Illegal, Uninsured and Under Scrutiny

Cost of caring for immigrants staggers hospitals, draws Congress’ attention
Laurie Cunningham | Miami Daily Business Review | 5.28.04

“Last week, the U.S. House of Representatives rejected a bill that would have required hospitals to ask patients coming to their ERs for proof that they are U.S. citizens or legal residents. For those without proof, hospitals would have been required to report them to the U.S. Department of Homeland Security for possible deportation.”

“‘The message is that because people who come here are going to need medical care, we must have a health care system that treats all people decently, regardless of where they’re from or why they’re here,’ said Joseph Zumpano, a health care lawyer and partner at Zumpano Patricios & Winker in Coral Gables. Zumpano was not involved in the Martin Memorial case.”

“Under the federal Emergency Medical Treatment and Active Labor Act, hospitals that receive Medicare and Medicaid payments are required to provide emergency care to all patients, regardless of ability to pay or immigration status. To offset this burden, the federal government provides some funding for emergency care for undocumented aliens. But it doesn’t pay for those who need long–term care for disabilities.”

Forge Feeding?

Feeding Time
Anthony Paonita | Law.com | 5.27.04

Overwhelmed by infoglut? Finally, there’s an easy way to stay on top of the news. And you can do it by looking at one—yes, only one—window on your computer desktop. The online wizard behind this is RSS, or “really simple syndication.” Simply put, it’s a way of funneling dynamic Web site headlines to harried newshounds. If a headline looks interesting, users just click on it, and their Web browser takes them to the article. If they don’t click, they haven’t lost any time waiting for a page to download.

State Shuts Down Hospital

State shuts down Rancho Cucamonga hospital over alleged violations
AP | 5.26.04

RANCHO CUCAMONGA – State regulators have temporarily shut down Angels Hospital, saying staff at the facility deprived patients of nourishment, failed to change respiratory equipment and relied on paramedics to resuscitate heart patients.

“I’ve never seen anything quite this dysfunctional,” said Brenda Klutz, deputy director of the state Department of Health Services, which regulates hospitals.

At least four patients died…

State regulators allege that staff at Angels Hospital:

• asked paramedics on at least three occasions to handle medical emergencies because no doctor was available.
• administered too little or no liquid nutrition to patients who needed the fluid to help their bodies repair damaged tissue.
• changed ventilator tubes only when they were visibly soiled to save money.
• left cardiac telemetry machines unmonitored for three hours on March 21 and turned the machines’ volume so low they couldn’t be heard throughout the unit.
• shorted patients’ medicines and failed to follow doctors’ orders for consultations with other specialty physicians.
• maintained inadequate staffing levels and employed inadequately trained staff.

How to Tie a Fomite

Disease fear in doctors’ ties | Guardian Unlimited

…Doctors who wear ties during their hospital rounds in efforts to look professional for their patients could unwittingly spread disease–causing bacteria, says new research.

…Researchers found that nearly half of the ties worn by medical workers harboured bacteria which could cause disease.

…The infections, including the superbug MRSA which is resistant to antibiotics…

Hat Tip BoingBoing

The tie is an anachronism, and its time in the acute healthcare setting is long overdue. The tie on male healthcare workers (esp. doctors) should go the way of artificial nails on female healthcare workers—at least attempts to clean nails were made. A fomite is a fomite!

Bucks for Barks

N.Y. Lawyer Fined for Barking at Witness
AP | 5.21.04

“NEW YORK (AP) - A lawyer who barked like a dog at a witness during a deposition has been fined $8,500 for misconduct and harassment of opponents.”

“Mr. Fink was barking up the wrong tree,” the lawyer quipped as he recalled the deposition. “I don’t know what motivated him to bark.”

Redacting Redactions

Illuminating Blacked–Out Words
By JOHN MARKOFF
New York Times | 5.10.04

Experts on the Freedom of Information Act said they feared the computer technique might be used as an excuse by government agencies to release even more restricted versions of documents.

“They have exposed a technique that may now become less and less useful as a result,” said Steven Aftergood, a senior research analyst at the Federation of American Scientists, of the research project. “We care because there are all kinds of things withheld by government agencies improperly.”

Revised EMTALA Interpretive Guidelines

Revised Emergency Medical Treatment and Labor Act (EMTALA) Interpretive Guidelines (PDF) released by CMS 5.13.04

• The interpretive guidelines serve to interpret and clarify the responsibilities of Medicare participating hospitals in emergency cases.
• They contain authoritative interpretations and clarifications of statutory and regulatory requirements and are to be used to assist in making consistent determinations about a provider’s compliance with the requirements.
• These interpretive guidelines merely define or explain the relevant statutes and regulations and do not impose any requirements that are not otherwise set forth in the statutes or regulations.

Online Education and a Border Collie

There are many factors that must be weighed when considering an online legal education—chief among the “negative” weights are lack of ABA accreditation and the potentiality of only being able to practice law in California sans reciprocity or significant practice experience.

I certainly would not have chosen this route to obtaining a JD as a primary career path; however, as a segue to a second career and as an augmentation to the primary career it may be the way of the future…

My law school calculus was very simple:

• no LSAT requirement—after a BS, MS, MD, board certification and recertification—absolutely no desire to be culled by anymore hoop jumping
• no commute (means more at home, which means wife is very happy)
• minimal effect on my ability to work full time—which by choice is about 50% night shifts
• no classrooms, I have way too many social interactions with my real job
• California license eligible

Of course I was somewhat naïve about the FYLSX (California’s “Baby Bar”) requirement at the completion of 1L. Suffice it to say, I passed on the first attempt—but it was truly the most intense examination I have ever taken (I’ll take my oral boards any day of the week before I would take the FYLSX again). I’ve never typed for so long—”laptopped” for 4 hours straight with about thirty seconds to spare. Presently on track for the CalBar in February 2007—Concord is four years (which is fine when you work full time).

Now for the border collie, well with an online education there must be a place where you do the “online part”—I suspect with most Concord students it is in some form of home office. My home office is shared with my wife, three teenage sons (the other computer), and a border collie. It is impossible to suppress herding behavior— whether its boys in the hall, cats on the street, or ants on the kitchen floor—they all must be herded. What is most distressing is when I’m taking a timed online quiz, essay, mid–term exam, or final is the propensity for the border collie to want to herd my computer mouse (he’ll even try to herd trackballs).

Just a well placed nudge of a wet nose between the thenar and hypothenar eminences and that essay is history…

The other major trial and travail of on online education is dealing with ambient noises in the home…alas another tale, but good headphones and lots of white noise CDs are my prescription (esp. the electric fan and air purifier CDs).

As Uninsured Patients Turn to Emergency Departments

As Uninsured Patients Turn to Emergency Departments for Care of Untreated Illness, Emergency Physicians Call for Coverage for All Americans

Released by:

The American College of Emergency Physicians, with the support of The Robert Wood Johnson Foundation

RSS Tutorial—News, News, & More News

RSS Tutorial Part IV: News, News & More News

Very good article on RSS news services—especially the types available.

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