INdiana Systemic Thinking

December 4, 2007

FSSA to Launch Childcare Ratings

In an article from the Fort Wayne Journal Gazette comes this story:

“The Indiana Family and Social Services Administration’s Bureau of Child Care announced plans Monday to roll out a quality rating system for child-care providers across the state.

The program, called Paths to QUALITY, is a free and voluntary rating system designed to help parents find and select the best care for their children in licensed centers, family child-care homes or unlicensed registered ministries.”

Please see the full story for links to the site and further information.

The Blogmeister remembers what a difficult task it was to find good, quality, childcare when the minibloggers were young.  In fact, the Blogmeister has never understood why it isn’t mandatory that all childcare facilities have to be licensed.  Even though this is a voluntary program, at least it will give parents a place to start.  It is hoped this program really takes off and someday all providers will have to sigh up for the ratings and be licensed.

Anti-psychotic Drugs in U.S. Nursing Homes

Filed under: Elderly — kurtglmft @ 10:10 pm
Tags: , , , ,

Hat tip to Fort Wayne Observed for posting this article regarding Medicare and Medicaid payments for anti-psychotic drugs in nursing homes. 

Check out the post here.

Divorces Bad for Environment

In a “duh, I should have published on that” story from the Fort Wayne Journal Gazette, Researcher “Jianguo Liu, an ecologist at Michigan State University” has determined divorces waste resources and are bad for the environment.

“A married household actually uses resources more efficiently than a divorced household,” said Jianguo Liu, an ecologist at Michigan State University whose analysis of the environmental effects of divorce appears in this week’s online edition of Proceedings of the National Academy of Sciences.

More households mean more use of land, water and energy, three critical resources, Liu said.

Households with fewer people are simply not as efficient as those with more people sharing, he explained. A household uses the same amount of heat or air conditioning whether there are two or four people living there. A refrigerator used the same power whether there is one person home or several. Two people living apart run two dishwashers, instead of just one.

“Per person, divorced households spent more per person per month for electricity compared with a married household, as multiple people can be watching the same television, listening to the same radio, cooking on the same stove and or eating under the same lights.

That means $6.9 billion in extra utility costs per year, Liu calculated, plus an added $3.6 billion for water, in addition to other costs such as land use.”

“People have been talking about how to protect the environment and combat climate change, but divorce is an overlooked factor that needs to be considered,” Liu said.”

This got the Blogmeister thinking…what are some other things that are wasted in a divorce?

Time and money spent courting

Engagement/Wedding rings

Time spent fighting about stupid stuff

Time spent fighting about important stuff

Happy times (yes, there were some or you wouldn’t be together)

Dreams your children will grow up being unaffected by divorce

The opportunity to continue to make your spouse’s life unbearable

Paper (ever see a divorce court file?)

Attorney time listening to why your spouse is a jerk (hint, they don’t care but it increases billable hours, see below)

Court time arguing about who gets the sweeper

Your money, paying attorney’s to screw your spouse

Your money, paying a mediator to make sure your both equally screwed

Time every other weekend you are not with your kids

Kinda makes marriage therapy a little more palatable, doesn’t it?

AADP Best Treatment or Cash Cow?

The Blogmeister was aware of this story, but was not going to post on it.  It seemed like a personnel issue at first and frankly posting would just be in bad taste.  However, more information is available from this Fort Wayne Journal Gazette editorial that appears to highlight more problems than just personnel.

Background:  Last week Alcohol Abuse Deterrent Program (AADP) head Terry Yeiter was asked to step down by his board.  It was thought there was some mismanagement of the medication at the program sites.  In fact, it appeared there was, as an audit showed more medication on hand than was supposed to be there.

First, the Blogmeister wonders if anyone contacted the Drug Enforcement Agency about this?  More history from the editorial;

“AADP was established to provide an aversion-therapy alternative to incarceration for repeat drunken-driving offenders. Court-ordered participants take Antabuse, the brand name for disulfiram, which blocks the body’s ability to process alcohol and causes discomfort or illness when taken in combination with alcohol. Last year, AADP administered Antabuse or breath tests to about 1,500 people a week. Offenders are required to pay for treatment.”

Second, is this really treatment, or Chemical Restraint?

The editorial goes on to wonder, “Certainly, AADP is a less-costly alternative to locking up repeat DWI offenders, but is it the most cost-effective alternative? Do the medical and constitutional questions about Antabuse treatment warrant its continued use? The program has been the subject of legal challenges, and there are questions about the drug’s effect on the liver.

Allen Circuit Judge Thomas J. Felts, who orders some offenders to the program, said that he is re-evaluating the best course for felony drunken-driving cases in light of the developments at AADP but said the program has been doing a good job in spite of the director’s departure.”

In addition, questions about how much money was made linger, “Questions about the program’s cost have long circulated. According to figures from the 990 form filed with the Internal Revenue Service, Yeiter earned $73,170 in 2006. That amount was down from 2005, when he earned $85,239 in salary and benefits and 2004, when he earned $91,897. Five other AADP employees earned more than $57,000 in 2006, and contracts for medical and legal services totaled more than $319,000.”

The Blogmeister joins with the Journal Gazette in calling for a reevaluation of the program from top to bottom.  The board of the program has agreed to do this, to their credit, but the Blogmeister feels more effort should be put into treatment, with qualified counselors and therapists, instead of the continued use of Antabuse.  One reason the program is successful is many physicians refuse to prescribe the drug due to the above physical concerns, so this is one of the few places Judges can order an offender to get the drug.   Second, the amount of money spent on salaries is outrageous for a nonprofit program.  It is programs such as this that give nonprofits a bad reputation for abusing their legal status and not paying their share of taxes.

New Healthcare Plan for UAW or More of the Same?

The Blogmeister isn’t quite sure what to make of this story from the Fort Wayne Journal Gazette.

Essentially the story focuses on the takeover of health-care benefits by the UAW after their most recent contract negotiations with the auto companies.  Here are some quotes:

“In early 2010, the union will become responsible for the health care bills of 540,000 retirees and their spouses, a population equal to that of Portland, Ore.

The numbers give the UAW bulk buying power and enough clout to bring costs down, according to some experts. Retirees, now on the same team as the entity paying their bills, will have incentives to live healthier and limit their health care use. Some observers also say the move will lead the union to step up its lobbying efforts for a national health care system.

If the union is successful in its cost-cutting efforts, those reforms likely would spread to companies and other health care consumers similar to the way health maintenance organizations led to cost cuts decades ago, said J.B. Silvers, professor of health systems management at Case Western Reserve University in Cleveland.

“If they come up with better models for how to provide health care, that will diffuse across the system probably pretty fast,” he said. “In that sense, everybody’s going to benefit.”

In the contracts, GM, Ford and Chrysler agreed to put billions into union-run trusts that will pay bills for all retirees and spouses and for active workers and spouses after they retire. Formulas for the companies’ contributions are complex, with varying levels of cash and notes that are convertible into stock, and further payments if the funding level drops.”

Feel free to post your comments.

Discount Drugs for Marion County

In a story last night from the Indianapolis Star;

Marion County residents will now have the opportunity to save 20% of the cost of any prescription medication, not covered by their insurance.  The program is open to anyone, of any income level, and regardless of insurance coverage. 

“They will be available at libraries, the township trustee office and some senior citizen centers, said Michael Price, chief deputy auditor at the Marion County’s auditor’s office, which is administering the program locally. ”

“Rhode Island-based Caremark, a benefits management company, gets a fee from the pharmacies for administering the program.”

Health Insurance Sales Not Always Truthful

Here’s a shocker.  Insurance salespeople are not always truthful about what their policies may cover.  In an interesting and innovative approach to make sure health insurance agents are not misleading the public, Kerry Weems, Chief of the Centers for Medicaid and Medicare, has asked his staff to sit in on sales pitches to consumers and/or act as “secret shoppers” for health insurance.  The Centers for Medicaid and Medicare has specific requirements for what insurance companies may tell prospective buyer of policies.  The results have led to sanctions for some insurance companies.

You may read the article here from the Fort Wayne Journal Gazette.

Four Teenagers Escape from Madison Center

From the been there done that file;

The South Bend Tribune reports today four teenagers escaped from the Madison Center Inpatient unit after overpowering a staff member.  The girls jumped into the St. Joseph River to escape pursuers and were promptly apprehended.  The girls, although no doubt wet and cold, were not injured.  No injuries were reported to the staff member.

Hate it when that happens!

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