Philadelphia has one of the world’s largest urban park systems. And, according to census data, the city has the highest proportion of people 65 and older of any of the 10 largest cities in the country.

Yet 73 percent of Philadelphians over 60 reported never using their neighborhood park in the previous year, according to data from Public Health Management Corp.’s 2008 Household Health Survey.

That troubles local advocates for seniors because of the benefits that public parks can provide for older adults. Being engaged and connected in the community is related to older adults’ being more physically active and to the length of time that seniors want to stay in their homes, according to an analysis by Allen Glicksman, director of research and evaluation for the nonprofit Philadelphia Corporation for Aging.

Regular exercise can help seniors prevent falls, the leading cause of injury or death for people 65 and older. Other research from the 2008 survey showed that people with health limitations are less likely to use public recreation facilities. So even perceived risks to unsteady legs, such as uneven steps, rickety handrails, and cracked sidewalks, could deter older adults from using parks, Glicksman said.

Read the full article: Phila. effort aims to make parks fit for seniors

The new changes in insurance regulations provide an opportunity for scammers to take advantage of consumers. Several insurance scam cases in Pennsylvania have been reported and there is an expected increase in the near future. 

 The Intelligencer reports:

“One consumer group found more than one-third of state insurance bureaus reported “much higher” health insurance fraud last year. Scammers are seeking to exploit consumer confusion over coming changes involving insurance coverage.

A person bearing a government ID badge appears at your door with a sales pitch that goes something like this:

By law, all Americans are now required to obtain health insurance. You have 30 days to comply or face jail time. Sign here to buy your coverage.

The claim sounds legitimate. Most people have heard something, somewhere, about the new federal health care law and how it requires that everyone carry health insurance. But those coverage requirements don’t kick in for another four years. The law also carries no criminal penalties for not obtaining health insurance. And one more thing, the government won’t offer insurance policies under the law. But crooks are counting on people not knowing these things, or anything about the Affordable Health Care Act, consumer rights and protection advocates say.”

Read the full article: Health insurance scams flourishing

Tips on avoiding medical insurance scams

 Currently, there are different types of scams that exist. Educating the community on the 2011 expectations of the Affordable Care Act is will aid in eliminating the scams. The National Association of Insurance Commissioners’ have published tips and reminders on how to avoid scammers.

The Intelligencer reports:

“The National Association of Insurance Commissioners’ tips on how to avoid being a scam victim:

Be aware: Beware of fax, e-mail, telephone poll solicitations. For seniors, Medicare officials contacting you should have your account information on record so don’t give it out.

Check if insurer is legit: Don’t give out any personal information until you verify with your state insurance department that the insurer and agent are licensed to write insurance in your state. Generally, health insurance companies that sell policies to individuals or to employers must be licensed in each state where they do business; the producers (agents or brokers) who sell policies must also be licensed in the states where they sell policies.

Keep paperwork: Ask for copies of all paperwork you sign. Keep a copy of the payment receipt or check for your initial premium payment.

Follow up: Call the insurer if you don’t receive a copy of your insurance policy outlining your coverage within 30 days of your purchase.”

Read the full article: Avoid the new health law scams

Ten to 13 percent fewer surgical patients in New Jersey and Pennsylvania would die if hospitals in those states had as many nurses as California law requires, according to a University of Pennsylvania study published Tuesday.

The study of 1.1 million patients in 2005 and 2006 found that the nurse-to-patient ratios mandated in California could have saved the lives of 468 patients in New Jersey and Pennsylvania over a two-year period.

Linda Aiken, who led the study and directs the Center for Health Outcomes and Policy Research at Penn, said improved nurse staffing likely could save “many thousands a year” nationally.

The study was based on reports to states of deaths within 30 days of surgery and surveys completed by 22,336 nurses. It was published in the journal Health Services Research. Aiken said 18 states, including Pennsylvania, were considering legislation on nurse-staffing levels.

She decided to compare California to other states rather than look at what happened in California before and after the law so that people would see this as a broader issue. “What happens in California,” she said, “is relevant for other parts of the country.”

California became the first, and only, state to enforce minimum nurse-to-patient standards in 2004. For example, it says one nurse can be responsible for no more than five patients on a medical-surgical unit and two in an intensive-care unit.

Find out more.

State Sen. Daylin Leach (D-Delaware, Montgomery) today introduced a bill that would provide better access to treatment for the thousands of Pennsylvanians who suffer from eating disorders.

Senate Bill 1138 would require Pennsylvania’s health insurers to cover non-hospital, in-patient treatment for eating disorders and the underlying issues that may cause them.

“Too many victims never receive the care they need to pinpoint the causes of eating disorders and effectively treat them. Without addressing these causal and maintaining factors, most patients will quickly lose weight and relapse,” Leach said. “It is my goal, with this legislation, to ensure that no Pennsylvanian suffering from these diseases will go untreated and face the risk of recidivism again.”

Leach noted that studies have shown the most effective course of treatment is through 24-hour support and structured programs. Non-hospital, residential treatment facilities are often where those types of programs are offered.

“It has been shown that the best course of action for those who suffer from an eating disorder to take is to receive care at a residential treatment facility,” Leach added. “However, few insurance plans in our state cover such programs and facilities. Unfortunately, that means that Pennsylvanians are denied access to the most effective and efficient treatment available.”

According to the National Institute of Mental Health, 1 in 5 American women struggle with an eating disorder, including anorexia nervosa, bulimia nervosa and binge eating. Without treatment, up to 15 percent of individuals diagnosed with an eating disorder will die or suffer from long-term chronic illness as a result.

Advocates for a mental illness support organization that is facing a 75 percent funding cut from Lehigh County pleaded with commissioners to restore funding at a budget hearing Wednesday.

The local branch of the National Alliance on Mental Illness is facing a reduction of about $25,000, taking the county’s annual contribution to roughly $7,000 in 2010.

The organization helps people with severe mental illness, such as schizophrenia, bipolar disorder and post traumatic stress disorder. The branch handles 500 calls per year, resource director Janet Bendics said.

NAMI’s local budget is roughly $70,000.

”This is a group families go to when they are in crisis,” Allentown psychiatrist Paul Gross said. ”If NAMI doesn’t exist, there will be a void.”

The mentally ill and their families often contact the organization when they are transitioned out of an institution or in severe need of assistance. The group offers educational classes and advocacy. Without support from NAMI, Gross said, the mentally ill can wind up wandering the streets, being violent or even committing suicide.

Commissioner Chairman Percy Dougherty said the cut is the direct result of the state budget.

”The county did not cut this money. The state is responsible for cutting the funding,” Dougherty said.

Find out more at the Morning Call.

Reaching agreement on spending to support mentally retarded individuals in their hometowns is just one of many issues keeping opposite sides apart in the painful state budget debate.

Gov. Ed Rendell and state lawmakers are literally going line-by-line over hundreds of budget items looking for spending cuts they can agree upon to erase a $3.2 billion deficit and meet a constitutional mandate to balance the budget. A look at the funding for community mental retardation programs shows just how complicated this exercise can be.

The debate in Harrisburg is over whether the state can continue efforts to move mentally retarded individuals off waiting lists for community services during a time of fiscal crisis.

About 47,000 mentally retarded adults receive services to live in group homes, participate in daytime job or job-training programs or go to adult day care. Family members can receive support so they can provide care at home.

Finding a slot for an adult child in a program can ease the day-to-day burden on families, relieve financial stresses and help that individual lead a more independent life.

Read more at the Times-Tribune.

Reports the Centre Daily Times:

Hundreds of Pennsylvanians traveled to Capitol Hill Thursday to join thousands of others in a health care rally.

The group, which included a contingent from State College, said they want Congress to include a public health care option as lawmakers write its package of reform. Many brought personal stories about themselves, family members, friends or just folks in the community who have suffered from high health care bills.

“I believe that health care is a human right, and that everyone’s entitled to health care,” said Emily Fetterhoff, a Penn State senior who is interning with Health Care for America Now, a grassroots organization that helped organize the rally.

…

Union groups, families and community organizers wore colorful T-shirts, waved signs and chanted during the rally under a hot, midday sun Thursday. Those from Pennsylvania then marched to a nearby brew-pub for draft pale ale, air conditioning and more speakers.

…

Among those speaking was U.S. Sen. Arlen Specter, a Democrat who said he is open to a public health care option that preserves competition.

“Your enthusiasm has a big effect on what goes on three blocks away (in) Congress,” he told the crowd.

At the pub, U.S. Rep. Joe Sestak, a Pennsylvania Democrat, stood on a chair and told listeners he thinks Americans need the same health care available to members of the military.

Reports the Morning Call:

One by one, speakers told stories about how the country’s health care system had let them down and urged lawmakers to act quickly to reduce costs and ensure coverage for every American, as President Barack Obama wants.

”We can’t wait,” Maureen Kurtek of Minersville, Schuylkill County, told a crowd of thousands next to the Capitol, detailing how she lost six fingertips and half of her foot after her insurance company balked at covering an expensive therapy she needs to fight lupus.

…

Among the key sticking points is the decision to create a public health insurance option that would compete with private plans, a choice that U.S. Sen. Arlen Specter, D-Pa., endorsed Thursday. Supporters argue it would force private plans to be more efficient and give the opportunity for coverage to those who can’t get insurance elsewhere. Opponents say it would put the private market out of business.

”We all agree there is a need for substantial health care reform. The question is how much reform can we afford,” U.S. Rep. Charlie Dent, R-15th District, who opposes a public option, said in an interview this week.

In the practice of medicine today, the sacred physician-patient bond is being broken. Health insurers’ cost-driven decisions are overriding the direct relationships doctors have with their patients.

The Post-Gazette’s April 1 story, “Switch To Generic Epilepsy Drugs Raises Flag,” about the practice of switching patients from brand-name to generic drugs, alluded to the role insurance companies play, telling the story of a young epilepsy patient whose doctor switched him to a generic drug “because of insurance.”

But the broader story of how patient care is being compromised in the name of profit needs to be told. Patients’ long-term health often is compromised for short-term gains.

As a primary care physician with more than 20 years of experience, I have continued to watch how insurers’ practices impede physicians’ ability to care for their patients. Our autonomy is being eroded, and my patients, who come to me expecting to receive the treatment we mutually decide is best for them, often leave confused when they are denied that treatment.

Without question, controlling costs is important. But as a doctor, knowing a patient is being denied the best treatment because of an insurer’s decision is troubling.

As insurance companies continue their move toward a standardized care model in which they strive for little deviation in treatment of patients who have the “same” condition, they seem to forget that physicians are not working with widgets. Patients are individuals and medicine is an art. It is not an exact science.

Insurers today can dictate which drugs to use because there is no evidence of significant benefits of one drug over another based on head-to-head trials. Drugs in the same class are generally thought to be therapeutically equivalent because of similar mechanisms of action. So, if you have high cholesterol, you may be prescribed one of any number of generic statins even though they have different characteristics and different patients metabolize them differently. It naturally follows, then, that substantial differences in patient outcomes may be expected.

This is just one example of how insurers are interfering with patient care.

Read the rest of Dr. Zdunek’s editorial at the Post-Gazette.

With yet another tragedy in the headlines, Pennsylvania residents can wait no longer for strong regulations to protect residents of our state’s assisted living facilities.

Such regulations would prevent outrageous and dangerous practices such as those that forced the Department of Public Welfare to close the Cambridge Brightfield assisted living facility.

Earlier this month, an aide at the center in Hatfield, PA.,  was indicted for involuntary manslaughter in the death of a 79-year-old resident, Ronald Myers, there last October 9.  She had fed Mr. Myers hot cereal, which severely scalded his lips, tongue, and mouth.  He could not speak and was left untreated for nearly a day and died several days later as a result of his burns. The employee was fired and the facility was soon prohibited from taking in new residents, but it was far too late to save Mr. Myers.

“Pennsylvania must regulate assisted living facilities so that they provide quality care for a wide range of residents in an environment that supports their independence, choice and health,” said Alissa Halperin, Senior Attorney and Deputy Director of Policy Advocacy at the Pennsylvania Health Law Project and director of the PA Assisted Living Consumer Alliance. “This is not the first time when medical care has been urgently needed but not immediately provided in a personal care or assisted living facility.   And, this is not the first time reportable incidents have gone unreported to the state licensing agency.”

…

Pennsylvania needs strong regulations that clearly establish residents rights and assurances that they can be exercised without retaliation, that clearly define what services will be provided to each resident based on his or her individualized care needs, that assure residents are cared for by adequate amounts of well trained staff, and that set life and fire safety standards at the national levels recommended for assisted living.

Read more from PALCA.

An advocacy group for disabled persons has filed a federal class-action lawsuit against the state Department of Public Welfare challenging the department’s practice of holding mentally retarded adults at state psychiatric hospitals.

The suit, filed Thursday on behalf of eight mentally retarded adults, including two from Luzerne County, alleges DPW is not doing enough to transfer persons who are institutionalized into community-based programs that would better suit their needs.

It further alleges DPW has failed to provide adequately trained staff at psychiatric hospitals to deal with the issues that afflict those with mental retardation and psychiatric illnesses.

The suit was filed by the Philadelphia-based Disability Rights Network of Pennsylvania.

…

Part of the problem is that the staff at the hospitals is not trained to provide mental health services to persons with mental retardation in a manner that takes into consideration their intellectual disabilities, said Robert W. Meek, an attorney with the Disability Rights Network.

Find out more at the Times-Leader.