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As Medicare and Medicaid Turn 50, Use of Private Health Plans Surges

Medicare -- New York Times - Thu, 07/30/2015 - 12:00am
Enrollment in private insurance plans has soared as the government has tried control costs and improve care for Medicare and Medicaid beneficiaries.
Categories: Elder, Medicare

An Interview with Antoine McDonald, Public Services Intern

In Custodia Legis - Wed, 07/29/2015 - 1:16pm

Today’s interview is with Antoine McDonald, a summer intern working in the Public Services Division of the Law Library of Congress.

Photo by Donna Sokol

Describe your background.

I was born and raised in Rochester, New York where I graduated high school in 2010. I then attended The Lincoln University in Oxford, Pennsylvania, the nation’s first degree-granting Historically Black College or University (HBCU), where I received a Bachelors of Science in Mass Communications. During my time on Lincoln’s campus, I was a public relations intern for the university, news anchor for Lion Media News, member of the Forensic Society debate team and treasurer and member of the Omega Psi Phi Fraternity Incorporated BETA chapter. I currently attend North Carolina Central University’s School of Library and Information Sciences and work as a graduate assistant. Upon graduation in 2016 with a Master’s in Law Librarianship, I plan to attend law school and pursue a career that encompasses law and library science.

How would you describe your job to other people?

If I had to describe my job, I would sum it up as challenging and rewarding. I say that because upon entering this position there were many concepts that were new to me, but as a library and information science student, I naturally worked hard to research any unfamiliar topics in order to obtain the information needed to successfully complete my assignments. That hard work and dedication always pays off the moment you can accurately apply what you’ve learned.

Why did you want to work at the Law Library of Congress?

Since I will be graduating soon, I strongly felt that interning at the Law Library of Congress would provide me a platform to demonstrate what I’ve learned thus far as a student and enable me to develop as an aspiring law librarian.

What is the most interesting fact you’ve learned about the Law Library?

One of the most interesting things that I’ve learned during this experience was the process involved in acquiring new materials for the library’s collection, as well as some unusual ways in which the Law Library has been able to make use of its collection of legal resources. Kurt Carroll, chief of the Collection Services Division at the Law Library, shared one of his more memorable experiences that stuck with me, which was the time his division helped the government of Haiti reproduce digital copies of portions of its legal collection that had been lost when the 2010 earthquake in Haiti destroyed its national library.

What’s something most of your co-workers do not know about you?

I was fortunate enough to study abroad in Burgos, Spain for two months during my junior year of undergraduate school, which has been one of my most memorable and impactful experiences in my life thus far. Although our dorms and classes were located in Burgos where we spent much of our time, we also visited places like Madrid, Bilbao, and the Guggenheim Museum and even witnessed a bull fight in a classical arena.

Categories: Research & Litigation

‘I Don’t See Any Stigma': Father Fights Suicide In Black Community After Son’s Death

CommonHealth (WBUR) - Wed, 07/29/2015 - 1:09pm

Joseph Feaster Jr. with a portrait of his son Joseph Feaster III. (Jesse Costa/WBUR)

Joseph Feaster Jr. is not a minister. He’s a successful Boston attorney. But for the last five years he’s been doing a lot of preaching about a subject close to his heart.

“My ministry right now, because it’s even more personal — it involves my son — is around mental health,” Feaster says. “And if I can help the next person to understand it, to get through it, that’s my being.”

His son carried his name and was thereby Joseph Feaster III. He died by suicide in 2010, at the age of 27.

His death came at a triple-decker on Elmore Street in Roxbury, not far from Dudley Square. That’s where he had lived most of his life — first with his parents and sister, and then renting an apartment from his father.

His father recalls lots of times going with Joseph to Horatio Harris Park, less than a block from the family’s home. The elder Feaster doesn’t remember any signs of mental illness in his son as a child.

“No, not at all. I mean, he was a happy kid,” Feaster recalls. “He played here. He climbed the structures here. He would be with his sister and her friends. And he had a great smile.”

Joseph’s older sister nicknamed him “Smiley.”

He played Little League baseball and then football in middle and high school in Newton, where he attended school through the METCO program. He got good grades and received awards for his academics and conduct, his father says.

Joseph with his sister, Aalana, in 2004. (Courtesy)

‘There’s Nothing Wrong With Me': Denial Hampers Treatment

The first sign of any mental health issues was after Joseph returned from freshman year at the University of Pittsburgh in 2002. He had some type of psychotic break in which he was rambling incoherently and saying he was seeing and hearing things. Then he lunged at his father.

“His eyes were — it was like he had seen a ghost. So I left the apartment. I mean, I’m in tears at this particular point in time,” Feaster says. “But I had the wherewithal and the knowledge to know that there was this process, Section 12.”

Feaster wants to make sure other families know about and use Section 12. It’s the state law that authorizes involuntary hospitalization of someone who poses a risk of serious harm to himself or others because of mental illness.

Feaster went to Boston Police, and they sent a special operations unit to Joseph’s apartment. After breaking down the door and using bean bags to stun Joseph, officers removed him safely.

He spent a short time in two hospitals and then started in an outpatient bipolar disorder program. But he wanted nothing to do with the medication and therapy advised by doctors, according to his father.

“There’s denial. ‘I don’t have anything. There’s nothing wrong with me.’ The medicine changes [them],” Feaster says. “When you’re in manic state, you can rule the world. Why would you want to take something that’s going to bring you down?”

For the next seven years, his father says, Joseph showed no obvious signs of mental illness. He obtained a degree in political science from UMass Boston, while making a living selling DVDs and CDs online.

A studio photo of Joseph, 15 or 16, with his father. (Courtesy)

Then he got accepted to a new technological entrepreneurship master’s degree program at Northeastern University. But during his first year he had another psychotic break. Police were again called to his Roxbury apartment, and this time he reacted in an extreme way.

“He jumped out of the third-floor window carrying a samurai sword, took off… and as a result of that, he’s surrounded by all these police officers, guns drawn, [him] carrying this sword,” Feaster recounts. “And apparently a sergeant tackled him, and that’s what probably saved his life.”

Feaster knows things could have ended much differently.

Joseph was hospitalized for a week or two, and his father says this was the first and one of very few times Joseph acknowledged he might have bipolar disorder. He told the doctors he would take his medicine, and he was sent home. But again, he didn’t follow the treatment.

Joseph’s next mental health break came more quickly, just seven months later. This time he took his own life.

Rising Concern About Suicide Among African-Americans

[Watch on YouTube]

“I don’t see any stigma from my son having had an illness,” says Joseph Feaster, Jr. “People will talk about, ‘Oh, so-and-so has breast cancer, so-and-so has lung cancer.’ But if you say, ‘Oh, wow, they had schizophrenia,’ you don’t hear folks talking about it. Well, my sense is [mental illness is] the silent disease in the African-American community.”

There are several diseases referred to as “silent” epidemics among African-Americans. But Feaster says the community has largely avoided discussion of mental illness and suicide for specific reasons.

“It was long-held in the black community that that’s not something that we — we’re not going to kill ourselves, because of the religious belief, but also just, we just don’t do that. That’s a white person’s illness. Well lo and behold, that turns out to be not true,” Feaster explains.

Boston NAACP President Michael Curry, who’s a friend of Feaster’s, agrees.

“There’s always warning signs that something’s getting worse,” Curry says. “And the warning signs have been there in communities of color.”

Curry says mental illness and suicide have taken a back seat to other issues of concern in the black community, like poverty, racism, and criminal justice. And those have taken a toll on mental health.

He’s hearing from clinicians in Boston’s African-American community that suicide is on the rise, even if it’s not yet reflected in confirmed suicide statistics.

National data show the suicide rate for African-Americans has stayed fairly steady and significantly lower than for white Americans, though a recent study shows a suicide increase among black children.

But Curry says in assessing the risk of suicide in Boston’s African-American community, he includes behavior such as so-called “suicide by cop” and drug abuse that leads to death. And no matter the method, he says, all of it demands action.

“What I have to remind people often is it’s all of our responsibility. If a kid commits suicide in Roxbury or is the victim of a drive-by [shooting] in Roxbury, it should rock you to the core if you live in Wellington,” Curry reflects “You’ve got to get off your butt, and you’ve got to figure out what your role is to be next to Joe [Feaster], to figure out how to save lives.”

At Peace, Spreading A Message

Before Joe Feaster Jr. became an activist on the subject of suicide, he struggled not only with losing his son, Joseph III, but with concern about his son’s soul.

‘Suicide: A Crisis In The Shadows’ Full Series: Suicide: A Crisis In The Shadows

“But my pastor said [Joseph] could still go to heaven notwithstanding, because of the illness, and I believe that’s where he is,” Feaster says.

With that sense of peace, Feaster, who now lives in Stoughton, started a support group of sorts at his church, Morning Star Baptist Church in Mattapan. About 30 people came to the initial meetings to talk about mental illness and suicide.

“When I started sharing about it, people started to share,” Feaster recalls. “And I remember one person said, ‘You know, I thought my son was just being lazy, that he wouldn’t get up, he wouldn’t go to school, he wouldn’t do etcetera.’ Well, [that person] never recognized that he was suffering from depression.”

Attendance eventually dropped off, so Feaster has redirected his focus to working with organizations including the National Alliance on Mental Illness of Massachusetts.

And through it all, he says he often refers to his son in the present tense. He believes Joseph still lives in loved ones left behind, and through their fight for more awareness of mental health issues and suicide.

Resources: You can reach the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) and the Samaritans Statewide Hotline at 1-877-870-HOPE (4673)

Categories: Health Care

Islamic Law: A Bibliography of Works Published in English, 2009-2014

Law Library of Congress: Research Reports - Wed, 07/29/2015 - 10:00am
The Law Library of Congress is proud to present a new report, Islamic Law: A Bibliography of Works Published in English, 2009-2014.

This bibliography contains English-language books and articles within books that discuss Islamic law. The titles were published in the years 2009-2014 and are held in the Library of Congress. The listing is divided into three sections: works on the history of Islamic law, general works on contemporary law, and works devoted to contemporary law on a specific topic, including alternative dispute resolution, banking and finance, citizenship, commercial law, constitutions, construction, criminal law, family law, food, health, human rights, international law and national security, organizations, privacy, and women's rights.

Visit http://www.loc.gov/law/help/islamic-law-bibliography/2009-2014.php to read the entire report and http://loc.gov/law/help/islamic-law-bibliography/2003-2008.php to read a previous version (works published from 2003-2008).

This report is one of many prepared by the Law Library of Congress available at http://loc.gov/law/help/legal-reports.php and one of the new reports highlighted at http://www.loc.gov/law/help/current-topics.php. The Law Library of Congress produces reports for members of Congress and others. Learn more at http://blogs.loc.gov/law/2013/05/law-library-provides-global-legal-research/.
Categories: Research & Litigation

China: Real Property Law

Law Library of Congress: Research Reports - Wed, 07/29/2015 - 10:00am
The Law Library of Congress is proud to present a new legal research report, China: Real Property Law.

Individuals cannot privately own land in China but may obtain transferrable land-use rights for a number of years for a fee. Currently, the maximum term for urban land-use rights granted for residential purposes is 70 years. In addition, individuals can privately own residential houses and apartments on the land ("home ownership"), although not the land on which the buildings are situated. Both urban land-use rights and home ownership are subject to registration.

Visit http://www.loc.gov/law/help/real-property-law/china.php to read the entire report.

This report is one of many prepared by the Law Library of Congress available at http://www.loc.gov/law/help/current-topics.php. The Law Library of Congress produces reports for members of Congress and others. Learn more at http://blogs.loc.gov/law/2013/05/law-library-provides-global-legal-research/.
Categories: Research & Litigation

Right to Peaceful Assembly

Law Library of Congress: Research Reports - Wed, 07/29/2015 - 10:00am
The Law Library of Congress is proud to present a new report, Right to Peaceful Assembly.

Freedom of peaceful assembly is a recognized right under international human rights law. This report provides a comparative review of one aspect of this right: whether advance notification or authorization is required for an assembly to take place under the law of France, Italy, Portugal, Spain, Sweden, the United Kingdom, and the United States. The report also reviews the relevant case law of the European Court of Human Rights.

Visit http://www.loc.gov/law/help/peaceful-assembly/index.php to read the entire report.

This report is one of many prepared by the Law Library of Congress available at http://www.loc.gov/law/help/current-topics.php.
Categories: Research & Litigation

Congress Overwhelmingly Approves Bill Bolstering Medicare Patients’ Hospital Rights

Kaiser Health News - Wed, 07/29/2015 - 9:34am

The U.S. Senate unanimously approved legislation Monday night requiring hospitals across the nation to tell Medicare patients when they receive observation care but have not been admitted to the hospital. It’s a distinction that’s easy to miss until patients are hit with big medical bills after a short stay.

The vote follows overwhelming approval in the U. S. House of Representatives in March. The legislation is expected to be signed into law by President Barack Obama, said its House sponsor, Texas Democratic Rep. Lloyd Doggett.

It’s called the NOTICE Act, short for “Notice of Observation Treatment and Implication for Care Eligibility.” The law would require hospitals to provide written notification to patients 24 hours after receiving observation care, explaining that they have not been admitted to the hospital, the reasons why, and the potential financial implications.

Those implications can be dire. Observation care hurts seniors in two ways: It keeps Medicare’s more comprehensive hospitalization coverage from kicking in, and it means they may not get Medicare’s limited nursing home benefit if they need care in a facility after being in a hospital.

To qualify for Medicare’s nursing home coverage, beneficiaries must first spend three consecutive midnights as an admitted patient in a hospital, and observation days don’t count.

Without that coverage, seniors could pay thousands of dollars for the nursing home care their doctor ordered, or else try to recover on their own. Observation care is a classification used when patients are not well enough to go home but not sick enough to be admitted.

Use Our Content This KHN story can be republished for free (details).

And because observation care is provided on an outpatient basis, observation patients usually also have co-payments for doctors’ fees and each hospital service, and they have to pay whatever the hospital charges for any routine drugs the hospital provides that they take at home for chronic conditions such as diabetes or high cholesterol.

A handful of states already require observation care notices, including New York, Connecticut, Maryland, Pennsylvania and Virginia, said Doggett. But Medicare officials have been reluctant to take similar steps.

Hospitals will have to comply with the NOTICE Act 12 months after it becomes law.

A Medicare official declined to answer questions about the NOTICE Act because he said the agency does not comment on pending legislation. However, he said an online brochure from Medicare describing observation care advises patients to talk to their physicians or other health staff if they have questions about whether they have been admitted.

Just two months ago, Sean Cavanaugh, a deputy administrator at the Centers for Medicare & Medicaid Services, fielded a barrage of questions on the issue from members of the Senate Special Committee on Aging.

“There is an assumption if [patients] are being wheeled into a hospital bed,” and they are getting treatment, then they have been admitted, Sen. Claire McCaskill, a Missouri Democrat, told Cavanaugh. When Sen. Susan Collins, a Maine Republican, repeated McCaskill’s question asking if CMS would require notification, he said the federal government has been “pushing very hard” to encourage hospitals to educate patients about observation care. But he said it wasn’t clear that the agency could require hospitals to do more to inform patients.

“A new legislative requirement was the most direct way to address the problem,” Doggett said.

Meanwhile, the number of claims hospitals submitted for observation care continues to skyrocket. According to the most recently available data from CMS, total claims increased 91 percent since 2006, to 1.9 million in 2013. Long observation stays, lasting 48 hours or more, rose by 450 percent to 170,219 during the same period, according to a Kaiser Health News analysis.

In 2013, Medicare officials attempted to control the use of observation care by issuing the so-called “two-midnight rule,” which would require hospitals to admit patients who doctors expect to stay at least two midnights. But Congress delayed its enforcement after hospitals said the rule was confusing and arbitrary.

Although it’s better for patients to know when they are on observation status, Toby Edelman, a senior policy attorney at the Center for Medicare Advocacy, said they may not be able to do much about it. She said there is no set process for challenging observation care while in the hospital, unlike issues such as disputing a discharge order when admitted patients feel they are not ready to leave.

The only way to switch from observation to admitted status is to persuade a physician or the hospital to make the change, said Edelman. And that decision doesn’t apply to the time the patient has already spent on observation.

Challenging observation care after leaving the hospital can be frustrating since Medicare appeals judges may decide that a patient’s condition did not require inpatient-level care — even though they received care that could have been provided  nowhere else but a hospital.

Some hospital officials are worried that once patients find out that they are receiving observation care and have not been admitted, they may panic.

Marna Borgstrom, CEO and president of Yale-New Haven Hospital in Connecticut, told the Senate Special Committee on Aging last year she detected a small but alarming trend: When patients learned they were receiving observation care, they left the hospital against medical advice.

“I’m confident it would be an even greater number if more patients knew about the potential burden of being deemed an outpatient,” Borgstrom said.

This article was produced by Kaiser Health News with support from The SCAN Foundation.

Categories: Health Care

New Features Added to Congress.gov Based On Your Feedback

In Custodia Legis - Wed, 07/29/2015 - 8:45am

Since the unveiling of Congress.gov in September of 2012, we have been constantly adding new features with each release, and many of the features in this release are based directly on your feedback.

Accessibility
We want to make Congress.gov more accessible, and our new feature, “Listen,” helps us deliver on this goal. Listen appears on bill summary pages and will read the text of the bill summary aloud to you. If you would like to focus on certain text, you can highlight it and Listen will read the highlighted text to you. You can also download an audio file of the bill summary to listen to it on the go.

Listen on Congress.gov

Enhanced Email Alerts
We released legislative email alerts in February 2015, and you provided us with some great feedback on this feature. You let us know that you when you receive an email alert concerning a bill, you need the title of the bill to appear in the alert. We appreciate your feedback and have added bill titles to legislative email alerts.

More Appropriation Tables With Enhanced Content
When we released Congress.gov in 2012, you let us know that you wanted more content included in the appropriation tables to simplify the process of tracking appropriations. We listened, and delivered new appropriation tables with enhanced content, starting with a table for the most recent fiscal year, 2016. We continue to work our way back, and now have appropriation tables with enhanced content going back to 2005.

Congress.gov Appropriations Table

Search Within Committee and Member Pages
In the past, you could only refine your results on member profile and committee pages using the facets menu. With the new release, you can use the powerful “Search Within” results feature on committee and member pages to quickly locate the legislation and reports you need.

Search Within Results on a Member Profile Page

Explore the Complete List of Enhancements
We hope you enjoy the new release! You can explore the complete list of enhancements included in this release below.

July 2015

Enhancements – User Experience:

  • Facets
    • Political party and Congressional Record section facets allow the user to multi-select
  • Search
    • Users may use next/previous arrows to navigate through search results
    • Citation pattern matching has been adjusted
    • Middle name and nickname are now supported in cosponsor/sponsor fields
  • Advanced Search
    • It is now possible to edit the URL with a parameter that will keep the search form open
    • A preset date query is now supported, e.g., “yesterday”
  • Detail / Profile pages
    • Search within results is available on member and committee profile pages
  • Help/About pages
    • The committee field value list has been adjusted
    • The bioguide field value list has been adjusted
  • Listen
    • Listen will read aloud the text of the bill summary page
    • The user can also highlight portions of the text to be read by Listen

Enhancements – Accounts / Alerts / Saved Searches:

  • The following changes were based on user feedback:
    • The bill title has been added to bill and member alerts
    • Members alerts are triggered by amendment cosponsorship/sponsorship

Enhancements – Browse:

  • Adjustments have been made to the treatment of private laws
  • Sort has been added to the recently received text browse report

Enhancement – Appropriation Tables:

  • Added tables for prior years in the new appropriations table format that debuted in March 2015

 

Let Us Hear From You
Please keep providing us with your great feedback so we can make Congress.gov even better for you.

 

Categories: Research & Litigation

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