Democratic lawmakers in the U.S. House of Representatives want to increase taxes on the highest- earning American families to help pay for an overhaul of the nation’s health-care system.
Legislation to be unveiled on July 13 would raise $540 billion over the next decade by setting a 1 percent surtax on couples with more than $350,000 in annual income, said Representative Charles Rangel, chairman of the tax-writing Ways and Means Committee. Higher rates would take effect for those earning $500,000 and $1 million, Rangel said.
There was a fresh round of talks yesterday as Democratic leaders tried to quell a rebellion over the cost of health-care legislation by dozens of members of their own party.
In a letter to party leaders, 40 members of the Blue Dog Coalition, a group of self-proclaimed fiscally conservative Democrats, raised “strong reservations” about the draft of a bill they said would fail to sufficiently reduce health-care costs and may hurt doctors and hospitals.
The protest forced party leaders to postpone yesterday’s scheduled release of the draft, as well as a House Energy and Commerce Committee debate that was expected to begin July 13. The objections from Blue Dog Democrats prompted the legislation’s authors to revise the measure, said the aide, speaking on condition of anonymity.
The plan the Ways and Means panel agreed on yesterday would require individuals to begin paying the surtax when their income hits $280,000, with higher rates taking effect when those incomes reach $400,000, and again when they hit $800,000.
It would be levied on adjusted gross income, before deductions for items such as mortgage interest and charitable gifts. Regular income taxes are assessed after such write-offs.
While the surtax would go into effect in 2011, Representative Allyson Schwartz of Pennsylvania said it would increase if projected savings that Democrats expect the legislation to achieve aren’t realized. “We were discussing doing it at a lower rate, then building to a higher rate in later years if we don’t get enough savings,” Schwartz said.
“We need small businesses and entrepreneurs to create new jobs and jumpstart economic growth,” Senator Jon Kyl of Arizona said in a statement. “But they can’t if they are saddled with an onerous surtax on their business income.”
The plan “shows once again that there are some who have no concept of how private industry creates jobs and grows the economy,” Kyl said.
President Barack Obama said yesterday that passing a comprehensive overhaul of the system is his “highest legislative priority” and he expects it will be achieved.
“I’m also looking at the federal budget,” Obama said. The only way to reduce the deficit is to “corral and contain” health costs. Referring to Obama’s push to extend coverage to the estimated 46 million uninsured Americans, the group said: “We cannot ‘add’ new consumers to a broken system.

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While it is important to eat as many healthy and balanced foods as possible every day, it is equally important to not harm overall health by consuming foods that actually damage the body. The toxins released from highly processed refined sugars can have negative effects on overall health wiping out the benefits of other, more healthful selections.
Nutrients in foods are highly synergistic interactive complexes. For example, a vitamin is an extremely complex organic substance needed in small amounts yet essential for life and metabolic processes (growth, maintenance, repair, energy).
Although often considered a single substance, each vitamin is a group of chemically related compounds. Separating (fractionating) the group of compounds into single, incomplete portions converts it from a physiological, biochemical, active micronutrient into a disabled, debilitated chemical of little or no value to living cells. The synergy is gone.
By making intelligent choices, one can obtain even greater health benefits than he / she had previously thought possible.

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MONDAY, June 15 (HealthDay News) Stimulant medications commonly prescribed to treat attention-deficit hyperactivity disorder (ADHD) are associated with an increased risk of sudden death, but those deaths are still rare, new research finds.
Children and teens taking ADHD stimulant medications were seven times more likely to die suddenly than their peers, the study found.
What we found to our surprise is that even if you take out confounding factors, the association between stimulant use and sudden death was still significant, said study author, Madelyn Gould, a professor of clinical epidemiology in psychiatry at Columbia University/New York State Psychiatric Institute in New York City. m confident the association is real and significant, but its very rare. I dont want our findings to change prescribing patterns or for a parent to change their willingness to use stimulant medications if theyre called for, but physicians should monitor patients with any new medication you give a young person.
[...] The complete story is at http://health.usnews.com/articles/health/healthday/2009/06/15/adhddrugs-linked-to-sudden-death-in-kids.

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An immensely important influencing factor in making sure that your skin will always appear young, vibrant and healthy is to have a regular skin care plan. In their eager search for eternal youth our scientists have created all manner of skin care products for us to use. Wonderful and wild announcements are often delivered about the amazing results from applying it regularly. Annoyingly these claims are very commonly simply false and little or no, real, evidence actually exists. As more of us browse the Internet in an attempt to discover a product or treatment to maintain our good looks, more of us are fooled by this kind of advertising. Alarmingly microdermabrasion and skin care organizations are often as guilty of this practice as others.
Starting a regular skin care plan is just the primary step in attaining the goals of young, vibrant and healthy looking skin. More often than not we are required to go that little bit further and find something that works for us. In years gone by this meant cosmetic surgery but incredibly this is no longer needed as microdermabrasion is available.
Microdermabrasion is a non-invasive procedure that is well known for its favorable results. Annoyingly many of the microdermabrasion web sites, in their attempts to acquire folk to use their treatments and services at their spa, cosmetic clinic or beauty salon, present images which are not really a true representation of the results gained there. It is, therefore, very important that you attempt to discover the true degrees of their talents. One of the best and easiest ways in which to do this is to simply ask for examples of the results that prior patients gained and also for any recommendations made by such. You should ask friends, colleagues and family members if they have knowledge of their reputation or have been there themselves. If it is true that they have a good reputation then it is most probable that they are proficient in microdermabrasion.
If you are planning to get |book yourself a block of microdermabrasion treatments there is a selection of factors of which you should be made aware of, especially in relation to after or before microdermabrasion. Before your sessions commence you will have a consultation with your consultant who will examine your skin and decide upon the most suitable pretreatment. For treatments of microdermabrasion it is often the case that you are told that you should use some of their products and include them into your regular skin care regime.
Following microdermabrasion treatments you may appear a little pinkish in the face. Do not get upset because this is usual and it will soon subside. However you should not expose your skin to too much sun after microdermabrasion as the skin is sensitive and could be damaged.
If you are looking for at home microderdermabrasion treatments please take a visit http://www.microdermabrasioninfo4u.

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Sorry! We haven't created a WisdomCard for this search yet.
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The database also offers a directory of hotlines for Canadian health-related organizations, fun facts, news stories, and other great tools. Like KPL's other databases, all you need to access this great resource is a KPL library card. You can even log on at home by visiting the eBranch on KPL's website.
So if you're a teen or are a caregiver or educator of teens, this database is definitely worth checking out!
For more great KPL databases, click here.

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To date, research on stalking has focused almost exclusively on adults. This paper examines the nature of stalking among adolescents to determine the characteristics of stalkers and their victims and the utility of intervention orders for managing this behaviour. Its findings indicate that a majority of perpetrators are male and almost all victims know their stalker, with prior relationships including ex-school peers, family members, ex-intimate partners and former friends. Threats and physical assaults occur in a majority of these cases and the impacts of adolescent stalking mirror those reported by adult victims, with anxiety and fear both commonly occurring. However, unlike adult stalking which is usually motivated by rejection, adolescent stalking most often occurs in the context of bullying. Intervention orders were granted in almost half of the study cases. Where applications where not granted, half the victims discontinued the application prior to hearing, almost one-quarter of victims did not attend the hearing and the remainder of cases were struck out. While intervention orders are commonly used to curtail stalking, their effectiveness is yet to be established. Longitudinal research which follows youth stalking cases is needed to determine the mental health, social and vocational impacts of stalking; reasons for high rates of intervention order discontinuation by victims; rates of recidivism into adulthood and the impact of intervention orders on offenders.

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Six-year-old Ali died last week, and health workers don't know the source of his disease. Bird flu has been blamed in the deaths of 26 people in Egypt since 2006, the most of any nation outside Asia.
By Jeffrey Fleishman
5:15 PM PDT, April 29, 2009
Reporting from Cairo -- Beyond smokestacks and whipped donkeys, past fish curled on dirty ice and sparrows skimming laundry hanging in alleys, the death of 6-year-old Ali Mohammed Ali brought mystery, health inspectors and truckloads of police to a poor Cairo neighborhood.

Ali, a first-grader and computer wizard from Shubra el Kheima, died last week in a hospital, his lungs full of fluid, a stent in his chest. Health officials say he had bird flu, but they can't pinpoint where he picked it up: The market, the school, on the rooftops with the pigeon keepers or on a recent trip to his grandfather's village in the Nile Delta?

Nobody knows. Homes and classrooms have been disinfected, neighborhood poultry has been confiscated and culled, and the man splitting chicken breasts with a machete next to the baker keeps watch for police in case he has to disappear in a hurry. There is alarm and nonchalance, talk of a health epidemic, grumbles of conspiracy.

"The Health Ministry came. They checked our flat, they took our blood. They tested everyone in this building for infection," said Ali's mother, Aleya Ismail. "But still they don't know how it got into my son. Where can I raise poultry here? Under the bed? How could this virus have found him?"

Egypt has had 65 cases of bird flu, including 26 deaths, since 2006 -- the highest national toll outside Asia, where the virus, designated as H5N1, was believed to have first appeared in humans in 1997.

Ali's fever and final hours in an intensive care unit came days before word came of the swine flu outbreak that is suspected in the deaths of more than 150 people in Mexico and has spread in the United States and into Europe and the Middle East. Egypt has ordered the slaughter of the nation's 300,000 pigs.

Bird flu, which has killed 257 people worldwide, threatens to be a pandemic but has yet to reach that critical stage, though it has become embedded in bird flocks and spread to dozens of nations. Arising mainly from direct contact with infected fowl, bird flu lingers at the edge of the swine flu crisis, another deadly squiggle of cells and strands beneath the microscope.

The World Health Organization is concerned that, like swine flu, the avian virus could mutate and become easily transmissible between humans. Scientists fear that if this happens the avian virus could be more dangerous than the swine flu outbreak, overwhelming cities such as Cairo, where overcrowding, poor sanitation, suspicion and cultural traditions are more potent than Tamiflu prescriptions and warnings spoken through the masks of health workers.

Shubra el Kheima unfolds where the Nile ripples through marsh grass as it flows north out of Cairo toward the delta. Apartment buildings of brick, dried mud and mortar heave against one another, keeping daylight out of the alleys until the sun is at its highest. The market blows with garbage, flies whirl, donkeys chew grass off carts, and cats slip past coal bins and into the butchers.

Most families, like Ali's, arrived decades ago from villages. They were electricians, laborers, seamstresses. They hauled country life to the city; their sons and daughters raise chickens and race pigeons, and when they don't know the exact address of a friend or cousin they yell names through alleys and are guided by fingers pointing this way and that. Anyone passing a corner can sip water from clay jugs, known as ollas, a communal drinking habit since ancient times.

God moves them; the loudspeakers at the mosque crackle with his name. They are suspicious of police and anything that bears a government stamp or imprint of officialdom. They have rocked one another's babies, buried one another's dead and finished one another's sentences. And now they can't believe that Ali, a boy they knew, is gone, taken by a virus whose name is two capital letters and two numbers.

"The police have seized the chickens from the market," said Hayem Mohammed, a heavyset woman with gold looped earrings and an aluminum cane. "Why should we be scared? We all believe in God and God's will."

"I'm not convinced it was bird flu," said Alaa Abou Donya, a burly man standing in the shade near a mechanic's shop. "Ali's family used to have pigeons, but they cleaned up their house a year ago. They buried Ali in a normal grave. You wouldn't do this if the boy had been infected."

Down another alley, men sip from ollas, their eyes following a stranger. No one sneaks in here; life and space are too compressed. The alleys open to the wide street. The cabbage man lifts his tarp at the market, green spills into the dust; women sell eggplant and red onions, and fish, long dead, bob in the water of melted ice. A thwack and a tug, bits of chicken tumble from Sayed Mohammed Ahmed's chopping block; cats flock to his feet.

"I only sell farm-raised chickens," he said. "It's the ducks and chickens raised in houses that are infected. But when the police come they take all the meat no matter where it came from. I have to hide when I see them."

He skinned and sliced, handing two breasts to a woman; his sticky fingers reached for money from his shirt pocket.

"People aren't scared," he said. "They understand this bird flu scare is all a trick to kill the business of local chicken producers so importers connected to the government can make big money. That's what this is all about."

Behind a window with a pastel shutter, Ali's mother sits on a bed in a room decorated with plastic flowers and a poster of Mecca. She is dressed in mourning black, except for the glint of pearl on the pin in her head scarf. The needle prick in her arm, where they drew blood to give her son, is weeks old now. She blames the doctors and hospitals for not figuring out what was wrong with him until he was too far gone to bring back.

"He had a fever," Ismail said. "I took him to five doctors who said it was only a throat infection. They gave him antibiotics. Another doctor said he had pneumonia. We took him to a private hospital. They said his lungs were full of fluid that needed to be sucked out, but they didn't have the tools. We took him to a state hospital. It took them three days before they drained the fluid."

Her son started fading. A doctor asked if the family raised poultry at home. She said no. The flat was too small and cramped and her husband's father had forbidden it years ago. The health inspectors came to investigate; no one else was sick. They widened the search to the neighborhood and Ali's grandfather's village in the delta. Nothing.

Ismail sat near her daughter, Noura, 8, and her 7-month-old son, Ahmed. A woman carrying groceries peeked in and headed up the stairs. The sun was high over the littered alley.

jeffrey.fleishman@latimes.com

Noha El-Hennawy of The Times' Cairo Bureau contributed to this report.

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information, home based health care tips towards healthy living and better way of life.
Health Remedy Guide helps you to get more information about your health problems its causes and symptoms, home remedies and treatment.
This Online Home Remedies Guide to better health is divided into several Categories. Each category is provided for easier search where you find ailments and home remedy suggestions faster.

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Sorry! We haven't created a WisdomCard for this search yet.
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answered by John Halamka this week, “How do we build Health 2.0 into the delivery system?” Both Rushika and John will participate in a debate on this topic in Boston.
I am an internist who has been working for the last 5 years to design, build, and test radically new models of delivering primary care to improve experience, outcomes, and affordability of care. I currently serve as Medical Director of one of our redesigned practices in Atlantic City, NJ. Yesterday afternoon, Mr. Santos, a 53 year old Hispanic doorman at a local hotel, came in to see me quite visibly distraught. His prior primary care doctor had without asking him or discussing the issue checked a PSA (Prostate Specific Antigen) as part of his “routine” blood tests and the results were mildly positive (6.5). He was told, “Your screen for Prostate cancer was positive, you need to see a urologist right away to have it taken care of.” All he heard, of course, was “cancer” and “positive” in the same sentence. Before Mr. Santos had time to even form the first of the dozens of questions he had, the doctor had already strode out the door. Over the next few weeks, Mr. Santos went online to read about PSA and prostate cancer (which yielded over 6 million pages on Google), and started talking to his friends at work about the issue. What he surmised, quite correctly, is that the way forward for him was not at all clear, and that instead of finding answers he only had more (but better) questions. What really was his chance of having Prostate Cancer? If he did what really were the benefits of catching it so early? Were the risks of the biopsies worth this benefit? What were his other choices.

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If you are overweight you are not alone now it's a growing trend and one that has so many health risk. Being obese is no different than being an alcoholic or some other addicted to cigarettes, except in the fact that we have to face food 3 times a day. How successful would a smoker be if he had to just smoke 1 cigarette in a day or an alcoholic to have 1 beer a day. They would be in a bad shape.

Everybody know the diseases and problems that obesity can cause but very few of us have successfully won the battle. And today with some of best slimming pills on the market we can have help. Asking for help is not admitting defeat, it is just asking for allies.

Today the main problem is that there are so many pills on the market how do we know what to choose. Lets break down the best slimming pills into some categories that help understand what they do and how they can help you.

The first main category out of three is the Appetite Suppressants. These are most popular types of slimming pills. They work by making the person fill full and not want to eat, person typically has less cravings. This is good for the people who are emotional eaters who feel hungry after an argument or something makes them sad. This can also help you reach for the tissue box instead of the cookie jar. This is not for people who just want to lose a few vanity pounds this is for someone who needs to lose weight to reduce or decrease health problems.

2nd group of pills are those of the Fat Burning type. Normally, some people think that these are best slimming pills but remember each type of pill is for different people who need different support. This pill works by getting rid of fat in the liver with Choline and Inositol.While the L-carnitne and Oleic help increase the rate of fat burn. Always look at the ingredients of anything you put in your body but especially in case of medication. Look for these ingredients in the pill before you decide to discuss it with your personal doctor.


For more information about Slimming Pills visit us.

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INTRODUCTION TO GRANT PROPOSAL WRITING (PART I): STRATEGIES AND WRITING TIPS [Episode 22]
http://socialworkpodcast.com/2007/08/introduction-to-grant-proposal-writing.html
In the first episode, J. B. Singer (host) interviews Dr. Edward Sites about strategies for developing and writing a grant proposal.
Source : Social Work Podcast. August 13, 2007.
Questions to ask before writing your proposal:
(1) Is this project one in which the author and his/her agency has sufficient interest to pursue to the finish?
(2) If funded, will the staff be able to handle this new project with their other work?
(3) Is the author sufficiently skilled to plan, organize, direct, coordinate, control and evaluate the project? (Keep in mind here that when I say author, I am assuming the author will become the project director, though sometimes proposals are written for hire by proposal writers not expected to be involved in the project if the proposal is funded.)
(4) Are the project goals and objectives sufficiently congruent with those of the parent organization?
(5) Will the parent organization back the project with administrative and other supports?
(6) Are adequate facilities, equipment release time, etc. available?
(7) What risks to the author and organization are there and are these reasonable?
(8) Questions to ask about your finished proposal:
(8a) Who are you and what qualifies you to present this proposal?
(8b) What is the problem you seek to address?
(8c) Have you identified the need?
(8d) What do you propose to do about that problem?
(8e) How exactly will you go about this and what exactly will you deliver?
(8f) How much will it cost?
(8g) How will you know if you have accomplished your goals and objectives?
(8h) What objective evidence is there of the nature, purpose and capacity of you and your organization and what do other qualified parties think of your idea, your approach to addressing it and your organization?
INTRODUCTION TO GRANT PROPOSAL WRITING (PART II): THE NARRATIVE, BUDGET, AND APPENDICES [Episode 23]
http://www.socialworkpodcast.com/GrantWriting2-64.mp3
In the second episode, J. B. Singer (host) interviews Dr. Edward Sites about about the three sections most commonly found in grant applications - the narrative, the budget and the appendices.
Source : Social Work Podcast. August 21, 2007.

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This posting was seen on the AMA Foundation listserv, concerning an upcoming Institute for Healthcare Advancement conference .

The Institute for Healthcare Advancement (IHA) will be holding their 8th Annual Health Literacy Conference, "Health Literacy: Bridging Research and Practice", on May 7-8, 2009 in Irvine, Calif. Presenters will provide an overview of their best practices, programs and research, discuss these applications in a primary care setting, and teach attendees skill sets to better serve their clients. Conference attendees include health educators, nurses, physicians, dentists, dieticians, researchers, writers, librarians, administrators, and others.

The deadline to submit a Poster Abstract is March 13, 2009. The deadline for early bird registration is April 3, 2009.

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Ramaiah Bheenaveni asked: Beliefs and Practices in Women Health Ramaiah Bheenaveni *Rural women's health is an infinitely broad topic. Many Indian women have come from circumstances in which women have limited access to healthcare. Traditionally, there has been discrimination towards women in decision-making; access to resources such as food, education and health care; job opportunities; and in child-rearing and parenting. However, women's health in rural areas affects everything in their environment from their families to their economies and vice versa. A woman's health, especially among the poor and illiterate, is often neglected not just by her family but by the woman herself. She is taught not to complain and if she does then she is directed either to use condiments in the kitchen or try faith healing.

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Medicaid authorizations are not difficult to obtain for a simple service such as therapy rendered by a Licensed Psychologist (LP), such as myself. It entails the filling out of a one page form which is faxed or mailed and usually the therapy is re-authorized after the basic 8 sessions are utilized.

However, this is completely NOT true as related to the Enhanced Services such as Community Support Services.

And let's not forget this fact. Secretary of NC DHHS, Cansler, worked as a private lobbyist to assure that Value Options got the multi-million $$$$$$ gig doing authorizations for NC Medicaid clients. Prior to that, he worked as second in command at NC DHHS from 2000-2006. Now, he's back at NC DHHS and gee, I wonder how it is that Value Options NOW works to limit the $$$$ utilized for Community Support Services.

Is that a coincidence? this ever diminishing Community Support Services $$ or are there surreptitious intentions here?

Which reminds me, I have not yet heard from Secretary Cansler regarding the 'private' minute meetings associated with the removal of 50 Broughton (Western NC public psychiatric hospital) to be consumed by the private, free-standing, 14% only Medicaid beds psychiatric hospital in Winston Salem being built by Old Vineyard Behavioral Health (OVBH).

OVBH had private meetings starting in early 2008, as per the Centerpoint LME notice put out 2.20.2009, with Centerpoint LME as well as NC DHHS. IN that memo, Cansler was stated as heralding this creation of cooperation in order to create hospital beds within a facility that could only have 14% Medicaid beds as per the Centers for Medicaid and Medicare Services (CMS) IMD exemption rule. That rule requires that psychiatric hospital beds for Medicaid clients be in general hospitals in keeping with CMS belief that psychiatric patients also much of the time could have or do have physical difficulties that could need attending to.



So, how does Value Options destabilize Endorsed Provider companies?

Remember: NC Mental Health Reform was supposed to be about: privatizing and making more competitive! mental health services.

However, there are multiple newspaper articles from every newspaper in NC, over the past several years, documenting that mental health providers have dropped like flies leaving consumers w/ no services and the reasons can be pinned directly onto Value Options and how they interpret the confusing memos created by NC DHHS.

Basically, here's the gig: the Endorsed Provider companies operate to some extent on faith in terms of providing Community Support Services to clients who have serious mental health challenges and are attempting to upgrade their skills which is the agenda of CSS.

The Endorsed Provider companies put their necks out in providing CSS to clients. CSS must be re-approved every 90 days. New signatures of the client/ the client's guardian must be re-obtained. Recently NC DHHS created a new "Update/ Revision Signatures' page. However, they were not clear as to WHEN this new signature page had to be used. Additionally, Value Options takes months to provide a written authorization for services. This results in the Endorsed Provider company being squeezed from both ends: they have employees who see their CSS clients and they must be paid but then VO shuffles the cards always in their favor.

You might think that the 'wrong form' is not such a big deal but this would be incorrect. If the wrong form is turned into Value Options, the client can have a 'gap' in services which means that ALL of their services can be cut.

Most importantly, if there is a 'gap in service', it counts as a NEW APPEAL and the services are not guarantees under Maintenance of Service.

Indeed, it appears that VO employs this 'you turned in the wrong form' as an opportunity to remove CSS Medicaid services.

This is not to even mention the yearly update of the Person Centered Plan (PCP) form and all of its issues.

CSS requires reauthorization every 90 days. If, CSS are cut by VO, the Medicaid client can appeal. The client can continue to receive the same CSS during this period identified with "Maintenance of Service." However, again, the Endorsed Provider company has to put its neck out, assuming that VO will continue the same level of CSS, usually 8 hours/ week/ client.

Unlike what the Endorsed Provider companies and their employees are required to do which is to not allow a gap of services to take place, VO can take months from the time that the authorization request is submitted by the Endorsed Provider company to give a written authorization. This means that for that period of time, the Endorsed Provider company is counting on the continuation of services.

This loss of money as related to employing CSS workers and paying them on a regular basis when the CSS may be cut significantly to 1 or 2 hours/ week (which is now not uncommon discourages companies from providing continuous Community Support Services as they have to go out on a limb in terms of 'having faith' that the CSS will be authorized.

That is one significant reason for a loss of mental health services in NC.

More recently, in 2009, NC DHHS created this new 'Update / Revision Signatures page'

Here is an example of how this has played out recently as pertaining to this new 'Update/ Revision Signatures page':



Medicaid client living in a Family Care Home (where tens of thousands of mental health challenged clients live in NC) has been in Medicaid appeal for over a year. OVER A YEAR.

This means that the Endorsed Provider company has been operating on faith for OVER A YEAR.

Client has been covered by 'Maintenance of Service' (Medicaid pays for his Community Support Services while it is in appeal). Client had a mediation hearing one month ago; his services were extended for one month at the same rate so that he could obtain a neuropsychological assessment (he has a head injury). He obtained this assessment.

The Endorsed Provider company QP (supervisor) sent in the 'signature page' associated with the Maintenance of Service. VO maintains that the WRONG signature page was sent in which will create a gap in service which means that the Endorsed Provider company will suck wind.



Here is the NC DHHS memo explaining WHEN to use WHICH signature page:

http://www.dhhs.state.nc.us/mhddsas/servicedefinitions/servdefupdates/iu54/dmadmh2-2-09update54.pdf

NOTE: Implementation Update #51 indicates that, “The revised documents will have an effective implementation date of January 1, 2009; this means that any PCP annual review that is due in January of 2009 will need to be updated on the new forms. Revisions will not be subject to the new forms, only the annual plan.”

• The new documents are now effective March 1, 2009.

• Any Introductory PCP, Complete PCP or PCP annual review that is due in March of 2009 will need to occur using the new format.

• It will also be necessary to use the new Update/Revision form for any reviews taking place in March 2009. The only significant change to this form is the signature page. If a new service is added to a PCP as a result of a review and update/revision to the plan, Part 1, Section A of the Signature Page, with the new check boxes must be used.

PROBLEM: Used old signature page as no new services added on this review (3/17/09) as per Implementation Update #54;



Was it clear to you WHEN and WHICH form you were supposed to use?

NC DHHS needs to employ some English majors to overview their publications as they appear to not be able to write them clearly if that is what they are trying to do which is an assumption in itself.


Here is the e mail to VO as associated with the turning in of the wrong signature page:

PSDCustomerService (PSDCustomerService@valueoptions.com) : Ryan N. is identified as the VO provider liaison employee:

"We apologize if DMA’s Implementation Update led you to believe that the new PCP signature page was not needed for this review, unfortunately, per DMA any review that takes place after 3.1.09 does need to be performed on the new signature pages. The signature pages included in your request are signed on 3/16 and 3/19 by QP and member and the PCP itself shows the reviewed data as 3/17/09. As per another of DMA’s policies we will only be able to grant authorization as of the date of updated corrected request if received so there will be a gap in services due to this. "


Basically, VO interprets NC DHHS memos in such a way that mental health services are removed and there is very little that the Endorsed Provider companies can do other than just go broke.

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Now as a grown up librarian, it is still amazing to me the diversity of information that one can stumble over while on the way to looking something else entirely unrelated.  Browsing and serendipity can play a part in pursuing research whether you’re surfing the net or standing in the book stacks, holding an actual book.
Librarians do hear this phrase occasionally: If it’s not online, I don’t want it.  A recent observation (in my problem-based learning class) is that this generation of Milleniums much prefer their research information online… and who are reluctant to walk into the “bricks and mortar” library to find a textbook in print.
As collection managers and archivists, one of our major responsibilities is to deliver current library materials and services in the manner in which our patrons best like to “consume” them.  The shift from print to digital access does impact how librarians select (and store) their core collections.
A complex mix of collection management decisions weigh format and availability versus price and expected (potential or future) usage which also roughly indexes the librarians expectation about the longevity or lasting value of the material.
Thrown into these choices: Collection budgets (which are shrinking), and what our students, clinicians, pharmacists and the general library users prefer to use (print or online). Luckily, in this library there are librarians with decades of experience to muse with these decisions… and thanks for the advice, AD!
In other words, does it make better sense to buy one (physical, paper) textbook produced in 2009 for $450 (for example) when you could, as as alternative, purchase an electronic, perpetual version of the work for $1,000 which can be read simultaneously by up to five online readers and whose clinical content is updated monthly?  Collection management, a bit like the practice of medicine, is both an art and a science.
The goal is to select the most cost-effective means to provide the essential resources needed by your particular community.  As the migration of library collections continues away from print to digital access (i.e., always on, never checked out, 24 x 7 x 365 days per week…  provided that the network is up and running), the next post in this series will explore concerns and decisions that academic-medical librarians in 2009 need to balance in order to offer the most complete collections available.

I would like to welcome our newest reference librarian - JK -to the health science library this week.
We are so glad you joined us.

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It seems like everyone from celebrities to the girl on the treadmill next to you is on a detox diet -- but does that mean you should be too?
Let's see.
First of all, detoxing is enormously popular.
Sales of herbal formulas for cleansing, detoxification and organ support among natural food retailers were more than $27 million from Dec. 2, 2007, to Nov. 29, 2008, according to SPINS, a market research and consulting firm based in Schaumburg, Ill., that caters to the natural and organic products industry. A survey by Mintel International, a Chicago-based research firm, found that 54 food and drink products were launched in 2008 with the word "detox" in their descriptions -- up from 15 in 2003.
Proponents say detoxification cleanses the body of harmful toxins we gather from pollutants such as pesticides, plastics, heavy metals, and artificial growth hormones. These toxins build up in our livers and kidneys, causing weariness, headaches, weight gain, depression, and even fertility problems, says Lolane Glundal, wellness educator at the Natur Tyme health store on
Bridge Street in East Syracuse.
The solution, she says, is to cleanse the body, or detoxify, using a combination of specific herbs and vitamins in conjunction with a restricted diet.
Critics say no evidence shows any medical benefit of detox dieting, and that some forms of detoxing are dangerous. They argue that the body is perfectly capable of cleansing itself naturally.

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Dr. Chandler,
While this is a moderated site, I can assure you that the intention is to promote dialogue, not shut it down. The idea behind having a moderator is to insure the safety of the space, that’s all. We are fortunate to have this forum supported by the town.
You have some excellent insights and ideas. Thank you for expressing them. The crushing paperwork that obstructs direct care providers from actually providing care and the non-uniformity of paperwork across service areas is a major problem. This is one more result of workers on the ground having been “listened” to, because protocol demanded it, but not heard. Among other things, your comment about the fundamental lack of understanding about how market forces would impact the system is right on, in my humble opinion.
Let’s be sure that we are holding the people responsible for policy decisions about MH, DD, and SA care in NC accountable, and give credit where credit is due. Orange County plays a very small role in how the system functions. Their only roles are to supplement funding provided by the state, and to have one county commissioner sit on the board of the Area Program, also known as the LME. I have been disappointed that the county hasn’t done more in the past to fill holes, and that political considerations about not taking on the state’s responsibilities may have resulted in missed opportunities for improved care in Orange County. However, Orange County is a victim just like the rest of the state, not a perpetrator in this case. And relative to other counties, they are pulling their weight.
I am no apologist for the many failures of mental health reform. However, I will say that OPC is forced to operate within the confines of policy dictated by the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, which is a division of the Department of Health and Human Services. I can also tell you that, by and large, the people that work at OPC are as committed to helping the population you serve as you are, and in some cases, overqualified for the jobs they are performing. I can only imagine that many of them are as frustrated as you and I are with the current state of affairs. I frequently work closely with several members of the OPC staff who work long and hard to make the best of a difficult situation, and frankly, take a lot of lumps that they don’t deserve. I think we can make better recommendations when we don’t paint public servants with a broad brush.
Unfortunately, NC ranks 43rd in funding per capita by state in mental health funding, and the people responsible for how those limited state funds will be spent need to make tough decisions that necessarily exclude care for deserving and needy citizens. Utilization management for those (un?)fortunate enough to qualify for Medicaid is provided under contract by the for-profit, multi-state corporation Value Options. I hope that you will support returning the UR function to LMEs, as well as single-stream funding that would give them more flexibility to use dollars where they are needed most, rather than being restricted to rigid categories. Single-stream funding has been given to several LMEs, including Durham, I believe.
I totally agree with your point about utilizing the untapped resources of our university system. There are efforts underway that are gaining traction. You might have heard the UNC Dept. of Psychiatry recently opened a new “Center for Excellence in Community Psychiatry” in Carrboro. Gov. Perdue has endorsed developing similar sites across the state. Also, the UNC Gillings School of Global Public Health is funding a project led by Dr. Joe Morrissey to utilize computer modeling to better quantify service needs across NC. Also, the UNC School of Social Work is leading an effort to develop a tuition forgiveness program that would place clinical social workers in underserved parts of the state.
Allied professionals, especially clinical social workers, are being wiped out under the current regime, another foolish tragedy of reform that is the legacy of Easley’s DHHS.
In my opinion, real solutions can only be implemented by a new management team at the Division of Mental Health, Developmental Disabilities that demonstrate a new orientation to developing policy for the system of care in North Carolina. As your post illustrates, there is no shortage of good ideas in North Carolina. Implementing them is the crux. I think we can all agree, the public lacks confidence in the leadership at the Division of MH, DD, and SA. Bringing new leadership there is a critical next step. If you agree, you should let Secretary Lanier know.

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Nontraditional resources for nontraditional students. When you can't study anymore, take a break and explore some of the labels on this site for fun and informative content. The inclusion of products or services in this blog is not an endorsement by the Criss Library. The resources in this blog have been selected by John Reidelbach, Electronic Resources Access Librarian, Dr. C.C. and Mabel L. Criss Library, University of Nebraska at Omaha, jreidelb@mail.unomaha.edu.

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