctor.’ “

Teddy says his Brooklyn-raised father was so proud of his military service that he would go nowhere but the VA for treatment. On September 28, 2013, with blood in his urine and a history of cancer, Teddy and his wife, Sally, rushed his father to the Phoenix VA emergency room, where he was examined and sent home to wait.

“They wrote on his chart that it was urgent,” said Sally, her father-in-law’s main caretaker. The family has obtained the chart from the VA that clearly states the “urgency” as “one week” for Breen to see a primary care doctor or at least a urologist, for the concerns about the blood in the urine.

“And they sent him home,” says Teddy, incredulously.

Sally and Teddy say Thomas Breen was given an appointment with a rheumatologist to look at his prosthetic leg but was given no appointment for the main reason he went in.

Read More and Watch Video Here

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Veterans dying waiting for healthcare

Are we fulfilling our promise to veterans?

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The New American

Wednesday, 23 April 2014 15:08

Democrat Says Worst of ObamaCare Yet to Come

Written by 

 


 Photo of Rep. Stephen Lynch (D-Mass.): AP Images

It is always noteworthy when a lawmaker breaks what seems to be the “Cardinal Rule” against speaking out against one’s own party, particularly when it regards the party’s signature accomplishment. The Obama administration cannot possibly be pleased with the assertions made by Representative Stephen Lynch (shown, D-Mass.) about the healthcare law, which stand in direct opposition to statements made by the president about the very same law.

On April 17, readers may recall, President Obama announced during a White House news conference that the healthcare law “is working.” Yet during an interview with the Boston Herald, Lynch did not hesitate to criticize the law when he said the worst of the Affordable Care Act has yet to be seen.

“There are parts of Obamacare, or the Affordable Care Act, that were postponed because they are unpalatable,” he told the Herald. “As these provisions come into effect, the administration thus far is saying, ‘Gee, we really can’t handle this right now so we’re going to delay it.’”

 

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MICHAEL REYNOLDS / EPA 8 minutes

Kathleen Sebelius Resigning as Health Secretary

Health and Human Service Secretary Kathleen Sebelius is resigning, U.S. officials told NBC News on Thursday.

U.S. officials told NBC News that President Barack Obama on Friday will nominate Sylvia Mathews Burwell, currently director of the White House Office and Management and Budget, to succeed Sebelius, 65, the former governor of Kansas, who was an original member of the Cabinet that Obama appointed when he took office in January 2009.

Image: U.S. Secretary of Health and Human Services Sebelius answers a question while she testifies before the Senate Finance Committee hearing on the President's budget proposal for FY2015, on Capitol Hill in Washington LARRY DOWNING / Reuters

As secretary of Health and Human Services, Kathleen Sebelius was the public face of the bug-ridden rollout of President Barack Obama’s health care insurance initiative..

No reason for Sebelius’ departure, was immediately available, but she came under sustained criticism as head of the agency in charge of the controversial rollout of Obama’s health care reform initiative.

Sebelius told Obama of her intentions in early March, a White official said, but she didn’t tip her hand when she told the Senate Finance Committee earlier Thursday that 7.5 million Americans had signed up for health coverage under the new law — a figure that exceeded the original expectations despite the months of problems.

Sebelius has apologized numerous times for the glitch-prone website, which initially blocked many Americans from comparing and enrolling in health insurance plans. Testifying before a House committee in October, she conceded that the website, healthcare.gov, was “a miserably frustrating experience for way too many Americans.”

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Bloomberg

Sebelius Said to Resign as U.S. Health Secretary

Photographer: Andrew Harrer/Bloomberg

Kathleen Sebelius, secretary of Health and Human Services, speaks during a Senate..

Kathleen Sebelius, the U.S. health secretary who steered the troubled rollout of President Barack Obama’s signature health-care law, will resign just as the program topped its first-year enrollment goal, according to two people familiar with the decision.

The resignation of Sebelius, 65, is expected to be announced tomorrow, said the people who asked not to be identified because the decision is still private. Sylvia Mathews Burwell, 48, director of the Office of Management and Budget, will be nominated to succeed Sebelius, one of the people said. White House officials had no immediate comment on the report.

A former Democratic governor of Kansas, Sebelius was an early backer of Obama’s campaign for the president. She spent five years running the Health and Human Services Department, presiding over the largest change to government health programs since Medicare and Medicaid began almost 50 years ago.

Sebelius’s resignation closes the first major chapter of the Patient Protection and Affordable Care Act, or Obamacare. The 2010 law is projected to eventually offer health insurance to 25 million more people in the U.S., paid for with changes to Medicare, taxes on health-care providers and a requirement that all Americans have insurance.

Sebelius’s departure was unexpected by at least one person close to her, Kansas Insurance Commissioner Sandy Praeger, a Republican who has worked with her since 1991. Praeger said she was at a dinner where the health secretary spoke last week and that “she seemed like she was in it for the long haul.”

Enrollment Goals

Assessing Sebelius’s work, the number of people who signed up for coverage through Obamacare may trump the difficulties in getting there when the new online insurance marketplaces started with flawed technology last October. In total, 7.5 million Americans signed up for private health plans through the exchanges, half a million more than the government’s most optimistic estimates.

The secretary “played a key role that enabled the Affordable Care Act to become the law of the land, and she worked tirelessly to implement it successfully,” Ron Pollack, executive director of Families USA, a Washington-based health advocacy group that supports the law, said in an e-mail. “We owe her an enormous debt of gratitude for her excellent work in improving health care for families across America.”

Sluggish Start…

 

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Healthcare cuts canceled after Dem complaints

Getty Images

The Obama administration announced Monday that planned cuts to Medicare Advantage would not go through as anticipated amid election-year opposition from congressional Democrats.

The cuts would have reduced benefits that seniors receive from health plans in the program, which is intended as an alternative to Medicare.

Under cuts planned by the administration, insurers offering the plans were to see their federal payments reduced by 1.9 percent, which likely would have necessitated cuts for customers.

Instead, the administration said the federal payments to insurers will increase next year by .40 percent.

The healthcare law included $200 billion in cuts to Medicare Advantage over 10 years, in part to pay for ObamaCare.

The Centers for Medicaid and Medicare Services (CMS) on Monday said changes in the healthcare market meant it did not need to make those cuts to Medicare Advantage this year.

It cited an increase in healthy beneficiaries under Medicare, which it said has lowered projected costs for that program.

CMS separately is delaying a risk assessment proposal that was set to take affect under ObamaCare.

 

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Obama administration proposes 1.9% cut in Medicare Advantage payments

February 21, 2014 8:08 pm by

Barack ObamaMedicare Advantage plans could see payment reductions of 1.9 percent next year under proposed rates announced Friday by the Centers for Medicare & Medicaid Services.

Insurers, who have led a fierce lobbying campaign against payment reductions, have said the combination of the health law’s lower payment rates, new fees on health plans and other factors, including automatic federalspending cuts known as “sequestration,” mean that Medicare Advantage plans will see their Medicare payment rates drop by 6 percent – or even more — in 2015.

CMS said Friday its preliminary estimate is “the combined effect of the Medicare Advantage growth percentage and the fee-for-service growth percentage.”

America’s Health Insurance Plans said they are reviewing the details of the announcement to determine the total impact of the federal payment rates. In a statement, AHIP President and CEO Karen Ignagni was critical of the proposed rates, saying, “The new proposed Medicare Advantage cuts would cause seniors in the program to lose benefits and choices on which they depend.”

 

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Obama flip-flops on Medicare drug coverage

(REUTERS/Jonathan Bachman)

The Obama administration, in an abrupt about-face, said on Monday it would drop proposed changes to Medicare drug coverage that met wide opposition on grounds they would harm health benefits for the elderly and disabled.

Late last week, more than 370 organizations representing insurers, drug makers, pharmacies, health providers and patients urged the Centers for Medicare and Medicaid Services (CMS) to withdraw changes it had proposed for Medicare Part D.

One of the federal government’s most successful and cost-effective healthcare programs, Part D provides drug benefits for the elderly and disabled through private insurers to 36 million enrollees.

Critics said the changes, if adopted in coming months, could not only undermine Part D benefits but impact drug benefits available through Medicare Advantage, a program that allows Medicare beneficiaries to obtain their major medical coverage through private insurers.

“Given the complexities of these issues and stakeholder input, we do not plan to finalize these proposals at this time. We will engage in further stakeholder input before advancing some or all of the changes in these areas in future years,” CMS Administrator Marilyn Tavenner advised in a letter sent on Monday to members of the Senate and House of Representatives.

The proposals were opposed by both Republicans and Democrats in Congress. The Republican Party had already begun to look for ways to leverage popular anger over the changes into campaign attacks on Democratic incumbents who could be vulnerable in November’s election showdown for control of Congress.

Elated critics of the proposed changes said the government had effectively agreed to start over in the face of broad, bipartisan opposition.

 

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New York Times SundayReview

The Obama administration’s proposed cuts to Medicare Advantage plans — the private insurance plans that cover almost 30 percent of all Medicare beneficiaries — are fair and reasonable. As it happens, they are also mandated by law. Yet Republicans, sensing a campaign issue, are telling older and disabled Americans that the administration is “raiding Medicare Advantage to pay for Obamacare.” The health insurance industry, for its part, is warning that enrollees will suffer higher premiums, lower benefits and fewer choices among doctors if the cuts go into force.

Some of this could in fact happen, although the industry has cried wolf before and continues to thrive. But the key point is this: Over the past decade, enrollees in Medicare Advantage have received lots of extra benefits, thanks to unjustified federal subsidies to the insurance companies. Now they will have to do with somewhat less, unless the insurers are willing to absorb the cuts while maintaining benefits. Enrollment in these private plans, offered by companies like UnitedHealth and Humana, has more than doubled since 2006, in part because of lower premiums and extra benefits, like gym memberships, that are not included in traditional fee-for-service Medicare.

What made these perks possible was, in effect, a subsidy from taxpayers and other Medicare beneficiaries. The federal government paid the private plans, on average, 14 percent more in 2009 than it would cost to treat the same people in traditional Medicare. The insurers used this extra money to reduce enrollees’ costs and add benefits.

The 2010 Affordable Care Act rightly required that these subsidies be reduced, although it stopped short of completely eliminating them. The reductions began to take effect in 2012, and have not, so far, visibly harmed beneficiaries or the plans. Since enactment of the law, Medicare Advantage premiums have fallen by 10 percent, the opposite of what some expected, and enrollment has increased by nearly 33 percent, according to the administration. But as the law intended, federal payments to the private plans dropped — from 7 percent more than services under traditional Medicare in 2012 to 4 percent more last year. The administration now proposes to further reduce the payments to Medicare Advantage plans in 2015. The loudest criticism has come from Republicans, but plenty of Democrats have chimed in.

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Soldier’s ‘Courageous Act’ Remembered as Fort Hood Begins Healing

 

Image: Sergeant First Class Daniel Ferguson, of Florida, who served as a transportation supervisor and had been deployed to Kuwait, Iraq and Afghanistan, is pictured in this undated handout Fort Hood Public Affairs Office via Reuters

Sergeant First Class Daniel Ferguson, 39, of Florida, who served as a transportation supervisor and had been deployed to Kuwait, Iraq and Afghanistan, is pictured in this undated handout from Fort Hood Public Affairs Office. Ferguson was one of three victims killed at the shooting at Fort Hood.

 

In a final heroic act, Sgt. 1st Class Daniel Ferguson threw his body against the entryway of a door as a fellow soldier-turned-gunman blasted away in a terrifying rampage at Fort Hood.

Ferguson, 39, was fatally hit in the moment he became a human shield — a sacrifice remembered in a news conference Saturday.

Ferguson’s “courageous act of blocking the door with his own body prevented further bloodshed,” said Rep. Roger Williams, R-Texas.

Also killed in Wednesday’s shooting were Sgt. Timothy Owens, 37, and Staff Sgt. Carlos Lazaney-Rodriguez, 38. Sixteen others were wounded. Gunman Spc. Ivan Lopez died from a self-inflicted gunshot wound, officials said.

Rep. Williams, along with Rep. John Carter, R-Texas, met some of the wounded soldiers Saturday, and commended them on their valor. Among the victims was Maj. Patrick Miller, who was shot in the stomach with Lopez’s .45-caliber semiautomatic pistol.

Miller had called 911 as he tended to his own wounds.

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Slain Fort Hood counselor found his calling in Army

Courtesy of Mary Muntean – Timothy Wayne Owens, with his mother, Mary Muntean, at his wedding in August 2013.

 

Timothy Wayne Owens, a counselor at Fort Hood, was known to friends as a stand-up guy who triumphed over a hardscrabble upbringing to become an empathetic military man, one who helped people and defused conflicts.

So, it was no surprise to residents in his home town of Effingham, Ill., to hear that Owens lost his life trying to calm the shooter in Wednesday’s Fort Hood killings.

“He was a brave man,” said Owens’s mother, Mary Muntean, 77, who said she learned that her son had been killed as he tried to talk with Ivan Lopez, who has been identified as the man who killed three people and injured 16 in the shooting on the Army post.

Muntean said she received a call at her Effingham home from her son’s wife, Billy Owens, on Wednesday evening telling her that he had been shot five times after trying to calm Lopez in a post parking lot. Military officials have not released the names of those killed or injured or confirmed reports of how the violence unfolded. But friends of Owens said the account provided by his family fits the man they knew.

 

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Sgt. Timothy Owens was killed Wednesday night. Credit Courtesy of Glen Welton, via Associated Press

NYT Now

The names of the victims of the shooting in Fort Hood began to come out on Thursday, released by relatives and by officials offering their condolences.

In Effingham, Ill., family members told The Associated Press that Army Sgt. Timothy Owens was one of the three soldiers killed Wednesday in a mass shooting by Specialist Ivan Antonio Lopez. Sixteen others were wounded in the shooting. The Army has not released a list of the victims, pending notification of relatives.

The mother of Sergeant Owens, Mary Muntean, 77, of Effingham, told The Associated Press that she had learned of her son’s death in a telephone call with her daughter-in-law.

Unable to reach her son, she called his wife, Billie Owens, who first said he was in the hospital. Before long, Sergeant Owens’s wife called back, and Mrs. Muntean had her worst fears confirmed. “She said, ‘Mom, I want to tell you how sorry I am. Tim’s gone,’ ” Mrs. Muntean said, according to The A.P. “I broke down.”

Sergeant Owens dropped out of high school in 1995. But his mother said he earned his high school equivalency after joining the Army in 2004.

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Maj. Patrick Miller was wounded in the shootings.

A friend and former roommate, Paul Eatherton, said Sergeant Owens, whose family moved back to Effingham from Missouri in the mid-1990s, worked at Pizza Hut and studied tae kwon do at a local gym. Mr. Eatherton, a martial arts instructor at the time, said Sergeant Owens got his black belt and started teaching at a gym in Effingham.

“He was the best student I’d ever seen or known,” Mr. Eatherton said. “We’d go to tournaments, and he’d bring first places home every time.”

He said Sergeant Owens, who was in his mid-30s, had recently signed up for another six years in the Army. “I think he was going to be a lifer,” he said. He said he had not talked to Sergeant Owens for several months, but when he heard news of the shooting, he texted him immediately. He got no reply. “That really worried me,” he said.

The commander of Fort Hood, Lt. Gen. Mark A. Milley, said in an afternoon news conference, that nine of the 16 people wounded in the attack were taken to Scott & White Memorial Hospital in nearby Temple, Tex., for treatment. Three were upgraded to serious condition on Thursday. Hospital officials said doctors had operated on two patients, a man and a woman, who had been shot in the abdomen and neck. The third person had an abdominal wound. The other victims taken there were discharged.

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Specialist Ivan Lopez served in Iraq but did not see combat.

Specialist Ivan Antonio Lopez had seen a military psychiatrist as recently as last month. He was being treated for depression and anxiety, and had been prescribed Ambien to help him sleep. He had come back from a four-month deployment to Iraq in 2011 and told superiors he had suffered a traumatic head injury there. But military officials said he had never seen combat, and there was no record of any combat-related injury. He was being evaluated for possible post-traumatic stress disorder.

Still, military officials said, they had seen nothing to indicate that Specialist Lopez, 34 — who killed three people and himself and wounded 16 others on Wednesday in a shooting rampage at Fort Hood, Tex. — was violent or suicidal.

“He had a clean record,” Secretary of the Army John McHugh said Thursday morning in testimony before a Senate panel in Washington. “No outstanding bad marks for any kinds of major misbehaviors that we’re yet aware of.”

Lt. Gen. Mark A. Milley, the Fort Hood commander, said Thursday at a news conference that there were “very strong indications” that there had been a “verbal altercation” between Specialist Lopez and one or more other soldiers in the minutes before the shooting started, but the authorities were still investigating what role, if any, that played in the attack.

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Before joining the Army, Specialist Lopez was in the Puerto Rico National Guard. Credit Puerto Rico National Guard, via Reuters

“We have very strong evidence looking into his medical history that indicated an unstable psychiatric condition,” General Milley said.

Friends from his hometown in Puerto Rico said that Specialist Lopez was angry with the Army when he returned home for his mother’s funeral in November. Ismael Gonzalez, a former schoolmate who had kept in contact with Specialist Lopez on Facebook, said the soldier was very upset that he had initially been given only 24 hours to attend the funeral.

In addition, Mr. Gonzalez said, Specialist Lopez, who was earning $28,000 a year, told him that he was “in a precarious economic situation” trying to support his family in Texas and two children in Puerto Rico from his first marriage. And he was angry that the Army would not allow him to move his family onto the base at Fort Hood, Mr. Gonzalez said.

None of this had found its way into Specialist Lopez’s official record, though.

“This was an experienced soldier,” said Gen. Raymond T. Odierno, the Army’s chief of staff. “He spent actually nine years in the Puerto Rico National Guard before coming on active duty, so he’s a very experienced soldier.”

Those who knew Specialist Lopez as a young man, obsessed with the high school band, were even more stunned to learn what he was suspected of doing.

“I cannot believe you are speaking about the same guy,” said Sgt. Maj. Nelson Bigas, one of Specialist Lopez’s superiors in the National Guard. “He was the most responsible, obedient, humble person, and one of the most skillful guys on the line.”

For a year beginning in 2006, Specialist Lopez was deployed with his guard unit on the Sinai Peninsula, watching the border between Egypt and the Gaza Strip.

But, the authorities say, it was Specialist Lopez who went into Guns Galore in Killeen, Tex., near Fort Hood on March 1 and bought the .45-caliber Smith & Wesson semiautomatic pistol that was used in the shootings on Wednesday.

It was the same gun store where Nidal Malik Hasan, an Army major, had bought at least one of the weapons used in a 2009 mass shooting on the base.

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Specialist Lopez in an image from Facebook.

So information was emerging slowly on Thursday about Mr. Lopez. He was raised in the small fishing village of Guayanilla on the southern coast of Puerto Rico, about an hour and a half from San Juan. While there, he attended the School of Asunción Rodríguez de Sala, where he was active in the band and an enthusiastic drummer.

In 1999, he joined the National Guard, where he also played in the band. Later, he joined the Puerto Rico Police Department and became a member of its band. Officials said his record with the force was clean, with no disciplinary or behavioral problems.

His main job for the police was visiting schools and hospitals around Puerto Rico to give demonstrations on his percussion instruments. After he finished, other police officers would speak to the students or patients about gun violence, drugs and bullying, said Jeann Correa, the director of the unit for which he worked. His pay was $2,400 a month.

In 2010, getting a special leave from the police force, he shifted into the Army as a private first class and was quickly promoted to specialist and stationed with the First Armored Division at Fort Bliss in El Paso, Tex. He was an infantryman there but his military record shows that in November, because of a medical condition identified as plantar fasciitis, a painful foot ailment, he moved to Fort Leonard Wood in Missouri, where he trained to become a truck driver. In February, he was posted to Fort Hood in that capacity.

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Vets, Docs Worry Fort Hood Shootings Will Deepen PTSD Stigma

The word “PTSD” had barely left the mouth of Fort Hood’s commander late Wednesday when, across the nation, many veterans with those symptoms and doctors who treat the malady understood they faced a renewed battle: a resurgence of the stigma that comes with that diagnosis.

The Fort Hood tragedy –- 16 wounded and four killed, including identified shooter Ivan Lopez, a soldier being evaluated for PTSD –- is precisely the type of event that makes combat veterans cringe. Many worry they’ll be further mislabeled as dangerous time bombs, as the next to snap, and that post-traumatic stress will again be misrepresented and misunderstood as a condition that sparks public, violent outbursts.

“That is not what post-traumatic stress is or what it does,” said Ingrid Herrera-Yee, a clinical psychologist in the Washington, D.C. area who treats veterans diagnosed with Post Traumatic Stress Disorder and other mental health issues as well as their family members and civilians. Her husband, Army National Guard Staff Sgt. Ian Yee, spent three combat deployments in Iraq and Afghanistan.

“Yes, there is anger and irritability (associated with PTSD), but it’s usually internalized. You’re more likely to see it as someone who is withdrawn, anxious and numb, who’s lost interest in life. Some veterans explain it to me this way: ‘The last thing you want is to go out and lash out,” said Herrera-Yee, adding: “Just like any victims of a trauma –- rape or domestic violence -– they can become fearful of their surroundings, but they’re not going to react angrily toward their surroundings. For them, it’s all about avoidance.”

“You’re more likely to see it as someone who is withdrawn, anxious and numb, who’s lost interest in life. Some veterans explain it to me this way: ‘The last thing you want is to go out and lash out.'”

For years, Pentagon brass and branch commanders have urged troops and veterans to seek mental-health help if they feel the need, while repeating the message that, if they do see a doctor, they will not be viewed as weak but as strong. That campaign seems to have finally dented the macho-military mantra that every soldier can handle his or her own business. Many veterans are turning to doctors to begin addressing post-service anxiety issues, often fueled by repeated or long deployments.

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Gunman in Fort Hood shooting had behavioral issues, authorities say

 

An Iraq war veteran who was grappling with mental health issues opened fire at Fort Hood, Tex., in an attack that left four people dead and 16 wounded Wednesday afternoon, according to preliminary law enforcement and military reports. The gunfire sent tremors of fear across a sprawling Army post still reeling from one of the worst mass shootings in U.S. history.Many basic details about the shooting remained unclear in the chaotic hours after the first calls for help around 4 p.m., but senior U.S. law enforcement officials said the incident did not appear to be linked to any foreign terrorist organizations. The shooter was among those who died, the officials said.

The officials identified the shooter as Army Spec. Ivan Lopez, 34, a military truck driver, who was dressed in his standard-issue green camouflage uniform. Lopez opened fire in two locations on the vast central Texas post, inside a building housing the 1st Medical Brigade and in a facility belonging to the 49th Transportation Battalion.

Police spent Wednesday night searching his apartment in Killeen, the city that abuts the Army facility. Gen. Mark A. Milley, the commander of Fort Hood, said the soldier, whom he did not identify by name, served four months in Iraq in 2011.

Milley said the shooter “had behavioral health and mental health issues.” He said the soldier, who self-reported a traumatic brain injury and was taking anti-depressants, had been under examination to determine whether he had post-traumatic stress disorder. “We are digging deep into his background,” Milley said.

Milley said the soldier opened fire with a .45-caliber Smith & Wesson semiautomatic pistol that was purchased recently but was not authorized to be brought on the post. He was eventually confronted by a female military police officer. He put his hands up but then pulled out a gun from under his jacket. “She engaged,” Milley said, and then the soldier put the gun to his head and shot himself.

The shooting was the third major gun attack at a U.S. military installation in five years, leaving the nation grappling with the prospect of yet more flag-draped funerals for troops killed on the homefront. A government contractor went on a shooting rampage at the Washington Navy Yard in September, leaving 12 people dead. In 2009, Army Maj. Nidal M. Hasan opened fire on a group of soldiers at Fort Hood preparing to deploy to Iraq and Afghanistan, killing 13 people and wounding more than 30.

Doctors at the Scott & White hospital in Temple, Tex., said Wednesday that they have treated eight of the wounded and that one more was on the way. Three of the patients were in critical condition in the ICU, and five were in serious condition. Seven of them were male, and one was female. Their injuries ranged from mild to life-threatening, a majority of them caused by single-gunshot wounds to the neck, chest and abdomen.

President Obama said he was “heartbroken that something like this might have happened again.” Speaking during a fundraising trip to Chicago, he pledged “to get to the bottom of exactly what happened.”

 

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Four killed in shooting at Fort Hood; gunman dead, multiple injuries

A shooting at the Fort Hood military installation in Texas left at least four people dead, including the gunman, and more than a dozen were injured, according to authorities.

The gunman, identified by multiple government sources as Army Specialist Ivan Lopez, took his own life, officials said.

Lopez, 33, of Kileen, Tex., was wearing an Army uniform at the time of the shooting, Michael McCaul (R-Tex.), chairman of the House Homeland Security Committee, told reporters.

Four people were taken to Scott and White Memorial Hospital in Temple, Tex., and another two are being brought there, said Glen Couchman, the facility’s chief medical officer. Their injuries that “range from stable to quite critical,” he said.

The installation was locked down for much of the afternoon and into the evening after the shooting before being lifted shortly before 9 p.m. local time.

Speaking in Chicago, President Obama said his administration was following the shooting closely.

“I want to just assure all of us we are going to get to the bottom of exactly what happened,” he said. “We’re heartbroken something like this might have happened again.”

The base was the site of a shooting in 2009 that ultimately killed 13 people and wounded another 32, the worst mass murder at a military installation in U.S. history. Nidal Hasan was sentenced to death last year for the shooting after being found guilty of premeditated and attempted premeditated murder.

 

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BREAKING: Shooting at Fort Hood Military Base – 1 Death Confirmed

 

Published on Apr 2, 2014

SHOOTING SITUATION STILL ACTIVE, Multiple Gunned Down
FORT HOOD (April 2, 2014) At least one person is dead after a shooting late Wednesday afternoon on Fort Hood, a post spokesman confirmed.
Others were injured in the shooting, but the spokesman didn’t say how many.
The gunman is still at large and the spokesman said the incident is being treated as an active-shooter situation.
Warning sirens sounded late Wednesday afternoon at Fort Hood because of the incident.
A man who said he was a witness told News 10 that about 20 shots were fired in a post motor pool in the area of Motor Pool Road and Tank Destroyer Boulevard.

He said at least three people were hit.

He said the three victims were taken to a hospital.

The post was on lockdown as a result of the shooting, which occurred at around 4:25 p.m.

People on post were told to stay indoors.

A message that scrolled across the top of the post’s website said, “Shelter in place immediately. This is not a test.”

The 1st Calvary Division, which is based at Fort Hood, sent a Twitter alert telling people on base to close doors and stay away from windows.

Texas A&M Central Texas in Killeen canceled evening and night classes Wednesday at Fort Hood and at its Fairway building because of the situation on post.

First responders from surrounding communities were headed to the post.

Bell County sheriff’s deputies and Department Public Safety troopers were also responding, sheriff’s Lt. Donnie Adams said.

Media were being directed to the post’s Visitor’s Center.

On Nov. 5, 2009, Army psychiatrist Nidal Malik Hasan opened fire at Fort Hood’s Soldier Readiness Center, killing 12 soldiers and one civilian and wounding 29 others before two Fort Hood civilian police officers shot him.

He is now on the military’s death row.

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Expensive pills
March 29, 2014

There is a little known bill in the works which would force people in crisis into forced psychiatric treatment. Mad in America reported on March 28, 2014 that mental health advocates are urging protest against a forced treatment addition to a new Medicare bill. Many national mental health and disability advocacy groups have joined together to urge people to contact their senators in order to protest a section of a bill which was rushed through the House of Representatives by voice vote this week. This bill, Section 224 of HR4302, is up for a vote in the Senate on Monday.

Raymond Bridge, public policy director of the National Coalition for Mental Health Recovery has said: “In its rush to fix a problem with Medicare, the House passed a bill including a highly controversial program, involuntary outpatient commitment, with no debate and no roll call vote.” It appears to Bridge that the Senate may pass a version of the House bill which includes this troublesome provision on Monday. Daniel Fisher, M.D., Ph.D. has commented about this bill, saying: “It would bring America back to the dark ages before de-institutionalization, when people with mental health conditions languished in institutions, sometimes for life.”

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Mental Health Advocates Decry Forced Treatment Provision in “Doc Fix” Bill

 

WASHINGTON, March 28, 2014 /PRNewswire-USNewswire/ — The bill rushed through the House of Representatives by voice vote yesterday to patch Medicare regulations includes a highly controversial provision that has nothing to do with Medicare, and that would subject people in crisis to forced treatment. Studies have shown that such force causes trauma and drives people away from treatment, mental health advocates warned.

Today, an array of national mental health and disability advocacy groups joined together to decry this provision, which they view as a regressive attack on hundreds of thousands of Americans with serious mental health conditions.

“In its rush to fix a problem with Medicare, the House passed a bill including a highly controversial program, involuntary outpatient commitment, with no debate and no roll call vote,” said Raymond Bridge, public policy director of the National Coalition for Mental Health Recovery (NCMHR), a coalition of 32 statewide organizations and others representing individuals with mental illnesses. “And it seems that the Senate may pass a version of the House bill including this troubling provision on Monday,” Bridge added.

The 123-page Protecting Access to Medicare Act of 2014, H.R. 4302, includes a four-year, $60 million grant program (Sec. 224) to expand involuntary outpatient commitment (IOC) – also called Assisted Outpatient Treatment (AOT) – in states that have laws authorizing IOC. The laws allow courts to mandate someone with a serious mental illness to follow a specific treatment plan, usually requiring medication. The facts show that involuntary outpatient commitment is not effective, involves high costs with minimal returns, is not likely to reduce violence, and that there are more effective alternatives.

Assisted Outpatient Treatment is central to the controversial Helping Families in Mental Health Crisis Act (H.R. 3717), proposed by Rep. Tim Murphy in December 2013.

“This legislation would eliminate initiatives that use evidence-based, voluntary, peer-run services and family supports to help people diagnosed with serious mental illnesses to recover,” said Daniel Fisher, M.D., Ph.D., a psychiatrist and an NCMHR founder. “It would bring America back to the dark ages before de-institutionalization, when people with mental health conditions languished in institutions, sometimes for life.”

The provisions of H.R. 3717 would exchange low-cost, community-based services with good outcomes for high-cost yet ineffective interventions, according to the NCMHR; the National Disability Rights Network (NDRN), the non-profit membership organization for the federally mandated Protection and Advocacy (P&A) Systems and Client Assistance Programs (CAP) for individuals with disabilities; and the National Council on Independent Living (NCIL), which advances independent living and the rights of people with disabilities through consumer-driven advocacy.

 

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