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With NJ unfunded pension liability at $90B, panel advises cutting health benefits

New Jersey’s Pension and Health Benefit Study Commission has issued its final report on reforms it has said are needed to prevent public employee benefits costs from overtaking other budget priorities.

Despite unprecedented levels of funding and the dedication of state lottery revenue to the pension plans, the state’s estimated unfunded liability is now $90 billion, $10 billion more than in 2014, said commission member Tom Healey.

“While some progress has been made, it has not been enough,” Healey said. “The new governor, the legislature, public employees, and the citizens as a whole need to act to effect the comprehensive reform the commission suggests to make these benefits both affordable and secure.”

The commission has recommended that public employee health benefits be reduced and the savings be dedicated to pension payments.

Without more reforms, commission member Tom Byrne said, required pension payments won’t leave much money in the state budget for other priorities.

“We need to do it before the pension system becomes the Pac-Man that ate both the rest of the state budget — in terms of discretionary spending at least — and ate the retirement security of 800,000 New Jerseyans that depend on the pension system,” he said.

The pension funds will run dry in 12 to 14 years without additional reforms, Byrne said.

“There were certain people who wanted a stalemate until now, thinking that they would get a better deal in a new administration,” he said. “The fiscal constraints that exist aren’t going to change, and I think the sooner reality sets in about that the better off we’ll all be.”

The commission’s report is a blueprint for the next administration to consider, said Gov. Chris Christie.

“I hope this is a ‘Nixon goes to China’ situation,” he said. “I hope it’s that a Democratic administration and a Democratic legislature can speak truth to these unions and make them realize there’s no place else for them to go.”

Senate panel OKs retiree health care changes affecting police, firefighters

LANSING, MI — The House and Senate Competitiveness Committees voted on Tuesday to approve a package of bills that aim to assess and address underfunded pension and retirement health care systems in local Michigan communities.

The legislature is considering changes after the Responsible Retirement Reform for Local Government Task Force found a collective $7.46 billion in unfunded pension liabilities and $10.13 billion in unfunded health care liabilities lurking in local governments’ finances.

The task force couldn’t agree on the details of how to fix it, but an agreement between House and Senate leaders, along with Gov. Rick Snyder, was the topic of hearings at the state capitol on Tuesday, when both the House Competitiveness Committee and Senate Competitiveness Committee held testimony on identical, 16-bill packages.

The Senate committee moved it 4-1 along partisan lines, with Democrat Rebecca Warren, D-Ann Arbor, opposing.

“Disappointed that the bills being rushed through Competitiveness don’t reflect consensus recommendations of Retirement Task Force threaten to undermine the benefits that firefighters, police other public employees were promised,” Warren tweeted on Tuesday.

The bills introduced in the House and Senate would institute a five-step process to better assess the financial pictures of local governments struggling to fund promised retiree health care benefits. It would put the communities with not enough funding and no feasible plan to fix it — an estimated 20-30 communities, according to Senate Majority Leader Arlan Meekhof, R-West Olive — under a three-person Financial Management Team.

That team, organized under the state’s emergency management act, would have broad powers to rectify the underfunding, including through requiring the municipality to change its budget. If the municipality doesn’t comply and fails to rectify that noncompliance, it can be sent into emergency management.

Here are the retiree health care changes Michigan lawmakers are considering

Rep. James Lower, R-Cedar Lake, a sponsor of the House legislation, said the plan would help avoid situations like bankruptcy, where retirees could see their benefits reduced or taken away.

“Doing nothing is really, really dangerous for retirees,” Lower said.

Also testifying in support of the legislation was State Treasurer Nick Khouri, who said the bills had the governor’s support. The goal, he said, is to create sustainable pension and health care systems for local units of government.

But the bill met with criticism from democrats like Rep. Erika Geiss, D-Taylor, who pointed to the fact that communities were facing decreased revenue sharing payments from the state.

How Michigan’s revenue sharing ‘raid’ cost communities billions for local services

Khouri said the Snyder administration was open to talking about increases in revenue sharing.

But for local police and firefighters, who are counting on the retiree benefits, the

Midland Fire Chief Chris Coughlin of the Michigan Association of Fire Chiefs testified in the Senate committee on behalf of a coalition of police and fire organizations in opposition to the legislation. He said the task force came up with broad recommendations the groups supported, but the legislation jeopardizes what police and fire have been promised.  

“Police officers and firefighters put their lives on the line every day. We cannot support legislation that impacts the promises made in collective bargaining agreements. These promises were made and they need to be kept,” Coughlin said.

The House Competitiveness Committee passed the main bills 5-4 along mostly party lines, with Rep. Jason Wentworth, R-Clare, joining Democrats in voting against the bills. Three of the more ancillary bills in the package, House Bills 5314-5316, on revenue sharing funds, passed 6-0-3 with Republicans voting for them and Democrats passing.

The bills are pending now on the House floor, where they could be taken up at any time. 

The Senate on a tentative agenda put out Tuesday night has the bills listed as going all the way through final passage on Wednesday.

MLive Reporter Lauren Gibbons contributed to this story.

Senate panel OKs retiree health care changes affecting police, firefighters

LANSING, MI — The House and Senate Competitiveness Committees voted on Tuesday to approve a package of bills that aim to assess and address underfunded pension and retirement health care systems in local Michigan communities.

The legislature is considering changes after the Responsible Retirement Reform for Local Government Task Force found a collective $7.46 billion in unfunded pension liabilities and $10.13 billion in unfunded health care liabilities lurking in local governments’ finances.

The task force couldn’t agree on the details of how to fix it, but an agreement between House and Senate leaders, along with Gov. Rick Snyder, was the topic of hearings at the state capitol on Tuesday, when both the House Competitiveness Committee and Senate Competitiveness Committee held testimony on identical, 16-bill packages.

The Senate committee moved it 4-1 along partisan lines, with Democrat Rebecca Warren, D-Ann Arbor, opposing.

“Disappointed that the bills being rushed through Competitiveness don’t reflect consensus recommendations of Retirement Task Force threaten to undermine the benefits that firefighters, police other public employees were promised,” Warren tweeted on Tuesday.

The bills introduced in the House and Senate would institute a five-step process to better assess the financial pictures of local governments struggling to fund promised retiree health care benefits. It would put the communities with not enough funding and no feasible plan to fix it — an estimated 20-30 communities, according to Senate Majority Leader Arlan Meekhof, R-West Olive — under a three-person Financial Management Team.

That team, organized under the state’s emergency management act, would have broad powers to rectify the underfunding, including through requiring the municipality to change its budget. If the municipality doesn’t comply and fails to rectify that noncompliance, it can be sent into emergency management.

Here are the retiree health care changes Michigan lawmakers are considering

Rep. James Lower, R-Cedar Lake, a sponsor of the House legislation, said the plan would help avoid situations like bankruptcy, where retirees could see their benefits reduced or taken away.

“Doing nothing is really, really dangerous for retirees,” Lower said.

Also testifying in support of the legislation was State Treasurer Nick Khouri, who said the bills had the governor’s support. The goal, he said, is to create sustainable pension and health care systems for local units of government.

But the bill met with criticism from democrats like Rep. Erika Geiss, D-Taylor, who pointed to the fact that communities were facing decreased revenue sharing payments from the state.

How Michigan’s revenue sharing ‘raid’ cost communities billions for local services

Khouri said the Snyder administration was open to talking about increases in revenue sharing.

But for local police and firefighters, who are counting on the retiree benefits, the

Midland Fire Chief Chris Coughlin of the Michigan Association of Fire Chiefs testified in the Senate committee on behalf of a coalition of police and fire organizations in opposition to the legislation. He said the task force came up with broad recommendations the groups supported, but the legislation jeopardizes what police and fire have been promised.  

“Police officers and firefighters put their lives on the line every day. We cannot support legislation that impacts the promises made in collective bargaining agreements. These promises were made and they need to be kept,” Coughlin said.

The House Competitiveness Committee passed the main bills 5-4 along mostly party lines, with Rep. Jason Wentworth, R-Clare, joining Democrats in voting against the bills. Three of the more ancillary bills in the package, House Bills 5314-5316, on revenue sharing funds, passed 6-0-3 with Republicans voting for them and Democrats passing.

The bills are pending now on the House floor, where they could be taken up at any time. 

The Senate on a tentative agenda put out Tuesday night has the bills listed as going all the way through final passage on Wednesday.

MLive Reporter Lauren Gibbons contributed to this story.

Health care under examination at UW panel talk

Whenever Bill Novak | Wisconsin State Journal posts new content, you’ll get an email delivered to your inbox with a link.

Email notifications are only sent once a day, and only if there are new matching items.

What the Tech? App of the Day: Android control panel – WRCB

The White House says the true cost of the opioid drug epidemic in 2015 was $504 billion, or roughly half a trillion dollars. 

What the Tech? App of the Day: Android control panel – WRCB

The White House says the true cost of the opioid drug epidemic in 2015 was $504 billion, or roughly half a trillion dollars. 

Panel sheds light on refugee mental health

If you had to make a list of your four most important things, tangible or intangible, what would they be?

This is the question panelist Sarah Faulx posed to 40 audience members Friday night in William Pitt Union Dining Room B. After encouraging them to take out their phones and make the list, she said to imagine America is in crisis, and to then delete one item from the list.

The audience members deleted each item until only one remained. Faulx then said to imagine having to flee the country and to imagine how dear the last item becomes — whether it be friends, family, education or security.

This activity intended to help the audience understand the gravity of the panel’s discussion topic — mental health in the refugee community.

The panel, which the student club Facilitating Opportunities for Refugee Growth and Empowerment put together, included three speakers — Faulx, Ashok Gurung and Gemma Marolda — who all discussed refugee mental health.

Caroline Smith, a junior international and area studies and political science double major, is the co-president of FORGE. She said FORGE hosts two events each year outside of their general body meetings, including a fall panel, which is typically related to political issues.
“I was like ‘what can we focus on that would be interesting to our organization members, because most of them aren’t poli-sci majors?’ Most of them are biological science majors, so I thought that it would be really interesting to do it from a mental health perspective,” Smith said.

Marolda, a Pitt political science professor, gave background information about international immigration to preface the discussion. She said immigration shouldn’t have a negative connotation because it moves the global economy — and the pushback against globalization is rooted in fear.

“The greater the flow of migration, the greater the risk that you are going to lose your identity,” Marolda said.

Faulx, a licensed clinical social worker of Highland Park, followed Marolda and spoke about her work helping refugee kids work through their trauma.

“Refugees have to make huge sacrifices for safety and for loved ones,” Faulx said.

Faulx said sacrifices and traumatic experiences — such as undergoing persecution, fleeing one’s home country and being placed in a completely different culture — are emotionally scarring and can trigger mental illness such as anxiety, depression and post-traumatic stress disorder.

According to the Refugee Health Technical Assistance Center, studies have shown the PTSD rate in settled refugees to be 10 to 40 percent in adults and 50 to 90 percent in children, compared to about 8 percent of American adults and about 5 percent of American children.

Faulx said refugee trauma can be especially damaging to teenagers as their brains are still developing.

“Sometimes it takes a long time before kids will start to talk and discuss their journey and maybe a traumatic experience, so having that opportunity [to listen], I feel very fortunate for that,” Faulx said.

One method she uses when counseling refugee children is called “sand tray” therapy — a therapy technique in which the child creates scenes and plays with toys in the sand. How children play and what they create gives Faulx insight into what trauma they’ve gone through, and the tactile play is also therapeutic.

Gurung, the final panel member a Pitt alum, was a child refugee himself. After his father was jailed for speaking up for human rights, Gurung fled his home in Bhutan at age 9.

He said being a refugee was high-stress, especially with the poor conditions of the different refugee camps in Nepal he lived in for three years. He said he even became sick a few times because his stress levels were so high he was unable to adequately digest food.

Gurung — a co-founder of the Bhutanese Community Association of Pittsburgh — has recovered with the help of medical treatment, meditation and yoga, and he now works with Bhutanese refugees in Pittsburgh. He said he wanted to shed light on the refugee troubles that are sometimes overlooked, such as mental health.

Smith said it’s important to remember refugees need more than just basic necessities like food, water, a house and a job.

“Vulnerable groups are even more vulnerable to these kinds of [mental health problems]. Every step for them is just gonna be 10 times harder than someone who is born here,” Smith said.

Smith also said President Donald Trump’s refugee policies will have a negative impact on refugee mental health. Trump plans to cap refugee admission at 45,000 next year, a historically low number, the Wall Street Journal reported in September.

“From the resettlement organization, it’s not good, because resettlement agencies get funding depending on how many refugees they receive,” Smith said. “If they don’t get funding next year, refugees who are here who need services aren’t gonna get it.”

Faulx said it’s important for refugee children — and all children — to get information on mental health, specifically through school.

“That’s part of who they are as a human as well as their physical needs, to be cared for and taken care of, and this [mental health] issue needs to be addressed as well, just like your physical health,” Faulx said.

The mental health aspect of the panel attracted some audience members, including Cameron Hoffman, a junior history and political science double major. He said he frequently discusses refugees in his classes, but often in a different context.

“We’ve talked a lot about the numbers and the political aspects of it. We haven’t talked too much about the psychological issues that those refugees have, so I thought it would be pretty interesting to learn that aspect as well,” Hoffman said.

Marolda said refugee health is important because refugees are ultimately seeking a better life.

“We need to care because these are human beings just like you and me,” Marolda said.

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Skype’s new notification panel comes to Windows 10 for Insiders

by Michael Allison

 

Lawmakers defend ‘unprecedented’ Pentagon health panel, which could undermine FDA


65b6e_ Lawmakers defend 'unprecedented' Pentagon health panel, which could undermine FDA

Under a new defense policy bill, the Pentagon also could ignore FDA’s advice as necessary. | Getty Images

FDA currently has sole authority to authorize drugs and devices for emergency use.

11/06/2017 01:09 PM EST

Updated 11/06/2017 08:02 PM EST


The Defense Department — and not FDA — would have the power to approve drugs and medical devices under the defense policy bill that’s being hammered out by a conference committee, alarming congressional health staff and HHS who say it would undermine medical safety and potentially put soldiers at risk.

But the lawmakers backing the bill, including House Armed Services Chairman Mac Thornberry (R-Texas), say the measure is necessary and even overdue.

Story Continued Below

“The FDA has denied freeze-dried plasma to troops in the field for 10 years,” House Armed Services spokesperson Claude Chafin said, referencing a still-unapproved medical product that the Pentagon says is necessary to save the lives of military personnel. “The chairman has perfect moral clarity on this provision, and there is no doubt in his mind that it is the right thing to do for the troops.”

FDA officials counter that creating a new pathway to approve drugs is both risky and — in the specific case cited by Thornberry — not needed. “FDA has been working closely with DoD to bring freeze-dried plasma to our troops and anticipates that these products will be fully approved for safe and effective use for our armed forces as early as 2018,” an FDA official told POLITICO.

Section 732 of the Senate’s version of the National Defense Authorization Act creates a new regulatory structure that would allow the Pentagon to sign off on unapproved devices and drugs for emergency use on military personnel and others in harm’s way. The bill is in conference committee with final language expected as early as this week.

FDA currently has sole authority to authorize drugs and devices for emergency use.

“It’s unprecedented,” said one Democratic aide who works on medical safety issues. “We’ve never had a process for where an individual agency could [approve] drugs and devices … for its own use” and outside of the FDA. “It’s a massive shift.”

The language states that DoD would be able to approve “emergency uses for medical products to reduce deaths and severity of injuries caused by agents of war.” For instance, DoD could approve the use of freeze-dried plasma, which the department has repeatedly said can save the lives of military personnel who have suffered blood loss on the battlefield. While a small number of elite soldiers currently are deployed with access to freeze-dried plasma, the product is still awaiting full FDA approval, which hadn’t been expected until 2020.

“Traditional pathways to [FDA] approval and licensure of critical medical products, like freeze dried plasma, for battlefield use are too slow to allow for rapid insertion and use of these products on the battlefield,” according to the Senate Armed Services Committee’s conference report, defending its recommendation of the provision. “The committee believes this provision could lead to even higher survival rates from severe battlefield wounds suffered by servicemembers.”

But because the report language is so broad — for instance, “agents of war” isn’t a legal definition — staff say that it would open the door for the military to approve a wide range of products and treatments. For instance, DoD could plausibly approve a vaccine for soldiers who come down with the flu while deployed, one congressional aide said.

The conference language would create two safeguards. First, a new DoD committee of health care experts, appointed by the Defense secretary, would need to recommend emergency use of an unapproved drug or device. Second, the assistant secretary of Defense for health affairs would need to authorize the drug’s or device’s use after consulting with FDA.

But congressional aides and HHS staff say those standards don’t measure up to current safety practices. Rather than base a drug or device approval on years of safety and efficacy evaluations, it “leaves the decision up to a five-man committee,” said one individual with knowledge of how the DoD committee would be staffed. The Pentagon also could ignore FDA’s advice as necessary.

Staff on congressional committees with health jurisdiction say they were blindsided by the language, backed by Senate Armed Services Chairman John McCain (R-Ariz.), and have fought to remove it. But the provision is expected to remain, one individual with knowledge of the deliberations said on Monday afternoon. A Senate aide noted that it has bipartisan support from defense lawmakers.

Congressional staff involved in crafting the NDAA also defended the process of preparing the conference report. Three House Energy and Commerce Committee members — Chairman Greg Walden (R-Ore.), ranking member Frank Pallone (D-N.J.) and Texas Republican Joe Barton — were appointed to help negotiate Section 732, among other provisions in the bill that affect their jurisdictions.

HHS has warned Congress that the provision would undermine decades of existing protections and processes. For instance, DoD wouldn’t have access to FDA’s data, which means a decision could be made based on limited information provided by a drug or device manufacturer. DoD also wouldn’t be collecting safety and efficacy data in the same way as FDA.

FDA offered an alternative proposal, which would have expedited drug and device reviews and approval upon a DoD request, but the language wasn’t accepted.

FDA would not comment on the agency’s reported concerns with the bill. “The FDA does not generally comment on pending or potential legislation,” spokesperson Jen Rodriguez said.

Connor O’Brien contributed to this report.

Caviar introduces iPhone X Tesla with solar panel on the back

The Russian company that makes customized iPhones with a golden plaque of Donald Trump and Vladimir Putin now launched the iPhone X Tesla with a solar panel on the back. This is the second Caviar-modified Apple flagship this year after the meteorite-coated iPhone X in September.

According to the company, you just need to leave your phone laying on its face, and the back gathers sunlight to charge the device. The body also has PVD coating and shockproof plate. There is also a golden plate next to the camera setup because why not.

The company directly replaces the glass body with a titanium one. It also has 24K gold rims around the back edges and the camera bump.




iPhone X Tesla front and back

Caviar says the self-charging iPhone X is inspired “by three great scientists Nikola Tesla, Steve Jobs and Elon Musk”, although we doubt any of them would have such a questionable fashion choice for a handset.

The launch of the regular iPhone X is tomorrow, but the Tesla version release will be announced additionally. We hope you have a hat to hold on to, because the price of the modded phone with 64 GB storage is RUB259,000 or $4,445. If you want 256 GB, you have to shell out RUB274,000 or $4,700.

Source (in Russian)

Panel shares advice on navigating Maryland’s health exchange

Two days before people can begin signing up for health insurance through the state exchange, state and city health officials gathered in Baltimore Monday to offer advice for navigating the open enrollment season.

Marylanders face a shorter enrollment period this year, which comes after multiple Republican-led efforts in Congress to repeal and replace the Affordable Care Act — a central campaign promise of President Donald Trump.

At a Newsmaker Forum sponsored by The Baltimore Sun, city health commissioner Dr. Leana Wen said that while the language surrounding health care remains highly politicized, the health department’s stance remains simple.

“Our message is that it is important to have health insurance,” Wen said. “You should get health insurance now if you don’t have it. Health is everything, so take care of yourself by getting insurance now.”

Rumor: Samsung Galaxy S9’s Rear Panel To “Change A Lot”

The back panels of the Galaxy S9 lineup will “change a lot,” one known industry insider from China said earlier today, without elaborating on the matter. Samsung’s upcoming flagship duo is widely expected to adopt a dual-camera setup like the one introduced by the company with the Galaxy Note 8, though its exact implementation of such an imaging system may significantly differ from the one seen on the firm’s recently launched phablet. One major difference between the setup seen on the Galaxy Note 8 and one that may end up being featured on the rear plate of the Galaxy S9 and Galaxy S9 Plus may be the positioning of the fingerprint recognition reader; the placement of the fingerprint reader has been one of the main complaints consumers had about the Galaxy S8 lineup and while Samsung tried addressing those issues by separating the scanner and the nearest camera lens with a dual-LED flash and heart rate monitor on the Galaxy Note 8, some vocal users still weren’t happy with its position.

Consumer feedback may hence prompt the South Korean phone maker to place a fingerprint reader beneath the camera setup of the Galaxy S9 series and possibly even change its oval-like shape to a traditional circle, thus marking a significant design change that the aforementioned source claims will happen. Likewise, Samsung’s flagship devices have had their dual-LED flashes and heart rate monitors positioned above each other for years now, which is another hardware element that the Seoul-based tech giant may change for the Galaxy S9 flagships. The reasoning behind Samsung’s supposed decision remains unclear, though it’s presumably an effort to make the 2018 devices more elegant and functional as these two goals were the driving force behind most of Samsung’s recent phone design decisions, not accounting for those made due to technological limitations.

The Galaxy S9 and Galaxy S9 Plus are expected to be introduced in late winter or early spring, presumably around the time of Mobile World Congress 2018 which is starting on February 26th, though Samsung may once again hold a dedicated Unpacked event for the announcement of its latest premium smartphone tandem. Both devices should be available for purchase in most parts of the world by April and are likely to be one of the most commercially successful handsets of the year, as is usually the case with high-end Android offerings from Samsung.

iPhone LCD panel supplier LG Display says demand remains strong

LG Display, which makes IPS LCD displays for iPhones, says that demand from its clients remains strong despite a number of reports of sluggish iPhone 8 sales. The company’s chief financial officer made the comment while announcing an 80% increase in quarterly profits, just ahead of expectations …


65e63_screen-shot-2017-03-30-at-14-48-26 iPhone LCD panel supplier LG Display says demand remains strong

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Reuters reports that LG expects LCD screen shipments to ‘increase by “a mid-single digit percent” in the current quarter.’

“Mobile LCD panel sales have been supported, partly due to the release of the latest iPhone. And although large-size panel prices have been falling, LG has been able to hold its ground well on the strength of its premium products,” said Kim Yang-jae, an analyst at KTB Investment Securities.

LG also makes Apple Watch displays, though these are OLED rather than LCD.

Apple watchers will be paying close attention to Apple’s upcoming earnings report for iPhone sales numbers, with particular emphasis on the company’s guidance for the holiday quarter, which will provide a strong clue on anticipated iPhone X sales. The positive interpretation of modest iPhone 8 sales would be more people than expected holding out for the iPhone X.

All recent reports suggest that sales will be constrained by supply rather than demand, however.


Check out 9to5Mac on YouTube for more Apple news:

Panel Touts Success Integrating Primary Care, Population Health

Evan Behrle, a special adviser for opioid policy with the Baltimore City Health Department, described a program that seeks to reduce the infant mortality rate by 40 percent within eight years. B’more for Healthy Babies(www.healthybabiesbaltimore.com) places pregnant women enrolled in Medicaid into a triage system of team-based care focused on reducing premature birth, low birth weight and unsafe sleep. Nurses make visits in targeted neighborhoods using a map that highlights specific corridors of need.

When the initiative began in 2009, there were 13.5 infant deaths per 1,000 live births; by 2012, the rate had fallen to 9.7 deaths per 1,000 live births — a 28 percent drop. The disparity between white and black infant deaths decreased by nearly 40 percent during that period.

Many Baltimore residents who receive Medicaid benefits need more than health care. To address this, CMS’ Accountable Health Communities Model(innovation.cms.gov) screens patients for social needs and refers them to local help. The goal is to reduce the gap between clinical care and social services such as housing, food and transportation.

“We’re connecting people with services that already exist,” Behrle said.

Another initiative in Baltimore addresses the high opioid-related death rate. Last year, 694 people died of opioid overdose, which was more than twice the city’s homicide rate. New treatment programs address the problem by allowing patients who arrive in the ER after an overdose to begin treatment with buprenorphine right away, and peer outreach workers at several hospitals can refer patients who need counseling to community-based treatment centers.

Pointing to another problem, Behrle said that 25 percent of the 62,500 students enrolled in prekindergarten in Baltimore need glasses but do not have them. To help, Vision for Baltimore(health.baltimorecity.gov) launched in 2016. Through the program, city health officials set up mobile clinics outside schools and set up appointments for children’s eye exams. Health officials called students’ parents before and on the day of the appointment to confirm, and students who needed eyeglasses received them for free.

Maryland law requires vision screening to be provided to all students up to eighth grade, but lack of access to transportation and eye care services meant many students were not receiving the service. With Vision for Baltimore in place, the goal is to reach children in all primary and middle schools by 2019.

Vermont Initiative Boosts Primary Care Access

At the state level, panelists discussed Vermont’s Blueprint for Health initiative,(blueprintforhealth.vermont.gov) which supports the patient-centered medical home model.(blueprintforhealth.vermont.gov) Launched in 2006, the model includes 140 primary care practices — nearly all the primary care practices in the state.

Practices that participate in the program receive a monthly fee that averages $23 to $32 per patient and is calculated based on their performance ratings. Five insurers are participating, including Medicare and Medicaid.

Through the model, children in commercial plans and adult Medicaid beneficiaries reported more primary care visits, and hospital stays and imaging costs were reduced. Lower overall costs for Blueprint for Health patients offset the monthly payments made by insurers. Beth Tanzman, M.S.W., executive director for Blueprint for Health, discussed how the initiative has expanded while improving outcomes and lowering overall costs.

The program also helps address the opioid crisis in Vermont, which recorded 106 opioid-related deaths in 2016, by expanding the use of medication-assisted treatment.

“We’ve increased access to primary care,” Tanzman said. “We reduced the prevalence of chronic mobility disease. It is a good value for our investment.”

Related AAFP News Coverage
2017 PCPCC Fall Conference
States Build on Primary Care Models to Expand Access

(10/17/2017)

2016 State Legislative Conference
Speakers Tout Population Health, Primary Care Integration Success

(11/2/2016)

More From AAFP
Center for Diversity and Health Equity

WV broadband panel wants detailed reports on internet service – Charleston Gazette

A state board that oversees broadband expansion in West Virginia is asking the federal government to require internet providers to give more detailed reports about where they offer high-speed broadband service to consumers.

The data would be used to help state leaders determine where reliable internet service is needed most.

The West Virginia Broadband Enhancement Council requested the more precise broadband service reports in a recent letter to the Federal Communications Commission, saying current practices allow companies to paint a misleading and inaccurate picture of where they make broadband service available.

Now, internet firms across the U.S. must report service availability by census block, which can encompass a wide area that includes both urban and rural communities. So a company can claim it provides internet service to an entire census block, even if the firm only makes broadband available in the urban section of the census area.

The broadband council wants the FCC to require internet companies to disclose “address-level” data that would give a more accurate look at who’s getting internet service and who’s not, home by home.

“We made suggestions about getting down to the address level rather than the census-block level, which seems logical,” council Chairman Rob Hinton said at the group’s meeting Thursday. “If you report at the address level, you’ll be able to measure at the address level.”

In a letter to the FCC, Hinton noted that internet providers already have address-level data about their subscribers.

The council asserted that the census block data masks the “persistent lack of service and the growing divide” between areas with poor broadband service and those with no internet at all. Internet providers have little incentive to reveal such areas, Hinton wrote.

The address-level data will make it easier for the council to direct federal funding for broadband expansion projects in West Virginia, according to the letter.

“The [FCC], state agencies, and state attorneys general must assess competition levels and take steps to ensure adequate competition so that broadband is not available only in theory but in fact,” Hinton wrote to the FCC. “Using census-block data creates illusions of competition where none exists in areas with two or more providers that independently serve distinct areas that fall within the same census block.”

In the letter, the broadband council also asked the FCC to allow state agencies to submit their own data about internet speeds. West Virginia and other states have websites where consumers can test their internet connection’s download speed at home.

“The [FCC] can and should collect ‘on-the-ground’ data to compare provider claims to ‘actual consumer experience,’” the council’s letter states.

“We’re doing the speed testing,” Hinton said Thursday. “We think the FCC should adopt an alternative, or an addition to, in their reporting data. They should be able to accept data from a state agency, such as a broadband enhancement council, that has been validated. It’s user data.”

The FCC has not responded to the council’s letter.

Rugged, Linux-driven HMI touch panel has built-in 4G

MYIR has launched a $239, HMI touch panel with a 7-inch resistive screen that runs Linux on a TI AM335x, and offers -10 to 70°C support and a 4G LTE module.

MYIR’s Linux-based “MY-EVC5100S-HMI” touch-panel computer is designed for HMI systems in industrial control, manufacturing, vending, food and beverage, automation, and utilities applications. MYIR has already used the platform to develop a billing display application for electric vehicle charging pile stations.

MY-EVC5100S-HMI (left) and integrated in electric vehicle charging pile station
(click images to enlarge)

The MY-EVC5100S-HMI is built around the Texas Instruments Sitara AM335x SoC, which offers a single 800MHz Cortex-A8 core. It is possible the device runs on MYIR’s MCC-AM335X-Y or MCC-AM335X-J modules which build upon the same power-efficient TI SoC.

The system ships with 256MB or 512MB DDR3 RAM and 256MB to 1GB of NAND flash. A microSD slot provides storage expansion. The system’s 7-inch resistive touchscreen offers 800 x 480 resolution and 1,000-nit luminance. There’s also a Fast Ethernet port, a USB 2.0 host port, a serial debug port, and an audio jack.

Other interfaces are available from rugged Phoenix connectors, including 2x CAN, 2x RS485, and 2x RS232 interfaces, one of which is “reused with WiFi/BT.” There are also interfaces for a built-in brown-out detection circuit and optional supercapacitor battery module.

MY-EVC5100S-HMI bottom (left) and top detail views
(click images to enlarge)

The system ships with a mini-PCIe based 4G LTE module and SIM card slot that support FDD and TDD LTE, TDSCDMA, WCDMA, and GSM. Options include 802.11b/g/n and Bluetooth 4.1 BLE modules, as well as a Si4432 RF ISM transceiver module. An external antenna supports all the wireless options.

MY-EVC5100S-HMI side panel details
(click image to enlarge)

The MY-EVC5100S-HMI is further equipped with a watchdog, buzzer, and RTC. There’s a 12V power input, as well as power, reset, and boot buttons. The system is rated for an extended -10 to 70°C temperature range.

The Linux stack is based on Linux 3.14, and includes driver interfaces for various I/O and wireless devices. MYIR also provides the Qt 4.8.6 GUI with source code, as well as various demo samples.

 
Further information

The MY-EVC5100S-HMI touch panel is available now “for samples pricing” at $239 in single units. More information may be found on MYIR’s MY-EVC5100S-HMI announcement and product page.
 

FDA Panel Endorses Gene Therapy For A Form Of Childhood Blindness

fea42_spark-1_custom-af1ad614b6619563aa3d620c9cb4a2ea1d44501c-s1100-c15 FDA Panel Endorses Gene Therapy For A Form Of Childhood Blindness

A panel of experts has recommended that the Food and Drug Administration approve a treatment developed by Spark Therapeutics for a rare form of blindness.

Spark Therapeutics


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Spark Therapeutics

A panel of experts has recommended that the Food and Drug Administration approve a treatment developed by Spark Therapeutics for a rare form of blindness.

Spark Therapeutics

Gene therapy, which has had a roller-coaster history of high hopes and devastating disappointments, took an important step forward Thursday.

A Food and Drug Administration advisory committee endorsed the first gene therapy for an inherited disorder — a rare condition that causes a progressive form of blindness that usually starts in childhood.

The recommendation came in a unanimous 16-0 vote after a daylong hearing that included emotional testimonials by doctors, parents of children blinded by the disease and from children and young adults helped by the treatment.

“Before surgery, my vision was dark. It was like sunglasses over my eyes while looking through a little tunnel,” 18-year-old Misty Lovelace of Kentucky told the committee. “I can honestly say my biggest dream came true when I got my sight. I would never give it up for anything. It was truly a miracle.”

Several young people described being able to ride bicycles, play baseball, see their parents’ faces, read, write and venture out of their homes alone at night for the first time.

“I’ve been able to see things that I’ve never seen before, like stars, fireworks, and even the moon,” Christian Guardino, 17, of Long Island, N.Y., told the committee. “I will forever be grateful for receiving gene therapy.”

The FDA isn’t obligated to follow the recommendations of its advisory committees, but it usually does.

If the treatment is approved, one concern is cost. Some analysts have speculated it could cost hundreds of thousands of dollars to treat each eye, meaning the cost for each patient could approach $1 million.

Spark Therapeutics of Philadelphia, which developed the treatment, hasn’t said how much the company would charge. But the company has said it would help patients get access to the treatment.

Despite the likely steep price tag, the panel’s endorsement was welcomed by scientists working in the field.

“It’s one of the most exciting things for our field in recent memory,” says Paul Yang, an assistant professor of ophthalmology at the Oregon Health and Science University who wasn’t involved in developing or testing the treatment.

“This would be the first approved treatment of any sort for this condition and the first approved gene therapy treatment for the eye, in general,” Yang says. “So, on multiple fronts, it’s a first and ushers in a new era of gene therapy.”

Ever since scientists began to unravel the genetic causes of diseases, doctors have dreamed of treating them by fixing defective genes or giving patients new, healthy genes. But those hopes dimmed when early attempts failed and sometimes even resulted in the deaths of volunteers in early studies.

But the field may have finally reached a turning point. The FDA recently approved the first so-called gene therapy product, which uses genetically modified cells from the immune system to treat a form of leukemia. And last week, scientists reported using gene therapy to successfully treat patients suffering from cerebral adrenoleukodystrophy, or ALD, a rare, fatal brain disease portrayed in the film Lorenzo’s Oil. Researchers are also testing gene therapy for other causes of blindness and blood disorders such as sickle cell disease.

The gene therapy endorsed by the committee Thursday was developed for RPE65-mutation associated retinal dystrophy, which is caused by a defective gene that damages cells in the retina. About 6,000 people have the disease worldwide, including 1,000 to 2,000 people in the United States.

The treatment, which is called voretigene neparvovec, involves a genetically modified version of a harmless virus. The virus is modified to carry a healthy version of the gene into the retina. Doctors inject billions of modified viruses into both of a patient’s eyes.

In a study involving 29 patients, ages 4 to 44, the treatment appeared to be safe and effective. More than 90 percent of the treated patients showed at least some improvement in their vision when tested in a specially designed obstacle course. The improvement often began within days of the treatment.

“Many went from being legally blind to not being legally blind,” said Albert Maguire, a professor of ophthalmology who led the study at the University of Pennsylvania, in an interview before the hearing.

The improvement varied from patient to patient, and none of the patients regained normal vision. But some had a significant increase in their ability to see, especially at night or in dim light, which is a major problem for patients with this condition.

“What I saw in the clinic was remarkable,” Maguire told the committee. “Most patients became sure of themselves and pushed aside their guides. Rarely did I see a cane after treatment.”

That was the case of Allison Corona, who’s now 25 and lives in Glen Head, N.Y. She underwent the treatment five years ago as part of the study.

“My light perception has improved tremendously,” Corona said during an interview before the hearing. “It’s been life-changing. I am able to see so much better. I am so much more independent than what I was. It is so much better.”

The patients have been followed for more than three years, and the effects appear to be lasting. “We have yet to see deterioration,” Maguire says. “So far the improvement is sustained.”

The injections themselves did cause complications in a few patients, such as a serious infection that resulted in permanent damage, and a dangerous increase in pressure in the eye. But there were no adverse reactions or any signs of problems associated with the gene therapy itself, the researchers reported.

While this disease is rare, the same approach could work for similar forms of genetic eye disease, Maguire says.”There are a lot of retinal diseases like this, and if you added them together it’s a big thing because they are all incurable.”

If approved, the treatment would be marketed under the name Luxturna.

Senate panel OK’s bipartisan children’s health plan

WASHINGTON – The race is on in Congress to extend federal health care funding for nine million children before states run out of money for the program over the next few months.

Democrats say the effort could eventually be delayed by partisan politics.

A Senate committee Wednesday overwhelmingly approved a bipartisan funding measure for the Children’s Health Insurance Program (CHIP), in contrast with a House committee version expected to be endorsed on a majority Republican-only vote.

Democrats said Republicans complicated the prospects of the funding extension passing into law by tying the House version to a Medicare premium increase and cuts to an Affordable Care Act prevention program.

“The opportunity existed for a bipartisan compromise,” said New Jersey Congressman Frank Pallone, ranking Democrat on the House Energy and Commerce committee.

But linking continued funding for CHIP to controversial changes, he said, would make the proposal “contentious” and lead to “more delay and possibly no action until the end of the year.”

If the debate drags on that long, states and some low-income children could be in trouble.

Health officials in states are concerned about losing federal funds, which pay for most of the medical coverage after Congress missed a deadline to renew funding last Saturday.

That left the program without funding for the upcoming year, raising fears among healthcare advocates that some states may have to cut back coverage for children and health services to pregnant women, who are also covered by the program.

Most states have said they have enough leftover funding to carry them through early next year.

But some say they will run out of money sooner, and others ae beginning to figure out what they’ll do.

Oklahoma officials said that if funding is still uncertain at the beginning of the year, it would have to begin getting ready to eliminate pregnancy coverage for some women by April.

Minnesota officials warned that state would run out of money for the program by the end of September, making it one of four that would be tapped out by the end of the year.

It won a reprieve Monday when it received $3.6 million in emergency funding to carry on through October. A state health spokeswoman said it’s unclear what would happen if funding is still up in the air after that date.

The state is one of nine that would be required by the Affordable Care Act to find its own money to continue providing insurance to the children. The state, the spokeswoman said, could cut prenatal and postnatal care to some women.

How low-income children are covered varies from state to state, depending the structure of their CHIP programs, said Samantha Artiga, a Medicaid expert at the Kaiser Family Foundation.

Ohio is also required to find its money to continue insuring the children even if federal funds dry up because it provides coverage through Medicaid. But children in Georgia, Texas, Pennsylvania, Alabama and nine other states could lose coverage eventually as they set up state programs separate from Medicaid.

Massachusetts, Kentucky, Indiana, Oklahoma, and 27 other states structured CHIP as a combination program, allowing them to eliminate some recipients. But they would be required to continue insuring the remaining individuals, said Jesse Cross-Call, senior policy analyst for the Center on Budget and Policy Priorities.

When the potential funding crisis impacts states also varies, depending on how much they have left over from the past year.

Some states could run out of funding this year. Twenty-seven others face a possible dilemma between January and April of next year, according to the federal Medicaid and CHIP Payment and Access Commission. They include Kentucky, Massachusetts, Missouri, Ohio and Pennsylvania, Texas, Oklahoma and West Virginia.

Another 19 states, including Michigan and Indiana, are expected to have enough money until later in 2018.

The bipartisan Senate funding bill was negotiated in the Senate Finance Committee by Republican chairman Orrin Hatch of Utah and the panel’s top Democrat, Ron Wyden of Oregon. It would fund the program for five years, with the amount declining after the first two years.

Hatch, who worked with the late Sen. Edward Kennedy, D-Mass., to create the CHIP program in 1997, called it a “prime example of what government can accomplish when it works together.”

In the House, Republicans proposed the identical funding plan, but financed it by requiring wealthy seniors to begin paying Medicare premiums, a move opposed by AARP as well as Democrats.

The proposal would also disallow lottery winners from getting Medicaid, cut funding for community clinics, and shortened the grace period for people who don’t pay their Affordable Care Act premiums from 90 to 30 days.

Congressman Joe Barton, R-Tex., said it is “reasonable to find cuts to offset funding for the CHIP program.”

Panel of Billings mental health experts, law enforcement, children services weigh budget cuts

BILLINGS — Experts in Yellowstone County’s mental health sector issued a warning at a Tuesday night public forum: Proposed budget cuts within the Montana Department of Health and Human Services will threaten public safety.

Representatives from law enforcement, mental health agencies, local hospitals, senior services and children’s health programs met at the United Way in Billings to discuss the impacts of the budget cuts and potential solutions.

DPHHS submitted its proposed cuts to the governor’s office last week.

While the impacts on each state agency are different, they all agreed that the common result is a decline in public safety.

“These cuts will be felt in different ways but they all result in the reduction or elimination of services for those most in need and will have ripple effects throughout the community,” said Barbara Schneeman, vice president of RiverStone Health.

Schneeman said the cuts would have a direct fiscal impact of over $2 million and would impact more than 8,300 patients.

The cuts would eliminate the Kids First program in Yellowstone County, reduce operational support for communicable disease support, reduce vaccines for uninsured or under-insured adults, eliminate the Medicaid Passport to Health program, eliminate target case management for children and youth with special health care needs, eliminate the Medicaid health improvement program and Medicaid hospice services, according to Schneeman.

Representatives for Billings Clinic and St. Vincent Healthcare also prophesied a ripple effect.

“Billings Clinic in partnership with many agencies in Yellowstone County has created a network of safety to keep people in their communities, and losing some of this funding will be more of a burden and potentially put people out on the streets,” said Dr. Michael Temporal, family physician and director of population health for Billings Clinic.

Barbara Mettler, the executive director of South Central Montana Regional Mental Health Center, said her organization is already experiencing cuts and can’t withstand much more loss.

“Unlike some folks, we’ve already shut down our targeted case management team,” said Mettler. “When we closed the program we had approximately 230 people we were providing services to. So it’s not lack of need, it’s a lack of available resources.”

Yellowstone County is one of 11 counties in the 25,000 square miles served by the Mental Health Center.

According to Mettler, 60 percent of the center’s budget is Medicaid reimbursements.

Over the past eight years, the number of employees at the center has decreased from 165 to 160 employees.

“My biggest concern, biggest fear, is that if this continues, at some point we’ll have to close our doors and turn out 2,500 people on the streets with no mental health services,” said Mettler.

Billings Police Chief Rich St. John said that leaving mentally ill patients without treatment or consistent counseling is a recipe for disaster.

“We’re going to have to deal with all the people that have co-occurring addiction and mental health issues,” said St. John. “I tell people over and over again that we are law enforcement officers, we fight crime and evil. We are not social workers, but we routinely get pushed into social work.”

Jan Beggar, the chief operating officer of Alternatives Inc., agreed with St. John.

“Our biggest concern is public safety,” said Beggar. “(If these cuts are made) we’re letting clients who should be in treatment programs, incarcerated, into the community, but with no services at the mental health center, no room at the county jails.”

Beggar said there are 400 clients in jails across Montana awaiting placement in a program already and noted that any cuts would lead to swelling jail populations.

There are 1,600 people in programs through Alternatives Inc., according to Beggar.

Amy Fladmo, the director of Center for Children and Families, said her program’s Second Chance Homes for drug and alcohol-addicted mothers is at risk.

“The average length of time a child is in foster care is three and a half years,” said Fladmo. “With Second Chance homes we can narrow that down to approximately six to 12 months, which is a cost savings of $16,000 per child.”

Fladmo said the CCF’s child forensic interviewing program would also lose funding, which could harm the conviction rate of child sex offenders.

Children with mental and physical disabilities could lose programs through the Yellowstone Boys and Girls Ranch and Early Childhood Intervention.

CEO Mike Chavers said the 300 youth and families currently served at the ranch could lose their programming.

Additionally, about 35 positions at the Ranch would be eliminated through $1.2 million in salary reductions.

“Today in Montana, we have the highest number of kids sent out of state that we’ve ever had,” said Chavers. “If it’s $350 each day for us, it’s one and a half times for kids out of state.”

ECI Executive Director David Munson said the cuts are essentially setting the state up for larger costs down the road.

“Pay pennies now or many dollars later,” said Munson. “It’s about $7,900 per child per year in special education. If we can reduce those costs in our city, our district… they don’t need service later on.”

Munson noted that Montana would be the only state without ECI if the program were defunded.

“If you have a child or grandchild with a disability, you’d have to say ‘I need to move to Idaho or North Dakota or South Dakota or Wyoming or Guam or Puerto Rico so my child can get services,’” said Munson. “It’s mind-numbing that that is even on the block.”

The elderly citizens in Yellowstone County are also faced with cuts to programming through St. John’s and Big Sky Senior Services.

“We have a certain segment of our population that for any number of reasons runs out of resources while they’re with us and we have those who come to our doors without any at all,” said the Rev. Tom Schlotterback, vice president of Mission Advancement. “Historically, for 53 years, we’ve opened the gate and said you are welcome here. We will never close our doors, but we might have to start closing the gate for some of these people.”

Schlotterback said St. John’s absorbed $700,000 in losses in 2006. A decade later, St. John’s took a loss of $2.1 million.

“That gap will continue to increase unless funds increase and at least keep somewhat at pace,” said Schlotterback.

Denise Armstrong, the director of Big Sky Senior Services, said  many seniors need assistance.

“Our seniors, the ones we serve, are living at the poverty level,” said Armstrong. “We help them manage their money through a payee program because many of them have been exploited by their family members. There’s a lot of people 80 plus years old with no family members, no one in their lives and they need help.”

According to Armstrong, proposed cuts would result in a decrease of 700 employee work hours, 1,350 fewer meals served to seniors at meal sites, 674 fewer meals delivered to seniors, and 213 fewer rides for seniors to visit a doctor and the grocery.

The panel discussed a number of possible solutions, including a tobacco tax, local option tax and decreasing Montana’s reserve fund.

Montana law requires the ending fund balance to contain at least $143 million, but one proposed solution was to see if legislators could decrease the minimum and use some funds to make up for budget shortfalls.

Other solutions considered were increasing taxes on the wealthy and implementing program participating fees.

The proposed cuts were sent to Gov. Steve Bullock’s desk last week for review.

Suffolk panel balks at requiring appointees to pay for health care

A Suffolk legislative committee on Wednesday rejected a proposal to require all nonunion employees to pay a portion of their health insurance, as public employee union members warned the county against imposing a similar requirement on them.

Hundreds of Suffolk County Association of Municipal Employees, many wearing red shirts with the words “Standing Strong,” spilled out of the meeting room in Hauppauge.

The bill defeated by the Government Operations Committee would have saved the county $850,000 a year by requiring 323 nonunion workers, including political appointees and prosecutors, to pay 15 percent of health care costs starting Jan. 1. That would cost employees $1,500 a year for an individual plan or $3,154 for a family plan, county officials said.

While it wouldn’t affect union employees, union president Daniel Levler said, “If this is what will be asked of the unions, we will be vocally opposed.”

To cheers from the crowd, the committee voted to remove the bill from regular consideration, although some lawmakers said it would return if the county reaches an agreement with unions to pay for health care.

The Suffolk Legislature has rejected a number of County Executive Steve Bellone’s proposals to balance the budget. Earlier this year, a bill to stop automatic pay raises for nonunion employees failed to pass, and lawmakers failed repeated attempts to double a $55 fee on traffic tickets.

Deputy County Executive Jon Kaiman said last month that requiring nonunion “exempt” employees to pay was intended to “send a message” to other unions negotiating with Bellone’s administration.

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Bellone’s proposed budget released earlier this month estimates $30 million in savings in 2018 from union concessions.

“Our employees do a great job, but health care costs are out of control and taxpayers cannot be forced to bear that burden alone,” Bellone said in a statement Wednesday.

All union and nonunion employees hired after 2012 currently pay 15 percent of their health insurance costs.

More than a dozen AME employees and nonunion workers spoke against requiring them to pay into health care, with many saying they had taken lower-paid positions compared to the private sector in order to qualify for the benefits.

The workers proposed other ways to cuts costs or increase revenue, including reducing the number of take-home county cars, reducing outside contracting for services that can be done in-house, and increasing sales or property taxes.