вторник, 9 октября 2012 г.

Mexican Health Minister Visits Washington to Discus H1N1. - Virus Weekly

Jose Angel Cordova Villalobos, Secretary of Health, United States of Mexico, discussed preparations and responses to the H1N1 influenza during a visit to Washington D.C (see also Embassy of Mexico).

'The Centers for Disease Control was supportive in diagnosing this new virus in April. We are working together on preparedness plans against a new wave of H1N1 in Mexico, Canada and the United States. Cooperation is essential to face this new threat that we have,' said Secretary Cordova.

In Washington, Secretary Cordova met with Kathleen Sebelius, Secretary, Department of Health and Human Services (HHS), and representatives from the National Institutes of Health (NIH).

Video of this interview is available on YouTube here: http://www.youtube.com/watch?v=AXha1PnKang

This release was prepared by Qorvis Communications LLC for the Embassy of Mexico. More information is available at the U.S. Department of Justice.

Keywords: Embassy of Mexico, Influenza, Flu.

понедельник, 8 октября 2012 г.

New hope for elder mental health research.(View on Washington) - Nursing Homes

Occasionally, even the most experienced Washington observers must eat their words. Last year, I detailed in this column (October 2003, p. 8) why tripling the federal budget for the National Institutes of Health (NIH) has not produced new research that nursing homes and other long-term care providers can use. Most of that column remains valid; NIH's spectacular growth under both the Clinton and the George W. Bush administrations is unlikely to generate much benefit for SNFs' quality of care.

In February, however, the National Institute of Mental Health (NIMH) decided to devote a portion of its rapidly growing budget to specifically help older Americans. NIMH responded to pressure from the American Psychological Association's Office on Aging, the American Association for Geriatric Psychiatry, and other advocacy organizations by reestablishing a Geriatric Treatment and Preventive Intervention Research Branch (GTPIRB). NIMH had maintained such a branch during the 1980s but allowed it to be merged with a general 'adult mental health' branch ten years ago.

[ILLUSTRATION OMITTED]

Support for reestablishing an NIMH branch devoted to aging was bolstered by an internal work group report, which found that in 2002, NIMH provided four times the grant funding ($358 million) to child research as to aging research ($90 million). The NIMH work group's final report, Mental Health for a Lifetime: Research for the Mental Health Needs of Older Americans, found that few mental health researchers specialize in research on elderly patients, despite new information that many mental health problems associated with aging are preventable. According to Barry Lebowitz, PhD, the new GTPIRB director, 'A few years ago, you didn't use the terms 'preventive' and 'geriatrics' in the same sentence.'

The NIMH work group found that research grant applications proposing to study geriatric treatment and prevention of mental disorders other than Alzheimer's disease tend to score higher at NIMH than grant applications for other topics. The dearth of research, according to the work group, stems almost entirely from the lack of applications. To counter this problem, the work group recommended that NIMH actively recruit psychiatrists and psychologists to study the mental health needs of older Americans and create a position of Associate Director for Aging. Instead, NIMH split its Adult and Geriatric branch into two branches: the new aging branch and an adult-specific branch.

The GTPIRB will support a program of research, research training, and career development focusing on treatment, prevention, and rehabilitation of mental disorders in older people. The branch's program focus is broad and inclusive with respect to the type of patients, the severity of disorders, and the variety of community and institutional settings in which treatment is provided. The branch proposes to study all mental disorders, including Alzheimer's disease and related dementias, suicide, eating disorders, sleep disorders, and disorders related to the menstrual cycle.

Dr. Lebowitz explains that the new branch will present opportunities to conduct research on an array of topics, including chronic stress, depression, and brain-hormone interactions as they affect older populations. The research program's primary focus is the expansion of traditional treatment research ('efficacy studies') to include research of more practical and public health relevance ('effectiveness studies'). Interventions studied will include pharmacologic approaches (individual drugs and combinations of drugs), and behavioral and psychotherapeutic approaches (e.g., cognitive therapy).

The GTPIRB's Geriatric Psychosocial Program, headed by George T. Niederehe, PhD, will generate research that will be especially interesting to the nursing home field. Dr. Niederehe's responsibility includes grants for the development and application of new psychotherapeutic, behavioral, and psychosocial treatments, and assessment of standardized approaches to treatment based on treatment manuals.

Dr. Lebowitz points out that several NIMH-funded researchers already are known for focusing their attention on nursing home care. Virtually all of them are 'external' researchers who are attached to academic institutions and receive research grants for conducting their work in long-term care settings. Ira Katz, MD, PhD, for example, is director of the Section of Geriatric Psychiatry at the University of Pennsylvania and has received grants to study the most effective approaches to reducing the severity of depression in nursing home residents. Early results of his research are in a chapter on nursing home care in Evidence-Based Care for Patients With Dementia (Oxford University Press, in press).

Another NIMH-funded researcher known for collaboration with nursing homes is Bruce Pollock, MD, PhD, director of the Department of Psychiatry's Geriatric Psychopharmacology Program at the University of Pittsburgh. Dr. Pollock's research has focused on how the aging process changes the effectiveness of antidepressant medications. According to him, SNFs are in a difficult position because the interaction of antidepressants with other medications taken by residents can increase the risk of side effects, but undermedicating contributes to the relatively high incidence of clinical depression in the nursing home setting. Dr. Pollock also notes that nonpharmacologic intervention, such as making sure nursing home residents can choose an activity they're interested in during the week, can also help with depression.

According to Dr. Lebowitz, the refocusing of efforts recommended by the NIMH work group should include more support for research on the psychological effects of Alzheimer's. These include psychosis, hallucinations, sleep disturbances, and anxiety, in addition to the more familiar memory problems and disorientation. He also believes significant opportunities exist for the rehabilitation sections of nursing homes to serve as settings for practical studies on prevention of depression after a stroke. Dr. Lebowitz says that the branch already is planning to fund a study of preventive care in assisted living facilities, but he cannot release details until the grant award is formally announced to the researchers.

The funds involved in the reestablishment of NIMH's GTPIRB are only a tiny fraction of NIH spending. It involves millions of dollars--small change compared with the billions of dollars discussed in budget cuts and increases for Medicaid and Medicare. However, it is impossible to listen to the infectious excitement in the voices of these researchers and NIMH officials without feeling that their work has the possibility of making a real difference in the lives of nursing home residents. Hopefully, SNFs will take advantage of this enthusiasm by linking with academic mental health researchers to apply for NIMH grants.

In this case, at least, having to eat my words left a good aftertaste.

воскресенье, 7 октября 2012 г.

SEN. CANTWELL CONCERNED BY MOVE TO REDUCE EMERGENCY HEALTH SERVICES FOR EASTERN WASHINGTON VETERANS - US Fed News Service, Including US State News

The office of Sen. Maria Cantwell, D-Wash., issued the following press release:

Wednesday, Sen. Maria Cantwell (D-WA) expressed concern with a Department of Veterans Affairs (VA) plan to drastically reduce urgent care operating hours at the Spokane VA hospital. Under the proposal, Spokane urgent care facilities, which until recently were open 24 hours a day, would only be open from 8:00 AM to 4:30 PM. Cantwell is sending a letter to the VA asking for specific details on the reductions and an explanation of how the VA plans to continue quality urgent care services to veterans under the plan.

'I've heard from concerned veterans in eastern Washington who worry that under this plan, they will no longer have affordable access to the care they may need in an emergency,' said Cantwell. 'We need to make sure these brave Americans who have given so much for our country always have access to quality health services, including urgent care. I will continue to push for clear answers from the VA to make sure that veterans have access to the care they were promised.'

In a letter sent Wednesday to the VA, Cantwell expressed her concern with the plan to reduce urgent care services and asked the VA to provide answers to a list of specific questions. In her letter, Cantwell asked the VA to explain the proposal in detail, outline potential effects of the plan on area veterans, describe how veterans would receive and be compensated for needed urgent care outside of the new proposed hours of operation, and detail how the agency planned to make veterans and veterans organizations fully aware of the plan.

[A copy of Cantwell's letter to the VA follows below]

July 26, 2006

Dear Mr. Lewis,

Several veterans from the State of Washington have contacted me about the recent announcement to reduce the hours of operation for the urgent care facility at the Department of Veterans Affairs (VA) Medical Center in Spokane. Given their feedback, I am concerned about the potential impacts of this reduction in urgent care service availability on veterans in the Inland Empire and other significant impacts on health care delivery capacity in the region.

As I understand it, the VA recently announced that it would be reducing the operating hours for the urgent care facility at the Spokane VA Medical Center, which operated around-the-clock before the change. Following the change, urgent care facilities will only be available between 8:00 AM and 4:30 PM. While we need to use limited health care resources in the most efficient and effective way possible, numerous veterans in the region have contacted my office expressing concern about the reduction in urgent care hours and the process by which they were informed.

Providing adequate care for our nation's veterans is obviously at the core of the VA's mission. Further, the VA's decisions regarding the availability and breadth of services the agency provides obviously affects veterans and other health care providers in the surrounding community. With that in mind, please provide your written responses to the following questions:

* Can you please confirm the changes that have been made to the operating hours of the Spokane VA's urgent care facility?

* Can you please describe how the facility operated prior to the change?

* If veterans need urgent care outside of the operating hours of the Spokane VA facility, will the VA reimburse veterans or the health care providers for urgent care services? If there are conditions on the reimbursement of veterans for urgent care services, please explain those conditions.

* How did the VA consult with other urgent care providers in the Inland Empire about the impacts of the change in urgent care operating hours at the Spokane Medical Center?

* Did the VA consult with representatives from Veterans Service Organizations about the potential impact that the reduction in operating hours for the urgent care facility in Spokane would have on veterans?

* Is the VA confident there is adequate available capacity elsewhere to provide urgent care outside the new operating hours at a comparable cost to affected veterans?

* How has the VA worked to inform Veterans Service Organizations and individual veterans about the change?

I know we both believe that providing care for our nation's veterans is an important responsibility of the federal government. I look forward to your timely responses to these questions.

Sincerely,

суббота, 6 октября 2012 г.

African Delegation of Health Officials Visit Washington to Discuss the Importance of the PEPFAR Program in Combating AIDS, Malaria, and TB. - Health & Medicine Week

This past week a delegation of 15 leading African health officials representing Ghana, Uganda, Tanzania, Kenya, Rwanda, Ethiopia, Zambia, Lesotho, and Swaziland was convened in Washington by a partnership between The AIDS Institute and The Whitaker Group. The purpose was to provide information to Congress and the Administration about the importance of the President's Emergency Plan for AIDS Relief (PEPFAR), an international aid program that targets AIDS, malaria, and TB prevention, care, and treatment worldwide. Dr. Gene Copello, Executive Director of The AIDS Institute commented: 'The delegation visit to Washington comes during a crucial time as Congress is currently moving on reauthorizing the PEPFAR program which expires on September 30 of this year......its important for our policymakers to hear directly from health officials in the countries where aid from the United States is being provided.'

James Sykes, Global Program Coordinator for The AIDS Institute said 'We worked with our fellow global advocates through the Global AIDS Roundtable (GAR) to develop recommendations for reauthorization of PEPFAR. We submitted those recommendations to staff of the House Foreign Affairs and the Senate Foreign Relations Committees for consideration as they drafted their versions of the legislation. As we visited with each of the congressional offices, it became obvious that the voices of Africa, where PEPFAR is primarily implemented were missing from the discussion. That is why this delegation visit was so important, to reinforce the importance of sound recommendations.'

Dr. Steven Shongwe, Executive Secretary of the East, Central, and Southern African Health Community (ESCA), speaking on behalf of the delegation said, 'We first want to thank the United States for assisting Africa. PEPFAR is saving lives. We are thankful for the opportunity to come and express our gratitude, but also to speak to need for flexibility going forward. Flexibility - depending on the needs of the population and the type of epidemic.'

Dr. Cesar Caceres, Board President of The AIDS Institute said: 'The AIDS Institute was delighted to convene this important delegation along with The Whitaker Group. Visits and discussions the delegation had with Members of Congress, congressional staff, non-governmental organizations, and the State Department provided opportunities for an African perspective on the importance of PEPFAR to be expressed.'

Copello concluded: 'PEPFAR is an important global program for the prevention, care, and treatment of AIDS, malaria, and TB. It saves lives through the provision of critical aid to the developing world and helps to create sustainable, flexible, and quality healthcare systems. The AIDS Institute commends Congress and the Administration for continuing to move forward in a bipartisan manner to reauthorize this program in a timely fashion.'

Keywords: HIV/AIDS, AIDS, Acquired Immunodeficiency Syndrome, HIV, Human Immunodeficiency Virus, Malaria, Virology, The AIDS Institute (see also HIV/AIDS).

пятница, 5 октября 2012 г.

HHS to make health data available.(Washington Report)(Brief article) - Health Data Management

Byline: Joseph Goedert

The Department of Health and Human Services has launched an initiative to make federally generated community health data widely available to the public in easily accessible and useful formats.

'Our national health data constitute a precious resource that we are paying billions to assemble, but then too often wasting,' HHS Secretary Kathleen Sebelius said while announcing the Community Health Data Initiative. 'When information sits on the shelves of government offices, it is underperforming. We need to bring these data alive.' Doing so can help communities determine best approaches to improving health status, she added. Sebelius and Institute of Medicine President Harvey Fineberg, M.D., announced the initiative during IOM's Community Health Data Forum in Washington.

HHS by year-end will implement a new Health Indicators Warehouse providing online access to HHS data on national, state, regional and county health performance. Data will include such indicators as rates of smoking, obesity, diabetes, access to healthy food and utilization of health care services.

The warehouse also will include best practices on improving performance for specific indicators. Users can access some or all of the data at no cost and integrate it into their own Web sites and applications.

четверг, 4 октября 2012 г.

LONGTIME JOURNALIST JOINS DEPARTMENT OF SOCIAL AND HEALTH SERVICES AS EASTERN WASHINGTON MEDIA RELATIONS MANAGER - US Fed News Service, Including US State News

The Washington state Department of Social and Health Services issued the following news release:

Veteran Eastern Washington journalist John Wiley is the new Washington Department of Social and Health Services media relations manager for Eastern Washington, DSHS Secretary Robin Arnold-Williams announced today.

Wiley has been a professional journalist for more than 30 years, 26 of those years with the Associated Press as a newsman, desk supervisor and correspondent. He has worked out of the Spokane AP bureau for the last 20 years, including 12 years as bureau manager there. In 1985, Wiley opened the AP's Yakima bureau.

Stationed in Spokane, Wiley will work closely with each of the DSHS administrations' communications directors in Olympia as well as local staff and management in Eastern Washington. He will serve as regional spokesperson to the media and help support the administrations' long-term strategic communications and public-outreach plans.

'We're excited to have someone with John's reputation, media expertise and credibility to represent our agency to his long-time colleagues in the Eastern Washington news media,' Arnold-Williams said.

Wiley reports directly to DSHS Communications Director Thomas Shapley.

'It's an honor to have such a seasoned, savvy journalist to help tell the story of how committed the people at DSHS are to making life better for our clients, one person at a time, one life at a time,' Shapley said. 'And his knowledge of the region, the people and the issues will be invaluable in getting that story told.

Wiley is the point person in the region for media information involving:

* Aging and Disability Services Administration

* Children's Administration

* Economic Services Administration

* Health and Recovery Services Administration

* Juvenile Rehabilitation Administration

* Division of Vocational Rehabilitation

* Office of Deaf and Hard of Hearing

Wiley's new office is at 1313 North Atlantic, Suite 4250, Spokane, WA 99201.

He can be reached at 509-363-4797 (office) 509-688-4807 (Blackberry)

His e-mail address is wileyjk@dshs.wa.gov.Contact: Jennifer Gau, 360/902-7829, gaujena@dshs.wa.gov.

среда, 3 октября 2012 г.

April Medical Science & Health News Tips From Washington University in St. Louis. - AScribe Business & Economics News Service

Byline: Washington University, St. Louis

ST. LOUIS, April 9 (AScribe Newswire) -- The following are news and feature story ideas from Washington University in St. Louis. For more information on any of the stories below or for assistance in arranging interviews, please see the contact information listed with each story. For comments on the News Tips service, please contact the editor, Jim Dryden at (000)-000-0000 or drydenj@msnotes.wustl.edu.

---

THAT WILL BE $90,000, PLEASE

Researchers calculate cost-savings of living kidney donors

Of the 55,000 Americans waiting for kidney transplants, last year only 13,000 had the operation. Some 3,000 others died on the waiting list. Part of the problem involves obtaining donated organs. Currently only half of potential organ donors actually donate, but even if every eligible donor donated, many on the waiting list still wouldn't be helped. Living donors are another potential source of organs, and the transplants from living donors also have the greatest chance of success. Encouraging more people to donate a kidney while they are alive could put a big dent in the number of people on the waiting list, but how can society encourage more of those people to donate? Researchers at Washington University School of Medicine in St. Louis and the University of Minnesota set up a mathematical model to determine whether it might be cost effective to pay people for their kidneys. Potential ethical issues aside, the researchers determined that society could break even by paying as much as $90,000 to those willing to part with a kidney for money.

- Read more:

http://news-info.wustl.edu/tips/page/normal/808.html?asc

SAFE AND SECURE

Program will provide car seats for low-income children

According to the U.S. Centers for Disease Control and Prevention (CDC), car crashes are the leading cause of death for children. Almost 2,000 children age 14 and under are killed in automobile crashes each year and another 280,000 are injured. Proper use of car seats reduces the risk of death significantly -- by as much as 71 percent for infants and by about 55 percent for toddlers. The CDC also estimates that 50,000 serious injuries could be prevented and 455 lives saved each year if all children under 5 used safety seats. In spite of the dangers, 40 percent of American children 4 and under routinely ride unrestrained. But Emergency Department physicians at Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis are trying to change that. They are targeting low income families, training them in proper use of child safety seats and then giving those families gift certificates that can be redeemed for the seats. The Safe and Secure program hopes to cut down on deaths and injuries from car crashes by providing more than 2,000 free car and booster seats to Missouri families who live below the poverty level as determined by Medicaid.

- Read more:

http://news-info.wustl.edu/tips/page/normal/821.html?asc

QUALITY IMPROVEMENT IN THE ICU

Team approach aids patient health in Intensive Care

Because patients in intensive care units (ICUs) are, by definition, in dire health, the consequences of even the slightest medical error can be devastating. Now two quality-improvement studies by researchers at Washington University School of Medicine in St Louis suggest solutions to two of the most common and dangerous patient safety challenges in ICU patients: restoring normal phosphorus levels and preventing infections related to catheters. The research was a multi-disciplinary effort between physicians, nurses, dietitians and the rest of the surgical ICU team at Barnes-Jewish Hospital. The quality-improvement studies led to dramatic improvements in patient health and safety, and the team believes these initiatives could improve patient health and safety at any ICU in the country.

- Read more:

http://news-info.wustl.edu/tips/page/normal/813.html?asc

AVOIDING ESOPHAGITIS

Scientists hope to eliminate painful side effect of lung cancer therapy

More than half of the lung cancer patients who receive radiation treatment for their illness develop a painful swelling and inflammation in the esophagus known as esophagitis. Although treating the lung cancer is the top priority for doctors, researchers at Washington University School of Medicine in St. Louis hope to lower the risk of this unpleasant side effect. They have quantified risk factors for esophagitis, linking it to the amount of radiation a patient's esophagus receives and to simultaneous chemotherapy. The findings mean it may be possible to predict and potentially avoid esophagitis, according to Jeffrey D. Bradley, M.D., assistant professor of radiation oncology and lead author of a paper published recently in the International Journal of Radiation Oncology, Biology, Physics.

- Read more: http://news-info.wustl.edu/tips/page/normal/826.html?asc

вторник, 2 октября 2012 г.

Senate GOP introduces health reform bill. (Washington Notebook) (Column) - National Underwriter Life & Health-Financial Services Edition

There's been a lot of talk and some action on health care reform in Congress, the Department of Health and Human Services and the private sector in the closing days of the first session of the 102nd Congress.

It was no coincidence that 22 Senate Republicans held a press conference two days after Harris Wofford, a political neophyte, was elected to fill the Senate seat of the late John Heinz, tragically killed in an air collision.

The press conference was called to announce the introduction of a major health care reform bill by the Senate Republican Task Force on Health Care. The task force was created in 1990 by Senate Minority Leader Bob Dole, a co-sponsor of the proposed Health Equity and Access Improvement Act of 1991.

Impatient after waiting for the President to take the initiative in developing a major health insurance plan, the task force unveiled its proposal (NU, Nov. 18). Sen. John Chafee, R-R.I., task force chairman, said it 'builds on our health care system's strengths.'

It was refreshing to hear that the proposal, S. 1936, recognizes that 'our system needs to be modified to promote fairness, to respond to the needs of those it does not adequately serve and to otherwise prevent further erosion.'

The task force again reminded us that the United States' medical technology 'is among the best in the world,' and that 85 percent of all Americans, 'do have some form of health insurance.'

The word 'fairness' is seldom heard about a program to improve the country's health care system. More often, those with good health insurance through their employers say they are afraid that if a universal health insurance plan is enacted, their coverage will suffer.

In addition to the introduction of the Senate Republicans' health care bill, developments have continued at a fast pace.

Commercial and non-profit insurers, physicians and hospital representatives held a 'summit' meeting with Health and Human Services Secretary Louis Sullivan, M.D., on reducing health care administrative costs (NU, Nov. 11). By coincidence, it was held Nov. 5, the same day as the special election for the Senate in Pennsylvania.

Secretary Sullivan assured reporters at a press conference following the half-day summit that perhaps $20 billion could be saved through electronic billing and computerizing patient records when the system is fully developed.

However, Health Insurance Association of America President Carl Schramm stepped forward at the press conference to estimate that about $8 billion a year would be saved by streamlining the records system.

It needs to be done as quickly as possible, everyone agrees. However, the administrative reform steps being taken may be 'too little and too late' to keep up with the political forces calling for a major overhaul of the health care system.

Secretary Sullivan mentioned at the summit press conference, as he has before, that the possibility that 'Draconian measures' will overtake incremental reform is always there.

Moving right along, the National Leadership Coalition for Health Care Reform proposed a major overhaul of the health care system Nov. 12.

The coalition's 'play or pay' proposal has the support of an impressive number of corporations, labor unions, consumer groups and former Presidents Jimmy Carter and Gerald Ford (NU, Nov. 18).

Two days later, the House Democratic Caucus passed a resolution supporting comprehensive national health insurance legislation.

The resolution, offered by House Majority Leader Richard Gephardt and Rep. Marty Russo, D-Ill., said:

'All Americans will be guaranteed coverage for high quality health care which preserves their ability to choose their own doctor, hospital and other health care professionals.

The resolution also promised that 'in order to make high quality health care effordable to the individual and society, growth in health care costs will be contained and sources of inefficiencies and waste will be eliminated.'

Rep. Russo is the sponsor of H.R. 1300, a single-payer universal health insurance bill that now has 64 cosponsors, more than any other health care reform measure pending in Congress.

The last word on the political message from Pennsylvania's special Senate election comes from HIAA President Schramm. While it's 'the conventional wisdom that the health care issue won the election for Mr. Wofford, those who believe that could be wrong,' according to Mr. Schramm.

The Occupational Safety and Health Administration. (Washington Insider).(to target companies with severe or repeated safety violations)(Brief Article) - Set-Aside Alert

The Occupational Safety and Health Administration says it will target companies with severe or repeated safety violations for extra inspections and possible court action.

'This policy will focus on the high-gravity violators and will put more tenacity and teeth into our enforcement practices,' said OSHA Administrator John Henshaw.

The agency will conduct followup investigations of any employer who has received a 'high gravity' citation, reserved for the most severe violations, or who has had repeated serious violations or a fatality.

понедельник, 1 октября 2012 г.

Federal Grants Help HIEs Link Mental Health, Providers.(Washington Report) - Health Data Management

Byline: Editorial Staff

HealthInfoNet, the health information exchange for Maine, is one of five state HIEs to receive federal grants to facilitate the sharing of records between behavioral health and general medical providers. The Maine Department of Health and Human Services received the $600,000 grant from the Center for Integrated Health Solutions and funneled the money to the HIE. The center is a joint initiative of the Substance Abuse and Mental Health Services Administration and the Health Resources Services Administration. In Maine, the grant will link 25 behavioral health organizations with 200 individual providers.

воскресенье, 30 сентября 2012 г.

Arsenic Levels Not a Health Threat, Washington State Toxicologist Says. - Knight Ridder/Tribune Business News

By Sean Robinson, The News Tribune, Tacoma, Wash. Knight Ridder/Tribune Business News

Aug. 22--The letters from Asarco offer free medical tests, but Elaine Wagner, 63, never takes them.

'I've probably got arsenic in me,' she said, 'but I'm really afraid to go check. I'm afraid to know.'

On Thursday, Wagner's hands were stained with dirt. She was building a deck in the Highland Park neighborhood, not far from a site where state inspectors recently tested soil and found concentrations of arsenic that reached 475 parts per million.

That number exceeds the 230-ppm cleanup threshold set by the Environmental Protection Agency for neighborhoods around Asarco's former copper smelter in Ruston, and the state's lower threshold of 20 parts per million. But experts say the numbers don't present an immediate threat to public health.

'The levels found in these samples should not be an immediate health threat if people take proper precautions, but long-term exposure to the contaminants is a public health concern,' said Jim White, a toxicologist with the state Department of Health.

Precautions include mopping and vacuuming the house several times a week, taking shoes off at the door, and washing children's toys, bedding and pacifiers.

'These are just suggestions -- a way to minimize the amount of dust in the home,' said Glenn dfRollins of the Tacoma-Pierce County Health Department. 'It's up to the individual lifestyles.'

The latest samples collected by the state Department of Ecology and the Tacoma-Pierce County Health Department continue a $1.65 million study of wind-borne arsenic and lead contamination from the smelter, which closed in 1985. The study is scheduled for completion next spring.

Earlier tests conducted in King County showed concentrations ranging from 260 parts per million on the mainland to 460 parts per million on Vashon and Maury islands.

'We're just picking up the rest of the footprint,' said Marian Abbett, project manager for the Department of Ecology.

The new samples from Pierce County, taken with the permission of property owners, came from 116 undisturbed sites and residential properties with homes built before 1970 within the prevailing wind direction of the smelter. Each property owner received their results by letter.

DOE officials would not release the names of individual property owners who participated in the study, but test results show arsenic ranging from 2.46 ppm up to 475.

Officials note that a high result from one sample does not mean adjoining properties will show the same contamination level.

Asarco sends letters to residents in the neighborhoods around the smelter, offering free tests for arsenic contamination. Wagner has received several.

An avid gardener who calls herself a plantaholic, she has lived in the area since 1995. She rarely wears gloves, but she's getting more careful. She jokes about trying to avoid eating dirt.

Officials worry more about people swallowing arsenic-tainted dirt than breathing it. Children who play in dirt are believed to be at highest risk.

A child whose yard contains 200-400 ppm of arsenic could swallow 40-80 micrograms (millionths of a gram) of the toxic metal each day. According to the National Research Council, a lifetime of such exposure could lead to a cancer risk of about one in 100.

Erin Swortz, 29, brought her two children and her nephew to Vassault Park on Thursday, near an area where state test results show an arsenic concentration of 233 ppm. Swortz lives near the park, and her husband has worked as a soils engineer.

'I'm not too concerned with what's going on,' she said. 'If it was high risk, I think my husband would be moving his family. My kids aren't eating enough dirt to get sick.'

When the soils study is complete, the state and the area health department plan to take more tests in child-use areas, such as playgrounds, schools and day-care centers. The state hopes to find enough money to remove or cap arsenic-tainted soil in those areas.

In Tacoma, the EPA ordered Asarco to clean up yards with arsenic concentrations of 230 ppm or greater. The state's cleanup standard is 20 ppm, based on natural background levels.

Though some samples show results higher than the acceptable concentration, state officials admit there is little they can do about it other than offer advice. Asarco is trying to avoid bankruptcy, and federal and state toxic cleanup funds are scarce.

'The state does not have sufficient funds to do it all,' Abbett said. 'That's the million-dollar question. That's what we're grappling with, is how to deal with this large area.'

Ruth Brewster, 83, lives near an area where the state found arsenic concentration of 440 parts per million. Like Wagner, she received Asarco's letters. Unlike Wagner, she got herself tested.

'I came out all right,' she said. 'I suppose I should be concerned, but at my age, I'm not.'

To see more of The News Tribune, or to subscribe to the newspaper, go to http://www.tribnet.com

(c) 2002, The News Tribune, Tacoma, Wash. Distributed by Knight Ridder/Tribune Business News.

суббота, 29 сентября 2012 г.

EHR adoption challenged by obstacles: daunting issues abound; will financial incentives ultimately spur interest in a universal electronic health record?(WASHINGTON INSIGHTS) - Behavioral Health Management

A universal, simple, portable electronic health record (EHR) is one of the most promising potential benefits of the information age. An ATM card provides standardized access to information on a bank customer's financial accounts; it's no great technologic leap to envision a similar electronic key unlocking access to a patient's medical history. The EHR could provide a single standardized reporting mechanism for third-party payers, offer critical data to emergency room doctors confronted with an unfamiliar patient in crisis, and reduce the likelihood of adverse medication interactions. Above all, the EHR, using current technology, could slash healthcare administration's soaring costs.

The EHR's appeal has brought it to the forefront of healthcare policy. The National Institute of Medicine, the President's New Freedom Commission on Mental Health, and Newt Gingrich's healthcare reform action group all have endorsed the mantra that rapid IT deployment is critical for healthcare quality improvement and cost savings. On April 27, 2004, President Bush issued an executive order calling for a ten-year timeline for the development and implementation of health information technology to help achieve substantial improvements in healthcare safety and efficiency. David J. Brailer, MD, PhD, was appointed the federal government's first national coordinator for health information technology less than a month later.

Private-sector behavioral healthcare has moved rapidly to adapt electronic record keeping to patient billing and service records. Public-sector payers generally have moved more leisurely. However, in September 2005, the U.S. Department of Health and Human Services convened a two-day National Summit on Defining a Strategy for Behavioral Health Information Management and Its Role Within the National Health Information Infrastructure. Unfortunately, the summit's unwieldy name was only too fitting for an implementation process that appears to be cumbersome and weighed down with bureaucratic baggage.

In their meeting presentations, summit participants identified some of the reasons for the slow adoption of electronic records. Claudia Roth, PhD, president and CEO of the Western Psychiatric Institute and Clinic (WPIC) at the University of Pittsburgh Medical Center, related the arrival of health IT at her facility over a four-year period. After unsuccessfully attempting to acquire a commercially available system during the early 1990s, WPIC made a significant investment in developing its own electronic health information system, Clinical Progress Notes. One year later, WPIC abandoned continued development of the Clinical Progress Notes system in favor of purchasing a new system that would incorporate clinicians as system designers. Leaving clinicians out of the development and acquisition process had proven to be an expensive mistake because an EHR deployment's effectiveness depends largely on clinicians' willingness to use the system.

Adoption of a truly universal EHR that includes behavioral healthcare is likely to be even more difficult than the WPIC experience because many behavioral healthcare providers are solo-practice professionals. This is most often the situation in public-sector behavioral healthcare in smaller communities, where therapists generally operate on the basis of individual contracts issued by the local mental health, education, and criminal justice authorities. These solo-practice therapists lack the infrastructure support--and frankly the time--to commit themselves to learning new computer-based health information systems.

Beyond these practical issues, summit attendees recognized the existence of a cultural gap between the clinician's perception of therapy as 'art' and the expectation that an EHR will need standardized definitions that might well produce artificial segmentation of interventions into neat but inaccurate care descriptions. This already has become a problem in efforts to establish uniform billing codes for mental health therapy, in which practices such as peer interventions and family therapies give auditors heartburn as they try to distinguish services for the patient from services for the patient's support system. Summit participants voiced platitudes about the need for 'strong leadership' and 'workforce training on a national scale,' but they ultimately agreed that the only way to overcome clinician prejudices about oversimplification of the description of care in an EHR will be to achieve widespread practical use of a universal record in clinical settings.

Mental health consumers have their own reservations about the deployment of a universal EHR. The summit briefly acknowledged that patients and their families will insist on control over the records' contents, as well as protection against the misuse of information that would become available through the system. Sylvia Caras, a spokesperson for the consumer movement, explained that the fears relate more to the potential for stigmatization of behavioral health patients. 'There is a real concern that an inappropriate diagnosis or inaccurate information could remain in the record for years, without the consumer having any way to edit the misinformation,' she said.

Other attendees added that effective behavioral healthcare requires confidential information about consumers that falls outside of the 'normal' health record, including sexual preferences, financial supports, and experiences with employers and government authorities. Achieving a balance between what therapists need to know and what other healthcare professionals should not learn about behavioral healthcare patients is going to be a serious challenge in implementing a truly universal record.

The challenges confronting a universal EHR may become complicated by the fact that SAMHSA has assumed responsibility for federal leadership in this arena. SAMHSA already has been heavily involved in its own 'universal' behavioral healthcare information system: the National Outcome Measures (NOMs). SAMHSA applies NOMs to behavioral healthcare services in ten domains:

* abstinence

* employment/education

* crime and criminal justice

* stability in housing

* access/capacity

* retention in care

* social connectedness

* consumer perception of care

* cost-effectiveness

* use of evidence-based practices

These domains might be reasonable measures for public-sector care, in which reduction of dependence on taxpayer support is a major issue, but they have much less relevance to the reasons private-sector consumers become patients. For example, the NOMs offer no assessments of therapy's ability to produce satisfying sexual relationships or to help consumers overcome problems of grief that may not directly affect their 'life in the community.' Nevertheless, SAMHSA officials at the summit effectively endorsed the NOMs as the core of a behavioral healthcare EHR.

In truth, SAMHSA's ability to influence public-sector behavioral healthcare is sharply undercut by its relatively minor role in financing direct care. Medicaid and Medicare--financing systems that lie outside of SAMHSA's purview--today fund the vast majority of public-sector behavioral healthcare. The federal Centers for Medicare & Medicaid Services (CMS) maintains electronic records for behavioral healthcare that are far more influential than SAMHSA's NOMs for the simple reason that their use influences the financial viability of thousands of behavioral healthcare providers. The summit paid only minor attention to this issue, perhaps because SAMHSA representatives vastly outnumbered CMS participants. Adoption of a universal EHR undoubtedly will have significant benefits for quality, the dissemination of evidence-based practices, and even the accountability of SAMHSA's grant-funded interventions. Ultimately, however, changes in healthcare in the United States are driven by financial realities and incentives. The federal government's policy of supporting better use of health IT must acknowledge this fundamental principle before it can escape the hothouse atmosphere of summits and seminars.

To send comments to Dr. Stoil and the editors, e-mail stoil1105@behavioral. net. To order reprints in quantities of 100 or more, call (866) 377-6454.

пятница, 28 сентября 2012 г.

Anxiety running high over budget and health reform. (Washington Notebook) - National Underwriter Life & Health-Financial Services Edition

The fate of the administration's health care reform bill seems inextricably linked to the outcome of the budget reconciliation bill, which at this writing is pending in the Senate.

The linkage is principally due to the fact that the only way the federal deficit can be reduced in the long run is to enact health care reform that significantly slows rising costs.

Contributing to the anxiety about the outcome of health care reform and the budget reconciliation bill are the recent political and public relations faux pas emanating from the White House.

'The President is going to have to recover substantially in the polls before he offers his health care proposal,' according to Gordon Wheeler, the Health Insurance Association of America's director of political affairs.

Mr. Wheeler said the President's withdrawal of his nomination of Lani Guinier as chief of the Justice Department's civil rights division 'has severely weakened him on Capitol Hill.'

President Clinton will have to do considerable fence-mending with members of the Congressional Black Caucus where 40 votes could be lost over a vote on budget reconciliation or health care, Mr. Wheeler noted.

The Guinier nomination was 'essentially, a Catch 22' situation for the President, he observed. 'All in all, it doesn't bode well for timely action on health care,' he said. However, he added that the President should be protected by his staff from having to read 'every piece of paper' before making a decision.

In going all-out to win House passage of the reconciliation bill by a narrow margin, President Clinton went to Capitol Hill and met with the House Democratic caucus and a joint meeting of House and Senate Democratic leaders. He argued against caps on entitlements, such as Medicare and Medicaid.

The President opposed a proposal offered by Rep. Charles Stenholm, D-Texas, to impose caps on entitlements. The Stenholm provision, the 'Entitlement Discipline Agreement,' was passed as part of the budget reconciliation measure.

The Stenholm provision creates a mechanism to monitor total costs of entitlement programs and, if costs exceeded target levels set by the Office of Management and Budget, the President and Congress would be held accountable and be required to take action each year.

If the targets were exceeded by more than one-half of one percent, the President would have to recommend to Congress spending cuts, tax increases, or both to wipe out the overage, or to make no changes and raise the targets.

On the morning President Clinton went to Capitol Hill, he had lunch with a group of Chief Executive Officers to persuade them to support the budget reconciliation bill. He told them the energy tax is a good tax that would get interest rates down and have 'credibility in the markets.'

He pointed out that the bill has $100 billion in entitlement cuts. A reporter then asked the President during a photo opportunity with the business leaders, 'what about an entitlement cap, as some people on the Hill want? Wouldn't that help?'

President Clinton replied that he was not opposed to a cap on health care spending, but it should be done in the context of health care.

Noting that 'this is a good place to discuss this,' he said that 'the United States government has already contributed to the rising costs of health care for employers by squeezing Medicare and Medicaid and forcing those costs off onto private employers...

'If we did it now,' he said, 'it would run the risk of two or three years from now having another big increase in their costs, undermining their ability to hire American workers and to keep American competitive.

'So if we're going to have a health care cap, let's do it with health care. That's the way it should be done,' the President said.

четверг, 27 сентября 2012 г.

Congress questions FDA authority over qualified health claims.(WASHINGTON) - The Food Institute Report

In a statement accompanying the recently enacted omnibus appropriations act for fiscal year 2008, Congress questioned the authority of the FOOD AND DRUG ADMINISTRATION (FDA) to authorize qualified health claims, according to FI Counsel, OLSSON, FRANK, WEEDA, TERMAN, BODE & MATZ.

The Consolidated Appropriations Act of 2008 (the State, Foreign Operations, and Related Programs Appropriations Act, 2008), signed by President Bush on Dec. 26, provides fiscal year (FY) 2008 appropriations for all federal agencies and departments, except the Department of Defense. In the Joint Explanatory Statement to the appropriations act, Congress cast doubt on whether FDA has the statutory authority to allow qualified health claims in food labeling:

The [House and Senate Appropriations] Committees are concerned that FDA may have exceeded its statutory authority when the agency decided to begin allowing the use of qualified health claims for conventional foods in 2003. Such claims are not based on the standard of 'significant scientific agreement' set forth in the Nutrition Labeling and Education Act [NLEA]. The agency has devoted literally thousands of hours of staff work to this undertaking at a time when the agency's ability to carry out its public health responsibilities are severely stretched.

While the consumer group CENTER FOR SCIENCE IN THE PUBLIC INTEREST has alleged in a lawsuit that FDA's policy on qualified health claims violates the NLEA and the Administrative Procedures Act, this is the first time that Congress has suggested that FDA may have exceeded its legislative authority in approving qualified health claims.

The Congressional statement requests that the Government Accountability Office (GAO) prepare a report on qualified health claims, including their usefulness and their impact on public perceptions of conventional foods. Moreover, the statement 'urges' FDA not to use any FY 2008 appropriated funds to review petitions for qualified health claims or to issue letters of enforcement discretion allowing such claims until the GAO report is completed.

In a related development, FDA has announced its intent to reevaluate, in light of new information, the scientific basis for four health claims, including two qualified health claims for dietary supplements (i.e., antioxidant vitamins and certain cancers, selenium and certain cancers). 72 Fed. Reg. 72,738 (Dec. 21, 2007).

Qualified health claims are health claims about the relationship between a substance and a disease or health-related condition where there is emerging scientific evidence in support of a relationship but such evidence does not rise to the level of 'significant scientific agreement.' FDA implemented its policy to permit qualified health claims (as part of its Better Nutrition Information for Consumer Health Initiative) pursuant to the decision in Pearson v. Shalala, 164 F.3d 650 (D.C. Cir.1999), in which the court held that the First Amendment does not permit FDA to reject health claims that the agency determines to be potentially misleading unless the agency also reasonably determines that no disclaimer would eliminate the potential deception.

среда, 26 сентября 2012 г.

GRANT WILL IMPROVE CHILDREN'S MENTAL HEALTH SERVICES IN WASHINGTON. - States News Service

OLYMPIA, WA -- The following information was released by the Washington State Department of Social and Health Services:

The Washington State Department of Social and Health Services received a one-year, $800,000 grant to improve mental health services for children across the state. The grant was awarded by the Substance Abuse and Mental Health Services Administration.

'We will develop a comprehensive strategic plan to improve, implement, expand and sustain the system of care principles and philosophy, with an emphasis on developing an infrastructure for state-level funding, policy and practice changes'' said David Dickinson, director of the DSHS Division of Behavioral Health and Recovery.

A 'system of care' (SOC) is an organizational philosophy and framework that is designed to create a network of effective community-based services and supports to improve the lives of children and youth with, or at risk of, serious mental health conditions and their families. This system can build meaningful partnerships with families and youth, address cultural and linguistic needs, and use evidence-based practices to help children, youth and families function better at home, in school, in the community and throughout life.

вторник, 25 сентября 2012 г.

GRANT TOIMPROVE CHILDREN'S MENTAL HEALTH SERVICES IN WASHINGTON - US Fed News Service, Including US State News

OLYMPIA, Wash., Nov. 16 -- The Washington state Department of Social and Health Services issued the following news release:

The Washington State Department of Social and Health Services received a one-year, $800,000 grant to improve mental health services for children across the state. The grant was awarded by the Substance Abuse and Mental Health Services Administration.

'We will develop a comprehensive strategic plan to improve, implement, expand and sustain the system of care principles and philosophy, with an emphasis on developing an infrastructure for state-level funding, policy and practice changes'' said David Dickinson, director of the DSHS Division of Behavioral Health and Recovery.

A 'system of care' (SOC) is an organizational philosophy and framework that is designed to create a network of effective community-based services and supports to improve the lives of children and youth with, or at risk of, serious mental health conditions and their families. This system can build meaningful partnerships with families and youth, address cultural and linguistic needs, and use evidence-based practices to help children, youth and families function better at home, in school, in the community and throughout life.

The grant will fund strategic planning to expand and sustain the number of jurisdictions and locations in Washington state that adopt an SOC. DSHS will collaborate with state and local child-serving organizations to plan and implement this project. For any query with respect to this article or any other content requirement, please contact Editor at htsyndication@hindustantimes.com

понедельник, 24 сентября 2012 г.

Highmark Chief Medical Officer Discusses Benefits of Meaningful Use Standards for Electronic Health Records at Washington, D.C. Forum. - Managed Care Weekly Digest

Dr. Donald Fischer, Highmark Inc.'s chief medical officer, will join representatives from two other leading health insurers today at the National Press Club in Washington, D.C. to discuss ways to improve health, increase patient safety and reduce health care costs through the use of electronic health records (EHR) (see also Electronic Medical Records).

With the Health Information Technology for Economic and Clinical Health Act of 2009, eligible health care professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified EHR technology and use it to achieve specific objectives. In July, the Department of Health and Human Services announced the 'meaningful use' standards and technical capabilities required for certified EHR technology that physicians and hospitals must meet to qualify for the bonus payments.

'Meaningful use standards will ensure that physicians and hospitals are using EHR technology to achieve their goal of providing, high-quality, coordinated care to patients,' said Dr. Fischer.

Dr. Fischer was invited to be a part of Thursday's discussion based on Highmark's strong support of national efforts to advance EHR adoption. In fact, the company will be the nation's first insurer to include the adoption of meaningful use standards in its pay-for-performance program, QualityBLUE. Highmark network providers can qualify for financial incentives by incorporating meaningful use standards with the implementation of electronic health records technology.

Meanwhile, Highmark is supporting the adoption of health information technology in other ways. In 2008, the company joined with the Pittsburgh Regional Health Initiative to offer practice training and coaching to support primary care practices involved in the Centers for Medicare and Medicaid Services' EHR demonstration program and in the acquisition of EHRs to achieve quality targets.

In addition, Highmark promotes the adoption of electronic prescribing through its $29 million Health Information Technology Grant program. Highmark has provided 3,140 physicians with more than $19.6 million to assist with health information technology, including electronic prescribing.

Keywords: Data Management, Electronic Medical Records, Health Information Technology, Health Policy, Highmark Inc., Hospital, Information Technologies, Legal Issues, Medicaid, Medicare.

воскресенье, 23 сентября 2012 г.

JAPAN NUCLEAR EVENTS AFTER QUAKE POSE NO HEALTH RISK IN WASHINGTON - US Fed News Service, Including US State News

OLYMPIA, Wash., March 17 -- The Washington State Department of Health issued the following news release:

State health officials have seen no increased radiation levels in local air samples after nuclear power plants were damaged in the earthquake and tsunami in Japan. Air monitoring continues as a precaution, though no public health risks are expected in Washington due to the events in Japan.

Although the situation at Japan's crippled nuclear power plants continues to change, the risk to Washington has not.

'Dangerous levels of radiation are not expected to reach Washington,' said Secretary of Health Mary Selecky. 'The tragic events in Japan don't pose a radiation exposure risk to people in our state. And we urge people not to take potassium iodide or iodine pills; it's unnecessary and could be harmful to some people.'

Potassium iodide, also known as KI, is only needed by people who must work in or around nuclear power plants during an emergency, or who live nearby and cannot evacuate. KI should not be taken by anyone in Washington because of the events in Japan.

Public health, meteorology, and radiation experts continue to make that point. Because Japan is so far away, radiation would be diluted before reaching our state and levels would be so low no protective action, including iodine and other supplements, is necessary.

Dr. Cliff Mass of the University of Washington, professor in the Department of Atmospheric Sciences, has been following the situation in Japan. 'There's little chance that a significant radiation threat exists for the Pacific Northwest from the Japanese reactor problems,' he said.

'Normal atmospheric mixing, radioactive decay, wash-out of particles, and settling will insure that concentrations would decline to very small amounts, even if highly favorable trajectories existed at the time of any major release,' Mass concludes.

State health officials provide additional information on the agency Newsroom page (http://www.doh.wa.gov/Topics/japan2011.htm), which is updated daily. For any query with respect to this article or any other content requirement, please contact Editor at htsyndication@hindustantimes.com

суббота, 22 сентября 2012 г.

JAPAN NUCLEAR EVENTS AFTER QUAKE POSE NO HEALTH RISK IN WASHINGTON. - States News Service

OLYMPIA, WA -- The following information was released by the Washington State Department of Health:

State health officials have seen no increased radiation levels in local air samples after nuclear power plants were damaged in the earthquake and tsunami in Japan. Air monitoring continues as a precaution, though no public health risks are expected in Washington due to the events in Japan.

Although the situation at Japan's crippled nuclear power plants continues to change, the risk to Washington has not.

'Dangerous levels of radiation are not expected to reach Washington,' said Secretary of Health Mary Selecky. 'The tragic events in Japan don't pose a radiation exposure risk to people in our state. And we urge people not to take potassium iodide or iodine pills; it's unnecessary and could be harmful to some people.'

Potassium iodide, also known as KI, is only needed by people who must work in or around nuclear power plants during an emergency, or who live nearby and cannot evacuate. KI should not be taken by anyone in Washington because of the events in Japan.

Public health, meteorology, and radiation experts continue to make that point. Because Japan is so far away, radiation would be diluted before reaching our state and levels would be so low no protective action, including iodine and other supplements, is necessary.

Dr. Cliff Mass of the University of Washington, professor in the Department of Atmospheric Sciences, has been following the situation in Japan. 'There's little chance that a significant radiation threat exists for the Pacific Northwest from the Japanese reactor problems,' he said.

'Normal atmospheric mixing, radioactive decay, wash-out of particles, and settling will insure that concentrations would decline to very small amounts, even if highly favorable trajectories existed at the time of any major release,' Mass concludes.

State health officials provide additional information on the agency Newsroom page (www.doh.wa.gov/Topics/japan2011.htm), which is updated daily .

Mental health care in Washington turns 150 - The Columbian (Vancouver, WA)

Mother Joseph

Pioneer in care for the mentally ill

---

A jail inmate was released 150 years ago in Vancouver, a processthat has been repeated fairly regularly ever since.

What Tom Riedlinger finds notable is the person who sprung thisinmate from the local lockup. The troubled woman became MotherJosephs first mental health patient.

After researching the history of care in the state, Riedlingerpoints to June 5, 1861, as the opening of Washingtons first mentalhealth care facility.

Riedlinger, a mental health professional in Olympia, describes itas the start of a system of compassionate care in what was thenWashington Territory.

Mother Joseph already had a lot on her plate. She and the fournuns who had come with her from Montreal were pioneers in education,health care and social services.

But they expanded their work when a Vancouver woman was jailedfor disruptive behavior. It was too much for the Sisters of Charityof Providence to bear, according to The Bell and the River, ahistory of Mother Josephs work in the Northwest.

There was the poor woman under the supervision of a man who hadneither morals or principles of any kind, wrote Sister MaryMcCrosson, quoting the chronicles of the religious order. We weremuch afflicted at this condition of things.

They decided to use two buildings near the boys orphanage forhousing the mentally deranged, according to the chronicles.

The woman, identified in the book as Marie Comito, was the firstpatient. However, the nuns apparently were not rookies in thisfield. A 19th-century reference said that the Sisters of Providencefounded in Montreal in 1828 have charge of the insane asylum nearthat city.

McCrossons book explains that Sister Praxedes, who had worked atthe Montreal asylum for several years, took charge of the Vancouverfacility for the mentally ill.

In 1862, the Washington Territory assumed responsibility for careof the mentally ill, said a state human-services website. Lackingfunds to build a hospital, the state contracted for the care of thementally ill with the Sisters of Charity.

The St. John of God Asylum welcomed Washington Territorys mentalhealth patients the most serious cases, anyway.

The community tolerated more disruptive behavior, Riedlingersaid. The less severe were cared for by their families, or leftalone. Mother Joseph got the most acute.

While there is no record of treatment methods, It was not asprimitive you as might think, said Riedlinger, who works in theinpatient psychiatry unit at Providence St. Peter Hospital inOlympia.

With psychiatric medications almost 100 years in the future,environment had a lot to do with stabilizing, Riedlinger said. Thesisters provided a stable and nurturing environment which was notthe case with the subsequent low bidders.

In 1866, two businessmen from what is now the Kelso area underbidthe sisters for the state contract.

After the low-bid process proved to be a poor basis for a mentalhealth system, Washingtons first asylum was established in 1871 atan abandoned Army post, Fort Steilacoom.

Still, there were problems. The states Department of Social andHealth Services website reports: In 1875, complaints about brutalityand poor living conditions led to the territorial government takingdirect control, and legislative approval of its director.

Riedlinger discovered that Marie Comito Mother Josephs firstpatient was among those who were transferred to the state facility.

There is another link that connects many current state residentswith that original patient, Riedlinger said.

Its still true that a great number of people who are mentally illare in jail.

пятница, 21 сентября 2012 г.

Maryland officials slam 'chaotic' health system in Washington, D.C. - Knight Ridder/Tribune Business News

By Jim McElhatton, The Washington Times Knight Ridder/Tribune Business News

Jul. 31--Maryland's top public health official yesterday called the D.C. health care system 'chaotic' and criticized the D.C. government's decision not to pay more than $5 million to Prince George's Hospital Center for the treatment of indigent city residents.

'Quite frankly, the District has been taking advantage of the Maryland health care system for years,' said Nelson J. Sabatini, secretary of the Maryland Department of Health and Mental Hygiene.

'They dump uncompensated care patients into Maryland because Maryland has a disciplined, regulated system [of reimbursement for charity care], and the District has nothing but a chaotic health care system.'

The criticism came in response to D.C. government's recent decision to refuse to pay a bill that Prince George's Hospital Center submitted in June for the treatment of indigent D.C. residents.

The Washington Times first reported Wednesday that the hospital's parent company, Cheverly-based Dimensions Healthcare System, is billing the D.C. government for treating city residents who don't pay their bills.

Company spokesman Bob Howell said Prince George's Hospital Center, which is just over the D.C. line in Cheverly, has been treating increasing numbers of indigent D.C. residents since the District closed D.C. General Hospital in June 2001.

Dimensions requested payment for the treatment of indigent city residents through the D.C. Healthcare Alliance, a $96 million city-funded insurance program for low-income individuals run through the D.C. Department of Health.

'The District government cannot provide money... for costs that were not directly provided to the city,' said Tony Bullock, a spokesman for D.C.

Mayor Anthony A. Williams. 'There is no basis to make this payment.'

Mr. Williams created the alliance program three years ago to fill the gap in health services created by the closure of D.C. General. However, city officials say the program doesn't pay providers outside of the District.

'We're sympathetic to their problems,' Mr. Bullock said, referring to Prince George's Hospital, which has lost $42 million in the past five years. 'But we can't just cut them a check.

'We had the same problem when we had D.C. General in operation, except the traffic was flowing in the other direction and tens of millions of dollars in services were being provided to non-D.C. residents,' Mr. Bullock said.

'But we never went to the county or the state of Maryland and said 'pay us for these services'.'

The District denied the payment claim in a July 14 letter to Dimensions from the District's Associate Chief Financial Officer Deloras Shepherd.

Mr. Bullock said city government can't control where residents seek hospital care. 'It isn't something that the government can monitor,' he said.

The hospital's demand for payment comes three months after Prince George's County and Maryland state officials agreed on a $45 million bailout for Dimensions, which also owns the 146-bed Laurel Regional Hospital.

To see more of The Washington Times, or to subscribe to the newspaper, go to http://www.washtimes.com.

четверг, 20 сентября 2012 г.

NUCLEAR EVENT IN JAPAN POSES NO HEALTH RISK IN WASHINGTON; STATE MONITORING - US Fed News Service, Including US State News

OLYMPIA, Wash., March 12 -- The Washington State Department of Health issued the following news release:

The state Department of Health is conducting ongoing air monitoring for radiation to see if the nuclear plant incident in Japan has affected radiation levels in Washington. There have been no elevated readings.

The agency's Radiation Protection staff expects no public health risk in Washington, and the monitoring is precautionary. If the situation changes in Washington, the Department of Health will inform the public.

State health officials are monitoring the events in Japan, and are in contact with the federal Nuclear Regulatory Commission and Environmental Protection Agency. An explosion took place at the Japan reactor site Saturday.

The nuclear plant incident in the wake of the earthquake in Japan has raised concerns among some people in Washington about windblown radiation coming to our state. Air sample readings in our state remain normal. The Department of Health Radiation Protection Program doesn't expect any change in environmental measurements taken in Washington.

Even in the event of a significant release from the reactor, radiation would be diluted before reaching our state and levels would be so low no protective action would be necessary. The state health department will continue its monitoring work as the situation in Japan develops and changes. For any query with respect to this article or any other content requirement, please contact Editor at htsyndication@hindustantimes.com

NUCLEAR EVENT IN JAPAN POSES NO HEALTH RISK IN WASHINGTON; STATE MONITORING. - States News Service

OLYMPIA, WA -- The following information was released by the Washington State Department of Health:

The state Department of Health is conducting ongoing air monitoring for radiation to see if the nuclear plant incident in Japan has affected radiation levels in Washington. There have been no elevated readings.

The agency's Radiation Protection staff expects no public health risk in Washington, and the monitoring is precautionary. If the situation changes in Washington, the Department of Health will inform the public.

State health officials are monitoring the events in Japan, and are in contact with the federal Nuclear Regulatory Commission and Environmental Protection Agency. An explosion took place at the Japan reactor site Saturday.

The nuclear plant incident in the wake of the earthquake in Japan has raised concerns among some people in Washington about windblown radiation coming to our state. Air sample readings in our state remain normal. The Department of Health Radiation Protection Program doesn't expect any change in environmental measurements taken in Washington.

Even in the event of a significant release from the reactor, radiation would be diluted before reaching our state and levels would be so low no protective action would be necessary. The state health department will continue its monitoring work as the situation in Japan develops and changes.

Cardinal Health, University of Washington Create Innovative Partnership to Advance Use of Molecular Imaging in Clinical Trials. - Heart Disease Weekly

Cardinal Health and the University of Washington (UW) announced an innovative public-private collaboration designed to advance the use of molecular imaging in clinical investigations and trials (see also Molecular Imaging).

Molecular imaging is one of the most promising areas of development in biotechnology, where specialized radiopharmaceuticals, or Positron Emission Tomography (PET) 'imaging agents,' are injected into the body to detect and trace abnormal cellular functions that are associated with health issues such as heart disease, neurological disorders and many forms of cancer. These imaging agents, which are visible using sophisticated imaging scanners, make it easier for physicians to non-invasively diagnose, monitor and potentially treat disease at the earliest stages of onset.

Through this collaboration, the UW's Department of Radiology will relocate a portion of its on-campus molecular tracer laboratories into Cardinal Health's PET manufacturing facility located in downtown Seattle. The UW laboratories that are part of the move will include one operated by Dr. John Grierson, who developed the PET agent F-18 fluorothymidine (FLT), which is now distributed nationally through Cardinal Health and is being used in a wide array of clinical trials. UW's Department of Radiology will have access to Cardinal Health's cyclotron, radiopharmaceutical products and research support services, to aid in the efficient operation of its research facility.

By co-locating in the same physical space, the two organizations will combine the University of Washington's internationally-recognized PET research and development expertise with Cardinal Health's expertise in the FDA-compliant production and distribution of PET imaging agents to accelerate the research, development and commercialization of new molecular imaging agents.

'Consistent with the cycle of innovation, we look forward to collaboratively working with Cardinal Health to develop new uses for molecular imaging tracers - and the clinical applications of tomorrow,' said Dr. Norman J. Beauchamp, Jr., UW professor of radiology and chairman of UW's Department of Radiology. 'Cardinal Health's nuclear pharmacy expertise and its commitment to supporting the growth of molecular imaging through clinical investigations make it an outstanding partner to help us work toward our ultimate, shared goal: to lessen the impact of devastating conditions including cancer, neurological disorders and cardiovascular disease.'

The University of Washington is one of the nation's leading research institutions, receiving more research dollars from the National Institutes of Health than any other public university in the United States.

Cardinal Health's Nuclear Pharmacy Services business operates the nation's largest network of radiopharmacies. The company has also strategically located its nationwide network of cyclotrons to enable many of its radiopharmacies to compound and dispense high-energy PET imaging agents in unit-dose form.

Its vast network of 'PET-enabled' pharmacies, combined with its broad nuclear pharmacy scale, comprehensive fleet and logistics capabilities enable it to play a critical role in supporting clinical trials of both proprietary and non-proprietary imaging agents.

Cardinal Health has already begun the process of expanding its Seattle radiopharmacy facility to accommodate UW's new radiochemistry laboratory, where UW researchers will work alongside Cardinal Health staff and technicians. Renovations to the expanded facility are expected to be completed by the beginning of 2011.

'We are very proud to partner with the University of Washington - one of the nation's preeminent research institutions - to advance the future of molecular imaging with the development of this innovative, world-class facility,' said John Rademacher, president of Cardinal Health's Nuclear and Pharmacy Services business. 'This collaboration will provide us with exciting new opportunities to partner with innovators and pharmaceutical research organizations to enable the research, development and commercialization of new molecular imaging agents that have the potential to dramatically improve patient health.'

Keywords: Cancer, Clinical Trial Research, Emerging Technologies, Imaging Agent, Marketing and Licensing Agreements, Medical Device, Molecular Imaging, Nanotechnology, Oncology, Therapy, Treatment, Cardinal Health Inc.

среда, 19 сентября 2012 г.

DEPARTMENT OF NATURAL RESOURCES HOLDS FOREST HEALTH MEETINGS ACROSS WASHINGTON STATE - US Fed News Service, Including US State News

The Washington state Department of Natural Resources issued the following news release:

Today the Washington State Department of Natural Resources (DNR) announced that the Forest Health Strategies Working Group is holding a series of public meetings about forest health. The meetings will be conducted from August 14 through 31 in eight different locations throughout the state.

'The health of Washington's forestlands is an issue that affects all of the state's citizens. Over the past few years, overcrowded forests have led to an increase in diseases and insect infestations and susceptibility to wildfire,' said Public Lands Commissioner Doug Sutherland.

'These meetings are designed to provide the public with information about the health of Washington's forests, particularly those near their communities, as well as what we can do to improve forest conditions,' he concluded.

The meetings will be held at the times and locations indicated below:

* August 14 - 6:30 pm in Longview at Cowlitz County PUD, 961 12th Ave.

* August 15 - 2:00 pm in Aberdeen at Aberdeen Timberland Library, 121 E. Market St.

* August 16 - 6:30 pm in Yakima at Yakima Valley Regional Library, 102 N. 3rd

* August 24 - 2:00 pm in Walla Walla at Walla Walla City Hall, 15 N. 3rd

* August 28 - 6:30 pm in Colville at Colville Public Library, 195 S. Oak St.

* August 29 - 2:00 pm in Omak at Omak City Hall, 2 N. Ash St.

* August 30 - 6:30 pm in Mt. Vernon at Best Western Cottontree Inn, 2300 Market Pl.

* August 31 -6:30 pm in SeaTac at Radisson Hotel Gateway SeaTac Airport, 18118 International Boulevard

The meetings have two purposes. The first of these is to provide the public with an opportunity to learn about current forest health issues and possible approaches to improve forest health conditions. The other purpose is to allow the public to comment on proposed legislation drafted to prevent or control insect and disease outbreaks.

In June, Commissioner Sutherland reassembled the Forest Health Strategies Working Group, consisting of 14 individuals knowledgeable about forests, forest ecology, or forest health issues. The 2006 Working Group is building on the work of a similar group that met in 2004 to identify opportunities to improve Washington's forest health conditions and report its findings to the State Legislature. The 2004 group's December 2004 report describes findings and recommendations for a desirable forest health program for Washington's forests.

The State Legislature asked the 2006 Forest Health Strategies Working Group to hold meetings across the state to listen to the public's concerns about forest health and proposed legislation. They are to use this information to craft a comprehensive forest health bill for the legislature's consideration in the 2007 session.

As drafted, the proposed legislation seeks to improve forest health conditions by authorizing DNR to monitor forest conditions and changes over time in coordination with universities, landowners, and state and federal agencies. It would also authorize DNR to provide technical and informational assistance to landowners, and would authorize the Lands Commissioner to establish technical advisory committees, as needed, in areas threatened by forest health conditions. The draft legislation calls for DNR to establish cooperative forest health projects to control and contain outbreaks of insects and disease.

The draft legislation and public meeting details are available at www.dnr.wa.gov/htdocs/rp/forhealth/ . Additional information regarding DNR's forest health program is also available on the website.

DNR - land manager and protector of natural resourcesAdministered by Public Lands Commissioner Doug Sutherland, DNR provides wildfire protection and supports the state Forest Practices Board in protecting public resources on 12.7 million acres of private and state-owned forestland. DNR geologists regulate surface mine reclamation; DNR staff provide technical assistance for forestry and mining; and provide financial and grant assistance for urban forestry to state and local communities.

Sutherland is Washington's 12th Public Lands Commissioner since statehood in 1889.Contact: Patty Henson, 360/902-1023, patty.henson@wadnr.gov.

JAIME HERRERA BEUTLER EXPRESSES CONCERN WITH PROPOSED CRITICAL HABITAT PLAN LOCKING UP STATE AND PRIVATE LAND "DOUBLES DOWN" ON APPROACH THAT HAS FAILED NORTHERN SPOTTED OWLS, FOREST HEALTH AND SOUTHWEST WASHINGTON JOBS. - States News Service

Vancouver -- The following information was released by the office of Washington Rep. Jaime Herrera Beutler:

In a letter to the U.S. Fish and Wildlife Service (USFWS) sent this week, Jaime Herrera Beutler said that the agency's proposed critical habitat plan would 'double down' on a forest management approach that for 20 years has failed to protect forests, the Northern Spotted Owl, and jobs.

The USFWS Revised Critical Habitat proposal would more than double the amount of land designated as critical habitat for the Northern Spotted Owl under the Northwest Forest Plan established in 1992, essentially grinding to a halt any economic activity generated from those lands.

In her letter that served as her formal comment on the proposal, Jaime points out that this approach has failed to preserve Spotted Owl populations: 'Yet even with all that has been taken, we continue to see the decline of the [Northern Spotted Owl] at nearly 3% per year, and now the USFWS is proposing to double-down on a plan that has failed to achieve its desired goals.'

She also highlights an increased threat of wildfires in northwest forests: 'There has been an explosive fuel build up in our PNW forests over the last two decades and without bringing about rational management we stand to suffer the same fate that Colorado is experiencing. Doubling the critical habitat boundaries within our PNW forests will not only fail to serve the [Northern Spotted Owl], it will ensure future catastrophic wildfires that will threaten our clean water, our forests and the wildlife within them, and our communities.'

Jaime also urges that the full economic impact be understood before any expanded plan moves forward, given the severe impact the Northwest Forest Plan has had on jobs throughout Southwest Washington: 'The cumulative economic impacts that have been experienced by our rural communities must not be ignored, and must be taken into consideration. No changes to the Critical Habitat boundaries should be made without a full economic study of the cumulative impacts that have taken place since the listing of the NSO.'

The full text of the letter is below:

Dan Ashe, Director

U.S. Fish and Wildlife Service

Department of the Interior

1849 C Street NW, Room 3331

Washington, DC 20240

Dear Director Ashe,

The Pacific Northwest is unique for its beauty, its way of life, and the richness of our resources. Unfortunately, since the listing of the Northern Spotted Owl (NSO) in 1990, many of our rural communities have lost much of what makes our region so special, and several, including some within my district, are struggling to survive. Yet even with all that has been taken, we continue to see the decline of the NSO at nearly 3% per year, and now the USFWS is proposing to double-down on a plan that has failed to achieve its desired goals.

State and Private Lands

In an unprecedented action, the USFWS is proposing to add significant amounts of state and private land under the revised critical habitat plan. The state of Washington Forests and Fish Law already provides the most environmentally protective standards of forestry in the nation. The forestry practices carried out on our state and private lands have yielded results that put our federal forests to shame. Our private and state lands, which have been managed to provide healthy, diverse forest acreage, are rich with a variety of wildlife, clean water, and much needed jobs for our communities. To further put these lands under the same strictures of mismanagement that our federal forests have experienced will lessen, not increase, the abundance that is found on these lands. The USFWS should exclude all private and state lands from the final rule.

Single Species Management

To its credit, the USFWS has acknowledged in the proposed rule the need to manage for a variety of habitats, and that management for a single species is harmful to the broader ecosystem. Regrettably, our federal forests are in serious decline and provide ample proof of that harm. Actions over the last two decades to develop a landscape of primarily Late Successional Reserves for the NSO, while virtually ignoring other species, has caused great harm to the wildlife that is dependent upon Early Seral habitat. My office has been approached by a variety of conservation organizations, academia, and wildlife biologists, including current and retired US Forest Service employees, who have seen the damage caused by the single species management approach that has been employed in our forests since the listing of the NSO.

They have noted numerous species that are facing serious decline due to the forced creation of unnatural and unhistorical conditions within our forests. Our forests and the species within them are sounding the alarm. It is time to end single species management, and to adopt science-based, sustainable forestry that will benefit our forests, our wildlife, and our communities.

Forest Health/Fuel Load

The devastating fires currently taking place in Colorado provide a heartbreaking demonstration of the end result if we continue on the path of mismanagement we have chosen for our federal forests. There has been an explosive fuel build up in our PNW forests over the last two decades and without bringing about rational management we stand to suffer the same fate that Colorado is experiencing. Doubling the critical habitat boundaries within our PNW forests will not only fail to serve the NSO, it will ensure future catastrophic wildfires that will threaten our clean water, our forests and the wildlife within them, and our communities.

Impacts to Communities

The Endangered Species Act was never intended to decimate our rural communities, but it has been misused in a manner that has accomplished just that. Congress intended for economic impacts to be considered as part of the equation when considering the steps necessary to protect an impacted species. The cumulative economic impacts that have been experienced by our rural communities must not be ignored, and must be taken into consideration. No changes to the Critical Habitat boundaries should be made without a full economic study of the cumulative impacts that have taken place since the listing of the NSO.

With the declining state of the NSO, our forests, our wildlife, and our communities it is obvious that the NSO Recovery plan has failed. More specifically, it has failed to: protect the Northern Spotted Owl, enrich our ecosystems, sustain our wildlife, and promote forest health. It has also crippled the economies of our rural communities.

We have 22 years of results to show that the current plan is unworkable. Rather than double down on this approach, it is time to develop a plan that is science-based and takes all of our wildlife and our communities into account. Thank you for your time and consideration.

Sincerely,

Jaime Herrera Beutler

WOMEN-HEALTH: APRIL 25 WASHINGTON MARCH TO BACK ROE V. WADE - Inter Press Service English News Wire

Lenora Lapidus for WomensENews
Inter Press Service English News Wire
03-26-2004
NEW YORK, Mar. 26 (IPS/GIN) -- March is women's history month
and it gave women much to celebrate.
Since the 1970s, a hard-won set of federal and state laws have
banned sex discrimination in the workplace, in the nation's
classrooms and the housing sector.
Likewise, since the Supreme Court decided Roe v. Wade in 1973,
the Constitution has guaranteed women the right to decide--free
from government interference whether to end a pregnancy.
These protections ensure that girls can aspire to build
independent lives for themselves and their families.
Despite the gains, women -- and in particular women of color -
- still earn far less than men for the same work. For every dollar
earned by a white man, white women earn 72 cents, while
African-American women earn 65 cents and Hispanic women earn 53
cents.
On April 25, at the March for Women's Lives in Washington, D.C.,
women will have the unique opportunity to collectively say to the
nation and the world: Women's equality depends on reproductive
freedom for all. Without meaningful access to contraception,
abortion, prenatal care and childbearing assistance--as well as
quality child care, secure housing and educational and economic
opportunities--equality for women will remain an empty promise for
too many.
The earning gap is only the beginning. Girls do not always have
access to the same educational, athletic and leadership
opportunities as boys.
Victims of domestic violence can be kicked out of public housing
simply because they have been abused. Immigrant women working in
service industries such as restaurants, hotels and garment
factories are often exploited and face discrimination. And for many
poor women, young women and those living in rural areas, the right
to make decisions about their own reproductive lives is a phantom
right, promised to all, but enjoyed by only a privileged few.
Yet, the ACLU Women's Rights Project works every day with women
whose dreams are derailed by injustice. Many of the roadblocks
women face in employment, housing, and education are linked either
directly or indirectly to reproductive rights issues. Some recent
cases make this connection clear.
Pregnant Officers at Risk A group of female officers in Suffolk
County, N.Y., came to the project seeking relief from a department
policy denying pregnant officers the opportunity to go on 'light
duty.' Instead the department forced pregnant officers to either
take leave or remain on 'full duty' even though they were not given
maternity-sized bullet-proof vests or gun belts.
The policy placed women in an untenable position: They could
continue to work and risk their health and safety or they could go
on leave and lose salary and seniority. The Equal Employment
Opportunity Commission in June 2003 agreed with our challenge and
found that the policy discriminated against pregnant officers.
Despite this finding, the county has yet to settle the case and we
await a hearing in federal court.
Welfare Excludes Some Children Since the passage of the 1996
welfare law, federal law permits states to deny public assistance
to children born into a family already receiving benefits. The
policy, known as a child exclusion policy, effectively coerces poor
women's reproductive choices, discriminates against children based
on the circumstances of their birth and, as research shows, does
nothing to help move women from welfare to work.
The Nebraska Supreme Court recently struck down that state's
child exclusion law as applied to disabled parents who are unable
to work. A legal challenge in New Jersey arguing that the state's
policy interfered with poor women's right to choose to bear a child
failed, however, leaving poor women on public assistance who become
pregnant with few options and scant resources. We are now pursuing
a legislative advocacy strategy to repeal this harmful law; similar
child exclusion laws were repealed in Maryland and Illinois in 2002
and 2003.
Honor Society Bars Teen Mothers When two high school girls in
Kentucky were denied membership in the National Honor Society
simply because they were teen mothers, the ACLU's Women's Rights
Project in 1998 sued the local school district. Both girls had
maintained a 3.5-grade-point average and had been involved in other
school activities, as required by Honor Society guidelines. The
case eventually was settled, and the school district was barred
from discriminating on the basis of gender or pregnancy in
selecting students to become members of the society. After
monitoring compliance with the settlement for several years, the
case was finally closed last month.
Without reproductive freedom, women cannot fully participate in
the work force, fully provide for their families or get the
educations they need.
The Women's Rights Project will be marching in April because
reproductive rights are fundamental to women's equality.
(WomensEnews, a service of news that matters to women, is
distributed by Global Information Network and available at
www.womensEnews.org)

Copyright 2004 IPS/GIN. The contents of this story can not be duplicated in any fashion without written permission of Global Information Network

FLRA DECISION: AMERICAN FEDERATION OF GOVERNMENT EMPLOYEES LOCAL 12 (UNION) AND DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION WASHINGTON, D.C.(AGENCY) - US Fed News Service, Including US State News

The Federal Labor Relations Authority issued the following decision:

61 FLRA No. 95

AMERICAN FEDERATION OF GOVERNMENT EMPLOYEES LOCAL 12 (Union)

and

UNITED STATES DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION WASHINGTON, D.C. (Agency)

0-AR-4003

DECISION

February 10, 2006

Before the Authority: Dale Cabaniss, Chairman, and Carol Waller Pope and Tony Armendariz, Members

I. STATEMENT OF THE CASE

This matter is before the Authority on exceptions to an award of Arbitrator Earle William Hockenberry filed by the Union under Sect. 7122(a) of the Federal Service Labor-Management Relations Statute (the Statute) and part 2425 of the Authority's Regulations. The Agency filed an opposition to the Union's exceptions.

The Arbitrator found that the Agency did not violate the parties' agreement by not placing the grievant in an Occupational Safety and Health (OSH) Specialist position when she completed the Agency's Career Enhancement Program (CEP). Therefore, the Arbitrator denied the grievance. For the reasons that follow, we deny the Union's exceptions.

II. BACKGROUND AND ARBITRATOR'S AWARD On February 3, 1997, the grievant completed the Agency's CEP and, pursuant to the guidelines of that program, was promoted from a GS-5 position to OSH Assistant (GS-6), a bridge position to the target position of OSH Assistant (GS-7). On October 11, 2000, the grievant was promoted to the target position. In 2001, the grievant filed an informal equal employment opportunity (EEO) complaint alleging age and gender discrimination. The EEO complaint was settled with the Agency agreeing to promote the grievant to OSH Assistant (GS-7, step 9).

In 2004, the Union filed the instant grievance alleging that the Agency had violated the parties' collective bargaining agreement and the settlement agreement by failing to promote the grievant to the position of OSH Specialist (GS-11 or GS-12). Unresolved, the grievance was submitted to arbitration. At the outset, the Arbitrator explained that the matter would be resolved using the parties' expedited arbitration process. The parties were unable to stipulate the issues to be resolved. Therefore, the Arbitrator framed the issue as follows: 'Did [m]anagement violate Articles 3, 16 and 19 of the [parties' agreement] when it did not place [the grievant] into an [OSH] Specialist position . . . after her completion of the . . . [CEP]? If so, what shall be the remedy?' Award at 3.

The Arbitrator reviewed the vacancy announcement for the CEP, witness testimony, and documentary evidence concerning other employees who had completed the CEP. Based on this evidence, the Arbitrator found that the grievant's successful completion of the CEP entitled her to 'a two level opportunity to move from her then GS-5 position to a GS-7 position as a Safety and Occupational Health Assistant, and not a Safety and Occupational Health Specialist[.]' Id. at 9 (emphasis in original). In addition, after reviewing the settlement agreement, the Arbitrator found that the grievant was entitled to 'nothing more tha[n] a retroactive promotion to the position of Safety and Occupational Health Assistant, GS-7, step 9 . . . .' Id.

The Arbitrator noted 'the requirement of the [s]ettlement [a]greement that `management will work with [the grievant] on development of an Individual Development Plan'' (IDP) and found that the Agency had attempted to fulfill this requirement 'without success due to the inability of the [g]rievant to provide essential training credentials.' Id. In this regard, the Arbitrator explained that '[a] clear reading of . . . the IDP indicates that there is an obligation on the part of both parties' and he found that the grievant's failure to provide necessary documentation 'erodes any argument of bias or discrimination on the part of the Agency in not completing the plan.' Id.

Based on the foregoing, the Arbitrator denied the grievance. [ v61 p508 ]

III. POSITIONS OF THE PARTIES

A. UNION'S EXCEPTIONS

The Union argues that the award is deficient because the Arbitrator incorrectly permitted the Agency to invoke the expedited arbitration process under the parties' 2005 agreement rather than the process under the parties' 1992 agreement. The Union also argues that the Arbitrator incorrectly relied upon Sect. 3 of the parties' settlement agreement as one of the grounds for denying the grievance. In this connection, the Union claims that Sect. 3 precludes the grievant from initiating 'new grievances on the facts or circumstances' of the informal EEO complaint. Exceptions at 7. The Union claims this provision is inapplicable because the informal EEO complaint and the instant grievance concern different facts and circumstances. In any event, the Union argues that the Arbitrator's reliance on this provision is inconsistent with his decision to hear the grievance on the merits.

Finally, the Union argues that the Arbitrator improperly relied on Sect. 4(b) of the settlement agreement, which requires management to work with the grievant on the development of an appropriate IDP because that provision, according to the Union, is irrelevant. Even assuming the provision is relevant, the Union argues that the Arbitrator misinterpreted it as requiring the grievant and management to jointly develop the IDP. See id. at 8.

B. AGENCY'S OPPOSITION According to the Agency, the Arbitrator did not err in deciding to use the expedited arbitration process because the parties agreed to use that process. In this connection, the Agency asserts that both the parties' 1992 and 2005 agreements permitted the parties to use the expedited arbitration process 'based on mutual agreement.' Opposition at 6 (citing Article 44, Sect. 7(c) of the 1992 agreement and Article 48, Sect. 7(b) of the 2005 agreement). In addition, the Agency asserts that the Arbitrator correctly found no violation of the parties' agreement.

IV. PRELIMINARY ISSUE

Under Sect. 2429.5 of the Authority's Regulations, the Authority will not consider issues that could have been, but were not, presented to the arbitrator. See, e.g., United States Dep't of the Air Force, Air Force Materiel Command, Robins Air Force Base, Ga., 59 FLRA 542, 544 (2003). There is no indication in the record that the Union argued below that the Arbitrator should apply the parties' 1992 agreement rather than the 2005 agreement. In fact, the Union concedes that 'the parties agreed to an expedited proceeding' before the Arbitrator. Exceptions at 5. As such, the Union's argument is not properly before the Authority, and we will not consider it.

V. ANALYSIS AND CONCLUSIONS

Under both Authority and Equal Employment Opportunity Commission precedent, 'a settlement agreement constitutes a contract between the employee and the agency, to which ordinary rules of contract construction apply.' SSA, Balt., Md., 57 FLRA 181, 184 (2001) (quoting Stone v. Summers, 2001 WL 27624 (E.E.O.C.)). Therefore, we apply the deferential 'essence' standard to review the Arbitrator's interpretation of the parties' settlement agreement. See, e.g., United States Dep't of the Navy, Naval Weapons Station, Yorktown, Va., 57 FLRA 917, 920 (2002). Under this standard, the Authority will find that an arbitration award is deficient as failing to draw its essence from the settlement agreement when the appealing party establishes that the award: (1) cannot in any rational way be derived from the agreement; (2) is so unfounded in reason and fact and so unconnected with the wording and purposes of the collective bargaining agreement as to manifest an infidelity to the obligation of the arbitrator; (3) does not represent a plausible interpretation of the agreement; or (4) evidences a manifest disregard of the agreement. See United States Dep't of Labor (OSHA), 34 FLRA 573, 575 (1990). The Authority and the courts defer to arbitrators in this context 'because it is the arbitrator's construction of the agreement for which the parties have bargained.' Id. at 576.

The Union's argument that the Arbitrator incorrectly relied on Sect. 3 of the parties' settlement agreement to deny the grievance does not establish that the award fails to draw its essence from the parties' agreement. Section 3 precludes the grievant from initiating grievances against the Agency 'relating to the facts and circumstances which gave rise to this informal complaint.' Joint Exh. 4. While the Arbitrator referred to this provision in a footnote, he did not rely on it in denying the grievance. See Award at 9 n.9. That is, the Arbitrator did not find that the grievance concerned the same facts and circumstances involved in the informal EEO complaint, as such a finding would have resulted in a procedural dismissal of the grievance. Rather, the Arbitrator considered, and ultimately denied, the grievance on the merits. Consequently, the Union has not shown that the award fails to draw its essence from Sect. 3 of the parties' settlement agreement.

The Union also disputes the Arbitrator's application of Sect. 4(b) of the parties' settlement agreement, [ v61 p509 ] claiming that the provision is not 'relevant' to the grievance. We reject this claim on the ground that, under longstanding Authority precedent, a party's disagreement with an arbitrator's determination regarding the relevance of the evidence is not a ground for finding an award deficient. See United States Dep't of Housing and Urban Dev., Denver, Colo., 53 FLRA 1301, 1318 n.8 (1998). Moreover, the Union has not shown that the Arbitrator's interpretation and application of Sect. 4(b) otherwise fails to draw its essence from the parties' agreement. In this regard, the Arbitrator's interpretation of Sect. 4(b) as imposing obligations on both the Agency and the grievant comports with the plain wording of that provision, which provides that management will 'work with' the grievant in developing an IDP. The Arbitrator found, as a matter of fact to which we defer, that the grievant did not provide necessary documentation to the Agency in order to develop the IDP. As such, the Union has not demonstrated that the Arbitrator erred in his interpretation or application of Sect. 4(b).

Based on the foregoing, we deny the Union's exceptions.

VI. DECISION