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Things that are going on that you might want to know. 

 

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How Many More Disabled People Must Be Injured in Nursing Homes? Information
Bulletin #206 (4/07).
 
The Government Accounting Office in March 2007 issued another devastating
indictment regarding the lack of federal enforcement against those nursing
homes which have "serious quality problems" and cause injury and abuse to
nursing home residents.
 
The GAO found that nearly half of the surveyed "homes with prior serious
quality problems, continued to cycle in and out of compliance during
fiscal years 2000 through 2005, causing harm to residents.  These homes
corrected deficiencies only temporarily and ... were again found to be out
of compliance."  Nearly 43% of the homes were "cited 69 times for
deficiencies that warranted immediate sanctions, but [56%] of these cases
did not result in immediate sanctions."  What a yo-yo!
 
How many nursing home residents disabilities, regardless of their age,
must suffer actual harm or be placed in "immediate jeopardy" by the
nursing home, have untreated or preventable pressure ulcers, be illegally
restrained, be abused, receive substandard quality of care, or die, BEFORE
the federal government and state government stop these nursing homes?
Why doesn't the federal government STOP funding the states and the nursing
homes that permit these abuses to continue without sanctions?  After all,
it's mostly state health departments that are supposed to monitor nursing
homes.  The state health departments know or are supposed to know which
nursing homes have "serious quality problems"  and especially those with
repeated "problems."
 
Why is the federal government continuing to spend $46 Billion a year of
Medical Assistance on any nursing home that injures persons with
disabilities?  Why are federal funds, which amount to 69% of the nursing
home industry's revenues, not ended where there is any repeated abuse or
neglect.  Why even wait until it is life- threatening?
 
These injuries are endemic to institutions that warehouse poor disabled
persons and this has been widely known for a long time?  Since 1998, the
GAO itself has issued 15 reports identifying weaknesses in federal and
state enforcement processes!  We do not need anymore reports or studies;
we need federal and state officials to end this abuse, neglect and death.
 
CMS surveyed the effectiveness of its three most widely imposed sanctions.
The findings are distressing.
 
    First, CMS and the states terminated nursing homes, i.e., closed the
nursing home involuntarily, in less than one percent of the homes.  No
need for the nursing home owners to be worried about that "sanction."
 
    Second, "civil monetary penalties" were only $350 to $500 a day, well
below even the paltry $3,000 maximum per day. And let's not forget that
CMS and your States pay Medical Assistance per day for these residents
while they are being injured. These nursing homes receive MA payments
every day while they are abusing and injuring residents.  From a monetary
calculation, it probably "pays" for the nursing home to take the civil
monetary penalty while continuing to receive the MA per diem
reimbursements.
 
    The third sanction is "denial of payment for NEW admissions."
Whoopie!  But for all those people already in the institution, the Medical
Assistance funds keep on flowing and nursing homes continue to pocket
their profits.
 
CMS claims its enforcement is "hampered by the overall complexity of its
immediate sanction policy."  One reason may be because CMS' sanction are
only "intended to DETER repeated noncompliance." Those institutions with
the"worst compliance histories ... escape immediate sanctions."  Why
aren't the sanctions intended to end the operations of a nursing home that
has repeated violations?
 
The GAO's "recommendations" were incredibly weak.  It took a little while
to surmise why GAO did not have the courage to really take on these
nursing homes. Then we reread the GAO letter to Senator Grassley who
requested the study.  In the first sentence, GAO states that the "nation's
1.5 million nursing home residents are a highly vulnerable population of
elderly and disabled individuals for whom REMAINING AT THOME IS NO LONGER
FEASIBLE."
 
Once you make that assumption, then it follows that you believe that we
must have these institutions.  But what if a large percentage of the
current residents could, with appropriate (and less expensive than nursing
homes) home and community-based services, stay at home or return to home?
Then you do not need nursing homes that abuse and injure people. That
assumption also underlies the CMS goal of only "deterrence," instead of
closing down repeated violators.
 
A few questions for advocates:
 
Have disability and older American advocates examined what your state
Health Department's enforcement process is?  How many nursing homes in
your state have been cited for "serious quality problems?" Has advocacy
has occurred to force your state's to decertify nursing homes that
repeatedly injure and abuse residents?  What about advocates inspecting
the nursing homes?
 
    Steve Gold, The Disability Odyssey continues
 

 

136

 

Concrete Plan to Speed Up Buses in Traffic

Article Tools Sponsored By
 
Published: April 27, 2007

It is springtime in New York and everywhere bulbs are blooming. Daffodils. Crocuses. Bus bulbs.

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Cary Conover for The New York Times

A bus stop called a bus bulb at Broadway and Spring Street is one of several being built for faster loading and unloading of passengers.

Bus bulbs?

In a program intended to help buses move more speedily down the traffic-and-construction-clogged streets of lower Broadway, the city is building a series of extensions to the sidewalk that should make it easier for buses to load and unload. In the taxonomy of traffic engineers, these extensions are known as bus bulbs.

Although the Broadway bulbs are rectangular, not bulbous, the term actually comes from the fact that in other parts of the world where bus bulbs have been used, like London, they tend to be rounded extensions near a corner.

The Broadway bulbs are concrete islands set just off the sidewalk. They are about 130 feet long and 9 feet wide.

The first bulb on Broadway was finished earlier this month at Spring Street. Another has been completed at Grand Street. And workers are building two more, at Walker and Franklin Streets.

The idea is that buses lose a lot of time pulling over to a curb and then pulling back into traffic. The bulbs essentially bring the curb to the bus, which does not have to pull over but instead stops in front of the bulbs to let passengers on and off and then continues on its way.

That is the theory at least.

Earlier this week, as this reporter waited at Broadway and Spring Street, a taxi pulled up to the bulb to discharge a fare, just ahead of an approaching M1 bus. The bus had to wait for the taxi to move on before it could pull up. Then, once passengers had boarded, the bus was blocked by a truck that was double-parked just beyond the end of the bus bulb, forcing the bus to pull into traffic to get around.

David Woloch, a deputy transportation commissioner for the city, said that by early July the city will mark the lane that runs beside the bus bulbs as a bus-only lane, from Houston Street to Ann and Vesey Streets. And, he said, the Police Department will enforce the bus-only restriction by ticketing cars that encroach on the lane.

Bus drivers were skeptical.

“I think it’s a waste,” the driver of the M1 bus that was blocked by the cab and the double-parked truck said of the bus bulbs. He would not give his name because he said he did not want to draw the attention of his superiors at the Metropolitan Transportation Authority. “It’s not going to do anything. Get rid of the cars and that’ll do something.”

On another day this week, a driver on another M1 bus was also skeptical. He said that the police do not do enough to enforce bus lanes elsewhere in the city. “That’s never worked,” said the driver, who also asked that his name not be used. “It doesn’t work on Madison. It doesn’t work on Fifth Avenue because people park in the lane. Or cabs drop off in the lane.”

As the bus continued south on Broadway, the driver pointed to the lane next to the curb, which was marked on the pavement as a bus lane. Despite that, the lane was mostly full of parked cars, most of them with city-issued placards on the dash, showing they were used by law enforcement personnel.

More than one bus stop was blocked with parked cars as well, some with placards, others with drivers sitting at the wheel. While the cars with placards are allowed to use the bus lane under the current rules, parking in a bus stop is prohibited.

“This is always like this,” the bus driver said. “And you know what’s missing? There are no ticket agents down here.”

Paul J. Browne, a deputy police commissioner, said 1,862 tickets were issued last year to drivers for using a bus lane. In addition, 4,205 tickets were issued for parking in a bus lane and 2,669 tickets were issued for parking at a bus stop.

That works out to just under 24 tickets a day in the three categories of tickets combined. He said the tickets were primarily issued in Manhattan.

So far this year, he said, 3,537 tickets have been issued for bus lane or bus stop violations.

“It may be a perception among some drivers, but in fact there is enforcement,” Mr. Browne said of the bus drivers’ complaints. “It may not be at the level they want or in an ideal world the level we want, but the fact remains we do enforce it every day.”

The new bus lane is intended to be different, partly because it will occupy the lane of traffic one lane from the curb, so it is less likely to be blocked by parked cars.

The city will spend $355,000 to create the lane and the four bulbs, which include metal fencing designed to make them more visible.

The bulbs and bus lane on Broadway are intended to encourage bus use in a stretch of Lower Manhattan where a large amount of construction regularly tangles traffic. The city plans to enhance five other bus routes, one in each borough, with dedicated lanes and high-tech equipment to make them more efficient.

“I think it’s great that they narrowed the street for the bus stop,” said Toni Oliveri, who was waiting one afternoon this week at Spring Street for the X27 express bus to Bay Ridge, Brooklyn. She said that people would no longer have to jump out from the curb, as they often did, to get the attention of bus drivers.

 

 

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10/27/2006  mjg  Ó2003 carmelo gonzalez    webmaster@carmelogonzalez.com   www.CarmeloGonzalez.com

Last updated on 07/19/2008