Blogging is one of those job responsibilities that never seem to quit and it is so easy to get behind on. Well, Congress is back soon, the kids are in school, and I better get back to this job as well.
It has been an important summer for my brain injury advocacy. I was elected this year to Chair the sub-committee of the national trial lawyers group on brain injury. The formal name of that group is the Traumatic Brain Injury Litigation Group (TBILG). The national association is the American Association of Justice (AAJ). I have served the TBILG and its goals of representing those with brain injuries since 1994 and I am honored to be chosen to lead it for the next year.
As part of my service to the TBILG, I moderated our program to over 100 attendees at our convention in San Francisco.
I have also recently given two speeches to brain injury groups on brain injury, one in Wisconsin on behalf of the Brain Injury Association of Wisconsin and one on Monday of this week in the Detroit area to the Michigan Association of Justice. The Wisconsin speech was entitled “A Lawyer’s Perspective on TBI.” The Michigan one: “Brain Injury is a Process, not an Event.” In the next couple of weeks, I will review some concepts from these two talks on this blog.
I have a busy fall ahead, but fall is one of my most productive times of the year and I will keep this blog up to date. Promise.
BIA-USA Urges Congress to Increase Funding for TBI Programs
From the Brain Injury Association of the U.S.:
Urge Congress to Increase Funding for TBI Programs!
The Appropriations Subcommittee on Labor, Health and Human Services and Education begins consideration of the FY10 funding bill today!
Over the next few days, the House Appropriations Subcommittee on Labor, Health and Human Services and Education will be considering a bill which will provide the funding allocation for programs authorized through the TBI Act and for NIDRR’s TBI-related research programs, including TBI Model Systems of Care.
Federal funding for these important TBI programs has remained stagnant over the last several years, as Congress has not provided increases sufficient to keep up with the increasing cost of doing business. The urgent need for increased federal support for a national TBI public health infrastructure and TBI research is further heightened by the recognition of TBI as the signature wound of the wars in Iraq and Afghanistan.
Urge Congress to Increase Funding for TBI Programs!
The Appropriations Subcommittee on Labor, Health and Human Services and Education begins consideration of the FY10 funding bill today!
Over the next few days, the House Appropriations Subcommittee on Labor, Health and Human Services and Education will be considering a bill which will provide the funding allocation for programs authorized through the TBI Act and for NIDRR’s TBI-related research programs, including TBI Model Systems of Care.
Federal funding for these important TBI programs has remained stagnant over the last several years, as Congress has not provided increases sufficient to keep up with the increasing cost of doing business. The urgent need for increased federal support for a national TBI public health infrastructure and TBI research is further heightened by the recognition of TBI as the signature wound of the wars in Iraq and Afghanistan.
Letter to waiting.com
Mr. Johnson,
My name is Teri Curington and I am finishing my graduate work this semester at The University of Texas at Tyler’s College of Nursing. I have worked in the field of ER medicine and neurological intensive care, working with patients who have suffered traumatic brain injuries, among other severe neurological injuries.
The purpose of this email is to request your permission to use some of the information and clip-art photo’s displayed at the website: http://www.waiting.com in a presentation I am going to be conducting in April. This presentation is a course requirement and will not be used for any other purpose.
The ‘Waiting’ website is one of the best I have seen which explains in detain and in plain English, brain injuries. In fact, I have recommened this site to several families whose loved ones have suffered severe head trauma (…and could use a good lawyer)!
Very Respectfully,
TCurington RN, BSN, NC USN
We granted this request and asked that she write us back with a copy of her presentation, which we will post when we receive it.
My name is Teri Curington and I am finishing my graduate work this semester at The University of Texas at Tyler’s College of Nursing. I have worked in the field of ER medicine and neurological intensive care, working with patients who have suffered traumatic brain injuries, among other severe neurological injuries.
The purpose of this email is to request your permission to use some of the information and clip-art photo’s displayed at the website: http://www.waiting.com in a presentation I am going to be conducting in April. This presentation is a course requirement and will not be used for any other purpose.
The ‘Waiting’ website is one of the best I have seen which explains in detain and in plain English, brain injuries. In fact, I have recommened this site to several families whose loved ones have suffered severe head trauma (…and could use a good lawyer)!
Very Respectfully,
TCurington RN, BSN, NC USN
We granted this request and asked that she write us back with a copy of her presentation, which we will post when we receive it.
Hospitals ill from more bad debt, credit troubles
Date: 12/28/2008 12:01 AM
By LINDA A. JOHNSON
AP Business Writer
TRENTON, N.J. (AP) — Gainesville’s first community hospital has been on life support since the Shands Healthcare system in northern Florida bought it a dozen years ago.
Now, because of the recession, the plug is being pulled on 80-year-old, money-losing Shands AGH. Next fall, its eight-hospital not-for-profit parent company will shut the 220-bed hospital and shift staff and patients to a newer, bigger teaching hospital nearby as part of an effort to save $65 million over three years across the system.
Like many U.S. hospitals, Shands is being squeezed by tight credit, higher borrowing costs, investment losses and a jump in patients — many recently unemployed or otherwise underinsured — not paying their bills.
All that has begun to trigger more hospital closings — from impoverished Newark, N.J., to wealthy Beverly Hills, Calif. — as well as layoffs, other cost-cutting and scrapping or delaying building projects.
More closings and mergers are on the way, industry consultants predict.
“They’ll get swallowed up by somebody else, if they need to exist, and if they don’t, they’ll just close,” said Tuck Crocker, vice president of the health care practice at management consultant BearingPoint.
Most endangered are rural hospitals and urban ones in areas with excess hospital beds and lots of poor, uninsured I know it’s a current affairs of the erratic or seen patients — those already financially ailing.
Hospitals, which employ 5 million people, are reporting that donations and investment returns are down, patient visits are flat and profitable diagnostic procedures and elective surgeries are declining as people with inadequate insurance delay care. But those patients are turning up later at ERs, seriously ill, making it tough for hospitals to lay off nurses and doctors.
All those problems are aggravating long-standing stresses: stingy reimbursements from commercial insurers, even-lower payments that generally don’t cover costs for Medicare and Medicaid patients, and high labor and technology costs.
Hospital executives and consultants say the growing number of people with high-deductible health plans is boosting unpaid patient bills. Many worry health reform efforts by the Obama administration could bring cuts in Medicare reimbursements, and many cash-strapped states already have begun cutting payments for poor people covered by Medicaid.
In the past few months, patients and insurers have been paying hospital bills more slowly. As a result, some think hospitals will start demanding up-front payments for elective procedures.
In November, Moody’s Investors Service changed its 12- to 18-month outlook from “stable” to “negative” for nonprofit and for-profit hospitals, citing “prospects of a protracted recession,” bad debt and the credit crunch.
“Looking forward, the cost of borrowing will likely be higher — and may be nonexistent for lower-rated hospitals,” Moody’s noted, a problem because hospitals borrow for everything from expansions and equipment to payroll and supplies.
Since October, there’s been “a dramatic slowdown” in plans for new wings and building upgrades, with many delayed indefinitely, said Paul Keckley of the Deloitte Center for Health Solutions.
“It probably means we won’t have as many new things in the hospital,” he predicted.
Tim Goldfarb, CEO of Gainesville-based Shands Healthcare, said his system, Florida’s second-largest provider of charity care, this year has seen bad debt jump 20 percent from patients with no insurance.
“We write them off,” Goldfarb said. “It’s a burden that we cannot carry any longer.”
Florida started cutting Medicaid reimbursements two years ago, when its economy started to slow, Goldfarb said. He fears another huge cut next year.
Shands already has paid off variable-rate bonds to avoid higher interest rates, deferred roughly $25 million in equipment purchases, shifted management meetings to church halls and adopted employee suggestions to save millions more.
Goldfarb believes closing Shands AGH will save nearly $100 million over seven years, mainly by avoiding costly renovations, but some administrative jobs will go.
Around the country, while some hospitals still are doing well, closings and bankruptcies seem to be picking up.
In New Jersey, where 47 percent of hospitals posted losses in 2007, five of the 79 acute-care hospitals closed this year, and a sixth may close soon. In Hawaii, nearly every hospital is in trouble, with two filing for bankruptcy and one nearly closing recently.
All over, hospitals are cutting costs by outsourcing services like housekeeping and security and trimming staff through layoffs, hiring freezes and attrition. Most are trying not to touch patient care jobs — nurses, pharmacists, therapists and X-ray technicians — as those already have staff shortages.
“The last thing we can do is skinny down our staffing right where we need it the most,” said Mike Killian, marketing vice president for the three Beaumont Hospitals in suburban Detroit.
There, auto industry job losses and other factors now equal fewer patients with commercial insurance. The system expects a $22 million loss, its first in at least 40 years, Killian said.
So Beaumont this fall announced a $60 million restructuring program that includes 4-10 percent pay cuts for doctors and managers, reducing overtime for some employees and eliminating 500 jobs, 200 already vacant, mostly outside of patient care.
Rich Umbdenstock, chief executive of the American Hospital Association, said some of the hardest-hit hospitals began reducing staffing and services as early as last spring and more will follow. He expects some to eliminate services — money-losers such as behavioral health treatment, or those with high operating costs such as burn units — rather than weaken their entire operation.
An association survey of more than 700 hospitals found two-thirds have seen elective procedures and overall admissions fall since July, and half have seen moderate or significant jumps in nonpaying patients.
An industry database on more than 550 hospitals found their third-quarter investment results amounted to a combined loss of $832 million, down from a $396 million gain a year earlier. During the quarter, those hospitals paid 15 percent more in borrowing costs and swung to a 1.6 percent average loss, from an average 6.1 percent profit margin a year ago.
“They’re having serious problems getting the capital they need for needed renovations and upgrading their facilities,” said Mike Rock, a lobbyist at AHA, which is seeking increased federal reimbursements from Medicaid and Medicare.
At Exempla Healthcare, with three hospitals in Denver and its suburbs, Chief Executive Jeff Selberg said there’s usually a 5-7 percent annual profit margin, but this year investment losses wiped that out. He’s scaled back a $200 million plan to upgrade facilities, information technology and clinical equipment and may halt construction of a new maternity unit and operating rooms at one hospital.
Selberg has seen a slight increase in bad debt and expects more problems.
“We feel like the wave is coming, but it hasn’t hit yet, and we don’t know how big this wave is going to be,” he said.
Copyright 2008 The Associated Press.
By LINDA A. JOHNSON
AP Business Writer
TRENTON, N.J. (AP) — Gainesville’s first community hospital has been on life support since the Shands Healthcare system in northern Florida bought it a dozen years ago.
Now, because of the recession, the plug is being pulled on 80-year-old, money-losing Shands AGH. Next fall, its eight-hospital not-for-profit parent company will shut the 220-bed hospital and shift staff and patients to a newer, bigger teaching hospital nearby as part of an effort to save $65 million over three years across the system.
Like many U.S. hospitals, Shands is being squeezed by tight credit, higher borrowing costs, investment losses and a jump in patients — many recently unemployed or otherwise underinsured — not paying their bills.
All that has begun to trigger more hospital closings — from impoverished Newark, N.J., to wealthy Beverly Hills, Calif. — as well as layoffs, other cost-cutting and scrapping or delaying building projects.
More closings and mergers are on the way, industry consultants predict.
“They’ll get swallowed up by somebody else, if they need to exist, and if they don’t, they’ll just close,” said Tuck Crocker, vice president of the health care practice at management consultant BearingPoint.
Most endangered are rural hospitals and urban ones in areas with excess hospital beds and lots of poor, uninsured I know it’s a current affairs of the erratic or seen patients — those already financially ailing.
Hospitals, which employ 5 million people, are reporting that donations and investment returns are down, patient visits are flat and profitable diagnostic procedures and elective surgeries are declining as people with inadequate insurance delay care. But those patients are turning up later at ERs, seriously ill, making it tough for hospitals to lay off nurses and doctors.
All those problems are aggravating long-standing stresses: stingy reimbursements from commercial insurers, even-lower payments that generally don’t cover costs for Medicare and Medicaid patients, and high labor and technology costs.
Hospital executives and consultants say the growing number of people with high-deductible health plans is boosting unpaid patient bills. Many worry health reform efforts by the Obama administration could bring cuts in Medicare reimbursements, and many cash-strapped states already have begun cutting payments for poor people covered by Medicaid.
In the past few months, patients and insurers have been paying hospital bills more slowly. As a result, some think hospitals will start demanding up-front payments for elective procedures.
In November, Moody’s Investors Service changed its 12- to 18-month outlook from “stable” to “negative” for nonprofit and for-profit hospitals, citing “prospects of a protracted recession,” bad debt and the credit crunch.
“Looking forward, the cost of borrowing will likely be higher — and may be nonexistent for lower-rated hospitals,” Moody’s noted, a problem because hospitals borrow for everything from expansions and equipment to payroll and supplies.
Since October, there’s been “a dramatic slowdown” in plans for new wings and building upgrades, with many delayed indefinitely, said Paul Keckley of the Deloitte Center for Health Solutions.
“It probably means we won’t have as many new things in the hospital,” he predicted.
Tim Goldfarb, CEO of Gainesville-based Shands Healthcare, said his system, Florida’s second-largest provider of charity care, this year has seen bad debt jump 20 percent from patients with no insurance.
“We write them off,” Goldfarb said. “It’s a burden that we cannot carry any longer.”
Florida started cutting Medicaid reimbursements two years ago, when its economy started to slow, Goldfarb said. He fears another huge cut next year.
Shands already has paid off variable-rate bonds to avoid higher interest rates, deferred roughly $25 million in equipment purchases, shifted management meetings to church halls and adopted employee suggestions to save millions more.
Goldfarb believes closing Shands AGH will save nearly $100 million over seven years, mainly by avoiding costly renovations, but some administrative jobs will go.
Around the country, while some hospitals still are doing well, closings and bankruptcies seem to be picking up.
In New Jersey, where 47 percent of hospitals posted losses in 2007, five of the 79 acute-care hospitals closed this year, and a sixth may close soon. In Hawaii, nearly every hospital is in trouble, with two filing for bankruptcy and one nearly closing recently.
All over, hospitals are cutting costs by outsourcing services like housekeeping and security and trimming staff through layoffs, hiring freezes and attrition. Most are trying not to touch patient care jobs — nurses, pharmacists, therapists and X-ray technicians — as those already have staff shortages.
“The last thing we can do is skinny down our staffing right where we need it the most,” said Mike Killian, marketing vice president for the three Beaumont Hospitals in suburban Detroit.
There, auto industry job losses and other factors now equal fewer patients with commercial insurance. The system expects a $22 million loss, its first in at least 40 years, Killian said.
So Beaumont this fall announced a $60 million restructuring program that includes 4-10 percent pay cuts for doctors and managers, reducing overtime for some employees and eliminating 500 jobs, 200 already vacant, mostly outside of patient care.
Rich Umbdenstock, chief executive of the American Hospital Association, said some of the hardest-hit hospitals began reducing staffing and services as early as last spring and more will follow. He expects some to eliminate services — money-losers such as behavioral health treatment, or those with high operating costs such as burn units — rather than weaken their entire operation.
An association survey of more than 700 hospitals found two-thirds have seen elective procedures and overall admissions fall since July, and half have seen moderate or significant jumps in nonpaying patients.
An industry database on more than 550 hospitals found their third-quarter investment results amounted to a combined loss of $832 million, down from a $396 million gain a year earlier. During the quarter, those hospitals paid 15 percent more in borrowing costs and swung to a 1.6 percent average loss, from an average 6.1 percent profit margin a year ago.
“They’re having serious problems getting the capital they need for needed renovations and upgrading their facilities,” said Mike Rock, a lobbyist at AHA, which is seeking increased federal reimbursements from Medicaid and Medicare.
At Exempla Healthcare, with three hospitals in Denver and its suburbs, Chief Executive Jeff Selberg said there’s usually a 5-7 percent annual profit margin, but this year investment losses wiped that out. He’s scaled back a $200 million plan to upgrade facilities, information technology and clinical equipment and may halt construction of a new maternity unit and operating rooms at one hospital.
Selberg has seen a slight increase in bad debt and expects more problems.
“We feel like the wave is coming, but it hasn’t hit yet, and we don’t know how big this wave is going to be,” he said.
Copyright 2008 The Associated Press.
The hardest part of waiting for someone to emerge from a coma
From someone who felt the need to connect with our http://waiting.com community:
waiting.com began as the merging of two ideas more than 11 years ago. First, provide as much information as possible to those who were actually waiting in a trauma center waiting room. Two, create a virtual connection to those who had gone thru it before, to those who were going thru it now. When it went online in 1997, it was the first time something like it had ever been done online, not just in brain injury, but in any field. To this day, it is the idea for which I am most proud.
Thank you Y Uribe for your contribution. We will soon add it permanently to the Bridge from Despair.
“The hardest part of waiting is the feeling of being alone. No matter how many people surround me, I feel alone. I push people away, don’t feel like talking to anyone, yet I am forced to talk. I feel rudest to those closest to me. Its hard how suddenly your the center of attention and it feels inadequate. I’ve learned that people don’t know what to say to you so they offer their help. They want to do something for you, and you should let them. It is hard as all hell in the beginning, but as you go on, you learn that it will be less of a stress to you. Let your friends in. Support is what you need. Take it when you can get it. Call people, talk to people.”
waiting.com began as the merging of two ideas more than 11 years ago. First, provide as much information as possible to those who were actually waiting in a trauma center waiting room. Two, create a virtual connection to those who had gone thru it before, to those who were going thru it now. When it went online in 1997, it was the first time something like it had ever been done online, not just in brain injury, but in any field. To this day, it is the idea for which I am most proud.
Thank you Y Uribe for your contribution. We will soon add it permanently to the Bridge from Despair.
Wounded Troops and Partners: Supporting Intimate Relationships.
From the Brain Injury Association of Wisconsin:
Dear Members and Donors:
Dear Members and Donors:
Intimacy, sexuality, empathy are among the areas that brain injured survivors have some of their most significant problems. Lower frontal lobe damage is likely to contribute to these problems. Vets have the additional issues stemming from the overlay of combat related emotional issues.
The following conference offering was sent to us from the BIAA. We are forwarding to you for your information.
The Center of Excellence for Sexual Health invites you to join elected officials, public and private agency leaders, healthcare professionals, members of the armed services, veterans, and concerned civilians for a one-day conference, Wounded Troops and Partners: Supporting Intimate Relationships.
This conference seeks to:You will hear first person experiences and receive briefings from leading experts on:
- Create visibility for the linkage of mental and physical disabilities like PTSD, traumatic brain injury, and serious burns with failed intimate relationships that contribute to higher suicide rates, divorce, and other problems
- Strengthen specific initiatives around intimate relationships for person with service-related disabilities
- Develop and expand enduring networks of people to serve these populations
- This is your opportunity to contribute to a national dialogue on how U.S. agencies, healthcare providers, and communities can help wounded troops and their partners develop and maintain healthy intimate relationships.
Featured speakers include Bob Dole, Dr. David Satcher, Dr. Richard Carmona, Dr. Margaret Giannini and Lee Woodruff.
- How healthy intimate relationships contribute to recovery from physical and mental trauma
- How lack of a satisfying intimate relationship contributes to ongoing mental health problems and suicide
- The special challenges and concerns of wounded women warriors
- How intimate relationships help wounded spirits heal
- The specific sexual health concerns of troops with disabilities
- How addressing sexual health concerns strengthens marriages and other committed relationships
Participate and send a strong message about the importance of wounded troops and their partners having access to the healthcare, counseling and resources
that they need to sustain intimate relationships that provide support and promote healing.
Please visit our conference website http://www.msm.edu/Centers_&_Institutes/CESH/Programs_&_Initiatives/Disabilities/Wounded_Troops_and_Partners/Wounded_Troops_&_Partners_Home.htm or contact our office for more information. There is no charge for registration. Lunch will be provided.
When
Wednesday, May 21, 2008 8:30 AM – 5:30 PM
Eastern Time Zone
Where
Henry J. Kaiser Family Foundation
Barbara Jordan Conference Center
1330 G Street, NW
Washington, DC 20005
We would encourage not only Vets and their loved ones to attend this conference, but anyone affected by brain injury.